Program Spotlight: University of Utah

Location:  Salt Lake City, Utah

Number of students:  41

Application Cycle:  April - August 1 through CASPA w/ supplemental app

Interview dates:  Invites out in October for November intervies

Start date:  Early May

Length of Program:  27 months

Public/Private:  Public, but no preference given to residents of Utah

HCE:  Minimum 2,000 hours

GPA:  Minimum 3.0 with minimum C in all courses

Shadowing:  Not required

The Good Stuff:

• This interview with 2 current students in the program is a pretty good representation of most PA programs.
• Coursework must be completed by the summer before matriculation (so while applying)
• No GRE required
• No specific requirement for Organic Chemistry
• After 1 year, students may apply for in-state status
• They offer information sessions
• International rotation options in Thailand or Guatemala
• The supplemental application is a time-limited form where you answer short essay style questions on the spot.
• The interview process seems to be a little different here.  In October they send out either an interview invite, a waitlist for an interview, or rejections.  It's a 2-day interview with a group session and a test over medical terminology, anatomy, and other assorted subjects.

Program Link:  University of Utah PA Program

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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)

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Program Spotlight: University of Colorado

Location:  Aurora, Colorado

Number of students: 44

Application Cycle:  April - September 1st through CASPA w/ supplemental app

Interview dates:  September - October

Start date: Late May/early June

Length of Program:  3 years

Public/Private:  Public

HCE: No specific requirement

GPA:  Minimum 2.8, with at least a C in all coursework

Shadowing:  No specific requirement

The Good Stuff:

• Specialized Tracks - They offer 4 different specific pathways that provide extra training in certain areas.  These must be applied for and are limited in the number of students accepted.  The pathways available are rural, global health, urban/underserved, leadership and education, pediatric critical and acute care
• GRE must have been taken in the last 5 years, unless you have a graduate degree and have previously taken the GRE for that
• At least 6 hours of Biology credits must be from the past 5 years and must be upper level
• Out of state tuition is significantly more expensive, but after the first year you can possibly get resident status
• They offer information sessions from January - April, with also usually one in November

Program Link:  University of Colorado PA program

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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)

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Program Spotlight: Quinnipiac University

Happy Friday!  Just wanted to mention that I have no idea how to pronounce the name of this school, so if anyone has any insight please share.  And if you haven't noticed by now, I'm doing these pretty much by the US News and World Report's list of top PA programs.  If there's any information you're looking for in these reviews as well, please let me know so I can add it!

Location:  North Haven, Connecticut

Number of students: 71 (This number is from 2015, but the website states they accept 54, with about 20 being from the Pre-PA program)

Application Cycle:  April - September 1 through CASPA

Interview dates:  September - December

Start date:  Late May/Early June

Length of Program:  27 months

Public/Private:  Private

HCE:  Minimum 2500 hours suggested (may consider if less)

GPA:  Cumulative and Science of 3.20

Shadowing:  Recommended, not required

The Good Stuff:

• Does NOT require the GRE
• They will accept pre-calculus or calculus in place of statistics
• Coursework must be completed by December before matriculation
• Entry-Level Master's Physician Assistant Program (ELMPA) - 4 years of undergraduate course work that get you a Bachelor in Health Science Studies, and if you meet requirements for the PA program, you are likely to be accepted after a faculty review.  They say it's not "guaranteed," but as long as you maintain a 3.0 GPA and have enough patient care hours, it seems like a great option.  This is not available to transfer students.  The curriculum looks pretty tough, but it's been developed to help you succeed in the PA program.

Program Link:  Quinnipiac University PA Program

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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)

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Prerequisites for PA School

When it comes to the classes required to get into PA school, most programs are pretty similar across the board.  Occasionally one program will be more picky than another or have more required courses, but the basics tend to be the same.

If you already have a Bachelor's degree and are going back to take classes, it will be easier to pick and choose what you need.  Some schools require that courses be done within a certain time frame (like the last 5 or 10 years), while others will accept coursework no matter when it was done.  This is definitely something to look when deciding where to apply if your undergraduate work was done some time ago.

