Letter of Recommendation - MD or PA/NP

[healthEngineer]

I have worked as an emergency medicine scribe for about 6 months and now the time has come to ask for a letter of recommendation. I have worked primarily with physician assistants and only with doctors a handful of times. One of the PAs I've worked with for over 100 hours, most of the docs I've worked with for just a few shifts. Would you recommend asking for a LoR from the PA, or should I try to ask one of the MD/DOs? If all else is equal, does an MD/DO letter carry more weight than a PA letter?

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[Mr.Smile12]

I have worked as an emergency medicine scribe for about 6 months and now the time has come to ask for a letter of recommendation. I have worked primarily with physician assistants and only with doctors a handful of times. One of the PAs I've worked with for over 100 hours, most of the docs I've worked with for just a few shifts. Would you recommend asking for a LoR from the PA, or should I try to ask one of the MD/DOs? If all else is equal, does an MD/DO letter carry more weight than a PA letter?

Is the PA a supervisor?

 

[healthEngineer]

Is the PA a supervisor?

Yes, the PA is essentially a supervisor because, as a scribe, I do the medical charting for him. I am beside each provider throughout each shift as they dictate notes, exam findings, medical decision making, and other stuff to put in the charts. Most of them (including the PA) review the charts for errors and provide feedback on how to improve. The PA I've been working with seems to be happy with my charting lately.

 

[Mr.Smile12]

Yes, the PA is essentially a supervisor because, as a scribe, I do the medical charting for him. I am beside each provider throughout each shift as they dictate notes, exam findings, medical decision making, and other stuff to put in the charts. Most of them (including the PA) review the charts for errors and provide feedback on how to improve. The PA I've been working with seems to be happy with my charting lately.

On the AMCAS side, many schools recommend but do not require a physician letter. I think this letter is fine as a clinical supervisor letter, even under an employment category. I'd ask around to admissions professionals about this situation.

 

[healthEngineer]

On the AMCAS side, many schools recommend but do not require a physician letter. I think this letter is fine as a clinical supervisor letter, even under an employment category. I'd ask around to admissions professionals about this situation.

Thank you!

@Goro or @LizzyM, what are your thoughts?

 

[Goro]

I have worked as an emergency medicine scribe for about 6 months and now the time has come to ask for a letter of recommendation. I have worked primarily with physician assistants and only with doctors a handful of times. One of the PAs I've worked with for over 100 hours, most of the docs I've worked with for just a few shifts. Would you recommend asking for a LoR from the PA, or should I try to ask one of the MD/DOs? If all else is equal, does an MD/DO letter carry more weight than a PA letter?

At my school, we'd put more weight onto an MD/DO LOR.

 

[Moko]

Anecdotally, from what I've seen, MD/DO/PhD letter writers tend to give more effusive praise compared to RN/PA/NP/non-clinical letter writers. Personally, I don't think a clinical supervisor letter is necessary in your situation unless a school (or your letter committee) is specifically requesting one. A letter from someone you've scribed for a few shifts is unlikely to be glowing or beneficial for your application. Just my thoughts.

 

[orthoPA81]

I am a former PA and current OMS-1. When I applied to med school I included a letter from the director of my PA program who is a PA. I made sure to also include multiple letters from MDs that I worked with and knew me well.

I contacted the medical school prior to finalizing my application to make sure they would accept the LOR from the PA. They said it was fine but didn’t count it toward the required MD/DO letters.

In the end I had four MD letters and one from the PA program director.

 

[nimbus]

This thread illustrates the sad state of affairs for EM these days.

 

[LizzyM]

Why are you asking for this letter? Is it something you are submitting to all schools or something requested by a pre-med committee, or some other reason? Are you applying MD, DO, or both?

 

[healthEngineer]

Why are you asking for this letter? Is it something you are submitting to all schools or something requested by a pre-med committee, or some other reason? Are you applying MD, DO, or both?

I am asking because right now I only have letters from professors I've taken classes with and I think it will be good to have a letter from a clinical supervisor. I would submit this letter to all schools when I start the application for MD programs.

 

[LizzyM]

I am asking because right now I only have letters from professors I've taken classes with and I think it will be good to have a letter from a clinical supervisor. I would submit this letter to all schools when I start the application for MD programs.

