The Physician Assistant Life

Murmur Madness: The Audio PANCE and PANRE Episode 45

Murmur Madness The Audio PANCE and PANRE Board Review PodcastWelcome to episode 45 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Today we are going to take a brief detour away from 10 daily questions and instead cover the murmurs you need to know for your PANCE and PANRE exam.

I have still included an 11 question exam at the end of this post so make sure you scroll down after you listen to the podcast.

There are a total of 17 cardiac conditions that may present on exam day in the form of a descriptive sound/murmur.

You will often be given supporting evidence such as the location of auscultation or radiation which you can use to narrow down your options.

There are total of 51 cardiac topics in the  NCCPA™ Cardiology PANCE and PANRE Content Blueprint which represents 16% of the PANCE and PANRE exam.

(click here to download the FREE NCCPA Content Blueprint cheat sheet)

These cardiac conditions and their associated murmurs cover a whopping 33% of the cardiology section of the PANCE and PANRE exam!

Take a listen to this week's podcast episode

If you can't see the audio player click here to listen to the full episode.

Let's break this all down:

Each of the links below opens the corresponding lesson on SmartyPANCE and is available to members (you must be logged in or join now)

There are 9 valvular disorders associated with murmurs:

Valvular Disorders (PEARLS and Flashcards)

  1. Aortic stenosis (ReelDx)
  2. Aortic regurgitation (Diastolic Murmur)
  3. Mitral stenosis (Diastolic)
  4. Mitral regurgitation
  5. Mitral valve prolapse
  6. Tricuspid stenosis
  7. Tricuspid regurgitation
  8. Pulmonary stenosis
  9. Pulmonary regurgitation

Five congenital heart diseases that have corresponding murmurs

Congenital Heart Diseases (PEARLS)

  1. Atrial septal defect
  2. Coarctation of the aorta
  3. Patent ductus arteriosus
  4. Tetralogy of Fallot
  5. Ventricular septal defect

One murmur associated with cardiomyopathy

  1. Hypertrophic cardiomyopathy

And a pair of conditions nested under the label of "other forms of heart disease" that have associated murmurs/heart sounds worth mentioning

Other Forms of Heart Disease (PEARLS)

  1. Acute and subacute bacterial endocarditis
  2. Acute pericarditis

Making Sense of Murmurs

Let's start with the valvular disorders:

You have 4 heart valves with two main conditions - half are diastolic murmurs and half are systolic murmurs. Here is a helpful mnemonic:

Recalling Common Systolic Heart Murmurs: MR PASS

  • itral
  • egurgitation
  • hysiologic (also known as functional, systolic flow murmur, a heart murmur heard in the absence of cardiac abnormality)
  • ortic
  • tenosis
  • ystolic - All the above murmurs are heard during systole.

MR PASS wins the Most Valuable Player award.

  • itral
  • alve
  • rolapse - Add MVP as another systolic murmur.

MR PASS often hangs around with MS ARD.

  • itral
  • tenosis
  • ortic
  • egurgitation
  • iastolic - All the above murmurs are heard during diastole.

Here are the nine valvular murmurs and their associated descriptions

Remember which are systolic and diastolic this can be very helpful at ruling out or ruling in a condition come exam day.

  1. Aortic Stenosis - Systolic harsh ejection crescendo decrescendo murmur at RUSB (aortic area) with radiation to the neck and apex
  2. Aortic Regurgitation - diastolic - soft high pitched blowing at LSB with patient sitting leaning forward and exhaling
  3. Mitral stenosis - diastolic - low pitched decrescendo rumbling with opening snap at the APEX (the mitral area) enhanced by expiration
  4. Mitral regurgitation - blowing holosystolic murmur loudest at the APEX (the mitral area) with a split S2 that radiates to the axilla and is increased by squatting, handgrip and expiration
  5. Tricuspid Stenosis - diastolic - mid diastolic rumbling at LLSB (tricuspid area) with opening snap
  6. Tricuspid regurgitation - High pitched holosystolic blowing murmur that radiates to the LSB (tricuspid area)
  7. Pulmonic stenosis - harsh midsystolic ejection crescendo-decrescendo murmur with widely split s2 at LSB that radiates to the left shoulder and neck
  8. Pulmonic regurgitation - diastolic -  high pitched, decrescendo murmur at LUSB increase with inspiration
  9. Mitral valve prolapse - Midsystolic ejection click head best at the APEX (the mitral area)

With these valvular murmurs you have 4 auscultation points which can be easily remembered using the mnemonic APT Ment watch this amazing video so you never forget!

Another helpful mnemonic: Aortic Pulmonic Tricuspid Mitral - ll P hysicians T ake M oney!

cardiac-auscultation-locations

  1. Aortic area: right 2nd interspace (Right upper sternal border RUSB)
  2. Pulmonic area: 2nd left interspace (Left upper sternal border LUSB)
  3. Tricuspid area: Left lower sternal border LLSB
  4. Mitral area: APEX

You can use the auscultation point to successfully narrow down your murmur and use the designation of systolic or diastolic to narrow down even further.

