Whether we like it or not, other people's opinions matter.
A good letter of recommendation can make your day; a great letter of recommendation can change your life.
Whether it is a dating review on Tinder, a restaurant recommendation on Yelp, a movie review on Rotten Tomatoes, or an open request for holiday vacation recommendations on Facebook, we look to our friends, colleagues, and specialists in the field for advice on how to make better choices.
Now don't get me wrong, I am not saying you should let Meghan McCrory ditch you at your high school winter formal to establish your self-worth (that wasn't nice, Meghan!). But the opinions of those we admire and respect, the ones whom we look to for guidance, the ones who will give us the cold hard truth in all instances – that matters!
Studies show that we value the opinions of our close network of like-minded individuals above other sources. With the availability of social proof and crowdsourced rating systems, there has been a shift away from trusting the experts and more toward the opinions of the many.
Just look at the sales figures for the latest summer blockbuster action pic!
Try to obtain one academic letter, one letter from a PA, and a second medical provider from another discipline, or supervisor in a medical setting (can be another PA). Make sure to request these early!
- Before meeting with the recommender have these ready:
- An updated resume
- List of PA schools you’re interested in applying to
- A paper stating what you may want specifically mentioned in the letter
Choice OverloadWhoever can best speak to your abilities are the best references. One has to be a healthcare provider. And they should not be family or family friends. But it's better to have the CNA who worked closely with you for years over the attending physician you only see for five minutes every week - Duke University PA ProgramClick To Tweet
Recommendations play a huge role when we are faced with choice overload. When required to decide among 100's or 1000's of related products with similar features and price points, where does one begin?
For example, when faced with the simple task of replacing my broken iPhone 13 case, I jumped on Amazon.com to make a "quick and easy" purchase. I love my current case and figure I would simply get a similar version.
Well, you can imagine how that went down.
Ninety minutes later, I was still browsing through the endless array of case options, features, colors, and Amazon recommended accessories. How about a new car charger? Dual USB adapter? Lightning cables? The list goes on and on! It has been two weeks, and I still don't have a replacement case. Maybe I will just keep my old one!
And what do we do when we get really stuck?
If you are like me, you read the reviews! And it is often here that we make our final purchase decision.
Nowhere is this truer than when PA school admission directors are searching among 1000's of PA school applicants.
CASPA - The Amazon Marketplace for PA School Applicants
CASPA is the Amazon marketplace for PA school applicants. Like trying to find that ideal iPhone case or a perfect pair of noise-canceling earbuds, PA schools need to fill.
They have vacant seats in their PA program. They want to find the best, brightest, financially responsible, capable, compassionate, forward-thinking, well-prepared, resilient, like-minded candidates, to fill their rosters.
The admissions directors place your application in their cart, click to preview, browse through a couple of pages, and then if there is any doubt, they scroll down to read reviews.
Or, in this case, your letters of reference.
Secrets of Successful PA School Letters of Recommendation
Admissions Director's Letters of Reference Tip:
What are you looking for in a letter?
It is likely that you will not see your letter. Your letter writer is submitting a digital letter of reference.
On the CASPA application, there is a page where you will submit the name, title, and email address of the 3-5 people you will be asking to include letters of recommendation.
CASPA will send an email to your letter writers indicating that they have been selected to submit a letter of reference on your behalf.
Four guidelines to Letters of Reference for PA School
When gathering your letters of recommendation focus on these 4 traits:
- Someone who has known you for some time
- Someone who practices in some field of medicine
- Someone who has seen how you interact with patients
- Someone who supports you as an applicant
Try to pick someone who has known you for some time'Know the people from who you receive letters of reference well!' - Dr. Shafran, Case Western Reserve PA SchoolClick To Tweet
It is better to get a letter from someone you have known longer than someone you have known for a shorter period of time.
One of the questions asked of the letter writer is how long you have known the applicant? How well could they assess you if they have met you only once or had you in the office for just 2-3 hours of shadowing?
The most desirable is someone who has been witness to your patient care experience. This could be a physician, PA, NP, DO, etc., who has witnessed your work with patients.
You can use nurses and clinical managers, although these references may not be as strong as the former. Ideally, they want to see a letter from someone who knows what you are getting into and is enthusiastic about you.
Practices in some field of medicine
If you don't have a lot of healthcare experience, this can be a hard one, and you may not be able to produce a letter from someone who has seen you working with patients in a clinic.
If this is the case, you are going to choose someone who knows you well and can speak to them about a domain that is relevant to the PA profession, such as your ability to communicate effectively or your science ability.
