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The 2+1 Rule: the Importance of Diversity in Reference Letters

Today I got an email from a reader asking me for some advice on which referees he should ask to write his three letters for medical school admissions. If you haven’t read my first article on reference letters, I urge you to do so before reading this one. If you’re too lazy, the cliff notes of that article are that you should pick referees who know you very well and who you know genuinely want to support you in your quest to become a doctor. Simply put, unless your referee has known you for a long time, he will have nothing of substance to say about you. And unless your referee really wants you to become a doctor, then he has no reason to producing something with substance.

Of course, the question that remains is: “but what if my three strongest references are too similar”?

Why Diversity is Good

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Why Reference Letters are Important and How to Pick Your Referees


Every medical school has a different philosophy when it comes to evaluating applicants. Some schools, like Queen’s and Western, look at your GPA and MCAT scores first, and pretty much guarantee you an interview if you meet certain cutoffs. Some schools, like the University of Toronto, look at your entire application package first before granting an interview: GPA, MCAT, personal essay, biographical sketch, and reference letters.

As with any medical school, you will get complaints about the process. Personally, I think it’s great that the medical schools have such different philosophies on admissions, so that many great candidates with different backgrounds are likely to get in somewhere. But when it gets more personal, and your application package isn’t as competitive at a certain school, it’s understandable for people to be a bit frustrated.

As an example, some applicants have voiced frustration with the fact that UofT’s medical school admissions places a greater weight on reference letters than some other schools. The most common argument is that there is a lot of variance involved with reference letters since it is out of the applicant’s control, in terms of how well the referees are able to write. So it is very possible that an applicant is fantastic, but his or her referee just lacks the skills, experience, and knowledge to put those ideas well onto paper.

In this article I want to analyze this common frustration, and then give my argument for why I think a medical school (or scholarship organization, summer program, etc.) might value reference letters.

Variance Exists Everywhere – Deal with It

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