I have a very supportive (and inspirational) professor who’s written a letter of rec for me - but it didn’t arrive in time to make it into my composite packet.
The packet’s done through my school’s Pre-Health Professions Advisement Office. It has my composite letter, as well as the individual letters of rec that went into it (it also has some stuff less relevant to this thread). Mine’s already arrived at my selected med schools.
My question is: would it pay to arrange to have the additoinal letter sent to (at least some) schools? I have 5 letters (2 professors, 1 prof/PI, 1 employer, 1 doc I shadowed) already included in the packet, plus the composite that draws from them, so it shouldn’t be necessary. On the other hand, this professor is also a respected MD, and she’s been very supportive of my strivings towards medicine.
Thanks for any feedback 
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You might check with admissions at your preferred schools and see what they say. Some might only read the composite, and others might value the additional input from a physician. It can’t hurt to ask, I would think.
I agree with Terry. At RWJMS they keep telling me to update them as my situation changes (i.e. I got one of my term grades back). If you think it would make a difference, I would go the extra step and ask them if it would be alright to forward the letter. If they say no, you are out nothing.
Do call each school and ask if you may submit one additional letter, and explain why. “If you don’t ask, they can’t say ‘yes’.” 
Cheers,
Judy