Getting Great Letters of Recommendation For PA School

Posted By: Paul   |   Getting Into PA School   |   124 Comments

Letters of recommendationGetting Great Letters of Recommendation for Your PA School Application

So you’ve decided you want to become a physician assistant, and soon you’ll be sending out PA training program applications. Letters of recommendation for PA school are a pivotal, so there are things to keep in mind to maximize your chance of acceptance. The following checklist should help avoid critical mistakes.

1. Start tracking your letters down early. You should start asking references if they are willing to write your letters of recommendation early (and save them on their computer!)  because it takes time to secure an agreement from writers, it takes time for your references to actually write their letters and submit them, and generally speaking, the earlier your application is complete, the better your chances of getting in. This is particularly true if you apply through CASPA.

2. Use references that will have broad appeal. Most schools will have you apply via the Central Application Service for Physician Assistants (CASPA). CASPA requires you to obtain three letters of reference. Once received, CASPA will distribute the same three letters to each school to which you are applying. For this reason, you should choose references that will have appeal to the widest range of schools. If you are concerned about appealing to the specific requirements of a particular school, you can speak to these in your essay, or in a secondary application, which you may complete later in the application process.

3. Clinical references are usually better than academic references. In most cases, schools prefer to learn about your clinical experiences over your academic experiences. This means seeking out references who have supervised you or worked closely with you in a clinical (patient care) setting. It makes sense, because this information speaks directly about your potential as a PA. The only exception is if you have a weak academic background (low grades or your coursework is more than 3 years old). In which case, you should consider getting one letter from the instructor of a class that you did well in, preferably in a science prerequisite.

4. Seek out letters of recommendation for PA school from people you are sure support you. It may sound obvious, but many people don’t do it. Find someone who truly likes you, and who supports your decision to become a PA. If you are unsure, ask them: “I am going to be applying to physician assistant schools, and I’m beginning to think about my letters of reference. Would you feel able to support me by writing a letter of reference if I asked you to?” If their response is anything less than an enthusiastic “Yes!” then consider finding someone else.  Remember that some people aren’t so candid about how they feel, and may bring up multiple reasons they can’t write for you, such as “I’m swamped and too busy,” “I’m already writing one for someone else,” or “I haven’t seen you in enough different settings.”  Reasons like these are synonymous with “I can’t enthusiastically support your application (for whatever reason).”

5. Don’t ask your reference for a hard copy.  For all CASPA schools and most non-CASPA ones, hard copy letters of recommendation are out.  Electronic submissions are — for the majority of schools — have become the standard.  Since you no longer can submit a paper letter you were given by your supporter, you need to keep in touch with anyone who will write for you.  Be sure to get their full contact information (address, email, phone number) so that if they end up taking a new job or moving, you won’t be left in the lurch.  CASPA makes this easy.  Simply provide CASPA with the name, title, degree, and email address of your reference, and how he or she knows you. Let your references know in advance when you will be submitting their information so they can gauge when the letter will need to be written. Once they have completed their letter they will submit it electronically to CASPA.

6. Waive your right to review your letters of recommendation. CASPA gives you the option to waive your right to review your letters, and you should. Not waiving this right signifies that you may wish to view them yourself, and implies that you aren’t confident that they speak well of you. This is a little like asking a potential employer not to contact your previous employer – a definite red flag to an applications committee.

7. When complete, send a thank you card to your letter writers (and maybe even a small gift — Starbucks gift cards are appropriate). This is just good manners. It shows your appreciation and keeps you in their good graces should you need to reapply next year.

Once your letters of recommendation for PA school are completed and submitted, you can cross this item off your extensive to-do list and breathe a little easier. Good luck!


  1. Jacquirosa June 17, 2011 at 2:29 am - Reply

    QUESTION! I hope you can answer this:
    I am already in process of filling out my application through CASPA and have 2 questions:
    1) I already clicked that I want to SEE my reviews.  It’s not that i don’t trust them, or else I wouldn’t have picked them, I just want to see it later if I want to!  It’s about rights, not questions….so after reading your suggestion to click this, I tried looking to change it and I can’t – what should I do?