Five congenital heart diseases that have corresponding murmurs

Congenital Heart Diseases (PEARLS)

  1. Atrial septal defect - Systolic ejection murmur at 2nd left intercostal space with an early to mid-systolic rumble and fixed splitting of the 2nd heart sound (s2) and CXR will show pulmonary vascular markings.
  2. Coarctation of the aorta - Late systolic ejection murmur-posterior or continuous murmur if collateral flow. Will have absent or weak femoral pulses with a delay of palpable femoral pulse and HTN in arms but low or normal blood pressure in the legs
  3. Patent ductus arteriosus - Continuous, rough, machinery-like murmur, heard best in the first interspaces of the LSB
  4. Tetralogy of Fallot - Harsh systolic ejection murmur heard best at the left sternal border. Associated with bluish skin, trouble gaining weight, and sudden loss of consciousness during crying or feeding
  5. Ventricular septal defect - Harsh high pitched holosystolic murmur heard best at the LSB with ride radiation and a fixed split S2

One murmur associated with cardiomyopathy

  1. Hypertrophic cardiomyopathy - Medium-pitched, mid-systolic murmur that decreases with squatting and increases with straining. S4 gallop and apical lift with thick, stiff left ventricle. HCM is the leading cause of sudden death in athletes and may cause angina.

Several of these conditions have a "tell" that make it easy to identify the condition and they are usually always part of the question stem

  • HOCM Sudden death in athlete
  • Atrial Septal Defect Fixed wide splitting of S2
  • Coarctation of Aorta X-Ray, Rib notching, absent or weak femoral pulses with a delay of palpable femoral pulse and HTN in arms but low or normal blood pressure in the legs.
  • PDA Machine like murmur
  • Tetralogy of Fallot Cyanosis with crying or feeding
  • VSD Holosystolic Murmur

And a pair of conditions nested under the label of "other forms of heart disease" that have associated murmurs/heart sounds worth mentioning

Other Forms of Heart Disease (PEARLS)

  1. Acute and subacute bacterial endocarditis  - A new mitral regurgitant murmur in a patient with a history of IVDA, fever (39.0º C),* and a blood culture that reveals 2 out of 2 positive growth
  2. Acute pericarditis - Although this is not a murmur, it is important to identify a pericardial friction rub heard best with patient upright and leaning forward. Chest pain is also relieved by sitting and/or leaning forward

You can listen to all these murmurs and see their associated waveforms at www.smartypance.com/courses/cardiology

Here is a wonderful video from the Khan Academy of how to approach murmurs video of murmurs

Murmur Flash Cards

Episode 45 PANCE and PANRE Murmur Quiz

You will see from these questions on the PANCE and PANRE things aren't always so straightforward.

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Your answers are highlighted below.
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Looking for all the podcast episodes?

This FREE podcast series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SmartyPANCE

I will be releasing new episodes every few weeks. The Academy is discounted and now includes complimentary access to SmartyPANCE so sign up now.

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ReelDx is now part of SmartyPANCE!

Included is a full cardiology content blueprint board review exam with over 147 cardiology specific questions and 51 cardiology blueprint topics covered in detail. This is in addition to 1,000's of additional board review questions and NCCPA content blueprint courses covering all 13 organ areas.

I am also happy to introduce ReelDX™ patient case based integration into many of the SmartyPANCE blueprint lessons. It's like a virtual rotation from the comfort of your couch!

If you want ReelDx just sign up on SmartyPANCE - It's just a $10 upgrade!  You can Sign up HERE

 This podcast is available on iTunes and Stitcher Radio (among others)

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

 

Does PA Program length matter?

does-pa-program-length-matter

In 2004 I graduated from the UMDNJ (now Rutgers) PA program.

It was a three-year PA program with a nearly 100% PANCE pass rate.  At the time, Rutgers was one of the best ranked PA schools in America and they continue to rank among the top 25 PA schools in the country.

As an avid practitioner of the confirmation bias I fell victim to the "more is better" principal and figured that my 3 year PA school program naturally must provide a more  comprehensive education.  Why else extend the length of a program?

But a recent article published by the PAEA in the Journal of Physician Assistant Education provides a more scientific answer to this question.

Does a longer PA program have any advantage over a standard two-year program?

In March of 2016 the PAEA published this research article examining the relationship between physician assistant educational program length and PA programs' 5-year  average PANCE first time pass rates.

Relationship Between Physician Assistant Program Length and Physician Assistant National Certifying Examination Pass Rates

Fifty years ago Duke University graduated the first class of physician assistants as part of a two-year program whose goal was to rapidly deploy these clinicians to assist physicians in delivering medical care.

During the past two decades, the PA program length has increased to an average of 26 months, with some programs spanning 36 months.

The longer programs were developed to accommodate the extra time needed to complete a master's program senior project.

The "more is better" attitude has some negative consequences including

  • Increased student debt
  • Delayed entry of qualified clinicians into the health care system at a time of practitioner shortage

As longer program became more common, some medical educators questioned whether 2 years was an appropriate length of time to train PAs, especially in light of their expanding scope of practice and the decrease in pre-pa school medical experience which defined the previous generation of PAs.

Since we PAs need to pass the PANCE exam to be eligible to practice and the fact that this is an indicator of entry-level clinical competence, there is an obvious advantage to knowing whether a longer length of training is associated with higher PANCE pass rates.

