Letters of Evaluation (LOE) for Medical School

By Elizabeth LaScala PhD

One of the most important and often least carefully considered components of the medical school application are letters of recommendation, called letters of evaluation (LOE). The AAMC provides guidelines for writing such a letter and these guidelines offer critical insight about whom to ask and when.

First let’s review some basics: you can send a minimum of four and a max of six letters. Ideally, you should have two from science or engineering faculty, one from humanities or social sciences faculty, and one to three from a research principal investigator (MD or MD PhD), job or internship supervisor (preferably from an individual with a medical degree) or other mentor/coach. If you are applying to DO programs, it is wise to have a DO trained physician write one of your letters. Choose individuals who know you very well over a long period of time and can speak to your personal characteristics. Your grades and test scores are available on the application, so this info is unnecessary to include, unless the recommender needs to do so to provide important context.

A LOE writer’s chief job is to provide an accurate assessment of your suitability for medical school. Each writer should be able to speak to direct behaviors they have observed that would provide evidence of specific and desirable attributes in a medical school candidate; these include critical thinking and reasoning competencies, the quality of your written communication, service orientation, social skills, cultural sensitivity, ethics, reliability, collaborative nature, resilience, and capacity for self-improvement. A recommender who can speak to how you respond to obstacles and use them as opportunities to learn and grow can make a powerful addition to your profile. A recommender who can write about how you might add to a school’s diversity or make other unique contributions can also add strength to your application. If you have a draft of your personal statement you can offer it; some recommenders might enjoy reading it.

Be sure to ask for a strong LOE and be prepared to allow the recommender to say “No” to your request—this honest response is far better than getting a lukewarm or even negative letter. Finally, give recommenders plenty of time to write an effective letter—at least four weeks is reasonable.


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