How to Score First-Rate Letters of Recommendation


In preparing to apply to PA school, you undoubtedly will sift through tens if not hundreds of programs, evaluating their requirements in order to identify programs that seem like a good fit for you.


As a result, your application is bound to look like thousands of others - comparable both academically and in prior experience. So how does a pre-PA student stand out in a sea of similar applicants? By crafting a solid personal statement (covered in this prior post) and securing high-quality letters of recommendation.


When done well, these two areas can make a great application exceptional, an average application special, and a mediocre application competitive.


Because you are not composing the letter of recommendation (LOR), you might assume that the quality of the recommendation is out of your hands.


But, this is simply not true. You have a significant amount of control in how these letters reflect on your quality as a PA school candidate.


This post will break down how to obtain high-quality letters of recommendation into a simple process so you can take the steps needed to distinguish yourself in your application to PA school.


What to know

Programs typically require three LORs, and some programs also require one or more letters from a specific role - professor/advisor, PA or other clinician, or a supervisor.


For CASPA applications, LORs are part of an “evaluation,” which includes contact information for your reference, a ratings portion where your reference scores you on a scale of 1-5 in several criteria, and the LOR.


CASPA requires a minimum of three evaluations, even if the programs to which you are applying require less.


You can submit up to five references through CASPA. You have the ability to change or delete your references before the evaluation is completed, but you will not be able to delete a completed evaluation.


CASPA will verify your application when at least two evaluations are completed, and additional evaluations will be sent to your schools immediately once they are submitted. The same evaluations are sent to all programs to which you apply.


Click here to subscribe


Who to ask

As a group, your references should be able to demonstrate your ability to handle the academic load of PA school, your understanding of the clinical environment, and your work ethic. Each reference should focus on one of these areas and be able to speak to your strengths in the area.


A well-rounded trio may include a professor (academic load), a PA who you worked with or shadowed (clinical environment), and a supervisor (work ethic).


I would hesitate to use two references from the same experience, for instance a physician and a supervisor in the same facility from your work as a CNA.


Using references from different experiences will better highlight that you consistently performed well across the variety of roles that you have held. Using multiple references from the same experience runs the risk of seeming as if your experience is limited.


A key point to remember when choosing a reference is to focus on who can BEST speak to your ability in one of these three areas. A supervisor from a non-medically related job that you have held through three years of college may be in the best position to describe your reliability and trustworthiness. A certain TA may be better positioned than a professor to write you a high-quality LOR.


PA schools care about the quality of your character and your likelihood to succeed in their program, not about the prestige of your letter writers. Choose references who are most familiar with your strengths.



When to ask

There is not a set time frame of when to ask for a reference, but you should follow the general “Goldilocks principle” - asking when your relationship with your potential reference is neither too hot nor too cold.


It is not appropriate to ask for a reference from someone whom you have no relationship with, even if you are struggling to find references. A friend of a friend who is a PA, a professor that you have never spoken to, or your volunteer supervisor who you met last week are off limits.


You will not get high-quality letters of recommendation from people who do not know you, and it will be obvious to PA programs that your references know very little about you. It is essential to establish a relationship before asking for a recommendation, but the good news is you can start now.


For professors, go to office hours and ask questions. Show up to every class on time, and engage in class when you are there. Demonstrate that you are interested in learning and growing.


If you developed the relationship but will be applying to PA school later, let the professor know before the semester is over. It is perfectly fine to tell them that you plan to apply to PA school next semester or next year, really enjoyed their class and appreciate the help that they gave you, and ask if they would be willing to be a reference when you are ready to apply.


Do not wait until you have not seen an instructor for a semester to ask. You will be much more memorable if you ask when the relationship is at its peak, then keep in touch once in a while so that you remain familiar.


This is even easier to do with academic advisors who may be with you throughout college. Keep regular appointments to discuss your goals and ask advice, and let them know how you are applying the advice they have already given you.


Click here to subscribe

For PAs and other clinicians, wait until you have worked with them for a few months. This includes working in a clinical role or shadowing a provider.


When shadowing, ask a lot of questions about their experiences as a provider and in training. Once you have fulfilled any required shadowing hours, ask if you can continue to shadow regularly as it fits with your schedule - half a day every other week is reasonable to keep the relationship going.


If you have shadowed regularly but will be unable to continue, ask if they would be willing to be a reference for you before you finish shadowing. Then, stay in touch at least once a month to ask a few questions and stay engaged.


(Need help finding a PA to shadow? Check out this series on shadowing.)


For your supervisor reference, you should also have a few months of regular experience before bringing up the topic of a reference. This may vary depending on how much you are working or volunteering under the direction of the supervisor, but it should be enough that you feel fairly comfortable asking.


Asking anyone for a reference should make you a little nervous, but if you feel like you might faint, you are likely asking too early into the relationship.


Evaluations may be completed in CASPA before you finish the rest of your application, so you can ask for references at any point of an open application cycle. Ask far in advance of your application deadline, and consider imposing your own deadline (CASPA allows you to do this) on the reference to be sure the evaluations are received in time.


There's nothing wrong with asking a reference to complete an evaluation by 4-6 weeks ahead of when you plan to submit your application. Your application will go nowhere without the three references, so do not hope that your references will abide by a final deadline, give them one of your own in order to have some cushion.



How to ask

Similar to your personal statement, a LOR is much more powerful when it includes specifics that relate to being a PA or a PA student.


Once you have identified your potential references based on the general areas to cover (academic, clinical, and work ethic), you will see what specifics you should include in your request.


For instance, when asking a PA from a clinical position for a reference, you can say “I was hoping you would be willing to provide a reference and letter of recommendation for me to PA school because you have been best positioned to see my interaction with patients and have first hand knowledge of how our coworkers have come to count on my reliability." 


This helps the letter writer know why you chose them specifically, and helps to set the tone for what you want to be communicated to PA schools.


First, ask in person. Then, follow up by email with additional details. Be sure to include any specifics that you think your reference may be uniquely qualified to speak to (as in your original request), and details on how the CASPA system (or non-CASPA program) will work.


CASPA will send out an immediate email to your reference once you add them to your application.

Click here to subscribe


Keep in mind that individuals who may be your best references may not have much experience with writing LORs. Be prepared to provide some additional guidance on what could be included in the letter (based on their interaction with you) to better demonstrate your qualifications for PA school.


Get the “anatomy of a LOR” as part of your free LOR guide. This will help an inexperienced reference in providing you a solid LOR, and help you to understand what to ask when requesting a recommendation.

High-quality letters of recommendation can help bolster your application and are one of the very few ways to demonstrate within a PA school application what aspects of your personality and character will serve you well in PA school and as a PA.


Evaluations are not something to be put off until the rest of your application is complete. You should strategize your approach to obtaining quality recommendations as part of your overall PA school prep plan.


By starting this process early, you'll have the greatest chance to positively impact on your PA school application.