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Navigating the Path to Becoming a Physician Assistant in the U.S.: A 2025 Guide for International Medical Graduates Amid Evolving Immigration PoliciesEmbarking on a career as a Physician Assistant/Associate (PA) in the United States is a commendable goal for International Medical Graduates (IMGs). However, as of 2025, the journey has become more complex due to recent shifts in U.S. immigration policies under the current administration.

Notably, initiatives like Project 2025 have introduced stricter visa regulations and increased scrutiny of international applicants.

These changes have raised concerns among prospective IMGs about their eligibility and the feasibility of pursuing PA programs in the U.S. Understanding these new challenges is crucial for effectively navigating the application process and achieving your professional aspirations.

Understanding the Physician Assistant RoleBefore delving into the application process, it's essential to understand the role of physician assistants (PAs) in the U.S. healthcare system. This cannot be overstated.

You may notice that I use the terms "physician assistant" and "physician associate" interchangeably throughout this article. I do this intentionally, as these terms are currently synonymous. The PA profession is undergoing a name change, but this process has been slowed by pushback from organizations such as the American Medical Association (AMA). For more information on the PA title change, you can visit the AAPA website.

The following is the most common explanation you will see for the PA role:

"PAs are licensed clinicians who practice medicine in collaboration with physicians. Their responsibilities encompass conducting physical exams, diagnosing and treating illnesses, ordering and interpreting tests, and prescribing medications. The PA profession emphasizes a team-based approach to healthcare, ensuring comprehensive patient care."

Memorizing the definition is not enough. You are competing with thousands of highly qualified PA school candidates who have dedicated years to pursuing a PA degree. Many of these candidates have accumulated hundreds of hours of experience and have spent significant time shadowing physician associates. To stand out as a competitive candidate, you need more than just textbook knowledge. The scope of the PA profession in the U.S. is diverse and evolving rapidly. It is essential to take the time to understand the role thoroughly. You can often fulfill this requirement by gaining patient care experience (more on this below) and finding a suitable mentor who can guide you through the process.

Evaluating Foreign Medical DegreesFor IMGs, the initial step involves validating your foreign medical degree. This process requires a course-by-course evaluation to determine U.S. equivalency. Several credential evaluation services, such as World Education Services (WES), offer these assessments. However, it’s imperative to verify each PA program’s acceptance of foreign degree evaluations, as policies vary. Not all programs recognize foreign credentials, making it essential to consult individual program requirements before proceeding.

Completing Prerequisite CourseworkRegardless of prior medical education, PA programs mandate the completion of specific prerequisite courses within U.S.-accredited institutions. Courses completed at foreign institutions typically do not satisfy these prerequisites.

Common required subjects include anatomy, physiology, microbiology, and chemistry. Enrolling in these courses at a U.S. college or university ensures compliance with program standards and enhances your foundational knowledge aligned with U.S. medical education. For a detailed guide on designing the perfect pre-PA school curriculum, refer to Prerequisite Coursework: How to Design the Perfect Pre-PA School Curriculum.

Demonstrating English ProficiencyProficiency in English is vital for effective communication in clinical settings. IMGs from non-English-speaking countries are generally required to provide proof of English proficiency. Standardized tests such as the Test of English as a Foreign Language (TOEFL) or the International English Language Testing System (IELTS) are commonly accepted. Each PA program stipulates its own minimum score requirements. Some programs may waive this requirement if applicants have completed a certain number of credit hours at a U.S.-accredited institution. It’s advisable to review the specific English proficiency criteria of each program to which you intend to apply.

Acquiring Relevant Healthcare Experience

You might believe that 15 years of experience as a medical doctor overseas qualifies you for PA school. However, that's often not the case!

PA programs highly value direct patient care experience, preferably obtained within the U.S. healthcare system. This experience not only familiarizes IMGs with U.S. medical practices but also demonstrates adaptability to diverse healthcare environments.

Common roles include medical assistant, phlebotomist, or emergency room technician. While some programs may consider foreign healthcare experience, U.S.-based experience is often preferred. Engaging in volunteer opportunities or shadowing practicing PAs can further strengthen your application by showcasing commitment and practical understanding of the PA role. For an in-depth look at healthcare experience requirements, see Healthcare Experience Required for PA School: The Ultimate Guide.

Understanding Licensure and Certification RequirementsMany highly qualified International Medical Graduates (IMGs) interested in becoming Physician Assistants (PAs) in the U.S. often hold a common misconception. They believe that their foreign-trained medical degree, typically an MD, will allow them to immediately start practicing as a PA in the U.S. This belief is understandable; if you are a doctor in India, it seems logical to think that you could practice as a PA in the U.S.

But, to practice as a PA in the U.S., graduation from an Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accredited program is mandatory. Subsequently, passing the Physician Assistant National Certifying Examination (PANCE) administered by the National Commission on Certification of Physician Assistants (NCCPA) is required. It’s important to note that even with prior medical training, IMGs must complete an ARC-PA accredited PA program to be eligible for certification and licensure (sorry, there is NO getting around this). Licensure requirements can vary by state, so researching the specific requirements of the state where you intend to practice is crucial.

Navigating Visa and Residency ConsiderationsFor non-U.S. citizens or permanent residents, securing the appropriate visa is a critical component of the process. As of 2025, the U.S. administration has implemented policies under Project 2025 that may affect visa availability and requirements for international students. Notably, there have been increased restrictions and scrutiny on student visas, especially for individuals from certain countries.

Additionally, the administration has proposed changes to visa reciprocity agreements, potentially impacting the ease of obtaining student visas. It’s essential to identify PA programs that support international applicants and are authorized to sponsor student visas. Engaging with the international student services of prospective programs (as in this example from the Stanford PA program) can provide valuable guidance tailored to your situation.

Researching PA Programs Open to International ApplicantsNot all PA programs accept international applicants or recognize foreign medical degrees. Therefore, thorough research is essential. Some programs may have specific tracks or support systems for IMGs. It’s advisable to contact admissions offices directly to inquire about specific requirements, support services, and the success of previous IMG applicants.

For a comprehensive list of U.S. Physician Assistant programs that accept international students, please visit the PA School Finder website. This site provides detailed information about various requirements, including those specifically for international applicants.

Preparing a Competitive ApplicationThis may all sound daunting, and you might be wondering if you have a chance of getting into a US PA program as a foreign graduate. However, there is good news: you bring a lot to the table, especially to programs that seek a diverse pool of students.

A compelling application includes more than just academic achievements. Highlighting your unique experiences, cultural competencies, and multilingual abilities can truly set you apart.

Crafting a thoughtful personal statement that reflects your journey, motivations, and understanding of the PA role is crucial. Securing strong letters of recommendation from U.S.-based healthcare professionals who can attest to your clinical skills and adaptability will further bolster your application. Engaging in mock interviews and seeking feedback can enhance your interview performance, demonstrating your preparedness and commitment.

ConclusionThough it may seem daunting, transitioning from an International Medical Graduate to a U.S.-certified PA-C is a challenging yet achievable goal. By understanding the PA role, validating your credentials, completing necessary prerequisites, demonstrating English proficiency, acquiring relevant experience, and preparing a comprehensive application, you position yourself for success.

In 2025, evolving immigration policies, such as those proposed in Project 2025, have introduced stricter visa regulations and increased scrutiny of international applicants. It’s imperative to stay informed about these changes, as they may impact visa availability and requirements for international students.

Engaging with professional organizations (like your state and local chapters), seeking guidance from mentors, and maintaining flexibility in your plans will be crucial in navigating these uncertainties. With determination and strategic planning, you can overcome these challenges and contribute meaningfully to the U.S. healthcare system. You've got this!

Seeking Professional GuidanceAs you have seen, navigating the path to becoming a Physician Assistant/Associate (PA) in the United States as an International Medical Graduate (IMG) presents unique challenges. But fear not, you are not alone!

To enhance your chances of success, consider leveraging professional guidance tailored to your specific needs. Our International Pre-PA Applicant Consultation Service offers personalized support to help you navigate the complexities of the PA application process. This specialized service includes a comprehensive review of your background and qualifications, paired with a one-hour consultation with an expert advisor who has been through the process.

We focus on strengthening your application, addressing any areas of improvement, and providing actionable strategies to bolster your candidacy. By utilizing such resources, you can confidently navigate the application process and move closer to achieving your goal of becoming a PA in the U.S.

International Pre-PA Applicant Consultation Service

The post Navigating the Path to Becoming a Physician Assistant in the U.S.: A 2025 Guide for International Medical Graduates Amid Evolving Immigration Policies first appeared on The Physician Assistant Life.

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The 10 Best Cities for PAs to Move to in 2025Updated: March 31, 2025

The Booming PA Job MarketIn its latest ranking of best healthcare jobs, U.S. News and World Report has once again placed physician assistants near the top of the list - ranking PAs as the #2 healthcare job and the #4 best job overall in America for 2025. This recognition reflects the growing importance and demand for PAs in today's healthcare landscape, as reported in their March 2025 rankings.

PAs are not just in high demand—they're experiencing one of the most robust job markets in all of healthcare. According to the most recent Bureau of Labor Statistics data, approximately 153,400 PAs are currently working in the United States. They enjoy excellent compensation, with a median salary that has now reached $130,020. The highest-paid 25% of PAs earned over $151,720, showcasing the lucrative potential of this career path.

What's even more impressive is the projected growth rate for the profession. Physician assistants are expected to experience significant job growth of 28% between 2023 and 2033, dramatically outpacing the average growth rate for all occupations, which hovers around just 3%. This translates to approximately 39,300 new PA positions being created across the United States in the coming years.

What's driving this exceptional demand? A report from the Bureau of Health Workforce projects a shortage of over 57,000 full-time physicians by 2025, increasing to 81,800 by 2035. As healthcare systems struggle with these physician shortages, PAs are stepping in to fill critical gaps in patient care, particularly in primary care settings.

The PA hiring landscape also varies significantly by region. Our analysis of hiring data across all 50 states reveals fascinating patterns that can guide your career decisions in 2025. For instance, in Connecticut—home to our #1 ranked city—50.2% of employers are actively recruiting PAs, with 25.4% reporting positions that have remained unfilled for at least six months. This indicates both high demand and potential hiring challenges that could benefit job seekers with competitive salaries and incentives.

So, what are the best cities for physician assistants to live in 2025? To answer this question comprehensively, we've partnered with Indeed, one of our top 10 best websites for PA job searches, to analyze the metro areas with the most job listings for physician assistants. We've combined job availability data with salary information from Indeed and Salary.com, while also factoring in housing affordability metrics from Zillow.

Here are the best US cities for PAs to live in 202510. New York, NYThis urban mecca has no shortage of physician assistant jobs, but at an impressive annual salary of $135,175, the Big Apple is still the least affordable place to live on the list. For PAs specializing in surgical roles, the compensation can be even more attractive, with surgical PAs commanding an average of $133,030 nationwide as of March 2025.This premium may help offset the high cost of living for specialists in the city.

• Percent share of job listings (rounded): 10.3% (Ranked 3rd)
• Average annual salary: $135,175 (Rank 2nd)
• Median home price: $763,240
• Salary as a percentage of home price: 15.3% (Rank 10th)
• Median annual rent: $39,000
• Rent as a percentage of income: 38% (Rank 10th)

9. Orlando, FLWhile "The City Beautiful" comes in ninth for average annual PA salary, its solid percentage of job openings for physician assistants gives Orlando a boost when compared to the rest of the country. Orlando's growth aligns with the trend of higher-population states like Florida offering increasing opportunities for PAs, particularly in in-demand specialties like family practice, hospitalist roles, and urgent care.

• Percent share of job listings (rounded): 8.7% (Rank 5th – tie)
• Average annual salary: $112,656 (Rank 10th)
• Median home price: $378,415
• Salary as a percentage of home price: 31% (Rank 5th)
• Median annual rent: $20,796
• Rent as a percentage of income: 20% (Rank 7th)

8. Baltimore, MDAnother city with above-average physician assistant job openings compared to the rest of the country, Baltimore continues to be a hot city for PAs. With Maryland reporting 42% of employers actively recruiting PAs and the ongoing physician shortage projected to exceed 57,000 nationwide by 2025, Baltimore's exceptional salary-to-housing ratio (60%) makes it particularly attractive for professionals seeking financial stability.

• Percent share of job listings (rounded): 9.5% (Rank 4th)
• Average annual salary: $121,918 (Rank 5th)
• Median home price: $190,890
• Salary as a percentage of home price: 53% (Rank 1st)
• Median annual rent: $17,796
• Rent as a percentage of income: 15.5% (Rank 6th)

7. Riverside, CARiverside is a prime spot for physician assistants, where the average salary of $130,035 is higher than the national median salary reported by the BLS. This places Riverside PAs well within the upper compensation range nationally, where the median is now $130,020 and the top 25% earn over $151,720. U.S. News & World Report California continues to be a leader in PA employment opportunities.

• Percent share of job listings (rounded): 6.3% (Rank 7th)
• Average annual salary: $130,035 (Rank 4th)
• Median home price: $650,854
• Salary as a percentage of home price: 19.5% (Rank 8th)
• Median monthly rent: $1,138
• Rent as a percentage of income: 10.6% (Rank 5th)

5. Philadelphia, PA (tie)Philadelphia tied for the smallest share of jobs among the top ten with 5.9 percent. The average annual salary of $129,178 isn't the highest on the list. But Philadelphia is relatively affordable to live in for a big city, coming in third place on the affordability of homes. Pennsylvania's strong showing on this list reflects the state's commitment to utilizing PAs to address healthcare gaps, with 37.4% of employers actively recruiting these professionals.

• Percent share of job listings (rounded): 5.9% (Rank 8th – tie)
• Average annual salary: $129,178 (Rank 3rd)
• Median home price: $218,079
• Salary as a percentage of home price: 40.6% (Rank 3rd)
• Median annual rent: $17,160
• Rent as a percentage of income: 14.39% (Rank 9th)

5. Charlotte, NC (tie)With an above-average salary for physician assistants compared to the rest of the country, Charlotte is the largest of the three North Carolinian cities to make our list. Charlotte exemplifies why North Carolina has become a PA employment powerhouse, with metropolitan areas offering substantial opportunities across multiple specialties including family practice, pediatrics, and orthopedic surgery

• Percent share of job listings (rounded): 5.9% (Rank 8th – tie)
• Average annual salary: $118,658 (Rank 8th)
• Median home price: $386,760
• Salary as a percentage of home price: 32% (Rank 6th)
• Median annual rent: $16,464
• Rent as a percentage of income: 15% (Rank 8th)

4. Raleigh, NCIs this another Raleigh vs. Durham flame war? Both cities rank exceptionally well for average annual salary and rent affordability, but Durham slightly edges Raleigh this time. The Research Triangle region benefits significantly from the projected 28% growth in PA positions between 2023 and 2033, creating a continuous stream of new opportunities in this healthcare-rich corridor.

• Percent share of job listings (rounded): 8.7% (Rank 5th – tie)
• Average annual salary: $119,270 (Rank 7th)
• Median home price: $435,232
• Salary as a percentage of home price: 27% (Rank 7th)
• Median annual rent: $14,520
• Rent as a percentage of income: 13.5% (Rank 4th)

3. Pittsburgh, PAThe Pittsburgh metro area might not have the highest-paying salary on the list ($120,493), but the cost of housing is very affordable, coming in third place for both apartments and homes. As healthcare facilities work to address the growing physician shortage, Pittsburgh's combination of academic medical centers and affordable living makes it increasingly attractive to PAs seeking work-life balance.

• Percent share of job listings (rounded): 5.9% (Rank 8th – tie)
• Average annual salary: $120,493 (Rank 3rd)
• Median home price: $219,884
• Salary as a percentage of home price: 42.5% (Rank 3rd)
• Median annual rent: $14,700
• Rent as a percentage of income: 13.4% (Rank 1st)

2. Durham, NCIs there any doubt that North Carolina is the best state for PAs? Durham earns the number two spot by the sheer number of job openings for physician assistants, making up 22.5 percent of openings within the top ten. Durham's exceptional performance confirms wider observations that North Carolina has become a national leader in PA employment, particularly with growing demand for specialties like cardiology and general surgery among travel PA positions.

• Percent share of job listings (rounded): 22.5% (Rank 1st)
• Average annual salary: $118,414 (Rank 9th)
• Median home price: $391,000
• Salary as a percentage of home price: 30.7% (Rank 9th)
• Median annual rent: $14,700
• Rent as a percentage of income: 11.7% (Rank 3rd)

1. Hartford – West Hartford – East Hartford, CTGreater Hartford is an all-around strong choice for physician assistants, performing especially well on job availability and housing affordability. That $131,503 average annual salary will truly go a long way here. Connecticut's top position is reinforced by statewide data showing 50.2% of employers actively recruiting PAs, making it one of the hottest markets in the country for these healthcare professionals in 2025.

• Percent share of job listings (rounded): 16.2% (Rank 2nd)
• Average annual salary: $131,503 (Rank 1st)
• Median home price: $179,170
• Salary as a percentage of home price: 43.5% (Rank 3rd)
• Median annual rent: $12,000
• Rent as a percentage of income: 11.5% (Rank 2nd)

Additional Analysis and InsightsLooking beyond the top 10 cities, our state-by-state analysis reveals some compelling trends in PA hiring across the country:

• Growing Retirement Wave: Alaska (12.7%), North Dakota (13.4%), and New Mexico (12%) have the highest percentages of PAs planning to retire within the next five years, potentially creating significant opportunities for new graduates in these states.
• Unfilled Position Hotspots: Alaska (38.1%), New Mexico (37.2%), and Montana (34.7%) lead the nation in positions remaining unfilled for at least six months, suggesting these areas may offer competitive compensation and relocation packages to attract talent.
• Most Active Hiring Markets: The District of Columbia (51.3%), Connecticut (50.2%), and New York (47.2%) have the highest percentages of employers actively recruiting PAs, indicating robust job markets with numerous opportunities.

When considering your next career move as a PA in 2025, these hiring trends combined with our city rankings provide a comprehensive picture of where your skills may be most valued and compensated.

Considering an even bigger PA career change. How about going international?

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Multiple Mini Interview (MMI) Strategies for PA School: A Comprehensive GuidePreparing for PA school interviews can feel overwhelming, especially when facing the unique challenges of Multiple Mini Interviews (MMIs).

Unlike traditional interviews, MMIs involve a series of short, focused interactions at various stations, each designed to assess different aspects of your abilities. Whether it's handling ethical dilemmas, behavioral questions, demonstrating communication skills, or thinking critically under pressure, MMIs test a wide range of competencies crucial for success in PA school.

In this comprehensive guide, we break down the key strategies to help you excel in MMIs. We cover everything from understanding the MMI format and the types of questions you'll face, to mastering specific scenarios with practical examples.

I've included this detailed workshop video by Deanna Matzen, which provides insights on how to effectively navigate ethical, situational, and projective questions—core components of most MMIs.

Click here to access the webinar slides!

What is an MMI?Multiple Mini Interviews (MMIs) are a series of short, focused interviews used by many PA schools to assess candidates.

Unlike traditional interviews, MMIs typically consist of 6-10 stations, each designed to evaluate different aspects of a candidate's abilities, including:

• Teamwork
• Communication
• Self-awareness
• Maturity
• Empathy
• Critical thinking

MMIs aim to provide a more holistic view of applicants, going beyond academic achievements to assess character and interpersonal skills.

Why Are More Schools Using MMIs?1. Multiple perspectives: With different interviewers at each station, schools get a more comprehensive picture of each applicant. 2. Reduced bias: Evaluation rubrics help limit subjective factors like charisma or chemistry. 3. Behavior over backstory: MMIs focus more on how candidates act in specific situations rather than their personal history.

MMI FormatMMIs can be conducted either virtually or in-person, typically following this structure:

• 5-10 stations
• 1-2 minutes to read a prompt
• 3-8 minutes to respond
• Possible break stations between active stations
• Total duration of up to 2 hours

Pro tip: For virtual MMIs, have paper and pencil ready for note-taking!

Types of MMI QuestionsMMI questions can vary widely, but generally include:

1. Traditional
2. Behavioral
3. Ethical
4. Situational
5. Communication/Teamwork
6. Critical thinking
7. Data analysis
8. Role-playing
9. Essays

Traditional QuestionsTraditional questions often focus on your motivations for pursuing a career in healthcare, your understanding of the PA profession, and your personal strengths and weaknesses. These questions are similar to those in a typical interview and assess your background, experiences, and aspirations.

Behavioral QuestionsBehavioral questions look at past behavior as a predictor of future actions. They often start with phrases like "Tell me about a time when..." or "Describe a situation where...". These questions evaluate your experiences and how you've handled specific scenarios in the past, highlighting your skills in teamwork, leadership, and problem-solving.

Ethical DilemmasEthical questions assess your ability to navigate complex moral situations. For instance, deciding between two patients who need a liver transplant tests your understanding of medical ethics and decision-making skills. These questions evaluate your capacity to weigh different ethical principles, such as beneficence, non-maleficence, and justice, and to make balanced, thoughtful decisions.

Situational QuestionsSituational questions present hypothetical scenarios to evaluate how you would handle specific situations. For example, you might be asked how you would respond if you witnessed a colleague committing fraud. These questions focus on your problem-solving abilities, ethical considerations, and how well you can apply theoretical knowledge to practical situations.

Communication/TeamworkQuestions in this category assess your interpersonal skills and ability to work collaboratively. They may involve role-playing scenarios where you must interact with a "patient" or "colleague" or participate in group discussions. These questions evaluate your communication style, teamwork abilities, and conflict resolution skills.

Critical ThinkingCritical thinking questions test your analytical skills and ability to process information quickly and accurately. You might be asked to interpret data, evaluate the reliability of different sources of information, or solve complex problems. These questions assess your logical reasoning and ability to think under pressure.

Data AnalysisData analysis questions require you to interpret and analyze information presented in charts, graphs, or tables. You might be asked to identify trends, make predictions, or draw conclusions based on the data. This tests your quantitative skills and your ability to make informed decisions using evidence.

Role-playingRole-playing questions put you in hypothetical scenarios where you must act as a PA or in another professional role. This could involve interacting with patients, colleagues, or family members in challenging situations. These questions assess your empathy, communication skills, and professionalism.

EssaysSome MMI stations may involve writing short essays on various topics. These questions test your written communication skills, ability to organize your thoughts, and articulate your reasoning clearly and concisely. Essay questions may cover ethical dilemmas, healthcare policies, or your personal motivations.

Types of MMI QuestionsThe questions in MMIs can be categorized into several types:

1. Ethical Dilemmas: These questions assess your ability to navigate complex moral situations. For instance, deciding between two patients who need a liver transplant tests your understanding of medical ethics and decision-making skills.
2. Situational Questions: These scenarios evaluate how you would handle specific situations, such as dealing with a colleague committing fraud. The focus here is on your problem-solving abilities and ethical considerations.
3. Behavioral Questions: These questions look at past behavior as a predictor of future actions. For example, discussing a time when you worked effectively in a team.
4. Communication and Teamwork: Questions in this category assess your interpersonal skills and ability to work collaboratively. This might involve role-playing or group discussions.
5. Critical Thinking: These questions test your analytical skills and ability to process information quickly and accurately.
6. Projective Questions: These are off-the-wall questions designed to see how creatively and uniquely you think. An example might be, "If you were a car, what kind would you be and why?"

This guide focuses on ethical, situational, and projective questions, which are crucial for PA school interviews.

General MMI StrategiesDo: Investigate thoroughly: Ask questions and seek clarity. * Call on higher authorities: Reference laws, policies, or supervisors when appropriate. * Qualify your statements: Be specific and precise in your responses. * Consider all perspectives: Weigh different viewpoints before making a decision. * Ask questions about unclear aspects: Clarify any ambiguities in the scenario. * Take a clear stance or action*: Show decisiveness in your answers.

Don't: Make exceptions to rules: Stick to ethical and professional guidelines. * Dominate group discussions: Encourage participation from others. * Overstep your assigned role*: Respect the boundaries of your role in scenarios.

Ethical Dilemmas: Medical Ethical PrinciplesWhen faced with ethical scenarios, consider these four key principles:

1. Beneficence: Do the most good
2. Non-maleficence: Do no harm
3. Patient Autonomy: Respect the patient's right to make their own healthcare decisions.
   • Privacy (HIPAA)
   • Consent
   • Truth-telling
4. Justice: Ensure fair and equitable distribution of medical access

Situational Questions: What Would You Do?For situational questions, focus on:

• Specific actions you would take
• Applicable laws and regulations: Consider legal implications
• Available resources: Identify the tools and resources at your disposal
• Similar past experiences: Use the SCARF method (Situation, Complication, Action, Result, Follow-up) to relate past experiences
• Relevant medical ethical principles: Integrate these principles into your response.

Example: The Liver Transplant DilemmaLet's walk through a sample ethical/situational scenario:

Prompt: Two patients need a liver transplant, but only one liver is available. How would you decide between a 64-year-old retired politician who is a recovering alcoholic and a 26-year-old mother of three on welfare?

Answer Strategy:

1. Restate the prompt: Clarify the scenario.
2. Identify the central conflict: Highlight the limited resource.
3. Address ethical, legal, and professional limitations: Discuss relevant restrictions.
4. Identify what you need to know: Use if/then statements to explore different outcomes.
5. Take a stance: Make a reasoned decision based on the information provided.

Example response:

"If both patients had an equal chance of surviving the procedure and supporting the liver, and if both were fully aware of the risks and willing to undergo the procedure, and if I had to make this decision alone without higher authority, I would choose the younger mother. She has more life ahead of her and three dependent children. However, I would only do this if there were no other alternatives or solutions available."

Projective Questions: Thinking Outside the BoxProjective questions may seem unrelated to becoming a PA, but they assess creativity, critical thinking, and your ability to think on your feet.

Tips for answering projective questions:

• Draw from hobbies, interests, or experiences unrelated to healthcare: Show your unique personality.
• Prepare a list of unique facts about yourself in advance: Be ready with interesting anecdotes.
• Keep your answer concise but interesting: Engage your interviewer with a memorable response.

Example: "If you were a car, what kind of car would you be?"

ConclusionMastering MMI strategies takes practice, but with these tips and techniques, you'll be well-prepared to showcase your skills, ethics, and unique personality. Remember to stay calm, think critically, and let your true self shine through. Good luck with your PA school interviews!

Want more interview prep?

With our comprehensive mock interview package, you'll receive a 45-minute live mock video interview, feedback, suggestions for improvement, a link to watch and replay your recorded interview as many times as you like, along with expert strategies and tips to make your interview day a success.

PA School Mock Interviews: Prepare with a LIVE, Recorded Video Interview

Sources:

• MMI Interview: The Ultimate Guide (150 Sample Questions Included)
• The Savvy Pre-Med: Tips for Common Types of MMI Interview Questions (with Samples and Examples)
• The Savvy Pre-Med: 250 Sample MMI Interview Questions to Practice in 2021
• UCAT Masterclass: 6 Common MMI scenarios and how to ace them
• Principles of Clinical Ethics and Their Application to Practice

Resources:

Guidelines for Ethical Conduct for the PA Profession

The post Multiple Mini Interview (MMI) Strategies for PA School: A Comprehensive Guide first appeared on The Physician Assistant Life.

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Elevate Your Personal Statement: Using Bloom’s Taxonomy for Impactful WritingThe most common advice writers often give pre-PAs is to "show, don't tell" in your essays. (Though we like to encourage showing AND telling - just like kindergarten!)

One form of showing is telling a story in a narrative form, like a scene in a book. Or it could use specific and descriptive anecdotal examples to illustrate a point.

While that is valuable advice, I recently wondered if we've failed to talk about showing through using higher-order/critical thinking skills.

You may not be familiar with Bloom's Taxonomy. I only learned about it a few years ago when I began teaching science at a university.

Bloom's Taxonomy seeks to distinguish the different levels of learning. The lower the level, the less complex and difficult the task; the higher the level, the more complex and difficult the task.

photo © Jessica Shabatura

Most undergraduate students are expected to produce work that is within the lower three levels -- knowledge/describing, comprehension/understanding, and application. Master's level students are expected to produce work that exhibits proficiency in application and analysis. Doctoral students should be evaluating and creating new ideas.

How can you use this in your personal statement?Start with noting the verbs you use when describing both your own HCE/PCE experiences and observations of PAs. Then compare the verbs to the following chart (or using any of a number of charts you can find online):

In which level of Bloom's Taxonomy do you find the verbs you used?

If they fall mostly within the first two levels, can you think of ways to discuss your experiences that use some of the verbs in the Apply and Analyze levels?

Here's an example:

"The PA consulted with patients just as a physician would. If she needed to discuss a case with a physician, they spoke as equals and decided on a plan. The combination of autonomy but with a support system is exactly what I want in a medical career."

It is a good description, but it makes me wonder why this collaboration is important. What's the benefit to patients? Why does it matter to the applicant?

I’d like to see it go a step further and consider a higher order of thinking: What are the benefits of these relationships to each member of the healthcare team, including patients? What did the applicant discover,or what did the relationships demonstrate? What is an example of how the applicant models this type of collaboration in other scenarios?

Have you tried elevating your writing using Bloom's showing verbs? If so, please give us an example in the comments!

For more guidance on writing a strong personal statement, check out these resources:

1. How to Write the Perfect Physician Assistant School Application Essay
2. Do You Recognize These 7 Common Mistakes in Your Personal Statement?
3. 31 Physician Assistant Personal Statement Examples
4. 5 PA School Essays That Got These Pre-PAs Accepted Into PA School
5. The Ultimate PA School Personal Statement Starter Kit

Single Edit One-on-one Service Supplemental Essays

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How to Answer Behavioral Questions in Your PA School InterviewEffective Strategies and Real-Life Examples for Mastering Behavioral Interview QuestionsIf you're preparing for a Physician Assistant (PA) school interview, you're likely aware that behavioral interview questions are a critical component.

These questions are designed to uncover how you have handled various situations in the past, providing insight into your potential as a future PA.

The way you respond to these questions can make a big difference in the success of your interview. This blog post will guide you through strategies to prepare for these difficult questions and will offer example answers to some common scenarios.

Understanding Behavioral Interview Questions* Strategies for Preparing for Behavioral Interview Questions + Strategy 1. Understand the Competencies: + Strategy 2. Use the STAR Method + Strategy 3. Reflect on Relevant Experiences + Strategy 4: Customize Your Answers + Strategy 5: Practice, But Don’t Memorize + Example Behavioral Interview Questions and Answers + Conclusion: Navigating Your PA School Interview with Confidence and Authenticity - Tailored Mock Interviews and Comprehensive PA Consulting Services Behavioral interview questions are designed to reveal insights into your previous actions in specific situations.

The rationale is that your past behavior is the best predictor of your future performance. In the context of PA school interviews, these questions are used to assess qualities such as empathy, teamwork, leadership, resilience, and ethical judgment.

The rationale behind these questions is rooted in the idea that past behavior is the best predictor of future performance. For PA school interviews, this means that admissions committees are looking for evidence that you possess the qualities necessary to succeed both in PA school and as a practicing PA.

Typical behavioral questions might include:

• Can you describe a time when you had to handle a stressful situation?
• Tell me about a moment when you made a mistake. How did you handle it?
• Have you ever had a conflict with a coworker or classmate? How was it resolved?
• Tell me about a time you interacted with a really challenging patient.