Where should your letters of recommendation come from?
You work with what you've got. There is ideal, and there is real. What most of us have to work with is something in-between.
One Academic Letter from an instructor or professor of a prerequisite science:
- Someone who taught you one of the "big 5 sciences": anatomy, biology, microbiology, physiology, or chemistry. This is someone who can attest to your academic ability specific to the field of science and medicine.
"We require 3 LORs through CASPA. One MUST be from a MD/DO/PA/NP with whom you have worked or shadowed. Additionally, this is just me personally, professors write horrible reference letters. It's as if they hold themselves on a high pedestal to which no person can reach. Be leery of asking your professor for a letter." - Mickey King, the Admissions Director for South University Savannah PA
You definitely need a letter from a medical provider where you have volunteered or worked:
- A provider is a universal term for an MD, PA, NP, DO, or anybody who cares for patients somewhat independently. Of course, the ideal letter is going to be from a PA but this is not always possible. When I applied to PA school, I did not have a letter from a PA, was this a big deal? I don't know I still got into PA school.
A letter from another provider from another discipline or supervisor in a medical setting:
- If you received a letter from a PA in #2 you can choose another provider such as an MD, DO, NP, or RN who knows you personally and has seen you work directly with patients.
- If you don't have another provider, you can choose a clinical director, charge nurse you worked under, volunteer coordinator, or direct supervisor.
- I received a letter from the supervisor of the medical records department where I worked. She ended up writing me a wonderful letter. You can see a couple of my letters here.
Summary of the ideal situation:
- Academic letter + 2 provider letters (ideally one from a PA)
- Academic letter + provider letter + healthcare work supervisor
What should they demonstrate? Dependability, honesty, and intellectual curiosity!
How good do your letters of reference need to be?
You want the best letter you can get. You want a letter from someone who glows and raves about you. Why?
Anybody who reads letters of recommendation assumes that they will be writing for you because they believe in you, and letter writers who don't know you well will speak in "glowing" platitudes.
What is a glowing platitude? A platitude is a remark or statement, especially one with a moral content, that has been used too often to be interesting or thoughtful.
Here are a couple of examples:
- Platitude: Stephen has a positive attitude and works well with others
- Glowing recommendation: I don't ever remember him saying an unkind or angry word. He is the most positive person I have worked with in my Laboratory Medicine career of 25 years.
- Platitude: Stephen has a strong worth ethic and has experience working in the healthcare field
- Glowing recommendation: He works hard, but has a balanced life with leisure activities. I'm impressed with his career development as a student... working in Healthcare information (1.5 yrs), laboratory (1.5 Yrs), and a summer camp with special needs children. he has since trained as an EMT, has a patent-pending for a physical therapy machine, and worked at a Blood Bank center. All of these experiences give him a broad base of knowledge for a healthcare career as a physician assistant.
- Platitude: I think this person would be a good fit and would be capable of performing the relevant duties.
- Glowing recommendation: I am really sad to see this person go, but you are so much the better for it because they need to be in this field and I am enthusiastic about them.
Moral of the story:
- Pick someone who is enthusiastic about you!
- You want someone who can write well and will take the time to write well about you!
How do you go about getting letters of recommendation?
This can be tough. One way is to scout out early who you may want to write your letter and then do your best to impress.
Are you taking a human anatomy course and have a wonderful professor who you feel could provide an excellent reference?
Then do your best to show up early, attend or lead extra study sessions, create study groups, and offer to assist the professor in a lab set up or clean up. You don't want to be a "kiss ass." You want to be helpful, show that you are a hard worker, a leader, a dedicated student, and make yourself stand out. Then, if all seems well at the end of the course, you can gently ask for a letter of recommendation.
Are you working or volunteering? Well, if you are not, you should be.
Then be the wonderful person you naturally are. Please show up on time, offer to help wherever you can, don't worry about pay, work for free, or pay them :-), always keep a positive attitude, grab every learning opportunity available... again, the goal is not to schmooze, it is to be yourself. I know you are a passionate, caring person who is highly motivated and goal-oriented. Don't be afraid to take the initiative... After 12 months or more of hard work and effort, the letters will be flowing!
- You are not looking for good letters, you are looking for amazing letters! The letters should shout from the mountain tops that they would be stupid not to take you.
- The quality of letters always trumps where they come from, in other words, don't get so caught up on the ideal letter writers that you choose a less enthusiastic writer in place of someone who adores you but sits outside the "ideal" category.
