Medical School Letters of Recommendation: Your Complete Guide

Decoding who to ask, how to ask, and making strong choices in a critical component of your application.

1. Why Letters of Recommendation Matter

Letters of recommendation (LORs), also called letters of evaluation, offer admissions committees a credible, third-party perspective on your readiness for medical school. In many cases, they carry equal weight with your MCAT and GPA when that evidence is reinforced by character and academic rigor.

2. How Many Letters Are Typically Required?

Most schools request 3 letters total—commonly:

2 science faculty letters (biology, chemistry, physics, or related sciences)
1 additional letter from a healthcare/clinical supervisor, research mentor, or non-science professor

Some schools accept or prefer a committee letter (provided by your undergrad’s pre-med advising office).

AMCAS (for MD programs): allows up to 10 letters to be uploaded, but schools will only review what they require. Most expect 3–5.
AACOMAS (for DO programs): typically requires at least 1 letter from a physician (DO preferred), plus 1–2 academic letters.

Tip: Always check each program’s website for specifics before finalizing your list.

3. Who Should Write Your Letters?

Select recommenders who genuinely know you and your work, ensuring each can speak in detail to your:

Intellectual ability and perseverance
Teamwork, compassion, and motivation
Commitment to medicine

Not ideal: letters from well-known individuals who don’t truly know you (e.g., celebrities, clergy, alumni)

4. Tips for Asking Effectively

Ask early—provide at least 4–6 weeks notice.
Meet in person (or virtually) to explain your goals.
Provide recommenders with a summary document—include your resume, transcript, personal statement, and deadlines.
Be clear in your request: “Can you write me a strong letter reflecting our shared work together?”
Follow up politely and always send a thank-you note.

5. What Makes a Strong Letter?

According to AAMC guidelines, standout letters include:

A clear description of your relationship with the evaluator
Specific anecdotes highlighting observed behaviors and competencies
Contextual comparisons to peers (e.g., “in the top 10% of students I've taught”)
Unique qualities you’ll bring to medicine

6. Common Pitfalls to Avoid

Too many letters: Stick to what's required—extra letters may dilute your application.
Weak or generic writers: Don’t ask someone who doesn't know you well.
Missing deadlines in AMCAS or AACOMAS systems.

7. Submitting Letters Through AMCAS & AACOMAS

AMCAS (MD programs)

Uses the AMCAS Letter Service.
Writers upload letters through:
- AMCAS Letter Writer Application
- Interfolio (third-party)
- VirtualEvals (used by some pre-med offices)
Applicants generate a Letter Request Form in AMCAS for each writer.

AACOMAS (DO programs)

Uses the Letters by Liaison portal.
Similar process: applicants assign evaluators in AACOMAS and provide them with upload instructions.
DO schools often stress a letter from a DO physician as essential.

8. What UMHS Recommends

At UMHS, we expect:

At least one academic (science) letter
One from someone familiar with your professional or clinical performance

For applicants without committee letters, these two help form a strong application foundation.

Quick Checklist

Step	Action
Identify Writers	Science faculty, clinical supervisors, research mentors
Confirm Requirements	Check each school’s AMCAS/AACOMAS LOR policy
Prepare Materials	Resume, transcripts, personal statement
Assign Letters	Use AMCAS Letter Request Forms or AACOMAS portal
Track Deadlines	Ensure letters are uploaded before primary submission
Thank Writers	Always follow up with appreciation and updates

Final Thoughts

Letters of recommendation are more than formalities—they’re powerful tools that validate the person behind your application. By choosing your recommenders thoughtfully, preparing them well, and respecting their time and perspective, you help ensure your application is both memorable and compelling.