These questions require more than just theoretical answers; they demand concrete examples that demonstrate your character and skills.

Strategies for Preparing for Behavioral Interview QuestionsStrategy 1. Understand the Competencies:First and foremost, research the PA program where you are interviewing and identify the competencies that the program values. This can often be found in the program's mission statement, during an open house, on pre-PA forums, PA virtual fairs, or by querying a current PA student at the program.

Common competencies might include communication skills, ethical decision-making, critical thinking, and teamwork. Understanding these will allow you to tailor your responses to reflect the qualities they are looking for.

Strategy 2. Use the STAR MethodThe STAR method is a structured manner of responding to a behavioral interview question by discussing the specific Situation, Task, Action, and Result of the experience you are describing:

• Situation: Set the scene and give the necessary details of your example.
• Task: Describe what your responsibility was in that situation.
• Action: Explain exactly what steps you took to address it.
• Result: Share what outcomes your actions achieved.

Using the STAR method ensures that your answer is coherent, engaging, and complete. It helps you deliver a clear story that demonstrates your competencies effectively.

Strategy 3. Reflect on Relevant ExperiencesBefore your interview, spend time reflecting on your experiences from school, work, volunteer activities, or personal life. Identify situations that highlight your critical thinking, teamwork, communication skills, and adaptability. Make a list of these experiences and practice articulating them using the STAR method.

Strategy 4: Customize Your AnswersWhile it’s helpful to prepare answers to common behavioral questions, it’s essential to tailor your responses to reflect the specific values and competencies that the PA program you are applying to emphasizes. Use the information gathered from strategy 1 (when you researched the program thoroughly) and try to understand what characteristics they value most in their students.

Strategy 5: Practice, But Don’t MemorizePracticing your answers is crucial to perform confidently, but beware of over-rehearsing. You want to avoid sounding like you're reciting a script during the interview. Instead, focus on understanding the structure of your answers and the key points you want to convey. This approach will help you to be more adaptable in the interview and to respond naturally to the questions asked.

Example Behavioral Interview Questions and AnswersLet's apply these strategies to some common PA school behavioral interview questions.

Example 1: Tell me about a time you interacted with a really challenging patient.

• Situation: During my shift at a busy family practice clinic, a patient became visibly upset after waiting over an hour past his scheduled appointment time. He expressed his frustration loudly in the waiting room, stating his intention to leave without seeing the doctor.
• Task: As the front desk coordinator, it was my responsibility to manage the situation, ensure the patient felt heard, and prevent him from leaving without receiving the care he needed.
• Action: I approached the patient calmly and empathetically, apologizing for the delay and explaining the reasons behind it, which were unforeseen emergencies that required immediate attention. I reassured him that his appointment was a priority and that we would expedite his visit as soon as possible. To demonstrate our commitment to his care, I offered a complimentary beverage and a quiet place to wait, ensuring he felt valued and respected.
• Result: The patient decided to stay after our conversation, appreciating the transparency and the measures taken to accommodate him. He later expressed gratitude for the care received and understanding of the situation. This experience reinforced the importance of effective communication and empathy in resolving patient dissatisfaction and maintaining trust in healthcare settings.

Real-world response: Mock interview with Daniela Alcázar

In this real-world example, Daniela opens up about her encounters with emotionally charged patients in an oncology department. Under the guidance of PA Life mock interviewer Tolu Fannon, Daniela discusses the complex emotions these patients experience and how clear communication and kindness can make a significant difference. Tolu emphasizes the importance of answering interview questions with specific examples and lessons learned, advising viewers on the best practices for narrative clarity and authenticity. She stresses that general responses can lead to missed opportunities to demonstrate real-life proficiency.

Example 2: Tell me about a moment when you made a mistake. How did you handle it?

• Situation: In one of my first volunteer experiences at a local hospital, I accidentally violated HIPAA regulations by discussing patient details in a non-secure environment.
• Task: I needed to rectify the mistake and ensure it didn’t happen again.
• Action: I immediately reported the incident to my supervisor, apologized, and attended additional training on HIPAA compliance.
• Result: My openness in addressing the mistake and taking corrective action helped reinforce the importance of privacy regulations, and I have maintained a spotless record since.

Example 3: Have you ever had a conflict with a coworker or classmate? How was it resolved?

• Situation: During a group project in my undergraduate program, there was a misunderstanding about the division of work, leading to a conflict.
• Task: As the team leader, it was my job to resolve the conflict.
• Action: I organized a meeting to openly discuss everyone's expectations and perceptions. Through this dialogue, we realized the communication error and collaboratively redesigned the task division to be more equitable.
• Result: The project was not only completed on time but received high praise from our professor. This incident underscored the importance of clear communication and teamwork.

Example 4: Tell me about a time when you had to work closely with someone whose personality was very different from yours.

• Situation: As an EMT with a calm, methodical approach, I was paired with a partner who preferred intuitive, aggressive actions during emergencies.
• Task: Our goal was to provide efficient medical assistance and ensure patient safety while managing our differing approaches.
• Action: We discussed the importance of balancing our methods and agreed to review each call together to learn from each other’s strengths and improve our teamwork.
• Result: This approach led to better collaboration and more effective emergency responses, enhancing our ability to care for patients and earning recognition from our team and supervisors.

Example 5: Give an example of how you handled a high-pressure situation.

• Situation: During my time as an emergency room technician, there was an instance when we had multiple critical patients arrive simultaneously.
• Task: My role was to assist with triaging patients and providing initial care.
• Action: I prioritized patient needs based on the severity of their conditions, communicated effectively with the nursing staff and doctors, and made sure that all documentation was handled swiftly and accurately.
• Result: My actions helped streamline the workflow and ensured that all patients received timely care. My team was able to manage the situation more effectively due to my initiative in organizing the immediate tasks and communication.

Conclusion: Navigating Your PA School Interview with Confidence and AuthenticityPreparing for behavioral interview questions is more than rehearsing answers—it's about demonstrating the core competencies that make a successful PA. This blog post has equipped you with the strategies and insights needed to transform your personal experiences into compelling stories that showcase your skills, empathy, and readiness for the challenges of PA school and beyond.

Remember, the key to success in these interviews lies in your ability to articulate real-world examples that highlight your adaptability, problem-solving capabilities, and ability to work effectively under pressure. The STAR method is not just a tool for structuring responses; it's a way to communicate your personal journey and professional ethos in a narrative that resonates with interview panels.

As you continue to prepare for your PA school interviews, take the time to reflect deeply on your experiences, practice your storytelling skills, and, most importantly, remain authentic to your true self. The examples and strategies discussed here are designed to inspire and guide you, but your unique experiences and genuine responses will make you stand out as a candidate.

Good luck, and may your journey to becoming a PA will be fulfilling and successful!

Additional reading:

The Top 46 Physician Assistant Applicant Interview Questions

Enhance Your Preparation with Our Tailored Mock Interviews and Comprehensive PA Consulting ServicesTo further enhance your preparation, consider our specialized services designed to boost your readiness and confidence. Our Mock PA School Interview Service offers a realistic interview experience with personalized feedback from experienced PA educators and admissions experts. For more comprehensive guidance, our Pre-PA Consulting Service provides in-depth support on application strategy, document preparation, and one-on-one coaching.

Mock PA School Interview ServiceOur Mock PA School Interview Service offers a realistic interview experience tailored to the unique demands of PA school applications. By participating, you'll receive:

• Personalized feedback from experienced PA educators and admissions experts.
• Insight into the types of questions you'll face, including those tough behavioral queries.
• Techniques and tips to improve both your answers and your confidence.

Pre-PA Consulting ServiceFor more comprehensive preparation, consider our Pre-PA Consulting Service. This service is perfect for candidates who are seeking:

• Advice on application strategy to strengthen your PA school application.
• Guidance on personal statement writing, resume crafting, and securing impactful letters of recommendation.
• One-on-one coaching sessions to develop a clear and compelling narrative for your PA school journey.

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From Mock Interviews to PA Practice: Tolu Fannon Shares Her Journey

In this virtual shadowing Q&A, Deanna Matson from The PA Life sits down with Tolu Fannin, a practicing physician assistant/associate who has gone from being a pre-PA student utilizing mock interviews to prepare for PA school, to now serving as a mock interviewer herself to help the next generation of aspiring PAs.

Tolu openly shares her experiences and advice gained throughout her journey.

Key takeaways from the interview include:* The importance of gaining quality patient care experience before applying to PA school. Tolu worked as a paramedic and ER tech to gain hands-on clinical experience. * Tips for selecting a PA program that aligns with your goals, such as going to school where you ultimately want to practice and considering factors like cost and program resources. * Study strategies for the didactic year include explaining concepts to classmates, finding a good note-taking system, and dedicating time to studying like a full-time job. * The benefits and challenges of clinical rotations, from great preceptors that lead to job offers, to learning to adapt to different practice styles and personalities. * Tolu's experience working in primary care out of school and her recent transition to urology, a specialty she loves for the mix of clinic and procedures. * Financing PA school through loans, and options like loan repayment programs for those who go into public service. * Advice for pre-PAs on finding shadowing opportunities, gaining volunteer hours, and spacing out challenging science prerequisites.

Throughout the conversation, Tolu emphasizes the importance of remembering your "why" for becoming a PA, having grace with yourself through the ups and downs of the journey, and recognizing that while the path isn't always smooth, it is incredibly worthwhile. Her words will resonate with and inspire pre-PAs and practicing PAs alike.

Check out the video above to see the full interview. If you're preparing to apply to PA school, you can even book a mock interview or consulting session with Tolu herself! No matter where you are in your journey, Tolu's story illustrates the exciting opportunities ahead.

Book Consultation with Tolu Fannon:

Pre-PA Consulting and Advising

The post From Mock Interviews to PA Practice: Tolu Fannon Shares Her Journey first appeared on The Physician Assistant Life.

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The Most Important Reports and Data on Physician Assistants (PAs)As you conduct a standard search for physician assistant trends, including salary, admissions statistics, required prerequisite coursework, program costs, etc. you will come across various weblogs and resources that contain data and statistics to varying degrees. Finding the most up-to-date statistical information and distinguishing what is and isn't relevant can be challenging.

The good news is that the majority of the data you uncover during your search is sourced from only a handful of research articles published on a regular basis by a small subset of reliable sources. Mainly the Physician Assistant Education Association (PAEA) and the National Commission on Certification of Physician Assistants (NCCPA).

This data is usually published online and made available as a series of free PDF downloads. Each research report is packed full of statistical information that (while detailed) can contain significant overlap.

Although both the NCCPA and PAEA have made significant progress in creating more user-friendly reports (including visual aids and graphics), the overlap between these reports and the sheer amount of data can be overwhelming.

In this blog post, I will summarize key findings from the most influential national reports on PAs by organizations from the Physician Assistant Education Association (PAEA), the National Commission on Certification of Physician Assistants (NCCPA), and the American Academy of PAs (AAPA).

Moreover, I aim to create an up-to-date repository of these resources that you can bookmark and revisit as new reports and data are released.

Major topics covered in these reports include:

• Demographics of recently certified and currently practicing PAs
• Specialty preferences and clinical practice settings
• Salaries, incentives, and compensation benchmarks
• PA program tuition, enrollment, and graduation trends
• Student debt and postgraduate pursuits
• Burnout rates and job satisfaction
• And much more...

PAEA Research and ReportsPAEA conducts several annual research initiatives and surveys of member programs, faculty, and students. These reports aim to learn more about the issues facing PA education and the profession, support PA programs and decision-makers with the best data, and empower PA researchers.

PAEA Research & Reports1. Program Report (latest #35 October 2020)PAEA's longest-running research endeavor collects information about program operations, program and student financial information, student and faculty characteristics, and more.

Here are some key findings from the latest PAEA Program Report:

• The average PA program tuition continues to rise, reaching $95,058 for private programs $52,585 (in-state), and $93,313 (out-of-state) for public programs in 2018-2019. This reflects a 3-5% increase from the previous year.
• More PA programs are paying for clinical rotations - in 2019, 52% of programs reported paying for some or all clinical rotations, up from 48% in 2018. The average payment was $291 per student per week.
• The average first-year PA class size was 48 students, continuing an upward trend. Total enrollment across all PA programs was 29,341 students. Graduating class sizes averaged 44 students.
• The student-to-faculty ratio was 13:1 based on full-time faculty headcount or 12:1 based on full-time equivalent (FTE) faculty counts.
• In the 2019 graduating cohort, the on-time graduation rate was 93.5%. The top reasons for delays in graduation or dismissal were academic issues, personal reasons, and deceleration to the next cohort.

PAEA Program Report2. Faculty and Director Report (latest #4 July 2020)This report informs the association and PAEA member programs about employment trends that may affect the recruitment and retention of PA faculty and directors.

Here are some key highlights from the latest PAEA Faculty & Directors Report:

• Average faculty salary was $99,771. The average program director's salary was $135,493.
• The top factors faculty considered most important when applying for positions were location, work-life balance, job stability, fringe benefits, and reputation of the institution/program.
• 67.4% of faculty reported working clinically. Of those, average hours of clinical work per week was 11.6 on own time and 8.2 hours on release time.
• 46.9% of faculty had ever published research or scholarly work over their academic careers. In the past 2 years, 30.1% had published.
• 14.0% of faculty had received external funding for research or scholarly work in the past 3 years.
• Top faculty stressors were self-imposed expectations, increased work responsibilities, institutional procedures/red tape, and lack of personal time.
• If given the choice, 76.7% of faculty would probably or definitely still work at their current program, while 82.0% would probably or definitely still be a PA educator.

PAEA Faculty & Director Report3. Curriculum Report (latest #6 February 2023)This survey is administered in three parts that rotate annually and correspond to the major phases of PA school: the prerequisites/admissions phase, the didactic phase, and the clinical phase.

Here are some key highlights from the PAEA curriculum reports on clinical, didactic, and prerequisite curricula:

Clinical Curriculum Report

• Over 90% of programs required ACLS, BCLS, HIPAA, and completion of the didactic phase before students could participate in clinical rotations.
• The average program required 9 distinct rotations, 47 weeks, and 1,752 contact hours of supervised clinical practice experiences (SCPEs).
• Over 70% of programs used Typhon or E*Value to track student contact hours. About 35% used Excel or other spreadsheets to schedule SCPEs.
• Over half of programs were paying for some or all clinical sites due to competition from other PA programs and other health professions students. About 30% had increased or considered increasing tuition to cover clinical payments.

Didactic Curriculum Report

• The organ systems-based approach was the most common instructional model and curriculum delivery method.
• The average program devoted 6% of the didactic curriculum to interprofessional education.
• Over 80% of programs required a master's capstone project, most commonly a scholarly paper.

Prerequisite Curriculum Report

• The most universally required prerequisites were anatomy, physiology, microbiology, biochemistry, statistics, and psychology.
• About half of programs required upper division natural science prerequisites with a C letter grade minimum.
• Over 90% of programs used CASPA and required references, a personal statement, an on-site interview, and a seat deposit.

PAEA Curriculum Reports4. Student Report 5: (latest #5 June 2023)This survey collects rich data from matriculating and graduating students to learn more about reasons for choosing the profession, satisfaction with programs, future practice plans, and more.

Here are some key highlights from the PAEA student surveys:

Matriculating Student Survey (MSS)

• Over 90% of matriculating students decided to pursue a PA career due to the desire to care for patients, mobility between specialties, and work-life balance.
• The average matriculating student applied to 9 PA programs, received 4 interviews, and 2 acceptance offers.

End of Program Survey (EOPS)

• 85% of graduating students participated in required interprofessional education opportunities during PA school.
• Over 90% of graduating students felt prepared across all PA competencies, especially for patient-centered care and self-assessment/professional development.
• 32.3% of 2,065 EOPS respondents said “Yes” they received grants, scholarships, and/or stipends for their graduate PA education.
• 35% of graduating students had either accepted a job offer or received at least one offer, with over half expecting or receiving salaries between $100K-$110K.
• 20% of graduating students reported personally experiencing some form of discrimination or harassment during PA school.

PAEA Student Report

NCCPA Research and ReportsNCCPA has a robust repository of data on Certified PA demographic and practice characteristics. The information collected in the PA profile is compiled and is used to produce four annual reports regarding PA practice.

NCCPA Research & Reports 1. Statistical Profile of Recently Board Certified PAs (latest report 2022)PAs who have been certified (for the first time) for six months or less. This report highlights the data collected from this module.

Here are the key findings from the 2022 Statistical Profile of Recently Board Certified Physician Assistants report summarized in bullet points:

• There were a record 11,092 recently certified PAs represented in all 50 states and Washington, D.C., in 2022. This is a 19.4% increase from 2018.
• 75.4% of the 2022 cohort are female. The median age is 27 years old.
• 10.6% of recently certified PAs identify as Black/African American, up from 7.9% in 2018. 9.1% indicate they are Hispanic/Latino/Spanish origin compared to 8.0% in 2018.
• 58.9% have accepted a clinical PA position so far, compared to 46.7% at the same point in 2021. 36.2% were still searching for a position.
• 75.4% of those employed received 2 or more job offers. 64% are earning over $100k salary.
• Top specialties are surgical subspecialties (17.4%), emergency medicine (16.4%), and family medicine (16.2%). 21.2% are in primary care, down from 24.0% in 2018.
• 51.3% accepted jobs in hospital settings. 29.9% took positions in private practice offices.
• Of those still seeking jobs, 44.1% prefer to work in the area where they grew up and 39.8% hope for a hospital setting position.
• 58% without a job desire over $100k minimum salary. Top desired incentives are CME/certification reimbursement and professional development.
• In 2022, 3.1% (vs. 1.9% in 2018) of recently certified PAs indicated they are a National Health Service Corps Scholar or a state or federal loan repayment program participant, which requires practicing in a Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA).

NCCPA Recently Certified PA Report2. Statistical Profile of Board Certified PAs by Specialty (latest report 2022)Here is a summary of some of the key findings from the 2022 Statistical Profile of Certified PAs by Specialty report:

• Over 140,000 certified PAs provided responses. The top 5 specialties are family medicine (17.1%), emergency medicine (11.2%), orthopedic surgery (10.7%), primary care (23.1%), and dermatology (4.2%).
• 30.8% of PAs have changed specialties 2 or more times in their careers. Occupational medicine (56.2%) and geriatrics (43.9%) had the highest rates.
• 26.0% of PAs reported an increase in clinical opportunities in the past year. The top specialties were cardiothoracic surgery (34.9%), critical care medicine (33.4%), and emergency medicine (30.3%).
• 36.7% of PAs said their employer is hiring. Critical care medicine (63.5%) and oncology (51.7%) had the highest demand.
• 28.5% of PAs have over $100k in educational debt. Critical care medicine (39.2%) and psychiatry (36.6%) were the highest.
• 83.6% of PAs are satisfied with their current job. Satisfaction was highest in plastics (89.0%) and lowest in emergency medicine (78.3%).
• 32.2% of PAs reported at least 1 symptom of burnout. Emergency medicine had the highest burnout rate at 39.9%.

NCCPA PAs by Specialty Report3. Statistical Profile of Board Certified PAs (latest report 2022)
Here is a summary of key findings from the 2022 Statistical Profile of Board Certified PAs:

• There were 168,318 certified PAs in 2022, a 28.4% increase since 2018. 70.6% are female. The median age remains 38.
• Top specialties are surgical subspecialties (18.6%), family medicine (17.1%), and emergency medicine (11.2%).
• 41.7% of PAs work in hospitals. 37.1% work in private practice offices. 5.6% work in urgent care.
• 40.3% of PAs participate in telemedicine, up from 8.7% in 2018. The top telemedicine functions are follow-up with patients (88.8%) and diagnosing/treating (82.8%).
• 34.7% of clinically active PAs have their own patient panel, with a median of 100 patients. An estimated 10.4 million patients are seen by PAs per week.
• 8.7% plan to leave their clinical PA position in the next year, up from 5.6% in 2018. The top reasons are seeking another PA position (57.1%) and burnout (43.3%).
• 32.2% of PAs report at least one symptom of burnout. This is up slightly from 30.6% in 2021.
• Mean income for PAs has risen to $120,204, an 8.7% increase since 2018.
• 5.4% of PAs completed a postgraduate residency or fellowship program. The top specialties are emergency medicine, general surgery, and internal medicine subspecialties.

NCCPA Board Certified PA Report4. Specialty Supplement Report on Secondary Specialty (latest report 2022)Here is a summary of some of the key findings from the 2022 Specialty Supplement Report on Secondary Specialty:

• 64.6% of PAs with cardiothoracic vascular surgery as their primary specialty also have it as their secondary specialty. This is the highest rate among the specialties.
• 50.4% of PAs with emergency medicine as their primary specialty also list it as their secondary specialty.
• Critical care medicine PAs have the highest rate (38.9%) of matching primary and secondary specialties.
• Over 30% of PAs in the specialty areas of occupational medicine, physical medicine/rehabilitation, plastic surgery, and pain medicine have changed specialties 2 or more times.
• The top reason PAs reported having a secondary clinical position across most specialties was to supplement earnings from their primary position.
• Emergency medicine is the most common secondary specialty listed among primary specialties.
• The median hours worked per week in secondary specialties is 10 hours across primary specialties. Mean ranges from 8-13 hours per week.
• Urology PAs that have a secondary specialty reported the highest median (15 hours) and mean (14 hours) hours worked in their secondary position.

NCCPA Secondary Specialty ReportOther Important Annual ReportsOf the three additional resources on this list, two produce important annual salary reports (AAPA and Medscape). I have included a link as well to The Association of Postgraduate PA Programs, which provides research articles on postgraduate training for PAs. An honorable mention goes out to the PA History Society, which continues to do excellent work in preserving the physician assistant profession’s history and achievements.

AAPA Salary ReportHere is a summary of some of the key findings from the 2023 AAPA Salary Report:

• In 2022, PAs’ median compensation was $120,000 – a 4.3% increase from $115,000 in 2021!
• The median hourly wage was $65.88, up from $63.08 in 2021.
• Median productivity-based compensation was $180,000, also up from $170,000 in 2021.
• In 2022, PAs again said employers were funding professional development at pre-pandemic levels.

AAPA Salary ReportMedscape Physician Assistant Compensation Report 2023Here is a summary of the key findings from the Medscape PA salary report in bullet point form:

• Average PA compensation increased 4% to $134,000 in 2023, up from $129,000 in 2022. Average base pay also rose from $118,000 to $122,000.
• Nearly two-thirds of PAs received a pay increase in 2023 compared to 2022, but 8% saw their income decrease.
• Only half of PAs feel they are fairly compensated in 2023, down from a high of 74% in 2020.
• Most PAs continue to work in medical offices/clinics (48%) or hospitals (30%), with stable proportions in recent years. Just 7% are self-employed.
• The highest-paid PAs work in surgery/OR ($151K) and emergency/urgent care ($148K). Compensation rose the most for acute care and clinic settings.
• Significant compensation gains often go to veteran PAs - those with 21+ years of experience saw 7% pay increases on average.
• Regional pay differences persist - Pacific states tend to pay PAs the most, but the cost of living is also higher.
• Factors beyond salary impact job satisfaction, like work/life balance, respect, and autonomy. Locum tenens provides flexibility.

Medscape Salary ReportAPPAPThe Association of Postgraduate Physician Assistants Programs website provides a collection of research articles focused on postgraduate training for Physician Assistants and Nurse Practitioners, covering topics like accreditation, selection criteria, and implicit bias training in residency and fellowship programs. It serves as a valuable resource for insights into the latest trends and challenges in PA and NP postgraduate education.

I hope this summary of important data and research serves as a useful overview of the current state of the PA profession in terms of education and practice. The comprehensive information contained in these reports reflects a commitment to using evidence-based policies and planning to support the PA workforce, enabling us to maintain and improve access to outstanding medical care.

If you know of any additional resources or reports that you find helpful, please share them in the comments section. Be sure to bookmark this page for future reference, as we will update it regularly.

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How Much Does it Cost to go to Physician Assistant (PA) School?So you are considering PA school?Great, now how are you going to pay for it?

With the average undergraduate education debt prior to PA school at $36,300 and the average anticipated debt load from PA school at $112,500, it's probably time to ask the next logical question:

How much does PA school cost?Like most college and advanced degree programs in the United States, the price of PA school is rising.

Based on current tuition data supplied by PA programs, the American Academy of Physician Assistants (AAPA), The Physician Assistant Education Association (PAEA), and the most recent NCCPA Statistical Report:

The Average Cost Across all PA Schools for the 2024-2025 Application Cycle (based on school tuition reporting) is as follows: The average cost across all PA programs (public and private) for resident tuition for a 27-month physician assistant/associate program in 2024 is $95,165 * The average cost across all PA programs (public and private) for nonresident tuition for a 27-month physician assistant/associate program in 2024 is $103,660*

Based on the latest PAEA/AAPA reports:

• The average cost of public resident tuition for a 27-month physician assistant program is $50,289
• The average cost of public non-resident tuition for a 27-month physician assistant program is $88,6777
• The average cost of private tuition for a 27-month physician assistant program is $91,639
• The average program length is 27 months

The average increase in nonresident tuition over the last five years was 3.5%, whereas resident tuition rose by 5.33%.

The Cost of Public vs. Private PA ProgramsOf particular interest was the difference between public and private institution tuition and fees.

• The average total resident tuition and nonresident tuition were higher for PA programs from private institutions than for those from public institutions.
• There was a 4% to 7% increase in the average total resident tuition for public and private institutions.
• The average total incidental costs (books, medical equipment, etc.) for public and private institutions increased by 23% and 139%, respectively.
• Today, 62.5% of PA programs are private, while only 35.6% are public.

Average Costs of PA Program Fees Public vs. Private Physician assistant program fees at public institutions: $5,937 * Physician assistant program fees at private institutions: $4,672*

Cost of APPLYING to PA School in 2024Just when you thought it couldn't get worse. Before you can enjoy the hefty cost of PA school itself, you have to factor in the cost of applying. Based on my calculations this could be as much as $6000 in 2024!

The REAL Cost of Applying to PA School in 2024

Cost of all US Physician Assistant (PA) ProgramsThis table includes the cost of 338 US public and private physician assistant programs that report resident and nonresident tuition (not including fees) for the 2024-2025 academic year. Tuition prices constantly change, so make sure to check the PA program website.

For a more detailed comparison of all US PA programs, use my brand new 14-variable Perfect PA Program Picker. You can also search and sort geographically on my PAschoolfinder directory website.

