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Honestly depending on what it was you were hospitalized for this might be a "choose the worst of two evils" situation.

Can you just have a come to Jesus meeting with your coach and ask if he'll include it? Or are you not that close?
 
We're not too close, unfortunately. Another reason I'm hesitant to ask for a LOR is that he seemed a bit upset about my hospitalization? I met with him a few weeks after being discharged and he asked why I went to a physician instead of a team mental health counselor
Ah, yeah, absolutely do not get a letter from this person.

If asked you can just say he was a very hands-off individual/high level organizer and you felt like others knew you better. Which from reading your information is the truth. Just not the whole truth
 
FWIW, I only had 1 letter from one of my MMEs and I got a secondary from UCI, UCLA, and UC Davis on the first day and these schools screen heavily.
 
We are definitely not looking to match your MME with your LOR. Not sure a letter from a coach is super relevant to med school admissions anyway! And MME are activities that had meaning for YOU, no matter how many hours you spent or whether your involvement was high-level. Doesn’t matter at all what your coach thought of you; it matters what you learned from your experience.
 
This just popped into my head now, but I'm wondering if not having an LOR from someone associated with one of my MMEs will be a red flag. Did varsity sports in college, but ended up sort of having to step back from competition a little bit when I went through some personal stuff (wasn't taking care of myself, ended up being hospitalized, it kinda sucked). I decided not to ask my coach for a LOR because he's very aware of the situation I dealt with and I didn't want to risk him potentially mentioning it in a letter.

My involvement in sports was the activity I spent the most time on in college and was one of my MMEs: will it look bad to adcoms that I don't have a letter from my coach? I have LORs from my two other MMEs
As others have said, I think its totally fine to not have a LOR from every MME. I did extensive nonclinical volunteering (listed as MME) at a homeless shelter and I did not have any corresponding LOR.
 
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