Do Letters of Recommendation Actually Work?

In an age of holistic admissions, letters of recommendation are still common among CSD admission requirements; however, research suggests the tool systematically advantages some applicants while disadvantaging others. Historically, programs commonly use letters of recommendations because it provides a narrative context that could offer insight into future professional behavior. The issue at hand is not intent, rather it is validity.

Newkirk-Turner and Hudsen (2022) found that letters written for Black applicants contained phrases that could negatively influence evaluators. Examples included hedging language and descriptors that emphasized effort over ability.  Critically, it was found that these phrases were not random; they tracked with outcomes. Black applicants who were admitted had fewer biased phrases and those not admitted had more. 

Related research by Cheng et al. (2023) found that Black applicants were more likely to be described as “competent” compared to White applicants who were described as “exceptional.” Moreover, White and Asian applicants were characterized with terms such as “skills” and “leadership.”

Gendered language patterns were noted. Women were described using “communal” traits such as “hardworking” and “kind.” Compared to men who were described using “agentic” traits such as “leader,” and “exceptional.” Letters of recommendation for women were frequently included doubt-raising language (e.g., “she will likely succeed”), compared to stronger statements of perceived ability for men, (e.g., “he will succeed”). These findings are consistent with earlier work by Madera et al. (2009), which suggests that such patterns are persistent over time.

Taken together, this raises an important question: Do letters of recommendation work? While they offer narrative insight, the evidence suggests they also reflect systematic differences in how applicants are described based on race or gender. Further, this raises concerns not only about bias, but what these letters actually measure, and if they meaningfully predict future academic and clinical success.

Letters of recommendation may still have a place in admissions, but only if programs are willing to critically evaluate their function. Structured evaluation systems, similar to what already exists in CSDCAS, could be strengthened using the existing Likert rating scale but expanding to have evaluators additionally answer required standardized prompts to justify each score. Alternatively, programs might consider replacing letters altogether with more performance-based indicators. 

As a discipline, CSD must consider whether continued use of letters of recommendations is justified by evidence, rather than tradition. In clinical practice, clinicians do not accept unstandardized, subjective, and bias-prone tools to make decisions. Yet in admissions decisions, programs continue to rely on an uncalibrated measure to shape both entry into the profession and the future of the clinical workforce.

References

Cheng, V.Y., Munson, M., Termini, C.M. (2023). Approaches to address bias in letters of recommendation. Trends in Pharmacological Sciences, 44(6), 321-323. https://doi.org/10.1016/j.tips.2023.03.002

Madera, J.M., Hebl, M.R., & Martin, R.C. (2009). Gender and letters of recommendation in academic: Agentic and communal differences. Journal of Applied Psychology, 94(6), 1591-1599. https://doi.org/10.1037/a0016539 Newkirk-Turner, B.L., & Hudson, T.K. (2022). Do no harm: Graduate admissions letters of recommendation and unconscious bias. Perspectives of the ASHA Special Interest Groups, 7(2), 463-475. https://doi.org/10.1044/2021_PERSP-20-00117

Lisa Osier
CAPCSD Admissions Committee Member