| PA Program | Resident tuition | Nonresident tuition | | A.T. Still University (Arizona) | $108,604 | $108,604 | | A.T. Still University of Health Sciences (Central Coast) | $100,928 | $100,928 | | AdventHealth University | $90,490 | $90,490 | | Albany Medical College | $67,242 | $67,242 | | Alderson-Broaddus University | $105,160 | $105,160 | | Arcadia University (Arcadia University-Glenside) | $98,730 | $98,730 | | Arcadia University – Dual Degree: MPH/MMS | $130,365 | $130,365 | | Arcadia University – Delaware Campus | $98,730 | $98,730 | | Arizona School of Health Sciences | $99,524 | $99,524 | | Ashland University | $92,500 | $92,500 | | Assumption University | $110,000 | $110,000 | | Augsburg University | $99,567 | $99,567 | | Augusta University | $48,825 | $97,650 | | Baldwin Wallace University | $89,000 | $89,000 | | Barry University – St. Petersburg | $79,646 | $79,646 | | Bay Path University | $112,770 | $112,770 | | Baylor College of Medicine | $112,031 | $112,031 | | Bethel University (MN) | $97,104 | $97,104 | | Bethel University (TN) | $96,250 | $96,250 | | Boston University School of Medicine PA Program | $114,491 | $114,491 | | Brenau University | $95,855 | $95,855 | | Bryant University | $105,717 | $105,717 | | Butler University | $94,100 | $94,100 | | California Baptist University | $97,380 | $97,380 | | California State University – Monterey Bay | $108,283 | $108,283 | | Campbell University | $72,595 | $72,595 | | Canisius College | $98,450 | $98,450 | | Carlow University | $96,900 | $96,900 | | Carroll University | $96,695 | $96,695 | | Case Western Reserve University | $103,397 | $103,397 | | Central Michigan University | $93,100 | $93,100 | | Chamberlain University | $103,870 | $103,870 | | Chapman University | $121,472 | $121,472 | | Charles R. Drew University of Medicine and Science | $111,061 | $111,061 | | Charleston Southern University | $94,665 | $94,665 | | Chatham University | $102,906 | $102,906 | | Christian Brothers University | $110,800 | $110,800 | | Clarkson University | $108,087 | $108,087 | | College of Mount Saint Vincent | $105,000 | $105,000 | | College of Saint Mary | $84,300 | $84,300 | | College of St. Scholastica | $100,130 | $100,130 | | Colorado Mesa University | $83,850 | $83,850 | | Concordia University | $96,250 | $96,250 | | Concordia University-Ann Arbor | $99,610 | $99,610 | | Creighton University – Omaha | $90,984 | $90,984 | | Creighton University – Phoenix | $94,237 | $94,237 | | CUNY York College | $36,655 | $74,385 | | D’Youville University | $83,032 | $83,032 | | Daemen College | $103,688 | $103,688 | | Delaware Valley University | $98,300 | $98,300 | | Des Moines University | $88,560 | $88,560 | | DeSales University | $82,500 | $82,500 | | Dominican University | $99,890 | $99,890 | | Dominican University of California | $120,140 | $120,140 | | Drexel University | $95,706 | $95,706 | | Duke University Medical Center | $106,812 | $106,812 | | Duquesne University | $298,324 | $298,324 | | East Carolina University | $46,526 | $46,526 | | Eastern Michigan University | $85,078 | $85,078 | | Eastern Virginia Medical School | $95,529 | $116,325 | | Eastern Virginia Medical School – Early Assurance | $87,865 | $108,661 | | Elizabethtown College | $111,000 | $111,000 | | Elon University | $101,578 | $105,134 | | Emory & Henry College | $83,608 | $83,608 | | Emory University | $109,594 | $109,594 | | Fairleigh Dickinson University | $108,000 | $108,000 | | Faulkner University | $89,250 | $89,250 | | Florida Gulf Coast University | $55,024 | $138,479 | | Florida International University Herbert Wertheim College of Medicine | $91,172 | $93,564 | | Florida State University | $64,887 | $74,889 | | Francis Marion University | $80,624 | $148,971 | | Franciscan Missionaries of Our Lady University(Our Lady of the Lake College) | $90,392 | $90,392 | | Franklin College | $87,500 | $87,500 | | Franklin Pierce University | $81,900 | $81,900 | | Frostburg State University | $61,777 | $90,090 | | Gannon University | $211,935 | $5,803 | | Gannon University-Ruskin | $127,340 | $127,340 | | Gardner-Webb University | $97,122 | $97,122 | | George Fox University | $117,600 | $117,600 | | George Washington University | $145,836 | $145,836 | | Grand Valley State University-Grand Rapids | $79,619 | $79,619 | | Grand Valley State University-Traverse City | $79,619 | $79,619 | | Hardin-Simmons University | $103,400 | $103,400 | | Harding University | $106,244 | $106,244 | | Hawai’i Pacific University | $51,074 | $51,074 | | High Point University | $112,000 | $112,000 | | Hofstra University | $123,790 | $123,790 | | Howard University Physician Assistant Program | $67,546 | $67,546 | | Idaho State University | $75,863 | $128,753 | | Indiana State University | $39,618 | $77,841 | | Indiana University School of Health & Human Sciences Master of Physician Assistant Studies Program (IUPUI) | $62,160 | $89,688 | | Ithaca College | $108,465 | $108,465 | | James Madison University | $68,495 | $88,168 | | Johnson & Wales University | $101,112 | $101,112 | | Kansas State University | $56,271 | $113,830 | | Kean University | $76,454 | $98,161 | | Keck Graduate Institute | $117,850 | $117,850 | | Kettering College | $95,046 | $95,046 | | King’s College | $94,350 | $94,350 | | Lake Erie College | $90,160 | $90,160 | | Lawrence Technological University | $106,000 | $106,000 | | Le Moyne College | $95,778 | $95,778 | | Lincoln Memorial University | $95,060 | $95,060 | | Lincoln Memorial University-Knoxville | $95,060 | $95,060 | | Lipscomb University | $119,527 | $119,527 | | Lock Haven University | $61,947 | $88,157 | | Loma Linda University | $107,680 | $107,680 | | Long Island University | $116,100 | $116,100 | | Louisiana State University Health Sciences Center Shreveport | $39,000 | $66,000 | | Louisiana State University – New Orleans | $53,446 | $105,877 | | Marietta College | $80,000 | $80,000 | | Marist College | $101,220 | $101,220 | | Marquette University | $110,277 | $110,277 | | Marshall B. Ketchum University | $125,362 | $125,362 | | Marshall University | $68,642 | $107,142 | | Mary Baldwin University (Murphy Deming College of Health Sciences) | $89,010 | $89,010 | | Marywood University | $91,670 | $91,670 | | Massachusetts College of Pharmacy and Health Sciences (MCPHS) – Worcester | $139,125 | $139,125 | | Mayo Clinic School of Health Sciences | $99,160 | $99,160 | | MCPHS University (Boston) | $147,075 | $147,075 | | MCPHS University (Manchester/Worcester) | $139,125 | $139,125 | | Medical University of South Carolina | $62,818 | $108,409 | | Meharry Medical College | $115,554 | $115,554 | | Mercer University | $85,674 | $85,674 | | Mercy College | $97,560 | $97,560 | | Mercy College of Ohio | $100,800 | $100,800 | | Mercyhurst University | $106,713 | $106,713 | | Methodist University | $102,550 | $102,550 | | MGH Institute of Health Professions | $111,300 | $111,300 | | Miami University | $112,000 | $112,000 | | Miami-Dade College | $31,866 | $77,347 | | Michigan State University | $74,998 | $85,001 | | Middle Tennessee State University | $65,722 | $149,380 | | Midwestern University (Downers Grove) | $117,874 | $117,874 | | Midwestern University (Glendale) | $127,104 | $127,104 | | Milligan University | $99,420 | $99,420 | | Misericordia University | $105,315 | $105,315 | | Mississippi College | $90,400 | $90,400 | | Mississippi State University – Meridian | $70,000 | $128,334 | | Missouri State University (formerly SWMS) | $49,838 | $77,678 | | Monmouth University | $134,300 | $134,300 | | Morehouse School of Medicine | $80,000 | $80,000 | | Mount St. Joseph University | $92,400 | $92,400 | | New York Institute of Technology | $144,060 | $144,060 | | North Central College | $111,549 | $111,549 | | North Greenville University | $111,600 | $111,600 | | Northeastern State University | $39,438 | $73,223 | | Northeastern University | $100,950 | $100,950 | | Northeastern University – Dual MS/MPH Program | $100,950 | $100,950 | | Northern Arizona University | $80,360 | $111,152 | | Northwest University School of PA Medicine | $102,078 | $102,078 | | Northwestern College | $89,570 | $89,570 | | Northwestern University | $102,078 | $102,078 | | Nova Southeastern University, Fort Lauderdale | $87,875 | $87,875 | | Nova Southeastern University, Fort Myers | $87,875 | $87,875 | | Nova Southeastern University, Jacksonville | $87,875 | $87,875 | | Nova Southeastern University, Orlando | $87,875 | $87,875 | | Ohio Dominican University | $86,390 | $86,390 | | Ohio University | $58,956 | $61,294 | | Oklahoma City University | $90,874 | $90,874 | | Oklahoma State University | $41,928 | $81,928 | | Oregon Health & Science University | $93,636 | $93,636 | | Pace University – Pleasantville | $117,000 | $117,000 | | Pace University-Lenox Hill Hospital, NYC | $123,622 | $123,622 | | Pacific University | $110,005 | $110,005 | | Penn State University | $80,214 | $80,214 | | Pennsylvania College of Technology | $58,356 | $82,800 | | Pfeiffer University | $118,310 | $118,310 | | Philadelphia College of Osteopathic Medicine | $103,931 | $103,931 | | Philadelphia College of Osteopathic Medicine – Georgia Campus | $103,931 | $103,931 | | Point Loma Nazarene University | $117,860 | $117,860 | | Presbyterian College | $94,000 | $94,000 | | Quinnipiac University | $104,835 | $104,835 | | Radford University | $80,295 | $80,295 | | Red Rocks Community College | $69,448 | $79,870 | | Rochester Institute of Technology | $251,536 | $251,536 | | Rocky Mountain College | $103,457 | $103,457 | | Rocky Mountain University of Health Professions | $115,938 | $115,938 | | Rocky Vista University | $95,298 | $95,298 | | Rosalind Franklin Univ of Medicine (formerly Finch) | $98,728 | $98,728 | | Rush University | $102,360 | $102,360 | | Rutgers University | $91,884 | $137,826 | | Sacred Heart University | $114,405 | $114,405 | | Saint Catherine University | $101,185 | $101,185 | | Saint Elizabeth University | $109,499 | $109,499 | | Saint Francis University | $118,626 | $118,626 | | Saint Joseph’s University (Univ. of the Sciences) | $100,000 | $100,000 | | Saint Louis University | $92,860 | $92,860 | | Salus University (formerly Pennsylvania College of Optometry) | $91,340 | $91,340 | | Samford University | $90,150 | $90,150 | | Samuel Merritt University | $114,644 | $114,644 | | San Juan Bautista School of Medicine | $108,604 | $108,604 | | Seton Hall University | $129,600 | $129,600 | | Seton Hill University | $113,932 | $113,932 | | Shenandoah University | $100,680 | $100,680 | | Slippery Rock University | $86,472 | $119,341 | | South College – Asheville | $101,250 | $6,250 | | South College – Atlanta | $105,750 | $105,750 | | South College – Knoxville | $105,750 | $105,750 | | South College – Nashville | $105,750 | $105,750 | | South University in Savannah | $98,475 | $98,475 | | South University, Richmond | $99,645 | $99,645 | | South University, Tampa | $99,630 | $99,630 | | South University, West Palm Beach | $99,630 | $99,630 | | Southern California University of Health Sciences | $108,997 | $108,997 | | Southern Illinois University | $70,000 | $120,000 | | Springfield College | $118,320 | $118,320 | | St. Ambrose University | $106,518 | $106,518 | | St. Bonaventure University | $102,500 | $102,500 | | St. John’s University (formerly SVCMC) | $135,240 | $135,240 | | Stanford University | $162,945 | $162,945 | | Stephens College | $90,230 | $90,230 | | Sullivan University | $109,900 | $109,900 | | SUNY Downstate Medical Center | $56,770 | $104,930 | | SUNY Upstate Medical Center | $56,770 | $104,930 | | Temple University Lewis Katz School of Medicine | $90,445 | $94,744 | | Texas Tech University Health Sciences Center | $44,881 | $95,881 | | The CUNY School of Medicine (formerly CCNY Sophie Davis School of Biomedical Education) | $38,815 | $68,400 | | The University of Texas Southwestern Medical Center, Southwestern School of Health Professions | $38,528 | $85,008 | | Thiel College | $110,700 | $110,700 | | Thomas Jefferson University – New Jersey Campus | $97,126 | $97,126 | | Thomas Jefferson University, Center City Campus | $97,126 | $97,126 | | Thomas Jefferson University, East Falls Campus | $99,068 | $99,068 | | Touro College (Long Island) | $135,530 | $135,530 | | Touro College (Manhattan) | $151,630 | $151,630 | | Touro College (Middletown) | $135,350 | $135,350 | | Touro University California | $145,470 | $145,470 | | Touro University Nevada | $104,591 | $104,591 | | Towson University CCBC – Essex | $47,236 | $97,804 | | Trevecca Nazarene University | $92,300 | $92,300 | | Trine University | $106,400 | $106,400 | | Tufts University | $106,938 | $106,938 | | Union College | $132,450 | $132,450 | | University of Alabama at Birmingham | $65,780 | $156,745 | | University of Arkansas | $66,561 | $93,392 | | University of Bridgeport | $102,655 | $102,655 | | University of California-Davis | $145,683 | $145,683 | | University of Charleston | $87,500 | $87,500 | | University of Colorado | $64,242 | $139,086 | | University of Dayton | $94,482 | $94,482 | | University of Detroit Mercy | $106,350 | $106,350 | | University of Dubuque | $96,000 | $96,000 | | University of Evansville | $99,050 | $99,050 | | University of Findlay | $118,643 | $118,643 | | University of Florida | $55,320 | $122,994 | | University of Iowa | $52,573 | $101,229 | | University of Kentucky | $61,816 | $113,903 | | University of Kentucky – Morehead | $52,807 | $104,895 | | University Of La Verne | $110,920 | $110,920 | | University of Lynchburg | $92,372 | $92,372 | | University of Mary Hardin-Baylor | $133,190 | $133,190 | | University of Maryland Baltimore Physician Assistant Program | $84,796 | $112,636 | | University of Maryland Eastern Shore | $68,760 | $105,390 | | University of Michigan – Flint | $104,432 | $160,832 | | University of Missouri – Kansas City | $79,856 | $95,830 | | University of Mount Union | $91,000 | $91,000 | | University of Nebraska Medical Center | $55,110 | $86,705 | | University of Nevada, Reno | $92,730 | $92,730 | | University of New England | $102,430 | $102,430 | | University of New Mexico | $60,702 | $86,749 | | University of North Carolina – Chapel Hill | $63,268 | $109,414 | | University of North Dakota | $50,618 | $73,570 | | University of North Texas HS Center Ft Worth | $36,483 | $97,671 | | University of Oklahoma, Oklahoma City | $93,058 | $93,058 | | University of Oklahoma, Tulsa | $93,058 | $93,058 | | University of Pittsburgh | $90,936 | $108,076 | | University of Pittsburgh – Hybrid Program | $90,936 | $108,076 | | University of Saint Francis (Fort Wayne) | $114,275 | $114,275 | | University of South Alabama | $58,080 | $135,278 | | University of Saint Joseph | $124,094 | $124,094 | | University of South Carolina SOM | $52,815 | $91,896 | | University of South Dakota | $49,291 | $101,539 | | University of South Florida | $68,166 | $129,066 | | University of Southern California (LA) | $174,380 | $174,380 | | University of St. Augustine for Health Sciences | $106,085 | $106,085 | | University of St. Francis | $94,500 | $94,500 | | University of Tampa | $107,114 | $107,114 | | University of Tennessee Health Science Center (Memphis) | $49,154 | $81,518 | | University of Texas Rio Grande Valley | $100,000 | $100,000 | | University of Texas – HS Center at San Antonio | $40,431 | $86,534 | | University of Texas – Medical Branch at Galveston | $100,000 | $100,000 | | University of the Cumberlands | $83,537 | $83,537 | | University of the Cumberlands, Northern Kentucky Campus | $85,732 | $85,732 | | University of the Pacific | $125,902 | $125,902 | | University of Toledo | $76,902 | $123,786 | | University of Toronto | $107,010 | $107,010 | | University of Utah | $78,120 | $116,314 | | University of Washington | $85,365 | $85,365 | | University of Wisconsin – Madison | $53,987 | $109,571 | | University of Wisconsin – La Crosse | $40,188 | $78,264 | | Ursuline College | $105,100 | $105,100 | | Utah Valley University | $79,520 | $119,520 | | Valparaiso University | $105,280 | $105,280 | | Wagner College | $164,760 | $164,760 | | Wake Forest University (Bowman Gray) | $87,540 | $87,540 | | Wayne State University | $46,718 | $86,411 | | Weber State University | $77,640 | $112,640 | | Weill Cornell Medicine Graduate School of Medical Sciences | $91,260 | $91,260 | | West Chester University | $79,682 | $103,013 | | West Coast University – Texas | $81,426 | $81,426 | | West Coast University – California | $118,117 | $117,822 | | West Liberty University | $86,991 | $122,949 | | West Virginia University | $81,595 | $123,588 | | Western Michigan University | $66,830 | $100,245 | | Western University of Health Sciences | $88,210 | $88,210 | | Westfield State University | $94,880 | $94,880 | | Wichita State University | $47,628 | $89,329 | | Wingate University | $97,370 | $97,370 | | Wingate University-Hendersonville | $97,370 | $97,370 | | Xavier University of Louisiana | $98,178 | $98,178 | | Yale University Physician Assistant Online Program | $111,167 | $111,167 | | Yale University Physician Associate Program | $115,052 | $115,052 | | Yeshiva University | $107,520 | $107,520 | | Average: | $95,165 | $103,660 |

How much did it cost me to go to PA School?When I was attending the Rutgers University PA program in 2001 (yes, I know the dinosaur age), the annual tuition was just $10,000 per year (without fees)! Since this was a 3-year program, my total cost, minus fees, for the entirety of my PA school education was roughly $30,000.

I was one of the lucky few who received a stipend from the National Health Service Corps and had my PA school paid for. I would suggest you look into this program as well.

How much would my same PA program cost in 2024?Here is the breakdown of my school (Rutgers PA program) and the projected cost of tuition and fees for the 3-year program starting in 2023.

Total Cost of Attending Rutgers Physician Assistant Program in 2024 The total cost of in-state tuition to attend the Rutgers University PA program in 2023 is $93,677 (cost in 2012: $69,524) * The total cost of out-of-state tuition is $140,572*

How about the Fees?* $175 campus fee * $700 technology fee * $360 school fee * $2,312 health insurance fee per year x 3 = $6,936 * $450 lab-intensive fee * $150 clinical admin fee * $100 parking/year x 3 = $300

Total in Fees: $9,071In a later blog post, I will be discussing the cost of books, medical supplies, and general living expenses. Unless you attend PA school on a part-time basis, it is difficult to maintain a job along with a full-time PA school curriculum.

Also, you may have noticed that Rutgers University has a three-year PA school curriculum. How does this compare with shorter programs?

Take a look at my 14-variable Perfect PA Program Picker!

How much did your PA school cost?

Is it worth it?

• Stephen Pasquini PA-C

The Perfect PA Program Picker: PA School Search, Sort, Match, and Apply

The post How Much Does it Cost to go to Physician Assistant (PA) School? first appeared on The Physician Assistant Life.

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Generative AI and PA School Applications: What You Need to KnowCan ChatGPT Write Your PA School Personal Statement? Risks & AlternativesOver the past year, Artificial Intelligence (AI) has gone from being a subject for science fiction movies to a tool that just about anyone can access.

Today, the AI tools that are of critical importance to aspiring PAs are “generative AI” chatbots; the most commonly known and used is OpenAI’s ChatGPT.

ChatGPT is officially defined as a “large language model-based chatbot developed by OpenAI….that enables users to refine and steer a conversation toward a desired length, format, style, level of detail, and language” (Wikipedia).

What this means in practical terms is that you can ask the chatbot to do things to help you with writing tasks, such as research topics, correct surface errors, or even make the tone of an email more polite.

With so much riding on written documents like personal statements and supplemental essays, aspiring PAs want to use all of their resources to make sure that their applications are as strong as possible. What some may not know, however, is that CASPA has added the following academic integrity affirmation component to its release statement:

CASPA’s statement on generative AI: practical and ethical considerations

"I certify that all written passages within my CASPA application, including but not limited to, personal statements, essays, and descriptions of work and education activities and events, are my own work, and have not been written, in whole or part, by any other person or any generative artificial intelligence platform, technology, system, or process, including but not limited to ChatGPT (collectively, "Generative AI"). I am strictly prohibited from using Generative AI to create, write and/or modify any content, in whole or part, submitted in CASPA and/or provided to PA programs on behalf through any means of communication. PAEA and PA Programs reserve the right to use platforms, technology, systems, and processes that detect content submitted in CASPA and/or processes that detect content submitted in CASPA and/or provided to PA programs that were created, written, and/or modified, in whole or part, through the use of Generative AI." - Source CASPA Release Statement

Anyone who has used the US common application to apply to colleges and universities has seen an affirmation statement like this. It basically asks applicants to state that what they’re submitting is their own work and that the content is true.

Following some recent high-profile cases of wealthy parents paying consultants to get their otherwise unqualified kids into prestigious universities, institutions of higher education are taking stronger positions on dishonesty. CASPA is clearly stating that the use of generative AI is currently considered academic dishonesty.

Here at The PA Life, our editors have received a number of questions from clients on the topic, including everything from “is it okay to use Grammarly to check for spelling errors (affiliate link)?” to “Can readers tell if I’ve used ChatGPT?”

As a resource for aspiring PAs and practicing PAs, we at The PA Life take questions of professional integrity very seriously. Let’s start the conversation with some of our most frequently asked questions (FAQs).

Is it cheating to use an editor to help with my personal statement?This is a topic of ongoing discussion among The PA Life’s leadership and our editors. We draw a clear line between editing and revising personal statements (and other documents) for clarity and “ghost writing.” Our editors can help authors optimize organization, sentence structure, word choice, and style, but we do not “generate” content. If we feel that an essay is missing important information, we will share that information with its author and make recommendations. The key to a strong personal statement is the word “personal.” If someone or something else writes your personal statement for you, it will be not only dishonest, but inauthentic, and readers have a good sense for authenticity in writing.

What about using The PA Life’s one-on-one service?Our one-on-one service gives writers a chance to talk to the editors in real time as they collaborate on personal statements. Editors might ask questions or suggest topics, but, again, the editors do not “generate” content.

Can I use tools like spellcheck or Grammarly to check my essay for errors?At this time, most institutions of higher education simply consider these tools because they do not create content. Here, we are differentiating between content, what you mean, and how you say it. Grammarly may recommend word choices that are close but aren’t exactly correct (we see it from time to time), so proceed with caution and double-check any suggestions that you accept.

Can readers tell if I have used ChatGPT or other generative AI for my personal statement?The short answer is yes. Think of it this way: if you can ask a chatbot to write something for you, check it for errors, or make adjustments to it, you can also ask a chatbot to check an essay to see if it’s been generated by AI. There are actually specific apps that are made to do this. Because we see a lot of personal statements, we noticed very quickly that there are some distinctive characteristics of AI-generated essays. Admissions committee readers will be reading a lot of personal statements, too, so we can assume that they’d begin to make the same observations.

Can ChatGPT make mistakes?The short answer to this is also yes. You may have heard the term “machine learning.” AI only knows what we, as humans, teach it. It learns from us. And, critically, it learns from the information that is out there floating around on the internet: the good, the bad, and the ugly. AI can reflect our biases and our mistakes. It has been known to generate texts that are hateful and exclusionary. It has been known to generate texts that are outright plagiarism of the texts that have been used to train it. It also can’t “hear” the sound of language, so it misses some of the subtleties that we can hear in our heads when we read written language. Theoretically, these issues will get better over time, but for now, don’t make the assumption that any chatbot is smarter than you are or better at writing.

Is all generative AI like ChatGPT, Bard, or Claude.ai bad?No, it’s not. We’ve seen the very valid concerns of writers and other artists who are worried that they’ll be replaced by AI, and AI can be used to do some pretty bad stuff. However, with careful leadership and governance, generative AI, especially the language- and text-based applications, can be democratizing. For under-resourced and traditionally excluded communities, these tools can provide opportunities for inclusion. Non-native English speakers can use generative AI to express their concerns for wider audiences, especially regarding issues that disproportionately affect economically disadvantaged communities.

We can look at AI in the historical context of technological innovations. In the early days of X-ray technology, near the beginning of the twentieth century, people were fascinated by seeing people’s skeletons in real-time. These machines were used to do everything from measuring feet for shoe stores to entertaining partygoers, and there was a general assumption that X-rays were no more harmful than light. It didn’t take long, however, for researchers and users to start reporting skin burns and even cancers. X-ray technology was transformative; we can’t imagine modern medicine without it. But it wasn’t entirely harmless, and it took us a while to learn how to use it responsibly.

It’s not a bad idea to remember that, throughout human history, our ability to create new technologies has often outpaced our ability to reckon with their outcomes. We are witnessing the early days of AI tools, a technology with tremendous potential to change our world and to change us.

As healthcare providers, PAs should consider the complexities of AI and stay up to date on ethical concerns as we learn more about the topic. We at The PA Life welcome your questions and participation in this ongoing conversation.

Key Takeaways:

CASPA has taken a firm stance prohibiting the use of AI tools like ChatGPT to generate any part of application materials, including personal statements. Doing so would be considered academic dishonesty. While editing tools are currently allowed, admissions committees can likely identify AI-written essays. Aspiring PAs should write authentic personal statements in their own words.

• CASPA prohibits the use of generative AI to create application content and considers it to be academic dishonesty.
• AI-driven editing tools like Grammarly are acceptable for checking errors, but use suggestions cautiously.
• Admissions readers can likely identify AI-generated essays, and aspiring PAs should write personal statements authentically in their own words.
• Professional editors can help with clarity and style, but not writing content.
• AI can be powerful, but using it responsibly and ethically is crucial.

Note: Some of the links in this post are affiliate links. This means that if you click on a link and make a purchase, I may receive a commission. This helps me keep the lights on and continue creating content for you. I only recommend products that I personally use and love.

The post Generative AI and PA School Applications: What You Need to Know first appeared on The Physician Assistant Life.

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How to Change PA Specialties: Pain Management, Family Practice, DermatologyFrom Pain Management and Family Practice to Dermatology: Cassie McGee, PA-C, Shares Her Journey in Our Latest Virtual Shadowing SessionIn this FREE PA Virtual Shadowing session, Cassie McGee, a PA who graduated in 2015 from St. Francis University's PA program, talks about her journey and experiences in different medical fields.

After starting in pain management, she spent five years in family practice, gaining a diverse range of skills and knowledge. In May 2022, she transitioned to a dermatology clinic, where she received approximately one year of training before becoming the sole provider at the clinic.

Cassie provides a comprehensive look into her career, highlighting the unique aspects of the PA profession. She delves into the flexibility of changing specialties, drawing from her own experiences in transitioning from Pain management to Family Practice to Dermatology.

Cassie's journey exemplifies the adaptability required in different working environments and the continuous challenge and reward of learning across various medical areas. Additionally, she shares valuable insights into skill development, navigating professional challenges, expanding her medical knowledge, and offers practical applications and salary information for prospective PAs.

Timestamps: From Introduction to Closing Remarks

00:00 Introduction and Guest Background
00:40 Discussion Format and Topics Overview
01:16 Cassie's Journey to Becoming a PA
06:10 Q&A Session about PA School
09:55 Transition to Professional Life: Pain Management
11:55 Transition to Family Practice and Diverse Scope
14:33 Q&A Session about Family Practice
24:17 Transition to Dermatology
26:29 Current Role and Experience in Dermatology
31:17 Support from Nurses and Medical Staff
31:56 Opportunities for Shadowing and Training
33:00 Work Schedule and Patient Visits
34:11 Training for Specialties
35:11 Switching Specialties and Future Plans
35:50 Broadening Scope within Dermatology
36:47 Answering Audience Questions
43:52 Salary and Payment Structure
49:06 Choosing the PA Route and Specialty
56:23 Clinical Rotations and Preparation
57:47 Work-Life Balance in Different Specialties
59:14 Closing Remarks

Ready to Embark on Your Own PA Career Path?Inspired by Cassie McGee's journey through various medical specialties?

If you're a current or aspiring PA looking for guidance, our expert PA consulting services are here to help. From navigating PA school applications to choosing your specialty and preparing for your career, we offer personalized support every step of the way.

Our experienced PA team can provide invaluable insights and advice tailored to your unique journey. Don't wait to make your dream a reality – book an appointment today and start shaping your future in the rewarding world of physician assistance!

Pre-PA Consulting and Advising

The post How to Change PA Specialties: Pain Management, Family Practice, Dermatology first appeared on The Physician Assistant Life.

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I’ve Been a PA for 18 Years, and Still, Nobody Knows What I Do for a LivingPicture this: it's summertime, the sun is shining, the bathing suits are coming out of storage, and it is time to take our annual family vacation.

This year, with COVID restrictions waning and my never fading hunger for adventure, I decided to take the family on a ten-day surf trip along the west coast of Costa Rica.

We purchased plane tickets, packed our bags, and set out on the open road. It was an epic adventure.

Along the way, we met interesting people from all over the world. This is one of my favorite parts of traveling. It levels the playing field. Everyone is in the same position, open to new experiences, primed, and ready to explore beyond their safety bubble.

The "What Do You Do" QuestionNow, more often than not, when meeting a new person, the question arises, "What do you do for a living."

Now, if you are a PA, you are probably already nodding your head because you know what's coming next.

More often than not, when I tell people what I do, they kindly nod in agreement, but their expression is one of total confusion.

Sometimes, I am met with a follow-up question, but that often causes even more confusion. The conversation then moves on. Occasionally, I push on, or, to make life easy, I give up and ask more about what they do for a living.

Contrast this to my wife, an RN of 23 years. When she tells people that she is a nurse, people get excited; she gets to talk about her specialty (oncology), and people thank her kindly for her service.

Please understand that I am not complaining. I love what I do, and I love sharing it with others. But it's frustrating and, at times, disheartening.

How to Tell People That You are a PAIf you came to this post looking for a one-size-fits-all answer to this question, sadly, I still don't have the answer. But I will give examples of how I try to answer this question. If you know the secret sauce, please share it in the comments below.

With 18 years of practice, I have tried every way possible of attempting to explain what I do for a living. Below is a sampling.

Here are the three main variations I use, along with some typical responses:

• "I am a PA." Response: "A what?"
• "I am a physician assistant." Response: "Oh, like a medical assistant."
• "I am a physician associate." Response: a complete look of confusion

In response to this, and in an attempt to further clarify what I do, I have tried several approaches:

• "We are kind of like nurse practitioners. Do you know what a nurse practitioner is?" Response: a confused nod.
• "We are kind of like doctors. We prescribe, diagnose and treat patients, and can do much of what doctors do. We work in collaboration with doctors." Response: oh, so you are a doctor!
  • Note: Doctors probably hate the "We are kind of like doctors" comment, but in primary care practice, we can all agree our duties are often indistinguishable. It's important to note that I do not pretend to be a doctor, nor do I play one in real life.
• "We are like eternal medical residents." (I honestly hate that I have given this response, but you know, these are desperate times... Response: yep, you guessed it, total confusion!

Questions people ask me.

• So you are kind of like a nurse?
• So you assist doctors!
• Do you need to go to college for this?

And it's not just people from other countries.Honestly, I can completely understand why anybody outside the US would be 100% confused by what we PAs do. We are, after all, a reasonably new medical profession that has, until recently, been relatively confined to the United States.

But my main frustration comes from the fact that most people in the United States still have no idea what PAs do, what we are called, or are familiar with our level of medical training.

Who's to Blame? How about the AAPA?I know many people will hate me for saying this (yes, I am looking at you, AAPA), but I partially blame our professional body for the lack of understanding of the PA profession.

This is, after all, the result of poor (OK, nonexistent) marketing and inadequate branding - and the confusion is likely to worsen with our recent name change to physician associate.

How to Solve The ProblemPAs need a branding department!It's going to take lots of money and boots on the ground to explain to people what we do.

Let's start by finalizing the name change - I know this is an unpopular opinion, but I have mixed feelings about our name change to "physician associate." Just when patients were beginning to understand the role of the PA, we are now associates. Although I understand all the reasoning behind it (some of which is undoubtedly ego-driven), it will cost a lot of money ($21.6 million, according to AAPA estimates) and cause much confusion. That being said, it's a clean slate. So, let's finalize this already, put a stake in the ground, and embrace a name - Here's looking at you, American Medical Association (AMA)!

We need more PAs on TV - Yes, you read that correctly. How many episodes of Grey's Anatomy, ER (to their credit, they tried), Chicago Hope, and House (or whatever new medical drama is hot today) do we need to start seeing PAs on TV? Yes, Americans watch TV, and even though these dramas rarely reflect the actual day-to-day lives of medical practitioners (I'm looking at you, Grey's Anatomy), it's time we start to see PAs in ALL of these medical dramas. Yes, we need to see a PA running into the mop closet to engage in casual sex before scrubbing into surgery or seeing a patient for follow-up. Americans get that! So, we need to pay real money to TV show executives to cast leading actors as PAs in their shows. I know it seems ridiculous to task the AAPA with engaging with ABC executive producers, but come on, I think we can all get behind a PA McDreamy!

Stephen Pasquini PAC in the remake of the hit television series ERWe need to educate hospital and clinic staff - We need medical teams who understand what we do and explain this to patients at the time of their booking. Like the docs, I only have 15 minutes for an appointment, and I shouldn't have to spend 1/4 of this explaining to patients why they are seeing a PA or educating them about my profession. Let's all be on the same page. Patients shouldn't have to feel like they are receiving second-rate care, and it is only through a thorough understanding at all levels that we can ensure they don't.

We need literature explaining what PAs do in every exam and waiting room. And by literature, I mean really cool videos with PA staff featured in the videos.

Doctors need to get off their high horse! OK, I get it. You spent four years in medical school and completed a residency. To borrow a line from Avitar, "I see you." I love doctors. I am 100% on your side. But we all have the same goal - to keep our patients safe and healthy. There is no I in TEAM, and PAs serve a valuable role in ensuring access to care. Get on the bandwagon already. If you don't like it, you certainly don't have your patient's best interest in mind.

Embrace Optimal Team Practice - Optimal team practice (OTP) is a healthcare delivery model in which PAs, physicians, and other healthcare professionals work together to provide quality care without burdensome administrative constraints. Under OTP, PAs can practice to the full extent of their education, training, and experience without requiring a specific relationship with a physician. This allows PAs to provide care more efficiently and effectively and improves access to care for patients.

In conclusionThe journey of understanding and recognition for PAs is a long, windy road filled with much-needed conversations and clarifications.

Whether through a revamped branding strategy or through the subtle yet impactful narrative of a TV drama (NBC, if you are reading this, I am available for the ER remake), the essence of what we do must resonate throughout society.

The rebranding, the dialogues, the representation in media, and the education of our peers and patients are all steps toward painting a clearer picture of who we are and the invaluable service we provide.

After all, amid all the confusion, our core remains faithful to its mission: to deliver care with empathy, expertise, and excellence.

So, the next time someone asks, “What do you do for a living?” take a deep breath, wear a smile, and embrace the "life-affirming" journey of explanation. Every curious mind is a step towards a future where our profession is understood and celebrated. Through each interaction, we are defining our work and reshaping the landscape of healthcare, one understanding at a time.

Here’s to the many more discussions, explanations, and representations awaiting us on the horizon. The voyage of discovery continues, and we are all a part of it.

Thanks for reading!