Time is of the Essence

The Association of American Medical Colleges predicted a shortage of more than 60,000 physicians in 2015, and a shortage of twice as many by 2025.

The PA field is experiencing rapid growth and increased demands.

The Bureau of Labor Statistics has predicted a 30% increase in demand for PAs over the next decade, a much faster than average rate of growth.

In response to the shortage of physicians and the increased demand for PAs, institutions of higher education have recognized the imminent need for more PA graduates.

Encouraged by the high rating of career potential for the profession, these institutions have initiated the development of many new programs.

As of October 2016, there 218 accredited programs (153 with continuing accreditation), with even more applying for provisional accreditation (46 schools) in the United States.

There are also a number of established and developing PA programs in other countries.

number-of-accred-programs-9-2016

Do longer PA programs lead to greater levels of PA competence?

Successful PANCE passage suggests PA graduate competency.

If study results indicated that shorter PA programs prepared students to pass the PANCE as well as longer programs do, then educators might have the incentive to structure shorter programs.

Reducing the length of training while maintaining competent graduates would help to reduce PA student debt, ease clinical site competition, and more expeditiously deploy PA graduates into the health care workforce.

Relationship Between Program Length and PANCE Pass Rates

pa-program-length-and-pance-pass-rates

Median total PA program length is 27 months, with total program length ranging from a minimum of 24 to a maximum of 36 months.

  • Median program's 5-year average first-time PANCE pass rate was 95%.
  • Program PANCE pass rates ranged from a minimum of 73% to a maximum of 100%.

Data on individual phase length (didactic and clinical phase) of programs

  • Median length of the didactic phase was 13 months, with a minimum of 10 and a maximum of 22 months.
  • Median length of the clinical phase was 12 months, with a minimum of 10 and a maximum of 24 months.

Program phase length and PANCE pass rates demonstrated no significant relationship for the didactic phase, and no significant relationship for the clinical phase

Discussion

Medicine is an ever-changing field that continues to grow in both volume and complexity.

As a result, the amount of information and skills that a PA student must master has become burdensome; this information overload may prompt PA educators to consider lengthening the educational process.

Although increasing the number of PAs graduating each year will help to partially mitigate the physician shortage, the effects of longer length programs on students and educational institutions must be considered.

There are several considerations regarding longer educational programs:

  1. Competition is increased for clinical sites because more new programs are being developed and longer programs require additional clinical training sites
  2. There is an inadequate number of experienced PA faculty to cover the required coursework needed for a longer curriculum
  3. Students incur increased tuition debt, which can exceed $100,000 at private universities. This expense may prompt PA graduates to opt for more lucrative careers in specialty medicine and forego the primary care field where the greatest need exists.
    • It is predicted that only 16% of new PA graduates will fill primary care positions by 2025!

How about shorter Medical School?

In a similar manner, it has been suggested that streamlining medical education for physicians and shortening the length of training would lower student tuition debt and focus attention on team-based medicine.

Several medical schools already offer shorter programs. Although there are limited outcome data on graduates of these schools, there is no evidence that they perform poorly on board examinations.

The authors of the study call for a 30% reduction in medical education length by 2020.

The Results

does-pa-program-length-matter-2

Study analysis indicated no relationship between total program length or individual didactic or clinical phase length and PA program's average PANCE pass rates.

The implications of this study suggest that shorter PA programs prepare students to pass the PANCE and enter the workforce as effectively as longer programs.

With the anticipated rapid growth of PA programs, these results could influence established and developing program directors' decisions on determining program length.

Since the current average program length is 26 months, program directors may feel the need to replicate this curriculum model; however, as noted, there are drawbacks to longer programs.

Longer PA programs are associated with:

  • increased institutional costs
  • increased demand for faculty
  • increased student debt
  • a delay in deploying clinicians into the workforce
  • increased institutional costs for faculty, advisor, and staff support
  • additional classroom space
  • an additional semester of preceptor stipends for scarce clinical experiential practice rotations

Not to mention, students in longer programs will accrue additional fees as well as housing, transportation, and tuition costs for each additional semester

Owing to clinical site shortages, many programs are now paying for clinical rotations, increasing the cost of operating the program.

Final thoughts

Since grading and joining the workforce, I have had the had the opportunity to work alongside dozens of competent, highly skilled, compassionate, hard-working, and dedicated PAs, most of whom attended 27 month programs.

Each one of them is proof positive that my superiority complex was completely unwarranted.

This article proves my growing suspicions that longer PA programs offer no real benefit with evidence to suggest longer programs have unwanted side effects such as increased student debt, a strain on faculty, institutions, and rotation sites.

The downstream consequences of increased PA school debt are pushing more and more new PA school graduates into specialty practice based on financial necessity.

While I admit PANCE pass rates are not the best predictor of professional acumen my anecdotal evidence supports the research provided in this study.

Also, I completely agree with the authors who support a 30% reduction in medical school education.

In many parts of the world the medical school didactic phase is combined with a two-year undergraduate program resulting in a much shorter and highly focused medical education. Often just five years. This would bring many new applicants (many who currently are on the PA school track) into the role of supervising physician.

