Medical School Letter of Intent vs. Letter of Interest in 2026
Applying to medical school is an enduring process. Even after all applications are submitted to schools, the work does not end there. The pressure turns up as students await interview invitations, prepare for interviews, or continue waiting for the final decision after interviews. Needless to say, the process requires a lot of patience.
The 2025-2026 application cycle underscored just how competitive that process has become. According to the AAMC, 54,699 people applied to medical schools in the United States in 2025, a 5.3% increase from the previous year. First-time applicants rose by 8.4%. Meanwhile, the incoming class of 23,440 matriculants was the largest to date, yet that still means a significant number of well-qualified applicants did not receive the acceptance they were hoping for. In a cycle this competitive, small, strategic actions can matter. One of those actions is writing a medical school letter of intent or a letter of interest.
However, it doesn’t mean nothing is in your hands. Many students decided to put their all during this time into extra acts that could certainly turn the tides towards them. Writing a medical school letter of intent or a letter of interest is one such way to do so.
The two letters are incredibly similar in their structure and contents, but not in their purpose. So what’s the main difference between a medical school letter of intent vs. a letter of interest?
The Key Difference: Commitment Level
The most prominent aspect that distinguishes a letter of intent from one of interest is the extent of commitment. A letter of intent conveys to the medical school in question that you are dedicated to matriculating. In other words, it is a promise that, if accepted, you will certainly attend.
As for a letter of interest, the purpose is simply to show a strong desire to attend a medical school. However, your statement would not hold you to attend should you decide not to. The purpose of a letter of interest is perhaps for students waiting on a few of their top schools but still have not chosen between them.
Both the letter of intent and the letter of interest aim to boost students’ chances of receiving an acceptance.
Let’s understand the two types of letters in detail.
Why Letters of Intent and Interest Matter More in 2026
Before getting into the specifics of each letter, it helps to understand why these letters carry real weight in the current admissions environment. In 2025, for the first time in history, total enrollment in U.S. MD-granting medical schools exceeded 100,000 students. That milestone reflects both growing interest in medicine and expanding class sizes, but it does not mean getting in has become easier.
The overall acceptance rate across all U.S. MD-granting schools was approximately 42.9% in the 2025 cycle, meaning roughly 4 out of 10 applicants were accepted to at least one school. At the individual school level, the picture is far more competitive: on average, MD schools accept about 4.23% of their applicants. Six programs had acceptance rates below 1%, and only 18 programs had rates above 7%. For students who want to understand what to know before getting into medical school, these numbers reinforce that every part of the application process matters.
Meanwhile, the mean GPA for matriculants in 2025 was 3.81 (up from 3.79 the previous year), and the mean MCAT score for matriculants was 512.1 (up from 511.8). With credentials creeping upward year over year, applicants need ways to stand out beyond their numbers. A well-written letter of intent or interest is one of the few tools available after applications and interviews are complete.
Admissions consultants and experts have also noted a shift in how medical schools use their waitlists. There is evidence that some programs are under-admitting their initial class and relying more heavily on waitlist movement, partly in response to changes in the AAMC’s Choose Your Medical School (CYMS) tool. This means letters of intent may carry even more influence than in past cycles, because schools are actively looking for signals that a waitlisted applicant will commit.
Perhaps the most telling statistic: in 2023, 45.8% of medical school matriculants were accepted to only one medical school, and 20% of matriculants received only one interview. For many successful applicants, the margin between acceptance and rejection was narrow. A letter of intent can be the factor that tips the balance.
What is a Medical School Letter of Intent?
To be more specific, a medical school letter of intent is solely for students with a single dream program or school in mind. If you have received acceptances, but are becoming antsy at the lack of your response from that one medical school you’ve been eyeing, you’ll want to consider a letter of intent.
A medical school letter of intent is strong in its ability to drive home your integrity as a potential medical student. Certainly, the letter isn’t a contract. However, to send a letter of intent to a school, and then fail to attend once accepted, is a breach of ethics as a student. This is especially important considering the emphasis medical schools traditionally place on ethics. Doing so not only puts you in an unfortunate light, but it also devalues the contents of the recommendation letters that supervisors took time to write.
Medical schools are just as serious about the application process as the applicants are. With thousands of applications coming in from all over, they must tediously survey all to seek the right students to uphold the school’s legacy. Thus, a letter of intent is nothing to underestimate. Students who are also weighing whether medical school rankings should influence their decision may find that committing to a school based on genuine fit, rather than prestige, makes their letter of intent more authentic and more effective.