Stephen Pasquini PA-C

The post I’ve Been a PA for 18 Years, and Still, Nobody Knows What I Do for a Living first appeared on The Physician Assistant Life.

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Everything You Need to Know About Being a PA (and then some)

Being a physician Assistant/Associate (PA) is incredible. But there are a number of certifying bodies and critical numbers that will make this process clearer for anyone not familiar with the PA profession or trying to understand the PA marketplace and the players in it.

Here is a quick "one-pager" with links to helpful PA Life Resources at the end.

Contents:

• Certifying bodies
• PA Journals and Forums
• Practicing PA Data
• PA School Applicant Data
• PA Program Data
• Scholarships, grants, and loan repayment programs
• The International PA Marketplace
• Emerging Trends for the PA Profession
• PA Life Links and Resources Certifying bodies* The Physician Assistant Education Association (PAEA) produces The PAEA program report, which is where you can find the treasure trove of data on PA school applicants and PA schools. They also produce the End of Rotation (EOR) and End of Curriculum (EOC) blueprints along with the PAEA PA School Program Directory.
• The ARC-PA is where you can find data on accredited PA programs. There are currently 300 ARC-PA accredited PA programs and several more in development.
• The APPAP is the certifying body for PA postgraduate residency programs (about 200 + programs with 1-3 students in each program)
• The National Commission on Certification of Physician Assistants (NCCPA) is the only certifying organization for PAs in the United States and produces the Physician Assistant National Certification Exam (PANCE), the Physician Assistant Recertification Exam (PANRE and PANRE-LA), and Specialty Certificates (CAQs).
• The American Academy of Physician Assistants (AAPA) is the national professional society for physician associates/physician assistants and advocates and educates on behalf of all PAs and provides tools to improve PA practice and patient care.
• Chartered chapters of AAPA – based within five regions (for state chapters), five federal service areas, and two U.S. Territories – serve their members through advocacy initiatives, locally-based CME, networking opportunities, social gatherings, timely professional information, and job resources.
• The Physician Assistant History Society, Inc., is dedicated to the history and legacy of the physician assistant profession through the identification and collection of appropriate papers, manuscripts, magazine and newspaper clippings, newsletters, reports, dissertations, oral histories, and visual artifacts, such as films, slides, videos, photographs, and digital images.
• Each country has its only newly minted PA certifying bodies, which is actively growing. The PA Hx Society offers a nice timeline.

PA Journals and Forums* Journal of the American Academy of Physician Assistants (JAAPA) – A clinical, peer-reviewed journal published monthly by AAPA * News Central – An online resource featuring breaking medical news and commentary relevant to you. * The Journal of PA Education is dedicated to advancing physician assistant (PA) education by publishing ethically produced, scholarly manuscripts germane to PA educators and by providing a forum for the sharing of ideas and innovations that will enhance the education of PA students. * PA Forum: An active forum for PAs, PA students, and those interested in the profession. Engage in discussions, seek advice, and network with peers.

Recommended Reading:

The Most Important Reports and Data on Physician Assistants (PAs)

Practicing PA Data

| Characteristic | Data | | --- | --- | | Number of certified physician assistants | 168,318 (May 2022) | | Median annual salary | $121,530 per year, $58.43 per hour (as of May 2023). The percentage earning over $200,000 has increased to 3.9%. | | Average student loans debt | The average student loan debt for PAs is $112,500 | | Highest-paying specialty | Anesthesiology | | Lowest-paying specialty | Pediatrics | | States with the most certified physician assistants | California, New York, Texas, Florida, North Carolina | | States with the highest concentration of certified physician assistants per 100,000 population | Connecticut, New York, North Carolina, Nebraska, Montana | | Growth of the physician assistant profession | 28.7% between 2017 and 2021 | | Racial/ethnic diversity | Racial/ethnic diversity has remained relatively consistent over the past 5 years. 80.3% of PAs are white, 6.5% Asian, and 3.3% Black/African American. | | Job satisfaction | 83.6% of practicing PAs are satisfied with their job, down slightly from 84.6% in 2018. 32.2% report at least one symptom of burnout. | | Specialty change | Out of all Board Certified PAs, half have taken advantage of their flexible role by switching to different specialties at least once. Nearly 31% of PAs have changed specialties two or more times throughout their career |

FACT: On average, PAs receive 125 credit hours of graduate education before being awarded a Master's degree. How many credit hours does it take to earn a Doctorate degree in other healthcare fields?

• Physical therapist (DPT): 118 credit hours
• Nurse Practitioner (DNP): 74 credit hours
• Psychologist (PsyD/PhD): 114 credit hours
• Occupational Therapist (DNP): 103 credit hours
• Audiologist (AUD): 120 credit hours

Source: @family_med_pa

Average PA salary by specialty:

• Cardiothoracic and vascular surgery: $143,807
• Dermatology: $136,749
• Critical care medicine: $134,027
• Neurosurgery: $131,883
• Emergency medicine: $130,689
• Orthopedic surgery: $126,640
• General surgery: $124,661
• Plastic surgery: $123,169
• Hospital medicine: $120,615
• Psychiatry: $119,416
• Pain medicine: $118,013
• Cardiology: $117,636
• Oncology: $117,394
• Occupational medicine: $117,178
• Urology: $117,007
• Geriatrics: $116,544
• Internal medicine-general practice: $113,727
• Otolaryngology: $112,803
• Family medicine/general practice: $112,074
• Neurology: $111,496
• Primary care: $111,477
  Physical medicine/rehabilitation: $110,993
• Gastroenterology: $110,544
• Obstetrics and gynecology: $107,790
• Pediatrics-general: $100,392

Industries with the highest levels of employment in Physician Assistants:

| Industry | Employment | Hourly mean wage | Annual mean wage | | --- | --- | --- | --- | | Offices of Physicians | 76,270 | $ 58.90 | $ 122,510 | | General Medical and Surgical Hospitals | 33,070 | $ 61.44 | $ 127,800 | | Outpatient Care Centers | 13,560 | $ 65.89 | $ 137,040 | | Colleges, Universities, and Professional Schools | 4,370 | $ 52.08 | $ 108,330 | | Offices of Other Health Practitioners | 1,900 | $ 56.97 | $ 118,490 |

Source: U.S. Bureau of Labor StatisticsStates with the highest employment level of Physician Assistants:

| State | Employment | Hourly mean wage | Annual mean wage | | --- | --- | --- | --- | | California | 15,540 | $ 69.48 | $ 144,520 | | New York | 14,790 | $ 65.20 | $ 135,620 | | Texas | 8,930 | $ 63.93 | $ 132,980 | | Florida | 8,480 | $ 53.33 | $ 110,930 | | North Carolina | 7,150 | $ 57.61 | $ 119,830 |

Source: U.S. Bureau of Labor StatisticsTop paying states for Physician Assistants:

| State | Employment | Hourly mean wage | Annual mean wage | | --- | --- | --- | --- | | Washington | 3,040 | $ 69.90 | $ 145,390 | | California | 15,540 | $ 69.48 | $ 144,520 | | Alaska | 430 | $ 69.45 | $ 144,460 | | Connecticut | 2,820 | $ 68.89 | $ 143,280 | | Nevada | 1,260 | $ 67.96 | $ 141,360 |

Source: U.S. Bureau of Labor StatisticsTop paying metropolitan areas for Physician Assistants:

| Metropolitan area | Employment | Hourly mean wage | Annual mean wage | | --- | --- | --- | --- | | San Jose-Sunnyvale-Santa Clara, CA | 720 | $ 82.87 | $ 172,370 | | Napa, CA | 30 | $ 79.52 | $ 165,400 | | San Francisco-Oakland-Hayward, CA | 2,120 | $ 78.11 | $ 162,480 | | Vallejo-Fairfield, CA | 90 | $ 76.72 | $ 159,570 | | Fairbanks, AK | 40 | $ 75.78 | $ 157,610 | | Beaumont-Port Arthur, TX | 140 | $ 75.41 | $ 156,850 | | Yuba City, CA | 60 | $ 74.72 | $ 155,420 | | Leominster-Gardner, MA | 30 | $ 74.07 | $ 154,060 | | Sacramento--Roseville--Arden-Arcade, CA | 750 | $ 73.34 | $ 152,540 | | Santa Rosa, CA | 170 | $ 72.57 | $ 150,950 |

Source: U.S. Bureau of Labor StatisticsDistribution of PAs by Most Frequently Practiced Specialty

Three specialties accounted for almost 40% of practicing PAs: family medicine (18.4%), orthopedic surgery (10.3%), and emergency medicine (8.9%).

• Family Medicine: 18.4%
• Surgery: Orthopaedics: 10.3%
• Emergency medicine: 8.9%
• Urgent care: 6.1%
• Other: 5.0%
• Internal medicine: General: 4.3%
• Hospital medicine: 3.8%
• Dermatology: 3.3%

The distribution of PAs by specialty has been changing over time. In 2016, family medicine was the most common specialty for PAs, with 22.4% of the workforce. However, the proportion of PAs working in family medicine has declined in recent years, while the proportion working in other specialties, such as surgery and emergency medicine, has increased.

The distribution of PAs by specialty also varies by state. For example, in California, the most common specialty for PAs is emergency medicine, while in Florida, it is family medicine. This variation is likely due to factors such as the state's population demographics, the availability of healthcare resources, and the regulations governing PA practice.

Overall, the distribution of PAs by specialty is constantly evolving. As the healthcare landscape changes, so too will the demand for PAs in different areas.

PA School Applicant Data* ~35,000 people apply to PA school in a given year. * 8,802 of those applicants were accepted into PA school (~32% of all PA school applicants (first-time and reapplicants) were accepted into a PA program) * Of the PA students accepted, more than two out of three (65.3%) (a.k.a. the majority) had applied to PA school previously. * The average PA program's acceptance rate is ~20%

| Characteristic | Data | | --- | --- | | Average age of applicants | 26 years old | | Gender distribution of applicants | 66% female, 34% male | | Race/ethnicity distribution of applicants | 62% white, 17% Hispanic/Latino, 10% Asian, 9% Black or African American, 2% American Indian or Alaska Native, 1% Native Hawaiian or Pacific Islander, <1% other | | Median household income of applicants | $75,000 | | Number of PA school applicants in 2022 | 35,000 | | Average acceptance rate for first-time applicants | 20% | | Average acceptance rate for second-time applicants | 30% | | Average number of schools applied to by applicants | 15 | | Average GPA of applicants | 3.6 | | Average science GPA of applicants | 3.5 | | Average GRE scores of applicants (verbal/quantitative/analytical) | 153/157/160 | | Average healthcare experience of applicants | 3,000 hours (The average matriculating PA student has between 4,000 and 5,000 hours of clinical experience prior to beginning PA school) | | Number of US PA programs | 330 (~304 accredited) | | Average PA program acceptance rate | 20% | | Debt | On average, students enter PA school with $37,446 in outstanding educational loans, and $12,051 in non-educational consumer debt before accumulating additional debt related to their PA education. New PA students plan to finance an average of 84% of their PA education. |

PA Program DataMost PA programs are 27 months and are divided into two phases (a.k.a two halves)

1. The didactic phase (all the bookwork starting with anatomy, pharmacology, clinical medicine, etc.) Here is an example from a current PA program.
2. The clinical phase (students are doing their core rotations (family med, emergency med, internal med, pediatrics, women's health, general surgery, etc., and elective rotations). Here is an example of the clinical phase from the same PA program.
3. The most affordable PA programs tend to be at public universities for in-state students.

| Characteristic | Data | | --- | --- | | Average length of program | 27 months | | Average class size | 40 students | | Average cost of program | $100,000 | | Most common types of degrees offered | Master of Physician Assistant Studies (MPAS) and Doctor of Physician Assistant Studies (DPA) | | Required courses | Anatomy, physiology, biochemistry, pharmacology, medical ethics, clinical medicine | | Elective courses | Public health, leadership, business, research | | Licensure requirements | Pass the Physician Assistant National Certifying Exam (PANCE) | | Average first-time PANCE pass rate | 92% | | Most expensive PA programs | Duke University ($112,000), Stanford University ($112,000), University of Southern California ($119,000) | | Cheapest PA programs | University of Wisconson ($42,000), University of North Dakota School of Medicine ($52,000), University of South Dakota ($59,020) | | Number of US PA programs | 330 (~304 accredited) | | Current number of current PA students | 55,000 |

Scholarships, grants, and loan repayment programsThe average student loan debt for PAs is $112,500. This is significantly higher than the average student loan debt of $57,520. PAs also have higher interest rates on their loans, which can be between 7-12%. For comparison, The average medical school graduate owes $250,990 in student loan debt.

Here's a table highlighting some common scholarships, grants, and loan repayment programs available to physician assistants (PAs). Keep in mind that availability might vary by location, institution, and other factors, so it's always wise to consult directly with the respective organizations or your educational institution's financial aid office.

| Program Name | Type | Description | Eligibility | Website | | --- | --- | --- | --- | --- | | National Health Service Corps (NHSC) Scholarship Program | Scholarship | Covers tuition and fees and provides a living stipend. Requires a commitment to work in underserved areas for a specified time. | PA students committed to primary care in underserved areas. | NHSC | | Physician Assistant Foundation Scholarships | Scholarship | Several scholarships are offered to PA students based on factors like financial need, academic achievement, etc. | Various eligibility criteria depending on the scholarship. | PA Foundation | | Health Resources and Services Administration (HRSA) Loan Repayment Program | Loan Repayment | Offers significant loan repayment in exchange for working in a Health Professional Shortage Area (HPSA) for two years. | Licensed PAs working in a qualifying specialty and location. | HRSA | | Indian Health Service (IHS) Loan Repayment Program | Loan Repayment | Provides loan repayment for healthcare professionals who commit to practice in health facilities serving American Indian and Alaska Native communities. | PAs who commit to practice in qualifying locations. | IHS | | State-Specific Loan Repayment Programs | Loan Repayment | Many states have individual programs to provide loan repayment for PAs working in underserved or rural areas. | Eligibility varies by state and program. | Consult your state's health department or educational institution. | | Federal Pell Grants | Grant | Need-based grants for undergraduate and certain post-baccalaureate programs. | Financial need, undergraduate or specific post-baccalaureate programs. | Federal Student Aid | | Military Scholarships for PAs | Scholarship | Various branches of the military offer scholarships in return for a service commitment after graduation. | Acceptance into a PA program and commitment to military service post-graduation. | Army, Navy, Air Force | | Albert Schweitzer Fellowship | Stipend | Stipend of up to $2,000 to PA students dedicated to serving underserved communities | See website | Schweitzer Fellowship | | Tylenol Future Care Scholarship | Scholarship | $5,000 - $10,000 scholarships for students pursuing healthcare degrees, including PAs | See website | Tylenol Future Care Scholarship |

The International PA MarketplaceHere is a list of countries that have Physician Assistant (PA) or PA-like providers, along with links to their certifying bodies (where available):

| Country | Title | Education Requirements | Program Length | Certifying Body | Average Salary | | --- | --- | --- | --- | --- | --- | | United States | Physician Assistant | Bachelor's degree, prerequisite courses | 2-3 years | NCCPA | $115,000 | | Canada | Physician Assistant | 2 year community college diploma | 2 years | CAPA | $95,325 | | United Kingdom | Physician Associate | Bachelor's degree in life sciences | 2 years | FPARCP | $66,957 | | Netherlands | Physician Assistant | Bachelor's degree | 2.5-3 years | NAPA | $65,000 | | Liberia | Physician Assistant | Bachelor's degree | 2 years | LINPAA | $12,000 | | India | Physician Assistant | Bachelor's degree | 3 years | IAPA | $9,600 | | Ghana | PA Medical (Medical Assistant) | Diploma | 2 years | Ghana Physician Assistant Association | $1,800 | | South Africa | Clinical Associate | Bachelor's degree | 3 years | PACASA | $17,000 | | Australia | Physician Assistant | Bachelor's degree | 2 years | ASPA | $101,000 | | Saudi Arabia | Assistant Physician | Bachelor's degree | 2 years | Saudi Commission for Health Specialties | $50,000 | | Germany | Physician Assistant | Bachelor's degree | 3 years | None | $66,000 | | New Zealand | Physician Associate | Bachelor's degree | 2 years | Unregulated | $70,000 | | Afghanistan | Physician Assistant | Bachelor's degree | 2 years | Afghanistan Board of Medical Specialties | $18,720 | | Israel | Physician Assistant | Bachelor's degree | 2.5 years | Israel Ministry of Health | $50,000 | | Bulgaria | Physician Assistant | Bachelor's degree | 3 years | Bulgarian Association of PAs | $24,000 | | Ireland | Physician Associate | Bachelor's degree | 2 years | Irish Society of Physician Associates | $65,000 | | Kenya | Clinical Officer | Diploma | 3 years | Clinical Officers Council | $7,200 |

Canada has one of the fastest-growing markets of PAs and deserves a close look: https://capa-acam.ca/. We did a whole series on the development of the PA profession internationally on The PA Life: https://www.thepalife.com/physician-assistants-pas-and-associates-around-the-world/

Emerging Trends for the PA ProfessionThis post touches on the tip of the iceberg of the PA profession. Compared to MDs, Nurses, and NPs, we are still a relatively new profession (started in 1969) and are still actively figuring out where we exist in the healthcare continuum.

Here are a few ongoing developments that will shape the PA profession in the years to come.

• The PA Name Change: In May 2021, the American Academy of Physician Associates (AAPA) voted to change the official title of the PA profession from "physician assistant" to "physician associate." The change came after years of research and debate, and the hiring of a healthcare marketing research and branding firm to determine the best title and marketing strategy for the profession. The AAPA House of Delegates (HOD) passed the resolution affirming "physician associate" as the official title of the PA profession by a majority vote of 198 to 68. The new title, "physician associate," directly addresses the common misperception that PAs merely "assist" physicians. The AAPA is still recommending that its members continue using the old title.
• Optimal Team Practice: Optimal Team Practice (OTP) is a policy that allows physicians, physician assistants (PAs), and other healthcare professionals to work together to provide quality care without administrative constraints. The policy was enacted by the American Academy of PAs (AAPA) in May 2017. To support Optimal Team Practice, states should: eliminate the legal requirement for a specific relationship between a PA, physician, or any other healthcare provider in order for a PA to practice to the full extent of their education, training and experience; create a separate majority-PA board to regulate PAs or add PAs and physicians who work with PAs to medical or healing arts boards; and authorize PAs to be eligible for direct payment by all public and private insurers.
• The PANRE-LA: PANRE-LA stands for PANRE Longitudinal Assessment. Launched in 2023, it's an alternative to the traditional Physician Assistant National Recertifying Examination (PANRE). PANRE-LA is a longitudinal exam that's administered quarterly over a three-year period using an "open-book" format.

One thing is for certain, though, with the advancement of new technologies (especially AI) and the ever-growing cost of delivering care to an aging population, PAs will continue to be an integral part of the healthcare environment.

Will AI Phase Out Physician Assistants? Not on My Watch!

Bookmark this page, as we will continue to update it regularly.

PA Life Links and Resources* International PA Resources * The Ultimate PA School Application Timeline * Scholarships, Grants, and Loan Repayment Programs for Physician Assistants * The Ultimate PA School Applicant Logbook – Track HCE, PCE, Volunteer Hours, Schools, Costs (and more!) * Who Gets Into PA School? Here’s What You Need to Know * How Much Money Do Physician Assistants (PAs) Make? * PA SchoolFinder and PA Program Match * Physician Assistant Stats

The post Everything You Need to Know About Being a PA (and then some) first appeared on The Physician Assistant Life.

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Who Gets Into PA School in 2024? Here’s What You Need to KnowLeslie Mean is a 25-year-old single white female who presents to the PA school admissions committee on her second attempt to get into PA school.

She has a 3.6 overall GPA and a 3.5 science GPA. She holds a Bachelor of Science degree in biology, had an SAT score of 1,200, and a GRE score of 303.

She has two years of hands-on clinical experience working as a CNA and a long history of volunteer work, which exemplifies her desire to help her community.

She is kind and considerate and has reference letters that demonstrate her maturity and strong interpersonal skills.

She was accepted into PA school on her second attempt.

Who is Leslie, and why did she get into PA School?When asking the question: What do I need to do to get into PA school? You would be smart to talk to Leslie.

Leslie is a hypothetical PA school applicant who went on to become a PA school student, an entirely average PA school student.

She also embodies what PA schools across the country are looking for at this very moment.

How do I know this?

Because the most recent data from the PAEA semi-annual report, representing responses from over 85% of PA programs detailing characteristics of the 27,283 PA school applicants and 8,802 students accepted in PA school, show that they are filling their seats with Leslie.

As much as I like to talk about not being average and differentiating yourself from the pack, it's nice to know what average is. Average provides a baseline by which you can measure your progress, set goals, and develop an application timeline.

Does this mean you have to be just like Leslie to get into PA school?

Absolutely not, first, factors such as race, age, ethnicity, etc., are of no importance, and you certainly don't have to be female to get into PA school (I am living proof).

But it is safe to assume that most schools are looking to keep their graduation and certifying exam pass rates high. They have an incentive to take fewer risks, and because of this, anything below average is considered a risk.

Thus, take a good look at Leslie and focus on factors that you can control to differentiate yourself, like your academic standing, your experience, your volunteer activities, your references, and your essay.

If you set the bar at Leslie and end up being a Mother Theresa, I am fairly sure you will be accepted into PA school, although I have no data on religious preference and PA school acceptance rates.

What are your chances of getting into PA school?

• Approximately 27,283 people apply to PA school in any given year.
• Approximately 20% of all applicants across the nation gain acceptance to a PA program in any admissions cycle.
• Applying to one PA program gives you about a 25% chance of acceptance while applying to 12 PA programs increases those chances to 49%. There is no statistical benefit to applying to more than 12 PA programs.
• Of the PA students accepted, more than two out of three (65.3%) (a.k.a. the majority) had applied to PA school previously.
• The average PA program's acceptance rate is 7%. However, some schools have much higher acceptance rates, while others have much lower acceptance rates. For example, the acceptance rate at Harvard Medical School is 4%, while the acceptance rate at the University of Central Florida is 65%. So, what does an average PA school applicant who is admitted to PA school (i.e., student) look like?Let's take a look:In studies, the five most influential noncognitive factors known to have an effect on PA school admissions are faculty interactions, career motivation, knowledge of the PA profession, maturity, and professionalism. - Journal of Physician Assistant EducationClick To Tweet→ The average PA school student is 25 years old* The average age of first-year students ranged between 25 and 28 for all categories
• The median age at application is 25 years old
• The median age of recently certified PAs is 27
• For the past six years, the median age of all certified PAs is 38

| Age Range | Percentage of Matriculants | | --- | --- | | 22-23 | 21.6% | | 24-25 | 24.5% | | 26-27 | 22.2% | | 28-29 | 17.1% | | 30-31 | 10.8% | | 32-33 | 3.6% | | 34-35 | 1.1% | | 36-37 | 0.6% | | 38+ | 0.4% |

Source: PAEA program report→ The average PA school student is femaleThe gender distribution of first-year students has started to stabilize after a 20-year trend of a gradually increasing proportion of women. In 1980, 36 percent of PAs were female. Today, 65.6% of matriculated PAs are female.

• Female: 65.6%
• Male: 32.9%
• Non-binary: 1.5%

| Gender | Percentage of Matriculants | | --- | --- | | Female | 65.6% | | Male | 32.9% | | Non-binary | 1.5% |

As you can see, the majority of matriculating PA students are female. This is consistent with the overall trend in the healthcare field, where women make up a majority of the workforce.

There are a few reasons why there are more female matriculants than male matriculants in PA schools. First, women are more likely to be interested in healthcare careers. Second, women are more likely to apply to PA school than men. Third, women are more likely to be accepted to PA school than men.

However, it is important to note that the number of male matriculants in PA schools has been increasing in recent years. This is likely due to the fact that the PA profession is becoming increasingly popular, and more and more men are choosing to become PAs.

→ The Average PA school applicant has a bachelor’s degreeThe majority of PA school applicants hold a baccalaureate degree.

• No academic degree: 8.1%
• Certificate: 0.2%
• Associates Degree: 2.6%
• Baccalaureate Degree: 70.5%
• Master’s Degree: 6.6%
• Doctoral Degree: 0.9%

→ The Average PA school applicant graduated with a degree in Natural SciencesMost PA school applicants hold a degree in natural sciences (biology, chemistry, etc.), but this doesn't mean you have to!

| Major | Percentage of Matriculants | | --- | --- | | Biology | 28.4% | | Health Sciences | 19.4% | | Psychology | 16.2% | | Chemistry | 12.2% | | Sociology | 7.7% | | English | 5.2% | | Other | 9.1% |

The most common major is biology, which makes up 28.4% of all matriculated PA students. This is likely because biology provides a strong foundation in the sciences, which is essential for PA school.

Other popular majors include health sciences, psychology, chemistry, and sociology. These majors also provide students with the knowledge and skills they need to succeed in PA school and in the PA profession.

It is important to note that there is no one "right" major for PA school. PA programs are looking for applicants with a strong foundation in the sciences, but they also value applicants with a variety of experiences and perspectives.

Here are some tips on how to choose the best undergraduate major for PA school.

→ Matriculating PA students had an average of 2,669 patient contact experience hours.PA school applicants come to the table with a variety of medical experiences, especially if they are strong applicants.

It is important to note that the amount of clinical experience required for PA school varies from school to school. Some schools may have no minimum requirement, some may have a minimum requirement of 1,000 hours, while others may require 3,000 hours or more. It is important to research the specific schools that you are interested in to see what their requirements are.

To be a successful PA candidate, you should aim to have at least 2,000 (preferably 3,000+) hours of hands-on patient experience at the time of application. This is 20-30 times more than the number of hours needed for medical school!

Experience in one of the following areas is common:

• Nursing
  • Registered Nurse (RN)
  • Licensed Practical Nurse (LPN)
  • Certified Nursing Assistant (CNA)
• Allied Health
  • Physical Therapist
  • Occupational Therapist
  • Registered Radiologic Technologist
  • Athletic Trainer
• Emergency Services
  • Emergency Medical Technician (EMT)
  • Paramedic
  • Emergency Room Technician
• Miscellaneous
  • Phlebotomist (that was me!)
  • Medical Researcher
  • Medical Volunteer

Medical Experience Statistics for PA School ApplicantsOf applicants admitted to PA school, 90.5% worked in healthcare before applying to PA school. The most common healthcare experience is a certified nursing assistant (CNA) 30.4% and medical assistant (MA) 26.5%. Among those accepted, 23.3% worked as a scribe, 19.3% had experience as an EMT/paramedic, and 8.9% had experience as an emergency room technician. In addition to paid healthcare experience, 55.2% of matriculating PA students participated in volunteer community service work, such as Peace Corps, AmeriCorps, service-learning activities, and mission work.

| Health Care Employment Prior to PA School | Percent | | Nursing assistant | 30.2% | | Medical assistant | 26.5% | | Scribe | 23.3% | | EMT/Paramedic | 19.3% | | Emergency room technician | 8.9% | | Home health aid | 8.7% | | Phlebotomist | 7.3% | | Clinical research coordinator/assistant | 7.3% | | Physical therapist/Physical therapy assistant | 5.7% | | Pharmacy technician | 4.1% | | Athletic trainer | 3.8% | | Medical technician | 3.3% | | Medical reception/records | 2.9% | | Medic or medical corpsman | 1.7% | | Radiology technician | 1.6% | | Dental assistant/hygienist | 1.4% | | Source: 2020 PAEA student report |

Average Health Care Experience Hours of Matriculating StudentsAccording to the latest PAEA program survey and report, for those applicants accepted to PA school, the average student had 2,669 patient contact experience hours. Accepted students had, on average, 1,490 hours of “other healthcare experience,” 378 hours of community service, 1,883 hours of other work experience, and 108 hours of healthcare shadowing.

| Experience | Maximum | Mean | Median | 75th Percentile | 90th Percentile | | --- | --- | --- | --- | --- | --- | | Patient Contact Experience | 25,000 | 3,240 | 2,669 | 3,850 | 5,834 | | Health Care Shadowing | 2,807 | 215 | 108 | 152 | 231 | | Community Service | 18,000 | 719 | 378 | 515 | 938 | | Other Health Care Experience | 9,000 | 1,791 | 1,490 | 2,098 | 2,903 | | Other Work Experience | 12,651 | 2,315 | 1,883 | 2,278 | 4,200 |

Source: PAEA program report* 2023-2024 Update: Some recent data suggests HCE hours are significantly declining, with a new average of 1.88 years of healthcare experience among matriculating (accepted) students.

Admissions directors Q&A: What are some of the points that are extremely impressive to you in the application?

Commitment to community, overcoming adversity, a WELL written narrative, great letters of reference from someone that REALLY knows you, ability to juggle many responsibilities simultaneously, and activities that show a particular passion for something are what we look for in a PA school applicant - Penn State University PA ProgramClick To Tweet→ GRE scores of those accepted into PA school tend to be in the above-average rangeThe mean GRE scores for matriculated PA students are 152.2 for verbal reasoning, 152.0 for quantitative reasoning, and 3.9 for analytical writing. The 25th percentile scores are 140 for verbal reasoning, 139 for quantitative reasoning, and 3.0 for analytical writing. The 75th percentile scores are 164 for verbal reasoning, 165 for quantitative reasoning, and 4.5 for analytical writing.

| GRE Section | Mean | 25th percentile | 75th percentile | | --- | --- | --- | --- | | Verbal Reasoning | 152.2 | 140 | 164 | | Quantitative Reasoning | 152.0 | 139 | 165 | | Analytical Writing | 3.9 | 3.0 | 4.5 |

The average GRE score of matriculated PA school students has been trending up over the years.

| Year | Average Total GRE Score | | --- | --- | | 2021 | 303.6 | | 2020 | 302.2 | | 2019 | 301.4 | | 2018 | 299.8 |

As you can see, the GRE is the most commonly required exam for PA school admissions. This is followed by the TOEFL, the MCAT, and the SAT.

| Exam | Required by | | --- | --- | | GRE | 57.7% | | TOEFL (Internationl Students Only) | 71.3% | | MCAT or GRE | 14.0% | | SAT | 10.0% | | ACT | 7.0% | | CASPer | 5.0% |

Competitive GRE scores average around a composite score of 300, and scores above 310 are extremely competitive. This averages to about 150 on verbal reasoning, 150 on quantitative reasoning, and 3.5 on writing.

Please note that these scores are averages of past GRE examinations, and you should consider your score competitive if they are above the 50th percentile.

Percentiles are more important than actual GRE scores. Every GRE differs in difficulty, which is why none of them can be considered equivalent, thus, necessitating the need to use a standardized ranking method.

• GRE Percentile Math: 42.5%
• GRE Percentile Verbal: 53.5%
• GRE Percentile Analytical: 54.2%

→ The average PA school student has between a 3.5 and 3.6 overall GPA and an undergraduate science GPA of 3.5 According to the latest PAEA program report, the average undergraduate overall GPA for PA school applicants who were accepted into PA school was 3.6. Accepted students had, on average, a science GPA of 3.5, a non-science GPA of 3.6, and a CASPA BCP (biology, chemistry, and physics) GPA of 3.5 * The average overall GPA for students who were not accepted* into PA school was 3.28. Non-matriculant science GPA was 3.17.

