Shadowing Etiquette

image.jpg


Shadowing is something that is recommended for most programs, and required by some.  If you are possibly considering PA school, I recommend shadowing at least some to see if it's really what you want to do.  It's easy to read about what a Physician Assistant is and see all of the awesome articles about how it's ranked as one of the best jobs, but that doesn't necessarily mean it's for you.  Shadowing will also help you when it comes to interviewing and answering questions that address what a PA does and how a PA is different than a physician.

So once you've found some places that will let you come spend some time with them, you definitely want to be a good guest!  That will help you to get a good letter of recommendation (LOR), get more hours at that location, or possibly get them to connect you to some colleagues that may be able to help you out.

Don't be afraid to ask questions before you go in!  If you're shadowing in a hospital there may be some clearance stuff with HR that you need to do to even be allowed to be there.  It's perfectly fine to ask general questions, like when and where they want you to report and what you should wear.  (When in doubt, go with business casual.)  It may sound harsh, but a PA is unlikely to wait around for you when they have a schedule of patients to see, so do your best to be where you need to be on time.  As a PA, we know that this is for your good, so don't feel like you have to impress the PA you're shadowing.  You want to make a good impression (for possible future LOR), but we want you to learn and see if this job would be a good fit for you.

Know the basics of HIPAA.  This is basically the healthcare rules that are in place to protect patient's privacy.  It's kind of common sense, but if you've never been in a clinical setting you may not know how serious these are.  Basically all of the patient's personal information and anything you may see is private and you should not talk about it with anyone other than the person you're shadowing or other related healthcare staff.  And if you recognize a patient's name as someone you know, it's perfectly fine for you to say you don't feel comfortable seeing them in a medical setting.  And then make sure not to share the details of that encounter with anyone who may also know the person.  It can be really easy to slip up and go "Oh, I saw so-and-so's dad the other day," or something like that, but the patient may be seen for something that is not public knowledge and it's their right to maintain that privacy.

When you show up to shadow, it's a good idea to bring something to take notes, something to do if there's some downtime, and any questions you may have.  Sometimes there are some slow days (like the one I had yesterday), and it stinks that you may not get to see many patients, but that gives you a great opportunity to ask questions about PA stuff.

When you're seeing patients, feel free to ask your preceptor questions when you've left the room.  This will show that you were paying attention and that you are actually interested in being there.  If there's something you don't understand or didn't catch what the diagnosis was, just ask!  And again, don't feel like you have to impress the PA, obviously you are there to shadow because you want to become a PA, so we want you to learn.

Before you leave, make sure to get some contact info (phone number, e-mail) in case you have any questions or need a letter of recommendation in the future.  Also keep a very good log of your hours including where you shadowed, what specialty you were in, how many hours, and anything cool you saw.  This will come in handy for the CASPA application or other applications.

Last, but not least, whenever you are a PA and students call looking to shadow, don't forget that you were in their shoes at one point trying to find shadowing sites too.

Share any tips you have for shadowing below!

Listen to the accompanying podcast episode now! 

Choosing the Right PA Program

image.jpg

  
According to the PAEA Program Directory, there are 217 PA programs (including provisional and probation).  That's a lot of different programs!  While the outcome at the end of a program is the same (you're a PA!), the experience to get there can vary greatly.  This is my list of specific factors to look for and ask questions about when you are trying to decide where to apply.

For more information on choosing a PA program, check out this guest post from one of our coaches, Jourdyn

To make your process easier, check out the Applicant’s Manual of PA Programs for a list of every program, including their mission statement, prerequisites, requirements, accepted stats, contact info, and tons of other information. Get it on Amazon now (affiliate link).

  • Location - This is pretty obvious. You have to decide how important it is for you to be where you want to be. If it's not that important, you can apply more widely. You also need to decide if setting is a factor, such as city vs rural.

  • Length of Program - These are all pretty comparable, but still something to consider. Most programs I've seen are around 25-27 months (6-7 semesters), but there are some programs that are shorter or longer. I don't think this should be the biggest factor in your decision.

  • Private vs Public/Cost - Cost is a huge factor in choosing a program. A public program is usually going to be more affordable than a private program, but this is not the rule. When estimating total cost, you need to take into account tuition, fees, books and supplies, testing, and living expenses. Those numbers can add up quickly! Most people have to take out loans, and that massive number at the end of two years can be a little daunting.

