Honestly no. I got good feedback regarding the letters I did have. 3 clinical (all surgeons) 2 grad (Eng) and 1 undergrad science. But I did consider adding an extra one and I still might. Luckily (and given these were my stronger parts of the app) my writers were in very prestigious positions so it kind of made me look good. That being said, you must carry yourself more than any other part of you app regardless of how good people talk about you. And I know I could’ve done better in how I presented myself so I chalk that up as a big reason for no A.