Interesting factoid: As the age of applicants increases, their GPA tends to be lower.

| GPA type | Average | | --- | --- | | Overall GPA | 3.6 | | Science GPA | 3.5 | | Non-science GPA | 3.6 | | CASPA BCP GPA (biology, chemistry, and physics) | 3.5 |

| GPA | Percentage of Matriculants | | --- | --- | | 3.75 or higher | 56.5% | | 3.50-3.74 | 28.5% | | 3.25-3.49 | 8.5% | | 3.00-3.24 | 4.5% | | Below 3.00 | 2.0% |

→ Most PA school students are Caucasian

As you can see, the majority of matriculated PA students are white. This is consistent with the overall trend in the United States, where white people make up the majority of the population.

However, it is important to note that the racial makeup of PA students is becoming more diverse. The percentage of Asian matriculants has increased in recent years, and the percentage of Hispanic/Latino matriculants is also increasing.

If you are considering applying to PA school, it is important to be aware of the racial makeup of PA students. If you are a member of a minority group, you may want to consider applying to programs that have a strong commitment to diversity and inclusion.

| Race | Percentage of Matriculants | | --- | --- | | White | 67.2% | | Asian | 14.3% | | Hispanic/Latino | 10.3% | | Black or African American | 5.4% | | Native American | 0.8% | | Multiracial | 2.0% |

→ What are your chances of being accepted into PA school?1. If you apply to one PA program - you have a 25% chance of getting in 2. If you apply to 12 programs (or more) - you have a 49% chance of getting in 3. The average number of PA programs applied to is 8

Interesting factoid: There is little statistical benefit of applying to more than 12 programs!

→ Pucker up, baby. Most PA students are single!Most students are single (72.2%), though about a quarter are married (24.5%). A little under two percent were divorced, and 1.6% were in a domestic partnership/civil union.

Most students (92.1%) have no legal dependents. For the nearly 7.9% of students that reported having legal dependents other than themselves, the average number of dependents was two, with a range of 1 to 9 dependents.

| Legal dependents | Percentage of Matriculants | | --- | --- | | With | 7.9% | | Without | 92.1% |

Over 30% of respondents said they were considered dependent of their parents.

| Marital Status | Percentage of Matriculants | | --- | --- | | Single | 72.2% | | Married | 24.5% | | Divorced | 1.6% | | Domestic Partnership/Civil Union | 1.6% | | Separated but still legally married | 0.2% | | Widowed | 0% |

→ Most PA students are from "The Burbs"Half of the students reported spending most of their time in a suburban setting. One-quarter of respondents reported spending most of their time in a rural environment, followed by 15% in an inner-city setting.

→ Most PA students don't come from extreme riches
According to the PAEA Student Report, the median family gross income of matriculated PA students was $110,000. This means that half of the matriculated students had a family gross income below $110,000, and half had a family gross income above $110,000.

The family gross income of matriculated PA students varies widely. The 25th percentile family gross income was $85,000, and the 75th percentile family gross income was $135,000. This means that 25% of the matriculated students had a family gross income below $85,000, and 75% had a family gross income above $85,000.

| Family Gross Income | Percentage of Matriculants | | --- | --- | | Below $85,000 | 25% | | $85,000-$110,000 | 37.5% | | $110,000-$135,000 | 25% | | Above $135,000 | 12.5% |

Admissions directors Q&A: Who is the perfect PA school applicant?

Our program will look to utilize a holistic approach to admissions. We look at academic success, life experiences, and community activities to evaluate all candidates. There is no one mold to fit the PA profession. However, PAs need strong communication skills, leadership, grit, and a willingness to support the community - Michigan State University PA ProgramClick To TweetStudents need to be well organized, know how to manage their time and outside influences, and have a genuine desire to help and care for people. PA school is rigorous, so we recommend honest conversations with family and friends ahead of your start. - CWRU PA ProgramClick To Tweet→ PA school students don't smoke pot and are not drug dealers or part of the Italian MafiaAccording to the PAEA Student Report, 99% of PA programs require a background check and 92% of PA programs mandate drug testing. This means that the vast majority of PA programs require applicants to undergo a background check and drug test before they can be admitted to the program.

The background check typically includes a review of the applicant's criminal history, driving record, and employment history. The drug test typically screens for illegal drugs, such as marijuana, cocaine, and heroin.

The purpose of the background check and drug test is to ensure that the applicant is of good moral character and that they are not using illegal drugs. PA programs have a responsibility to ensure the safety of their students, faculty, and patients.

If you are considering applying to PA school, it is important to be aware of the background check and drug testing requirements. You should also be prepared to provide documentation of your criminal history and drug use.

Here is a table that summarizes the background check and drug testing requirements of PA programs:

| Requirement | Percentage of Programs that Require | | --- | --- | | Background Check | 99% | | Drug Testing | 92% |

Some Important PointsIt's Not Rocket Science: It is important that a candidate demonstrates reasonable aptitude in the hard sciences such as anatomy, physiology, chemistry, and biology. It is more likely that the committee may overlook a grade of C in U.S History or Spanish I. They will be less tolerant of a marginal grade in the sciences.

Show compassion: Your GPA is stellar, and you've amassed an impressive amount of medical work experience in the little spare time you have while keeping your grades pristine, but you still get that dreaded rejection letter. Why?

You didn't do enough volunteer work. Volunteering exemplifies your desire to help your fellow man—the attribute identified by schools as one of the most integral to becoming a successful PA.

Students who have had experience in working with underserved populations, rural or diverse populations, performing volunteer service or disaster relief, or other experiences that illustrate a drive and compassion for others often stand out to the admissions committee!

The view from the top isn't that crowdedIt's an easy race to the bottom, so set your sights on the top.

Many people will be set back when they read that only 25% of applicants will be accepted into PA school in any given year, but this should be good news. Being in the top 25% in any field is not nearly as hard as it sounds, simply because the majority of the competition is in the bottom 75% and has bottom 75% qualifications.

For example, you have read this entire post, so you now know what the average PA school applicant who has had some success looks like. You understand what a top 75 percent candidate looks like. Your goal now is to be better than the average 75% and exceed the top 25%.

If you aim high, you will be competing with a much smaller minority, and your odds of getting an acceptance letter will increase dramatically. It also helps if you apply to 12 programs.

*Tables and data were sourced from the latest PAEA Semi-Annual Report.

The post Who Gets Into PA School in 2024? Here’s What You Need to Know first appeared on The Physician Assistant Life.

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Crafting the Perfect Letter of Recommendation for Your PA School ApplicantsThe Importance of Prioritizing Character Over CredentialsAs a preceptor and mentor for PA school applicants, I am frequently asked to write CASPA letters of recommendation.

For years, when writing letters of recommendation, I had a specific process that I followed.

First and foremost, I only agree to write letters for individuals whom I know well and have worked with for a significant amount of time. This ensures that I have a thorough understanding of their character and can provide an accurate recommendation.

Second, I asked that all applicants provide me with a copy of their personal statement, a list of all their activities and accomplishments, academic achievements, etc. Whatever they think makes them special - both in their eyes and in the eyes of the admissions committee.

Finally, I would take all this data and create a recommendation letter that I felt highlighted an applicant's very best traits.

This must be awesome, right?

Guess what? I was totally wrong.

Character Trumps Credentials Every Time!When it comes to writing letters of recommendation for students aiming to secure a place in a Physician Assistant/Associate (PA) school, it's critical to keep in mind that character trumps credentials every time.

We all know that grades, healthcare experience, and extracurricular activities are crucial, but what separates an outstanding student from the rest is often their character.

Let's explore this crucial element further.

Unraveling the Tapestry of a Student's CharacterAs I mentioned earlier, for years, when a student approached me for a letter of recommendation, I would always ask for a list of their academic and extracurricular achievements.

I thought it was helpful to recount these accolades in detail, but it's important to remember that college admissions representatives are already privy to this information through transcripts and activity sheets. Reiterating it is not just redundant but also a missed opportunity.

Instead, you should use your letter to delve deeper into the tapestry of the student's character, personality, and individuality. It's these stories of integrity, resilience, and compassion that truly illustrate a student's readiness for PA school.

A Powerful Recommendation: The Story of CharacterI came across this wonderful account of a recommendation letter written for a graduate school applicant we'll call Sam.

At the time, Sam was immersed in his role as a researcher. One day, he spotted a $100 bill lying unnoticed on the floor outside his preceptor's office. Instead of keeping the found money for himself, he picked it up and immediately went to his supervisor's office. He was determined to make sure that the lost money was returned to its rightful owner.

This may seem like a simple, mundane story, but it speaks volumes about Sam's character.

His determination to return the money showed his integrity and respect for others' property. These are not traits you would glean from his transcript or activity sheet, but they are critical attributes that a PA school would appreciate.

A Letter of Recommendation: Echoing the Student's IntegrityWhen writing Sam's recommendation letter, this incident became the letter writer's focal point. It demonstrated his inherent integrity, a quality not easily conveyed through grades or club memberships. This story painted a vivid picture of Sam as a person, far beyond his academic prowess.

The goal of a recommendation letter is to provide the admissions representative with an inside look into the student's character and to speak in a voice that complements the data already available.

This kind of letter helps construct a more complete, three-dimensional picture of the student, making them more than just a sum of their grades and extracurricular activities.

Character: The Underlying Theme in AdmissionFrom my experience and from listening to PA school admissions officers, I've realized that the most impactful letters of recommendation often revolve around character. It's stories of honesty, integrity, resilience, and compassion that truly resonate and create lasting impressions.

So, when asked to write a recommendation letter for a PA school applicant, remember to go beyond what's already known. Explore the deeper aspects of their character and personality, and relay stories that truly exemplify their virtues.

It's these real-life narratives that make a student stand out, transforming them from an applicant to a prospective PA in the eyes of the admissions committee.

Action Steps:For Letter Writers:1. Prioritize Personal Stories: When writing the recommendation letter, prioritize personal stories that show the applicant's character over achievements and accolades. Such anecdotes give the admissions committee insight into aspects of the applicant's personality and character that can't be gleaned from transcripts or resumes. 2. Meet with the Applicant: Have a one-on-one meeting with the applicant to better understand their experiences and personal journey. It's not about what they've achieved academically but about how they've grown as a person and what values they hold dear. 3. Echo the Applicant’s Integrity: While noting an applicant's academic or extracurricular prowess is helpful, aim to highlight aspects of their character such as honesty, integrity, and compassion. These traits are as vital for a prospective PA as the credentials.

For PA School Applicants:1. Be Genuine: When discussing your achievements and experiences, focus on those that genuinely resonate with your personal journey toward becoming a PA. Remember, your character is as significant as your credentials. Be ready to share stories that reflect your integrity, resilience, and compassion. 2. Prepare a Personal Statement: Even if it's not 100% ready, prepare a personal statement that communicates your motivations and experiences that led you to pursue a career as a PA. This can give the letter writer more insight into your character. 3. Communicate with Your Recommender: Have an open conversation with your recommender about what makes you a unique candidate for PA school. Go beyond just academic and extracurricular achievements, and discuss incidents or experiences that have shaped your character and values. Choose from experiences gleaned during your time interacting with and working with your letter writer. These real-life narratives can help your recommender write a more effective letter.

Looking for some inspiration: Here are my pa school letters of recommendation along with some letter of recommendation templates.

The post Crafting the Perfect Letter of Recommendation for Your PA School Applicants first appeared on The Physician Assistant Life.

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Don’t Make This Mistake with Your PA ResuméWhy your Physician Assistant resumé needs a summary section and how to write one

Resumé writing is hard, but a good SUMMARY section can do a lot of your work for you.

This often overlooked, yet simple-to-add section of your PA resumé can be the difference between getting an interview or never making past the early gatekeepers. In this article, I'll explain why every job searching PA should add a summary section to their resumé and provide concrete examples of how to do it.

Your PA Resumé Needs a Summary Section...Here's Why I’ve been teaching technical and business writing since the late 1990s and resumés, CVs, cover letters, statements of purpose, and other application materials have become some of my specialties. It’s been fascinating to watch the genres—especially resumés—evolve.

The resumé format your parents used was designed for typewriters and paper When I was an undergrad, resumés were written on typewriters. When I was in graduate school, we transitioned from DOS to Windows. When I started teaching, the game changers were MS Word and the Adobe creative suite. Then we had Googledocs! Piktochart! Canva! Then social media (I’m looking at you, Pinterest!) convinced us all that we should and maybe even could be graphic designers.

Things were changing on the other side of the resumé, too. When I was an undergrad, hand-typed resumés and cover letters were delivered via snail mail, usually—GET THIS—directly to the person who could actually hire for the position.

As with design, however, modern technology has influenced hiring. Increasingly sophisticated software has provided gatekeepers for the persons or committees with the superpower of hiring; and it's not just the gauntlet of HR interns, assistants, and managers.

Suddenly, your resumé has to parkour its way past these gatekeepers like Lara Croft juking a T. Rex in Tomb Raider. That HR intern? He has no idea what the job you’re applying for even is. He’s sorting a pile of resumés hot off the printer from the “info"@email.com address and comparing them to each job description. His whole job is just to make sure that your resumé gets into the correct pile so that it can make it upstairs to the next gatekeeper.

The Gatekeepers First, you've gotta get it past this guy And, just when you thought HR Intern was the toughest guardian, Applicant Tracking Software happened. It is, in fact, more accurately “applicant screening software,” but you can see the problem with the acronym.

Kudos to the branding professional on that front. Now you've got a bot screening your resumé before it even gets to HR Intern.

Hi, I'm a bot and I'll be reading your resumé. So, now you’re thinking, why even bother? How will my resumé ever get past any of these gatekeepers?

I am happy to tell you that there are ways and today we’re going to talk about the first one: the magical SUMMARY section.

The Magical Summary Section When your dad taught you how to write a resumé, it went something like this. Your name and contact information were up top and then you had a heading that said OBJECTIVE.

The objective said something like “to act as a [name of position] for [name of company]." Objective lines, unsurprisingly, went the way of the Dodo. The SUMMARY section arose in their place.

Don't actually make your heading with rubber stamps. Also called KEYWORDS, SKILLS SUMMARY, and a variety of other catch-alls. What this section does is simply list the specific skills, education, experience, certifications, etc., from the job description. It’s sort of a sneak peek at the main points of the resumé.

Think of Mr. Intern. He’s got a handful of job descriptions for the positions the company is staffing and he needs to figure out which resumé goes with which job.

Does he want to scan the body text multiple times trying to find the required education, experience, skills, etc? Spoiler alert: he does not.

Listing those terms right up front makes his reading task easier and moves your resumé into the correct pile. I find it helpful to think of the screening process as an obstacle course.

Think of that guy at the top as your SUMMARY section, helping you get over the wall. Now, think of the screening software. It’s going to scan your resumé, look for matches, and report them in terms of “hits.” This SUMMARY or KEYWORDS section solves both problems. Once your resumé makes it into the hands of the right person—the person who actually knows what the job entails and who would be a good fit for it—then that person can read the details.

What to Put in the Summary Section of your Physician Assistant Resumé So, what should you put in the SUMMARY section of your physician assistant resume? Important question! In the broadest terms, it’s an abbreviated version of your whole resumé, so:

• Experience
• Skills
• Education
• Certifications

Start with the description that you saw on LinkedIn, Glassdoor, indeed, or wherever you find PA job postings. It’s going to say things like

• At least three years of healthcare experience
• Family Medicine/Urgent Care
• Physician Assistant (PA)
• Bilingual English/Spanish preferred

Keep the language CONCISE, CONCRETE, and QUANTIFIABLE This is not the place to make claims like "positive attitude," "self-starter," or "highly-motivated." While those are all admirable qualities, as I have written elsewhere, they are about as effective in a SUMMARY section as claiming to have good posture.

Anyone can make these claims; they are not measurable. They take up valuable space that would be better used following the old "show, don't tell" advice from creative writing. You can talk about your delightful personal qualities in your cover letter or, better yet, once they already like you enough to interview you.

Here's an example of a SUMMARY section that addresses the qualifications listed above

PA-S/PA-C (May 2022) offers 5+ years of direct patient care experience; Rotations in Family Medicine, Urgent Care, Emergency Care, Internal Medicine; MA in PA Studies, Duke University; Bilingual English/Spanish

The language in the SUMMARY section mirrors the language in the job description closely enough that both the HR Intern and the screening software can identify matches.

You may have noticed that the items in the SUMMARY section not only reflect the content, but that they also follow the order in which they're listed in the description. That's just one more little trick to make your resumé line up neatly with the job description. And by "the job description," I mean EACH job description.

The SUMMARY section makes customizing your resumé for each job easier. The SUMMARY section doesn't just make the reading tasks of the HR intern and the applicant screening bot easier: it makes YOUR life easier! You've heard that you need to customize your resumé for each individual job; that sounds just loathsome, doesn't it? I mean, writing a resumé just once can feel existentially exhausting. You're telling me I need to write a new one for every job I apply to?

Welp, it's the SUMMARY section to the rescue once again. Instead of reworking your whole resumé for each job, you can just brush up your keywords to make them match the job description.

Each time your resumé gets past one of these gatekeepers, it gets closer to the person who can read about your accomplishments and qualifications and actually understand them.

A good SUMMARY section helps your whole resumé clear the early hurdles and tells the last few readers at a glance that you ARE qualified for the job.

Conclusion... The summary section of your resumé is one of the most important pieces of the PA job application process. It’s the first thing a potential employer sees and it can be the difference between your getting an interview or not. That’s why it’s so important to make sure your summary stands out from the crowd. In this article, we’ve provided some tips on how to write an effective summary that will make you stand out.

If you need help writing a great summary, our team here at The PA Life can assist you. We offer professional resume revision services that will help you create a summary that stands out and showcases your skills and experience in the best possible light. Don’t let your resume summary hold you back from getting the job of your dreams – let us help!

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How to Write a Personal Statement Intro that Readers Want to Read You’ve probably heard the advice that you should open your personal statement with a story or anecdote.

This story should “grab” your readers’ interest, tell them who you are, and help pivot to the main theme: what brings you to the PA profession.

That’s a lot to ask of one anecdote, and choosing the right one can feel intimidating.

Here are some tips for choosing––and telling––your best story The “three things” rule

The conventional wisdom among people who study this genre (yes, there are people who study statements of purpose) is that readers can remember three identifying details about you.

Your opening story is where you can use that knowledge to make sure that your readers remember the details you want them to.

Don’t start with a story of your childhood unless it leads directly to your interest in being a PA. Think of your personal statement as helping your readers paint a mental picture of you. PA school requires hard work, dedication, and maturity. You want the admissions committee readers to envision you as someone who is mature and well-prepared to succeed in PA school. While it is possible to get there from an anecdote about your childhood, it’s going to take additional steps. Even if you have known you wanted to be a PA since you were putting Band-Aids on your stuffed animals in kindergarten, that’s probably not the only–or most relevant–story that you have.

Also, this is such a common introductory topic that it’s practically a default setting.

What to write instead.

Think about an experience you’ve had as an adult that inspired you and made you think “I want to be a PA so that I can do [X].” Focus on that “doing” part–we want readers to see you in action.

Here are some ideas to consider. Jot down an answer for each of these that is relevant.

• Shadowing PAs, observing, or working alongside a PA
• Caring for a patient
• A moment of teamwork
• A time when you felt fulfilled
• A time when you felt frustrated

Once you have a couple of ideas to choose from, you can see which one is going to lead you to your main point: Why you want to be a PA.

Don’t start with a story about a different healthcare professional. Do you know why you want to be a PA vs. an NP? Here's a great answer! Maybe a different medical professional inspired your interest in healthcare, a doctor, RN, or EMT, and from there you discovered the PA profession. The better choice is the story that begins with a PA––an encounter as a patient, shadowing, collaboration, etc.

What to write instead.

Starting with your specific PA experience means you don’t have as many steps between the opening and why you want to be a PA. You have more room to develop the story, and your reader isn’t left to wonder where you’re going with it. You don’t want readers to think that you really wanted to have a different career but have settled on PA for whatever reason.

The prompt asks applicants to explain why they want to be PAs and not just healthcare providers in a general sense.

Don’t write about your personal health problems.

Another topic to avoid in your PA school essay is referring to your own health problems–again, with the exception of an anecdote that is directly relevant to PAs.

When we return to that idea of the three things that readers remember about you, you want to be very careful with one of them being the image of you ill or infirm. Even though illnesses, injuries, and loss often shape who we are and make us stronger and more resilient, you can’t predict how AdComms will see this information.

What to write instead.

If your big AHA-moment that brought you to this point was when you broke your leg and a PA was the one who cared for you with great compassion and expertise, that’s fine. But, tell us about that awesome PA. What did that PA do, specifically, that inspired you? You have a very limited amount of real estate on the page; use more of it to talk about the PA. You can acknowledge your illness or injury with a broad generalization; Something like this: “When I was in the hospital with an illness/injury/recurring health problem….” Then the focus is less on you and more on the PA profession.

Don’t write too much about yourself.

Enough about you! Let’s talk about ME! Another pothole to avoid is the tendency to tell your story with too much YOU in it.

I know, you’re thinking “wait, isn’t this essay supposed to be about me?” It is, but stay with me here. It’s easy to start writing about your experiences and suddenly find yourself with an essay full of the word “I,” and reading those kinds of essays can get old fast.

What to write instead.

Let’s face it. You’re going to have to write I, me, and my. Just think of them as a necessary ingredient, like salt, for example, that you don’t want to overuse.

It’s fine to start every sentence with I on your first draft while you’re trying to work out your topics, but when you start editing and revising your personal essay, see if you can flip the perspective on some of those I/me/my statements. Instead of “I felt inspired by the PA’s caring words,” try “The PA’s caring words inspired me.”

Don’t write about how the PA profession is going to benefit you.

You may have heard a lot of great things about having a career as a PA: the training prepares you to move between PA specialties so you’re less likely to get burned out or bored; the training is shorter and costs less than getting an MD; there’s more “work-life balance.” (That work-life balance might start to sound like this applicant wants to leave early to make it to crazy pants night at the karaoke bar every Thursday.) While these all may be true to some extent, they are all about why the career would benefit YOU.

Write this instead.

There is nothing wrong with an interesting job, saving time and money, or work-life balance. All of those are good things, but, again, consider how they might sound to the committee readers who've already read a big pile of these essays when they get to yours.

• What do you have to contribute as a PA?
• How can you use your training to be a giver, rather than a taker, in your community?

When you apply to any graduate school, you are asking them to invest in you: time, money, and effort. What are you going to do with that investment? How are you going to represent their institution and the PA profession in the world? How are you going to make the world a better place, if only on a limited scale? Be a good return on investment.

Don’t go for the “dark and stormy night” opener.

I know, you’ve been told more or less forever that you’ve got to write an "eye-catching” opening that will “grab” your reader’s attention. And you’re wringing your hands trying to think of a dramatic moment from your life, or at least one that can be embellished to seem more intense or cinematic. “And as the lightning bolts crashed down around me at the top of the volcano, I knew that it was my calling to be a PA!” You can imagine that those would start to seem a bit overwrought after a while to our poor AdComm reader.

What to write instead.

Most PA school applicants were not creative writing majors, but here’s the good news: neither were most committee readers. No one expects you to write the Great American Novel or the opening scene from an action movie. You are a scientist; your readers are scientists. They will understand the impact of experiences that might seem less-than-dramatic to healthcare-provider people. In fact, they probably have first-hand experience with how powerful some of the smallest gestures can be–listening to a patient, making someone feel welcome and valued, sharing a personal story. Go with simple and authentic over pyrotechnics.

It’s all about empathy.

In the courses I teach on writing and rhetoric–and you might remember this from your college composition courses–we talk about what makes writing effective (affiliate link). It’s not so much a question of writing being good or bad as it is of it working. It has to be appropriate to its audience, purpose, and occasion.

Think about that. Really put yourself in your committee reader’s position. What is that reader doing? What is that reader’s task? How can you make that reader’s task easier?

Envision that reader, your audience: She’s probably not getting paid to read these applications. Being on academic committees is considered a required “service” to the institution.

What is the occasion on which she is reading? Maybe she’s been at work all day, she’s tired, and her kids are thundering through the house like maniacs as she reads the personal statements that have been assigned to her.

Really envision her. This is what I tell my students. Is she still wearing her scrubs? Does she have a cat sleeping in her lap?

What is she looking for? What is her purpose for reading? She wants to get to know you a little bit better, wants to envision you as a real person and not just a resume, transcript, or profile. She does not want to have to work hard to figure out what you’re saying or why you’re using the word “utilize” when “use” works just fine. She remembers being in your shoes and feels a connection to some of your shared experiences. She wants to know that you have a pretty good idea of what you’re getting into and that you’re ready for it.

She also understands that a statement of purpose is a unique genre, or category, of writing. She is not expecting Harry Potter, Shakespearean sonnets, a legal document, or advertising copy. She does not want a challenging narrative technique or plot twist. Writing to meet her expectations helps her to engage with, comprehend, and retain the content.

Great news! PAs are GREAT at empathy!

Seriously, it is practically their superpower. Empathizing with your reader is an opportunity for you to hone that craft.

It can be hard to shake off the writing advice we got in high school, probably because we were quite literally drilled on it–with a stopwatch–and told, implicitly or explicitly, that if we didn’t do it this way, we wouldn’t get into college and it was a short path from there to a tragic life.

If you want to really attract your reader’s attention, keep it, and help them remember you, go for clarity and authenticity. We here at The PA Life can help you hit just the right note and help you feel more confident about meeting the challenge of the compelling opening scene.

A Lesson from the Professor: Grammatical Bulk

Something to keep in mind as you write your introduction–and your whole personal statement, for that matter–is what we professors of rhetoric and composition (writing) call “grammatical bulk.” Here’s what that means.

The reading brain does all kinds of guessing and forecasting to make reading and comprehension faster and easier. For example, it assumes that items that are physically close together on a page (“proximity”) are more closely related in meaning than those that are physically farther from each other.

Another assumption that readers’ brains make is that whatever takes up more physical space on a page is the most important. Readers “hear” this topic in their heads as more emphatic, simply because, relative to the rest of the text, there’s more of it. We can use this knowledge to make sure that we give more space to the topics we want our readers to emphasize and less to the topics on which we’d prefer that they read, note, and move along.

So, as you look at your introductory narrative, imagine dividing it into its main themes and highlighting each with a different color. The one that has the most “grammatical bulk”--just the biggest blob of color–will be the one that your reader unconsciously assumes is most important.

Conclusion: Intros and conclusions as sandwich bread

If you’re still not sure which of your stories to use as your introduction, consider how it will work with your conclusion.

While we don’t want to revert to the high school trick of concluding by saying something like “In conclusion…” and then repeating your intro and high points, it is useful to think of the introductory paragraph and the concluding paragraph as bookends or two slices of bread holding the sandwich together.

In this metaphor, your body paragraphs are the lettuce, tomatoes, lunchmeat, and condiments. What topics do you want to address in your conclusion? Do you need to tie up any loose ends? Look toward the future? An intro and conclusion that have a clear relationship can make an essay feel whole and contained.

The Takeaway

The introduction to your personal statement is like the first domino in a domino rally. If you take the time to set it up thoughtfully, it will make the rest of the essay fall gracefully. We here at The PA Life know that it’s not easy, but if you’re applying to PA school, you’re probably good at doing hard things. We’re cheering for you!

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PA School Reapplicants: How to Rewrite Your PA School Essay for Guaranteed Success Are you reapplying to PA school after not gaining acceptance last round?

What will you do with your old personal statement? Toss it completely? Change a few details and cross your fingers?

The answer is somewhere in the middle.

What should you do with your original PA school personal statement as a PA school reapplicant?

Never regret a day in your life. Good days give happiness, bad days give experience, the worst days give lessons, and the best days give memories.

― Dr. Sukhraj Dhillon

The first step? Take an objective look at your personal statement What's the first step to rewriting your PA school personal statement as a reapplicant? Take an objective look at your personal statement.

Start with having a trusted friend read it. Ask them to mark what stood out as strong and memorable. What answered that all-important question: Why do I want to become a PA?

Ask your reader to note what seems unnecessary or weak. Give this person permission to be brutally honest. These first impressions will show you what sections to keep as well as delete.

What do you want to communicate in this round of applications? Next up: Ask yourself what you really want to convey in this round of applications.

You have likely expanded your clinical skills and passion for the PA profession. How can you highlight that growth, along with the personal history that brought you to the profession, to show that you deserve a coveted spot in PA school?

Rewrite your personal statement introduction

While you may have worked hard to make your past introduction shine, you will need to completely rewrite it. Many PA programs compare reapplicants’ essays from year to year and reworking your essay shows those programs you are serious about presenting an effective application each cycle.

What has happened in the last year that has reinforced your desire to become a PA?

Was there a patient who completely changed your approach? Or better yet, changed you?

If so, describe that encounter. This is your chance to ignite your readers’ interest, so carefully consider what you want to say and how you want to say it.

PRO TIP: Rewrite your PA school personal statement introduction.

Make sure to read:

How to Write a Personal Statement Intro that Readers Want to Read

Rewrite your patient care example from your previous personal statement

Now, look at the patient care example from your previous personal statement. You will also want to rewrite this.

Whether it is in your introduction or midway through your essay, resist the temptation to keep that same old story. This is often the most memorable part of your personal statement, so you will want to make it pop.

Describe yourself in action connecting with a patient on a human level. You will want to demonstrate your ability to serve with empathy and expertise. While you may be tempted to keep the theme from your last essay, in most cases you will want to update that as well.

PRO TIP: Rewrite the patient care example from your previous personal statement.

Revise the details that have changed since your last application Next, revise the details that have changed since your last application.

You probably have gained shadowing hours, expanded clinical skills, and added more prerequisites. Note all these developments. This is the place you can show your commitment to growth and improvement.

If you have a new role, make sure you include that. Admissions committees want to see that you have moved forward toward your goal and leveraged the time to improve.

You bring one more year of patient interactions, personal and professional growth, and collaboration with coworkers as a candidate. Make sure you spotlight your enrichment.

Much of the information that has not changed can remain but...

Much of the information that has not changed can remain. Just make sure you vary your language so each sentence feels fresh.

Switch the opening lines of every paragraph and change the structure of some of your sentences so your essay reads differently. You may be tempted to skip this step but trust me—taking the time to evaluate each sentence will ensure a cohesive, compelling, and revitalized essay.

PRO TIP: You can keep the information that has not changed just make sure you vary your language, so each sentence feels fresh.

Write a new conclusion

Lastly, you will want to write a brand-new conclusion.

Tie back to your new introduction in some way and reiterate your essays’ theme as well as your commitment to becoming a PA. Also, restate your desire for expanded clinical responsibility for patients.

PRO TIP: Write a brand-new conclusion

"Your job as an artist is to write what's missing" Most importantly, do not lose heart and don't let fear stand in the way of your art. Lin-Manuel Miranda famously said, "Your job as an artist is to write what's missing." Is there anything missing in your essay? Be honest, be authentic, and do your job as an artist… Find what's missing, then write it!

Many applicants find success after multiple application cycles. Maintain your resolve to become a PA and let it propel you toward your goal.

Some of the best PAs I know found that the extra year or two it took them to land a spot in PA school yielded more depth and fulfillment in their work.

You have gained skills and perspective in the last year, so grab a pen and show your dream program how these experiences will make you a more compassionate and effective PA.

