Health Professions Advising

Question:  I am wondering about getting more letters of recommendation to augment my application at wait-list schools. At this point, can I just have the writer send the letters directly to the schools or, to save them time, can I take the letter myself and copy and send it to the schools? My PI here at the NIH has written me a letter already, but I may have one of the post-doctoral fellows with whom I work very closely write me another one. I know they would be happy to do so.

Answer: The letters should still be confidential, so give your recommenders the stamped-addressed envelopes and ask them to send the letter as soon as possible to the schools where you are wait-listed. This is a very good idea. They could also email the letter if their letterhead appears in the email. In that case you could give admission deans’ titles and email addresses to the recommenders to use. Good luck! ♦

Question: I had a great relationship with my freshman seminar professor this semester, and I asked her for a letter of recommendation. She hasn’t written many letters for med school, and was wondering what kind of information to include? Are there any guidelines for what should be included in a letter of recommendation? 

Answer: Just this month, a working group of med school personnel, premed advisors, and other administrators within the Association of American Medical Colleges (AAMC) published a set of guidelines that can be shared with letter writers. These guidelines emphasize the idea that a letter should provide an assessment of your suitability for medical school, they provide suggestions for the kinds of background information that can be helpful within a letter (e.g., how long the recommender has known you and in what capacity), and they stress the importance of pointing out ways that you might make a unique contribution to your medical school class. Most importantly, they highlight the desire that recommenders comment on behaviors that they have observed that may demonstrate core-level competencies that the medical schools are looking for in future physicians. You can find the guidelines online at https://www.aamc.org/initiatives/admissions/332572/lettersofevaluationguidelines.html (there is a printable version at the bottom of the page).

Of course, they don’t expect any single letter writer to be able to speak to all of the competencies, but ask you consider who you’re asking for a letter, think about which ones you may have exhibited while working with them. For example, if you participated in a group project that culminated in a presentation, they may be able to comment on your teamwork skills and oral communication. If your first paper needed serious work, and you went into office hours and to the writing center, and improved your writing substantially by the end of the semester, he professor could comment on your capacity for improvement and response to a challenging situation (resilience and adaptability), and possibly your critical thinking and written communication skills. As a freshman, you can also consider these competencies as you choose your activities going forward, so that you always have an eye on your personal development relative to the kinds of habits of mind and personal characteristics that are valued in a holistic admissions process at the medical school. The full definitions of the competencies are available here: https://www.aamc.org/initiatives/admissions/328178/competencyfulldefinitions.html.

Aside from the actual text that’s within the letter, we also refer you to the letter of recommendation form that’s available to give to each of your recommenders, so that they know where to send their letters, and our office’s suggestions for letter writers (both are available as pdf documents here: http://www.princeton.edu/hpa/applicants/letters/), and other questions of the week that we have addressed regarding letters: http://www.princeton.edu/hpa/faq/rec-letters/  ♦

Question:  I'm applying to medical school this summer.  I'm collecting letters of recommendation, and I'm wondering if it's okay to have a letter from a peer. I'm not saying my best friend, but someone who I became acquainted with as a result of my being the president of a student organization, someone who can talk about my extensive involvement in this organization but who is still only an undergrad. Thank you.

Answer: In general, no. Letters from peers aren't valued much by medical schools and we would recommend you avoid them. The comments of your acquaintance, as a current undergraduate, won't be taken very seriously by medical schools UNLESS she/he co-writes the letter with an administrator or dean on campus. Does your student organization have a faculty sponsor or adviser, and if so, might this person sign off on the letter while your friend writes most of it? This would be the only way to proceed, if feasible. ♦

Question: Is it OK to get a letter of recommendation for med school from my preceptor? I’m applying this summer and at the meeting before winter break I thought you said that preceptors were fine. Just checking. Thanks!

Answer: Your memory serves you well. A letter of recommendation from a preceptor or a TA is fine. You’ll want two letters from someone who taught you in science courses, and often in the science disciplines it is the preceptors, TAs, and lab instructors that get to know you best. If a preceptor offers to co-sign his/her letter with the primary professor for the course, that’s nice, but it certainly isn’t necessary. Any doctoral candidate at the University who instructs our undergraduates is a perfectly acceptable recommender. Now, one final note: Princeton is not a large state school where many of your courses (particularly introductory ones) might be taught by graduate students; you do have the advantage at Princeton of meeting our more senior faculty from time to time. It would appear strange to medical schools if all of your 4-6 letters were from preceptors!  ♦

Question:  I am a sophomore hoping to apply to medical school starting a year from now (summer after junior year), to go straight into med school after graduation.  You request that we have 4-6 letters of recommendation submitted to your office by April 13.  I read that you forward all recommendations to medical schools.  Do these 4-6 recommendations take the place of us having professors send letters directly along with our applications over the summer?  Or do I need to ask professors to write two sets of recommendations?  My brother informed me that medical schools only want 3 letters of recommendation.  So how does HPA forward 4-6 to medical schools?  Will admissions committees read them, or does someone assign priority to them?

