POLL/DISCUSS: Should prehealth offices drop committee letters?

[Mr.Smile12]

Over the last five years, many prehealth undergrad offices are dropping their commitment letter processes as they have found marginal benefits to their advisees. Many on this forum have expressed frustration about being excluded or the timing of these letters for their candidacy.

Answer the question and voice your opinion behind your vote.

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[LizzyM]

As a recipient of these letters, I can say that some are very valuable (all of the Ivies, Hopkins, Duke, Emory, just to name a few ) but many are not.

I have learned from some folks here that the letters can be onerous to obtain including very early and unyielding deadlines to participate, a charge for the letter, and the feeling that the committee is uninformed (true in some cases but not all).

Some of the best committee letters will tell a story you can't easily tell and package you to be attractive to adcoms. When you tell of a hardship it can sound like an excuse but a good committee letter can describe it in such a way that we want to nominate you for sainthood. Of course, good individual letters from faculty who have known you for a number of years and in different roles can do the same, not everyone has had those types of interactions.

In my experience, most of the public schools are not great at committee letters and some of the private schools fall short too. Bad letters are very rare and these days, the way most Americans (but not Canadians, God bless them) write letters, it seems like every pre-med walks on water. For that reason, rather than get rid of committee letters, I'd love to see an elimination of all letters of recommendation. That said, I voted "no" because if letters are to be required, I'd like to keep committee letters.

 

[wysdoc]

I think some colleges will drop the committee letter because they require a tremendous amount of work to write a good one.
However, the better pre health offices know what should go into a strong letter and can write one that is helpful.

I don't like that "some" colleges will only write such a letter for their best applicants, which makes them be able to say they have a very high percent of acceptance to med school from their college. I think they conveniently leave off the students who were pre-meds but didn't get one of their letters.
If a letter is so formulaic that a particular prof sends out the same letter for everyone, it would have limited value

 

[LizzyM]

Unfortunate that the students of podunk state universities have yet another inequity in this already uphill battle, especially at the t20 research institutes where pedigree matters. I am curious if admissions accounts for this when comparing between ivy vs state school applicants.

In my experience, no, they do not. That is not to say that such students don't have a shot but the odds are against them.

 

[Goro]

I get annoyed when committee LORs sing glowing praise of their applicant, but then score them like 4/5 instead of 5/5.

Ditto what the wise LizzyM said about walking on water with multiple C's/B-'s in the transcript.

 

[eigen]

We've moved to "for students who it benefits".

I think a lot of the discussion surrounding this is that a "committee letter" can be a lot of different things. I've run our committee letter process for the last half-decade or so, and we do them as composite letters: we solicit feedback from a wide selection of faculty, and ask them to submit "mini letters" on their interactions with the students. Then we interview the students and look over their packet. The composite letter draws from both our interviews and uses the content of the letters, as direct quotes.

The benefit of this for a lot of students is that it allows us to more holistically evaluate the student in context of their entire work at the institution. The con is that... this is an immense amount of time per student to do well.

Where it really benefits students is those who are (a) non-traditional, (b) majoring in something outside of the typical, or (c) who have not had repeat instructors for many of their science courses. Often, these are students who may have had lots of faculty who can write positive but short evaluations of a student, in the context of a single class, or a single extracurricular. If a student was just picking three of those faculty, they would not have a strong set of letters. But 8-10 of them put together as a single composite letter? That can more fully contextualize the student.

It puts them on par with the students I can write a "strong" letter for that talks about their progression from classes they had with me in their first year through their last year, who I advised and had in my research lab or who were leaders in clubs I advise.

Going back to the original point... when I got to my institution, the letters we were writing were next to useless. There was a staff advisor who wrote them, based often on a short interview with the student and little to no context.

 

[eigen]

The people on most premed committees are grossly misinformed on admissions and what it takes to be a competitive applicant.

My students tell me this all the time. Interestingly enough, they have very different opinions on what it takes to be a competitive applicant to all of the alumni who've gotten into medical school, as well as the people I talk to regularly on admissions committees.

I'm not saying there aren't clueless advisors out there, but there are an awful lot of students who take "pre-med rumors" as facts, and are often far less informed about the actual process than they think they are. And they tell me all the time that I'm grossly misinformed about admissions and what it takes to be a competitive applicant.