When done right, a letter of intent can pull a student out of the brink of hopelessness at being denied by their number one program.
What is a Medical School Letter of Interest?
A letter of interest serves a different, somewhat more flexible purpose. While a letter of intent is a firm commitment to one school, a letter of interest communicates strong enthusiasm without locking you in. You are telling a school that you are genuinely excited about the possibility of attending, but you are not making a binding promise.
This distinction matters practically. You can send letters of interest to more than one school. Students often use them when they have several programs they would be happy to attend and want each of those schools to know they are a serious candidate.
Another important timing difference: a letter of interest can sometimes be sent before you have received an interview invitation. If you have submitted your application and have not heard back, a letter of interest can signal to the admissions committee that you are genuinely motivated and not simply casting a wide net. Some admissions experts note, however, that letters of interest are most useful before the interview stage. Once you have interviewed and are on a waitlist, a letter of intent (if the school is your clear first choice) tends to carry more weight.
For students who are reapplying to medical school, a letter of interest can also serve as an early signal of continued commitment and growth since the previous cycle.
When to Send a Letter of Intent
The best time to send your medical school letter of intent can depend on many factors. Generally, the rule of thumb is to wait until after your interview with the medical school. Remember, it will only be that one, top medical center to which you will send a letter. Even if you have received an invitation for interviewing, don’t send any letter until after the interview. Doing so will be premature and rob you of the opportunity to use the interview to your advantage in the letter.
What about medical schools that have not yet sent an interview invitation? Do not send a letter of intent. Wait until they reach out for an interview. Otherwise, never send a letter of intent to a school that hasn’t displayed interest.
So you received an invitation and attended the interview. It was enlightening, you learned more about your desired program, and you feel it went by wonderfully. Now what?
After the interview, simply wait for about a month before sending a letter of intent. Again, doing so earlier is a bit desperate because schools just begin to send out admission acceptances during that time. A good sign that it’s time is when you begin to receive some acceptances from other programs to which you’ve applied (if any). Chances are, you may be anxious that you haven’t heard back from your dream school. That’s the right time to pull out the letter of intent.
Key AAMC Timeline Dates for the 2025-2026 Cycle
Understanding the AAMC’s “traffic rules” can help you time your letter more precisely. Here are the dates that matter most:
- February 19, 2026: “Plan to Enroll” becomes available through the AAMC Choose Your Medical School (CYMS) tool in AMCAS.
- April 15, 2026: Applicant protocols ask applicants to narrow their acceptance offers to three schools.
- April 30, 2026: “Commit to Enroll” becomes available. This indicates the applicant has made a final selection and withdrawn from all other schools.
- May 1, 2026 and beyond: Applicants may hold only one medical school acceptance, so most waitlist movement begins in May.
For most medical schools, letters of intent are best sent sometime in April, as admissions committees begin reviewing waitlists in earnest after the May 1 commitment deadline. If you interviewed early in the cycle (fall or early winter), waiting until February or March is reasonable. If you interviewed in late winter or spring, sending the letter approximately one month post-interview is typically appropriate.
But wait! Before you do anything, ensure that the medical school allows letters of intent. Some programs prefer applicants not to engage in ongoing or continued communication with the school. For example, schools such as the Chicago Medical School at Rosalind Franklin University, the University of Arizona College of Medicine, and several California medical schools have historically discouraged contact from waitlisted applicants. A simple check of the school’s policies, or shooting an email to any medical students you know or an advisor from the school can clarify it. Sending an unsolicited letter of intent does not fare well, especially if the rules are clear.
Finally, it’s time to create the medical school letter of intent. How is it done?
How to Write a Medical School Letter of Intent
Following a formal letter structure, a medical school letter of intent first begins with an address to the Dean or the Director of Admissions. The recommendation is to research the name to whom you are writing, and ensure it’s the right person. Current best practice advises against using a generic greeting like “Dear Admissions Committee,” as this can come across as impersonal. If you cannot find the right name through the school’s website, call or email the admissions office to ask. Make sure to double-check before you do anything.
One practical detail that many applicants overlook: include your AAMC ID at the top or bottom of your letter. This makes it easy for admissions staff to locate your file and connect the letter to your application. It is a small step, but it signals professionalism and consideration for the people reviewing your materials.