Technological advances can not be ignored and will be a huge factor in augmenting and automating our medical knowledge allowing for greater ease of providing  real-time evidence based medicine using the most up to date clinical guidelines without the need to memorize and ever growing web of medical data.

Using knowledge from studies like these along with tools to gather, collect and digest big data we can work together to maintain a highly skilled compassionate medical workforce while decreasing student debt, reducing medical error and driving down healthcare costs.

PAs will continue to be at the forefront of this transition for years to come.

Resources: The Journal of Physician Assistant Education: March 2016 - Volume 27 - Issue 1 - p 3–6

The PANCE and PANRE Content Blueprint Checklist

pance-and-panre-nccpa-content-blueprintYour Blueprint to Success Starts Here!

If you are at all like me the hardest part of studying for your PANCE or PANRE is figuring out where to begin.

There is an ever growing list of review books, podcasts, online programs, in-person review courses, and anecdotal recommendations to choose from.

It is overwhelming!

So the key to success is to choose one or two, set a study schedule and STICK WITH IT!

The NCCPA is kind enough to provide us with a list of topics that will be on the exam in the form of the NCCPA™ Content Blueprint.

They do not deviate from this list of topics. Sometimes their questions are frustratingly complex or convoluted for sure, but, it is a safe bet that if you know the key terms from each of these topics you will pass your exam.

The take home message from the NCCPA is clear: follow the blueprint and your success is guaranteed, but who has time to review and memorize 467 diseases?

The NCCPA™ Content Blueprint Breakdown

  1. Cardiology 16% - 51 topics (diseases)
  2. Pulmonary 12% - 32 topics (diseases)
  3. GI and Nutrition 10% - 41 topics (diseases)
  4. Musculoskeletal 10% - 39 topics (diseases)
  5. ENT 9% - 57 topics (diseases)
  6. Reproductive 8% - 46 topics (diseases)
  7. Genitourinary 6% - 30 topics (diseases)
  8. Neurology 5% - 27 topics (diseases)
  9. Endocrinology 6% - 18 topics (diseases)
  10. Psychiatry 6% - 26 topics (diseases)
  11. Dermatology 5% - 45 topics (diseases)
  12. Hematology 3% - 18 topics (diseases)
  13. Infectious Disease 3% - 35 topics (diseases)

Total: 13 organ systems and 467 topics (diseases)

Some topics are very narrow such as viral croup, other topics are extremely broad such as normal labor and delivery... I mean seriously how do you even begin to wrap your head around this one?

To simplify this process, I am providing you with this interactive content blueprint checklist.

I have also been compiling pearls sets with flashcards to help simplify the review process and help you hone in on the questions stems that should help guide you to the correct answer.

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.

Follow this link to download your FREE copy of the Content Blueprint Checklist

pance-and-panre-nccpa-content-blueprint

FREE Download

This is a completely interactive checklist and unlike a static book I have created a searchable online index of the entire content blueprint as part of the Smarty PANCE/PANCE board review website.

The checklist links to each of these 467 topics, members can simply click on a topic to explore it further.

Also included are 13 topic specific content blueprint exams available to all members, as well as a slough of other exams and review material.

Members of both the PANCE and PANRE Academy and Smarty PANCE receive access to both sites with a single login... Cool!

If you are interested in becoming a member you can sign up here (The PANCE and PANRE Academy) or here (Smarty PANCE + ReelDx)

If you have any questions or need help along the way don't hesitate to drop me a line or leave me a message in the comments.

Warmly,

Stephen Pasquini PA-C

Episode 43: The Audio PANCE and PANRE Board Review Podcast

the-audio-pance-and-panre-academy-physician-assistant-board-review-podcastWelcome to episode 43 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will continue to take a break from topic specific board review and covering 10 general board review questions.

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can't see the audio player click here to listen to the full episode.

Episode 43 PANCE and PANRE Podcast Quiz

1. A mother brings in her five-year-old boy for his school physical. She voices some concerns about his readiness for school, saying he seems to be socially immature. She has noticed he does not interact with other children well, and that when he plays with them, he has a tendency to "place them" and then run around them as if they were statues. He rarely cries when he is hurt, and he shrugs off any attempt to hug him. He has good attention to details, and will sit and draw the same geometric shapes over and over again, but does not seem interested in learning the alphabet. He avoids eye contact with anyone. Which of the following is the most likely diagnosis?

  1. Normal 5 year-old
  2. Social phobia
  3. Autism
  4. Avoidant personality
Click here to see the answer

2. A 3-week-old male infant presents with recurrent regurgitation after feeding that has progressed to projectile vomiting in the last few days. The mother states that the child appears hungry all of the time. She denies any diarrhea in the child. Which of the following clinical findings is most likely?

