The composite letter is a unique, comprehensive letter written by a “composite writer” that provides an in-depth perspective on an applicant’s preparedness for medical/dental school. The composite writer integrates their own observations about the applicant with information from the applicant’s support letters and other support materials (such as the applicant’s autobiographical sketch, resume, and transcript). When completed, the composite will be a holistic summation of the applicant’s academic, professional, and extracurricular experiences, as well as their personal qualities and character. It is Dartmouth’s version of a “committee letter," used by other institutions.

What is ultimately submitted to medical and dental schools is the Dartmouth Composite Letter of Evaluation Packet, which is created by HPP staff to ensure confidentiality, integrity, and quality. The packet is a single PDF document that includes the composite letter, the applicant’s support letters, and a cover letter created by HPP that explains some of the unique aspects of Dartmouth College.

Composite letters are required to have the following:

1. Confidentiality waiver (see below) and the applicant’s AAMC ID number (HPP will send you this). Place it at the top of the composite, after your letterhead.
   - COMPOSITE LETTER OF EVALUATION FOR [APPLICANT’S FULL NAME], AAMC ID [INSERT #]. [Applicant’s First Name] has waived in writing [his/her/their] right to access this evaluation packet.
2. Letterhead: This can be an official letterhead from the writer’s employer or a self-created one. If the writer creates their own letterhead, it should contain their name, contact information, the name of their employer, and their title/position.
3. Signature: This can be an electronic signature (ex., Adobe Reader with signature capability), a JPG/PNG of your signature copied/pasted to a Word document, or a handwritten then scanned signature.
4. Date: Should be at the top of the letter after the writer’s letterhead.
5. Correct Name and Spelling: Writers – especially those who may be writing multiple letters – should make sure they include the correct name and spelling of the applicant they are writing for.
   - It’s okay to use the applicant’s nickname if that is what they commonly go by. Ex. using “Nick” or “Ali” instead of “Nicholas” or “Alison.”
   -  It’s okay to use Ms./Mrs./Miss or Mr. to refer to the applicant if you prefer to be more formal.
6. Salutations: Make sure to start your composite letter with typical salutations such as “To Whom It May Concern” or “Dear Admissions Committee.”
7. Direct Quotes from Support Writers: You should directly quote each support writer in the applicant’s file AT LEAST ONCE. It does not need to be a long quote. Make sure to reference the support writer by name when you use a direct quote or paraphrase information from their letter.

Yes! The Composite Letter is confidential. The applicant waives their right to view both the composite letter and their support letters of recommendation. Do not share your composite letter with the applicant!

Additional note about sharing an applicant’s personal information: If you know personal information (i.e., challenges due to background, personal or family health issues, mental health, financial status, etc.) about the applicant that you believe is relevant to your evaluation, make sure to get the applicant’s permission before sharing!

Who will see my composite letter?
Please note that each of the following entities will have access to your composite letter on a need-to-know basis; however, they will keep your letter confidential from the applicant.

1. Health Professions Program Staff: HPP reviews and edits composite letters to ensure quality and integrity. HPP also creates the final Dartmouth Composite Letter of Evaluation Packet, which contains a cover letter from HPP describing unique aspects of Dartmouth, the composite letter, and the applicant’s letters of recommendation.
2. Medical and Dental Schools: Including admissions staff, admissions committee members, and interviewers.
3. Administrative staff from application services: For medical schools, the common application services are AMCAS (MD schools), AACOMAS (Osteopathic schools), and TMDSAS (for Texas medical schools). For dental schools, the common application services are AADSAS and TMDSAS (for Texas dental schools).

We advise applicants to establish deadlines with you. Our recommended target date for students is mid-May to June 25th. If this can't be met, our final suggested deadline is July 31st. These dates are just suggestions; however, setting a deadline within this suggested timeframe is ideal. Deadlines are crucial because once the composite letter is submitted, HPP needs sufficient time to work with composite writers to review and edit the composite letter to create a final draft. This process typically takes 1 – 4 weeks. The length of time it may take to review a composite letter is influenced by the following: the date it is submitted, the number of other composites on our list to review, the edits needed, how quickly the composite writer can respond to feedback, etc.

There are many steps in this process, and any delays could impact the applicant’s application timeline. Since medical schools have rolling admissions, the timing of the composite letter with the applicant’s application is a critical factor.