Remember, if you need help along the way, our skilled editors can coach you through your rewrite. Please do not hesitate to reach out to us. We are always here as you strive toward this worthy goal.

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Physician Assistants: What We Are and What We Are Not Physician Assistants/Associates (PAs) are amazing professionals who can do many things, but there are some things we cannot do (nor do we want to ).

In this blog post, I will outline what a PA is and what we are not. So, if you are curious about PAs or want to know what we can and cannot do, read on!

What Physician Assistants Are Physician assistants are professionals who diagnose, treat, and help prevent illnesses.

Physician assistants are authorized to work independently of physicians, with supervision from a licensed physician or surgeon. State regulations determine the scope of supervision of PAs by physicians.

Physician assistants are trained to provide primary care in the office, hospital, school, or clinic setting.

In the United States, physician assistants are called PAs (this is more than just an acronym), and we are also called physician associates - depending on who you ask!

Physician assistants are medical providers who have duties that may include taking medical histories and physical examinations; ordering x-rays and other tests; interpreting test results; diagnosing diseases; counseling patients on general health issues such as nutrition, exercise, or stress management; writing prescriptions for medications or surgical procedures when qualified to do so by experience or training; prescribing medication when authorized by law to do so in the course of their job duties; performing physical therapy if qualified to do so by training or experience.

Physician assistants can assist surgeons during surgery.

PAs can prescribe medications in all fifty states.

Physician assistants are educated in a master’s or doctorate program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

PAs are part of a healthcare team that includes physicians, nurses, and other medical professionals who work together to provide high-quality care for their patients.

Physician assistants are limited to a scope of practice determined by state law and may vary depending on the setting in which they work.

Certified physician assistants are PAs who have passed a national certification exam, the Physician Assistant National Certifying Exam (PANCE), and have been certified. PAs who are certified receive the designation of PA-C.

Physician assistants can be licensed but not certified - they need to pass their certification exam to be certified. PAs can work without certification but will face few options.

PAs are lifelong learners, and maintaining certification requires one hundred continuing medical education (CME) credits every two years and recertification examinations, the Physician Assistant National Recertification Exam (PANRE) every ten years. PA certification maintenance mirrors the physician certification maintenance process.

PAs must complete training at an accredited institution to be licensed as a PA.

Physician assistants and PA-like medical workers (nonphysician clinicians) that function under the supervision of a doctor are working all around the world in various capacities and go by different names.

Physician assistants are eligible for certification as Medicare and Medicaid providers.

Physician assistants are well compensated and have one of the best jobs in America.

PAs are able to change specialties throughout our careers, and we do not need to acquire a new certification to do so.

Although PAs pass a National Certifying Exam, we must satisfy requirements dictated by the state where we wish to practice and apply, pay additional fees, and submit documentation to obtain (and maintain) state licensure.

What Physician Assistants Are Not Physician assistants are not medical doctors, nor do we want to be.

Physician assistants are not independent practitioners, and we cannot independently practice medicine without a licensed physician being involved in our work.

Physician assistants are not physician's assistants. Ever!

PAs are not mid-level providers, physician extenders, or non-physician providers. These phrases are not only hurtful to PAs but also out of date and should be avoided.

While physician assistants can do many things, they cannot perform all the duties of a medical doctor. For example, physician assistants can assist in surgery, but we cannot perform surgery.

Physician assistants do not become PAs as a stepping stone on their path to becoming medical doctors.

PAs are not unhappy being called physician assistants unless they have a fragile ego, in which case they should have become doctors.

Though we share similar duties in certain situations, physician assistants are not the same as nurse practitioners.

PAs are not advanced practice providers or advanced practice clinicians: Grouping PAs with other providers should be avoided. These terms are problematic, as they are imprecise and applied inconsistently.

PAs are not required to choose a specialty area of practice during (or after) PA school.

Physician assistants are not required to complete a residency program to practice in a given specialty.

Physician assistants are not the bosses of anyone. We are part of a team working in collaboration with other medical professionals to provide the best possible care for our patients.

Physician assistants are not required to pass the certification exam on the first try. You get up to six attempts over six years and up to three attempts in a given year.

What PAs Are and Are Not As you can see, being a physician assistant is a complex topic.

PAs are not medical doctors, assistants to doctors, or just nurse practitioners with a different title. We are physician assistants/associates (PAs) who have chosen to specialize in the practice of medicine and work under the supervision of a licensed physician.

We have a strong focus on the practical application of medical knowledge and are committed to providing the very best care to people from all backgrounds in the communities we serve.

The fact that so much confusion surrounds the role of physician assistants is a reflection of the growing demand for affordable, accessible medical care. No doubt, the future of health care lies in the hands of capable PAs, and it is up to us to navigate this role with intelligence, humility, and tenacity.

If you have any questions about being a physician assistant, the Physician Assistant National Recertification Examination, or anything else related to physician assistants, please feel free to ask in the comments below.

Additional Reading:

Physician Assistant vs. Nurse Practitioner vs. Medical Doctor

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How to Squash PA School Interview Day Stress (4 Simple Steps)A four-step plan to ease your mind and boost your confidence ahead of the big day.

Imagine you’ve landed an interview at your dream PA program.

But once you enter the interview room, you freeze up. Your mind goes blank, and you lose access to all those thoughtfully crafted answers you’ve prepared.

Needless to say, it’s not your finest hour and you're certain you ruined your chances for a PA school invite.

A few minutes later, on your drive to the airport, everything comes rushing back. If only you’d thought of these impressive responses during your interview! But it’s too late.

This is a familiar story for many who experience the pressures associated with PA school interview day.

But by understanding how pressure affects your mind and body, you can learn to change your response to such situations and squash your PA school interview day stress.

In this post, I utilize research-proven strategies to create this 4-step plan that includes straightforward exercises you can use to help calm your nerves and boost your confidence ahead of the big day.

Just relax and be yourself Let me guess, you've heard this said before: "Just relax and be yourself!" This is a common aphorism touted as the solution to calming all your PA school interview day anxieties. Although it's timeless advice, it's also 100% guaranteed NOT to help calm your nerves on the big day!

Other familiar platitudes for easing PA school interview day stress include:

1. Practice sample PA program questions
2. Get plenty of rest before PA school interview days (as if )
3. Stay hydrated
4. Eat healthy meals on PA school interview day
5. Go into PA schools feeling confident
6. Be prepared for PA program tour and PA student life questions

Do you feel calm yet? I didn't think so.

High pressure and high stakes PA school interview day is a high-pressure and high-stakes situation. It's the culmination of years of demanding work and preparation, so it’s no surprise that PA students want to do well in their PA school interviews.

PA programs know this too, which is why they design difficult interview questions to see how well applicants can think on their feet.

A lot of PA schools ask behavioral questions like “Tell me about an ethical dilemma you faced in your profession?” or the dreaded “What would you say is your biggest weakness?”

These types of questions can be tough because there aren't any right answers--there's just what feels most natural at the moment when the question is asked.

But if you're well prepared, PA school interview day can also be a fun time. PA school interviews are your chance to show off everything you've learned on your Pre-PA journey so far, and it’s an opportunity to learn more about the PA program and the interview process.

Here are four ways you can beat down pressure, calm your nerves, and take back control during your PA school interview

1. Approach your interview by first recognizing what's NOT at stake

Consider the scenario portrayed at the beginning of this post in which you're under a lot of pressure during your nerve-racking PA school interview. What could you have done to avoid your natural reaction to that pressure?

The stakes were obvious: if you did well in the interview, you'd likely be accepted into PA school. If you didn't, it would be back to the drawing board.

However, fixating on the consequences is not going to help you succeed during your interview; instead, it only adds to the intensity and anxiety of the situation.

No, the first step is to focus on what isn't at risk. Look at your life from a distance and determine what won't change regardless of the outcome. Will you still have your family, friends, spouse, children, or other relationships if you aren't accepted after this interview?

What about your health – will it stay the same? Will you be mostly financially secure after?

Key point: To calm your nerves consider the anchor points in your life and use them as a counterweight to the demands of the moment.

2. Become your own psychologist

Sometimes, it's enough to recognize what's NOT at stake. However, for some, this approach cannot entirely compensate for the risk of failure.

So, consider becoming your own psychologist and ask yourself these three simple questions to avoid progressing from anxiety to pure panic during your interview.

3 Questions to ask yourself before your interview to avoid progressing from anxiety to panic:

1. Begin by thoroughly evaluating what you claim is at stake. What kind of proof do you have that this moment really is all you have made it out to be? For example, is this really "The only chance you will ever have at PA school", will you really have "Thrown all those years of time, energy, and money down the drain if you don't get accepted this cycle", or is it true that "This particular PA program is the only program that could ever make you happy?"

2. Second, consider you are advising a pre-PA in the same situation as yourself. If someone you knew was applying to PA school and made a mistake during their interview or wasn't accepted, would you really consider them to be a total failure?

1. Finally, consider this: What benefit do you get from placing so much pressure on yourself? Does all this pressure YOU have conjured make you better or worse?

Key point: ask yourself these three questions to avoid progressing from anxiety to panic during your PA school interview:

1. Is what you claim to be at stake a true representation of the situation or worry for worries sake?
2. How would you treat an applicant in your same situation?
3. Does more worry make your situation better or worse? I think you know the answer.

Now be your own psychiatrist, how would you advise your pre-PA self?

3. Focus on what you can control

The next part of the pressure squashing equation requires handling uncertainty with direct action. You can do this by focusing on what you can control.

Focusing on things you can’t change only amplifies the uncertainty of the situation (and increases stress). Instead, remind yourself that there are three things always within your control: your routine, breathing, and perspective.

Focus on these three things you can control:

1. Your routine: Creating a routine can help you maintain a solid structure while adapting to changing situations. This will give you a sense of control from the onset. How do you create a PA school interview day routine? You create a routine through highly structured practice. It's a tactic used by most elite athletes and one you can use to squash PA school interview day stress.

2. Your breathing: Your breathing quickens during peak pressure periods, but you can also cue yourself to take longer, deeper breaths by slowing down and deepening your breathing. This is known as coherence, and it serves to counteract the detrimental effects of immediate stress. To implement this try decreasing your usual twelve breaths per minute to six and let your heart rate align with your breathing. The effects will be immediate.

3. Your perspective: When you view something as a threat, it can appear insurmountable. But by asking a few vital questions, you can reframe the threat and start down the road to action. Start by considering what you're learning from the experience. You're learning more about the PA school interview process, meeting other pre-PAs from diverse backgrounds with shared goals, learning what types of questions the committee is likely to ask and how they like to ask them. Then ask yourself what you can do right now to help yourself advance.

Key point: In the face of peak pressure uncertainty, focus on what you can control.

4. Manage pressure by connecting with why it matters to you

To squash pressure remind yourself why you are applying to PA school in the first place, and why it is so important to you.

You can do this by connecting your interview day to these three core types of meaning: growth, contribution, and connection.

Consider who you're helping because you have welcomed this pressure into your life. Whose lives could be better because of this experience? Think of your contribution to future patients andhow this connects to your passion for medicine and equality. Place this at the center of your entire interview. View this journey as an expansion of your capacity, capability, and understanding - an opportunity to push the boundaries of growth, both your own boundaries and those set for you by others and by society. Challenge yourself to learn from this high-pressure situation.

Key point: By redirecting your focus on helping others you can take the focus off your performance. This shared belief among yourself, the interviewers, and the other applicants can drive your interview and help squash your anxiety.

Go forth and rock your interview! Now that you’re armed with a few tools to take on peak pressure moments and focus on performing at your best, it's time to put these tools into practice.

Accepting uncertainty reframes the future to contain more than one possibility, to trust that in the end, everything will work out. It may not turn out as you expected or desired, but what will happen will happen.

Curb the volume of pressure over the long haul by sleeping enough, eating well, and exercising.

When you approach peak pressure moments before your interview, focus on what isn’t at stake, on what’s within your control, and on remembering our common thread - a shared goal rooted in the grace that comes with helping others.

Now relax, you got this!

Warmly,

Stephen Pasquini PA-C

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How to Choose the Best Undergraduate Major to Get into PA school Choosing an undergraduate major can be a difficult decision, especially if you are interested in becoming a physician assistant/associate (PA).

Given the competitiveness of PA admissions, you would think there is a single best major or route to becoming a PA, but there is not!

The PA profession has changed a lot over the years. Beginning as a second career for military-trained medics in the 1960s, the PA profession is now a first-choice career pursuit for many undergraduates allowing students to plan early and accordingly.

But still, many people come to the PA profession later in their life. Some individuals are teachers, bankers, dietitians, or even firefighters and return to school to pursue PA as a new career path. If this is you, then you may already have an undergraduate degree.

Or perhaps you are like me and are on a pre-med (MD/DO) path and discovered the PA profession aligns better with your life purpose. If this describes your situation, you may require less of an overhaul and a bit more of a course adjustment.

While there is no required major for admission to PA school, there are required courses that must be completed to apply. This applies equally to first-time undergraduates and returning students who may already hold a degree.

Majoring in the wrong subject can set you back years when it comes to getting into PA school, and there are certain approaches and majors that will streamline the process and make your application more efficient and more competitive.

In this blog post, I will discuss the different types of undergraduate majors that are most competitive for getting accepted into PA school and help you choose the right undergraduate major to address your (and the admissions committees') needs. I will highlight key points along the way.

Key points: Not everyone's journey to PA school is the same. Some people realize early on that they want to be a PA and can draw a straight line from high school or undergrad to PA school. For others, it may be more of a zigzag, a choice they made while in undergrad, after graduation, or mid-career. Your station in life will determine your choice of major... and that's OK. Where there is a will, there is always a way!

What PA programs want to see in every PA school applicant Before deciding on a major on your pre-PA path, it's essential to understand what PA schools are looking for in a good PA school candidate. This will help guide your decision-making.

Here are three things that ALL PA schools want to see in a PA school applicant Your choice of major should help you achieve the following three things.

1. Excellent grades. This should come as no surprise. PA school is difficult, and it comes at you swiftly. And, while PA programs want you to thrive, they cannot hold your hand throughout the entire process. They want to see evidence that you will be successful in your studies and help them with their PANCE pass rates. After all, the best indicator of future performance is past success.

Key point: Pick a major that you love. Passion for a topic usually translates naturally into good grades. If you didn't get good grades right out of the gate, don't let this stop you. There are still ways to get into PA school with a low GPA if you can demonstrate upward mobility. Sometimes this comes with a shift in your major.

2. A convincing answer to the question of why you want to be a physician assistant: You should pick a major that will help demonstrate your why! Specifically, your "why do I want to be a PA?"

• Zoology - this was my undergraduate major. Many people think zoology is the study of animals. But it was my academic advisor who opened my worldview with this major that allowed me to focus on human biology (we are animals after all), physiology, biomechanics, social biology, and genetics. These were all topics I was able to discuss on my application.
• Psychology or sociology - as I will mention below, psychiatry is the #2 most popular second major for successful PA school applicants. As a PA you will work with people, not surprisingly, a keen understanding of how people think and why they make certain choices (affiliate link) is golden.
• Health sciences - this is a major that was available when I was an undergraduate, but a health science major learns health care, health promotion, disease prevention and improving the lives of their patients. This all sounds good to me.
• Traditional biological science majors – biology, chemistry, anatomy, microbiology, etc. These are all classics for a reason.
• Kinesiology - my cousin who is now a successful orthopedic PA was a kinesiology major who also worked as an athletic trainer in undergrad. This makes sense and the admissions committee was able to connect the dots between her undergraduate major and her desire to become an orthopedic PA.
• Foreign language - There are many reasons why majoring in a foreign language can be an excellent choice for PA school applicants especially if your goal is to provide care within a non-English speaking community.

Key point: You must know your "why" and your "why not's"... in this case, your why not's being why not a nurse practitioner, or why not an MD? Then you need to connect the dots by relating your major to your passion for becoming a PA, not just a healthcare provider or a person who wants to help people. But specifically, your desire to become a physician assistant.

3. Evidence that you are a genuinely good person: fabulous, you are a chemistry major with a 3.95 GPA and 2,000 hours of run-of-the-mill HCE, and you play the violin. These are all excellent traits, but they don't make your application stand out.

To truly stand out, you will have to exit your comfort zone. From day one, find opportunities to accumulate valuable healthcare and patient care experience that show your passion and compassion and demonstrate your love and enthusiasm for all things PA. Volunteer a LOT, be proactive, not reactive, create opportunities where they didn't exist, define what you care about then pursue it. Join every healthcare and PA-related organization or association you can find. Join a local pre-PA club, or if there isn't one at your school, start one. Also, don't think that all your activities must be limited to healthcare. If you are passionate about global warming, then do as Gandhi did and be the change you want to see in the world. This will shine through your entire application.

Key point: You are a great person - now demonstrate this through action. Sometimes this will require stepping out of your comfort zone, and sometimes this will require you to endure challenges or even failures along the way. Keep knocking on doors. All it takes is one door to open to shed new light on your life.

What is everyone else doing? The most common undergraduate majors for successful PA school applicants. According to the most recent Student Report, the most common degree major among those who are accepted to PA school is biology (41.5%), followed by health sciences (14.8%) and exercise science/athletic training (8.8%).

Based on this data alone, you could easily conclude that the best majors to consider when applying to PA schools include biology, biomedical sciences, kinesiology or exercise science, chemistry, and psychology.

All of this makes sense. If you’re in a rush, you can pick a major that requires these prerequisites, and you can save money and time.

But the following quote comes to mind:

Escape competition through authenticity. When you're competing with people it's because you're copying them. It's because you're trying to do the same thing.

• Naval Ravikant (The Almanack of Naval Ravikant)

Be a “divergent” by choosing a non-science major You may assume that majoring in the humanities or fine arts will make you less competitive because these subjects are not directly related to healthcare; however, do not let this discourage you from pursuing a non-science major.

Majoring in one of these subjects makes you a bit of an outlier and can make you a more competitive PA school applicant. It demonstrates that you are a well-rounded person, a divergent thinker, and have "non-traditional" skills that you can bring to a PA class that is chock-full of biochemistry majors. Members of the PA admissions committee will find this refreshing.

Key point: Escape competition through authenticity. When you're competing with people, it's because you're copying them. It's because you're trying to do the same thing. Consider majoring (or minoring) in the humanities or fine arts. If you go this route, make sure you knock those PA school prerequisite courses out of the park ... straight As in these courses combined with a humanities degree can be a winning combination.

Checking off the necessary requirements As I mentioned in the introduction, while there is no required major for admission to PA school, there are required courses that must be completed to apply. ALL programs have specific prerequisites that applicants MUST meet... or else!

In essence, you can take any major you want and still be qualified for PA school as long as you have completed the required credits, which include, among others:

• Anatomy
• Microbiology
• Biology
• Chemistry
• Physiology
• Healthcare Ethics
• Mathematics
• Medical terminology
• Statistics

Key point: While there is no required major for admission to PA school, there are required courses that must be completed in order to apply. It would behoove you to do your research early. Start finding PA programs that interest you. Create a free CASPA account (there is a lot of program information in CAPSA) and go to the PA program website to discover all the requirements. The earlier you do this, the better!

Three strategies for choosing your Pre-PA major from a recent PA school graduate: When I asked a recent PA school alumnus about her recommendations for choosing a PRE-PA major, she offered these three strategies. They unite passion, efficiency, and good grades.

1. Pick what you like: You should pick a major that you like - no matter if health-related or not. A lot of the time, this is science-related for those going into healthcare. However, if you are super passionate about public health or communications as well as being a PA, you could always still make this your major.

When it comes time to apply, you should tie into your personal statement or interview and explain why you chose this as your major! It is important to understand that picking a major will help you gain skills and knowledge that will benefit you, so refrain from picking it just because it is easy- make sure that you like what you learn, and it will help you be prepared for your career.

1. Be efficient: You might decide that picking a health- or science-focused degree track is your best route because there is a lot of course overlap between the degree and the courses required by PA programs.

Very common majors in this route would be biology, chemistry, nutrition, neuroscience, pre-med, etc. This would be a science-heavy schedule but would help you to knock out those pre-req classes faster! It also prepares you for PA school since PA school is all science-heavy. (Remember to always check with programs to make sure the class you are taking fills a course requirement if you are not sure!)

Also, don’t feel pressured to appear well-rounded by studying an area that doesn’t interest you. Your grades, extracurriculars, and personal statements will reveal if you’re following your passion. So be honest with yourself, and if you want to stay all science- you can do so!

1. Pick what will help you be most successful (i.e. good GPA): You could also focus on picking a major that will encompass all the above but also choose a major that helps you maintain a high overall GPA.

Don’t get caught up in how a course or degree might "look," concentrate on making academic choices that will serve you. If you think physics is going to look the best because it is a challenging science- but your grades are lacking, that will not help you. Most PA schools will consider your science, non-science, and overall GPA when evaluating your application. So, another perspective is to select the major that you’re confident you can earn high grades in.

How about a double major? If you are not sure what major to choose, it may be a good idea to double-major in two subjects that interest you.

According to the latest PAEA Student Report, 7.0% of successful PA school applicants had double majored as undergraduates. The most common bachelor's degree second majors among those applicants accepted to PA school are psychology (19.3%), followed by foreign language (16.2%), and biology (14.2%).

Key point: Double majoring in two subjects that interest you is a wonderful way to ensure your application will stand out. Majoring in more than one subject demonstrates to PA schools that you have the ability and motivation needed for success as a healthcare provider and handle the rigors of a PA program.

What's Your Best Pre-Physician Assistant Major? Choosing an undergraduate major is not always easy; however, there are certain majors that will set you apart from other applicants and help increase your chances of getting accepted into PA school.

Majoring in one of the sciences detailed above is a direct and time-honored path to PA school that will make you a competitive applicant. Majoring (and doing well) in one of these core sciences demonstrates that you have the necessary skills and knowledge to succeed in a rigorous PA program. Because much of the required coursework for PA school is rolled into your major you may be able to save time and money.

Majoring in one of the humanities, fine arts, or taking a nontraditional path can make you an outlier... And that's a good thing. Keep in mind that PA school is extremely competitive and as a science major, you will be swimming in a school of similar fish. Majoring in something other than one of these classic pre-PA subjects can be helpful by demonstrating to PA schools and PA school admissions committees that you are well-rounded, have a thirst for knowledge, and have the necessary skills and to succeed as a healthcare provider.

Majoring in two subjects can also make you a more competitive well-rounded applicant and demonstrates that you have the ability and motivation needed for success as a healthcare provider.

Your choice of major should align with your goal of a competitive GPA (3.5+), descent GRE scores (300+), a sprinkling of PA, NP, and MD shadowing experience, plus so much healthcare experience and volunteer experience that you can't even keep count anymore. (See my Pre-PA applicant cheat sheet for a quick run-down)

I have seen dance majors, drama majors, political science majors, and acupuncturists all get into PA school. Your major is the scaffolding you will stand on as you paint your Pre-PA academic canvas. The right pre-PA undergraduate major is the one that provides the colors that fit YOUR palate.

The choice is yours… and I can't wait to see what you create!

Stephen Pasquini PA-C

Recommended Reading:

The Ultimate PA School Applicant Cheat Sheet With 7 Quick Tips for Getting into PA School

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The Real Cost of Applying to PA School PA school can come with a hefty price tag, but it's an investment in your future.

The same can be said about the process of applying to PA school.

Prospective PA students will encounter a number of costs along the way to enrolling in physician assistant/associate school. Here's a look at what these costs are and some ways you can save money.

First things first - Important applicant considerations that determine your total cost: According to the latest PAEA student report for incoming PA students (i.e. successful applicants who were accepted into a PA program):

• The average number of PA programs they applied to was eight (with the likelihood of getting into PA school topping out somewhere between 8 to 12 schools)
• The average number of interviews they were granted was three

We will use these averages to determine the costs of applying to ten PA schools during the 2022 PA school application cycle.

1. CASPA The Centralized Application Service for Physician Assistants (CASPA) simplifies the process of applying to physician assistant programs.

Of matriculating PA students, 92% applied to PA school through CASPA. Of the 8% of PA students who bypassed CASPA, the majority were in PA programs with pre-professional phases (circumventing CASPA by being directly admitted to the graduate-level program) or applied to one of the few PA programs that do not use CASPA.

You start by selecting the programs you wish to apply to, then submit one application that includes all necessary materials. Once received by CASPA, your application and materials go through a verification process before being transmitted to all your selected programs.

CASPA charges $179 for the first program you apply to and $55 for each additional program.

Here is an example of charges accrued to apply to 10 PA programs through CASPA:

• First Program (program 1): $179
• Program 2: $55
• Program 3: $55
• Program 4: $55
• Program 5: $55
• Program 6: $55
• Program 7: $55
• Program 8: $55
• Program 9: $55
• Program 10: $55

The total cost of CASPA for ten PA programs: $674

Running total: $674

How you can save money: Apply for the CASPA Fee Assistance Program.

At the start of the cycle, a limited number of fee waivers are provided to qualified applicants on a first-come, first-served basis. Each fee waiver covers only the initial application fee ($179), so if you wish to apply to additional programs, you are responsible for the $55 per school fee. If you received a fee waiver during a previous cycle, you may still apply for another in the next cycle.

1. Supplemental Application Fees: Some schools also have a secondary application fee, adding an extra $25-100 per application.

Contact the program you are applying to and see if they require this, and then learn how to pay the fee and submit the supplemental application.

Example from the NSU website: Once the CASPA application has been received by Nova Southeastern University, a supplemental application will be made available online. Your complete supplemental application must be received no later than January 15 in order to be considered for admission for the May entering class. Once we receive the GRE scores, the supplemental application, and the $50 fee, your file will be reviewed by the admissions counselor.

Supplemental applications may need to be submitted with your CASPA application. They may have different deadlines than the CASPA application or be invite-only that the program will send via email after reviewing your CASPA.

When you are checking for the deadline and form of the supplemental application, be sure to note the price.

Here is a hypothetical example where seven of the ten schools you applied to have required supplemental applications:

• Program 1: $50.00
• Program 2: $50.00
• Program 3: $65.00
• Program 4: $55.00
• Program 5: $50.00
• Program 6: $55.00
• Program 7: $50.00

Total supplemental application fees: $375

Running total: $1,049

How to save money: check to see if any of the PA programs you are applying to offer a supplemental application fee waiver.

Many programs (such as USC and Oregon) will waive the supplemental application fee for applicants who ask for it or who have qualified for the CASPA fee waiver!

1. (Optional) CASPA Professional Transcript Entry Service (PTE) If you prefer not to enter all your coursework yourself, the Professional Transcript Entry Service (PTE) specialists can enter it for you for an additional fee. This service is only available for completed coursework from accredited schools. Coursework from unlisted schools, foreign coursework, and planned/in-progress courses are ineligible for PTE and must be entered by you.

Fees for PTE are as follows:

• 1-3 transcripts: $69
• 4-6 transcripts: $95
• Seven or more transcripts: $145

In this hypothetical scenario, you have chosen to use the CASPA transcript entry service for 10 PA programs

Cost of CASPA professional transcript entry service for ten PA schools: $145

Running total: $1,194

How to save money: this is a concierge service and NOT required for application. Save money by entering your coursework yourself.

1. GRE and Preparation for the GRE The Graduate Record Examinations (GRE) is a standardized test that is an admissions requirement for many PA schools in the United States.

The GRE is owned and administered by Educational Testing Service (ETS) and is available at home, seven days a week, with appointments available as early as 24 hours after you register. It is also available at Prometric® test centers and on specific dates at additional testing locations outside the Prometric test center network.

• The GRE Test cost is $205.
• GRE score distribution: $27 per recipient
• GRE test preparation (software, book, in-person prep): $58 - $499

In this example, we will assume you have decided to apply to 7 PA programs that require the GRE and have used the Magoosh online GRE preparation course, which is ~$179.

Total cost of GRE, prep, and score distribution to seven PA schools: $205 + 179 + (7 x $27) = $573

Running total: $1,767

How to save money: You can choose to do what I did and avoid PA programs that require the GRE but given so many schools now require the GRE as part of their application requirements, you will be limiting your options. You can save on GRE test prep by purchasing used books and purchasing online programs during the holiday discount season or taking preparation courses offered by your community college.

1. CASPer A growing number of PA programs are adopting the CASPer exam, a web-based situational judgment test, as a component of the PA school application process.

You will need to read the program requirements carefully to determine if completing the CASPer test is mandated.

Example from Clarkson University: Completion of the CASPer test that assesses non-cognitive and interpersonal characteristics important for successful students and graduates of our program and is used to complement the other applicant screening tools. Completion of the CASPer test is required and should be taken once your CASPA application is submitted. Results are valid for one admissions cycle. Plan your test date accordingly. Test dates are limited.

• CASPer test cost: $25
• CASPer score distribution: $12 per recipient

In this example, we will assume five of the ten schools you have applied to require CASPer.

The total cost of CASPer and score distribution for five schools: $85

Running total: $1,852

CASPer test results are only valid for one admission cycle; applicants who have completed CASPer in previous cycles must retake it for the current cycle.

How to save money:

Use the PASchoolFinder website to sort PA programs by CASPer requirements and find PA schools that don't require the CASPer exam (most don't). There are no fee waivers for the CASPer exam.

6. PA School Interview Expenses In addition to the application fees when you land those interviews, and if they’re in person, you will need to budget for travel expenses and a proper, professional outfit to wear!

Unless you are the most incredible PA school applicant of all time, chances are you will not be invited to every PA school you apply to for an interview.

Let's say you are fortunate and are invited to three out of the ten schools you applied to for an interview. Let's break down the hypothetical costs.

Interview attire: For PA school interviews, both men and women should wear a pantsuit. Prices vary depending on the brand and style.

• Clothing: $250
• Flight: $450/flight
• Hotel: $100/interview
• Food: $100/interview

Total for three interviews: $250 + ($450 x 3) + ($100 x 3) + ($100 x3) = $2,200

The cost of just travel expenses per interview is around $650

Running total: $4,052

How to save money:

• See if your school has a virtual interview option.
• Use open-ended booking to find the best flights. This is one case where flying "red-eye" would not be advised.
• Save money on hotel expenses by either staying with friends, using Airbnb, or utilizing a student host program if they have one.
• Save money on rental car expenses by using Uber/Lyft or public transportation
• Pack food and eat cheap.

• Save on clothing using whatever tricks you have up your sleeve.

• PA school prep Many people spend years preparing their applications only to have them thrown out for errors or omissions. If you devote time to perfect your application now, it could save you a lot of money in the long run.

