Navigating Medical School Applications: The Three Types of Letters Applicants Send

By late fall, the halfway point in each year’s medical school application cycle, some applicants will have received interview invitations, while others may be wondering if they’ll receive any. Regardless of which side a prospective student finds themselves on, the question I get most often this time of year is: Should I submit a letter of interest to schools I have not heard from yet? First, let’s take a step back. Recently, the Association of American Medical Colleges (AAMC) defined the three types of letters applicants send to med schools:

• Letter of Intent: This letter communicates your strong belief that you would be a good fit and asset for a specific medical school.
• Letter of Interest: A letter sent to admissions offices by an applicant on the alternate/wait list to communicate to the medical school the applicant's interest to attend if given an acceptance.
• Notice of Significant Updates: Examples of significant updates might include published research or articles, or significant honors or grants awarded.

Each medical school determines what, if any, information they will take from applicants after submission. To find this information, log into the AAMC’s Medical School Admission Requirements (MSAR) site, where schools note what types of letters they accept and any additional rules or restrictions. The reason I started with the new definitions above is that applicants may hear from friends and mentors that they should send a letter of interest, but that advice may be outdated. Over-communicating or sending updates when not allowed can work against your application. Anything you send needs to be useful to the admissions committee’s review. It has long been the case that a Letter of Interest and a Letter of Intent are sent after an interview or after being placed on a waitlist. In a Letter of Intent, which is sent to just one medical school, the applicant explains why the school is their first choice, what they will bring to that school, and clearly states that they will accept an admissions offer if given. This also means that, if admitted, the applicant will withdraw applications from all other schools. A Letter of Interest is similar in content but does not include the statement that the applicant will attend if admitted. For those waiting for interview invitations, that leaves the Notice of Significant Updates. It should be clear by now that applicants need to be strategic and thoughtful in their approach and should only send a letter if they have a significant update to their application. The AAMC MSAR site linked above lays out a few examples of updates to include, and applicants could also consider taking on a new job or clinical experience, especially if it addresses a weakness in their application. A few guidelines for the Notice of Significant Updates:

• Always include your name, admissions cycle, and AAMC/TMDSAS/AACOMAS ID.
• Write in a professional tone and be concise.
• Similar to the “experiences” section of the medical school application, describe the update with an eye on impact, core competencies, and growth.
• As always, include an appreciation of the ongoing consideration of your candidacy and thank the admissions committee for considering your application.