  • Cadaver lab vs models - This is where you have a say in your education. Some schools have cadaver labs, and even these can vary. The difference is that you actually dissect the cadaver versus studying from an already dissected cadaver. And then there's learning from books and models. This may not be a huge factor for your decision, but learning from a cadaver can be very valuable, and I would strongly recommend it if you are at all interested in a surgical field. There's a great advantage to getting to feel the difference in nerves and veins and seeing how the tissues look in real life before you get into an OR.

  • GRE requirements - The majority of programs require the GRE. The minimum requirements are typically just a baseline and this doesn't hold a ton of weight in the decision process, so I would recommend taking it regardless, but there are a few programs that do not have specific requirements.

  • GPA/Science GPA - GPA is a huge factor, and most programs also calculate a separate science GPA. The alternative to GPA is a requirement for minimum grades in coursework, like a "C" minimum. There are some programs that do not have minimum GPA requirements, but these programs still usually have a pretty high average GPA of the students they accept. From the experience I have with admissions, I would say if the school has a specific minimum GPA and you don't have that number then it probably isn't worth it to apply. This is used to weed out applicants quickly, and often if your GPA doesn't meet the minimum you won't make it to the department. **The only exception to this is if it is a school you really want to go to and you have plans on taking classes to raise your GPA and reapply, then go ahead and submit because it will show improvement as a reapplicant.

  • Health Care Experience (HCE) - The amount of direct patient care required varies greatly between programs. Like GPA, some schools have no specific requirement, but can have high averages of the accepted students. Other programs have requirements ranging from hundreds to thousands of hours. What counts as "direct patient care" experience can vary between the programs, so if you have any questions at all it would be worth calling your top programs to ask before investing your time and possibly money. For example, my program accepts hospice volunteering as HCE, while at other programs it's strictly volunteering

  • Shadowing requirements - Pretty much the same as HCE, some schools have no requirements while others have certain hour requirements. Some programs also require you to shadow multiple fields, so definitely worth checking on.

  • Bachelor's degree vs no degree requirement - At this point, the majority of programs do require a Bachelor's degree to be accepted. There are still a few out there that will accept you solely if you have the correct prerequisites.

  • Prerequisites - All programs will have specific classes they require for applying. The can influence what major you decide on if in undergrad and also where you apply. If you have a question about these requirements, definitely get clarification from specific programs. This will prevent you from wasting your time or money on classes you don't need. It can even be subtle things like statistics versus biostatistics. The other big one is organic chemistry. Look for if they specifically require this or just general chemistry courses.

  • Clinical flexibility - Clinical rotations make up a whole year of your program, and it's important to know where you will be. Do they send you wherever they need a student? Can you decide where you want to be for the most part? Are there international options for rotations? The most information on this will come from the program itself or former students. If you are able to do a tour or meet with the department, this would be ideal, but asking at the interview is fine as well. This is especially important for students with spouses/children/family because you don't want to get separated if you don't have to be.

  • PANCE pass rates - This information should be readily available on the program's website or by calling the program. It makes sense that you would want to go somewhere with a good pass rate because that means the students are well prepared for boards.

  • Small group opportunities - What is the teacher to student ratio? Is there any type of small group learning? When learning clinical skills and physical exam, many people do better in a smaller setting, so at least worth asking about.

  • Job opportunities - Does the program help you to find a job when you graduate? It's likely that the faculty may have some resources when it comes to job searching so it's a good thing to ask about. My program sends out e-mails when someone contacts them with a job opportunity and has a job board as well.

  • Amenities - It's important to look into what resources will be available to you while you are in school (that you are paying for of course). Is there a gym to use? Is there food on campus? Is there a good library? Some programs even provide a computer for you to use while in school!

  • Extracurriculars - If it's a large program there may be more extracurricular opportunities available to you. This could include intramurals, religious groups or meetings, clubs, or volunteer opportunities. My program had an awesome student-run health clinic that our whole class participated in and student officers as well.

  • Employment during the program - Although it is strongly discouraged in most programs, there are some places that will allow you to work if you desire for a few hours during the didactic phase. PA school is no joke, so I'm not sure how someone could actually do well working and going to school, but that may be something you want to look for.

Here is a blog post from a PA-S about how he chose what program to attend.  

What are some things you are looking for when you're deciding where to apply?  Or if you're already in a program, why did you choose the one you did?


Program Spotlight: Duke University Medical Center

image.jpg

  
Duke's PA program is consistently ranked extremely high every year, and their standards and requirements reflect that.  Here's some info if Duke is at the top of your list!

Location:  Durham, North Carolina

Number of students:  88

Application Cycle:  Opens in April.  CASPA by Oct 1; supplemental application by Nov. 1 - priority if complete by August 15!