When you have completed writing your composite letter, you will submit it to HPP at HPP@dartmouth.edu for review. Please submit a Word copy of your composite letter (NOT PDF or any other document format).

HPP will then work with you to review and edit the composite letter to create a final draft. Once we agree on a final draft, HPP will create the final Dartmouth Composite Letter of Evaluation Packet and upload it to the relevant application service.

We highly recommend keeping the composite letter to 2 – 4 pages. Do not write more than 5 pages. Medical and dental schools read hundreds of letters each year, so being concise and “straight to the point” is valuable.

Tips for Keeping the Composite Concise

Based on feedback we’ve received from medical schools, we recommend avoiding details about the structure of your course or your research, unless it’s necessary for the reader to understand the applicant’s performance or qualities, strengths, competencies, etc. that they demonstrated. Even then, details should be kept brief. Beyond stating your position and possibly how long you’ve been in your role, no additional background information is necessary, unless it helps provide context for your evaluation of the student.

When reflecting on your experiences with and direct observations of the applicant, provide specific examples and consider the following:

1. Qualities in the classroom, rather than grades. Medical and dental schools can see the applicant’s performance metrics (i.e., grades, GPA, MCAT or DAT scores). What they don’t know is the context, such as how the applicant acted in the classroom, lab, or office hours, or if you were delighted to have them in class. There’s also no need to rehash class standing or grades, unless there is important context about it.
   • Speaking to the applicant’s intellectual engagement is highly valuable. It is also great to talk about how the applicant led a lab team or navigated a tricky group conflict, or consistently had unusually perceptive or creative comments, or was particularly good at incorporating feedback, etc.
   • Including statistical comparisons can be helpful (but not necessary), as they show clearly how the applicant’s performance stands out among their peers. For example: “Based on my 10 years of teaching, I would place Maria in the top 2% of students I have taught.” If you decide to include a statistical comparison, ensure you support it with specific examples.
   • Context for a grade can be helpful. For example, His final grade does not reflect his success. He actually didn’t do well on the first exam, but then he put in every effort into fully engaging with the class and material—office hours with me, tutoring, shifting study strategies, and as he gained confidence, he asked increasingly meaningful questions with genuine curiosity. These are the qualities I would value in my physician.
2. Personal qualities based on your observations. Write about if they’re notably patient, empathetic, extra-prepared, go above and beyond, etc. You can also include information from Teaching Assistants, Graduate Research Assistants, or others who worked closely with the applicant. You can also include information from evaluation forms. It’s OK to co-write with a grad student or TA. You can also include snippets of feedback, if the applicant received peer feedback or worked as a TA themself.
   • Please note: We do not recommend asking the applicant to draft their own letter, as this would undermine the integrity of the process. Instead, you could ask the applicant to provide you with an autobiographical sketch, request that they draft bullet points on what they would like you to focus on, a list of roles and responsibilities they had in your lab/job, or on their achievements directly observed by you, etc. It can also be helpful to set up a meeting with them to talk through ideas!
3. Talk about the applicant’s growth! Applicants who learn how to learn/study in a new way, how to take feedback, or how to move beyond setbacks, are great for medical and dental schools to know about, and much more telling than someone who sailed right through the class.
4. Share personal information about the applicant that helps medical and dental schools contextualize their performance. Again, please make sure it’s okay with the applicant if you are sharing their personal information that might otherwise be considered confidential, such as information about their physical or mental health, or a Title IX experience. An applicant who communicated professionally about challenging circumstances and still won your endorsement could be the rising star they’re looking for. Similarly, your personal reaction to the applicant can be helpful. For example, “I’d be delighted to have them in my lab as a graduate applicant” or “I would eagerly send my family members to her as a physician” is meaningful.
5. Discuss the applicant’s experiences if you have direct knowledge. For instance, you were the applicant’s supervisor, coach, PI, etc., and got to see the applicant in action, and therefore, can speak directly to their experience. By discussing the applicant’s experiences (ex., research and other scholarly pursuits, volunteer or service work, Greek life, athletics, professional or clinical experiences, etc.), you can provide a comprehensive view of the applicant beyond just their grades and test scores. You can discuss how these experiences have shaped the applicant and their journey, the skills and abilities they developed, or demonstrate how they interact with others in various settings. If you have not seen the applicant in these experiences directly, it is not as helpful to provide an overview of their resume, as medical schools will already have access to this.
6. Reflect on the applicant’s motivations. Medical and dental schools want to know the applicant’s motivations for pursuing a career in healthcare. As a writer, you can give insight into how the applicant’s motivations are reflected in their academic journey; in their extracurricular or professional pursuits; and how they worked to develop the personal qualities necessary to be a good healthcare professional, such as compassion and empathy, interpersonal skills, communication skills, leadership, and advocacy etc.

