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Prob not absolutely required but highly advised.

depends on the school/ a few may require all PI letters. You should check schools‘ requirements.

for MD PhD, yes you’d need letters from all research exp.
 
On that note, if I think a letter is going to be okay (no strong) should I include it? My research that got pubs was done remotely, so I never met my PI in person. I am sure he will give me a letter that will be average strength. Would it be better to not include it if I have 3 strong letters from professors already?
In my book, a PI LOR isn't really needed unless you're gunning for Md/PhD.
 
The top 20 research schools will find fault with the least little thing because they need a reason to reject 85% of the applicants before interview. Not having a letter from a PI you worked with closely enough to co-author a paper together is a red flag. YMMV. Proceed at your own risk.
 
The top 20 research schools will find fault with the least little thing because they need a reason to reject 85% of the applicants before interview. Not having a letter from a PI you worked with closely enough to co-author a paper together is a red flag. YMMV. Proceed at your own risk.
Does this apply if you are a non-trad and the research was 7 years ago in college? 1 mid-author paper from my time in that lab, I could get a letter of rec but not sure how relevant that is given how much time has passed and how much I've changed since then. Will have a letter of rec from the research I've been doing since college (2 papers, 1 first author, pending acceptance). My GPA is already a red flag for T20, but I've been trying to recover that through post-bacc, trying to avoid more red flags.
 
Thank you! In your opinion, are nonclinical volunteer letters worthless? I have some hospital volunteering and charity work letters I could throw in that are fairly strong.

Yes. Hospital volunteer letters are a complete waste of time. If you worked full-time for a charity, that could be a useful letter. If you were volunteering for special events, fund raising or the usual 2 hours per week sort of thing, much less valuble.

Does this apply if you are a non-trad and the research was 7 years ago in college? 1 mid-author paper from my time in that lab, I could get a letter of rec but not sure how relevant that is given how much time has passed and how much I've changed since then. Will have a letter of rec from the research I've been doing since college (2 papers, 1 first author, pending acceptance). My GPA is already a red flag for T20, but I've been trying to recover that through post-bacc, trying to avoid more red flags.

If something is relevant enought that you list it in the work/activities section, there will be those readers who switch to the letters section to see if there is a corresponding letter from someone in that lab. They won't necessarily look at the date of the work. the letter would say that they knew you 7 years ago when you were in the lab and contributed by doing x y and z and are remembered for __. Some will repeat whatever you tell them as to what you are doing now and make some kind of appraisal of your potential as a medical student. Sometimes it will be a backhanded compliment that you weren't cut out for research but that you have the attributes of a good physician.
 
The top 20 research schools will find fault with the least little thing because they need a reason to reject 85% of the applicants before interview. Not having a letter from a PI you worked with closely enough to co-author a paper together is a red flag. YMMV. Proceed at your own risk.

Hi @LizzyM and @Catalystik , I had the opportunity to work with a Nurse- Scientist who I performed clinical research under. I worked with her on a paper, got a poster presentation and an oral presentation. She was a great individual who mentored me throughout. However, the problem is she is highly against physicians as when she was working in the 60s, she feels they looked down her and other nurses .

She has tried to get me to deviate my path from medicine; for ex., I told her I'm passionate about religion and she suggested I choose Theology school. I told her I enjoy patient care and immediately she said I should choose nursing school. I think she is under the impression that i'm not 100% on medicine.

I really want to ask her for a letter, but I am worried that the letter might say something wrong about my desire to be a physician or something negative of that nature. What would you advise in this situation? Is there any way i can find out her thoughts on the matter in writing me a good letter?
 
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Hi @LizzyM and @Catalystik , I had the opportunity to work with a Nurse- Scientist who I performed clinical research under. I worked with her on a paper, got a poster presentation and an oral presentation. She was a great individual who mentored me throughout. However, the problem is she is highly against physicians as when she was working in the 60s, she feels they looked down her and other nurses .

She has tried to get me to deviate my path from medicine; for ex., I told her I'm passionate about religion and she suggested I choose Theology school. I told her I enjoy patient care and immediately she said I should choose nursing school. I think she is under the impression that i'm not 100% on medicine.

I really want to ask her for a letter, but I am worried that the letter might say something wrong about my desire to be a physician or something negative of that nature. What would you advise in this situation? Is there any way i can find out her thoughts on the matter in writing me a good letter?
You can outright ask her about whether she could write you a strong, supportive letter for med school. If she is not enthusiastically agreeable, and even in the least bit dismissive, don't get the letter.
 
You can outright ask her about whether she could write you a strong, supportive letter for med school. If she is not enthusiastically agreeable, and even in the least bit dismissive, don't get the letter.
You are right, I think it's best to be outright. Here is what I plan on saying, " ...... Do you feel comfortable in writing me a strong, supportive letter of recommendation for medical school? If you have any reservations whatsoever, please feel free to let me know as I completely respect your word and where you stand"
 
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