If you are working on your degree and know you want to go to PA school (or do something medical), you have a choice of what major to choose.  There are many majors that will also require the majority of prerequisites needed for PA school, and although it would be wise and most time efficient to choose one of these, you may have other interests that you would like to pursue as well.  I majored in Biology, but in my graduating class there were all kinds of degrees, including Math and Accounting.  Some other majors to consider would be Chemistry, Health Promotion, Biological Science, or Kinesiology.  Your school may have some other specific majors that would get you what you need as well.  So it's not really what your major is that matters, it's what classes you take.

So the basic classes you will need for PA school are typically as follows:

• Biology w/ lab - usually 2 semesters
• General chemistry w/ lab - usually 2 semesters
• Anatomy and Physiology w/ lab - usually 2 semesters of a combined course or one of each if they are separate
• Statistics or Biostatistics - Some schools will only accept one of these so be sure to check the program's website and if you still are not clear, call the program and ask specifically

Classes you might need, and should consider taking if possible:

• Psychology
• Organic chemistry and/or biochemistry w/ lab - (Organic chemistry II was my only C+ in college, and it was miserable, so unless you have a deep love for chemistry, avoid this if possible.   Mine was part of my Biology major so it was not an option.)
• Microbiology w/ lab
• Other science electives

It is a good idea to check the website of any program you are interested in and the prerequisites should be clearly listed, and then crosscheck this with courses you have already taken or what is required for your major.  My biology major only counted Anatomy as a general elective, so I ended up taking over the summer since it was basically just extra.  I was concerned about taking it at a different school than UGA, so I called ask the programs I was interested in if that was ok, and the consensus was that as long as I had the prerequisites, it didn't matter where it was at.

As daunting as the coursework may seem, it is really to your benefit when you start PA school.  It's so fast paced that there isn't time to review everything from undergrad, and they need you ready to go and familiar with science basics.  Most medical schools don't even require anatomy or some of these other courses, but it's because they study anatomy for an entire year, while PA students typically do it in 1 semester!  These are tough classes, so if you are able to spread them out, that may be in your favor if you are able to get better grades.  In some cases schools want at least a C or B, no matter what your overall GPA is.  So start planning as soon as possible to get all of your classes done to be ready to apply!

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Program Spotlight: Oregon Health & Science University

Location:  Portland, Oregon

Number of students:  42

Application Cycle:  April - September 1st on CASPA with a supplemental application

Interview dates:  September - early January

Start date:  June

Length of Program:  26 months

Public/Private:  Public

HCE:  Minimum 2,000 hours by application deadline

Minimum GPA: 2.8 (Average 3.5)

Shadowing:  Valued, but no specific number

The Good Stuff:

• No preference for Oregon residents
• They are on a quarter system
• There is a Community Service Education project to teach the public about a prevalent health issue that is required for graduation
• The interview has a circle type format with multiple applicants and interviewers asking questions to everyone - a great way for them to see how you work as a team
• There are some classes taken with the medical students, but they may be transitioning to more of a team-based learning model

Program Link:  Oregon Health & Science University

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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)

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What is a PA?

I assume that everyone who visits this site knows what a PA is, but that may not necessarily be true.  The public is still somewhat uneducated about PAs and their capabilities, and as anyone interested in the profession it is our job to educate people.  I often get asked, "So when are you going to be a real doctor?" or "Are you going back to medical school?" so there is a true misconception of the education and role of PAs.

PA stands for physician assistant.  Although some people don't like the term "mid-level," I think it is a pretty good description for the role of PAs.  PAs have more education and are taught differently than nurses, but do not go through the rigorous training of residency that physicians have.  Nurses are educated in a holistic way so they can provide the best care possible to the patient, but they are not able to diagnose or treat patients.  They basically receive orders for a specific patient, and ensure that the patient is cared for according to the doctor's plan.  Physicians go through 4 years of medical school, then choose a specific specialty, and then complete a residency that can range from 3-12 years, and sometimes more.

The majority of PA programs require an undergraduate degree, and then offer a Masters.  PA programs are typically 2-3 years of very intense school, and then you are able to choose whether to do a residency or get a job.  The idea of PA residencies is fairly new, so the majority of new grads go straight into a position.  To become a certified PA, there is a national test that students must pass, and then they must be certified by the state they work for.  This must be maintained with recertification exams and keeping up with continuing education and state standards.

