Letters that speak for you

1How letters reach schools

Letters never go through you. Each one travels from the writer to the application service, which sends it to your schools. There are three common routes:

Check your college first. If your school has a pre-health committee, ask how it collects letters before setting up anything else.

2Using Interfolio

Interfolio's Dossier lets writers upload a confidential letter once. You can then send it to medical school application services when you're ready. Sending letters requires a Dossier Deliver subscription, which costs $59.99 a year for up to 50 deliveries.³ The AAMC Fee Assistance Program does not cover Interfolio fees.² Letters stay stored even if your subscription expires.⁴

Step 1: Request the letter

1. Create a free Dossier account at interfolio.com.
2. Go to Letters and click Request a Letter.⁴
3. Add your recommender as a contact and choose Email as the request method.
4. Check the confidential box. This waives your right to read the letter, which medical schools expect.⁴
5. Set a due date. Interfolio sends your writer reminders 7 days and 1 day before it; without a due date, no reminders go out.⁴
6. Write a personal message and attach your packet (section 3) under Supporting Materials.⁴
7. Click Send Request. You'll see each letter's status (requested, pending or completed), but not its contents.⁴

Step 2: Send letters to AMCAS (MD)

1. In AMCAS, add each letter entry. This creates a Letter Request ID for each one.
2. Copy your AAMC ID and add it in Interfolio's Account Settings. Type it in rather than pasting, since pasted text can carry hidden characters.²
3. In Interfolio, go to Deliveries → New Delivery, search for AMCAS and click Start Application.²
4. Add only the letters, enter the matching Request ID next to each one, click Save Request IDs and submit.²
5. Allow 3 to 5 business days for letters to attach to your application.²

A common surprise. AMCAS currently accepts letters only with a physical (handwritten) signature, not an electronic one. Each file must be under 5 MB, and more than eight letters need two separate deliveries.² Mention the signature rule to your writers.

Step 3: AACOMAS (DO) and TMDSAS (Texas)

• AACOMAS: add your 10-digit AACOMAS ID in Interfolio, then send through Confidential Letter Upload. Delivery takes 1 to 4 business days. AACOMAS letters can't be replaced once delivered, so send final versions only.²
• TMDSAS: first create the letter request inside TMDSAS and choose Interfolio as the delivery method. Then add your 6-digit TMDSAS ID in Interfolio and submit. Writers must put your TMDSAS ID on the letter. Processing can take up to 14 business days, and May through July is peak season.²

3What to give your recommenders

Ask in person or by email first, then send a packet once they agree. Ask whether they can write a strong letter, which gives them an easy way to say no if they can't. This is advice from pre-health advisors, not a data-backed rule.

Being first-gen is part of your story. The AAMC guidelines ask writers to describe obstacles you've overcome and what you'd add to a medical school class, but to include sensitive personal information only with your permission.¹ Tell your writers what you're comfortable having them share.

4The 17 premed competencies

The AAMC lists 17 competencies that entering medical students should show, in three groups.^1,5 Share this list with each recommender, and point out which ones they saw you demonstrate.

5Request template

Copy this, personalize the bracketed parts, and attach your packet.

Dear [Professor/Dr. Name],

Thank you for agreeing to write a letter of recommendation for my medical school application. I've attached my resume, a draft of my personal statement and a few moments from [your class/our work together] that meant a lot to me.

I've also attached the AAMC's guidelines for letter writers and its list of 17 premed competencies. Medical schools ask writers to describe how applicants have shown these qualities, so I've noted the ones I think you saw most clearly.

You'll receive an upload link from [Interfolio/AMCAS]. Please note that AMCAS currently requires a handwritten signature. If possible, I'd be grateful to have the letter by [date].

Thank you for your time and support.

Sincerely,
[Your name]