Interview dates:  October - January (~240 invites) with rolling admissions

Start date:  August

Length of Program:  24 months

Public/Private:  Private

HCE:  minimum of 1,000 hours of direct care by the time your application is complete (~1 year working full time)

Shadowing: No specific requirements

The Good Stuff:

  • Diversity is encouraged!
  • Technically no GPA requirement, but must have at least a C in all courses
  • Although you are encouraged not to work, students may work up to 20 hrs weekly during the first year
  • Pre-reqs must be COMPLETE by the December before matriculation
  • Not good chances for college seniors (<5% of 2014 class) unless you have a ton of HCE
  • International students must have 1 year (30 hours) of classes at a US college
  • Prerequisites - doesn't specifically require Organic chemistry or labs with anatomy
  • Relatively affordable at about 38,000 a year for tuition (similar to many public schools)
  • Decision will come in the mail no later than March 1
  • There's no specific time frame that prerequisites must have been taken in
  • They lease computers to students to use during the program
  • They offer Orthopedic and Surgical residency programs

Program Link:  Duke PA Program


For the most up to date information on PA programs in one place, check out The Applicant’s Manual of Physician Assistant Programs. (Affiliate link)


Preparing for Interviews for PA School

image.jpg

  
So once your application is complete, the waiting begins!  And it's pretty terrible.  It's always difficult waiting on the call or e-mail that could have a big impact on your future, but while you're waiting there are some things you can do to prepare.  Then when you do get that exciting invite, you'll feel like you're ready to own the interview that you just prepared for!

1. Interview attire:

A SUIT!  For PA school interviews, I'm a firm believer in wearing a suit.  Once you're done and it's a job interview that may be a little more laid back and business casual is okay, but for this all-important interview I recommend a suit.  For guys and girls.  This is going to sound a little sexist, but some advice I was given before my interview was that females should wear a pants suit (as opposed to a skirt) because it is one less thing that differentiates you from males.  I don't know if there is truth in that, but I wore a pants suit and all of the females who were accepted from my interview group were wearing pants.  I think they were saying it is less of a distraction and makes them judge you a little less on appearance.

I don't think a suit has to be boring either.  Most people think all suits are black and that's not true today (mine was light gray).  The most important things are that it fits well and looks professional.  For girls, you can always show a personality with a little color or jewelry choices.  So once you're done applying, if you do not already own an appropriate outfit, I suggest looking for a good professional suit that you will be comfortable in.

2. Do your research.

You probably have already spent a good deal of time looking into the schools you're applying to, but dig a little deeper.  Figure out what is unique about each school you are interested in and what you have questions about.  Write this stuff down and take it to the interviews if you have to.  The program's specific website will obviously be a good resource.  Check out my "Program Spotlight" series, and if there's a school you would like covered send me an e-mail or leave a comment!

Another website that is extremely helpful is The Physician Assistant Forum.  This is the most active forum I've found of pre-PA, PA-S, and PA-Cs on the internet.  They have specific sections for each school where people post their status of the application and often the interview layout and tips on the interview.  They will also start posting when they get accepted, so you can know what to expect and hopefully find some of your classmates when you are also accepted!

3. Figure out what you want them to know about you.

This is one of my favorite tips, and one that I think possibly helped me the most!  An interview coach at UGA told me to write down everything I wanted my interviewer to know about me so those topics were my focus, and then when they asked me questions I could bring it back to these topics and try to incorporate them.  This was great for me. A lot of times when we get into high pressure situations, like a PA school interview, our thoughts just fly away!  By preparing ahead of time and knowing what you want them to know about you, it's easier to stay focused.  This could include anything from specific personal experiences, struggles you've experienced, or specific qualities about your character.

4. Mock Interviews

This is another thing that I think helped me the most.  I had a mentor who I casually met with and she asked me questions similar to the ones she was asked.  I don't think I answered many of those questions well, but it helped me to think about what I did want to say when I was asked again at my real interview!  It also helps nerves to be answering a question that you have practiced answering.  *Shameless plug alert*  I would love to help you prepare and offer that as part of my PA Coaching Services, but if you have a mentor or teacher they may be able to help too.  Sometimes undergraduate schools will have a Career Services division as well that may offer some resources.

5.  Get Up to Date with Current Events

If you're not someone who follows the news very closely, do some research and familiarize yourself with some current events in the nation and the world.  Specifically, pay attention to events that have to do with healthcare or Obamacare.  Schools love to specifically ask about these things, and it can really throw you off your game in an interview if you aren't prepared for it.  Sometimes they will ask how current insurance changes may specifically affect PAs, so knowing what's going on and how it could affect YOU (as a hopeful PA-C) in the future is very important to know.

