How to Write a Great Medical School Letter of Intent or Letter of Interest (Example Included)
/Learn when and how to send these two types of update letters to get off the waitlist and into your dream school
----
Part 1: Introduction to medical school letters of intent and letters of interest
You can find countless articles online discussing how to write a great medical school personal statement, how to ace your interviews, and pretty much every other medical school admissions topic.
However, very few of these articles address one of the hardest parts of the med school application process: waiting.
As a medical school applicant, you’ve been a go-getter for the past few years, if not your whole life. You’ve put in tons of study hours to achieve a strong GPA and MCAT score, applied for the best physician shadowing and volunteering opportunities, took initiative and demonstrated leadership across your extracurricular activities, and worked your tail off to write great application essays. In other words, waiting for good things to happen is not the way you’re used to operating.
Unfortunately, waiting—patiently or impatiently—is an important part of the admissions process. You have to wait for interview invitations after submitting your secondary essays. Then, after your interviews, you have to wait to receive an admissions decision, possibly after being placed on various waitlists. This is far from unlikely given that some schools place up to 50 percent of interviewees on their waitlist!
What makes this process even more difficult is that admissions committees don’t typically provide a timeline of when to expect updates or notifications. And, although rare, an adcom may inform you of your acceptance or rejection pretty much right up to the start of the fall semester.
Naturally, there will come a time in your admissions process when you will wonder, “What should I do while I wait for [an interview offer/admissions decision]?” Sometimes, the answer is that you unfortunately must wait. Other times, the answer is that it’s time to reach back out to various admission committees by submitting a letter.
You may have heard of two types of related yet distinct letters that you can send to admission committees: a letter of intent or a letter of interest. These letters can help boost your odds of escaping admissions purgatory and getting into med school. However, different situations call for different types of communications, and approaching these letters the wrong way can actually hurt your chances of being accepted.
This guide will clear up any confusion you may have about when and how to send each type of letter so that you can scratch your itch to do something in a productive manner.
----
Part 2: Letter of intent vs. letter of interest
Many applicants mistakenly use the terms “letter of intent” and “letter of interest” interchangeably, perhaps because they share the LOI acronym. Yet, the two types of letter differ in various ways. We’ll discuss each in detail below so you can determine which one best fits your needs.
Additionally, we’re often asked how “update letters” fit into the picture. We do not view update letters as a distinct letter category because we encourage students to include updates whenever possible in their letter of intent or letter of interest. In other words, both of these types of letters should operate as update letters in addition to expressing your intent or strong interest in attending a given med school.
Medical school letter of intent
What it is: A letter of intent should express your clear desire to attend a particular medical school due to your perceived fit with its curriculum, academic environment, student body, culture, and so on. You must also communicate what you might contribute to the school if admitted.
Goals: To inform the medical school that it is unequivocally your top choice and that you will surely accept an offer of admission.
How many schools to send it to: One, since only a single school can be your top choice.
Why medical schools appreciate it: Schools want to maximize their “yield”—that is, the percentage of admitted students who choose to enroll—because it impacts their rank, exclusivity, and prestige. Therefore, when comparing two otherwise equal candidates, schools will be attracted to the one who has expressed a clear desire to attend their program if admitted.
When you could send it: One month after your interview, whether you’re placed on the waitlist or haven’t yet heard back. You may send a second letter of intent if over two months have passed since your initial one and you have meaningful updates to share.
What it should include:
An expression of thanks for considering your application
A recap of what you especially appreciate about their school
Updates since you last communicated with them
Demonstration of fit between your updates and experiences with the school’s unique offerings
What you will contribute to the school (e.g., student body, curriculum, initiatives)
A clear statement that you will attend if admitted
A second expression of thanks for considering your application.
Important things to note for your letter of intent:
Be sure your letter of intent is free of grammatical and spelling errors.
Do not send a letter of intent to more than one school. Remember, your letter of intent states that, should you receive an offer of admission, you will definitely attend that school. Therefore, you can only inform one school of this.
Make sure the school accepts letters of intent. Some schools specifically ask that you not send one. If the school you wish to attend asks prospective students not to send one, then do not send one.
Pay attention to guidelines regarding format and method of submission. For example, some schools specify that you must send your letter of intent through a portal or they may request a specific file type. If that’s the case, pay particular attention that you follow instructions.
Medical school letter of interest
What it is: Like a letter of intent, a letter of interest should express your enthusiasm for a medical school’s academics, offerings, and culture. Moreover, you should highlight ways in which you will fit with and enrich the student body.
Goal: To inform medical schools that you are highly interested in attending if admitted.