Introduce yourself in the first paragraph. Cut to the point by explaining the purpose of the letter, to demonstrate your intent to matriculate. Generally, students say their name, interview date, and may choose to mention their interviewer’s name as well. It would not hurt to include a brief part of your positive interview experience or a tidbit you learned about the medical school. Students who want advice on how to make that interview reference resonate should consider reviewing common medical school interview questions and reflecting on which moments stood out most. As long as it’s clear in the first paragraph that it is a letter of intent, any other enhancements can distinguish you from the crowd.
In the second paragraph, explain in detail exactly what about the medical school prompted a letter of intent. Why do you want to attend so strongly? Naturally, this section should be specific to the school. Avoiding vague language elevates your “argument” for your desire to attend. For example, note anything you saw or recently discovered about the school during the interview. This may include dual enrollment programs, exclusive research opportunities, specific renowned professors with whom you’d like to work, or close connections with certain hospitals. If the medical school truly is where you intend to matriculate if accepted, writing this section may come easily to you.
The third paragraph turns the focus back to you. Here, you will detail what you can promise to contribute to the school. Why are you a good fit? Think about how you stand out from other applicants; everyone has at least one special aspect. For example, you can discuss personal experiences in research or volunteering, an extracurricular activity, or related projects that can provide value to the school. A rule of thumb is to tie your accomplishments back to the mission statement. How will your skills memorialize the school’s core values? Additionally, include any recent developments or accomplishments since your initial application.
The Hybrid Approach: Combining Intent with Updates
Multiple admissions experts in 2026 recommend treating your letter of intent as a hybrid document that also functions as an update letter. Rather than sending a separate update letter and a separate letter of intent, you can strengthen your case by weaving meaningful updates into your letter of intent.
For example, if you have completed new clinical hours, published research, earned a certification, or taken on a leadership role since your original application, include that information in the third paragraph alongside your description of what you bring to the school. This approach saves the admissions committee from reading two separate letters and presents a unified, forward-looking picture of who you are now.
However, this only works if the updates are genuine and relevant. Don’t pad the letter with minor achievements just to fill space. If you have nothing new to report, a straightforward letter of intent without updates is perfectly fine.
Finally, double-check the letter as many times as you need to. Remember, a medical school letter of intent is completely optional. The more time and effort you put into it will only improve your chances.
How to Write a Medical School Letter of Interest
The structure of a letter of interest is similar to a letter of intent, but the language and level of commitment are different. Here is how to approach it:
Begin by addressing the letter to a specific person, just as you would with a letter of intent. In the first paragraph, introduce yourself, mention your application, and clearly state that you are writing to express strong interest in the program. Do not use language that implies a binding commitment. Instead of “I will attend if accepted,” write something like “This program remains one of my top choices” or “I would be thrilled to receive an acceptance.”
In the body of the letter, explain why the school appeals to you. Be specific. Mention particular aspects of the curriculum, clinical training sites, community health initiatives, research focus areas, or faculty whose work aligns with your interests. Generic praise is not useful; the admissions committee wants to see that you have done your homework and that your interest is grounded in real knowledge of the program.
If you have updates since your application, include them here. New experiences, improved grades, completed coursework, or clinical hours all strengthen a letter of interest.
Close the letter professionally and briefly. Reiterate your strong interest, thank the committee for their consideration, and leave it at that. Like a letter of intent, keep the letter to one page.
Students who are also sending post-interview communications may want to review how to write a medical school thank-you note, since a thank-you note immediately after the interview and a letter of interest sent weeks later serve different purposes and should not repeat the same content.
Example of a Medical School Letter of Intent
Dear [Dean or Director of Admissions],
My name is Darren Jacobs, and I have applied to [School Name]. After my interview on October 3, 2025, with [Interviewer], I want to officially communicate that [School Name] is my first choice. Thus, I give my statement of intent that I will attend [School Name] upon acceptance. Learning more about the program has made it clear to me that I would be an excellent fit.
My interview was an educational opportunity for which I am so grateful. Visiting the school grounds brought more amazing things about [School Name] that further cemented my desire to attend. Speaking with [Interviewer’s Name] gave me an idea of the values of the faculty. After visiting many other schools, I found [School Name] to exceed my expectations in its program opportunities. In particular, I was excited to see opportunities for student-led clinics where I hope to learn and contribute within the scope of my training.
Furthermore, I have learned just how strongly [School Name] believes in its mission statement of spreading respect and offering full support for medical students. The many students I met on campus were incredibly informative, helpful, and I learned about [School Name]’s modern and integrative learning practices. As a multifunctional learner, I appreciate the ability to learn in all ways: individual-learning resources, group-learning, and abundant assistance from faculty. Overall, the ambiance and environment made me certain that [School Name] is where I hope to matriculate.
