Medical School Admissions

January 20, 2009 7:35 AM

Asking for a friend: I am in interviewing at medical schools, and I am considering writing a letter of intent, but am unfamiliar with the protocols, expectations, and ramifications...

How much of a difference does writing a letter of intent make in the selection process and what are the ramifications (in medical school, while applying for residencies, and beyond) of backing out of a letter of intent?

I recently interviewed at a top tier, widely known medical school (A), and they will be reviewing my application in February. In the last few days (almost unexpectedly) I was also invited to interview at another top tier school (B) at the very end of February. Of course I would love to attend one of these schools, and from my research (culture, environment, location, academic structure, etc) I think my first choice will be school B. However, for various reasons I think that I have a better chance of being admitted to School A than School B. This guess is based on the date of my interviews (School B interview is only two weeks before March 15, when med schools have filled their slots), and my guess that School A is more selective in choosing who they interview. Because both of these schools are very selective, I want to write a letter of intent in order to bolster my application to School A, but if I am later selected for a position at School B I am likely to go there instead.

Boiled down: Do letters of intent help medical school applicants that have not been placed on a wait list, and what happens when an applicant backs out of the statements made in that letter? I am well aware of, and wrestling with, the morality of stating that I will attend School A when I have my doubts. I am trying help my chances of getting in to School A as much as I can, since my interview with School B is so late in the process. Also, will a letter of intent to either school affect my position at School C, a state university where I have already been interviewed and accepted?

posted by Science! to education (8 answers total)

Yes, letters of intent helps at any point in the process (unless you're talking about a school like Yale, that gets dozens of those things and know how badly you want to come to their school from the beginning). However, reneging on one is considered extremely dishonorable. You're writing a formal document stating that if accepted, you will come. That's called a contact. In doing so, you have lied to the dean. They won't pursue legal action against you, but don't even consider applying to that school for residency, and keep in my mind that petty politics haven't disappeared from the field of medicicne (Ha. Hahaha. HAHAHAHAHAHAHA) so it's not out of the realm of possibilities that the information will be shared among admissions offices.

In other words, don't do this. Even if it doesn't hurt you in the long run, because as you said the chances of both acceptances are slim, it's just very low class behavior.

Letters of interest (where one doesn't promise to attend if accepted, but raves about the school) are an option, but not terribly effective for top tier schools. So, hedge your bets with A (and cancel the interview with B if accepted) or don't send a LOI at all.

Lastly, no, C is unaffected here. Congratulations on being accepted to medical school in the united states! Not an easy feat.
posted by namesarehard at 10:11 AM on January 20, 2009

Of course, it is actually called a contract. Not much proofreading going on here. Ugh, Jeez, the whole thing needs an edit. medicine, amongst. Forgive me.
posted by namesarehard at 10:13 AM on January 20, 2009

It will not help your application. I have asked our director of admissions this question when a friend wanted to send a letter of intent, and he mentioned that intent letters are ignored at pretty much all schools in the country. There are specific procedures in place for accepting applicants and letters of intent do not fit in there. That said, it also doesn't hurt and makes you feel better over a process of which you have no control at this point, that's why many people do it. Sending a letter of intent which you would not honor is pretty sleazy though. But the chances that it would affect you in the future are negligible unless you happen to run into the same people in the future and they happen to remember you.
posted by Brennus at 10:14 AM on January 20, 2009

There is no clear answer to your question as such a letter will have varying impact depending on the typical practices of each individual admissions office. At most competitive places it probably doesn't have any impact. If anything, a letter like this will only be at best marginally helpful (and only to someone waitlisted or right on the borderline) especially if you are unable to clearly and convincing express why that particular school is really "the right one" for you. That said, the conventional wisdom is that expressing additional enthusiasm/interest in a program certainly can't hurt, particularly if it is genuine.

While applicants are often corresponding with (and pestering) admissions offices after the formal application process is over, my understanding is that it's not that common to see very formal (in legalese) letters of intent. I could be wrong on that though as I'm a bit removed now from the process now.

I would however caution you about sending such a letter if you plan to back out of it. It's quite doubtful that a program will take legal action if you back out as they have no shortage of people on their waitlists most of the time and your letter probably wouldn't be binding anyway. However admissions directors (perhaps moreso at the residency level, but also for med schools) are notorious for communicating with each other particularly when they have significant overlap in their applicant pools. It might not harm the outcome of this application process, but it could potentially burn an important bridge for your future or even earn you a bad reputation at the place you end up if things get out.

Also, on an ethical level, if you're willing to write such a letter what's stopping you from sending the same letter to all the programs and how would that really be any different? You say you are grappling with the morality of such an act. Let me tell you as someone further along in medicine, that you really are on a slippery slope with this sort of thing. You will be faced with a barrage of far more difficult ethical decisions in the future -- in many cases your personal self-interest will be at odds with either that of your colleagues or worse, your patients. The wrong choice may have truly disastrous consequences. Not only is this a bad start and omen for the future, but ultimately for your own sake, I assure you that once you develop a bad reputation it's very hard to kick. It's really in your own best interests to maintain as unimpeachable an ethical track record as is possible.

My recommendation would be to send any formal declaration to B as it would be genuine and in good faith. Ethically, such a letter doesn't keep you from expressing additional interest in A in less binding language that reflects your genuine interest in A. You can continue to correspond with the folks at A and make attempts to bolster your application or express how you and A might be right for each other. Maybe even consider a second look/visit at both A and B. That sort of honest post-application communication will probably be just as helpful in getting you in without crossing the line or being dishonest. Really how this sort of thing helps your chances is by making your name and file stand out in the admissions officers' mind more than anything.
posted by drpynchon at 10:34 AM on January 20, 2009

It will not help your application. I have asked our director of admissions this question when a friend wanted to send a letter of intent, and he mentioned that intent letters are ignored at pretty much all schools in the country.

Well, that's not totally accurate. They're routinely ignored at the higher-ranked schools, but I know for a fact they are not ignored at 'pretty much all schools in the country.''
posted by namesarehard at 11:35 AM on January 20, 2009

Here are a couple of threads on SDN about LOIs:

one and two

I just skimmed them, so if they aren't helpful . . . there is a search function on the site that might come up with more results. SDN is a great resource, if your friend isn't already familiar with it.
posted by lblair at 3:58 PM on January 20, 2009

. . . Although, take the things you read on SDN with a grain of salt, since many of the members are premed know-it-alls who have no idea what they are actually talking about :-) but there are also some admissions committee members from medical schools who post on a regular basis.
posted by lblair at 4:00 PM on January 20, 2009

First year med student here. Never even heard of, and definitely didn't ever consider, writing any letters of intent. Sounds like a scam. =D

Go with the flow, bro. You'll soon find out that going with the flow is a necessity in med school. Or it'll kill you.

Congrats!
posted by expletivization at 5:02 PM on January 20, 2009