 

[IlDestriero]

The problem is that there is a lot of inconsistency and some bad advisors out there. Sadly, some are biased or may be gatekeeping to prop up stats. As an example, I went to an elite private school and the pre med cub was run by the pre med advisor and committee chair. My friend and I were peripherally involved in the cub from the start of freshman year, for many reasons, while doing our own thing re research, volunteering, service, etc. More than adequate.
When it came time to work on application planning the advisor told both of us we were not good candidates and we should go to dental school. Not surprisingly we both declined her offer for what would have clearly been a glowing committee letter. He went to a top 5 med school and is now the CEO of a major medical services company and I, always the slacker, only went to a top 20 school, but on a free ride courtesy of Uncle Sam, and went on to be faculty at at 2 top 10 universities and work at a world class Children’s Hospital. But dentist would have been good too, I guess? 🦷 🤢

 

[LunaOri]

Premed committees and committee letters vary. Some committees actively discourage applicants from seeking a letter so they can maximize their "yield", and that's awful. That being said, I skim the letters looking for tidbits of information that are unique to that student. For example, I recently saw the application of a student from a bottom-tier college whose committee letter said that they were one of the best pre-med applicants they had worked with in the past 30 years; that helped.

 

[eigen]

A vast majority of committees are poorly run, and this only has the potential to hurt students.

I feel like this is a claim that needs some sources other than "I say so". How many committees have you personally interacted with? Are you just extrapolating from your experiences, or are you relying on people complaining about their committees on SDN / Reddit as a data source?

Making general claims lacking evidence is not something I'd hope to see from an applicant to a field based on empirical science.

This would make med school admissions an unequal playing field from university to university. Rather why not just let medical school admissions just make their own decisions?

This inequity is just as apparent if not more so with individual letters. A student at a school with class sizes of 20 has a lot more instructor access than one with classes of 200, and is likely to get stronger, more tailored letters. A student who doesn't have to work to support themselves can spend more time volunteering or working in a research lab, and as such is going to get stronger letters. Time to study / ability to pay for MCAT prep is inequitable, and students going to schools with grade inflation have an advantage over those who don't.

Why does the existence of letters as a source of evidence mean that medical school admissions aren't making their own decisions?

 

[eigen]

Some committees actively discourage applicants from seeking a letter so they can maximize their "yield", and that's awful.

And then they use this to advertise their school based on ****ty pumped up admissions stats. Which students then think are normal, and so prospective students choose that school so they can succeed in being a doctor.

I spend so much time explaining to HS students and their parents that they should be skeptical of schools that report 90% acceptance rates from their undergrads.

 

[eigen]

You say committee letters are a source of evidence. What are they a source of evidence for?

Did you read the several paragraphs I provided upthread discussing that?

However, I will bring up the point that I see many complaining about committees, but no students praising it. I wonder why.

Probably because people don't tend to complain online about things that they're happy with, as a general rule.

Im wondering If you have any data that supports a majority of premed committees benefit applicants, when it seems the premise of the question is the opposite.

This is a completely unrelated discussion to the claim you made. You said that a majority of committees were poorly run, which isn't about letters. It's about pre-med committees and advising. They're related, but the claim isn't the same.

With no committee, then there's no structure to ensure a university can meet the pre-requisite requirements students need for medical school. There's no body to provide equivalence letters for students when a course description doesn't translate in an application. There's no dedicated advising for students who are pre-med (or pre-dent, or anything else). Suggesting that (a) most committees are bad, and (b) committees actively harm students over not having one is a wild claim, and as such deserves some support other than "there are unhappy people complaining on the internet".

 

[RunnerDad]

Committee letters can cause inequity and promote unfair advantages based on prestige and nepotism. However, as some of the adcom members have explained above, they can also be extremely informative. These two statements are not mutually exclusive.

My premed kid has lived a privileged life, but not so privileged as to attend a school that offers committee letters (let alone meaningful ones). As with many benefits of privilege, if my family member were the beneficiary of a committee letter, I might well vote to keep them. Since they aren't, my emotional response is to find the fault in these letters. I'm not casting a vote, because it's more important for the applicants and past applicants themselves to have a say in this than someone like me.