  1. Bile-stained vomitus
  2. Hemoccult positive stools
  3. Olive-sized mass in the right upper abdomen
  4. Sausage-shaped mass in the upper-mid abdomen
Click here to see the answer

3. A 65 year-old with COPD receiving their first pneumococcal polysaccharide PPSV23 vaccination should be revaccinated in

  1. 1 year
  2. 3 years
  3. 5 years
  4. Never
Click here to see the answer

4. Which of the following therapies is recommended for a 13 month-old child with sickle cell disease?

  1. Folic acid and penicillin V
  2. Ferrous sulfate and penicillin V
  3. Folic acid and ferrous sulfate
  4. Folic acid, ferrous sulfate and penicillin V
Click here to see the answer

5. A patient with severe COPD presents to the Emergency Department with a 3 day history of increasing shortness of breath with exertion and cough productive of purulent sputum. An arterial blood gas reveals a pH of 7.25, PaCO2 of 70 mmHg and PaO2 of 50 mmHg. He is started on albuterol nebulizer, nasal oxygen at 2 liters per minute, and an IV is started. After one hour of treatment, his arterial blood gas now reveals a pH of 7.15, PaCO2 100 mmHg and PaO2 of 70 mmHg. Which of the following is the most appropriate next step in his treatment?

A. Decrease the oxygen flow rate.
B. Administer oral corticosteroids.
C. Intubate the patient.
D. Administer salmeterol (Serevent)

Click here to see the answer
Explanations

6. A patient should be tested for tuberculosis prior to being treated with

A. etanercept (Enbrel).
B. cyclosporine (Neoral).
C. methotrexate (Rheumatrex).
D. prednisone (Deltasone).

Click here to see the answer
Explanations

7. Which of the following side effects is associated with long-term administration of phenytoin (Dilantin)?

A. Ataxia
B. Hypotension
C. Osteomalacia
D. Cardiac dysrhythmia

Click here to see the answer
Explanations

8. Hairy leukoplakia has the greatest prevalence of distribution on the

A. palate.
B. floor of the mouth.
C. lateral tongue.
D. gingiva.

Click here to see the answer

9. 75 year-old male presents for a routine physical. Vitals are normal with no orthostatic changes. On physical examination, a fine cortical movement with repetitive rubbing of the tip of the thumb along the tips of the fingers is noted at rest. Which of the following is the most likely diagnosis?

A. Seizure disorder
B. Peripheral neuropathy
C. Shy-Drager syndrome
D. Parkinson's disease

Click here to see the answer
Explanations

10. A 45 year-old female presents to the emergency department with generalized, hot, erythema of the skin. Physical exam reveals an oral temperature of 102 degrees Fahrenheit, purulent conjunctivitis, and mucosal erosions. Her skin is painful and separates from the dermis with touch. Which of the following is the most likely cause for this condition?

A. Penicillin
B. Prednisolone
C. Aspirin
D. Hydrochlorothiazide (HCTZ)

Click here to see the answer
Explanations

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy .

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

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Married with Children in PA School: How This Mom Makes it Work

Married with Children in PA School - How This Mom Makes it WorkMy name is Nikki, and I am a mother of two boys, 2 and 6 years old.

I am also a PA student.

For me, it was a long and difficult journey to get into PA school. I applied three consecutive years before finally getting accepted to a PA school in San Antonio, which is about a 3-hour drive from where I live.

Although I was excited to finally be accepted, it was a difficult decision for me and my family because it meant I had to move out to San Antonio while my family stayed behind.

I knew it would be hard, but I could not lose this opportunity. I was one of the 45 students accepted out of 1,800 applicants and I needed to figure out how to make it work.

I Couldn't do it Alone

My husband and my mom are very supportive and I would not be able to do it without them.

My mom decided to move in with us and help us to take care of the kids. The most difficult part for me at the beginning was to help my mom and my husband to get along. They are both great but it is hard for them to work well together because they both have very strong personalities. However, it seems to be getting better so I can’t complain now.

I go home to see my children over the weekends and try to communicate on Skype almost every day. It has been six months since I started PA school and it has gone by really fast since I am so busy.

My 6-year-old was getting into trouble in school and a couple of times I had to drive back and forth from San Antonio to be able to attend his class and the meetings with his teachers.

I used to overreact to his “bad behavior” but it only made things worse. I don't like to feel like I have no control in raising my children, so sometimes I get too emotional. I appreciate it when my husband or my mom do exactly what I ask them to do regarding the kids because it makes me feel like I can contribute to their life the way I think is the best for them.

I know it sounds silly and not very reasonable but I want to feel like I am still a big part of making decisions for my kids.

Finding Time to Study

I really need my weekends to study so when I come home to see my family I try to spend one full day and night with them and then go back to studying.

I do miss my family and some weekends I cannot come to see them, especially when we have finals or too many tests at once. On these occasions, we found a bus that my mom can take and bring the kids with her. I love it when this happens because I get to see them and will not waste 6 hours driving back and forth when I can spend this time studying.

The PA program in San Antonio is far more advanced than I expected. I have never studied so hard in my life even though I have two degrees. We already had some people that had to leave the program because they did not make it through the first semester. I know I have to be diligent and manage my schedule the best I can.

I don't think I have a typical situation since I do not really live with my family at the moment but I am sure there are people who are in my shoes or will be.

PA schools are very competitive and it is becoming harder and harder to get in. Unfortunately, you will not always be accepted at the PA school of your choice (or maybe fortunately because I love my school now).

I think the benefit of my situation is that I can actually study at home anytime and not feel anxious to go home and see my kids every day since they are not here.

I do miss them and love them very much but I keep reminding myself of my goals and sacrifices. I explain to my 6-year-old son that I study now so I can help people to be healthier and so we can afford to travel.

He is excited about this and sometimes says he wants to go to my school instead of his.

