I agree, and I tend to stick to the "framed hand written thank you letter" plan, but a number of people who are providing letters for me, are professors that I have grown to share a friendship with. This is not mere sycophancy; one of my professors had passed away, and I went to his house and made dinners for his family while they were in mourning, as they were not allowed to do so themselves while observing memoriam for the lost. Multiple professors, who're writing my letters, have transitioned from teacher, to mentor, to friend. They all even signed my college yearbook. I am proud to have friends that can give me sound, objective advice when I'm in need, and I am honored that they are willing to give me their blessing in a medical school letter of reference. Steaks, Salmon, Pheasant. Beluga Caviar. Russian High Tea. Peter Lugers and The Palm. When the news of good fortune (fingers crossed, toes crossed, greater tubercle of humerus crossed) rolls in that I have been accepted to medical school, I'll be making alot of restaurant reservations to share an evening of reflection and celebration with each one of my professors who I now proudly call my friends.