6. Be Prepared to GO!

A lot of these programs do not give much notice for interviews, and if you are possibly taking someone's spot who cancelled it could be even shorter.  I think a month prior is about the longest I've heard of, but sometimes the call will come on a Friday for an interview the following Monday.  So be on your toes!  And check your spam folder often!  One of my best friends missed her interview because it went to her spam folder, and luckily they let her come to a later date.  This short notice can be tough with jobs and childcare, but try to let them know at work that you may be needing some time off and have your friends and family on standby if possible.

7. Prepare financially.

For the majority of PA school interviews, you are expected to pay for travel expenses, meals, and hotels.  If you've applied to multiple programs and are hoping for multiple interviews, go ahead and get your finances in order to be able to cover these.  Put a little extra into savings or skip eating out during interview season if you are concerned about being able to afford going to interviews.

8.  And the most difficult one, be patient.

Waiting is so tough, and patients is a virtue right?  It can be very tempting to call the programs you applied to multiple times to make sure they have your application and see why they haven't sent you an interview invite yet, but this can backfire as well.  As good as it is to make sure they know you are very excited about their program, use a little self restraint.  It's fine to call or e-mail if you have a legitimate question, and if you know you have submitted everything and haven't heard back I would say give it about a month before contacting them.  And if they tell you to just wait, then do it.  On the other hand, if it's getting towards the end of interview season, and you've been waiting, and been patient, and STILL not heard anything, I think it's fine to check in on your status at that point.

That's all I've got for today, but what are your biggest tips for preparing for interviews, and the waiting period?

Other Resources to Check Out: 


How to Get Shadowing Hours

image.jpg

It's become a huge requirement for most programs to have a good amount of shadowing hours.  The number I see thrown around the most is 100, but some programs do not have a specific number while others want even more than that.  I think shadowing is important because it lets you get a good idea of a what a PA does in a typical day, because while we talk about all of the fun stuff a lot, there's more involved (paperwork, late patients, no shows).  It can be very difficult and frustrating trying to find people that will let you come follow them around for a little while.  Most of the schools want you to directly shadow PAs (not physicians) and want a few different areas as well, so keep this in mind when looking for places to shadow.

As a provider now, I do understand that with a busy schedule it can be difficult to think about having someone that could potentially slow you down.  After having someone with me that my SP knew for a whole week, it was actually a lot of fun having someone to teach and asking questions.  It made me think a little and also made me feel more confident about what I know.  So that's my little aside to encourage current PAs to let students shadow, and to give students a little insight to why everyone doesn't say yes right away.

1. Use your connections.

Think about people you know and who might be able to help you get in touch with people.  This could be your parent's friends that work at doctor's offices or hospitals or doctors you have gone to for a long time.  Don't be scared to reach out to people you haven't been in contact with in a while because this is important for your future and the worst thing that happens is they say no!  Personally, while in undergrad I remembered that one of the teachers at my high school had a daughter who went to PA school, so I awkwardly sent her a Facebook message, but she was willing to talk to me and gave me some very valuable information!

2.  Use your resources - internet and the phone book

This is another example of the worst thing that can happen is someone saying no.  Get the phone book out or search your area and call places and ask if they have a PA and if they have students shadow.  I did this while I was in Athens at UGA, and out of everywhere I called one place said yes and 2 asked for my resume (which I thought was weird).  I ended up shadowing in dermatology under an awesome PA once a week and it was totally worth all the cold calls and awkward conversations.

Also check hospital websites and see if they have a shadowing program.  Another option is calling PA programs in the area you are interested and seeing if they have anyone or e-mailing faculty members to see if they know of any opportunities.

3. Join organizations.

Many of the PA organizations have either a forum or part of their website that provides names of people that are willing to have students shadow.  Look into joining a few of these to see if you can make some connections.  I definitely recommend joining AAPA and your state organization at least.  Also consider any specific fields you are interested in.  Our local GAPA chapter will occasionally send out e-mails from students looking to shadow.

Listen to the accompanying podcast episode now!

It can be tough and discouraging to be told no over and over, but if you are able to get even a few hours it will be worth it!  What are some of your tips for getting shadowing hours?