Advice to PA School Parents

If I were to give advice to future PA school students with children I would say stay focused on your main goal and know why you are doing this.

I do have my moments when I cry and get emotional but I talk to my kids, my husband, and my mom and they make me feel better. I remind myself that time goes by fast and I am pursuing my dream that will not only benefit me but my family and many other families in the future.

I would encourage you to connect with people in your class and make good friends. It has helped me to stay positive through difficult times. You have to develop inner strength that will carry you through any personal problems and still allow you to focus on studying. Otherwise, it will not be possible to make it.

We have a great tradition in our school. The class that was before us assigned each one of the new students a “Big person”. They just matched one person with another one according to some similarities. My “Big” has two children and they live with her. She was really helpful and supportive throughout my first semester. She made me feel more "normal” on several occasions when I did not know what to do.

She gave me advice on how to cope with problems and how to best address my needs along with those of my family throughout PA school.

I have two more years to go and I know they will go fast. I am enjoying my journey but I can’t wait to go back to my family and be there with them and for them.

All I can say is to get your support system together, make sure you have reliable people who can help you throughout the whole program and you can definitely make it through.

Best of luck pursuing your dreams!

This is a guest post by current PA student extraordinaire Nikki Clark

Nikki has been a licensed acupuncturist for 9 years. When a PA saved her son’s life it triggered her to choose a path of becoming a PA. She is pursuing her dreams to become a PA and to be able to educate people on prevention and treatment of illnesses and diseases. She has two sons and a supportive family that inspires her to be a better person and to stay strong and positive.

Also, in case you were curious, I asked Nikki about her mom, her husband's feelings about her moving to San Antonio to attend PA school and why they chose to live separately during her time as a student. Here is her answer:

I am originally from Ukraine and then lived in Houston since 2006.  My mom was living in Ukraine and had to make a big move for me. I really admire my mom. I do not think I could have been where I am today without her love and support. My husband's job keeps him in Houston so moving for him was out of the question.

My husband was supportive but truly very sad about me moving away. However, since it is only a 3 hour drive it does not seem too bad. I think the worst part for him is dealing with my mom and  trying to have his life arranged completely differently. But he has been with me throughout the whole process and is still there for me. We try to make date nights whenever we can and communicate over the phone every day. He sends me pictures of the kids and comes here whenever he can.

*If you or anyone you know is interested in submitting a guest post to the blog just drop me a line at stephen@thepalife.com - if your article is accepted you will receive a $50 Amazon gift card or a free 1 year subscription to the PANCE and PANRE Academy (your choice). Stay tuned our next PA parenting article will be from a father of two!

A Question for Physician Assistants: Why Are You In It?

Why Are You In It? The Physician Assistant Life

Are you looking to make money as a physician assistant or are you looking to make the world a better place with what you do?

It’s an honest question and the two options are very different.

The latter involves being interested in giving value to someone other than yourself. The former involves doing anything and everything to add zeros to your bank account.

Neither option is inherently wrong. The problem is that most PAs begin with a desire to help people and, over time, once fully indoctrinated into the "system" they (we) become fundamentally changed.

If you’re simply looking to make money, the strategy basically comes down to generating as much revenue as you can, while avoiding an unfavorable outcome. Or, as we in the medical field have so humbly named "covering your ass."

Sometimes it’s as simple as showing your boss that you can see 6 or 7 patients in an hour.  Sometimes it’s not speaking up in the face of gross healthcare inequalities.  Sometimes it’s taking the higher paying job in order to please others or prove your self-worth.

The organization you work for, and therefore you, do whatever it takes to maximize profitability.

Success is much easier to measure too—you simply look at how many patients you have churned out, and count how much money you make.

Did it cover costs? Does it cover your livelihood and expenses? Were you able to maximize your retirement accounts? Is your boss happy? Awesome - you win and you’re a success.

If you’re looking to make the world better with what you do, it’s a little more difficult.

Haiti-2013-023

Just because you want to make things better doesn’t mean the universe will align and show you the way.

Making the world a better place through the work you put out into it starts with you and how you answer the tough questions.

Do you actually like the work you’re doing? Does it align with a greater purpose in your life? Is the message behind what you do bigger than what you do? Are you truly stoked to do it?

People are attracted to excitement, so if you’re genuinely excited about something, others will take notice. Real excitement is contagious, like the flu (but with less sniffling).

Though doing something that makes the world better doesn’t stop with you. It also includes being super valuable and in service of others.

What about your work helps your patients? What about your work makes their life better? What about your work makes them truly stoked? Because when they’re excited, others will take notice of that too.

Measuring "Success" 

Haiti-2013-237

Measuring the success of doing work that makes the world better is also a little muddy. There are several key performance indicators (KPIs) involved, each of them based on your own unique purpose and passion.

Sure, patient wait times, satisfaction surveys and money or revenue may be a part of it, but they’re not the only indicators. How much did you enjoy the process, regardless of the bottom line?

How much did your patient benefit from your work, regardless of the volume (as in, maybe you only saw 10 patients today, yet all of them  left healthier, having an experience that positively changed their lives).

In measuring success this way, it’s fairly easy to succeed as well - you get to do work you love that’s lined up with your purpose and valuable to the patients it’s for.

