AAMC Guidelines for Writing a Letter of Recommendation / Evaluation for a Medical School Applicant

Letters of recommendation/evaluation are a critical component of the medical school application and are highly valued by medical schools. Since more than one school will review your letter, please do not address a specific medical school in your letter. Please address the letter “Dear Admissions Committee.”

While medical schools cannot require applicants to waive their right to see a letter of recommendation/evaluation, they are clear that they prefer these letters are confidential as they believe evaluators will be more candid. For this reason, we ask that you do not have applicants write their own letters. You can, of course, request any information you like, including resume, personal statement, and/or autobiographical questions, to assist in your evaluation/recommendation.

These guidelines from the Association of American Medical Colleges aim to improve the letter writing process in order to benefit both letter writers and admissions committees. They are organized into two sections that describe (1) tips about how to write a letter and (2) key areas of interest to medical schools.

How to use the guidelines:

Please note that use of these guidelines is optional. They are intended to help you think about your letter and facilitate the writing process.

Medical schools do not expect any one letter writer to provide information about every characteristic of an applicant. In fact, they require multiple letters specifically because no one letter writer is expected to know everything about an applicant.


1. Provide an accurate assessment of the applicant’s suitability for medical school rather than advocate for the applicant.

2. Briefly explain your relationship with the applicant:

  • How long you have known the applicant;
  • In what capacity you have interacted (e.g., faculty, pre-medical advisor, supervisor, etc.); and
  • Whether you are writing based on direct or indirect observations.

3. Quality is more important than letter length. Focus on the applicant rather than details about the lab, course, assignment, job or institution.

4. Only include information on grades, GPA or MCAT scores if you are providing context to help interpret them. Grades, GPA, and MCAT scores are available within the application.

5. Focus on behaviors that you have observed directly when describing applicants’ suitability for medical school. Consider describing:

  • The situation or context of the behavior
  • The actual behavior(s) you observed
  • Any consequences of that behavior

6. Admissions committees find comparison information helpful. If you make comparisons, be sure to provide context. Include information about:

  • The comparison group (e.g., students in a class you taught, students in your department, co-workers, etc.)
  • Your rationale for the final comparison

Key Areas of Interest

A. Unique Contributions to the Incoming Class

  • Describe obstacles that the applicant had to overcome, and if applicable, how those obstacles led to new learning and growth
  • Explain how the applicant may contribute to a medical school’s diversity, broadly defined (e.g., background, attributes, experiences, etc.)

Note: If you write about any information that could be considered potentially sensitive, confirm with the applicant that s/he is comfortable with the inclusion of that information.

B. Core, Entry-level Competencies

Describe how the applicant has, or has not, demonstrated any of the following competencies that are necessary for success in medical school.

Core Competencies for Entering Medical Students

Interpersonal Competencies

Service Orientation: Demonstrates a desire to help others and sensitivity to others’ needs and feelings; demonstrates a desire to alleviate others’ distress; recognizes and acts on his/her responsibilities to society; locally, nationally, and globally.

Social Skills: Demonstrates an awareness of others’ needs, goals, feelings, and the ways that social and behavioral cues affect peoples’ interactions and behaviors; adjusts behaviors appropriately in response to these cues; treats others with respect.

Cultural Competence: Demonstrates knowledge of socio-cultural factors that affect interactions and behaviors; shows an appreciation and respect for multiple dimensions of diversity; recognizes and acts on the obligation to inform one’s own judgment; engages diverse and competing perspectives as a resource for learning, citizenship, and work; recognizes and appropriately addresses bias in themselves and others; interacts effectively with people from diverse backgrounds.

Teamwork: Works collaboratively with others to achieve shared goals; shares information and knowledge with others and provides feedback; puts team goals ahead of individual goals.

Oral Communication: Effectively conveys information to others using spoken words and sentences; listens effectively; recognizes potential communication barriers and adjusts approach or clarifies information as needed.

Intrapersonal Competencies

Ethical Responsibility to Self and Others: Behaves in an honest and ethical manner; cultivates personal and academic integrity; adheres to ethical principles and follows rules and procedures; resists peer pressure to engage in unethical behavior and encourages others to behave in honest and ethical ways; develops and demonstrates ethical and moral reasoning.

Reliability and Dependability: Consistently fulfills obligations in a timely and satisfactory manner; takes responsibility for personal actions and performance.

Resilience and Adaptability: Demonstrates tolerance of stressful or changing environments or situations and adapts effectively to them; is persistent, even under difficult situations; recovers from setbacks.

Capacity for Improvement: Sets goals for continuous improvement and for learning new concepts and skills; engages in reflective practice for improvement; solicits and responds appropriately to feedback.

Thinking and Reasoning Competencies

Critical Thinking: Uses logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.

Quantitative Reasoning: Applies quantitative reasoning and appropriate mathematics to describe or explain phenomena in the natural world.

Scientific Inquiry: Applies knowledge of the scientific process to integrate and synthesize information, solve problems and formulate research questions and hypotheses; is facile in the language of the sciences and uses it to participate in the discourse of science and explain how scientific knowledge is discovered and validated.

Written Communication: Effectively conveys information to others using written words and sentences.

Science Competencies

Living Systems: Applies knowledge and skill in the natural sciences to solve problems related to molecular and macro systems including biomolecules, molecules, cells, and organs.

Human Behavior: Applies knowledge of the self, others, and social systems to solve problems related to the psychological, socio-cultural, and biological factors that influence health and well-being.