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Medical School Letters of Recommendation: How Many, Who
Every medical school wants letters, and each one counts them differently.
AMCAS and AACOMAS each let you list up to 10 letters, but schools ask for far fewer. The eight schools below ask for two or three individual letters, or a committee letter in their place. Johns Hopkins, for example, wants two science professors and one non-science professor, or a committee letter. All four DO schools ask for or prefer a physician letter. Ask people who know you well, early in the year you apply.
How many letters of recommendation do you need?
The application services set the ceiling and each school sets its own number. The 2027 AMCAS Applicant Guide says “You may have up to 10 letters associated with your AMCAS application.” It adds that “the 10-letter total does not suggest that any one school wishes to receive 10 letters.” AACOMAS says “You can enter information for a maximum of 10 evaluations.” TMDSAS, the Texas application, takes a fixed set.
| Application | Letters you can list | Committee letter |
|---|---|---|
| AMCAS (MD schools) | Up to 10 letter entries | A committee letter or letter packet counts as one entry |
| AACOMAS (DO schools) | Up to 10 evaluations | A committee letter counts as one evaluation |
| TMDSAS (Texas schools) | Three individual letters, or one committee letter or packet, plus one optional extra | Committee letter or packet replaces the three |
Letters are not needed to submit. AMCAS says “You may submit your application before your letters of evaluation arrive at the AMCAS program.” Even so, “You must comply with each medical school's letter deadline(s).” Reapplying? AMCAS says “you will need to resubmit letters of evaluation to the AMCAS program for each application cycle.”
What do medical schools require for letters?
From each school's admissions page, read October 28, 2026. These rules change by cycle, so check the page again before you ask.
Johns Hopkins (MD)3, up to 5. Or a committee letter or letter packet
Who writes them: 2 science faculty and 1 non-science faculty who taught you. No preference for committee letters
In the school's words:
“Two (2) letters from science faculty members in science departments who taught you, and one (1) letter from a non-science faculty member who has taught you”
“Maximum number of letters you can submit is five (5)”
“There is no preference for a committee letter versus individual letters of recommendation”
Stanford (MD)3 to 6 individual letters
Who writes them: No set writers. A committee letter is optional and only the individual letters inside it count
In the school's words:
“A minimum of three and a maximum of six individual letters of recommendation is required.”
“Stanford Medicine does not have specific letter writer requirements”
“Pre-medical committee evaluations/letters are not required.”
Penn Perelman (MD)A committee letter, or at least 3 faculty letters. No school maximum (AMCAS allows 10)
Who writes them: At least 1 science faculty member whose course you took
In the school's words:
“Composite or committee: Individual letter/letter packet from a pre-health advisor or career service office, with or without additional letters attached.”
“A minimum of three (3) letters from faculty members who know the applicant well”
“at least one must come from a science faculty member with whom the applicant has taken courses.”
“The Perelman School of Medicine has no maximum for letters of recommendation”
UCLA Geffen (MD)3 to 5
Who writes them: People who know you well, such as a PI or mentor. A committee letter counts as one
In the school's words:
“We require 3 to 5 letters of recommendation.”
“Letters should be from individuals who know the applicant well and from individuals who have spent a significant time with them, e.g. PI or mentor”
“If your pre-health advisory office provides a committee letter, this letter will fulfill one letter requirement.”
PCOM (DO)At least 3
Who writes them: Prefers an advisor or committee, science faculty and physicians, preferably DOs
In the school's words:
“A minimum of three letters of recommendation are required”
“A pre-health advisor letter will meet the requirement for one of the three required letters of recommendation.”
“Physicians, preferably DOs, and/or other health care providers”
Touro College of Osteopathic Medicine (DO)A committee evaluation or 2 science faculty letters, plus 1 physician letter
Who writes them: Physician (DO preferred) who saw you with patients. No letters from relatives
In the school's words:
“You will need to submit an evaluation from a pre-professional advisory committee, OR two letters of recommendation from natural science faculty”
“One letter of recommendation from a physician (DO or MD) who has observed you in a clinical/patient-based setting.”
“Please note that a letter from a DO is preferred.”
“Letters from relatives will not be considered.”
Kansas City University (DO)2
Who writes them: A pre-med advisor or committee (or a science professor), plus a physician (DO or MD)
In the school's words:
“Two letters of recommendation”
“One recommendation letter should come from a pre-med advisor or committee at your current or last institution. Alternatively, you may substitute a science faculty member from your current or last institution.”