- If you are applying a second time, ask for new letters or if you know it was a great letter, ask the same references to submit the same letter a second time.
- Don't ever ask for letters from family!
- Don't ask for letters based on credentials from people who don't know you well. I have had people ask me for letters after a couple of email exchanges through this website. This is not a quality letter and will not work in your favor. It also makes me extremely suspect as a letter writer.
Advanced CASPA Reference Form Tips (for the prepared PA school applicant)
- Professors, physicians, and employers are busy people so ask at least 3 months in advance for a letter.
- Set up a little interview with your recommender so they can ask questions to better help write the letter.
- Before meeting with the recommender have these ready:
- Updated resume.
- List of schools you’re applying to.
- A paper on what you may want specifically mentioned in the letter (One professor actually complimented me on how prepared I was compared to other students for requesting the letter).
- The more personal a letter the better. Don’t ask for a letter from a professor who only knows you as a good grade in their class (that’s all they can really write truthfully).
- This is something you can do starting your freshman year so professors can remember you personally and write a great recommendation for you.
Answers to common CASPA letters of reference questions (from the CASPA website)
- Q: What is the difference between an evaluation, letter of reference, and letter of recommendation?
- A: Nothing. They are all the same thing.
- Q: How many evaluations must you enter?
- A: CASPA requires three letters of reference to be listed on your application in order to submit to CASPA, however, you may list up to five. These must then be completed through the CASPA reference website. CASPA will verify your application as long as two of your evaluations are completed. Any additional references received by CASPA will be available to your schools immediately once they are completed.
- Q: How long should the letters be?
- A: The file uploaded by references may not exceed 5 MB (this is a pretty big file). The Evaluator Portal will not allow references to exceed this file size when uploading their assessment.
- Q: Can I submit more than five references?
- A: NO. You may not submit more than five references via CASPA, and CASPA cannot accept any additional or substitute letters. However, you may want to contact the schools to which you are applying in inquire as to whether they will accept an additional or substitute letter. If so, you would send this additional letter directly to them.
- Q: Why can I only have five letters? Why are letters restricted to 5 MB in length?
- A: Restrictions regarding the length and number of references have been determined by the Physician Assistant Education Association (PAEA) and the CASPA Admissions Committee, which is made up of admissions officers from CASPA participating PA programs. These restrictions reflect the PA programs’ desire to receive concise assessments and allow a certain degree of standardization in the amount of consideration given to each applicant’s reference material.
- Q: Can I have different evaluations sent to individual programs?
- A: No. Each evaluation is sent to all programs that you applied to.
- Q: Can I send letters of reference which are on file at Interfolio or a career center?
- A: NO. All letters of reference must be completed via the CASPA reference website by the evaluators themselves.
- Q: Does CASPA accept committee letters?
- A: If you wish to submit a committee letter to CASPA, it must be a single composite letter written by ONE individual (usually an advisor) who will also complete the ratings section. This single evaluator must be listed on your application with the individual’s name. Do NOT label this letter as being from a group; i.e. “Thesis Committee.” The composite letter and ratings still must be submitted electronically through the CASPA Evaluator Portal and must consist of ONE composite letter which fits within the 5MB upload limit. Do NOT upload a file containing multiple letters. Please note that a committee letter only counts as ONE letter of reference. CASPA applicants using a committee letter must still submit additional individual references, completed by evaluators who were not involved with the committee letter.
- Q: What do I do if I want to change the person who is sending the reference or edit the information I entered?
- A: Even after you submit your application, you may edit, delete, or replace references whose status is still listed as “new” or “incomplete.” Once a reference is “completed,” you may not make changes to that reference, regardless as to whether or not you’ve submitted your application.
- Q: Can I e-submit my application before my references are received by CASPA?
- A: Yes. Once you have successfully filled out your application, you can e-submit it to CASPA at any time. However, your application will not be processed until CASPA has received all of your official transcripts, at least two letters of recommendation and your payment.
- Q: How can I view my letters of reference?
- A: Even if you have not waived your right to view the reference, you still cannot access the reference via CASPA. If you have not waived the right to view your reference, this means that you may ask your reference for a copy of their recommendation, or, once you matriculate into a PA program, you may view the reference in their offices.
- Q: Can CASPA forward my references to me, my evaluators, or schools not affiliated with CASPA? (i.e can I see what the reference said about me?)
- A: NO. As per the Family Educational Rights and Privacy Act of 1974 (FERPA), CASPA may not release letters of reference to anyone other than your designated schools, including other schools or the applicant themselves.
