Letter of Recommendation From a Doctor You Shadowed

Letter of Recommendation From a Doctor You Shadowed

A physician who was shadowed can vouch for what they observed: the dates and hours, how the applicant behaved with patients and staff, what they asked, and what they understood about the work. They cannot vouch for clinical skill, because a shadowing student does not examine or treat anyone. Saying that plainly makes the rest of the letter more credible.

This page is for the physician. It covers which school rules a shadowing letter meets, how to state the hours, a constructed 229-word sample, and when to say no. If you supervised the applicant's work instead of being shadowed, the constructed physician letter sample fits you better.

Every page quoted below was checked on November 7, 2026. AAMC's writer guidelines page returned HTTP 403 to our scripted checks that day, so nothing here is quoted from AAMC.

What shadowing lets a physician evaluate

Shadowing gives you a narrow but real view. You saw the applicant in your clinic on specific days. You did not see their coursework, and you did not see them care for a patient.

The premed competencies a shadowing host can speak to are a short list; that page shows them.

If the physician is a DO writing for osteopathic school, the DO physician letter page adds the paragraph only a DO can write.

The evaluation forms schools publish expect you to work inside that view. VCOM's optional physician form opens with: "Describe the nature, extent, and duration of your association with the applicant." Its rating grid gives every trait a "Cannot Judge" column. (VCOM physician form, PDF) TMDSAS tells evaluators that committees want "candid, honest insight into the applicant's strengths and weaknesses" and "an accurate assessment of the applicant's suitability" rather than advocacy. (TMDSAS, Evaluator Support)

What a shadowing physician can judge from the clinic floor:

• Reliability: did they arrive on time for every scheduled session, and come back?
• Conduct with patients: did they introduce themselves, step out when asked, keep quiet when they should?
• Questions: what did they ask afterward, and did the questions get better?
• Understanding of the work: could they describe what you do and why, in their own words?
• Professional boundaries: did they respect privacy and the team's time?

Our view: state the limit in one sentence and spend the rest of the letter on what you saw. "Because Ms. Halabi was shadowing, I cannot judge her clinical skill" is a sentence of fact, not a weakness. The basis is the VCOM form's "Cannot Judge" column and TMDSAS's request for an accurate assessment: both expect writers to say where their view stops.

The countercase: if the applicant also worked for you, as a scribe, medical assistant or volunteer with duties, you saw their work, not only their observation. Write the supervisor's letter and mention shadowing as one part of it.

Does a shadowing letter meet the school's physician rule?

Some schools' wording fits a shadowing physician; some does not. These are the schools in our DO letter requirements table whose pages describe the physician's relationship to the applicant.

For DO applicants, AACOM's list of what osteopathic schools look for includes students who "Have shadowed an osteopathic physician". (AACOM, Admissions Requirements)

Hours: what the letter should say about them

Give the numbers as facts: the dates, the number of sessions, the total hours, the setting. "Ms. Halabi shadowed me on ten Tuesday mornings between February and May 2026, about 40 hours, in an outpatient family medicine clinic." A reader can weigh that. "Ms. Halabi spent a great deal of time with me" cannot be weighed.

Your numbers may be checked against a second record. Some services ask the supervisor to verify hours separately from the letter. Liaison's help page says: "Some CASs allow applicants to have their observation hours reviewed and verified by supervisors in Liaison Letters." The verifier is asked to "confirm that the inpatient, outpatient, and non-clinical settings completed and planned/in progress hours are correct" and to enter contact information and, "If applicable," a license number. (Liaison, Verify Observation Hours)

If you get both requests, make the letter's hours match what you verify. If the applicant's entry is wrong, Liaison says to "contact the applicant directly so they can correct their observation hours and re-send it for approval." How applicants log the hours themselves is covered in how many clinical and shadowing hours for med school.

Constructed sample: 40 hours in a family medicine clinic

Constructed example, written by us, not a real letter. Context (invented): Dr. Helen Wojcik, DO, is a family physician. Nadia Halabi shadowed her for about 40 hours in 2026 and is applying to MD and DO schools. Every name, date and event is invented.

Nadia Halabi shadowed me on ten Tuesday mornings between February and May 2026, about 40 hours, at Northgate Family Medicine, an outpatient practice. Because she was shadowing, I cannot judge her clinical skill or her academic work. What I can describe is how she conducted herself and what she learned.

She arrived before my first patient every session and never missed one. With each patient she introduced herself, asked permission to stay, and stepped out without being asked when a conversation became sensitive. My medical assistant, who has worked with many shadowing students, mentioned this to me unprompted.

Her questions changed over the ten weeks. In February she asked what medications I was prescribing. By April she was asking why a patient with diabetes had stopped taking one, and whether the cost or the side effects were the reason. In our last session she asked how I decide when to use osteopathic manipulative treatment for low back pain and when to refer, and she listened to the answer about patient preference as closely as the one about technique.