As a school built on research and high-quality medical innovations, I would love to provide my skills to continue those ambitions. I continually keep up-to-date with advances in medicine, and I have an online blog dedicated to new research and medical discoveries. Furthermore, I have experience volunteering in hospitals, and I believe I would uphold [School Name]’s patient-focused values if I were to participate in the student clinic.
On my initial application, I mentioned that contributing to research was a goal of mine. Since then, I have taken on the role of a research assistant to improve my analytical skills. I know [School Name] is proud of its many research-based achievements and commitment to hands-on learning. I hope to offer my skills to the school’s research department and uphold the values that make this program so great. Additionally, I have written a few publications related to my desired specialization, which I have attached.
Once again, I am strongly committed to my intent to attend. Thank you for your time and consideration, and I will continue to remain hopeful that [School Name] will be my destination this fall.
Regards,
Darren Jacobs
AAMC ID: [Your AAMC ID Number]
Common Mistakes to Avoid
Even a well-intentioned letter can backfire if it contains certain errors. Here are the most frequent mistakes applicants make, and how to avoid them.
Sending a Letter of Intent to Multiple Schools
This is the most serious mistake you can make. A letter of intent is a promise. Sending it to more than one school is dishonest, and if discovered, it can result in rescinded acceptances. If you cannot confidently say you would attend a particular school if accepted, do not send that school a letter of intent. Send a letter of interest instead.
Ignoring the School’s Communication Policy
As mentioned earlier, some schools explicitly discourage additional correspondence from applicants. Ignoring this policy is not bold; it is careless. Always verify the school’s stance before sending anything. The Medical School Admissions Requirements (MSAR) database from the AAMC, as well as the school’s own admissions FAQ pages, are reliable places to check.
Being Too Generic
If you could swap the school’s name in your letter with any other school and the letter would still make sense, it is too generic. Admissions committees read hundreds of these letters. The ones that stand out are specific about what the applicant knows and values about that particular program.
Writing Too Much
Keep your letter to one page, which is typically 500 to 600 words. Admissions offices are busy, especially during waitlist season. A concise, focused letter is more effective than a long, rambling one.
Sounding Desperate or Entitled
Expressing genuine enthusiasm is good. Pleading, guilt-tripping, or implying that you deserve a spot is not. Strike a tone that is confident, respectful, and honest. If you are feeling anxious about the process, which is completely normal, channel that energy into making the letter specific and well-crafted rather than emotional.
Frequently Asked Questions
How do letters of intent and interest differ from a letter of update?
The purpose of an update letter is different from the other two. An update letter is meant to draw attention to activities you’ve been involved in since your application. If there are any new accomplishments, projects, or research developments you want medical schools to know, you can do so with an update letter.
Additionally, you can send an update letter to as many schools as you want. However, it’s meant for schools that have yet to accept or reject you. Only send update letters to schools for whose responses you are still waiting.
Now, can you send both an update letter and a letter of intent or interest? Yes, and the most ideal situation would go like this: You send an update letter to a school, and a few weeks later you receive notice that you’ve been waitlisted. A letter of intent or interest is the perfect response to go from the waitlist to the accepted list. That said, many admissions experts now recommend combining your updates directly into your letter of intent or interest, rather than sending separate documents. This hybrid approach keeps your communication streamlined and gives the admissions committee one strong, comprehensive letter to consider.
How many letters should I send?
For the letter of intent, only send one letter to one school. Do not send to multiple schools, nor should you bombard any particular school with more than one letter. The only one will suffice. For letters of interest, you can send them to multiple schools, since they do not carry the same binding implication.
What if I don’t have any accomplishments?
If you feel you haven’t done anything noteworthy enough to write about, think again. Even if you’ve never done research or volunteered, try to remember your university accomplishments. In-class or outside the classroom, you can find positive things to say about many triumphs.
For example, you can discuss tough classes, for which achieving a high grade felt meaningful to you. Perhaps you improved your grades from one semester to another. Perhaps you have some accolades, scholarships, or you made the Dean’s list. You may also include any significant class projects into which you invested a lot of work and time. Anything works as long as you demonstrate major progress or something you felt proud about, and you can relate that back to the school’s values. Students building their pre-med profile may also find it helpful to read about what medical school admissions committees actually value in clinical experience.
What tone should you use?
Since both the letter of intent and letter of interest are formal, keep your tone level and professional, with confidence and honor. The aim is to present yourself in a respectful, yet authentic manner. Avoid sounding overly casual, but also avoid stiff, impersonal language. Write as if you are addressing someone you respect and want to have a real conversation with.