    2) I also read on a different section here that you say to write in your essay about why you are a good candidate for THAT school – well I am applying to 9 schools all through CASPA, which is just ONE essay.  SO – how do I make each school feel special even though there are 9 different ones with a possible 9 different values, missions, etc etc.

    • Paul June 18, 2011 at 5:04 am - Reply

      As for #1, I doubt there’s anything you can do. You could try calling CASPA and asking them if there is any way that they can change it manually, but I think it’s a long shot. I wouldn’t worry too much about it – it’s probably not a major issue – just let it go.
      #2 Your point is a good one. Generally, you write the essay so that it has general appeal, since it is for ALL the schools you’re applying to. I would avoid details and statements that might nix you from consideration at any school if possible. Either way, if you write a killer essay, you will have a chance later via an interview or a school-specific secondary application – or both – to tailor your message to individual schools.

      If have a STRONG preference for a particular school, you might tilt slightly it their way so that it has extra appeal to them, but know that this is a bit of a gamble. I didn’t, but everyone’s situation is different.

  2. Antoinette August 21, 2011 at 8:23 am - Reply


    I’m applying to the PA program and the deadline is dec 1. I have asked only one doctor so far for a letter of recommendation. I’m unsure and very nervous about asking others. My question is, when do you advise I ask other people and when should I have my application in by?

    Thank You!

    • Paul August 21, 2011 at 11:19 am - Reply

      Don’t be nervous about asking for letters – you need them! Just make sure that you’re asking people who know you reasonably well and can say positive things about you. I think it’s good to have one or two backup letters, so I don’t see any reason that you should wait before asking others. If you think one may write a more positive letter than the rest, it might make sense to wait a little longer for it. Supervisors from healthcare-related jobs and professors can right letters too.

      As for completing your application, the schools have different deadlines, so it depends which ones you are applying to. But in general, the earlier the better. I think aiming to get it in at least a month before the deadline of the school that interests you most is a good goal.

  3. Katherine August 25, 2011 at 3:05 pm - Reply

    I was wondering if it would be a good idea to ask my director where I am currently employed to write a recommendation. I work for a Healthcare organization, but I’m not clinical. More data/coordinator. I have known her for about 2 years. She is very accomplished and supports me.


    • Paul August 25, 2011 at 4:19 pm - Reply

      Do you have other potential letter writers who can speak to your clinical and/or academic ability? It’s great that you have someone who supports you, but it won’t count for much if they can’t speak well to these areas, as they are the two areas that PA schools scan for. If you don’t have anyone like that to write for you, there are ways to find them, like volunteering in a clinic/ER, getting an EMT certificate, etc.

  4. york September 12, 2011 at 12:34 pm - Reply

    Just curious if a Dentist would make a good candidate for my third letter of rec. I worked with him for many years and he knows me well. The other letters would be from a science professor and a hospital supervisor for who I interned with.

    Thank you

    • Paul September 12, 2011 at 6:17 pm - Reply

      My opinion: a dentist is “just okay” to “kind of weak.” Science prof and hospital sup are great. Another instructor, perhaps? Or someone you’ve shadowed with more than once or twice? Search your brain – you probably are forgetting someone who might be ideal. If a dentist is the best you come up with, it’ll do. But I’d push for another strong reference.

  5. LMcKay September 14, 2011 at 1:36 pm - Reply


    Someone recently asked me to write their CASPA reference letter and I want to do a great job. I think this person would make an excellent PA but want to make sure that, because I know them as a non-clinical colleague, and not a professor, that I am addressing the best possible topics in my narrative. I am not the best person to address either academic topics or clinical/patient care topics. Are there any specific area’s or topics that I should be certain to address, beyond just the typical work ethic, dedication, professionalism type stuff?