I have hosted about 20 shadowing students. Ms. Halabi is one of the few who could describe, at the end, what a family physician's day is made of: the visits, the phone calls, the forms and the follow-up. I recommend her for medical school on the basis of what I observed.

Helen Wojcik, DO Family Physician, Northgate Family Medicine (555) 010-0193 · h.wojcik@northgate-example.org

The body, from "Nadia Halabi shadowed" to "what I observed", is 229 words.

Where the sample stays inside what was observed:

• Paragraph 1 states dates, sessions, hours and setting, then the limit. Everything after it is first-hand.
• Paragraph 2 reports behavior the physician saw. The medical assistant's remark is labeled as someone else's observation.
• Paragraph 3 shows growth through the questions themselves, with months attached. The osteopathic question gives a DO school something only a DO's clinic could produce.
• Paragraph 4 names the comparison group (about 20 shadowing students) and what the comparison is about (understanding the job), not a skill the writer never saw.
• The close endorses "on the basis of what I observed", which is the strength the letter can support.

What the sample leaves out: any claim about bedside manner as a clinician, any claim about her grades, and any "she will be an outstanding physician".

When the physician should say no

Decline when you cannot name one specific thing the applicant did or asked. A few afternoons with no conversation beyond greetings gives you nothing to write but adjectives, and the applicant is better served by a writer who saw them work.

If the request came through Liaison Letters, the decline is final: "You can decline recommendation requests in Requested or Accepted status as necessary. Please note that you cannot undo this action." You can "Enter an optional note explaining why you are declining the request." (Liaison, Decline a Recommendation Request)

Constructed example: a decline note to a shadowing student

Constructed example, written by us, not a real message.

Thank you for asking me. We spent two afternoons together and I do not know your work well enough to write the specific letter a medical school needs. A supervisor or physician who has seen you over months will serve you better. If it helps, I can confirm your shadowing dates and hours in writing.

That is 55 words. It gives the reason, points to a better writer and offers what the physician can honestly provide. For more decline wording, see how to decline writing a recommendation letter.

Questions physicians ask about shadowing letters

Can I write a strong letter after 40 hours of shadowing?

You can write an accurate one. Its strength comes from specific observations, such as questions that improved over the weeks, not from hours. Ten sessions gives you more to describe than one long day.

Should I mention that the applicant only shadowed?

Yes, in one sentence near the top. It is the first thing VCOM's form asks, and the reader needs it to weigh everything else.

Does virtual shadowing count?

TouroCOM's letter section says "virtual shadowing encounters will NOT be accepted." Xavier's page, which is about hours rather than letters, says "Online shadowing hours will be permitted".

The applicant offered me a draft. Can I sign it?

Write it yourself from your own observations. AACOMAS states that evaluations "cannot be completed or submitted by the applicant or another party on behalf of the evaluator." (AACOMAS, Evaluations) The applicant's notes on dates and patients are useful raw material. For uploading, see the AMCAS letter writer portal guide; more letter guides are in the medical school essays hub. If the physician you shadowed barely saw you work, compare who else can write a medical school letter.

Get a free review of the letter

Get a free Quick Review of your letter against GradPilot's Medical School Letter of Evaluation rubric. Its first check is the one this page turns on: whether the letter states your vantage and keeps every judgment inside it. It also reads for incidents instead of adjectives and an endorsement the letter's evidence supports. For a PA, dental or pharmacy applicant, use the health professions evaluation letter rubric.

Sources

Retrieved November 7, 2026, except where noted.

• Edward Via College of Osteopathic Medicine, Osteopathic/Allopathic Physician evaluation form (PDF) (no cycle stated): association question; Cannot Judge column.
• TMDSAS, Evaluator Support: candid insight and accurate assessment.
• Western University of Health Sciences, COMP and HCOM secondary instructions, Rev. 4/20/2026: physician you shadowed or worked with.
• Touro College of Osteopathic Medicine, Admission Requirements (fall 2027 on page): observed in a clinical setting; no virtual shadowing.
• Xavier University College of Osteopathic Medicine, Admission Requirements (class of 2027 on page): online shadowing hours.
• Arkansas College of Osteopathic Medicine, Admissions Requirements (no cycle stated); Rocky Vista University, DO Admissions (no cycle stated); A.T. Still University KCOM, Application Checklist (no cycle stated): physician-letter wording.
• AACOM, Admissions Requirements (no cycle stated): shadowing an osteopathic physician.
• Liaison, Verify Observation Hours, Decline a Recommendation Request and AACOMAS Evaluations (no cycle stated).
• AAMC, Guidelines for Writing a Letter of Evaluation: HTTP 403 on November 7, 2026; not quoted.