 

[eigen]

Committee letters can cause inequity and promote unfair advantages based on prestige and nepotism.

Can you elaborate on why you feel this is more prevalent in committee letters than... any letters?

 

[RunnerDad]

Can you elaborate on why you feel this is more prevalent in committee letters than... any letters?

A committee letter from an Ivy school, where undergraduates may have attended via legacy admissions, and which are already viewed as "better" schools than run-of-the-mill state universities, will give weight in an applicant's favor. One "leg up" builds on another. That's all I meant. It may not be true, but that's how it's perceived -- and perceptions impact confidence in a process, for better or worse. I don't have statistical data to support this opinion, it's just an opinion.

 

[pdidd3]

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Can you elaborate on why you feel this is more prevalent in committee letters than... any letters?

Because as a premed, I have some level of optionality of where I can seek letters from, like maybe outside my institution if my school is not good. Unfortunately this cannot be done with committee letters.

I don’t believe committees are inherently bad, but I think injecting their opinion of an applicant into the application is what I don’t like. Why should committee members who have not attended medical school have a say in my application?

Broader question for all the adcoms: Why are nonphysicians even involved in the medical school application process? I understand some administrative staff to handle logistics and community members to ensure the candidate is a fit for the community. I do not understand why anyone else is involved.

 

[eigen]

A committee letter from an Ivy school, where undergraduates may have attended via legacy admissions, and which are already viewed as "better" schools than run-of-the-mill state universities, will give weight in an applicant's favor.

Is that different than letters from Ivy faculty, or faculty at T10 medical school vs. letters from faculty at a no-name regional public university? In other words, what makes the "committee" part of the letter that much different in prestige?

The message from admissions committees is usually that the content of the letter is what matters, not whether it's committee vs. individual. As far as I'm aware, no schools current list a preference or requirement for a committee letter in US MD admissions.

 

[eigen]

Because as a premed, I have some level of optionality of where I can seek letters from, like maybe outside my institution if my school is not good. Unfortunately this cannot be done with committee letters.

But a committee letter isn't required? You still have the option of seeking individual letters, either in addition to your committee letter or in place of it. As far as I'm aware, no medical school currently requires a committee letter, and all I've seen have changed language that mentioned a preference for a committee letter.

I don’t believe committees are inherently bad, but I think injecting their opinion of an applicant into the application is what I don’t like. Why should committee members who have not attended medical school have a say in my application?

Isn't this the case for every letter? Pre-med committees are made of faculty, the same people that write letters for students. They're just faculty with experience in medical school admissions that have knowledge of what admissions committees want to see. Letters aren't usually about someone being a good physician, exactly, they're about someone's ability to handle the rigors of medical school coursework (why academic letters are preferred) and examples that speak to core competencies set up by AAMC.

I don't need to be a physician to write a letter about a students academic skills, science competencies, reliability / ability to grow and respond to feedback, communication abilities, etc.

 

[pdidd3]

Is that different than letters from Ivy faculty, or faculty at T10 medical school vs. letters from faculty at a no-name regional public university? In other words, what makes the "committee" part of the letter that much different in prestige?

The message from admissions committees is usually that the content of the letter is what matters, not whether it's committee vs. individual. As far as I'm aware, no schools current list a preference or requirement for a committee letter in US MD admissions.

Wow I did not know that medical schools had no preference with our without committee letters. That is not what my school emphasized to me. They made it seem like would be SOL without one. If true, def changes my opinion slightly.

 

[ecobio]

Wow I did not know that medical schools had no preference with our without committee letters. That is not what my school emphasized to me. They made it seem like would be SOL without one. If true, def changes my opinion slightly.

From what i understand, if your school offers a committee letter & you do not use it, it could possibly look suspicious to some schools. A couple of my secondary applications asked something along the lines of: If you did not submit a committee letter, and your school offers them, why did you not use it?

 

[eigen]

From what i understand, if your school offers a committee letter & you do not use it, it could possibly look suspicious to some schools. A couple of my secondary applications asked something along the lines of: If you did not submit a committee letter, and your school offers them, why did you not use it?

