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How Many Letters of Recommendation Do You Need for Medical School?

In addition to the stress of  taking Medical College Admission Test (MCAT) prep courses and taking the MCAT, requesting letters of recommendation can also bean anxiety provoking process. To make matters even more challenging, medical schools can vary widely in their requirements. So, how many letters of recommendation do you need for medical school? 

Schools ask for anywhere from two to five letters, with some allowing optional letters and/or committee letters. Visit the Medical School Admission Requirements (MSAR) or specific school websites for updated information.

How many letters should you prepare?

Although the American Medical College Application Service (AMCAS) allows up to 10 letters of recommendation, we recommend you do not exceed five or six. (The American Association of Colleges of Osteopathic Medicine Application Service [AACOMAS] allows six, Texas Medical & Dental Schools Application Service [TMDSAS] allows four.) This amount allows you to select people who can truly speak to your strengths and experiences while accounting for differences in specific medical school requirements. In particular, seek to check off the following boxes:

  1. Science professor whose class you took for a letter grade (Biology, Chemistry, Physics)
  2. Extracurricular observer (e.g., ambulance company owner, emergency department charge nurse, your lab’s principal investigator)
  3. Non-science faculty member whose class you took for a letter grade
  4. A professional (preferably a physician) who has observed you providing patient care


One recommendation letter can serve several functions. For example, your professor might be a physician you volunteered with outside of class. Alternatively, a researcher you work with or a research mentor may have observed you providing patient care. Thus, as long as your letters check off the above list’s items, you can have as few as four letters of recommendation. 

How to send different letters

The American Medical College Application Service (AMCAS) application allows students to choose the individual letters they want to send to each school, while the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS) and Texas Medical & Dental Schools Application Service (TMDSAS) do not. Choose people who can attest to your “Most Meaningful Experience” activities, and always try to ask them in person to benefit from nonverbal communication and cues. If you have to ask them over email, try to anticipate potential questions and preemptively address them.

Some medical schools relax their recommendation letter requirements for nontraditional applicants. However, this is very school-specific, so nontraditional applicants should enroll in a few science courses to get more recent professor recommendations. It’s best to find science faculty members and professors you learned from in the past three years. It’s worth reiterating: traditional or nontraditional, seek to check off the six boxes above to have individual letters paint a complete portrait of your capabilities.

When to send the letters?

From when to take the MCAT to sending recommendation letters, timing is everything. Request letters of recommendation from potential letter writers at least 2-3 months before submitting your primary application. This gives the recommender time to craft a strong letter, and allows you to skip the stampede of students asking for letters in May. Follow up with recommenders as needed to get all letters submitted by the end of June. Letters can be submitted later as long as they do not delay your secondary application. Submitting all your letters in June will just reduce your anxiety.

Finally, if a medical school wants a committee letter and your school offers, it is in your interest to do so. Otherwise, you risk them wondering whether you’re trying to hide something. For more information on medical school admissions, reach out to one of our expert consultants.

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