Are Md/phd rec letters make-or-break, or just break?

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Like the title says, can MD/PhD letters of rec from PIs get you interviews if they are really good (like high GPA/MCAT)? Or are they more like personal statements which usually only effect your app if they are really bad?
i also want to add that i happen to think my personal statements were what got me interviews at duke and columbia. adcom mentioned them to me specifically.
 
i also want to add that i happen to think my personal statements were what got me interviews at duke and columbia. adcom mentioned them to me specifically.
I'd like to add that also I think my personal statement played an important role. It was brought up during what I felt were my most meaningful/sincere interviews. I feel I have overall very solid LoRs, as well as one from my current PI who told me they'd never written a stronger one. I'd worked with them the longest and I can't imagine it not playing a fairly large role too.

Edit: My GPA was above the average but not a 4.0 and my MCAT below most MSTPs' average
 
i also want to add that i happen to think my personal statements were what got me interviews at duke and columbia. adcom mentioned them to me specifically.
sameeeeee
 
A lot of people don't believe me at-face-value when I tell people that we read your application and that a single number doesn't measure you, but several easily measurable values can exclude you. It happens, but it is incredibly rare that an MCAT of 500 or less gets admitted into a MD/PhD program, or that a cGPA below 3.00 does. Although it is true that not applying will always be rejected, a plan to remedy at least one of these values is most often necessary. Once you get by the minimums of that particular program, your application essays and LORs matter. Those minimum academic numbers vary and you can ask directly to each program in person, not in writing. I can tell you that we truly evaluate holistically, and although my medians are high, we review seriously applicants (and invite/have accepted) with life stories that explain certain numbers. Nevertheless, lower numbers will have a lower probability for an invitation and for an acceptance.
 
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