Shadowing/Letters of Recommendations

Shadowing is perhaps the most difficult thing to accomplish, especially if you have very little contact with anyone working in healthcare. Once you finally find someone to shadow, make sure you call that person or the office manager (office managers really like to be in on whats going on) and ask any questions you may have, like dress code, specific hours, and anything else you may want to know. I exhausted every reasonable resource. I asked every person I knew if they had any PAs as healthcare providers. I contacted the local chapter of AAPA, (For Florida...FAPA) and emailed those in my area although I did not receive any response from a single person on the list. I also contacted several MDs and was able to get some assistance there.
One particular MD felt compelled to offer to review my application and give me pointers for the interview at a price of an office visit which I politely declined. I was actually quite shocked that someone would want to be paid for assisting a student looking to gain admittance to PA school. But I am sure there are some who would pay for it. And I am sure there are services that will do this for you, but I do believe in the power of paying it forward so I hope to one day be able to assist others in my shoes!
When shadowing, try to observe several different practices and specialties if possible It is such a valuable experience and gives you a broader idea of the scope of practice of different PAs. The more you observe, the better it is for you. Many schools do not have an actual requirement for shadowing, Nova did not. But it is important to know this in advance. Some require you to have a log and have it signed off. One that comes to mind is University of Texas Pan Am. If you do want to log your shadowing, even for your own reference, I suggest going to the UTpan AM site and downloading their form just so you are able to have a guideline for your experiences.
Letters of Recommendations, also known as LORs, Uggghhhh! Here, again, it is important to Follow Directions!! Just as important as getting Good LORs is who you get your LORs from. Some schools have certain requirements for the LORs. Nova, for example requires 3 LORs, 2 must be from healthcare professionals and that does not mean the office manager, of which one must be a PA and then another from anyone, such as a professor or past employer etc...I admit that I did not follow directions. I was lucky that the admissions coordinator was kind enough to call me and tell me that I needed another LOR in order to fulfill the requirement. She did not have to do that. I could have easily ended up in the discard file but I like to think that she saw something good in my application that she was compelled to call me.
My original LORs were from a professor, an MD and a PA who was involved in healthcare education. The problem as it turns out was the last one was not a "practicing" PA. Go figure!
What a dilemma! I did not have a close rapport with any PAs that I felt comfortable asking for a LOR. I had shadowed several but I did not think they knew me well enough to write an honest assessment of my abilities. I had to review my shadowing experiences to decide who to call for this final LOR and I felt very time trapped.
I would not get an interview if I did not complete this requirement! I wanted this more than anything because I felt I would be able to do well at the interview.
I had shadowed several Family Practice PAs as well as a Derm PA. Of these, I decided on the one I felt most comfortable with and the one who was most willing to explain things to me and take the time to discuss my aspirations. I called him up and simply explained my case.
"I know its been a while (like 2 months) since I shadowed you and while I have shadowed several PAs, I felt most comfortable with you and your methods of practice, I have received a positive call from the program I am interested in but I am required to get a LOR from a practicing PA. Would you be interested in helping me with this?"
And there I had it! Or course, CASPA electronic LORs was no longer available to me so I had to have it written on a particular form that the program sent me and I offered to pick it up and mail it myself so as not to create a problem for the PA. But my real reason was that I could set a time frame for it and pick it in a sealed envelope and mail it out. This way I knew it was done and mailed!
This seems to be a big issue with LORs. Time...with CASPA you know when your LOR has been received because you can check the status. Anything coming after that as was my case, you really do not know if it is completed and mailed. With CASPA, you can change the person you have listed for a LOR as long as they have not started the process even after you have submitted the application. Therefore,if someone does not do it in a timely fashion, you can delete and add someone else.
Gauge the response and body language of the person when you ask for your LOR. If it seems that there is some hesitation, chances are you wont get it in due time. Find someone else. I have done this, and then when they come back 3 months later and say they never received the form through email, I just tell them that I submitted a list of possible people to write me a LOR and the system then chooses the ones to send. Everyone seemed satisfied. I guess I could have just said I did not feel comfortable with their response, but why create unnecessary ill feelings.
I was lucky in that everyone I asked to write actually sent me a copy of what they wrote without my asking. In fact, one sent it to me to confirm that they had correct info about me and my plans which was a very nice thing to do. For each of the people I had write, I sent them an email with pertinent facts about my life, education, and goals. I think this is important especially if the person does not know you on a personal level.
Both the shadowing experience and the obtaining of LORs are very important to understanding the profession and process. Hopefully, you will be able to be in a position to offer these services to a future PA-S one day!
Just as a quick note/edit:
If you need to get HIPAA (Health Insurance Portability and Accountability Act) training to shadow, I found this web site in conjunction with the George Washington University Medical Center that has you go through a powerpoint presentation followed by a short quiz and then they will email you a certificate of completion. I printed this of and gave a copy to every office manager where I shadowed. It is a good idea and certainly can not hurt to learn this now. It seems to be the biggest reason that practices and hospitals will not let you shadow, because of HIPAA restrictions.
Here is the link for those interested:
http://www.goodoutcomes.com/