As someone who's school offers a committee letter but who sits down with every applicant to work out whether it's the best path for them or not... I don't think they really care, they just want to know why. There's no difference in success for students at my institution who use or don't use committee letters, what matters to the success is choosing a letter that adequately represents them and their time at the institution.

For example, there are some students who avoid our committee letter process because they have academic integrity violations that we would ethically have to disclose. They would prefer to pick letter writers who don't know that they had integrity violations, so they can avoid mentioning it. This is a shady reason to avoid it.

On the other hand, wanting to include perspectives from outside of the institution? Great reason to not use a committee letter.

 

[MrTruck]

The entire med school application process is jokes. LOR's are useless and everyone has used GPT for every essay. You have people holding on to multiple acceptances till the end of spring and an interview cycle that is mostly finished by thanksgiving. Make a ranking system like residencies use tbh and force commitment in January. Use some SOAP-like method to open seats for remaining applicants.

 

[LunaOri]

A committee letter from an Ivy school, where undergraduates may have attended via legacy admissions, and which are already viewed as "better" schools than run-of-the-mill state universities, will give weight in an applicant's favor. One "leg up" builds on another. That's all I meant. It may not be true, but that's how it's perceived -- and perceptions impact confidence in a process, for better or worse. I don't have statistical data to support this opinion, it's just an opinion.

Perceived by you--not by adcoms! The advantage to a committee letter is that it comes from an official school office, so we know it's not written by the applicant's parent's buddies. There's no difference between a committee letter from an Ivy and one from a state school. Also, these days it is common for the preprofessional committee to submit the LOR as a packet and not write an evaluative "committee letter". The committee will pass along general information about the school, and the percentage of students who achieve a certain GPA, etc, but often doesn't comment on the individual student.

 

[RunnerDad]

Perceived by you--not by adcoms! The advantage to a committee letter is that it comes from an official school office, so we know it's not written by the applicant's parent's buddies. There's no difference between a committee letter from an Ivy and one from a state school. Also, these days it is common for the preprofessional committee to submit the LOR as a packet and not write an evaluative "committee letter". The committee will pass along general information about the school, and the percentage of students who achieve a certain GPA, etc, but often doesn't comment on the individual student.

Very helpful information, thank you!

 

[LizzyM]

Please note that some "committee letters" collect and compile the letters

As someone who's school offers a committee letter but who sits down with every applicant to work out whether it's the best path for them or not... I don't think they really care, they just want to know why. There's no difference in success for students at my institution who use or don't use committee letters, what matters to the success is choosing a letter that adequately represents them and their time at the institution.

For example, there are some students who avoid our committee letter process because they have academic integrity violations that we would ethically have to disclose. They would prefer to pick letter writers who don't know that they had integrity violations, so they can avoid mentioning it. This is a shady reason to avoid it.

On the other hand, wanting to include perspectives from outside of the institution? Great reason to not use a committee letter.

There are several ways to do the "committee letter" and some of them do allow the perspective of those outside of the school. Those commitees bundle the letters together and may quote liberally from them to make their points about the applicant. Some make a point of including all letters in full and others will just quote the letters and you can't know if they just cherry-picked the best parts. Some schools just provide a letter service and don't make any comments on the applicant.

Some committee letters might have an intro that explains that there are two versions of the course that meets the physics requirement, one that is calculus based and one that is not, for example, or other peculiarities of the curriculum.

Some schools will classify the students into very good, excellent, most excellent, and exceptional or some such words that all sound great until you figure out that very good is the bottom of the barrel. Some will actually show you all the those categories, tell you what percentage of last year's pre-med crop was in each category and what proportion of each group matriculated into medical school (thus showing the predictive nature of their classifications -- or a self-fulfilling prophesy). One school even classifies a student on several domains so that someone can be excellent in one domain but merely average in the others.

Some adcom members do wonder why someone has not availed themselves of the committee letter when it is well known that the school has one and, has been the case for me, the writers are known to me as members of the pre-med offices at our "pipeline" schools.

 

[Mr.Smile12]

A reminder I wrote...

Eight Questions About the Pre-Health “Committee Letter” - SDN

The Student Doctor Network provides free tools, resources, and advising services to help students become health professionals.

www.studentdoctor.net

 

[eigen]

Some schools just provide a letter service and don't make any comments on the applicant.