Average costs for various pre-PA services:

• PA school CASPA consultation: $149
• Personal statement editing: $135-$345
• Mock interviews for PA school: $125
• Resume creation: $195

Total for consultation + PS editing + Mock Interview + Resume editing: $599

Running total: $4,651

How to save money:

The use of dedicated pre-PA services is entirely optional. When I applied to PA school in 2001, there were no PA school applicant services. There was no such thing as CASPA or CASPer. Very few schools required the GRE, and the PA school applicant landscape was much different (and much less competitive) than it is now. So, let's be honest you do not need to use any of these services to be a successful PA school applicant and get into PA school. Some options include:

• PA school interviews - create your own mock interview day! Grab a good list of PA school interview questions and have a friend, family member, or colleague grill you.
  • No matter how much it pains you make sure to record it and watch it back.
  • Get dressed up just like you would on interview day.
• Personal statements and supplemental essays:
  • Submit your PA school essay for a free review in our comments section.
  • Many colleges have academic/career centers which provide free editing services to currently enrolled students.
  • Have a friend, family member, or trusted colleague (preferably all) read and edit your essay and provide feedback.
  • Submit your essay to any of the free online pre-PA forums such as Reddit or the physicianassistantforum.
  • Make sure to edit your essay with Grammarly (affiliate link) and the native editor in MS Word. They get better every year but don't 100% rely on them to make your essay error free.
  • Avoid the common PA school essay pitfalls and whatever you do make sure to write "physician assistant" correctly!
• Resumes - CASPA does not require a resume, so the request for one by a target program as part of a supplemental application may come unexpectedly. I won't lie, I see so many horrible resumes that it pains me.
  • Create a resume early, update and refine it as you go so you don't get rush it or delay your application.
  • ALWAYS limit your PA school application essay to one page and include the most relevant parts of your application. In addition to our pre-built pre-pa resume templates, I like resume.io or VisualCV for resume creation.

• CASPA - Create your CASAP account early! The earlier the better, there is no penalty for creating a CASPA account and you can familiarize yourself with the platform and become a CASPA expert all on your own.

• Seat Deposit: Once you're accepted into a PA program, you'll be asked to commit to the program by placing a deposit down to hold your seat. A seat deposit for PA school typically runs around $500-$1,000.

Programs usually allow several days or weeks to make your decision. You can make your deposit at any time and unless the offer is from your top choice PA program, it's best to wait until the last 1-2 days of this decision window to send your deposit.

You can continue to accept interview invitations and offers after you have placed your deposit.

Cost of PA school seat deposit: $500-$1,000

Running total: $5,151

How much does it cost to apply to PA school in 2022?

The total projected cost of applying to PA school in 2022 could be as much as $5,151

Based on the above real-world calculations, I recommend that you set aside $2,500 - $5,500 (depending on multiple factors) to apply to PA school. If you are working (which you should be) and clocking all those healthcare experience hours, make a budget and save money.

Here is the interesting thing: According to the most recent PAEA student report (which is always a couple of years behind) the costs of applying to PA school, including fees and interview-related expenses, were less than $1,000 for half of incoming PA students, with most students spending between $500-999.

According to the same PAEA student report those who spent a bit more on additional applications, supplementals, or interview costs accepted applicants spent under $2,000 for the entire application and interview process.

Only 7.8% of future PA students spent over $2,500 applying to and interviewing for PA school according to the PAEA student report.

But, I reckon, like most things involving budgets and money, accepted students significantly underreport the full cost of applying to PA school.

The best thing to do is to create a realistic pre-PA budget early on, save like your life depends on it (because it does), and your future you will be very thankful!

To help you get started I have created this free PA School Applicant Budgeting Google Worksheet. Copy the entire worksheet (Cmd/Ctrl + A) then paste (Cmd/Ctrl + V) into your own Google Sheet to start planning.

Best of luck with the application process!

If you have any tips on how to save money on Pre-PA applicant expenses or what your real-world PA school expenses looked like we would love to hear about it in the comments section.

Have a fantastic day!

Stephen Pasquini PA-C

The post The Real Cost of Applying to PA School first appeared on The Physician Assistant Life.

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Podcast Episode 90: Ten PANCE, PANRE, and Rotation Review Questions Welcome to episode 90 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast.

Join me as I cover ten PANCE, PANRE and EOR review questions from the Smarty PANCE Instagram/Facebook page and the smartypance.com board review website.

Special from today's episode:

• Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram
• Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook

Below you will find an interactive exam to complement today's podcast.

The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE.

• You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Podcasts, Stitcher, and most podcasting apps.
• You can listen to the latest episode, take an interactive quiz, and download more resources below.

Listen Carefully Then Take the Practice Exam If you can't see the audio player, click here to listen to the full episode.

Podcast Episode 90: Ten PANCE/PANRE and EOR Blueprint Questions 1. A 32-year-old male presents with acute ascending symmetrical paralysis and diminished reflexes in his bilateral lower extremities. He has a history of bloody diarrhea a few days ago. What did he likely eat that led to his symptoms?

A. Uncooked rice

B. Mayonnaise

C. Uncooked chicken

D. Soft unpasteurized cheese

E. None of the above

Click here to see the answer C. Uncooked Chicken

This patient has Guillain-Barré Syndrome (GBS), an acute immune-mediated polyneuropathic disorder. Clinical features include ascending symmetrical paralysis, diminished tendon reflexes, and respiratory muscle weakness.

GBS is typically precipitated by an infection. Campylobacter jejuniinfection is the most common precipitant of GBS. It is commonly found in uncooked poultry.

Cerebrospinal fluid analysis helps confirm the diagnosis. Treatment includes plasmapheresis and IV immune globulin.

View lesson: *Guillain-Barré Syndrome*

2. Which of the following disorders is characterized by a scaly, rough erythematous patch that appears on sun-exposed areas?

A. Seborrheic keratosis

B. Keratosis pilaris

C. Actinic keratosis

D. Lichen planus

E. Pityriasis rosea

Click here to see the answer Answer: C. Actinic keratosis

Actinic keratosis (AK) is a skin lesion that results from atypical keratinocyte proliferation. Risk factors include UV radiation, fair skin, and sunburns.

AK can present in various ways, but classically you will see an erythematous, scaly macule, papule, or plaque. A shave or punch biopsy can confirm the diagnosis. However, AK is often diagnosed clinically.

Treatment depends on the location and extent of the condition. Options include cryotherapy, fluorouracil, and imiquimod.It is important to remember that AK can develop into SCC.

View Lesson: Actinic keratosis (AK)

1. A 42-year-old male is admitted for typical pneumonia. He is given IV azithromycin and ceftriaxone. His QT interval becomes prolonged and he develops a polymorphic ventricular tachycardia. Which of the following is the most appropriate pharmacological management?

A. Intravenous calcium gluconate

B. Intravenous magnesium sulfate

C. Intramuscular epinephrine

D. Oral amiodarone

E. Oral procainamide

Click here to see the answer B. Intravenous magnesium sulfate

The patient developed torsades de pointes (Tdp), which is a specific type of polymorphic ventricular tachycardia in patients with a long QT interval. It is a ventricular dysrhythmia characterized by rapid (>100 bpm), irregular, wide QRS complexes that vary in size and shape. Diagnosis is made via EKG.

Examples of meds that prolong the QT interval include antiarrhythmics (amiodarone, sotalol), antimicrobials (fluoroquinolones, macrolides), antidepressants (fluoxetine, sertraline), and antipsychotics (haloperidol, quetiapine).

Treatment is usually IV magnesium sulfate.

View lesson: *torsades de pointes* (Tdp)

1. Which of the following is true about an indirect inguinal hernia?

A. It does not usually enter the scrotum

B. It is caused by a patent processus vaginalis

C. The strangulation risk is lower than a direct inguinal hernia

D. It is the least common type of inguinal hernia overall

E. It is medial to the inferior epigastric vessels

Click here to see the answer Answer: B. It is caused by a patent processus vaginalis

A hernia is a protrusion or projection of an organ through the body wall that typically contains it. An indirect inguinal hernia is specifically a protrusion of the abdominal organ into a patent processus vaginalis that extends into the inguinal canal.

Indirect inguinal hernias are the most common type of inguinal hernia. An indirect inguinal hernia is found lateral to the inferior epigastric vessels and it usually enters the scrotum. The strangulation risk is actually higher in indirect inguinal hernias. Definitive treatment is surgery.

View lesson: Indirect inguinal hernias

1. Which of the following is the most common cause of death in hemochromatosis?

A. Hepatocellular carcinoma

B. Diabetic-related complications

C. Acute respiratory failure

D. Left ventricular failure

E. Pancreatic cancer

Click here to see the answer Answer: A. Hepatocellular carcinoma

Hemochromatosis is an autosomal recessive disorder defined by excessive iron deposition in the liver, pancreas, and heart. It is often caused by a mutation in the HFE gene. Clinical features include skin hyperpigmentation, weakness, hepatomegaly, liver function abnormality, and diabetes mellitus.

Lab findings will show elevated serum iron, elevated ferritin, elevated transferrin saturation percentage, and decreased transferrin. Diagnostic tests include genetic testing and liver biopsy (gold standard, not always needed). Treatment consists of life-long phlebotomy. The most common cause of death in these patients is hepatocellular carcinoma.

View lesson: Hemochromatosis

1. A 15-year-old female with no medical history presents to the ER with altered mental status. She is tachycardic. Labs reveal a glucose level of 900 mg/dL and elevated beta-hydroxybutyric acid. Which of the following acid-base issues would you expect to see?

A. Normal anion gap metabolic acidosis

B. High anion gap metabolic acidosis

C. Metabolic alkalosis

D. Respiratory alkalosis

E. Respiratory acidosis

Click here to see the answer Answer: B. High anion gap metabolic acidosis

The patient most likely has diabetic ketoacidosis (DKA), a life-threatening emergency defined by insulin insufficiency, along with an elevation in counter-regulatory hormones. Patients in DKA will usually have a high-anion gap metabolic acidosis (HAGMA).

An anion gap is calculated by subtracting anions (HCO3- and Cl-) from a cation (Na+). It is normally 8 to 12. The gap is elevated in DKA because unmeasured anions (ketones) are giving off H+, which interacts with bicarbonate. Bicarbonate becomes depleted, thus increasing the gap.

Other causes of HAGMA include acute kidney injury, lactic acidosis, and toxins.

View lesson: Acid-Base Disorders

1. Which of the following is the first-line treatment for nasal polyps in patients with chronic rhinosinusitis?

A. Anti-histamines

B. Intranasal steroids

C. Leukotriene inhibitors

D. Beta-agonists

E. None of the above

Click here to see the answer Answer: B. Intranasal steroids

Nasal polyps are grayish masses filled with inflammatory mediators in the nasal cavity or sinuses. They are associated with aspirin sensitivity, chronic rhinosinusitis, asthma, allergies, and cystic fibrosis. Symptoms include increased nasal drainage, congestion, anosmia.

Nasal examination via nasal endoscopy can help confirm the diagnosis. The first-line treatment for nasal polyps is typically nasal corticosteroid spray. Surgery may be needed if the nasal polyp obstructs the cavity/airway.

View lesson: Nasal polyps

1. A 52-year-old female with a history of mitral valve regurgitation presents with exertional dyspnea. On physical exam, you notice abdominal swelling and lower extremity edema. You suspect pulmonary hypertension (PH). Which of the following is the gold standard for diagnosing PH?

A. Right heart catheterization

B. Chest radiograph

C. Computed tomography angiography

D. Echocardiogram

E. Polysomnography

Click here to see the answer Answer: A. Right heart catheterization

Pulmonary hypertension (PH) is defined by a mean pulmonary arterial pressure > 25 mmHg. The World Health Organization lists 5 broad etiologies of PH: pulmonary arterial hypertension (Group 1), left heart disease (Group 2), lung disease (Group 3), chronic thromboembolism (Group 4), and unknown causes (Group 5).

Symptoms are usually related to right ventricle failure and include “body congestion” signs: pitting edema, abdominal swelling, hepatomegaly, etc. A transthoracic echocardiogram is the best initial diagnostic test. A right heart catheterization is the gold standard for diagnosing PH.

View lesson: Pulmonary hypertension (PH)

1. A 72-year-old female smoker with a history of atrial fibrillation presents to the ER with severe abdominal pain for a few hours. Vitals are unremarkable. Physical exam reveals nothing significant. Which of the following is the gold standard diagnostic modality for the most likely diagnosis?

A. Computer tomography scan

B. Right upper quadrant ultrasound

C. Abdominal radiographs

D. Mesenteric angiography

E. None of the above

Click here to see the answer Answer: D. Mesenteric angiography

The patient most likely has acute mesenteric ischemia, which is the sudden onset of small intestinal hypoperfusion. The most common cause is emboli from the heart (usually from atrial fibrillation). Other causes include thrombosis and atherosclerotic disease. The most common artery occluded is the superior mesenteric artery.

Clinical features include acute onset of abdominal pain out of proportion of exam findings, abdominal distention, and elevated lactate. A good initial diagnostic test for a stable patient is an abdominal CT scan. The gold standard test is mesenteric angiography. Treatment is surgical revascularization and antibiotics.

View lesson: acute mesenteric ischemia

1. Orbital cellulitis most commonly occurs when an infection spreads into the orbit from which sinus?

A. Maxillary sinus

B. Frontal sinus

C. Sphenoid sinus

D. Ethmoid sinus

E. Temporal sinus

Click here to see the answer Answer: D. Ethmoid sinus

Orbital cellulitis is an ophthalmic emergency, as it can lead to vision loss. Clinical features include diplopia, decreased vision, pain during eye movement, proptosis, fever, and an erythematous, edematous eyelid. The most common bacterial culprits are Staphylococcus aureus and Streptococcus species. The ethmoid sinus is the most common origin of infection (90%).

The best diagnostic test is a high-resolution CT scan. Treatment is intravenous antibiotics, like IV vancomycin and ceftriaxone.

View lesson: Orbital cellulitis

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This Podcast is available on iOS and Android * You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Podcasts, Stitcher, and most podcasting apps.

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Print it up and start crossing out the topics you understand, marking the ones you don't, and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on Smarty PANCE.

The post Podcast Episode 90: Ten PANCE, PANRE, and Rotation Review Questions first appeared on The Physician Assistant Life.

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Little Big Men: The Rise of Kenya’s Clinical Officer This is part ten of a ten-part series by documentary filmmaker Adam Halbur on the PA model around the world.

Today we travel to Kenya and meet the dedicated pioneers and healthcare heroes who would become Kenya’s first Clinical Officers (CO).

View all posts in this series* As Good As You Can: The PA Model Around the World Part One * American Cheese: The Origin of the U.S. Physician Assistant * PAs in the Netherlands: The Dutch Physician Assistant * Why We Really Need PAs in The UK: The British Physician Associate * Meet The PA Pioneers of Israel: The Israeli Physician Assistant * Trials and Tribulations of the Liberian Physician Assistant * South Africa’s Clinical Associate (Clin-A): The PA Model Around The World * The Indian Physician Assistant (PA): Past, Present, and Future * The Australian Physician Assistant: The PA Model Around The World * Laos: The Birthplace of the U.S. Physician Assistant? * Little Big Men: The Rise of Kenya’s Clinical Officer

Kenya Clinical Officers (CO) Quick Facts:

• Name: Clinical Officers (COs)
• Can US PAs practice in Kenya: Yes - must achieve designation as clinical officer
• Kenya CO Salary: KES 60K/ month ($542 US/mo and $6,504 US/yr)
• Number of CO training programs: ~12
• Number of registered COs: ~24,106
• Prescription rights in Kenya: Yes
• Kenya Professional CO Association: Clinical Officer’s Council (COC)
• Kenya CO certification exam: COC pre-internship examination
• Kenya CO Certification Maintenance: No further examination outside of the pre-internship COC exam is required to practice.

The birth of Kenyan non-physician clinicians (Clinical Officers (COs) began in 1928 when Kenya, then occupied by the British, decided to train a select group of residents to practice medicine and provide care to the local population.

Without official Kenyan doctors present inside its own borders, the goal was to fill the gaps in the provision of healthcare to the constituents of the country.

In 1989, the Clinical Officer’s Council (COC) was created as a regulating body for the CO. There are 66 training institutions for Clinical Officers including Government, faith-based, private, and 12 universities. There are 23,000 Clinical Officers registered by the Clinical Officer’s Council (COC) today.

Where PAs and Physician Associates Can Work Internationally

Let The PA Stay! Let's begin our journey into the development of the PA profession in Kenya with a story.

When I (the author and documentarian) first started out as a writer after university, Dr. Jack Brown, from Sparta, Wisconsin hired me to edit his autobiography, now at The Monroe County Local History Room and Museum.

In the final chapters he recalls the politics behind hiring his first physician assistant in the early 1980s before his clinic was bought out by the conglomerate Gundersen Lutheran:

Dr. Paul Albrecht and I contacted the National Health Organization and succeeded in convincing the government agency that Sparta was indeed in an area with a doctor shortage.

It quickly replied that it would try to steer a few practitioners our way, but having worked for Uncle Sam, I knew something about government red tape and decided to hire a physician assistant or PA.

The PA was a new position in the medical field, a position that didn’t require the rigorous education of a full-fledged doctor but allowed that person to perform the duties of a general practitioner under the supervision of a doctor. In short, I hired PA Dan Robillard, who was a welcome relief while we waited for more doctors to show up.

The only problem was the Franciscan Sisters of Perpetual Adoration at St. Mary’s Hospital. I had always marveled how the nuns labored day and night to make things run smoothly, and I was very fond of them, especially since they had always gone out of their way to please me. So, it came as a surprise when I found out they were unhappy that I had hired a PA and they wanted a meeting to discuss the problem.

Mother Superior, who came from their headquarters in La Crosse, laid down the law in her opening statement:

“We would prefer you wouldn’t keep a PA under your hire. No one in La Crosse at St. Francis or any of the clinics has one.” She paused to let that sink in and then added, “We want you to fire Dan Robillard.”

I was dumbfounded. I blinked a couple of times before I jumped to my feet and startled myself by yelling, “Dan Robillard stays!”

The nuns jolted upright in their chairs astonished at the doctor who was always pleasant and telling jokes. “Without Robillard,” I continued, “Dr. Albrecht and I would drop dead running around in that new spacious clinic we’ve built. And Dr. Albrecht as you know has had a coronary and bypass surgery.

Now, if you people can rustle up a couple of doctors for our clinic, I might be persuaded to reconsider the PA question.” It was the first time and, I hoped, the last time that I would have to butt heads with the nuns. Fortunately, some calm ones from among them came to the rescue and eased tensions, and they agreed that Paul and I were under increased amounts of stress and let the PA stay.

Dr. Jack Brown

Little Big Men: The Rise of Kenya’s Clinical Officer (CO) Like the experience of Dr. Jack Brown (if not more dramatic) similar politics accompanied the rise of Kenya’s clinical officers (COs)

Kenya's clinical officers were at one time under nurses and were limited in their practice by medical officers, or doctors, even though COs, then called medical assistants, were running the national hospitals and health centers immediately after independence in 1963.

In some ways, the case of the CO is a microcosm for the whole of Kenya politics and its Big Man mentality, in which men traditionally have held power.

Indeed, many of the first COs have become locally influential figures, and one was even noted to have gone on to become a Member of Parliament.

I Trained as a Hospital Assistant Clinical Officer Jacob Kisang, the first chief of the Clinical Officers Council, recalls the evolution of the profession from the hospital assistant cadre, initiated sometime around 1928 when the British were training natives to dress wounds:

From 1954 to 1958, I trained as a hospital assistant.[i] When I qualified, I worked in Kenyatta National Hospital [at the time King George VI Hospital] for at least two years. Then I came to Tambach, which is my home district, and started working as a medical assistant.

Now first of all, our training was called hospital assistant. This was so because during the colonial days there were very few doctors, and they had to train hospital assistants to assist the doctors. Most of the medical people were doctors from overseas, so they started a medical training center in Nairobi called MTC.

It’s during the year 1960 when they changed the name from hospital assistant to medical assistant. Now as medical assistants, when independence came, most European doctors left the country, and therefore, they had to do an emergency training for medical assistants to become clinical officers.

Clinical Officer Jacob Kisang, the first chief of the Clinical Officers Council

According to Kisang, he managed his district alone for about 12 years, until 1976 when the first native Kenyan doctors had finished training at Makerere University in Uganda.

Isaac Nunda, another hospital assistant who was an early member and leader of the Hospital Assistant and Medical Assistant Association, trained as an anesthetist and assisted the famed Michael Wood of Flying Doctors, as well as set up operation theaters in Karisa and Thika.

The Wild, Wild West The Kenya medical community in the time after independence was a bit like the Wild West, with medical officers, medical assistants, nurses, and pharmaceutical technicians all vying with each other, while two factions within the medical-assistant cadre jockeyed for position.

The Hospital Assistant and Medical Assistant Association represented hospital assistants and nurses who had trained for one year starting in 1969 at Kenya Medical Training Center, Machakos, Nairobi, to become certified medical assistants.

This group was opposed to Joseph Ole Kiu, leader of those who were training in the three-year clinical program, first at Machakos and then Nakuru, to become registered medical assistants.

“When we were in Machakos,” Ole Kiu recalled:

This group, the certified group, did not want us to be trained. They said, “How do you bring people called registered medical assistants to train and you never took us to that level?” So they fought us. So we went to court.[ii] And there was this chief justice, he was a mzungu [white man]. He said, “It is only in London 1937 that a group on the lower level was opposing a group which was going to train.” It was only in London that such a case came up. So he threw that out.

Joseph Ole Kiu

And We Said No When Ole Kiu graduated at Nakuru, he and his fellow registered medical assistants, now renamed registered clinical officers by the Kamunge Commission, were not happy with the certified group and tried to form their own association.

However, the Registrar of Societies refused their request, and the registered COs joined the certified CO’s Hospital Assistant and Medical Assistant Association to become the Clinical Officers Association, with Nunda as national chairperson and Ole Kiu as his secretary.

A contemporary colleague suggested, off the record, Ole Kiu received the secretary post for agreeing to join the certified COs and for making other concessions, although according to Ole Kiu, the registered COs were merely required to pay the 2-shilling membership fee.

Now that the COs were united, they began their fight to free themselves of the nurses, who were ranked above them according to education, and from doctors, who restricted what drugs they could prescribe and what procedures they could do.

“I was working in the hospital [in Kisii] but very active in the Association,” said Nunda.

To work for the right of a clinical officer. Because during those days clinical officers were under nursing. Nurses were administering them. And we said, “No.”[iii] And clinical officers, wherever they worked if they had a clinic of themselves, were being supervised by a doctor. And they paid doctors for supervising their clinics. And so that’s one I didn’t like.

I'll Never Sign and Act On the CO agenda were academic advancement, legal recognition, and scheme of service, and Nunda used the crank telephones still in use then and went from district to district in person, inducting clinical officers into the fight.

Ole Kiu said they worked for ten years with certain doctors to put together an Act only to have it rejected by Parliament, which called it “inopportune,” due to opposition from other doctors. Their Act was shelved.

The clinical officers’ main opponent was Director of Medical Services Dr. W.K. Koinange, “who didn’t want us!” exclaimed Nunda.

Because Dr. Koinange swore, within us, “I’ll never sign an Act of Clinical Officers when I’m director of Medical Services.”[iv] He swore it…. We were in a meeting. He said, “I’ll not sign your Act” because he wanted us to be amalgamated with all cadres, with clinical officers, nurses, and everything. But simply clinical officers he didn’t like.

Koinange chased Nunda from his office, forcing him and Ole Kiu to utilize high government officials to petition to see the Head of State at that time, Daniel arap Moi.

Winning the Fight Ole Kiu, representing clinical officers, recalled going with Paul Tuukuo, representing pharmaceutical technologists, also seeking legal recognition, to meet with President Moi at the State House:

So Koinange heard that the clinical officers were going to see the President, so he informed the Minister [of Health, G. K.M'Mbijiwe]. By the time these guys came, we were already in State House…. So we stood, we had our own money, a little money. At that time the President was being given some—not chai [a bribe]—appreciation.[v] So we had our 30,000 [shillings]. Pharmaceutical technologists had 30,000…. So we went to see the President. So the President talked. Now, Koinange was coming closer to M'Mbijiwe, “Don’t allow them! Don’t allow them to talk! I say don’t allow them!”… So what happened, Tuukuo was the one to speak on our behalf. So these other guys talked. The President talked. And then when they finished, we pushed Tuukuo…. Then he said, “Your Excellency, Sir,” but he almost fell down, “these people hate us, these ones, they hate us, and they don’t want us. They have refused us, we pharmaceutical technologists, we clinical officers. We are the people working there, and these guys have refused us to be registered.”… Then [Moi] said, “The clinical officers, I know them. They are the ones treating even the white guys during the colonial times…. And at that time, these people were not even educated, but these ones now are more educated than those ones. So M’Mbijiwe, can you bring the Act to Parliament so these people are registered.”

According to the exchange rate at the writing of this blog, 30,000 shillings is about 300 U.S. dollars. After M’Mbijiwe, Mwai Kibaki became Minister of Health and, with more pressure from the COs, assured the passing of the Clinical Officers Registration and Licensing Act, Cap. 260, in 1988.

The Act freed clinical officers from supervision, no longer requiring them to get a medical officer to countersign on prescriptions.

At the time, Professor Lawrence Karanja was a clinical officer teaching at KMTC-Nairobi, while also obtaining a higher national diploma in orthopedic surgery.

We in KMTC had to suspend all of our lectures for two days. Everybody had to go and look for their Member of Parliament and convince him, let him go and support the Act….[vi] That’s the first time and the last time I ever went to Parliament.

When the Act was passed, according to Karanja, all the COs were happy and immediately obtained licenses to open private clinics.

Even COs in training were allowed to have part-time licenses, and after two or three years, COs were driving nice cars and building their own houses. Many have gone on to further education, and some have even started private medical training schools and other businesses, including the writer and director of this film, Reuben Waswa.

In 2017, the 1988 Act was replaced by the Clinical Officers Act No. 20, legalizing basic surgeries, such as cesarean sections, which some COs had already been trained to perform, and expanding the schedule of drugs COs can prescribe.

Crossing Over Kenyan medicine is still a bit on the wild side according to retired clinical officer Reuben Kbaba, who said everyone is crossing over—medical officers sometimes claim to be specialists, clinical officers sometimes claim to be doctors and pharmaceutical technologists sometimes offer services regulated to COs.[vii]

This competition initially brought health care to more people, distributed wealth through rural areas, and unified the disparate tribes as one nation.

The CO cohort, which outnumbers medical officers, has also given themselves gainful and rewarding employment. However, as I said in the last blog, we can’t all be physician assistants, and health should be approached from infrastructure, education, and socio-economic justice, as well as other standpoints, not merely as a Band-Aid to stem societal ills.

For Kenya, their Big Man society is slowly passing, women are entering the ranks of COs in greater numbers, and universal health care is a goal of the current administration.

And so, ends this blog series, which was to share with you some of the impressions and stories I have collected. Cheers.

About the Author

Adam Halbur is a writer and teacher living in Tokyo, Japan. A short version of his film As Good as You Can, As Professionally as You Can premiered at the 11th annual conference of the International Academy of Physician Associate Educators. Watch the “American Cheese” segment of the longer version here. Watch a short of the 50th AAPA Conference with interviews from Ruth Ballweg and David Kuhns here. Halbur is entirely self-funded, so if you appreciate his work, please consider making a small contribution to his feature documentary on the Kenyan clinical officer.

Videos from this post: [i] https://youtu.be/8vYEqaYPJ1M

[ii] https://youtu.be/qtAgwzqNh_o

[iii] https://youtu.be/dCjqN_XPv-A

[iv] https://youtu.be/_sAZTJLKz6Q

[v] https://youtu.be/284HMXSACYs

[vi] https://youtu.be/vUWoeUcYrtU

[vii] https://youtu.be/-JkzcX7prDQ

[viii] https://mosthustleanddesire.github.io/as_good_as_you_can/

[x] https://youtu.be/yXVwwqXvVNw

Additional Reading:

Where PAs and Physician Associates Can Work Internationally

The post Little Big Men: The Rise of Kenya’s Clinical Officer first appeared on The Physician Assistant Life.

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Podcast Episode 89: Ten PANCE, PANRE, and Rotation Review Questions Welcome to episode 89 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE, PANRE and EOR review questions from the Smarty PANCE Instagram/Facebook page and the smartypance.com board review website.

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Below you will find an interactive exam to complement today's podcast.

The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE.

• You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Podcasts, Stitcher, and most podcasting apps.
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Listen Carefully Then Take the Practice Exam If you can't see the audio player, click here to listen to the full episode.

Podcast Episode 87: Ten PANCE/PANRE and EOR Blueprint Questions 1. The definition of amblyopia is . . .

A. Congenital cataracts noted at birth

B. Retinal detachment seen in premature children

C. Irregular pupillary size

D. Increased distance between the medial and lateral canthus

E. Subnormal visual acuity in one or both eyes despite correction of refractive error

Click here to see the answer Answer: E. Subnormal visual acuity in one or both eyes despite correction of refractive error

Amblyopia, also called lazy eye, is a disorder of sight in which the brain fails to process inputs from one eye and over time favors the other eye. It results in decreased vision in an eye that otherwise typically appears normal

• Amblyopia is not correctable by refractive means
• Amblyopia occurs in early childhood when nerve pathways between the brain and an eye aren’t properly stimulated
• It may be caused by strabismus (crossed eye); uremia; or toxins, such as alcohol, tobacco, lead, and other toxic substances
• Symptoms include a wandering eye, eyes that may not appear to work together, poor depth perception, blurred vision, or double vision. Both eyes may be affected

DX: Screening to detect amblyopia in all children younger than five years of age

• Screening includes vision risk assessment at all health maintenance visits and vision screening at age three, four, and five years of age

TX: Treatment includes correction of refraction error as well as forced use of the amblyopic eye by patching the better eye

• Some children cannot tolerate the patch, in which case the good eye is blurred with glasses or drops (penalization therapy) to stimulate proper visual development of the more severely affected eye
• It is more resistant to treatment at an older age; thus, children should be treated early

View lesson: Amblyopia

A 45-year old woman being managed for ulcerative colitis, developed abdominal pain, vomiting, diarrhea, the passage of blood and mucus per rectum, and fever. On examination, she was pale, febrile (temp: 102.2 C), moderately dehydrated, heart rate: 124bpm. There was abdominal distention and tenderness, bowel sounds were hypoactive. Lab results showed Hb: 9g/dl, WBC: 14 x 109/L, elevated CRP. Stool was negative for C. difficile. HIV status was negative. Abdominal radiograph showed dilated transverse colon of about 11 cm. What is the most likely diagnosis of this patient?

A. Hirschsprung’s disease

B. Cytomegalovirus colitis

C. Toxic megacolon

D. Kaposi’s sarcoma

Click here to see the answer Answer: C. Toxic megacolon

The hallmarks of toxic megacolon (toxic colitis) are nonobstructive colonic dilatation (>6 cm) and signs of systemic toxicity. It occurs following complications from causes of colitis e.g. ulcerative colitis as is the case in the index patient.

Incorrect Answers:

• Hirschsprung’s disease (choice A) presents with chronic constipation. Patients are not usually toxic except when intestinal perforation occurs.
• Cytomegalovirus colitis and Kaposi’s sarcoma (choice B and D) Occurs in immunocompromised persons.

View lesson: Toxic megacolon

1. Which of the following is not transmitted by blood?

A. Hepatitis A

B. Hepatitis B

C. Hepatitis C

D. Hepatitis D

Click here to see the answer Answer: A. Hepatitis A

Hepatitis A is transmitted via the fecal-oral route

Incorrect Answers:

• Hepatitis B can be transmitted via blood and blood products through close living quarters/playground play as a toddler, vertical transmission, infected unscreened blood, needle stick injury, etc.
• Hepatitis D is transmitted via blood.
• Hepatitis C is transmitted via blood and blood products through Intravenous drug misuse, unscreened blood products, needle stick injury, vertical transmission etc

View lesson: Acute and Chronic Hepatitis

1. When is PKU testing performed?

A. 24 weeks gestation

B. 24 to 48 h after birth

C. 48 to 72 h after birth

D. at the first well-child visit

Click here to see the answer Answer: B. 24 to 48 h after birth

In the US and many developed countries, all neonates are screened for PKU 24 to 48 h after birth. Tandem mass spectrometry is the method of choice. It has a low false-positive rate, and excellent accuracy and precision.