We recommend identifying 2 – 4 common themes about the applicant, based on your and the recommenders' observations, and structuring the composite around those themes. If you need help generating ideas or identifying common themes, the AAMC Letter Guidelines is an excellent resource. It describes a variety of professional, intellectual, and scientific competencies. Do not feel obligated to address all the competencies listed.

Using Section Headers to Structure Your Composite Letter
We highly recommend using section headers! Although they are not required. Section headers are an excellent tool to organize your writing and improve readability and understanding for medical and dental admissions staff.

Focus on the applicant, not the research itself! Most medical school admissions professionals will not have the background to understand detailed or technical descriptions of research, and moreover, they are not particularly concerned about the actual research. Instead, they want to know about the applicant and their performance in conducting research. What were their roles and responsibilities? How did they learn or grow? How did they interact with others on the research team? What skills or abilities did they demonstrate? While some description of the research may be necessary to provide context for the applicant’s performance, these descriptions should be brief and written in layman’s terms.

Medical schools often ask applicants to address the question, “Why medicine?” in their personal statements and application essays. As a composite writer, you can expand on the applicant’s motivations to pursue medical/dental school from a thoughtful, subjective perspective. Highlight your observations of the applicant in action, your understanding of their journey, and the ways in which they have grown over time. The example below illustrates how to effectively convey an applicant’s motivations and growth.

You should directly quote each support writer in the applicant’s file AT LEAST ONCE. It does not need to be a long quote. Make sure to reference the support writer by name when you use a direct quote or paraphrase information from their letter.

You want to use direct quotes to support your evaluation of the applicant. In this regard, writing a composite letter is similar to writing a scholarly paper. You’re presenting an argument (i.e., the applicant is a strong candidate for medical/dental school) and you're using quotes and information from sources (i.e., the applicant’s support writers) to support/reinforce your argument.

For instance, if you have observed that the applicant has strong interpersonal skills, discuss specifically what you have observed. Then use direct quotes from support writers that support your observations.

Using Direct Quotes from the Applicant
While not required, some composite writers do choose to include direct quotes from an applicant’s personal statement and/or autobiographical sketch. This can be a useful way to reflect on the applicant’s motivations, demonstrate their personal growth or introspection, or highlight characteristics about them.

Consider using bold text strategically. While not required, strategically bolding sentences, phrases, or words can be a useful method for highlighting important aspects or points about an applicant to medical or dental schools. Just make sure not to overuse bolding so as not to diminish its impact.

Set up a meeting with the applicant. It may be helpful to arrange a meeting with the applicant (they may even request one with you!) to discuss their goals, ideas for content, expectations, and to agree on a deadline that works for both of you! Also, applicants will likely provide you with supportive materials, such as an autobiographical sketch and their transcript, but if you need more, do not hesitate to ask them.

Be honest with the student. If you do not feel you know the applicant well enough, or if you have had a negative experience with them, it is okay to say no. While this can be difficult, it is truly an act of kindness, as it allows the student to find someone else. Only say yes if you can write a supportive letter of recommendation.

Consistent Communication is KEY! Make sure to update the applicant if your personal timeline for writing the letter of recommendation has changed. We also recommend letting the applicant know whether there is a preferred way for them to contact you and/or whether you will be unavailable for any specific period of time! This can help the applicant immensely during what is often a high-stress time for them!

Yes! We have a more comprehensive Writing Guidelines for Composite Writers that includes examples from past composite letters, as well as a few Sample Composite Letters. However, because these are based on past composite letters, to maintain confidentiality we cannot post them publicly online. If your are a composite writer and would like to access these resources, please contact us at HPP@dartmouth.edu.