So, did you like doing it and did another person like receiving your care?

Awesome - you win and you’re a success.

Haiti-2013-154

We get caught up and stuck in our thoughts when we change gears in our focus, or when we try to measure success for both types of work for the same outcome.

If you’re in it to make the world better and you only look at money, you’re doing your work and process a horrible disservice.

Similarly, if you’re in it to make money and you feel unexcited or uninspired, you’re also doing that work and yourself a horrible disservice too.

If you're in it to make the world better and you look at the patient sitting in front of you, you’re doing yourself, and your patient a great, and honorable service.

Magically, you're likely to find, the success that drove you to this profession in the first place, will follow.

PS: If you’re stuck before you’ve even started, check out my resources page for some help and inspiration. 

Photo Credits:  From our medical mission trip in and around Port Au Prince Haiti. photos by: Courtney Reese

Scholarships, Grants and Loan Repayment Programs for Physician Assistants

How to Bankroll PA School Without Going BrokeIt goes without saying, PA school is expensive.

PA school is also demanding, which means you will have limited time (if any) to work while attending school.

With the average undergraduate education debt prior to PA school at $36,300 and the average anticipated debt load from PA school at $75,000-$124,000, it is important that you have a rock-solid plan for how you are going to pay for your PA school education.

Funding sources vary and federal loan programs will probably form the foundation of your assistance package, many states also offer financial aid funding.

Additionally, there are specialized scholarships, traineeships, and loan programs available. Remember — apply the resources from scholarships and grants before you accept loans. Then, only accept loans that you need.

Work closely with your financial aid department. They will be able to inform you about special loans and scholarships for which you may be eligible.

Federal and State Resources

  • Numerous loans and grants guaranteed by the federal government are available to qualified students. Visit the website for Federal Student Aid sponsored by the U.S. Department of Education.
    • Direct Subsidized Loans are loans made to eligible undergraduate students who demonstrate financial need to help cover the costs of higher education at a college or career school.
    • Direct Unsubsidized Loans are loans made to eligible undergraduate, graduate, and professional students, but in this case, the student does not have to demonstrate financial need to be eligible for the loan.
    • The Federal Perkins Loan Program is a school-based loan program for undergraduates and graduate students with exceptional financial need. Under this program, the school is lender. You must check with your school's financial aid office to see if your school participates in the Federal Perkins Loan Program
    • Federal Stafford Student Loan Program: These loans are offered through your bank, credit union, or other lending institutions. Graduate students may borrow up to $8,500 per year up to a total of $65,000. To qualify for a Stafford loan, you must demonstrate financial need as determined by the CM formula mentioned above. The interest rate varies. These loans are based on need, not creditworthiness. Therefore, no cosigner is necessary.
  • State sources of financial assistance include an agency in each state that guarantees federal student loans. Also, some states offer their own educational assistance programs with loans or grants. Check with your financial aid office to locate the office(s) in your home state.
  • Tax Credits are another option to explore.                                            

Scholarships and Traineeships

  • Americorps is a national network of hundreds of programs throughout the U.S. and is open to U.S. citizens, nationals, or lawful permanent residents aged 17 or older. This program helps pay for education in exchange for a year of service.
  • The Indian Health Service (IHS) scholarship program provides financial assistance for American Indian and Alaskan Native (federally recognized only) students enrolled in health professions and allied health professions programs. The IHS Loan Repayment Program (LRP) was created to support this mission by providing health professionals the financial freedom to fulfill your career goals. The IHS LRP awards up to $20,000 per year for the repayment of your qualified student loans in exchange for an initial two-year service obligation to practice full time at an Indian health program site.
  • The National Health Service Corps Program (NHSC) is a competitive federal program. Students dedicated to practicing primary care in communities of greatest need can compete for educational scholarships. I was a NHSC Scholar and you can read more about that here. They also offer a generous loan repayment program in exchange for 2 years service in a designated healthcare shortage area (see the next section below).
  • The Physician Assistant Foundation offers competitive scholarships for PA students who are currently attending an accredited PA program, are in the professional phase of the program, and are student members of AAPA. Visit the Foundation web pages for a current application or see below.
  • The United States Navy Health Services Collegiate Program is designed to provide financial incentives for college students in designated health care professions while completing baccalaureate degree requirements.
  • The U.S. Army Health Care team, offers a three-year loan repayment program for any PA- C who wants to serve as an Army PA.
  • PAs for Latino Health (PALH), a caucus of the AAPA, offers a $500 scholarship to currently enrolled PA students each year.