PAs have a supervising physician (SP) who oversees them to some degree and a lot of that depends on the state they are in.  For example, in Georgia the supervising physician must review 80% of notes written by PAs, but in South Carolina the supervising physician just has to review the notes occasionally with no specific requirement.  This website has a great graphic that shows the scope of practice for each state specifically.  The level of independence of PAs will vary based on the trust of the SP, specialty, experience, and state.  Personally, I have my own clinic schedule and I see all of my patients by myself.  If something difficult comes up, my SP is always available to discuss the case or pop in if necessary.  If I have any down time, I try to help her out as well.

PAs are similar to physicians in many ways.  They are able to see patients independently, take a history, make a diagnosis, decide on treatment, and prescribe medications.  There are also PAs who perform procedures and surgeries after adequate training.  In some states, there are restrictions on what medications PAs can prescribe, specifically pain medications.

Sources:

https://aapa.org/what-is-a-pa/

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Program Spotlight: George Washington University

Location:  Washington, DC

Number of students: ~60 (depends on MPH students)

Application Cycle: CASPA + supplemental application by October 1st

Interview dates:  Saturdays in September-November

Start date:  May

Length of Program:  25 months

Public/Private:  Private

HCE:  1,000 hours required, but recommend an additional 6 months experience

GPA: Minimum 3.0 (overall and science).  Must have a B- or better in all coursework

Shadowing:  No specific requirement

The Good Stuff:

• Some integrated classes with medical students and other healthcare students
• Have a joint Master of Public Health program (3 year program)
• Coursework must be done within the last 10 years
• No minimum GRE
• Interview day is 10 seven minute scenario-based multiple mini-interviews (MMI style) and a panel discussion with current students/alumni

Program Link:  George Washington University

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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)

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Book Review: Still Alice

I finished Still Alice by Lisa Genova yesterday, and it surprisingly didn't turn out to be quite as sad as I had expected!

The premise of this book is a psychology professor at Harvard is diagnosed with early-onset Alzheimer's and it goes through her journey from pre-diagnosis, diagnosis, and progression of the disease, as well as her family's reactions.  As an intelligent woman, Alice has a very difficult time with coming to terms with her disease.  This book paints a very accurate picture of how Alzheimer's may affect both a patient and the patient's family.

Alice starts by normally living her life and will just occasionally have some lapses in memory, but it's not until she gets lost on a route she runs daily that she realizes something is wrong.  Alzheimer's starts with the small things and slowly progresses to be a debilitating disease.  This book gave me much more empathy and understanding as to why Alzheimer's patients experience some of the symptoms they do.  Distrust was a big one, and I love the way this book showed how that can happen.  The brain is so powerful that it's almost scary.

Still Alice

By Lisa Genova

Buy on Amazon

When first finding out about the possible diagnosis, Alice's husband says, "I think you jumped the going to see a neurologist.  He looks at your set of symptoms and sees Alzheimer's, but that's what he's trained to see, it doesn't mean he's right."  This stood out to me because I think this is how a lot of patients feel when they go to the doctor, so it's our job to instill trust in our patients so they feel that we are treating them as individuals, and not just a disease.

As a PA student,  Still Alice gives a great view of patient-doctor relations and multiple Mini Mental Status Exams (MMSE).  These are simple tests that can be done to judge a patient's cognitive function, and the decline is seen very clearly in this book.  It also discussed treatments that are being used currently for Alzheimer's. Alice describes it this way - "Alzheimer's disease was an entirely different kind of beast.  There were no weapons that could slay it.  Taking Aricept and Namenda felt like aiming a couple of leaky squirt guns in the face of a blazing fire."

This book gave me hope that the research being done presently will result in a cure and better medications for Alzheimer's, and hopefully sooner rather than later.  This article shows that they have found changes of Alzheimer's occur much sooner than symptoms show up, so treatment could be starting much sooner as well.  In Alice's case, if treatment had begun earlier, it could have potentially slowed down the disease process.

I definitely recommend this book for anyone in the medical field or interested in medicine, or anyone who wants a better understanding of what exactly Alzheimer's entails.  A movie was recently made from this book as well!