    • Paul September 14, 2011 at 3:30 pm - Reply

      Those areas are good. I also think some nod to teamwork and communication skills would be good. PA schools want to generate PAs who are able to work closely with physicians and communicate effectively, since the PA/MD relationship is a partnership in the truest sense.

      Also, you may already have written letters of reference, but if not, I think that providing anecdotes or examples of the candidate’s conduct is a more compelling way to share positive traits that just a list of them alone.

      You deserve a medal for going the extra mile on your applicant’s reference letter. Most people wouldn’t bother to ask this question!

  6. Robert November 19, 2011 at 2:15 pm - Reply

    I have been honored to be asked for a letter of recommendation for a person I believe to be an outstanding candidate. My background includes an administrator for a famous municipal hospital but that is not where I worked with this individual although I am well aware of her ability to work with other members of the clinical team and as well as the other qualifications which would make her an excellant PA. My question is: Do I mention my previous background as the basis for evaluating her in comparison with others

  7. Soni March 8, 2012 at 8:48 am - Reply

    Thank you for all the helpful advice!

    I know that CASPA allows for 3 references, but what if I have ~5 in mind? I know some schools allow to send “extra references” via regular (snail :p) mail. Would this be beneficial, or should I only send the 3? It’s confusing because some schools want two professor recs, while others just want one.

    • Paul March 8, 2012 at 9:44 am - Reply

      Hi, Soni! You’re right; CASPA will only accept 3 letters. If other schools have different requirements, you should fill those with whatever letters you have that you didn’t use for CASPA. But would discourage you from sending more than the requested number of letters. Admissions committees get busy and extra data just bogs them down. But definitely, send the best ones you have.

      • Soni March 8, 2012 at 10:41 am - Reply

        Hi! Thanks for the quick reply.

        Ya, it’s just a little difficult to decide which 3 would be the best choices, because even to submit via CASPA, all the schools want the letters from different people i.e. 1 prof, 1 work, 1 community vs. 1 prof, 2 work vs. 1 PA, 2 prof….etc

        I just want to have a combo that would be ideal for all the schools I’m thinking of applying to.

  8. Christopher Bradshaw May 15, 2012 at 10:12 pm - Reply

    I am a Human Nutrition major and know one of my nutrition professors would write me a really strong recommendation letter. However, CASPA only allows three. I currently have one from my medical director at a practice I work at and another from a doctor at the same practice who is good friends with a PA Program Director of my number one choice school. I would really love to use the nutrition professor. Would that count as my Science Professor? Or should I find a core science professor who may not write one as strongly?

    • Paul May 16, 2012 at 8:46 am - Reply

      An interesting question. Since they would write a strong letter, and you ARE a nutrition major, I think I would use them. You might do well to call schools and ask, though, just to be on the safe side. Every school’s priorities are different.

  9. Ilona May 16, 2012 at 12:40 pm - Reply

    I am currently working on my application and would love to get some advice. I have a lor from a PA I work under, as well as from my physiology professor. Who should my third letter be from…the medical director of the clinic I work for (same place as the PA letter), from a hospital staff worker where I volunteered for 2 years, or my youth pastor (could really speak about my character)? Should I send additional letters to the schools…do they even look at them?

    • Paul May 16, 2012 at 5:55 pm - Reply

      I would not use your youth pastor. Of your other two choices, I would go with whomever you believe would write the best letter in support of your candidacy. CASPA will not accept additional letters, but they’re good to have in case one of the schools you are applying to requests extras as part of their secondary application. I wouldn’t spend too much time getting them – you’ll have a chance if the want them – but most likely they won’t want them.

      • ilona May 16, 2012 at 6:07 pm - Reply

        Thanks! …also, if the MD and PA letters come from the same place would that be acceptable?

  10. Saul June 5, 2012 at 12:12 pm - Reply

    I can get a letter from a pa i’ve shadowed, my supervisor in a medical related job, and my ap 1 and 2 instructor. Should this suffice? I believe I can get more? Should I? Can I have too many letters? My deadline is . 15th.

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