How many schools to send it to: As many as you have continued interest in.
Why medical schools appreciate it: Medical schools want to be pursued by prospective students. If you submit your secondary application and a significant amount of time passes without the med school hearing from you, they may assume you’re less interested in their program than in others. Moreover, many of your competitors will be taking the extra step to reach out and express their excitement about various programs. Although schools won’t be as convinced that you’ll help maximize their yield as they would be by a letter of intent, it doesn’t hurt to keep yourself in adcoms’ minds.
When you could send it: Assuming you have a meaningful update to share, there are two situations that warrant a letter of interest:
Six weeks have passed since submitting your secondary without hearing from the school.
One month after your interview, whether you’re placed on the waitlist or haven’t yet heard back.
You may send a second post-interview letter of interest if at least two months have passed since a previous letter and you have significant updates to share. In other words, don’t continue to write simply for the sake of writing; otherwise, you may run the risk of annoying adcoms.
What it should include:
An expression of thanks for considering your application
An emphasis of what you most appreciate about their program
Updates since your last communication
Connection between your updates and their offerings
How you will contribute to the school
A statement about your continued interest in their program
A second expression of thanks for considering your application
Important things to note for your letter of interest:
Ensure that your letter of interest is free of grammatical and spelling errors.
While it’s okay to send letters of interest to more than one school, you should avoid sending duplicate copies to multiple schools. Remember to personalize your letters and mention specific aspects of the school and its programs that are a great fit for you.
Be mindful of any guidelines for format and submission.
----
Part 3: Medical school letter of intent and letter of interest examples
The letter of intent and letter of interest should largely be written in the same way, save for the level of commitment you express near the conclusion—and perhaps in the introduction—of your letter. Reviewing examples of both can help you compare and contrast a letter of interest and a letter of intent.
Here’s an example to give you a sense of how to craft a professional, well-written letter of intent:
Dear Tufts University School of Medicine Admissions Committee:
Thank you for offering me a place on your waitlist. I am writing to inform you that Tufts University School of Medicine (TUSOM) is my clear first choice for medical school. After my interview day, I spoke at length with Tufts alumni near me—Drs. Julie Simmons and Ruth Goldberg—to learn more about the Tufts experience. Their enthusiasm for TUSOM increased mine as I came to more fully appreciate how graduates live and pass on to others the Tufts values of compassion, innovation, healing, service, and respect. And hearing about the complex brain conditions being treated at Tufts’ neurology clinics solidified my interest in branching out of my ongoing research and undertaking research specific to these diseases with Dr. Nikhar Mehta or Dr. John Lewandowski.
I would also like to update you on what has occurred since my interview in November 2020.
As indicated in my secondary application, I completed Booth Fundamentals in December 2020. Booth Fundamentals is a 6-month certificate program on the foundational business concepts from the University of Chicago Booth School of Business. I passed with High Honors—the highest possible grade, assigned to the top 5 percent of the cohort. Stepping into the role of a business leader and tackling case studies of diverse organizations has equipped me to engage in business discussions, and I would love to participate more fully in business as a Tufts student through the Medical Entrepreneurship program by collaborating with Boston companies on new healthcare ventures. I am also interested in representing TUSOM at the Progress in Medicine summit, which would prepare me to drive changes to improve the value of patient care as I progress through my training.
In December, I also took a contingent of Chicagoland volunteers to lobby alongside the American Heart Association at the Capitol. We enlisted the support of our state legislators on two bills that increase access to affordable healthcare and another to provide more healthy food choices to individuals living in the inner city. The scope of my advocacy has extended beyond pushing for legislation as a catalyst to fight heart disease. Over the past year, I worked with our local U.S. Senator to reform how child abuse cases are handled, culminating in the passage of Article 2451 in January 2021. This law puts enforceable protections in place for children by requiring Child Protective Services representatives in Illinois to respond to all cases of alleged abuse within 48 hours, not only those they believe are reportable. TUSOM’s curriculum provides a remarkable range of options to continue sharpening my policy skills, including the healthcare policy course headed by Dr. Samantha Chin.
Collectively, I see Tufts as the ideal medical school to become the physician leader I have long dreamed of becoming. If admitted, I will accept without hesitation. I am confident that I would simultaneously benefit from Tufts and contribute to making it an even better place.
Please contact me via email at enomura@uchicago.edu if I can answer any questions or provide additional information. Regardless of what you decide, I appreciate your consideration of my application.
