Medical Waitlisted TX resident - How should I handle letter of intent?

[Mr.Smile12]

Hello everyone,

I've been waitlisted at one of the schools here in the great state of Texas. I've read a few guides and articles for people in my situation, but would like to field some input from some of the excellent resources/users here on SDN. I'll provide some facts about the school and then posit some courses of action that I'd like some feedback on.

Background

• I interviewed right before Thanksgiving.
• The school accepts one LOI and allows for one additional LOR to be submitted directly to the school on my behalf
• I'm a professional non-trad applicant (not currently in school) working in a hospital for the past 3.5 years, so no academic updates from the Fall semester.
• My original 4 LOIs came from: an undergrad prof whom I TA'd for, two MD's who are my direct bosses with whom I work daily, and a RN whom is my research department supervisor.
• I interviewed at 2 schools in Texas and 0 OOS so far this cycle. This school was my top choice of the 2 schools in Texas I've interviewed at.
• I have applied multiple previous cycles and have made purposeful, thought-out improvements to my applications since then. I'd be thrilled to matriculate at this school this cycle.

Action Items

• I've already reached out to an additional doctor with whom I work and he's agreed to write an additional LOR on my behalf. Should I reference this fact in my LOI? Since it will be submitted by the doc directly to the school and not by me.
• The Texas schools know whether or not you got into another Texas school by virtue of the TMDSAS match process, and therefore they know I ranked them 1st. They don't know about my status at OOS schools. I am 99% confident I would matriculate here over any other option if accepted to save bank on tuition and get to stay in my home state, the only possible exception being if I got into the new school opening at the University of Houston (but they haven't opened applications yet for this cycle). I do intend on submitting an application there once they receive pre-accreditation status. Given this, is it disingenuous for me to write the following in my LOI (paraphrasing): "If offered a spot at X school, I would withdrawal my application from all other schools where I am currently being considered and intend on matriculating at X school". I would be over the moon to be accepted off the waitlist here, but I do plan on throwing an app in at UH once they open up their applications. I want to phrase this the best way without hurting my chances with my LOI (and technically speaking, I'm not even being considered at UH yet since they aren't pre-accredited, so the statement isn't wrong, but this is why I'm asking for help). Therefore wording this the right way to convey my intent to matriculate at X school in my LOI is important.
• Since I am a professional non-trad and can't offer academic updates in my LOI, any input/advice on how to optimize my LOI is appreciated.

Thanks, y'all.

I'll admit I am not in the TMDSAS so I don't know exactly how they communicate with each other about offers extended or waitlist statuses. That said, did you keep up contact with the schools that interviewed you from previous cycles? What was the nature of that relationship, and how did you keep it going and updating the admissions director about your progress? I cannot vouch for what my peers in admissions ask when it comes to communication, setting goals for improvement, and updating progress, but I think understanding that an admissions director or faculty member knows your efforts to improve is important. When it comes to talking to skeptical faculty members, we need to have the confidence to point out where you have listened to advice and made improvements to gain more trust that you have the motivation to succeed.

I also am not sure of the specific applicant "traffic rules" are in TMDSAS. For any post-interview communication, I would emphasize what impressed you from your interviews and try to demonstrate your interest in the schools from what the university's press releases or alumni office stories are when they are released. I would be very mindful about what new opportunities at the school continue to feed your interest in attending their program. I wouldn't necessarily play the "I'll attend your school if offered a spot" card; we hear that all the time, but it doesn't ever seem to sway the faculty members on our committee unless you fit some need in the class (demographically or geographically).

So it's hard to be patient, but realize that you want to come into receiving an offer without the air of desperation even if you don't have an offer. A strong advocate for your application would have known your persistence in applying for the third time and would know your situation well enough to determine whether you would be strongly supported as a student there. That's why I ask you about the nature of your ongoing networking with the schools you already interviewed at from previous cycles.

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[Mr.Smile12]

I had only 1 interview from previous cycles, and that was last year at a OOS MD school. And I did keep up communication, so far as to the extent that they was permissible. I sent detailed thank you letters to their admissions staff following the interview, inquired about feedback following my rejection (which they did not give). I emailed them again asking about how to word my "what have you done since your last application" secondary essay in context to detailing what I had one since my interview. I reached out to a now-MS3 who was one of the student reps whom helped run the interviews last year asking about the app process and we communicated back and forth a few times via email.

I also corresponded with an assistant admissions director at one of the TX schools, had a great telephone conversation when seeking feedback (very few schools provide individualized feedback) and I incorporated her feedback into improving my secondary essays to that school and still didn't get an interview.

Of the 3 schools I've interviewed at (2 TX this year, 1 OOS last year), I was genuinely more impressed with the overall interview experience, facilities, friendliness of the staff and students, and the overall culture than at either of the other schools I had interviewed previously. I talked about this in my thank you letters I sent them following my interview. So you'd suggest just repeating some of those same notions in my letter update?

I don't know when you interviewed but I normally received a thank-you note within the week of my interview with a candidate. (Granted, I told ALL who interviewed to make sure they send followup communication within a week.) I suppose if you wanted to send a followup communication, you can make a deeper statement reflecting on how you learned a lot more about their program. It's nice to show your gratitude, even if it doesn't necessarily benefit you when your file comes up for review. (I know for me, I always kept cards and copies of thank-yous my office received in the file, in case it was of any value to my faculty.)

Interesting. So the "intent" aspect of a LOI doesn't carry much weight in your opinion? (Unless the applicant would be a highly unique/desired matriculant in the class)? I think my professional , clinical, and research experiences are in the 99th percentile of most medical school matriculants, but my GPA is below average, MCAT above average. So I don't think I necessarily fit that highly desired category of being a 4.0/520 former Army medic with a Nature pub.

When you receive dozens to hundreds of those LOI's, one can see how valuable those communications are. It means nothing if we don't have a seat available for you. Every school will have its process on handling waitlist applicants. Some are demographically oriented (for example, replace a spot yielded by a woman with another woman) while others are straight-up by metrics. You'd be surprised how many MCAT above averages there are on a waitlist. In my opinion, the only situation I can think of where LOI's can be valuable is if the admissions office gets surprised with a suddenly expanded class size and the director has to fill a larger number of seats quickly. That doesn't happen except perhaps at new schools waiting for accreditation decisions.

Yeah I don't want to come across as desperate, but given the numbers game and the fact most applicants don't get a spot and that this is my 3rd cycle applying after having made a lot of improvements to my app, I sort of am desperate haha. That's why I'm hoping for some help wording my update letter diplomatically with candor and tactfulness given that this may very well be my only A/WL for the cycle and that I may not get another interview anywhere else.

The advanced networking before applying becomes important here because "good" admissions staff will have had a relationship with you and be able to vouch for you (for better or for worse) during deliberations. However, there really isn't much anyone can do if there isn't an available seat, and each admissions office has its own way of filling seats.