Can I send both a letter of interest and a letter of intent?
Yes, but not to the same school. You might send letters of interest to several schools where you are a strong candidate and genuinely interested, and then send a single letter of intent to the one school you are most committed to. The key is honesty: each letter should accurately reflect your level of commitment to that particular program. Never send a letter of intent to one school and a letter of interest to the same school, as this creates confusion and undermines your credibility.
Should I follow the exact medical school letter of intent or interest structure?
The basic layout of such letters can vary depending on where you look. But most examples have a similar structure indicative of a formal letter. As long as all the essential formalities are apparent, your letter should be fine. For example, the greeting and the closing, the balanced break-up of the content, and a professional tone throughout. Otherwise, feel free to make your letter your own. The more original and authentic your voice is, the more memorable it will be for whoever reads it.
How long should a medical school letter of intent or interest be?
Keep your letter to one page. Usually, this should translate to about 500 to 600 words. Going longer risks losing the reader’s attention, and padding your letter with filler weakens your strongest points. Edit ruthlessly. Every sentence should earn its place.
Does a letter of intent guarantee acceptance?
No. A letter of intent does not guarantee admission. It is one factor among many that an admissions committee will consider. Some schools may give it significant weight, particularly when making waitlist decisions, while others may barely consider it. The value of the letter depends on how well it is written, how specific it is, and whether the school’s admissions process is receptive to such communication. Even so, it can only help your candidacy when done correctly. It cannot hurt you, as long as you follow the rules outlined above.
Preparing for the 2026-2027 Application Cycle
If you are planning to apply in the upcoming cycle, the AMCAS application will open on May 1, 2026, with the earliest submission date of May 27, 2026. This cycle is for students who plan to start medical school in the summer or fall of 2027.
Knowing this timeline is useful because it gives you a sense of when you might need to think about letters of intent or interest. For most applicants, the relevant window for these letters falls between late winter and early spring of the year after they apply. That means if you submit your application in summer 2026, you would most likely send a letter of intent or interest in early to mid-2027.
In the meantime, the best thing you can do is build the experiences and knowledge that will make your eventual letter genuine and specific. Clinical exposure, research, community involvement, and coursework all contribute to the story you will tell in your application and, potentially, in a letter of intent months later. Students still in the early stages of building their pre-health profile can benefit from a clear overview of how to prepare for applying to medical school.
Practical Steps After Sending Your Letter
Once you have sent your letter of intent or interest, the waiting continues. Here is what to keep in mind during that period.
First, do not follow up repeatedly. One letter is enough. Sending additional emails or calling the admissions office to ask if they received your letter can come across as anxious or demanding. If you sent it by email and received a confirmation, trust that it arrived. If you sent it by mail, consider using a method that provides delivery confirmation.
Second, keep your other options open until you receive a definitive answer. Even if you have sent a letter of intent to your top school, do not withdraw from other programs prematurely. You can hold acceptances at other schools until the AAMC’s commitment deadlines require you to narrow your choices. If your top school does not accept you, you will want alternatives.
Third, continue strengthening your candidacy. If you can add meaningful experiences to your profile while waiting, do so. You may not send another letter, but any improvements will be reflected in your overall readiness for medical school. Students wondering whether additional academic work could help should consider reading about whether grad school can support a medical school application.
Finally, prepare mentally for any outcome. Rejection from your top choice does not define your career. Many successful physicians attended schools that were not their first pick. What matters most is what you do once you get there.
Final Thoughts on Letters of Intent and Interest in 2026
Overall, the medical school application process can seem endless. The work doesn’t stop even when all application essentials are submitted. Understandably, many applicants may feel antsy and restless. Writing these letters is a way that applicants can feel like they’re behind the steering wheel.
Although it’s impossible to know how much a medical school letter of intent or interest can change a decision, it never hurts to try. As long as you do it properly, a letter of intent or interest can only help you. At the same time, it can alleviate any anxiety. Some schools admit a significant portion of their class from the waitlist; some waitlists move substantially, and others barely move at all. A strong letter will not guarantee anything, but it positions you as a serious, committed, thoughtful applicant at a moment when admissions committees are making final decisions.
On the other hand, it’s important to take these letters seriously, because a disingenuous or lazy letter may damage your odds. To maximize your prospect, our Healthcare Internship Program and medical school admissions consulting services can assist you in building the clinical experience and professional guidance that make your application, and your letters, genuinely compelling.