“One from a physician (DO or MD)”
“Letters must be dated within two years of matriculation year”
Ohio University Heritage College (DO)2: a premed committee letter or a natural science professor, plus a second letter
Who writes them: A natural science professor plus a professor, physician or supervisor. A DO letter is desirable, not required
In the school's words:
“The applicant should submit a letter of recommendation from either a premed committee or one letter from a natural science faculty member who taught you in class, and a second letter from a professor (natural sciences or otherwise), a licensed physician (DO/MD), a supervisor, or another qualified professional.”
“A letter from an osteopathic physician is highly desirable but not required.”
What is a committee letter for medical school?
A committee letter is your college's own evaluation of you. AMCAS defines it as “A letter authored by a prehealth committee or prehealth advisor and intended to represent your institution's evaluation of you.” AMCAS has three letter types: committee letter, letter packet and individual letter.
Committee letter
Written by your prehealth committee or advisor, sometimes with other letters attached. Also called a composite letter.
Letter packet
A set of letters your college collects and sends. Unlike a committee letter, “a letter packet does not include an evaluative letter from your prehealth committee or prehealth advisor.”
Individual letter
“A letter written by, and representing, a single letter author.”
“Each letter type is considered one letter entry, regardless of the actual number of letters it contains.” AACOMAS works the same way: “a committee letter only counts as one evaluation and the individuals who contributed to the letter may not be used as additional evaluators.” Schools treat committee letters differently. Johns Hopkins says “There is no preference for a committee letter versus individual letters of recommendation”. At Stanford, “only the individual letters contained within the pre-medical committee packet will count toward the number of letters of recommendation.” At UCLA, “If your pre-health advisory office provides a committee letter, this letter will fulfill one letter requirement.”
One more rule: “The AMCAS program does not split packets or add or remove letters once the packets or letters have been received.” A letter meant for one school only should be its own individual letter entry.
Who should write your medical school letters?
TMDSAS puts it plainly: “Evaluators should know an applicant well enough to evaluate them both academically and personally.” It adds, “It is recommended that at least one of your evaluators be a current/former professor who can speak to your academic ability in the sciences.” A letter from someone who barely knows you says less than one from a writer who saw your work up close. Touro adds that “Letters from relatives will not be considered.”
Two science professors who taught you
Most schools in the table want at least one science professor, and Johns Hopkins and Touro want two. Johns Hopkins does not count psychology or computer science as science letters.
One non-science professor
Johns Hopkins asks for one. A humanities or social science professor who read your writing can describe how you think.
A physician you shadowed or worked with
Requested or preferred by all four DO schools in the table, ideally a DO. For MD schools, check each school's writer rules first. Stanford sets none.
A research mentor (PI)
UCLA names a PI or mentor as a good writer. At Johns Hopkins, MD-PhD applicants need two extra letters, usually from research faculty.
A supervisor from clinical work, volunteering or a job
Speaks to reliability and how you treat people. Useful if you have been out of school, since letters should be recent.
Your prehealth committee, if your school has one
A committee letter can replace the faculty letters at Johns Hopkins and Penn. At Touro it replaces the two science letters, and you still need a physician letter. Ask your advisor early about how the committee works.
Johns Hopkins lists which fields count as science and notes that computer science, earth sciences “and Psychology are not accepted as satisfying the science letter requirement”. Required courses are in our required classes for medical school guide.
When and how should you ask for a letter?
AACOMAS advises: “Choose your evaluators early in the application process to ensure they have adequate time to submit your evaluation.” School deadlines are firm. Stanford's rule for the 2027 cycle was “All letters must reach the Admissions Office from AMCAS no later than (11:59 PM PT) on October 9, 2026.” For this cycle, TMDSAS says admissions committees weigh the date on each letter, “with a strong preference for letters written after May 1, 2025.” Our steps:
1. Ask in person or by video first
Ask, "Do you know me well enough to write a strong letter for medical school?" A hesitant yes is your cue to ask someone else.
2. Ask early in the year you apply
Letters can arrive after you submit, but Johns Hopkins and Stanford count your file complete only when your letters are in. Ask in winter or early spring so writers are not rushed.
3. Send one follow-up email with everything
Your CV, a draft personal statement, a short list of what the writer saw you do, the service's request form and your target date.
4. Create the request in the application
In AMCAS, add the letter and email the request from the Letters of Evaluation section. In AACOMAS, the writer gets an email with a link to Liaison Letters.
5. Check status and thank them
Track each letter in your application. AACOMAS does not tell you when an evaluation is missing. Send a thank-you note and tell writers where you end up.
Here is the follow-up email after a writer says yes. It is an example we wrote, with made-up names. Change every detail to your own.
Our example: a follow-up email after a professor says yes
Our example: a follow-up email after a professor says yes
Subject: Letter of recommendation for medical school: materials and date
Dear Dr. Rivera,
Thank you again for agreeing to write a letter for my medical school application. I took your Cell Biology course in fall 2025 and worked in your lab this spring.
