Medical School Letter of Intent: How to Write One That Actually Matters

When you are deep in the medical school application process, the waiting can be excruciating. You’ve submitted your primary and secondary applications, crushed your interviews, and now… radio silence. It’s during this nerve-wracking period of purgatory that many applicants start thinking about sending a Letter of Intent (LOI) to their top-choice school.

But what exactly is a Letter of Intent? When is it appropriate to send one? And how do you write one that actually tips the needle in your favor?

In this blog post, we will break down the LOI step-by-step so you can make an informed decision — and craft a letter that truly matters.

What exactly is a Medical School Letter of Intent?

A Letter of Intent is a formal communication you send to a medical school stating that:

1. They are your clear first choice – if accepted, you will attend and withdraw your applications from all other schools.
2. You are reaffirming your interest in their program for specific reasons.
3. You are providing meaningful updates since your interview that strengthen your candidacy.

Think of it as the professional equivalent of saying, “You are my number one, and I’m fully committed to you if offered admission.”

Key Features of a True Letter of Intent

• Exclusive: You can only send an LOI to one school. NO EXCEPTIONS.
• Specific: It should be tailored to the school’s mission, values, and unique offerings.
• Justified: You are not just declaring your love for the school; rather, you are backing it up with specific reasons (both personal and professional).
• Professional: This is not the time for informal language.

A LOI is not just a “love letter.” It’s a formal pledge, and admissions committees take it seriously — which is why you must too. While the LOIs are technically not enforceable, not following through on a LOI is extremely unprofessional and can burn bridges currently and later in your professional career. Remember, the medical community is EXTREMELY small.

Why (and Why Not) to Send a Letter of Intent

Before drafting your letter, you need to decide if sending one is strategically worthwhile for you. Let’s review the pros and cons.

Reasons to Send a Letter of Intent

1. You have a clear first choice.
   If one school truly stands out as the perfect fit — and you know you will drop all others to attend — a LOI can communicate that level of commitment.

2. You have meaningful updates.
   Maybe you published a research paper, earned an award, assumed new leadership roles, or gained more patient-care experience since your interview. These can be great additions that reinforce your strong candidacy.

3. You want to demonstrate strong interest.
   In a competitive admissions process, showing that you are committed to attend if accepted can make you more attractive to a school trying to manage yield (the percentage of accepted students who enroll). Schools struggle with predicting how many students will accept an offer of admission, so having certainty can make their job easier.

4. You interviewed months ago.
   If it’s been a while since your interview, an LOI can remind the admissions committee who you are and why you are a great match before they make final decisions.

Reasons Not to Send a Letter of Intent

1. You’re not 100% sure.
   If you cannot confidently say you would attend if accepted, do not send an LOI. Sending one to more than one school or without true intent is unethical and will backfire.

2. You’re confusing it with a Letter of Interest.
   A Letter of Interest says, “I am very interested, but I am still considering other schools.” This can be sent to multiple schools. Letters of interest are OK to send if you have submitted your application but have not yet received an interview offer. While some students will also send them after interviewing, they are not very useful at that point because, all you are telling the program is “I’m still interested, but I am not 100% committed”. An LOI is a commitment — not just interest.

3. The school’s policy discourages them.
   Many schools explicitly say not to send additional communications. If they say this, follow their instructions! Ignoring this can hurt your application as you are clearly not following rules. Always check the school’s instructions first.

How to Craft a Medical School Letter of Intent That Actually Matters

A strong LOI is more than a formality — it’s a targeted, strategic message that reinforces your candidacy and makes it easy for the admissions committee to understand your intentions.

Here’s how to do it:

Step 1: Confirm that this school is truly your top choice

This is non-negotiable. Before you write, double-check:

• Would you absolutely attend if accepted, no matter what?
• Are you ready to withdraw from all other schools if you get in?

If your answer is anything less than “yes” on both, you are better off sending a Letter of Interest instead, or nothing at all.