This is true. I thought when it was compiled letters with no cover letter, that showed up differently? I know "Letter Packet" is often different from a "Committee Letter". I know they show up differently as categorized requests (Individual Letter, Committee Letter & Letter Packet) and AMCAS differentiates the two.

A standard cover letter is still considered, in my understanding, a "Letter Packet" if it does not offer separate evaluation of the student (Types of Letters of Evaluation). I've never been quite sure if they show up differently on behalf of the receiving school, but I do think differentiating the two in the discussion is useful.

There are several ways to do the "committee letter" and some of them do allow the perspective of those outside of the school.

Also a good point. I guess I should clarify and say that a school not being willing to include outside perspectives when a students major writers would be from outside the school would be what I consider a valid reason to not have a letter. I usually see this as particularly common for, say, transfer students who's research has also been outside the school, or students who've done a post-bac / worked for a few years and are removed from their undergrad institution.

I know ours differs from the norm of a composite letter in that we do not let students solicit the letters. One institution I worked for invited every faculty member who had taught the student a chance to contribute, and my current institution solicits 10-15 contributions from a wide range of faculty who taught the student. Both aim to provide an even rather than cherry picked view of the students progress.

 

[Mr.Smile12]

Comment #1 applies to so many committees...

I appreciate @pdidd3 's response above. I applaud the advice, and HPSA/SDN is doing surveys to make sure we understand your experiences with your application journey (the Fall 2024 experience survey is open for a few weeks longer)! For the most part, I can summarize their advice as "welcome to higher education! 🙂"

I agree that while maintaining your professional relationship with advisors is extremely important (and continues through the rest of your adult journey, whatever your path), some advisors are as passionate about making sure health professions programs see the unique qualities and experiences of students they feel can make an outstanding impact. There are a few prehealth/health professions students who do speak effusively about their prehealth advisors and even their committees (Here are our articles about our Advisors of the Year: 2022, 2023, 2024a and 2024b).

What makes this journey very difficult is that the distribution of real mentors and champions is not equitable. Larger institutions will have more administrators who do the prehealth advising while the faculty do the teaching/research. What is important is finding the champions, the mentors who care about you and your personal/professional approach to your future. Sure, most of them are not trained as health professionals or science experts, and that will happen when you are in medical school too BTW (comment #3 should be embroidered on the inside of your white coats).

As someone who has been working in "the system," let me point out how challenging changing the system is. You need success along your journey to give you credibility, but you also need the humility to know why the stakeholders act or react as they do. Higher ed is a very strange world, and medical/health profession ed is its own level of strange. At least with "Becoming a Student Doctor" and "Treating Trans Patients" we give you some insight to what the stakeholders think and the challenges you all face (to be supplemented by curricula and student/professional advocacy). Re: comment #4... we post a lot about the challenges of the next 10 years. (What do you think about doctor/caregiver unionization?) Some very interesting AMA chats are included, but anyone who wants to go to medicine should keep an ear to what the AMA is doing. Then ask yourself why AMA doesn't have membership to over half of all physicians.

For point 4: If you want to make change: show you're excellent and want to be involved in certain questions or projects. I hope many of you newly accepted applicants get involved with your AMSA/SNMA (or similar) chapters as you may have in your prehealth days. You'll get immersed in the overall challenges that peers think are important. Do well enough that your faculty consider you for admissions ambassadors or student seats on important leadership/governance committees such as curriculum or student promotion. Your medical student years give you some latitude to be a minor troublemaker, but make sure you make "good trouble." Stay connected to the network here... we've had people on this forum for decades, and I'm sure we can tell you how much they have had to "make change" with their years in school well back in the rear-view mirror. This means knowing when you need to do well with "game play" (comment #2) and when it is truly safe to share with mentors or ombudspersons or family.

I've worked with many prehealth advisors who care about advocating for their students, and not all of their personalities are docile when the rooms aren't filled with students. I've been impressed with many of their insights to make sure the process is less intimidating and cutthroat as other prehealth applicants make it to be. Similarly, many admissions and higher level admins I have worked with fight to keep some working bandwidth for the interests of applicants or students. I'm naive enough to believe in the common good and humanity of everyone I have the pleasure working with or advising, and that hopefully makes a difference.

