LOR from PA with MD cosign

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Oct 25, 2023
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I have a PA who I have worked closely with and have a great relationship with who has agreed to write me a LOR for this upcoming cycle, and one of the physicians (MD) that I work with has agreed to cosign the letter. However, I believe that the doctor would also write me a LOR if I asked, but I know that it would be less personal than if the PA wrote it. Is it better to have a strong letter from the PA with a physician cosign or to have a less informed letter from the physician? For context, I do already have a LOR from an MD from an internship I did in the past, but I am unsure of how personal/strong this letter is because they do give one to all of the interns.

Follow up question: Should I list the PA or the doctor as the letter writer if I choose to do the PA letter? I feel bad giving credit to the physician when the PA is the one who will be writing it, but I know that the MD will carry more weight with adcoms.

Not sure if this is helpful additional information, but I do also have LORs from two science profs and my research PI

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Frankly, for MD school (T20), I have not found letters from physicians to be helpful. I can count on one hand the number of PA letters I've seen in 25 years, and still have fingers left over. YMMV
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I will presume the PA works for the doctor, so one should include the doctor's contact information if they are co-signing. You probably have room to include both names, but I don't know if the application platform allows.

What you risk is an appearance that you are hedging on becoming a physician, and being a PA could be a backup. It depends on what insights about you as a physician and not a PA are included. Otherwise, you could be putting in the same letter for a CASPA (PAEA) application. It's otherwise impossible to tell you how strong the letter will be.

I also agree that rarely are physician letters helpful in a medical school application. It's different from dentists' letters where many clearly write outstanding support letters. "I want to eventually train this person to take over my practice when I retire in 10 years" endorsements are non-existent for physician letters.
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Hey, I ran into a very similar situation. I worked in a clinic with many PAs and just one doc, so I knew some of the PAs a lot better than I did the doc. One of the PAs i was closest to offered to write me a letter. I never ended up getting the doc to co-sign and just sent the letter from the PA lol. Hard to tell what impact it may have had to only have their signature on there, but I think it would have definitely been better to include the cosignature. As for who to list, I would still put the PA since it would be their name first at the bottom. Just my 2 cents.
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