Medical School LORs: Requirements, Tips, and Best Practices

You must get your letters of recommendation (AMCAS calls them Letters of Evaluation) from respected professionals who can personally and professionally speak to your potential to succeed in medical school.

Letters of recommendation are critical for medical school admissions because they give AdComs a glimpse of your work ethic, abilities, and who you are as a person. It will be one of the first ways they get to know you outside of your GPA and MCAT scores — hopefully leading to an interview.

In this article, you’ll find everything you need to know about requesting and submitting letters of recommendation (LORs) so that your med school application is as competitive as possible.

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How Many LORs Do You Need?

The amount of letters of recommendation you need is based on several factors, including which degree program you’re applying to, whether you’re applying in Texas, and what school-specific guidelines are in place.

Generally, most applicants need to get 3 letter writers to submit LORs. But let’s go through the different factors that could change your application requirements.

Pro Tip: Submit no more than 4 letters, even if you’re able to submit more.

Check with the schools you are applying to for any additional instructions or restrictions on the number of letters they’d like you to submit.

Types of Required Letters

Most medical school admissions committees require a minimum of three letters, but specific institutions may have different guidelines. You’ll need to check each school to be certain.

Typically, your required letters should include:

• 2 science letters of recommendation from a science faculty member, such as a professor who taught your courses in biology, chemistry, or physics (sometimes math)
• 1 non-science letter of recommendation from a non-STEM professor, such as humanities or social sciences

MD vs. DO Requirements

MD schools typically require a minimum of 3 letters. We recommend you secure at least two science LORs and at least one non-science LOR.

Here is our list of LOR requirements from each MD school: LOR Requirements for MD Schools

Those applying to osteopathic schools should have an osteopathic physician (DO) write a letter of recommendation for their medical school applications. You can still submit MD letters, but AdComs from DO schools highly prefer DO recommendations.

Here is our list of LOR requirements from each DO school: LOR Requirements for DO Schools

Read More: MD vs. DO

Limits by Application Service

Individual schools may have their own LOR limits, but the primary 3 application services have the following limits on how many LORs you can upload:

• AMCAS (for MD programs) — as many as 10 medical school recommendation letters.
• AACOMAS (for DO schools) — as many as 6 LORs.
• TMDSAS (for Texas MD schools) — a Health Professions Committee Packet or 3 letters of evaluation; an optional fourth letter may be submitted if you prefer.

A Note on TMDSAS LORs

For the Texas Medical and Dental Schools Application Service (TMDSAS), there are 3 formats for LORs you can choose between:

• Committee Letter Packet: A committee letter from a pre-medical committee or pre-health advisor with an attached supporting set of individual letters of recommendation.
• Letter Packet: A committee letter that pulls quotes from various evaluators. This letter may have additional supporting letters attached.
• Individual Letters: A collection of individual letters that includes a cover letter from a central collection service for the applicant, usually an advising office or school letter service. They do not make additional assessments of the candidate; the letter packet will contain the only recommendations.
  
  

Submission Guidelines

Letters of recommendation are typically due no later than the date of your secondary application submission. This is usually in July at the earliest and in August at the latest.

However, earlier is always better. Don’t wait to make a letter request or to send your LORs.

Letter writers generally submit their own letters according to instructions you share with them from your application service, but you can verify that they’ve been submitted.

Different letters to different schools? If you are applying through AMCAS, you are allowed to send different recommendation letters to different schools. AACOMAS and TMDSAS do not allow for this option.

Do you submit LORs after application submission? You can add letters of recommendation after submitting AMCAS as long as you haven’t already submitted the maximum number of letters. However, you are unable to delete or change any letters that have already been sent.

When is it too early to submit LORs? It is not possible for letter writers to submit recommendations before AMCAS opens. AMCAS letters of recommendation requirements include deadlines, yes, but also dates before which you cannot submit.

Read Next: Applying to Ontario Medical Schools

Who to Ask

Request letters from professors or mentors who will be able to speak to you and your abilities from a professional, educational, and medical perspective.

Outside of the 3 required letters of recommendation from science and non-science professors, we recommend requesting additional letters from people like the following:

• Community leader or somewhere you volunteered.
• Physician you have shadowed or who has been a mentor.
• Research supervisor or principal investigator.
• Your school’s pre-med advising committee.

Ask if they will vouch for you in a strong letter of recommendation. Have your materials, such as your up-to-date resume, ready to send them. The recommender should have a good sense of why you are interested in medicine and the strengths you hope can be covered in the letter.

Pro Tip: Consider asking someone who can write a LOR that addresses a concern on your application. For example, one letter writer might be well-positioned to explain a semester of bad grades due to a particular reason, such as bereavement or financial struggles that you overcame.

Feel free to send this PDF to your letter writers to help them write letters of evaluation. They’re guidelines provided by the AAMC (Association of American Medical Colleges).

Who to Avoid

Strong letters of recommendation are from people who can make compelling assessments of your character and skills, such as critical thinking and teamwork. Weak LORs are from anyone with no knowledge of you, a low opinion of you, or little credibility.