Step 2: Gather your updates

Your LOI should do more than rehash your interview answers. Collect 1–3 strong updates since your interview that show:

• Growth in your clinical, research, or leadership experiences.
• Continued academic excellence.
• Additional service or community work.
• Achievements that align with the school’s mission.

Step 3: Research the school — again

You have likely done this before your interview, but now is the time to go deeper. Look for:

• New initiatives, programs, or faculty research since your interview.
• Specific curriculum features that uniquely fit your goals.
• Alumni or student projects that inspire you.

The more specific your reasons, the more credible your commitment will sound. If you changed the name of the school you are applying to in your LOI, and the letter sounds appropriate, then it is not specific enough.

Step 4: Structure your letter

A LOI should be concise (1 page max), professional, and clearly state your commitment.

Suggested Structure

1. Opening & gratitude — Thank them for the interview opportunity and reaffirm your interest in the program.
2. Clear statement of intent — Explicitly state they are your first choice and that you will attend if admitted.
3. Evidence of fit — Explain why you’re a fantastic match for their program, referencing specific programs, values, or opportunities. Also, share what you will bring to their program.
4. Recent updates — Share 1–3 meaningful developments since your interview.
5. Closing & professionalism — Reaffirm commitment, express appreciation, and sign off respectfully.

Step 5: Write your draft (Sample Language)

Here’s a generic example you can adapt – do not copy this verbatim:

Dear [Admissions Committee or Dean’s Name],

I want to thank you again for the opportunity to interview at [School Name] on [date]. Meeting your faculty, students, and learning more about the curriculum only further confirmed that [School Name] is my top choice for medical school.

I am writing to express my clear intent: if accepted to your program, I will attend [School Name] and will withdraw my applications from all other schools. I am deeply committed to becoming a physician who [reference mission-aligned goal], and I believe [School Name]’s emphasis on [specific program/value] uniquely supports that path.

Since my interview, I have [update #1 — concise but impactful], [update #2], and [update #3]. These experiences have further prepared me to contribute to the [School Name] community both academically and through service.

Thank you again for your time and consideration. I hope to have the privilege of joining the [School Name] Class of [Year]. I do not expect a response; rather, I wanted to be transparent with my intentions.

Sincerely,
[Your Full Name]
[AMCAS ID or AAMC ID]

[Contact Information]

Step 6: Review, edit, and send

Before sending:

• Keep it under one page.
• Avoid generic praise — make it specific to the school.
• Triple-check grammar, spelling, and tone.
• It is OK to send it as an email but also consider sending it as a PDF attachment unless the school specifies otherwise.
• Address it to the Dean of Admissions or Admissions Committee.

Final Thoughts: Letters of Intent Are a One-Time Card

The Letter of Intent is not something to send lightly. It’s an ironclad commitment. You should only send one during your application cycle, and only to a school you are certain you would attend if admitted.

Sending LOIs to multiple schools or without true commitment is unprofessional and can damage your reputation in the admissions community. Remember, medical education is a very small world — integrity matters.

If done right, a LOI can:

• Reaffirm your interest in a meaningful way.
• Provide impactful updates that strengthen your candidacy.
• Signal to the school that accepting you will positively affect their yield.
• Increase your chances of being offered admission.

However, if you are unsure, hold off! A well-crafted Letter of Interest (or a simple update letter) can keep you on their radar without overcommitting.

Key Takeaways

• A LOI is a pledge to attend if accepted — send it to only one school.
• It is most effective when you concurrently have meaningful updates and a compelling, specific reason why the school is your ideal fit.
• Keep it professional, specific, and under one page.
• Integrity counts — do not send LOIs to multiple schools or without true commitment.

In the end, your LOI should be more than a declaration — it should be a confident, well-supported argument for why you and your dream school are the right match. If you approach your LOI thoughtfully, with sincerity and specificity, you will not just be sending another email into the admissions void —you will be making a clear, professional statement that hopefully will tip the scales in your favor when it matters most.

Please let us know at EMP if we can help you craft the ideal LOI!