What is a physician assistant?
Probably the most typical question I get asked! A physician assistant, or PA, is a provider who works with the health care team as a APP (Advanced Practice Provider). This means that a physician (MD/DO) needs to be supervising or overseeing the PA – this could be on site, as a collaborator, whatever the law is in that specific state. However, this is a very antiquated concept!
PAs can – and do – see their own patients, order and interpret studies, diagnose, prescribe medications, preform procedures, own a practice (in some states), and so much more. Depending on what kind of practice they work in will affect what they are able to do. PAs are highly educated members of the health care team, and a great career choice! In fact, being a Physician Assistant has been in the Top 10 Careers for the past few years.
For more information, check out the American Academy of Physician Assistants
The big push now is to consider the physicians working with us as collaborating physicians, not supervising or “overseeing” physicians. This is not independent practice, but ideally it does remove barriers to care and keeps the healthcare team!
What is the schooling like?
Most programs last around two to three years, depending on the amount of breaks they offer during the program. Additionally, there are programs that will give you a “dual” degree (i.e. a Master’s in Public Health) and these schools normally add on a year before or after.
Programs normally have a year of didactic learning, or book learning. This year will have your standard anatomy, physiology, pharmacology, and clinical medicine courses. Some programs follow a lecture-based system, while others use an inquiry-based learning. No matter what, the curriculum has to be approved by the PAEA and NCCPA, and so will be fairly standard across the board in what is required for students to learn.
Following this, PA students will complete around 2000 clinical rotation hours. These rotations are what make PA school so different – you often won’t start with rotations until your third or fourth year of med school and NP students typically do not complete as many hours. Rotations often include Primary Care, Emergency Medicine, Obstetrics and Gynecology, Pediatrics, Surgery, Behavioral Medicine, and General (Internal) Medicine. Depending on the program you attend, some rotations will be different and there could be “elective” rotations. These elective rotations would be in specialities you’re interested in.
*A great thing about PA school is that the rotation sites are already set up by the school – trust me, you don’t want to be trying to find rotations as well as studying! You can find/set up rotations depending on your program if you want them to be in a specific location. *
Being a PA student is a full time job, and this doesn’t even include studying! It is not recommended to work while in school, and honestly, I can’t even imagine how someone would. During didactic year, most students are in class from 9-5 Monday-Friday. During the clinical year, your hours will depend on your rotation site, but you will be completing at least 32-80 hours per week.
Throughout didactic year, you’ll have a plethora of tests, quizzes and assignments to test your knowledge base. You’ll also take an End of Rotation exam at the end of your clinical year rotations. My program used the PAEA End of Rotation Exams, which I found extremely helpful as I studied for the PANCE! These are standardized and gave me a good idea of where I stood compared to other students.
To become certified, after you graduate from an accredited program, you’ll sit for the PANCE. This is a 300 question, 5 hour long exam that gives you the “C” at the end of “PA-C”. This certification is required by most settings in order for you to work as a PA.
What’s the difference between a PA and a Nurse Practitioner? Or a Doctor?
Both physician assistants and nurse practitioners are APPs. Thus, they need to have a physician to work with (though in some states NPs no longer are required to have this). While there are a lot of similarities between the two – both can prescribe medications, see patients on their own, get paid roughly the same, undergo a shorter training program – there are major differences. Perhaps the greatest difference is the schooling. NPs must be registered nurses (RNs) before going to get a Master’s. A pre-PA simply requires a Bachelor’s in whatever major. Within the schooling, NPs learn through a “Nursing Based Model.” On the other hand, PAs learn in a very similar method to MDs: the “Medicine Model.” This means that our learning is much more pathophysiology based and focuses on disease etiology and management. Next, with clinicals, all PA-S will complete 2000 hours of hands-on clinical learning in which they examine and mange patients. NP students have much different requirements, which can fall below 1000 hours and can be part time. PA schools are almost never online or part time (only 1-2 programs out of 200+ have options like this)*, while NP schools can commonly be online or part time, so that their students can still work as RNs. PA school also has a heavier emphasis on procedures, while many of my NP friends ended up taking extra-circular procedures workshops to gain those skills. In addition, a PA is trained as a generalist, while a NP is a specialist (they must chose what kind of NP they want to become during their schooling – family, women’s health, critical care, etc).
Obviously, there are much greater difference between a PA and a MD/DO. A physician will go through four years of medical school, followed by 3 years of a residency program, plus/minus additional years or a fellowship (depending on what they chose to specialize in will determine how long it will take). Once they are in a specialty, they are much more locked in to that area; to change specialities, they would have to go through a new residency program. However, a PA can change specialities much more easily, often times it will just necessitates on the job training. A MD/DO does not require a physician to practice in collaboration with (obviously); a PA does. Salary wise, a doctor will make more money than a physician assistant, however, since their schooling is longer, they will have acquired more debt.
What is Optimal Team Practice?
OTP is a multi-tiered initiative by the AAPA to improve a PAs ability to practice within our scope, and to improve patient’s access to care. It is not independent practice! But, it will remove a lot of the unnecessary and outdated barriers that prevent PAs from practicing at the extent of their education.
Why did you chose to go to PA school?
I knew from a very young age that I wanted to be involved in medicine; my mother was a RN and going to NP school when I was a child and “healed” my favorite teddy bear with medicine. This was the moment I knew I wanted to be able to do the magic of medicine. In high school, I had shoulder surgery and met my first PA-C at my orthopedics office. He was incredibly smart, independent, and clearly knew what he was doing. He was very willing to answer any questions I could possibly come up with, and truly instilled in me how perfect becoming a PA was for me.