Sincerely,
[Signature]
Emika Nomura
AAMC ID: 12345678
Here’s an example of what a letter of interest might look like:
Dear Warren Alpert Medical School Admissions Committee Members:
Thank you for considering my application. I remain highly interested in attending Alpert Medical School because of its focus on innovative clinical research research and commitment to community service. At this time, I am writing to update you on work I have completed in recent months.
Since submitting my secondary application, I completed Booth Fundamentals in December 2022. Booth Fundamentals is a 6-month certificate program on foundational business concepts from the University of Chicago Booth School of Business. I passed with High Honors—the highest possible grade, assigned to the top 5 percent of the cohort—and focused my capstone project on improving public mental health services for children and adolescents.
I also continue to conduct case study analyses on patients with suicidal ideation through my research lab at Northwestern School of Medicine, which has sharpened my research skills and allowed me to understand how individual patients develop life-threatening mental illness. At Alpert Medical School, I would look to take part in the Basic and Translational Research Program and work with professors like Drs. Jennifer Barredo and Sarah Ann Thomas to study the diagnosis and treatment of emotional and substance use disorders and to apply findings to improve care options at the policy level.
In December, I also recruited a group of Chicagoland volunteers to lobby alongside the American Heart Association at the Capitol. We enlisted the support of our state legislators on two bills that increase access to affordable healthcare and another to provide more healthy food choices to individuals living in the inner city. The scope of my advocacy has extended beyond pushing for legislation as a catalyst to fight heart disease. Over the past year, I worked with our local U.S. Senator to reform how child abuse cases are handled, culminating in the passage of Article 2451 in January 2021. This law puts enforceable protections in place for children by requiring Child Protective Services representatives in Illinois to respond to all cases of alleged abuse within 48 hours, not only those they believe are reportable. Alpert’s curriculum provides a remarkable range of options to continue sharpening my policy skills, especially the integrated coursework on culturally sensitive care.
Ultimately, I view Alpert Medical School as the ideal institution to shape me into the physician scientist and policy expert I hope to become. I am confident that I would grow at Alpert Medical School while contributing to its transformative study environment.
Please contact me via email at enomura@uchicago.edu if I can answer any questions or provide additional information. While I would be honored to be meet with you personally if invited for an interview, I appreciate your consideration of my application regardless of what you decide.
Sincerely,
[Signature]
Emika Nomura
AAMC ID: 12345678
----
Part 4: Frequently asked questions
Do letters of intent or letters of interest make a difference?
This is something students have wondered about (and debated over) for years! Some feel it makes a positive difference, whereas others feel schools couldn’t care less. From working with students for almost two decades and hearing about various experiences, it seems students believe one (or more) of the following:
Schools don’t care about letters of intent/interest, and either
trash the letters they receive, or
briefly review them for anything that may stand out and then shove them aside file them away.
Schools do care about letters of intent/interest—they read them and use them to review applicants further.
While the extent to which the letters help applicants may be debatable, the consensus indicates that most students don’t believe sending one will diminish your chances of acceptance.
That said, to answer this question, we wanted to dig deeper and see what adcoms thought. According to some adcoms whom the AAMC interviewed, letters of intent/interest should only be sent if you share something that “adds significant new information to your file.” When asked whether such letters sway their decisions, an adcom at the University of Toledo College of Medicine and Life Sciences indicated that highlighting something important that demonstrates an applicant’s commitment to attend that school may help determine a student’s final outcome. There was no clear-cut answer, but the implication was there since this was referred to as the “exception” after saying that letters “rarely” sway decisions.
What should you avoid in a letter of intent or letter of interest?
The number one thing to avoid in a letter of intent or letter of interest is a web of lies. In most cases, you aren’t required to send any update letters, so it would be better not to send one at all than to send one that is full of embellished information.
You’ll also want to avoid rehashing things the adcoms already know, such as your GPA, MCAT scores, or extracurricular activities you’ve included in your primary application or referenced in your secondary responses. By the time it’s appropriate for you to send a letter of intent/interest, they’ll already know about those things—especially if you’ve already interviewed since those things would’ve influenced their decision to interview you in the first place.
Is a letter of intent legally binding?
Simply put, No. Letters of intent for medical school are not legally binding.
But before you breathe a sigh of relief and prepare to start rapidly firing off a bunch of copy-paste letters, consider the consequences of doing such a thing.
For instance, if you send multiple schools a letter of intent telling them all they are your “top choice,” what will you do if more than one school offers you an acceptance? You can only attend one, which means you’ll have to inform the other that you won’t be attending there. If you avoid informing them proactively, you can expect the school to do some digging on their own to investigate why someone who promised they’d attend if accepted has disappeared. At that point, there’s a chance you’ll be found out.