Those letters are essentially worthless to the adcom They do not provide answers to the questions that adcoms are looking to have answered by the letters which is "how will this student contribute to our academic community and are they a strong student academically and in ways not measured by grades (prompt and diligent, willing to ask for feedback and act on advice, strong contributing member to group projects and helpful/cordial to fellow students, etc)"

 

[healthEngineer]

Those letters are essentially worthless to the adcom They do not provide answers to the questions that adcoms are looking to have answered by the letters which is "how will this student contribute to our academic community and are they a strong student academically and in ways not measured by grades (prompt and diligent, willing to ask for feedback and act on advice, strong contributing member to group projects and helpful/cordial to fellow students, etc)"

Oh wow, that's the first time I've heard this! Thank you for that perspective. So do you recommend just submitting letters from professors who can speak to my academics? Or are there letters outside academia that would be valuable?

 

[LizzyM]

Oh wow, that's the first time I've heard this! Thank you for that perspective. So do you recommend just submitting letters from professors who can speak to my academics? Or are there letters outside academia that would be valuable?

The PI of any lab you worked in is expected if you are applying to the top research med schools. Sometime someone in a D-1 athletic team will have the non-science letter be from the coach. One of the nicest letters I ever saw was from a coach who described how much a gentleman the athlete was on road trips and how gracious when faced with fans, particularly youngsters, who wanted autographs, etc.

 

[healthEngineer]

Those letters are essentially worthless to the adcom They do not provide answers to the questions that adcoms are looking to have answered by the letters which is "how will this student contribute to our academic community and are they a strong student academically and in ways not measured by grades (prompt and diligent, willing to ask for feedback and act on advice, strong contributing member to group projects and helpful/cordial to fellow students, etc)"

I do see some schools such as UC Davis that recommend submitting a physician or clinician letter of recommendation. I'm a little flustered by this because many people recommend against sending LoRs from shadowed physicians. And the doctors I scribe for in the emergency department usually don't have enough time to eat let alone get to know me well enough to write a strong LoR. Any recommendations for getting a clinician LoR? @Goro @LizzyM @gyngyn

 

[chilly_md]

In those cases, it is a recommendation and not a requirement. Not having one will not hurt you. And a short letter from someone who does not know you well is unlikely to help in my opinion.

 

[LizzyM]

I do see some schools such as UC Davis that recommend submitting a physician or clinician letter of recommendation. I'm a little flustered by this because many people recommend against sending LoRs from shadowed physicians. And the doctors I scribe for in the emergency department usually don't have enough time to eat let alone get to know me well enough to write a strong LoR. Any recommendations for getting a clinician LoR? @Goro @LizzyM @gyngyn

I'm not at UCDavis so I can't say what they want from a clinician letter or what applicants who get admitted there did to fulfill that recommendation. You might ask on the UCDavis specific page.

 

[Lawpy]

I have worked as an emergency medicine scribe for about 6 months and now the time has come to ask for a letter of recommendation. I have worked primarily with physician assistants and only with doctors a handful of times. One of the PAs I've worked with for over 100 hours, most of the docs I've worked with for just a few shifts. Would you recommend asking for a LoR from the PA, or should I try to ask one of the MD/DOs? If all else is equal, does an MD/DO letter carry more weight than a PA letter?

MD/DO letters are far superior to PA letters. You’re applying to med school so focus on getting good physician letters

 

[Acapedia]

Definitely do not get a PA letter unless you absolutely have no other choice. Thats my $0.02

 

[WheezyBaby]

As a disclosure, I don't participate in the med student admissions process. However, I would want a letter to speak to the desirable characteristics of an applicant that are difficult to ascertain elsewhere. Functionality as a member of a team, integrity, dedication, perseverance, resiliency, ability to establish rapport / respond to emotions, demonstrate leadership, etc. A physician letter that accomplished these things I would probably look at somewhat more favorably than a nonphysician letter, but I think adcom should recognize to some degree that the opportunity to develop that type of relationship with a physician is variable and to put too much weight on it understates the privilege some have from having physician family members (or just the free time afforded by not having to work during undergrad). But as LizzyM was saying, I would look at something like a letter from a coach that spoke to an individual's ability to bring up his teammates or a letter from a physical therapist that spoke to an individual's ability to engage with and motivate patients to participate in therapy as considerably more valuable than a superficial physician letter. Specifically to this instance, I'd think about what you're hoping to get from the letter, but I personally wouldn't care much clinical specific skills like an applicant's ability to transcribe an organized H&P.

Happy for actual adcom to correct that as applicable however