Program Spotlight: University of Alabama at Birmingham

UAB Program Spotlight.png

* updated March 2020 *

Location:  Birmingham, Alabama

Number of students:  80 students

Application Deadline: August 1st

Admissions: Non-rolling

Interview dates: October - November

Start date: August - annually

Length of Program: 27 months

Public/Private:  Public

GPA Requirement: Overall: 3.0, Science: 3.0

HCE:  Preferred, but not required (Average 3,446 hrs)

Shadowing:  Preferred, but not required

LORs: Three required, not specific

Seat Deposit: $300

Tuition: In-State: $63,825 Out-of-State: $146,280

The Good Stuff:

  • No specific Organic chemistry requirements! This is a big one because that class is pretty ridiculous. My only C in undergrad.

  • They offer info sessions about once a month if you are interested in visiting.

  • Based on the stats provided on the website, it's about half in-state and half out of state

  • While most programs do not allow working, it is strongly discouraged, but still allowed during the didactic year. Not during the clinical year though.

  • 5 of the rotations are electives!!

  • This is considered specifically a surgical program so there is more focus on surgery

  • Offers dual degree MSPAS-MPH program where students begin online MPS courses in the spring and summer prior to PA program matriculation in the fall.

Program Link:  UAB


Program Spotlight: Augusta University

image.jpg

Formally known as the Medical College of Georgia, and then Georgia Health and Sciences University, then Georgia Regents University, the name is currently Georgia Regents University.  And this particular program is near to my heart because it's where I went to school!

Location:  Augusta, GA

Number of students:  44

Application Cycle:  July 1-October 15 (Rolling admissions = apply early!) and their application is NOT through CASPA

Interview dates:  September - January

Start date:  May

Length of Program:  27 months

Public/Private:  Public

HCE:  100 hours (prefer direct hands on experience)

Shadowing: 100 hours in at least 2 different specialties

The Good Stuff:

  • There's also an MPA bridge program for current PAs who finished a program before most became a Master's program.
  • Look into going for a "Closer Look" tour if you're interested in more information and meeting some current students and faculty.
  • Anatomy course has a cadaver lab w/ 8 students per body, and only 4 working on it at a time.  The lab can be accessed at any time during the first summer for studying.
  • The PA program has a simulation lab set up like a real OR for learning skills like scrubbing and suturing.
  • There's a PA run clinic for the underserved areas of Augusta that is held monthly.
  • There's a new financial assistance program for veterans.
  • This program has had a few different names in the past few years.  It may also be referred to as Medical College of Georgia (MCG), Georgia Health Sciences University, or Georgia Regents University

Link to program - Augusta University PA Program Website


For the most up to date information on PA programs in one place, check out The Applicant’s Manual of Physician Assistant Programs. (Affiliate link)


My Journey to PA School

image.jpg

So a lot of hopeful PAs I meet ask how I got to where I am today.  I was accepted the first year I applied and am now in Dermatology, which is a very desirable field.  Well I'll let you know what worked for me!

I first learned what a Physician Assistant was when I was in high school.  My dad went to his primary care and saw a PA for the first time.  Knowing that I was possibly interested in the medical field, he mentioned to me that it may be something I should look into.  I was a junior at the time, and not too concerned with my future, but when senior year started it was time to make some decisions.

I ended up at the University of Georgia, and declared Biology as my major.  I made this decision really just because it left my options pretty open.  I knew I wouldn't be able to do much with that alone, so I would be forced to make some kind of decision.  The idea of a PA was still in the back of my mind, but I wasn't completely sold yet.  I think during my first year of college, I researched and considered all types of things, including research, medical school, teaching high school, nursing school, PT school, dental school, and who knows what else.  But ultimately, I decided PA was the way I wanted to go.

So I started shadowing, got my CNA license and struggled through O-Chem, while wondering if all of this was going to be worth it.  PA school has become so dang competitive!! I'm a very detail-oriented person and spent a ton of time researching what it takes to catch the eye of these PA programs, so I felt pretty prepared when it came time to apply, but still terrified.

I applied as soon as possible (July 1st!) and I applied to all of the programs in Georgia, even though I clearly didn't have all of the requirements for some of the programs.  (I'll explain more about how I chose the programs I did in a future post.)  Fall of 2011 came, and I ended up getting interviews at the 2 programs I was actually qualified for, MCG and South University.  I prepared by doing a mock interview with a PA I had shadowed, and it was SO helpful!  Interviews came and went, and I actually ended up getting the call that I was accepted into MCG about 15 minutes after my interview ended at South!  That was an amazing feeling!

I graduated from UGA in December of 2011 to give myself a few months to prepare and relax before starting PA school (which I would definitely recommend) and started the program at MCG/GRU in May of 2012!  The rest is history, and by the grace of God, I am now helping patients at a job I love going to everyday (well, most days)!