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Program Spotlight: Wake Forest University

Location:  Winston-Salem or Boone, North Carolina

Number of students:  64 at Winston-Salem, 32 at Boone

Application Cycle:  April - September 1st through CASPA + supplemental application ($100 fee)

Interview dates:  September - December

Start date:  June

Length of Program:  24 months

Public/Private:  Private

HCE:  1,000 hours

Shadowing:  No specific requirement

The Good Stuff:

• They just recently opened a new campus in Boone!
• There are open house events at both campuses you can attend to get more information.
• Teaching style is called "inquiry based learning," or small-group, self-directed learning, which is a style a lot of medical schools are moving towards as well
• If you don't end up going there for school, they do accept students for clinical rotations from outside programs
• They do require a genetics course, which is not something that is as commonly required
• No specific organic chemistry requirement
• No employment is allowed while in the program
• A computer is provided for use by the school while in the program
• Emerging Leaders Program - If you also have an interest in the business side of things, Wake Forest offers a 34 month program where you start with getting a Masters in Management and then attending the PA Program
• Joint PhD program - You start the PhD program and can apply anytime during the first 3 years for the PA program.  The cool part is that your clinical research experience counts towards your 1,000 hours.

Program Link:  Wake Forest PA Program

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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)

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International Healthcare Experience

Who doesn't love to travel??  International healthcare trips can give you the opportunity to both travel and get the HCE that you need for PA school.  I think if you have the opportunity (aka - time and financial means) to get some experience abroad you should go for it!  These trips give you a cultural outlook on healthcare and the chance to see conditions that you might not encounter frequently in the United States.  Many times the medications and treatment options are more limited when you are in the field, which means you learn more about specific treatments and what they are useful for.  These trips can be a way to get a lot of hours as well.  If you're doing clinic for 10 hours a day for 5 days, that's going to get you 50 hours in 1 week!  It also gives you awesome subject matter for your interviews.  And amazing views like below (La Romana, Dominican Republic).

There are some cautions you should take before deciding to go on an international healthcare trip.  You do want to choose an area where you will be safe, and you want to travel with a group that is well-established.  These trips can be quite expensive, and you don't want to waste your time or money.  While on a trip, you also want to be cautious to only practice to a level you feel comfortable.  Sometimes countries have standards that are slightly different, and although you are learning, I would recommend not doing anything that you shouldn't be doing as a student or have no training to do, basically anything you wouldn't do in the States.  I've heard of people actually getting turned away from medical programs because they mentioned doing procedures during interviews that they probably should not have been doing (circumcisions, tooth extractions, etc.) and that was considered unethical.

Sometimes your bus might get stuck in a ditch on the way to clinic ^^^, and then all you can see for miles are fields (see below).
 

Financially, international trips can be expensive between the trip cost, flights, and spending money.  You could always work to raise this money, ask for funds as Christmas or birthday presents from family and friends, or even try a Kickstarter or FundMe.  Many people questions why you would spend thousands of dollars when there are plenty of people to help here in America.  Well, after one trip you'll be hooked.  It's so worth it to see how appreciative the patients are and how much it means to them that you would travel so far to help them.  It also opens your eyes to the needs of others in a whole new way when you are seeing people who don't have all of the material items and distractions that we have daily.  My biggest take home point was that no matter where you live or what you have, we all have the same healthcare issues.  It's very unifying.

The biggest thing to know and prepare for before you go on a trip is to BE FLEXIBLE!  After being on a few different mission trips, I have learned that it is rare for everything to go perfectly, and it's a lot easier if you accept that before you go.  As part of my internal medicine rotation, I was able to go for a week to the Dominican Republic on a trip with a few of the medical students at MCG (including my husband).  We had sent money ahead of time so they would have supplies and medications for us to use during clinic, but when we got there, we had nothing!  How were we supposed to hold clinics with no medications?  By the grace of God, another team at our base had miraculously ended up with over twice as many supplies as they needed and they were so kind to share with us.  Everything worked out!  But it was a little dicey for a little while there.

So the majority of these trips operate in similar ways.  You have a home base in whatever country you are going to, and from there you go to different areas to set up clinics each day. At these clinics, patients show up and wait to see a provider.  Sometimes there may be stations for vaccines or de-worming of children.  There can be hundreds of patients in a clinic during one day, but other days may be much slower.  At one of our sites, all of the men were out in the fields, so we only saw women, children, and the elderly.  There's usually a "free day" as well where you get to explore or do something fun.

This picture is of the first time I ever tried lobster, which was amazingly fresh and delicious, and on the beach seen in the title pic.    This was on our day off in the DR and we took a boat trip all around different islands and had a surf and turf BBQ on the beach.  Lots of sunburns, but totally worth it.