I attached my CV, a draft personal statement and a short list of moments you might remember, like the protein assay I troubleshot with the team in March.
You will get the request from AMCAS by email. My AAMC ID and Request ID are on the attached form. I am hoping to have all letters in by June 15.
Please let me know if anything else would help. Thank you for your time.
Best,
Jordan Lee
What do letter writers need from you?
For AMCAS, “You must provide your letter author(s) with your AAMC ID and AMCAS Request ID to ensure your letters are matched correctly to your application.” Writers upload a PDF or Word file through the AAMC Letter Writer Portal, or send it through Interfolio, which can take up to three business days to reach AMCAS. Schools may require official letterhead and a signature. TMDSAS asks for letterhead, the writer's contact details, your name, a date, English and a signature, and direct uploads can take up to 10 business days to process. For AACOMAS, warn writers that the request comes from support@aacomas.myliaison.com and may land in spam.
From you, writers also need the material that makes a letter specific: your CV or AMCAS Work and Activities entries, a draft of your personal statement, a few moments they saw firsthand and your target date. Keep following up. AACOMAS says “We will not notify applicants about missing evaluations.” Strict rules apply once letters arrive: “Many programs have strict guidelines and completed evaluations cannot be removed or replaced.” In AMCAS, “You may continue to add letters to your application and assign them to medical schools after the initial submission of your application”.
Should you waive your right to see your letters?
The waiver is a FERPA choice. AACOMAS explains that the law “gives you the right to access evaluations unless you choose to waive your right of inspection and review.” On a waived letter, AACOMAS says “Programs may view this type of evaluation as a more accurate representation of an applicant's qualifications.” And “Once you make a selection, you can't change it, so consider the choices carefully.” TMDSAS asks the same question: “Indicate whether you will or will not waive your right of access to the letters of evaluation sent on your behalf.” AMCAS keeps letters closed either way: “Under no circumstances will the AMCAS program provide access to letters of evaluation to you or your letter authors.” If you trust your writers, waive.
Will interviewers ask about your letters?
Letters help decide whether you get an interview at all. Stanford says “Interview decisions are made based on information submitted in the AMCAS application, Stanford Supplemental Application, and letters of recommendation.” Because your letters are part of the file that earns the invite, treat anything a writer could have described as fair game: the lab problem, the patient you sat with, the class where you struggled. Your secondary essays often ask for the same stories. For the full list of questions, see medical school interview questions and our medical school interview prep guide. Confetto runs mock interviews out loud with feedback.
“What would your recommenders say about you?”
A strong answer picks one or two qualities your writers really saw, backs each with a moment they were there for, and ends with what you are still working on.
Our example answer
My chemistry professor would probably say I ask the second question. After office hours I would come back with how I got stuck, not just the answer I wanted. The physician I shadowed would say I was quiet at first but good with patients once they were talking. One week she had me sit with a patient waiting for test results. I am still learning to speak up sooner on a team, and that is what I am working on now.
Sources: the 2027 AMCAS Applicant Guide, AACOMAS Applicant Help Center: Evaluations, TMDSAS Application Guide: Letters of Evaluation and the school pages linked in the table. All checked October 28, 2026.
Frequently asked questions
How many letters of recommendation do you need for medical school?
It depends on the school. AMCAS and AACOMAS each accept up to 10, but the eight schools in our table ask for two or three individual letters (or a committee letter), and some cap the total at five or six. Most of the eight want at least one science professor, and Johns Hopkins asks for two science professors and one non-science professor, or a committee letter in their place. Check each school's own page.
Do I need a committee letter for medical school?
Only if a school asks for one. Johns Hopkins gives committee letters and individual letters equal weight, and Stanford does not require one. If your college offers one, ask your prehealth advisor how it fits each school's rules.
Do DO schools require a letter from a DO?
Some ask for a physician letter and prefer a DO. Kansas City University requires a physician letter (DO or MD), and Touro College of Osteopathic Medicine prefers a DO. Ohio University Heritage College says a DO letter is highly desirable but not required.
Can I submit my AMCAS application before my letters arrive?
Yes. The AMCAS guide says you may submit before your letters arrive, and letters are sent to your schools as they come in. Your file at each school stays incomplete until its required letters are in, so do not let them run late.
Should I waive my right to see my letters?
Usually yes, if you trust your writers. AACOMAS says programs may see a waived evaluation as a more accurate picture of you, and the choice cannot be changed later. AMCAS never shows letters to applicants or writers.
Can I send different letters to different schools?
In AMCAS, yes. You assign each letter entry to the schools you choose. A committee letter or packet goes as a whole, so a letter meant for one school should be its own individual letter entry.