P.S. Watch the forums or newsletters: we want to hear your perspective on a few topics in the coming years, and we want to know the areas where more attention should be paid.

 

[Mr.Smile12]

The entire med school application process is jokes. LOR's are useless and everyone has used GPT for every essay. You have people holding on to multiple acceptances till the end of spring and an interview cycle that is mostly finished by thanksgiving. Make a ranking system like residencies use tbh and force commitment in January. Use some SOAP-like method to open seats for remaining applicants.

So, TMDSAS. Though the Chatbot comment still can apply.

Or an admissions lottery system.

New MD Program admissions process | School of Medicine | Queen's University

meds.queensu.ca

 

[HuskyMD Emeritus]

I was an application file reviewer who selected applicants for interviews the past couple of years. This year I'm doing interviews and the traditional interviews at my school is open file, so I still get to review the application. I find committee letters somewhat helpful but have seen some miss important qualities of the applicant mentioned in the individual letters. As a result, I read every single letter even if there is a committee letter that raves about the applicant.
Most committee letters nowadays are letter packets, with the cover letter mostly telling the reviewer the school grades, how challenging the school's courses are, and how they graded the students during COVID.
My advice to the applicants on SDN: Getting a truly good LOR takes a lot of work, you need to build a relationship with the writer, so start early. What I think is a strong LOR is one that reflects the relationship the writer has with the student, it will give a better evaluation. Sometimes I can even feel the enthusiasm the writer has for the applicant (not just because the writer said "I enthusiastically recommend ...." And there are ways the writer can describe the applicant that make that applicant special, but I can't tell you because the LORs are confidential.
Also, try not to get too many letters, it takes a lot of time to go through the entire application. I groan every time I have to review an application with 5 or 6 LORs. 3 strong LORs is better than 5 standard LORs.
And in case you applicants have not seen what an LOR looks like and why it's difficult to sift through them, most of the LORs are formatted like this:
1st paragraph: I am Dr. So and So, I am world famous for this or that and am an expert in my field. ....
2nd paragraph: I have been teaching for many years, my classes are known to the the most difficult......
3rd paragraph: Applicant was in my class and did well and I support his application to medical school.
I don't put a lot of weight on comments like "... Applicant was in the top 10% of all the students I have taught..." because this comment is very common. Even the doctors with whom the applicant shadowed will put this comment in their letters ( top 10% in shadowing???? that's not a helpful LOR).

 

[cocacola1942]

The entire med school application process is jokes. LOR's are useless and everyone has used GPT for every essay. You have people holding on to multiple acceptances till the end of spring and an interview cycle that is mostly finished by thanksgiving. Make a ranking system like residencies use tbh and force commitment in January. Use some SOAP-like method to open seats for remaining applicants.

 

[eigen]

1. Do not treat these committees as people who have your best interest at heart. As they themselves have pointed out, many committees do not. They have incentives that are not aligned with yours such as increasing the reputation of the undergrad at your expense. Speak with them in a minimal and professional capacity only. Tell them what they want to hear. Suck up to their egos during the committee process and campus interviews. This letter is another hoop you have to jump through, with likely little upside to you. Clearly many things arent even standard across schools.

Also, find this out when you choose your undergrad institution if you know you want to go this route already. I meet so often with students (and parents) who are attracted to "top institutions" that tout super high admissions rates because they play the game and don't support most of their students, and have committees that are (as you mention) entirely administrative and depend on this for a job.

OTOH, our committee work is all volunteer and 100% faculty. None of us do it because it's a job. We also view our primary goal as advocating for our students and helping them find where they will be successful in the system. Does this mean our (honest) admissions rates are lower? Sure. Because they include the person with poor stats but an upward trajectory who knows they have an uphill battle ahead of them. And they include the person who decided in their senior year they suddenly wanted to be a doctor and threw an application together despite our advice.

So for all the pre-college folks lurking... choose your undergrad carefully. If you visit campus, meet with the pre-health committee and advisors. If they won't take time to meet with you as an applicant, that tells you a lot about how much time they will make for you when you're there. Ask probing questions about their goals, their motivations, and things like "how much support to alumni get for their applications". And listen for honest, rather than unrealistically positive answers.