Letters of recommendation

Hope I’m posting this question in the right place!

This may seem early in the game to ask (still working on prereqs), but I’m just wondering about what types of letters of recommendation hold the most weight. For instance, I work twice per month as a volunteer nurse practitioner at a free community health clinic. I work pretty consistently with one of the volunteer family physicians and have gotten to know him fairly well on a professional level. When I told him I’ve decided to take the plunge and apply for medical school, he was very encouraging and even offered to write me a letter of rec. However, while we’ve worked together, he hasn’t really observed my clinical interactions with patients as our roles are rather autonomous. Would he still be considered a strong reference for me?

Also, I am going to start shadowing a family physician/geriatrician next month (planning to go into FP and considering a geriatrics fellowship down the line). I will strictly be shadowing, no personal interaction with patients. Does this mean I should forgo using him as a reference since he cannot really attest to who I am or what my capabilities are?

Any other ideas for strong letters of rec?

Thanks in advance for any feedback!


What I’ve learned is that adcoms want to see letters from people with whom you’ve had a long relationship (preferably longer than 12 months). This is even more important if you’ve marked the experience as “Most Meaningful”. The way it’s been explained to me is: if you volunteered/worked at a place for a long time and don’t have an LOR from that place, adcoms will question why. I’ve also been advised that a letter from a doc (MD or DO) is strongly recommended. So choose one you think knows you the best.

For example, I submitted six letters with my AMCAS:

  1. Former manager where I worked for 4 yrs

  2. The CIO from my current client where I’ve worked for 2+ yrs

  3. Nurse manager at the hospital where I’ve volunteered for 2+ yrs

  4. Physics prof (earned A+ in his class and did 1 yr of research with him)

  5. Gen Chem prof (A+ in both of his classes)

  6. Family physician that I shadowed for 3 months

    I shadowed a couple other docs but the one who wrote me the letter was the one I talked with the most. I also didn’t really interact with patients but he and I talked at length about the health care industry, managing a practice, and some conditions of certain patients. He wrote me an awesome letter.

    Hope that helps.

Hi! In my opinion you should accept the offer from the doctor at the volunteer clinic. I got one from the medical director of the clinic I volunteered at as an NP. Although they don’t come in the room with you, they do sometimes take care of patients you have seen or review your charts so they have an opportunity to get a sense of your practice. Also, they can speak to your commitment to underserved populations and to providing medical care. I feel this was one of my strongest letters.

I also got a letter from a family practice doctor who led a medical mission trip I went on for 10 days - because we were working together a lot and he DID have a chance to see my patient interactions.

AND I got one from a DO whom I shadowed, only about 4 times. He said that from our discussions outside of the exam rooms, and from the opportunities he gave me to talk with some patients (breastfeeding issues and a home birther) that he felt could speak about my patient interaction abilities. You must have shadowed a DO to apply to most DO schools, but it is not uncommon for the LOR from the DO to be after a shadowing experience. I think it is very important to have another letter from someone who has worked with you for much longer.