Avoid asking the following people for LORs:

• Someone who doesn’t know you well. Selecting someone who does not have sufficient knowledge of your skills and attributes may result in a generic or ineffective letter.
• A family member or a friend. Admissions committees prefer letters from unbiased professionals who can provide an objective evaluation of your competencies and potential as a medical student. Often, AdComs won’t accept LORs from a family member.
• People who may have reservations about you. If you think somebody may have a negative impression of you in the past, avoid asking for a letter. You may never know what they write, and a negative letter can significantly impact your application.
  
  

When to Ask

Ask for your letters early, at least 2-3 months ahead of your primary application deadlines.

Your letters of evaluation aren’t technically due until the secondary application deadline. However, if you wait to submit until the due date, you’ll be perceived as late.

Pro Tip: Ask letter writers by March for a June submission goal, just to have your ducks in a row.

Asking early and shortly after your class or a positive interaction with the letter writer gives them time to thoughtfully craft their opinions while everything is fresh on their mind. It also gives you one less thing to stress about if they are taking longer than expected.

How to Ask

Ask for letters of recommendation with grace, humility, honesty, and plenty of time.

Here are specific, actionable tips on how to ask for an LOR:

• Don’t make it like you’re only after a letter and not a real mentorship.
• Have a conversation with your professor, supervisor, or mentor before asking for a letter of evaluation to ensure your request doesn’t appear disingenuous. If an in-person meeting is not possible, sending a polite and well-crafted email is the next best option.
• Don’t sound like you’re entitled to an LOR.
• You can encourage them to talk about certain topics, but do not “require” it.
• Develop relationships with potential letter writers while you’re a premed, well before you need an LOR. Attend classes regularly, participate in extracurriculars, and visit during office hours so they get to know you.
  
  

Provide These Materials to Letter Writers

When you ask someone to be a letter writer, be prepared to provide relevant information and documentation they may need, such as the following:

• Contact info
• Resume
• Transcript

• Personal statement

• List of achievements, honors, and recognitions
• Instructions for submission, including letterhead and deadlines
• Consent forms, if required by the school
• Important details about the school to which you’re applying
• Any other relevant documents

You want letter writers to paint a holistic picture of your motivation, determination, and personality for medical school. Gladly offer the necessary supporting documents to each letter writer so that they can achieve this. Some letter writers may request a meeting with you in person to gather more information.

Send Reminders

We recommend a gentle, professional email follow-up to write and submit the recommendation if the LOR submission deadline is only a few weeks away.

Always consider the individual circumstances and relationship with your letter writer when reminding your writers to submit letters. Show grace, humility, and gratitude.

You can use this template to send your reminder:

Dear [Letter Writer’s Name],

I know you are busy with [insert classes/topics/activities to connect to letter writer]. Since I plan on submitting my medical school applications [on date or in # of days/weeks], I wanted to reach out and confirm that you’re planning to submit your recommendation letter in that time frame. Please let me know if there’s any additional information I can provide.

Thanks again for supporting my next steps with your letter!

Best,
[Your Name/Last Name]

Send Thank-You Notes

Thank you notes are an important way to show appreciation to the person who took the time and effort to write a recommendation letter on your behalf.

Your thank-you notes should acknowledge their support and how they’ve contributed to your journey thus far. Keep it genuine, express what you appreciate and why, and send your note in a timely manner.

Yes, you have to send thank-you notes.

You can use this template for your thank-yous, but it is best to personalize your notes:

Dear [Letter Writer’s Name],

Thank you again for taking the time to write your recommendation letter for my medical school applications. I appreciate your support and having you advocate for [talk about the abilities this letter writer knows of you]. I feel very fortunate to have a great professor/mentor/coach like you.

I will keep you posted throughout the application season!

Best,
[Your Name/Last Name]

Advice for Non-Traditional Applicants

Non-traditional applicants may be applying to medical school many years after graduating from undergrad or without a science background. Nevertheless, your letters of recommendation need to come from recent professors whenever possible.

Pro Tip: If you have been out of school for several years, take a few undergrad science courses or post-bacc classes, making your LORs more reflective of your current abilities, experiences, and character.

Non-traditional applicants are encouraged to communicate their unique perspectives, including through their letter writers. Ask for an LOR from someone familiar with your diverse background and non-traditional journey to provide a well-rounded picture of who you are.

Nowadays, it’s actually beneficial to be a non-traditional candidate because AdComs are looking for diversity of background. However, your recommendation letters are still a great place to help explain why you didn’t pursue medicine via the “traditional” route. Ask letter writers who can speak to how your non-traditional background makes you a strong med school candidate.

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FAQs

Be a Standout Medical School Applicant

There are a numerous amount of applicants, and you need your application to stand out. Your MCAT score and GPA are important, but letters of recommendation can give your applicant just the boost it needs. MedSchoolCoach is here to support you throughout the application process and help you get into the top medical schools.

Our team includes doctors who have served on admissions committees, helped hundreds just like you, and, of course, been through the process themselves.