Additionally, dishonesty before you even set foot inside the school shows a clear lack of integrity. What’s worse is that it doesn’t only reflect poorly on you; it also makes anyone who supported you—such as rec letter writers—look bad.
Bottom line: While letters of intent are not legally binding, you should in no way be tempted to do anything dishonest or unethical.
How long should my letter of intent/interest be?
You should aim to keep your letter within one page, using one-inch margins and no smaller than 11-point font.
Many students feel a strong urge to write longer letters, thinking that the more updates and demonstrations of fit they provide, the better. Nevertheless, this is usually most reflective of these students’ anxiety. Consider how many essays and letters adcoms read, and focus on writing your main points succinctly.
How should I send my letter of intent/interest?
Unless a medical school provides specific instructions on how to submit letters of intent or interest, we recommend that you send your letter to an admissions rep via email. While you could upload it to the school’s secondary portal, it’s impossible to know if adcoms are notified about portal uploads, so this method may risk your letter going unnoticed.
When submitting a letter via email, you have the option to either attach your letter as a PDF or to write it in the body of the email itself. When sending a PDF letter, we recommend inserting an image of your handwritten signature, as indicated in our example letter above. However, a signature image is unnecessary when sending your letter in the body of an email.
I know a student who sent over [3/4/5/etc.] letters to X Medical School and got in. Are you sure I shouldn’t keep sending letters to express my interest or intent to attend?
Remember that correlation does not equal causation. Given how many thousands of students apply to medical school each year, chances are that you will eventually hear about a student who sent six letters and got in, as well as a student with a 3.3 GPA who got into a top-10 school, and so on.
Rather than try every possible tactic you’ve heard about how to get in—many of which are not sound—we encourage you to only implement strategies that authentically demonstrate interest and fit with a medical school while being considerate of their difficult task of selecting among an incredibly impressive applicant pool.
Should I include updates on my academic work (e.g., courses taken, grades, GPA) in my letter of intent/interest?
Yes. If you’re still in college or are enrolled in a graduate program, it’s a good idea to provide updates on coursework completed since you submitted your applications, especially if you’ve received high grades. However, you don’t need to individually list or describe each class you took. Instead, briefly describe your coursework as a whole and provide your GPA for the term.
If possible, you might also draw connections between your recent coursework and the medical school in order to demonstrate fit.
I’ve already submitted a letter of interest/intent. What kind of updates warrant a second letter?
When deciding whether you should submit a second letter of intent or interest, having meaningful updates to share with the admissions committee should be your primary determining factor. Here are some examples of meaningful updates:
Academic updates, especially ones that significantly improve your GPA or fulfill med school prerequisites
Achievements such as publications, presentations, or prestigious awards (note: publication acceptances or invitations to present also count)
Relevant job promotions
Other significant accomplishments (for instance, in our example letter above, the applicant is involved with the passage of a congressional bill)
Unless there is a distinct accomplishment or milestone involved, updates involving new clinical, research, or volunteer experience are typically not as significant. Whether or not these alone warrant a second letter is debatable. That said, feel free to include these kinds of updates alongside the meaningful updates listed above.
The other scenario in which it would certainly be worth discussing clinical, research, or volunteering updates is if your application was originally lacking in these kinds of experiences. But, if you’ve already racked up hundreds of shadowing or volunteer hours, additional hours likely won’t change how adcoms view your application.
Here’s the bottom line: consider how your update meaningfully improves your candidacy.
Can I send a letter of intent/interest even if I have no meaningful updates to share?
Yes. If you haven’t yet sent a med school a letter of intent or interest, you can still write to them to express your strong interest or intent to attend. Make sure to demonstrate fit in your letter, and communicate any updates that you do have. That said, a letter of intent or interest will always be strongest when it includes meaningful updates.
We don’t recommend sending a second letter of intent or interest without major updates to share.
If a medical school states that they don’t accept updates or letters of intent/interest, should I send a letter anyway?
No. If a med school explicitly requests that you not send them a letter of intent or interest, disregarding these instructions will likely hurt your application, and it certainly won’t give you a leg up. However, sometimes the language around these kinds of communication can be unclear, so if you’re unsure of what a school’s policy is regarding letters of intent or interest, we recommend that you call their admissions office and ask.
About the Author
Dr. Shirag Shemmassian is the Founder of Shemmassian Academic Consulting and one of the world's foremost experts on medical school admissions. Over the past 15 years, he and his team have helped thousands of students get into medical school using his exclusive approach.