Once I got to undergraduate, I realized more that I wanted to be involved with medicine and that PA was the right route for me Once I began working as a CNA, I realized how much I cared about my patients and that I didn’t need to be the “head honcho”. I fell in love with the team based aspect of medicine, and I had a lot of great PA and physician mentors who guided me. I loved the lateral mobility, medical model (and generalist) training, and the fact that I would be able to treat patients that much faster – because I was ready to make a bigger difference in my patient’s lives than I could as a CNA. For me, attending PA school was an easy decision when I sat down and looked at my life goals.
What Prerequisites do I need to get in to a school?
Check the school website! Every school is slightly different! However, main prerequisites are:
Upper level Math
Upper level Biology
Do I need to take the MCAT?
Nope! No MCAT necessary! However, most schools require you take the GRE -Graduate Readiness Exam. This exam is made up of a Quantitive, Verbal and Writing Sections. Rough goals to shoot for would be at least a combined score of 300 or above the 50th percentile and a 3 or above on the writing.
As of the CASPA 2019-2020 cycle, there is also a new test that is being piloted – the PA-CAT. This is a 180 multiple choice questions based on 12 different subjects pulled from typical PA school prerequisites – anatomy (13%), physiology (13%), general biology (13%), microbiology (9%), general chemistry (11%), organic chemistry (9%), biochemistry (12%), statistics (3%), medical terminology (1%), sociology (4%), psychology (8%), and genetics (4%). This is not yet a standard requirement, so don’t worry too much about it now! Some schools have started requiring it for the CASPA 2021-2022 cycle
Do I need to have a specific major?
Nope! As long as you have your prerequisites within recent years (most schools say 5 years), it does not really matter what your major is! Obviously, the more science or health classes you have, the better you would look to the college. Also, schools definitely want to see that the challenge level of your classes increases with each year and that you grow as a student.
GPA does matter when applying to PA school, and it’s important that you work hard from your first moment in school to achieve your goal. CASPA does not accept grade replacement, but instead included the grade from every class you have ever taken – effectively “averaging” repeated classes, which does make your CASPA GPA lower than the GPA you have during school.
What are contact hours and how do I get them?
This is the most important/challenging thing about getting in to PA school. Depending on which school you apply to, you will need a different amount of hours. It could be anything from nothing to 2000 total by the time of applying. You need to make sure to check each school to see what they require.
Patient contact hours are exactly what they sound like – time you spend having contact with patients! And, this absolutely must be medical. This could be taking vitals, drawing labs, taking history and symptoms, etc. Some of the best ways of getting patient contact hours are a CNA, EMT, Medical Assistant, or Scribe. A bunch of things that don’t count for hours (or only count for a portion of the hours you work) include technicians or front staff, pharmacy assistants, volunteers (if you are just spending time with the patient and not doing anything medical), shadowing, transport staff, or lifeguards. If you have questions about what counts, seriously contact the program or look on the website. Almost every program will clearly state what counts for hours or does not. And, if it only counts for one school and not others, you’re better off doing something different.
My rule of thumb is to ask yourself, “Am I touching the patient in a way that impacts their medical care?”
Most students applying chose to take a year off, or a gap year, to get their hours. Working while going to school is not something most students would want to do, and getting hours is often very difficult work.
Is it okay if becoming a PA is a career change for me?
Of course! In fact, when I was applying – I applied during my senior year, so I went straight from undergraduate to PA school with no gap year – I was told that I was very young! A lot of the people in my class had undergone a career change to become a PA; we had everything from an RN to military members to researchers to high school English teachers. As long as you’re passionate about becoming a PA and put forth effort in to reaching that dream, you could have been anything beforehand. That’s the beauty of PA Schools!
This is a career built off of people who underwent a career change to be able to practice medicine
What did you look like when applying?
I was an undergraduate applicant, meaning that I applied the cycle during my third year of undergrad and went on interviews during the Fall and Spring of my senior year.
Bachelor of Science in Health Science
GPA – 3.6
Science GPA – 3.7
GRE – 159, 160, 5 in writing
PCE: 2000+ at time of application.
Shadowing – 3 different PAs and 1 MD for over 100 hours
Volunteering – 1000+ over three years of undergrad
I worked full time while attending school full time for 2 years as a CNA. First I worked on a Med/Surg floor, and then I transitioned to a general Pediatrics floor. I learned a ton from my experience, and am thankful for it every day! For volunteering, I didn’t just limit myself to medical related opportunities. I did a variety of different experiences that were all focused on what I was passionate about (pediatrics). I was in a sorority as well as a greek honors society.
I entered undergraduate knowing exactly what I wanted to do and how I wanted to achieve it, so I gave up a lot of the “fun” college experience to do it. It was definitely very challenging. However, I wouldn’t change any part of it for the world!
I ended up applying to 15 schools, got 7 interviews, 8 rejections, and ultimately ended up going to the best program for me!
Consultant Services to consider:
Now, I didn’t use a consultant service when I applied (simply because it was my first time applying, and if I didn’t get in I was going to reevaluate myself), but I heard nothing but great things about these companies, and ultimately ended up choosing to work for them!
Other Instagrams to follow:
If you head over to my Instagram and click on the people I follow, you’ll find my favorites! There are way to many to list here, and new ones pop up all the time
What’s your number one piece of advice?
Keep moving forward! Don’t let the obstacles you face make you give up on your dreams. Those challenges you face are what is going to make you into an amazing provider.
**Updated April 14, 2021