For a complete list, please visit the CASPA website - letters of reference
Want to see my letters of recommendation for PA school?
Physician Assistant Application Letter of Recommendation Samples: Applying to PA School
Here are two letters of recommendation I received when applying to PA school. I am not posting them here as a way to fluff my feathers but merely to serve as an example of what I included as part of my actual PA school application. A great letter of recommendation weighs heavily in your favor, I believe this (and a passion-filled essay) is the reason that I, an average student from a state university, was able to receive an acceptance letter over many Ivy league applicants with pedigree backgrounds and 4.0 GPA's. A great letter of recommendation must be earned. It comes when you provide a valuable service with the sole intent of doing your job or providing your service for the benefit of others...[Read More…]
Physician Assistant Letters of Recommendation: Downloadable Templates
This download includes nine physician assistant profession specific letters of recommendation to cover most situations:
- Letter of recommendation for PA School Applicant 1
- Letter of recommendation for PA School Applicant 2
- Letter of recommendation for PA School Applicant 3
- Letter of recommendation for PA School Applicant 4
- Physician assistant colleague letter of recommendation 1
- Physician assistant colleague letter of recommendation 2
- Letter of recommendation for staff (MA/Front Desk/Tech/ETC) pursuing healthcare career/graduate school 1
- Letter of recommendation for staff (MA/Front Desk/Tech/ETC) pursuing healthcare career/graduate school 2
- Letter of recommendation for PA Student who rotates in your clinic
These are pre-formatted MS Word document templates that you may modify and edit to your liking.
Writing a good letter of recommendation can be helpful, but writing a great letter of recommendation can change a person's life. If you care deeply about your coworker, colleague, employee, student, MA, staff member, or yourself (if you have been tasked with writing your own letter), taking the time to write a reference letter that will uniquely separate you from the pack is well worth your time.
View all posts in this series
- How to Write the Perfect Physician Assistant School Application Essay
- Prerequisite Coursework: How to Design the Perfect Pre-PA School Curriculum
- Healthcare Experience Required for PA School: The Ultimate Guide
- Secrets of Successful PA School Letters of Recommendation
- The GRE and PA School: The Pre-PA Advisor Series
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Thanks for your website and all the tips and tricks involved.
I am working on who to ask to write me LORs for my application next year. I have worked in healthcare for the last 4 years but I haven’t worked directly under a MD or PA so I am not sure who to ask for LORs. I have a professor writing me one and I was going to ask the DPT I worked with. I currently am in the Peace Corps and work mainly alongside a RN, she isn’t the recommended MD or PA but she knows me well and has seen me work with patients everyday. Would she be a better option for a LOR rather than a PA I showed for only week? A DPT isn’t exactly a MD but they did work with me saw me work with patients? Help please!
Stephen Pasquini PA-C says
Hi Liz, great questions. I would recommend asking those who know you best to write your LOR. The RN you work alongside would be a much better choice than a PA you shadowed for a week. I didn’t have a letter of recommendation for a PA, but instead, I asked those who had worked alongside me for years while in the University of Washington Campus lab. They wrote glowing LOR’s and were able to highlight my best traits and understood my passion for healthcare. So, although there are “standards” school always recommend they are not set in stone. Think about the kind of letter you would like to read when reviewing a PA school application. You will know when you have the right person to aks by using this as your filter.
Good day Stephen,
Reaching out as I was looking for more information on who would serve as the best reference when applying to PA school. In particular, I was caught up on this paragraph you wrote:
“The most desirable is someone who has been witness to your patient care experience. This could be a physician, PA, NP, DO, etc. who have witnessed your work with patients.
You can use nurses and clinical managers although these references may not be as strong as the former. Ideally, they want to see a letter from someone who knows what you are getting into and is enthusiastic about you.”
In my experience as a patient care technician, the nurses and clinical managers are the only individuals I interact with at length on a daily basis. I can count on one hand the times that MDs, NPs, and even PAs come on the unit and stay for longer than 7 minutes with a patient – and in that time they are not looking to speak with me while I empty urinals and take vitals.
In this case, would it not be more suitable to ask a nurse or manager to stand as a reference? Have you come across this before?
Appreciate your feedback.
Amanda A says
First I would like to say thank you for creating such a useful resource for students like me! I have spent countless hours absorbing all your information over the past few weeks, and it has helped me better understand the process behind becoming a PA.
Second, I was wondering if you have any tips on the best ways to ask someone for a Letter of Recommendations. I’ve read the article about figuring out who to choose, but I want to be sure to ask correctly.