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Recommendation Letters

Overview

Recommendation letters are one of the criteria admission committees use in the admissions process and are, therefore, one important part of your application.
To get good letters, participation in extra-curricular activities and positive interactions with faculty are important since both provide you with great recommendation letters written on your behalf.

Admissions Committees see on the application what activities you have listed, but recommendation letters tell them about how you interact with people in activities, and (hopefully) stress your good qualities.

Bad Letters

"He was dressed nice and followed me in my office for a week... and I think he will be a great physician... I strongly recommend this individual..." - is pretty much worthless in a recommendation letter and won't do you any good. Letters that merely state you were present are worthless. A doctor's opinion that you would be a great physician without any stated supporting evidence is also worthless. Letters that don't stress your personal strengths and qualities are worthless.

And you really don't want worthless letters. Indeed, you need great letters!

Great Letters

What will help you are descriptions that show what type of person you are so that the admissions office can see "who you are" and "what you are like". In a great letter you should be able to find strong positive descriptions of your personal characteristics and your attitude towards medicine that will make you a great physician. You should see statements that explain to the admissions people why you would be a great addition to the medical community.

The letter writer has to support the recommendation he or she is making in your behalf with evidence, writing about your qualities rather than just stating that you will be a fine physician or that you spent so and so many ours shadowing.



"He was punctual, eager to learn, very interested, asked questions, was very attentive, well mannered and friendly, and interacted well with patients. I enjoyed discussing things with him, etc. He eagerly watched surgeries and was very inquisitive, professional, respectful. He interacted well with patients and responded well to them. He was enjoyable to work and interact with....."
You get the idea.

Best letters are from people you have spent some time with so they could get to know you. That's why it is important to shadow physicians for more than just a few hours. One physician really opened up to me on day 3 and we developed a relationship. His letter was also great.

Faculty Letters

For faculty letters, make sure that the faculty member gets to know you by name. If he/she cannot greet you by name in the hallway, you should find someone else to write a letter for you or do everything you can to get to know him/her.

You can do this by visiting with the faculty member in his/her office to discuss prior assignments, for example.
"What can I do better?"
"Could you explain the details of this problem because I would have chosen a different way to solve this."
Ask questions about homework, assignments, readings, or how you are doing in class.

Here are some more specific suggestions.
In Physics and Organic Chemistry, homework or assignments can be intense. You may only have to turn in very little or none of your homework or assigned problems for grading but may have plenty of assigned material to work through on your own. When one of the problems doesn't make sense or presents an opportunity to ask your professor something, use them as an excuse to interact with your professor instead of just bypassing them.

What a wasted opportunity if you just bypass them! You need excuses to get to know your professor for a good letter, so use them. Go to your professor, ask him/her about the problem (even if you understand it).

Another example: In your biology course, if you are learning about a topic, find some extra info in your text, maybe something that was not directly assigned reading, or something that is difficult to understand (maybe you understand it, but you can ask for some clarification). You can ask about something that is related or still to be covered, but hasn't been covered yet in lecture.

What you will gain from this:
1. The faculty member will get to know you if you do this several times during the semester.
2. It indicates you are interested in the material enough to ask.
3. It shows you work hard, esp. since you are doing extra work besides the minimum required to turn in.
4. It gives you opportunity to mention you are going to med school and other topics to build a relationship.

If you don't talk to your professor, you will only be an unknown student (to the professor) in the class and the result is a very impersonal letter, which is worthless. Focus on a couple of faculty members in the sciences (preferably in the sciences, but any will do) to do this with. Pick someone you can connect with, or who just someone who seems nice and easy going.

How to ask for a recommendation letter

Physicians
Once you get to the end of your shadowing time, ask the physician: "Would you be able to write me a positive letter of recommendation for my med school application?" or "Do you have any reservations writing a positive letter of recommendation for me?"

Make sure you ask for a positive letter. Also, be sure to ask if he/she can honestly give you a good letter. If he/she cannot, thank him/her and ask someone else. Most letter writers are not cruel enough to say they would write you a positive letter and then write a bad one. Usually, if you ask, they will be honest and tell you that they can give you a great recommendation or tell you that they will not be able to, for whatever reason (it does happen).

Faculty
Same story. Ask for a positive letter and get their guarantee that they can write a great one. If not, don't have them write it! You need a great letter, nothing less.