Here are some of the reputable organizations I'm aware of, but there are tons out there!

Rahab's Rope - This is a group out of Athens, GA that focuses on getting women out of sex trafficking in India.  They do 1-2 medically based trips a year.  The founder of this organization spoke to a group I was in while I was in college at UGA and I was just so impressed by their mission and the work they have done so far.  It's one of my goals to go on a trip with them at some point.

Flying Doctors of America - This is an organization that takes trips all over the world!  One of the leader's daughters was in my PA class so he came to speak to us and explain a little about what they do.  The trips seem to be very well organized, and they work hard to make sure the accommodations are safe and comfortable.

Rivers of the World - This is the group that my trip to the Dominican Republic was organized through, and even though we had some bumps in the road, I would still recommend it!  The leaders know what they're doing and the sites are very well established.

And if you aren't able to go on a trip before you start school, there's the chance you can go during rotations!  If this is something you might be interested, be sure to ask the schools you are looking at.  People from my class went to Peru, and the most recent classes have been going to Uganda!  You also want to ask and make sure that these hours will be accepted as direct patient-care experience.

Where have you been on mission trips and what are your tips?

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Healthcare Experience for PA School

  
Healthcare experience (HCE) has become one of the biggest factors that PA schools look at, and some of the requirements are pretty high. For most programs, you're going to need "direct patient-care experience."  This usually does not include shadowing or volunteering, although some require these types of hours as well. It is not uncommon for programs to want at least 1,000 HCE hours.  About 1 year of full-time work will be about 2,000 hours just as a reference.

Before you decide to spend some money and time on any kind of training to get HCE, check with the programs you are interested in to be sure it will count.  There will occasionally be occlusions of certain jobs that you think would possibly count, or the opposite can be true as well.  The program I attended (Georgia Regents) actually accepted hospice volunteering hours as direct patient care, which was nice because it was free.

To become more competitive, I recommend doing some kind of formal training, unless you are able to find a position where they are willing to train you on the job. Occasionally, you can be trained as a medical assistant, scribe, or patient care assistant, but more often than not, you will have a better chance at getting a job if you are certified.  My high school offered an awesome program where you could become a CNA (Certified Nurse Assistant), and unfortunately I did not take advantage of this.  If you are starting out early, good for you! And take advantages of any training you can get as soon as possible.

Being that I still needed some experience, I decided to enroll in a CNA program.  These typically will be either condensed over a few weeks during the day or at night or spread out to accommodate different schedules.   I attended the program every Saturday for 3 months during my sophomore year of college, and did the clinical week during my Spring Break.  Not my favorite Spring Break, but totally worth it in the long run. It was a few hundred dollars unfortunately, but I made it back working full-time during the next summer.  I got a job as a CNA in a rehabilitation hospital and it was a great experience.

Looking back on that experience, it's made me question why PA programs would want you to have any healthcare experience, let alone thousands of hours.  My husband is a 4th year medical student and he didn't have to do anything like that at all!  I think by doing tasks that are sometimes not the most fun, it reinforces the teamwork aspect of being a physician assistant.  Once you are practicing, you will have such a greater appreciation and respect for the CNAs, medical assistants, EMTs and nurses because you have been in that position yourself and you realize how important they are.  I remember working as a CNA and the physician coming to find me to ask if I had noticed any changes in a certain patient because I spent so much more time with the patients than the actual providers.  And that's ok because they have a lot of people to take care of, but it really opened my eyes to just how much better healthcare can be if you approach it as a team effort.

Here are some of the fields that are typically accepted by most programs:

• EMT or paramedic
• Registered nurse (RN), BSN, LPN
• CNA (sometimes called a patient care assistant)
• Medical assistant
• Respiratory therapist
• Dietician
• Phlebotomist
• International healthcare based mission trips

Here is a great blog post with examples of what actual students did for healthcare experience before starting PA school.  

What are you doing to get your healthcare experience and how many hours are you applying with?

