Admissions Blog

Academic performance and other accomplishments presented in your CV are not the only things that matter when applying to medical school. Recommendation letters are a crucial part of your application, especially if your referees know you well professionally and are able to vouch for your character.

Upbeat interviewed two of our medical students who are also student file reviewers* to share their advice on what makes a good recommendation letter.

Student A graduated with a BSc in Pharmacy from National University of Singapore before joining our MD Class of 2018.
Student B graduated with a BSc in Biochemistry from Washington State University and an MSc in Biotechnology from Johns Hopkins University before joining our MD Class of 2017.

What makes a good recommendation letter?

A: First, let us delve into the purpose of a recommendation letter. It is a document that enables a reviewer to get a better sense of who you are as a person. Because reviewers are sometimes not able to get a clear picture of who you are and how you function in your respective environments, the recommendation letters serve this purpose for reviewers. It crafts an image of the candidate and his/her strengths and purpose/goals in life. Its role is to support what you have written in your application. Therefore, a good recommendation letter is one that tells reviewers about what you have accomplished and how you were able to achieve it – in a positive manner (hopefully). It would also contain how you are able to interact with in a team, basically highlighting traits which are suitable for medical school and becoming a physician. A good recommendation letter leaves a lasting impression on the reviewer, such that upon reading the letter, the reviewer will be sold on the potential of the candidate.

How can applicants choose who to approach for recommendation letters?

B: Approach someone you have worked with considerably and is able to bring forth your most notable strengths. Try to include some combination of academic (your classic letter from a professor who can discuss your academic strengths), observership (from a clinical posting you may have done to expose yourself to the field), leadership/extracurricular (that can discuss your skills in this regard), or research (if you have done considerable research work) letters. Academic and observership letters should always be included. Additional letters on leadership or research make your application stronger and better-rounded. If you have spent considerable time being employed in a medical or non-medical field, such as the arts, business or finance, that’s excellent! Include that letter too. Overall, limit yourself to no more than three to five letters.

After identifying the recommenders to ask, what advice would you give to applicants on approaching recommenders?

A: If it is going to be someone that you do not have a prior relationship with, take the time to get to know them. If you are not comfortable sharing your dreams with them, you would be hard-pressed to get them to help you fulfil your dreams. Take things slow and share your wish of applying to medical school and see how they react. Don’t ask for a recommendation before letting them get to know you a little better.

Letting them know upfront about your intention to apply to medical school can help. If, after some period of time and contact with your mentor, they offer to write a recommendation letter for you, it probably means that they have your best interests at heart. Voluntarism always beats servitude so goes the saying.

Other DOs:
• DO sound out your intent early. Let them know your intention especially if they expect a long-term commitment from you (work, research assistance).
• DO approach your referees early. For most people, writing a good recommendation letter requires concentrated effort and last minute writing may not yield something good (e.g. default to generic letter)
• DO remind your referees from time to time. They are busy people and tend to have other priorities.
• DO make it as easy a process for them to send the letter on your behalf. Provide email templates, addresses, and instructions clearly so they don’t have to search for instructions themselves.
• DO have a copy of your latest CV/Resume available for them to refer to.

B: Prepare a list of potential recommenders to contact a few months in advance. Approach them with an email at least six to eight weeks before your letter is due and inquire if they would be willing to be a potential recommender. Ask if they would feel comfortable writing you a strong letter of recommendation. This latter point is important as you ultimately want to include a strong letter in your application. Once you have your final list of referees, send them an email with information that would be potentially helpful in writing you a letter. Always include your personal statement and your resume/CV. Some referees find it helpful if you can also provide them with a list of bulleted points they can highlight in your letter. I advise being proactive about this and if you want specific points highlighted in your letter, mention these to your referee.

Are there bad recommendation letters?

A: Although most referees are usually nice about this (i.e. issuing a generic letter instead of discouraging the school from accepting the applicant), I have heard of a “bad” recommendation letter from a personal friend. This may have a potential significant bearing on the status of your application. Therefore, it is imperative that you seek out mentors/referees/supervisors that are able to write a strong letter for you.

B: Recommendation letters that are long (> one to one and a half pages) and regurgitate information available elsewhere on the application (especially that which was not observed directly by the recommender) could be better. A lot of the really long letters are often written by the student who has been given the opportunity to help write and provide a framework for the recommender to work with.

What are some of the things you look out for as a student reviewer when reading recommendation letters?

A: Generally I look to see if what a referee writes agrees with what the applicant has written in their application. Also, I look at what personal attributes the referees has managed to identify and why the applicant are suitable for Duke-NUS. The difference between a strong recommendation letter and a generic one cannot be underestimated, especially if it comes from a significant referee in the applicant’s life. Just like how a “bad” letter can weigh your application back, a strong letter functions as a boost for your application.

B: The sort of work the student has participated in, whether they demonstrated creativity or problem-solving skills, if they have a kind and empathetic personality, whether they can communicate ideas effectively or take feedback in a constructive manner, are they a leader or follower (both equally important in their own ways), where the applicant stands compared to other students the referee has worked with, and finally how well and how long the referee has known the applicant. No single letter (or file of letters) covers all of these; usually it is some combination of these that one tries to gain from a letter.

Do you have any other tips to share?

B: Applying to medical schools can be a stressful process. Plan ahead of time and organize your to-do list early to get through tasks in a timely manner. Write your personal statement and essays early, and have it proof-read by others. Always have an updated copy of your resume or CV ready to be sent out when required. Understand that while your reviewer would fully review your application file, they may also have limited time. For this reason, keep your descriptions in the experiences section short. No more than three to five well-written sentences that describe the organization’s role and more importantly, your specific work in the organization. Being succinct and communicating the important points is a skill that will serve you well in future applications and endeavors. Finally, remember to thank your letter writers and your potential interviewers, or anyone else that has helped you along the process. Good luck!

*Note: As both are student file reviewers in our admissions process, their names have been anonymised. Their personal opinions do not necessarily reflect the opinions of the school nor the admissions department/committee.