Does the reference letter we get from an MD have to be one we have known only through volunteering or shadowing, or can it be one who knows us personally? I'm asking because although i've shadowed docs and volunteered in hospital settings I wouldn't be anywhere near comfortable to ask them for a LOR. I've known an MD who's been a bit of a family friend for at least 5 years now and he would be able to provide a much better letter, but I don't know if that's not allowed.