If they have any hesitation or concerns about writing a great letter, thank them and ask someone else.
You have to be firm on this. Don't be shy. Make sure you ask. They will usually be up-front and tell you if they cannot give you a stellar letter. You want the best and you can only be assured of that by asking for one bluntly.

What a letter writer may want from you

Often, the letter writer may request a resume or curriculum vitae, listing your major accomplishments, schooling, etc. You may be asked to provide some additional biographical information about yourself or why you are interested in medicine. So, be prepared to provide this information if necessary. You may even consider providing this information without being asked for it to allow the letter writer to personalize the letter even more. Most likely, you will be asked for this information, anyway, so be ready for it.

What to do with letters

Most pre-med advising offices (or student affairs offices) at colleges and universities will give you a choice between having an open or a closed student file in which they collect all documents pertinent to your medical school application, including recommendation letters written on your behalf. You usually have to sign a statement and decide at the beginning, when your file is first created, if you want your file to be open or closed. If you ask medical schools which type of file is best to choose, some will tell you that they don't care. Don't believe them!! Some medical schools will only consider recommendation letters that were kept in a closed file and by far all schools prefer closed files to open files. So, what's the difference?

Open or closed file for your recommendation letters

Open file: You, as the student, have full access to all documents placed in your file. After a recommendation letter (or any other document) is received, you have full access to it and can look at anything in your file at any time. Most faculty members and others writing recommendation letters for you want to know in advance if your file is open or closed. If it is open, they are less likely to write negatively about you. When it is closed they have nothing to fear and write frankly. Therefore, medical schools prefer (and some outright require) that you have a closed file to ensure a more unbiased appraisal. YOU MUST HAVE A CLOSED FILE in my opinion and some advisors will tell you the same thing. That's why it is so important to ask letter writers frankly if they are able to write a very good letter without reservations up-front. You won't be able to see it once it is in your file.

Faculty members usually know the drill and you'll not see the letter they write for you. With physicians, many don't know about your file and they may either send their letter directly to the pre-med office or hand you a sealed envelope to deliver yourself. I'd recommend asking them for a second copy of the letter for "your own records". Some pre-med offices require the physician to mail a letter directly to them or notify the physician that your file is closed. If the physician, therefore, does not provide a copy for you, I would still recommend asking for a "personal copy" for your own records a few weeks or months later, letting the physician know you'd appreciate a copy if possible, but that he/she is not required to give you one. Or, if the physician would prefer to keep the letter confident without showing it to you, you'd understand and have no problem with that. Most physicians should not have a problem with your request.

Who should write letters for you

Physicians you spent time with
Managers of places you volunteered/worked at in clinical settings
Faculty who taught you
Faculty/mentors you did research with
NO personal friends, family, colleagues, or others should write letters for you!

Getting your personal copy of the letters

You should be able to get a personal copy from everyone with the exception of faculty, maybe, since they may be hesitant and most likely familiar with the "closed file" (and happy about the arrangement). If you have more letters than medical schools require, you can then choose the best ones to send to them. Most medical schools specify what types of letters and how many they want (usually 1-4) when you get your secondary application materials from the medical school.

Most medical schools only want one physician letter sent to them. If you have a letter from several physicians you can decide which is better and instruct your pre-med office to send that letter only. Similarly, if you have four or five faculty letters and the medical school only requires two, you can choose which two to have the office send. If you really don't know which to choose, go by your gut feeling. Some pre-med offices may not let students choose which letters to send, anyway.

Letter Timing

Recommendation letters are sent directly to medical schools from either your undergrad pre-med office or from the letter writers. You will have to tell your pre-med office or committee (or the letter writer) which letters to send from your file and which schools to send them to. Typically, when you receive your secondary application materials from the medical school, they provide you with information about what kind of letters they want from you (e.g. two faculty and one physician letter or one pre-med committee letter, one physician letter and one faculty letter, or whatever) and where to send them.

Letter Types

Most medical schools require a pre-med committee letter to be sent and an additional 1 to 3 other letters written by faculty or physicians in your behalf. Only submit what they ask for. If you have more letters or different letters than what they want, don't send the additional letters - they just clutter your file and your best letters may not get read at all. It is recommended that you don't send any school more than 3 or 4 letters total.



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