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What Can You Recommend?


The New Physician April 2001
Now that you’ve turned in your applications to the American Medical College Application Service (AMCAS), you’re probably thinking you can just sit back and wait for the schools to make their decisions. Right?…Wrong. More work lies ahead.

If you survive AMCAS’ first cut, you’ll have to submit a secondary application to provide your medical school with more information. You will not receive an acceptance letter without completing one. Some institutions send out a secondary application that is essentially nothing more than a postcard verifying you’ve never been convicted of a felony, while others will require additional essays and descriptive information from you. Regardless of its format, the secondary application is a mandatory step for acceptance into medical school.

In some cases, schools consider the secondary application to be more important than the “primary” application. At these institutions, the first cut usually focuses on such academic qualifications as grade-point averages and Medical College Admission Test scores. The second time around, schools are interested in a personal history exemplifying your character and commitment to medicine. As part of obtaining this information, school admissions committees will frequently ask for your recommendation letters to be submitted with the secondary application.

In this phase of the process, you’re competing with the cream of the applicant crop, and the secondary application cannot be taken lightly. You should complete it diligently and adhere to all the basic rules as you would for a primary application, such as using proper grammar and submitting the forms as early as possible.


Recommendation letters are an essential part of your application, so you must be prepared if medical schools ask you to submit them with your secondaries. To do this, you need to start collecting the letters long before the application process begins.

The best method for acquiring recommendations is to request them from your professors immediately after you’ve earned an “A” in a particular course or immediately after you’ve completed a notable project, such as a summer job or an extracurricular activity. This will ensure the letter writer will still have a fresh and positive impression of you in his mind.

You also need to familiarize yourself with how your premed institution handles recommendation letters. Each college or university has its own system for collecting and distributing these valuable testimonials.

If your school has a central premed advising office, have the letters sent there as soon as possible—yes, even in your freshman year—and have the office staff begin a file for you.

If there is no central office, ask your writer to have a letter ready and give him a time frame for when he might expect to send it to your schools. Since recommendation letters are left to the whim of the writer, you may have to be persistent about deadlines. When it’s time to mail the letter, provide the writer with prestamped, preaddressed envelopes; you can never make the process too convenient for him.


What do medical schools look for in recommendation letters? Think about the purpose of the letter: to validate your background and qualifications. You need letters that support your academic accomplishments and outside projects. If you really want to demonstrate your accomplishments, a recommendation should come from someone who has supervised or guided one of your projects and who will be able to explain to the admissions committee how you completed your project.

The “right” letter fleshes out your application by emphasizing your commitment and ability to manage academic and nonacademic projects. The “wrong” letter lacks details and simply repeats boring clichés about an applicant’s “hard work” or “ability to get along with others.” This may be true, but a recommendation should go beyond the obvious.

Here are some helpful hints on getting the “right” recommendation letters:

  • Some letters should be written by college faculty or practicing physicians who have supervised your work. These are the bread-and-butter letters every applicant should have. Some schools may even require a certain number of recommendations from science faculty. A good rule of thumb is to have at least two of your letters available from science faculty. And a physician’s recommendation could be a real plus. In fact, some schools require a reference from a practicing physician (or in some cases a practicing osteopathic physician).

  • Other letters should be written by people familiar with your extracurricular activities. If you have unique experiences that define part of who you are, you should have a recommendation from someone who has seen or supervised such activities. It doesn’t matter if the experience was working for a nonprofit charity, conducting laboratory research, or medalling in a banjo competition. All of these types of activities provide admissions committees with views of you as an aspiring, well-rounded physician, not just as a grade-grubbing bookworm.

  • Do not get letters from friends or family. Even if you’ve performed substantial, validated work with them, there’s always the appearance of nepotism or favoritism in these letters. Besides, if your work is legitimate, there should be plenty of other people available to vouch for you.

  • Your premed adviser, if you have one, should write a letter. Most colleges and universities have premed advisers. Among admissions committees, these advisers tend to carry significant weight because they’ve sent students on to the next level year after year. That means many of the medical schools trust their judgments and, in some cases, may even rely on their suggestions when making admissions decisions. Therefore, you should introduce yourself to your premed adviser early in your collegiate career so he will be able to skillfully write a letter on your behalf. Some admissions committees view the lack of a letter from your college’s premed adviser as a big red flag signaling you’re not the type of student they’re looking for.

  • Give up your right to review. Most colleges’ secondary applications include a space for you to waive your right to see recommendation letters. It is commonly acknowledged that unless you waive your right to see that letter, it will not be considered an honest appraisal by the recommender. So go ahead and waive your rights. Yes, you’ll be curious to read what they’ve written about you, but don’t take a chance here. If you’re really interested in reading the letter, ask the writer for a personal copy. Most will be happy to oblige.

  • Have more than three letters available. Most schools want three letters, typically two from science faculty and one from a nonscience teacher or extracurricular supervisor. However, you should never have only three letters of recommendation; you should try to rack up as many as possible. By having a slew of letters available, you can get a good idea of which ones will be better than others (assuming they provide you a copy, as stated above). You’ll also have a number of “back-up” letters in case one recommender doesn’t follow through. There’s nothing worse than discovering that one of your three letters has turned out to be a dud. By having many more available, you can simply substitute a better letter.

  • Set earlier deadlines. If a recommendation letter is due on a particular date, you might want to tell your letter writer that it needs to be completed a few weeks before then. You’ll be surprised how lax some faculty can be. Of course, you should be reasonable and give them at least several weeks to write the letter. Don’t approach a faculty member to ask for a letter due in three days.

  • Follow up. The best way to know if your recommendation letters have been written is to ask the medical schools if they’ve received them. This is more efficient than asking your faculty members if they’ve written your letters, since it is impossible for them to know of any problems with the postal service. Most schools will be happy to tell you if the letters have arrived. And if you check well before the deadline, you should have sufficient time to resend any letters that have not reached their destinations.

While many of these administrative activities may seem burdensome, they could make the difference between a medical school accepting or rejecting you. Secondary applications and recommendation letters are an integral part of your medical school application and should be taken as seriously as your initial AMCAS application. Hopefully these hints will make the process a little less painful.
New Physician contributing editor Paul Jung is author of Getting In: How NOT to Apply to Medical School (1999, Sage Publications). E-mail Dr. Jung with your questions and stories at