View lesson: Phenylketonuria

1. A 20-year-old female with a history of type 1 diabetes presents to the clinic complaining of weight loss, increased flatulence, foul-smelling stools, and a pruritic rash. You notice multiple papules and vesicles on the extensor surfaces of the elbows. Which of the following is most likely to be positive?

A. Anti-cyclic citrullinated peptide antibody

B. Anti-dsDNA antibody

C. Anti-tissue transglutaminase antibody

D. Anti-topoisomerase antibody

E. Anti-beta 2 glycoprotein 1antibody

Click here to see the answer Answer: C. Anti-tissue transglutaminase antibody

The patient has Celiac disease, which is an immune disorder characterized by sensitivity to gluten. It is more common in patients with Type 1 diabetes, autoimmune thyroiditis, Trisomy 21, and Turner syndrome.

Clinical features include diarrhea with bulky, foul-smelling floating stool, flatulence, and weight loss. Patients may have dermatitis herpetiformis, which is a rash located on the elbows, forearms, and knees.

Laboratory studies to order include anti-tissue transglutaminase antibodies and IgA anti-endomysial antibodies. The best diagnostic test is an upper endoscopy with a small bowel biopsy. Patients must avoid food with gluten, which includes barley, rye, oats, and wheat.

Incorrect Answers:

• Anti–cyclic citrullinated peptide antibodies (choice A) are highly specific to rheumatoid arthritis.
• Anti-dsDNA antibodies (choice B) are a specific marker for systemic lupus erythematosus.
• Anti-topoisomerase antibodies (choice D) are specific to diffuse scleroderma.
• anti-beta 2 glycoprotein 1 antibodies (choice E) are specific to antiphospholipid syndrome.

View lesson: Celiac disease

1. Which of the following is the most common cause of postpartum hemorrhage?

A. Severe vaginal laceration

B. Uterine atony

C. Hematoma

D. Retained products of conception

E. Placental abruption

Click here to see the answer Answer: B. Uterine atony

Postpartum hemorrhage is an obstetric emergency. It is defined as an estimated blood loss ≥ 500 mL during vaginal delivery or ≥ 1000 in a cesarean section. The most common cause is uterine atony.

Uterine atony presents as a soft, boggy uterus after delivery and should initially be managed with fundal massage and IV oxytocin.

In general, the main focus of managing postpartum hemorrhage should be (1) resuscitation and management of hypovolemic shock and (2) identifying and treating the underlying cause.

View lesson: Postpartum hemorrhage

1. A 37-year-old female with no past medical history is brought in by EMS. She is hypotensive. On physical exam, you notice muffled heart sounds and jugular vein distention. What is the most appropriate initial treatment for this condition?

A. Emergent needle decompression

B. IV beta-blockers

C. Pericardiocentesis

D. Thrombolytics

E. None of the above

Click here to see the answer Answer: C. Pericardiocentesis

The patient is experiencing cardiac tamponade, which is defined as fluid accumulation in the pericardial sac. The most common cause of cardiac tamponade is trauma. Other causes include malignancy, uremia, infection, and iatrogenic.

Patients may have Beck’s Triad – hypotension, muffled heart sounds, and jugular vein distention. They may also have pulsus paradoxus (large decrease in systolic blood pressure on inspiration).

The best diagnostic test is an echocardiogram. The treatment of cardiac tamponade is pericardiocentesis. An open surgical approach (i.e., thoracotomy) is typically needed for traumatic cases though.

Incorrect Answers:

• Emergent needle decompression (choice A) is the treatment of choice for a tension pneumothorax, which is when air rapidly accumulates in the pleural space. It typically presents as shortness of breath.
• IV beta-blockers (choice B) would be the management of an aortic dissection, not cardiac tamponade. An aortic dissection presents with sharp chest pain, pulse deficits, and hypotension.
• Thrombolytics (choice D) would be the preferred treatment for an unstable patient with a massive pulmonary embolism.

View lesson: Cardiac Tamponade

1. Which of the following should be avoided in patients who have an acute kidney injury?

A. NSAIDs

B. Aminoglycosides

C. Macrolides

D. Acetaminophen

E. Both A and B

Click here to see the answer Answer: E. Both A and B

Acute kidney injury (AKI) is defined by an acute decline in renal function. You will see an increase in serum creatinine with possible oliguria or anuria.

AKI can be broken up into 3 main etiologies: pre-renal, intrinsic, and post-renal. The most common cause of acute kidney injury overall is reduced perfusion. Prolonged pre-renal AKI can lead to ischemic acute tubular necrosis.

Nephrotoxic agents, such as NSAIDs, vancomycin, aminoglycosides, and ACEI/ARBs, should be avoided. Treatment is managing the underlying cause, plus correcting acid-base & electrolyte issues.

View lesson: Acute Renal Failure

1. A 38-year-old male presents to the ER with acute onset of dyspnea, dizziness, chest pain, and diaphoresis, He has had 4 episodes similar in the past. Vital signs are remarkable for mild tachycardia (103 bpm). Lab and imaging studies are insignificant. Which of the following is the best long-term medical treatment for the likely diagnosis?

A. Benzodiazepines

B. Selective serotonin reuptake inhibitors

C. Atypical antipsychotics

D. Calcium channel blockers

E. Melatonin

Click here to see the answer Answer: B. Selective serotonin reuptake inhibitors

The patient most likely has panic disorder. The DSM V criteria for panic disorder include the following:

• 1 or more panic attack that reoccurs without warning and at least 4 or more symptoms
• Must be worried about having another attack or change behaviors

Symptoms of a panic attack include diaphoresis, chest pain, lightheadedness, shortness of breath, palpitations, sense of doom, or fear of dying. The treatment of panic disorder is selective serotonin reuptake inhibitors. Patients may benefit from taking hydroxyzine or benzodiazepines on a short-term, as-needed basis.

View lesson: Panic Disorder

1. Which of the following best represents values you would expect in a patient with SIADH?

A. High serum sodium, high serum osmolality, low urine osmolality

B. High serum sodium, high serum osmolality, high urine osmolality

C. Low serum sodium, low serum osmolality, low urine osmolality

D. Low serum sodium, low serum osmolality, high urine osmolality

E. None of the above

Click here to see the answer Answer: D. Low serum sodium, low serum osmolality, high urine osmolality

SIADH or syndrome of inappropriate antidiuretic hormone secretion is characterized by the excessive release of ADH. ADH increases the permeability of the distal convoluted tubule and collecting ducts, increasing the reabsorption of water. This decreases plasma osmolality, increases urine osmolality, andleads to hyponatremia.

Causes include intrathoracic diseases (pneumonia, TB, acute respiratory failure, lung cancer), neurological issues (stroke, hemorrhage, tumors), and drugs (NSAIDs, opioids, ecstasy, and SSRIs). The goal is to determine and manage the underlying cause. Fluid restriction is often used as well.

View lesson: Syndrome of inappropriate antidiuretic hormone secretion

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This Podcast is available on iOS and Android * You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Podcasts, Stitcher, and most podcasting apps.

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Print it up and start crossing out the topics you understand, marking the ones you don't, and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on Smarty PANCE.

The post Podcast Episode 89: Ten PANCE, PANRE, and Rotation Review Questions first appeared on The Physician Assistant Life.

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How to Be a Better PA Part 2: Medical Staff, Administrators, and Supervisors This is part two of a special three-part podcast series by Joe Gilboy PA-C on becoming a better PA.

Part one was all about building better relationships with our nurses and ancillary staff.

In part two we cover essential strategies on how to stay off the medical staff radar and get the medical staff, administrators, and supervisors on your side.

Let's jump right into this special episode of The Audio PANCE and PANRE Podcast.

You can listen to the podcast below and read the summarized (and edited version) of the transcript or listen in your podcast player of choice.

The Audio PANE/PANRE Podcast Episode 88: How to be a Better PA (Part 2 of 3) You can also click here to listen to or download this episode.

Episode Transcript and Summary This episode was recorded by Joe Gilboy PA-C and edited for clarity and readability by Stephen Pasquini PA-C.

Welcome, everybody. This is Joe Gilboy, and this is a podcast to have a series of three podcasts on how to become a better PA.

Today, we're going to talk about medical staff, our administrators, and our supervisors, whether a nursing supervisor, PA supervisor, or possibly physician supervisor.

What I will be teaching you here in this podcast is how to interact with them and how to deal with them. And most importantly, how to have you make a better reputation for yourself and how to make you a better PA.

• First, we're going to talk about the medical staff, which is a big group of people.
• Second, we need to learn how to deal with administrators. These can also be the office managers at the clinics where you work.
• And then your supervisors, these are the people above you, whether a nurse, a PA, or a doc.
• Lastly, we will covering how to deal with (or leave) a toxic job

So, let's talk about all these three people we're going to have to interact with.

How to be a Better PA with Medical Staff

Let me explain who medical staff really are, not whom you think there are, but I'm going to show you who they really are.

I've been a physician assistant in the emergency room for 35 years. You would think that after 35 years, I've developed some tough skin. But there's one group of people that I fear the most, and you will begin to fear them as well. Who are they? The medical staff!

Everybody has a boss. For example, you have a boss, and your boss has a boss, they have a boss, everybody has a boss. But there's one person who's at the very top of this pyramid. That's medical staff.

So, when medical staff asked for something, when do you get it done? Now? Yes, right now, like yesterday was too late.

So, the medical staff has asked for your ACLs card, PALS card, NCCPA card, or DEA number. They want a TB test, a flu shot, or they want your antibody titer for chickenpox.

When are we getting it done?

Now! No, literally right now. Because you see, the last people you want to be on the radar is medical staff.

Let me share with you who medical staff really is.

What's their job?

Are you ready for this? I hope you're sitting down?

Their job is to fire you.

Yeah, you heard me. They want to find a problem. That's their job.

So, when they start asking for things, they're looking for a problem. So, let's just say a young physician assistant is working in urgent care that we will call Betty.

So, here's Betty, the new PA working at the urgent care. Medical staff wants something, and she's like, well, you know, I'll get to it tomorrow. I have a birthday party to go to this weekend. And you know, and then it's my parents, wedding anniversary, I'm going to have that. And then my boyfriend's taking me to this. And you know, I'll get back to it when I get back in town. And as this time has gone by, Tick-tock, tick-tock. She's getting these new emails in her inbox from the medical staff. They've sent one, they've sent two, they sent three. Now they send one to her, and they're saying, hey, if you don't get this done in 10 days, you're on suspension!

Guess who gets the seat in that email? Your boss.

Let me explain to you how this plays itself out. You see, at the end of the year, when you're up there for that yearly evaluation, they're going to say, "Hey, so how's our new physician assistant? How's she doing?"

Well, they're going to talk to a group of people. They're going to talk to the nurses. They're going to talk to the physicians. And guess who else they are going to talk to, folks? That's right, the medical staff.

"Are there any dings with this person? Have they no gotten things done on time?"

Now think about what I'm saying hard.

So, imagine you're the boss. And there's these two PAs that show up. One PA gets everything done on time, and the medical staff doesn't even know they exist.

They're like, yeah, this person gets his TB test and flu shot and antibody titers done on time.

There's this other PA. Well, we had him on suspension for a week because he wouldn't get a TB test. And you're the boss, and it's time for her yearly evaluation. Whom do you want to give the raise to?

Yeah, let that bounce around in your head for a second.

Whom do you want to give the raise to? The person that medical staff has no idea that even exists in the department because they're getting everything done on time or a PA that they had to put on suspension for ten days?

Now, do you get it, guys?

You see, I hate to say this, but getting along with the medical staff is not only the way to preserve your job. But it's also the way to make more money.

Because when it's time for that yearly evaluation, your boss is going to look at you like, "Hey, you show up to work on time, you get along with the nurses, and you get along with the medical staff." They want to keep you.

That's when you can turn the screw and say, okay, well, to keep me, I would like $10 more an hour, or more vacation time or whatever it is that you're trying to angle at. That's how this works, folks.

I get these new grads who get out of school. They tell their supervising physician that they want to make $80 an hour, right? And let's just say the going rate is $65. And the doc will say, well, wait a sec, you know, I start new PAs off at $65. They're going to go well; I'm a recent grad, and I deserve this. I deserve that. Or I went to some fancy, dancy school.

Now, can you understand that at the end of the day, your boss does not care where you went to school? It means absolutely nothing. That's just a piece of paper. What's going to mean everything to your boss?

Can you see 20 patients, not kill anybody, get along with the nurses, get along with the staff? And most importantly, doesn't get on the medical staff's radar.

This is about your reputation.

You want to be the PA that medical staff doesn't even know exist.

You're like, so when does this girl get her TB or guy get a TB test, always on time, gets his flu shot on time gets his antibodies done on time. I don't even know his DEA numbers expire because he turns it in on time. That's who you want to be.

So never, ever, ever get on medical staff's radar.

I am going to give you a little inside story. I got an email. This was about nine o'clock in the morning. I got an email from medical staff, and they wanted antibody titers. They're like, "you know, hey, Joe, we need your antibody titer, Hep B titer, measles titer, and chickenpox titer."

So that was nine o'clock in the morning. I was in the walk-in clinic at noon, getting my antibodies, titer tests. And then the lady looked at goes I said, Yeah, there's something about a DPT shot, and she goes, you know, our records down, we can't pick them up. I said, just give them to give it to me. And lo and behold, they did my antibody titer. And they gave me a DPT shot. And believe it or not, guess who got two DPT shots last year? Yeah, that's me.

The medical staff emailed me back that afternoon. I emailed them back within four hours. Everything's been done. And they emailed me back saying, "Hey, thank you for getting things done so expeditiously."

Does everybody understand my boss is looking at me like the medical staff doesn't even know you exist? They're kind of worried because you got two DPT shots. I'm like, you know, I got twice the amount of antibodies. I’m not really worried about it.

So now, at the end of the day, this is what I want to share with you. Don't ever get on the radar. They want something – you get it done. Right. Now, if you do that, guys, he'll do great.

How to be a Better PA with Administrators

So now the next group we need people we need to talk about is the administrators.

So, when the administrators come downstairs to your hospital, urgent care, walk-in clinics, surgery center, wherever it is, be polite, and be cordial. Be respectful to them. Say hey, it's great to see you, how have you been you know, it's you know, I hope all is well with you and sounds great.

So, if you're cordial and polite with them and respectful, they'll remember you. And then when that yearly evaluation comes up, the administrator can go to your boss (who's your boss's boss), and they go, hey, you know, I met one of your PAs the day ago, great guy. Very nice. He was very polite and very cordial, and very respectful to me. You've got a good kid on board.

And now your boss is going to go, "wait a second. I need to keep this new grad, maybe young pa, on board. That's what you want to do.

So, in other words, be polite, be cordial. Be respectful to your administrators, and remember, they're the ones that make policies.

I think it is kind of funny that everyone argues so much about who's in charge of making policies. At the end of the day, guys, it all boils down to policies. That's what you must play under.

These are the rules. They're not the referees. You must play by these rules. You can get mad at the referee, but he's just enforcing the rule.

So, think of administrators as the person who is just enforcing the policy. So, when you see the administrators, be polite, be cordial, be respectful.

How to be a Better PA with Supervisors

The last group of people that we need to be aware of is our supervisors. So, whether this is a nursing supervisor, PA supervisor, or physician supervisor, they are your supervisor. And I keep telling everybody this again: be respectful, kind, cordial, and very workable.

You want to be the PA that everyone wants to work with. You want to be the PA that when you walk into the OR suite, or you walk into the clinic, or you walk into the surgery center or walk into, you know, medical office or you walk into the ER, you're going to be that PA.

"Oh my gosh, it's going to be a great day. Look who's here." So, when the nursing supervisor comes up and asks you a question, again, be polite, cordial, and respectful. The same thing with your peers. Most people have a PA supervisor, right?

Just be polite and cordial with them. Your MD supervisors, you want to be that pa that does everything?

No, listen to me. You see, you want to be the PA that the MD is like, oh, god, this person's work with me today!

I know they'll pick up the extra patients. They'll pick up the pace. They'll do better in the OR. They're much more respectful. They're much more cordial. This is the person I want to work with, that guy or that like that girl, that's who I want to work with, it's them.

And this is what you need. Because you see at the end of the day, guys, what I'm really trying to share with you. And I'm trying to tie this all in with you. This is about reputation.

You see, guys, at the end of the day, no one cares where you went to school. I mean, I know it's a congratulation from whatever university or PA program you graduate from. Congratulations.

Okay. But no one cares. No one will care about your GPA. No one will care about your PANCE or your PANRE score. They'll mean absolutely zero.

What will mean everything, your reputation?

What kind of person is this individual like to work with? Are they good? Are they bad? Do they get along with the staff? Do they get along with medical staff? Do they get along with the administrators? Do they get along with the supervisors?

That's what's going to count, folks. Because at the end of the day, let's just say you leave your job and go to the next job. Who do you think they're going to call?

Yeah, they're going to call one of your supervisors. And what are they going to say? They're not going to say where you went to school. They are not going to say what your GPA was, your PANCE or PANRE score was?

They're going to say what kind of person you are to work with, which is based upon your reputation.

This is what I keep trying to hammer home is. So how does everyone understand where I'm trying to with this

In other words, the medical staff wants something. When am I getting it done? Now?

How am I going to be to the administrators when they come downstairs? I'm not going to be afraid of them. I'll walk up to them and shake their hand. I'm polite cordial respectful.

My supervisors, what am I going to be? Polite, cordial, and respectful.

I'm going to be that workable PA? Hey, can you go see these extra four patients? Do you mind staying an hour later? I'd love to. I'd love to stay 10 hours later. Thank you. Can I have another?

That's who you want to be. Not the person who is like, "well, I need to leave a half-hour early, and can I get my hour lunch? No, I want a two-hour lunch. You know, I just don't feel like coming in today because I just I'm not feeling it. You know, my chakra's not in line. You know, I'm just not feeling it."

Yeah, this is not who you want to be. This is not who they want to hire.

They want the person they can rely upon. They want the person that they can trust the reputation on, and this is what I'm trying to share with you.

The Toxic Job

One other little piece here because I know many of you guys are going to ask this question. Hey, Joe. I've got this really toxic supervisor. I got this toxic nursing supervisor, I've got this toxic PA supervisor, or I got this toxic physician supervisor, so just say you've got a toxic person in your crew, right?

And trust me, I've been here, guys; I have Pandora's box full of bad memories here. I just want to keep this box closed. So, I'm on your side here.

So, what do you do with the toxic nursing supervisor?

Two things. So, whether it be a toxic nursing supervisor toxic, physician assistant supervisor, toxic physician supervisor? So what do I do?

Okay, so this is the way you get out of this. This is how you thread the needle.

One, you go up to them directly. So, let's just say you have a toxic nursing supervisor, right? So, you go up to whoever this nursing supervisor is and say, "listen, I find some of the things you inappropriate, I don't find this working for the best interest of the department."

And remember, that's a buzz word, best interests of the department or the office, the surgery center, or the ER, this isn't serving the best interests of our department.

"So, if you don't mind, I would appreciate it, if you change your policy or attitude towards me or to the group of people."

So, the first thing you do is you confront you lay down your complaint.

You also followed it up with an email.

Dear nurse supervisor or PA supervisor, or MD supervisor. The other day, we spoke about (x,y,x). Thank you for your time consideration. Sincerely, Joe.

You have verbally stated this to them. And now you have an email, which is very important.

Now, let's say that they continue to be toxic. Now, what do you do?

Everybody has a boss. Now, you go to their boss's boss, except this time, you've got documentation.

And you say, "so, I presented this to my nursing or physician supervisor, and this is what I presented to them, and they continue this behavior."

I've been at some toxic jobs. I just look back, and I find it amazing that I ever survived. So, what do I recommend when people are in a toxic job?

You've completed the steps above. You've politely confronted them and verbalized this in an email, and you went to a higher source, and nothing got done.

So, when you leave this toxic job, how do you do it?

You be polite, be respectful, be cordial.

"This is my two-month resignation. Thank you for your time consideration.

You don't even bring it up. You just exit.

Okay. So, can we all agree that most of us sleep 6-8 hours a day, which means we're awake for 16, right? Eight to 10 hours is going to be at work.

My wife's a writer. So, she's off doing her writer stuff, right? I might see her for a couple of hours. I don't see her that much.

But my nurses, are you kidding me? I see them eight to 10 hours a day. So, you see, the people you work with are your family. You're going to spend more time with these people than your own family.

If you have a miserable family at work, you will take home a miserable attitude and then take it out against the people you love the most.

So, these toxic jobs that you sometimes get yourself into. Get out. Get out as soon as you can!

This will literally ruin your soul. And then you'll take it home to the people you love the most.

"But I'm making so much money."

I see this all the time; I hear this from all my students all the time.

"But Joe I was making such good money."

One of the things you learn about life as you get older, it's not always about money. I agree that money helps. It helps pay off your student loan, mortgage, car payments, bills, etc. I get it, I've got the same things.

But at the end of the day, I'm happy with the family I have in my ER. I get along great with everybody. I get along with the medical staff. I get along with the administrators, and I get along to supervisor. I get along with almost everybody. It's my family.

And so now, when I come home, I'm not in a bad mood. I don't have any toxic stew on me. So, I can spend time with my wife and my daughter, and my dogs. And I'm just Joe. Nothing came home with me.

Your Reputation Matters

And this is what I keep trying to share with you guys. This is how you develop a good, healthy reputation as a PA.

And now if you go to the next job, what's your boss going to say?

Oh, this guy is great. Or this girl is great. I don't want to give her up. She gets along with everybody. You're the luckiest person in the world to get her. Get him.

That's what you want to do.

So, listen, guys, it's been enjoyable. I hope this podcast has helped you out. And this is podcast two or three. The third and the final podcast is getting ready to come up. And at that podcast. We're going to wrap the first two podcasts up. And what are we going to talk about? Your reputation.

Take care, guys.

Joe Gilboy PA-C

The post How to Be a Better PA Part 2: Medical Staff, Administrators, and Supervisors first appeared on The Physician Assistant Life.

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The 4 Most Common Reasons PAs Quit Their Jobs According to a new AAPA research article (August 2021), the four most common reasons PAs quit their jobs are:

1. Better work/life balance (16.8%)
2. Moving to a new location (16.7%)
3. Better management/leadership/environment (reasons related to a toxic/abusive environment) (13.6%)
4. Better compensation/benefits (11.9%)

Other reasons PAs left their jobs included * Better professional/clinical opportunities (6.6%) * Corporate or external factors forced job change (for example, closed, lost contract, restructuring, company failing) (5.8%) * Opportunity to switch to a new clinical focus/specialty (5.6%) * Completed education or postgraduate program (5.3%) * Personal reasons/life change (4.4%) * Better management/leadership/environment (reasons unrelated to toxic/abusive environment) (3.1%) * Better commute (2.3%) * Reentered workforce following extended leave (for example, unemployment, sabbatical) (0.8%) * Left workforce to retire or take extended leave of absence (0.6%) * Left or joined military (0.6%) * Other (5.9%)

PAs quitting their jobs is important. When a PA leaves, it costs employers a lot of time and money, which can be bad for everybody.

Despite high career satisfaction, PAs have a turnover rate similar to physicians, and according to research replacing one PA can cost 100% to 200% of their annual salary.

Understanding why PAs quit and, more importantly, fixing it should be a major focus for institutions looking to retain and attract talent.

Today I am going to discuss the top four reasons why PAs choose to quit their job in a bit more detail.

4 Better compensation/benefits

What may surprise many of you is that #4 on this list of reasons PAs leave their jobs is directly related to pay.

You would think that compensation may be the #1 reason PAs seek greener pastures. But this research proves that once PAs make enough money to satisfy their basic needs (plus a few others ), the nonrenewable resources of time and life satisfaction often take precedence.

I recently left a well-paying private practice gig and accepted a lower-salaried position to pursue my dream career.

One could argue that doing what one wants in life (despite the almighty dollar) is a luxury afforded to those with the financial means to pursue their passions. But it is much more nuanced than that.

No one would criticize a PA for leaving a job in search of appropriate compensation. But if you are considering this route, remember the exorbitant cost of rehiring, as mentioned above. If you enjoy your place of employment and have proven value, you can always negotiate before leaving solely for pay.

Choosing reason #4 (more pay) to leave your current job can lead to #3 (toxic/abusive environment) if dollar signs are your main objective. I have seen it happen. Don't be afraid to make the administration aware of your value and always weigh your options.

3 Better management, leadership, environment (reasons related to a toxic or abusive environment)

The third most common reason PAs leave their job is for reasons related to toxic/abusive environment.

I have personally seen this A LOT in prior places of employment. Toxic environments created by supervising physicians and abusive coworkers or managers can create an unhealthy environment that is hard to mitigate.

I have left a job in the past due to stress created by a demanding supervising MD who (despite his best intentions) created an environment filled with anxiety and turmoil.

I have contemplated leaving workplaces associated with threatening leadership and watched as hospitals fell apart as clinicians and staff jumped ship seeking better places of refuge.

Research provided in the article found that 40% of PAs had quit a job in the past because of workplace stress, and this comes as no surprise.

Clinics and hospitals, and clinician-owned practices would be smart to pay attention to this research. While it is hard to avoid inter-office politics and "drama," much of the turmoil we face has to do with poor leadership that is oriented from the top-down.

2 Moving to a new location

The second-most common reason for PAs changing employers was that they moved away from their current employment.

The majority of Americans move for one of five reasons:

1. A new or better home/apartment (15%)
2. A family reason (other than getting married or starting a household) (15%)
3. A housing reason (other than wanting a new or cheaper house, better neighborhood, etc.) (14%)
4. To establish own household (10%)
5. New job or job transfer (9%)

Your income as a physician assistant is deeply tied to where you live. Connecticut had the highest salary for PAs at $137,060. Salinas, California, was the top-paying metropolitan area with an annual salary of $161,370. But according to data from the latest AAPA salary report, your true wage has a lot more to do with factors related to the cost of living.

1 Better work-life balance

The most common reason PAs reported changing employers was for better work-life balance.

According to the AAPA research article "employers may be limited by the demands of an industry tasked with providing around-the-clock patient care to address work-life balance effectively."

I would argue otherwise that the around-the-clock 24/7 nature of healthcare gives employers a perfect chance to work with employees to create a healthy lifestyle best suited for everyone.

Employers should offer more options for twenty or 30-hour workweeks and flexible (or reduced) schedules. They should make accommodations for career sabbaticals and extended (or short-term) leave. With the advent of telehealth and remote work blossoming during the COVID-19 pandemic, employers can offer work-from-home options. They should all make time for clinicians to complete administrative work as part of their scheduled work time instead of pushing it into their unpaid hours.

Work-life balance is attainable. Many administrators are too lazy, or employees are too afraid to ask for (or demand) what we need. And of course, until we separate benefits (particularly healthcare) from employment, this will continue to cause problems as employers will be stuck holding the bill, and employees have few options. I am hopeful this will change.

Have you left a job recently? We would love to know why in the comments section!

The post The 4 Most Common Reasons PAs Quit Their Jobs first appeared on The Physician Assistant Life.

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The Wealthy PA Part 3: Long Term Disability Insurance (and How to Buy it) View all posts in this series* The Wealthy PA Part One: Are PAs Wealthy? * The Wealthy PA Part 2: The Three Student Loan Repayment Strategies * The Wealthy PA Part 3: Long Term Disability Insurance (and How to Buy it)

If you lost the ability to work as a physician assistant, could you afford to live?

Roughly 30% of the population will find themselves with a long-term disability over a full working career. About one in seven people ages 35-65 can expect to become disabled for five years or longer.

Many people think they are adequately covered through their work, but here's a newsflash - you're probably not.

State Disability is temporary, and Social Security Disability is notoriously difficult to get approved for and only covers a fraction of your income.

The supplemental disability insurance offered by most employers is often short-term, covering only months of living expenses.

Therefore, you need to purchase your own long-term disability insurance either through your employer or an independent agent.

Being covered by disability insurance is one of the most important financial decisions you need to make, and we consider this mandatory insurance to own!

What is disability insurance? * If you are unable to work or unable to work as effectively as you normally would due to a physical or mental ailment, disability insurance replaces your income * For most working people, their greatest financial “asset” is their ability to work and earn a living * Disability insurance provides financial protection for that most important asset

Why do you need disability insurance as a physician assistant? * Unless you already can retire (financially), virtually every high-income professional should have disability coverage * If you were to be disabled for a significant period of time without disability coverage, you would experience significant financial hardship or ruin * Everything you worked so hard for during your schooling and career can be decimated in a short period of time

What type of disability insurance should a PA purchase? * There are two types of disability insurance: + Short-term disability insurance offers you a portion of your salary if you are unable to work for a short period of time (3-6 months) + Long-term disability insurance offers you a portion of your salary if you are unable to work for a longer period of time. The benefits last until you can go back to work or for the number of years stated in the policy. Some policies pay out as long as you are disabled until age 67

• We care much more about you having long-term disability insurance
• Short-term disability insurance is not needed if you already saved for an emergency fund

What if my employer offers group disability insurance? * Some employers may offer you group disability insurance as part of your benefit package + If they do, make sure you review the policy with an agent to ensure it provides adequate coverage! * An important detail on group disability plans that is not often mentioned is that the definition of disability in your group disability policy typically changes after 2 years of disability + This puts you at risk of no longer receiving benefits if you are still out of work due to sickness or injury * If your employer does not provide disability insurance (many will not), you need to work with an independent agent to purchase an individual policy

How much disability insurance do you need as a physician assistant? * For individual policies, typically the highest benefit you can get will range between 40% and 70% of your income. * Group policies typically provide 60% of your income up to a certain monthly cap, however the benefits are taxable * Generally, you want to aim to have at least 60% of your income covered

How much will disability insurance cost you as a PA? * A typical individual disability insurance policy will cost you 1-3% of the amount of income you are protecting * If you are a professional under age 30, the premiums for a good quality individual disability policy can typically be “locked-in” for somewhere between $100 to $300 per month * Every year that you wait, it becomes more costly, and you risk the ability to get the coverage if your health declines

How do you purchase long-term disability insurance as a PA? * Meet with a good independent disability insurance agent to discuss your situation and options. By independent, we mean that they can sell you policies from several different companies, not just one * When you work with an independent agent, you’ll need to provide them with additional information such as your age, gender, health, specialty, state where you live and work, etc. * They will then discuss policies available from each company with you. They should also help you compare them to your employer’s group policy * A good agent will be happy to teach you all about disability insurance, so make sure they review and explain the policy with you in detail

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About the author:

Wilson is a practicing inpatient oncology physician assistant and assistant professor. After graduation, he completed a PA Educator Fellowship at Touro University California and a Cancer Care Fellowship at Stanford. In addition to his clinical and academic roles, he has a passion for finance! He is the proud co-founder of APP Finance Clinic and enjoys helping guide physician assistants through their finances from graduation to retirement. (Read about Wilson's story here or click here to book a PA Finance consultation)

The post The Wealthy PA Part 3: Long Term Disability Insurance (and How to Buy it) first appeared on The Physician Assistant Life.