Answer:  Generally speaking, medical schools require at least 3 letters of recommendation.  We collect up to 6 for each applicant in this office, and forward them along with our evaluative letter, which is based on your pre-application interview.  The entire packet of material is referred to most often as your "committee letter."  We forward these packets to medical schools for you in early August of the year you're applying (2008 for you).  Your recommenders do not send letters directly to medical schools, nor should you ask them to do so.  All letters come directly from this office.  We know which ones to expect as you have cited them on your Form 4 (in the Application Guide you will receive at the mandatory pre-application meeting in December).  We cannot know whether the schools read every letter or not.  We hope that they do.  But in case they don't, we do put the very best letters right behind our evaluative letter, so that your strongest are on top.  We limit everyone to 6 letters max, no more; most applicants gather 4-5.  The April 13th deadline applied only to this year (2007) but will probably remain sometime around mid-April in future years. ♦

Question:  If I am planning to apply for an MD/MPH joint degree, how should I go about asking for recommendations?  Can I ask the same people to discuss their experiences with me with respect to both medicine and public health in one letter?  Or do I need to find two different sets of people to write separate recommendations for the MD and MPH?

Answer:  Each MPH program has slightly different requirements concerning letters of recommendation, so it's always best to check directly with the programs you've chosen to destermine what they would prefer.  Generally speaking, we would recommend that you obtain separate letters of recommendation for the two programs, MD and MPH.  Your committee letter from our office, which contains recommendation letters for medical school that you have asked your recommenders to submit to us, will go to your medical schools.  For MPH programs, however, you should gather approximately 3 letters discussing your interest in public health.  The people who write your MD and your MPH letters may certainly overlap; you need only ask each to tailor his/her letter to each advanced degree, creating two versions - often the changes needed are very slight.  How do the MPH letters get to your schools of public health?  The Career Services office on campus has a credentials service that will gather your letters and distribute them to your MPH programs, and it might be a good idea to register for this service if you are applying to many MPH programs.  Go to: http://web.princeton.edu/sites/career/Undergrad/GradSchool/credentials_info.html  for more information.  But if it's only a few schools you've chosen, it may be simple enough to ask your recommenders to send their letters individually to the programs (supply your recommenders with addressed, stamped envelopes, of course).  The sending of your med school letters is taken care of entirely by the HPA office. ♦

Question:  Hi, I have a question about recommendations.  If I am planning to apply to med school maybe a year or two out of college, should I still ask teachers for letters of recommendation now?  I’m a junior.  Also, what if I plan to apply to other types of schools or grants or programs in the meantime that also need teacher recommendations--can professors write a general type recommendation letter?  Or is it OK to ask the same professor for multiple letters?  Presumably they wouldn't have to change much, but I would guess having them tailor made for what you are trying to do is best.  What is the protocol for this?

Answer: If you do not plan to go to med school until a year or two after college, then you will gather the bulk of your med school letters during your senior year when you’re nearing the culmination of your undergraduate career.  However, in certain cases you might ask for a letter early—anytime during college—if you are afraid that someone will forget you, or if the recommender is leaving Princeton and may be difficult to contact in the future.  Please read other “Questions of the Week,” archived on our website, for suggestions on how you go about asking for letters.  You’ll need to give the recommender a copy of Form 5, found under Med School Applicants on our website, so that the recommender knows what to do with his/her letter (he/she should not give the letter to you!).  We will keep any letters that arrive in this office in your file at HPA to be used during the year you apply to med, dental, or vet school.  As for your secondary question, an all-purpose letter is not generally helpful, especially for medical school; your recommenders will need to tailor letters for specific purposes, although you’re right, there usually isn't too much work involved in this 'tweaking' as long as the recommender remembers to keep a copy of his/her letter. ♦

Question:  I just had a quick question about good sources for recommendations here at Princeton. I am majoring in Econ, which I love.  However, since most of the science classes I have taken thus far - as a non-major - are large classes, how would you suggest I go about getting recommendations for med school?  Anyway, thank you again for all your help.  I truly appreciate it!

Answer:  When the time comes to apply to medical school, we will recommend that you find at least two people in science (preferably people who have taught you, but not always) to write you letters of recommendation.  If this seems difficult given the size of the pre-med science courses, our first hope would be that you will continue beyond the med school requirements and take smaller, upper-level science classes during junior and senior year, where you will get to know your faculty more easily. Non-science majors should continue to take some science throughout their college years.  However, if for some reason it is still a concern of yours at the time you're applying, then you should approach the professor or TA in person, ideally after making an appointment (not hectic office hours, if it can be helped).  Bring with you a copy of one assignment from the class, just to jog their memory; a resume or informal list of activities, often your Form 2 from the packet of material that you will complete for our office (which lists your activities); and a rough draft of a statement about why you are pursuing medicine (often this is a draft of the Autobiography that you will write for our office, but not always).  Have this material available in a folder and offer it to your recommenders.  It's probably much more than they need, but it's better to have too much information about yourself rather than too little.  As long as you performed well in their classes and you've provided the recommenders with additional info, there's really nothing to worry about.  It is very rare that a professor refuses to write a letter, or writes a poor one, if the student goes to that much trouble. ♦

Question: I had a great summer internship and my supervisor offered to write me a letter of recommendation. Can HPA store it for me until I apply?

Answer:  It’s helpful to ask for a letter from someone right away if you don’t think you’ll remain in contact in the future. Health professions schools prefer recent letters, so some students will ask for letters early, and then contact your recommenders again to ask them to update the letter once you’re actually applying. We are happy to keep letters of recommendation on file for you. Please follow the guidelines on our website when requesting letters of recommendation. Also note that we can only send letters to health professional programs, not to internships, employers, or other institutions. ♦