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Program Spotlight: Emory University

Location:  Atlanta, Georgia

Number of students: ~58 (depends on MPH program)

Application Cycle:  CASPA April - October 1st (preference if before July 1st) and supplemental application (rolling admissions)

Interview dates:  October - January

Start date:  August

Length of Program:  29 months

Public/Private:  Private

HCE:  Minimum 2000 hours of direct patient care

GPA: Minimum 3.0 science and cumulative

Shadowing:  No specific requirement, but highly encouraged along with other volunteering hours

The Good Stuff:

• They have a yearly board review conference for the PANCE and PANRE that has CME. You can also buy this as a DVD series.
• There are some open house events if you are interested and want to check the program out
• Coursework must be done the December before you would start the program
• Require Organic OR biochemistry, so you don't absolutely have to take O-Chem
• There's a joint MPH-MPA program, which takes an extra year.  You have to apply to each program separately and start with the MPH program before starting the PA program.
• There are some great community service opportunities with this program
• From personal experience, they're quick to send out rejection letters if you don't meet the minimum requirements

Program Link:  Emory University

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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)

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Books for Medical People

Better / Complications

Better: A Surgeon's Notes on Performance

By Atul Gawande

Buy on Amazon

If you're looking for some recreational reading with a medical twist, here are some options that I highly recommend.  These are 2 books that I read before starting PA school, and I think anyone interested or involved in the medical field should read these books.  They are written by Dr. Atul Gawande.  Gawande is a surgeon so he can definitely relate, and on top of that, he's an incredibly skilled writer.  Easy to read, and makes you think.  Both Better and Complications address issues facing the medical field and Dr. Gawande's opinion on them.  I don't necessarily agree with all of his opinions, but they have helped me to form my own.

Still Alice / Being Mortal / The House of God

And if you have some extra time on your hands, here are some other books that I'm reading or are on my list!  I'm going to do some more detailed book reviews in the future, but comment below with any books that you recommend!

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Program Spotlight: University of Iowa

Location:  Iowa City, Iowa

Number of students: 25

Application Cycle: April - November through CASPA

Interview dates: September - December, notification by March 1st

Start date:  August

Length of Program:  28 months

Public/Private: Public

HCE:  Minimum 1,000 hours of direct patient care completed by December of the year before matriculation

Shadowing:  No specific requirement

The Good Stuff:

• One unique feature is that part of the didactic year is actually with the medical students
• Only accepts US citizens
• LOR - 3 total, must have 1 academic and 1 from healthcare supervisor
• They will accept the MCAT instead of the GRE
• They report a 100% employment rate after graduation
• No one has failed boards since 1996!  That's pretty amazing

Program Link:  University of Iowa

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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)

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Gap Year vs Starting PA School Immediately?

Due to the highly competitive nature of PA school, many of the programs have set requirements for how much healthcare experience they want you to have (along with volunteering and shadowing).  Some of these minimums are in the thousands of hours range (1,000-2,000), which can seem extremely daunting to an undergraduate student or someone changing fields.  Just as a reference, 2,000 hours is basically working full-time for a year.  On top of the seemingly crazy minimums, the actual averages of accepted student's hours is often much higher than the minimums!  This just confirms how competitive the field is, and how much work it takes to get in.

I was at a dinner tonight with PAs in my area and the question came up about whether it was a good idea to take a "gap year" to get experience and hours before applying to PA school, specifically between undergraduate graduation and starting a PA program.  While taking a year off to work does make you a more competitive candidate, I personally think that if you have the minimum requirements, or are close to the minimum amount of hours, it is worth applying to the schools you really want to go to.  Most people wanting to become PAs are very aware that many applicants end up having to apply more than once.  I believe by applying initially, even if you don't get in, if you were to have to reapply it makes you a stronger candidate.  This gives you a chance to show that you have taken the time to improve your qualifications and that you are still interested in the program.

If you are able to start PA school somewhat soon after finishing your prerequisite classes, which in some cases can even be within a week, you will have an advantage of already being in "school mode," which can be difficult to get back into if you've been out for a while.  Coming out of school will help you adjust to the rigorous academic schedule a bit better.  Personally, I was able to graduate in December from my undergrad (Go Dawgs!), and then my PA program started in May.  That gave me a few months to relax without the stress of classes and prepare for PA school.

This is all my own opinion, but what are your thoughts on taking a year off?  I would love to hear whether you agree or disagree!

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Shadowing Etiquette

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

  
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?

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Program Spotlight: Duke University Medical Center

  
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

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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)

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Preparing for Interviews for PA School

  
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: 

• A blog post on interview tips

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How to Get Shadowing Hours

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?

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