Loans, Repayment Programs, and Consolidation Services

  • The National Health Service Corps (NHSC) Loan Repayment Program is available to PAs in primary care or current students who plan to become primary care providers after graduation. You must agree to provide primary care services in a priority health professional shortage area for a minimum of two years.
  • Public Service Loan Forgiveness Program: The Public Service Loan Forgiveness (PSLF) Program forgives the remaining balance on your Direct Loans after you have made 120 qualifying monthly payments under a qualifying repayment plan while working full-time for a qualifying employer. Physician assistants qualify.
    • IMPORTANT: Loan forgiveness is an option after 10 years of payments, but it may not be an option if you refinance your loan during that period. So make sure you read the fine print!
  • Sallie Mae Tuition Pay Plans provide quality, low-cost, innovative solutions to paying for education. Tuition Pay is an interest-free plan that lets you break down the large lump-sum payments due at the beginning of each semester into easy-to-manage installments.
  • Common Bond: Ever wished your student loans could have a positive effect on society? Common Bond seeks to "reimagine finance based on our belief that business has a responsibility to further social good and promote welfare outside of its immediate customer base." Common Bond is unique in that they bring a 1-for-1 model to education through Social Promise. For every fully funded degree on the CommonBond platform, they fund the education of a student in need for one year through the nonprofit Pencils of Promise. They even fund a trip to Ghana with Pencils of Promise so that borrowers (and employees) can go and meet some of the children who the Social Promise has helped to fund.

Insider's tip: Looking to refinance a loan? Magnify Money is a wonderful website that lets you compare and contrast student loan options.  Just beware that if you have federal loans, refinancing to private loans may result in losing protections like special repayment plans (such as the public loan forgiveness program) that can help you in a time of need. Make sure you can comfortably afford your new payments if you refinance. And take the time to get rates from several providers.

AAPA Constituent Organization Scholarships

  • The Physician Assistant Foundation offers competitive scholarships for PA students who are currently attending an accredited PA program, are in the professional phase of the program, and are student members of AAPA. Visit the Foundation website for a current application.  Here are some of their current offerings. The 38 PA students who were awarded scholarships during the 2014 application cycle are listed here.
    • Bristol-Myers Squibb Endowed Scholarship — four $2,500 awards
    • National Commission on Certification of Physician Assistants (NCCPA) Endowed Scholarship — six $2,000 awards
    • Procter & Gamble Endowed Scholarship — six $1,000 awards
    • AAPA Rural Health Caucus Scholarship — two $2,000 awards to students from a rural area, who are committed to serving a rural community.
    • Ron Pace Memorial Scholarship — one $1,000 award to Florida-based students who are veterans and in their second year of PA school. Named in memory of Ron Pace, a Florida Academy of Physician Assistants past president and AAPA Outstanding PA of the Year Award recipient, who served in the U.S. Navy for 20 years.
  • Association of Physician Assistants in Oncology offers a $2,500 award for PA students. The award consists of two parts: $500 to help with travel to AAPA's Annual Conference to receive the award and $2,000 (unrestricted). Apply by March 1st.
  • California Academy of Physician Assistants offers three annual student scholarships for student members. Apply online by December 31.
  • Lesbian, Bisexual, and Gay Physician Assistant Caucus offers $1,000 grants for two PA students to attend AAPA's Annual Conference to help foster involvement and awareness of the caucus within the AAPA. Apply by January 15.
  • Pennsylvania Society of Physician Assistants has six annual student leadership scholarships and three scholarships for students who choose to enter the writing competition. Apply online by June 30.
  • Physician Assistant Academy of Vermont offers a scholarship of $1,000 and free attendance at the annual PAAV Winter CME conference for PA students who are residents of Vermont. Apply by June 30.
  • Physician Assistants in Orthopedic Surgery offers one or two $500 scholarships from the Susan Lindahl Memorial Scholarship Fund, established to encourage young PA students to enter the field of orthopedics. Apply by August 15.
  • The Society of Army Physician Assistants honors the memory of Captain Sean P. Grimes, through the Captain Sean P. Grimes Physician Assistant Educational Scholarship Award. Apply by February 1st.
  • The AAPA Veterans Caucus Scholarship seeks to recognize the achievements of an outstanding veteran of one of the seven branches of the Uniformed Services who is currently enrolled in a PA program.

Note: Grants are similar to scholarships, and availability is based on resources and financial need. When you submit your FAFSA form, you will be considered for Pell Grants.

Also, check your place of employment, organizations and place of worship for any grants for which you may be eligible.

Scholarships and Grants Awarded by the AAPA

They are all due January 15, 2015.

  • Student Academy Outstanding Student Society
    • Description: This award recognizes three student societies for their outstanding service to the profession.
    • How to apply: Download the Student Academy Outstanding Student Society Award application
    • Award/Prize: $500 for each of the three top placing programs
    • Additional details: All of these student societies documented their work in the following categories: public education and advocacy of the profession, public service and outreach, promotion of the diversity and professional involvement. Seventy-five percent membership is required to participate in this award.
  • Student Academy Travel Grant Awards
    • Description: A $500 grant for AOR student society representatives and Student Academy selected HOD student delegates or alternates to minimize travel expenses to the annual conference.
    • Eligibility Criteria: HOD students must be one of the selected students; all applicants should be members of AAPA
    • How to apply: Download the Student Academy Travel Grant application
  • Student Academy PA Student Mentor Award
    • Description: This award recognizes a PA who has demonstrated exemplary service to PA students and has furthered the leadership, educational, and professional development of PA students.
    • Eligibility Criteria: none specified
    • How to apply or nominate someone: Download the Student Academy PA Student Mentor Award application
  • Student Academy PAragon Student Award
    • Description: This award honors a PA student who has demonstrated exemplary service as a PA student.
    • Eligibility Criteria: Need at least 5 applicants; student should be a member of AAPA
    • How to apply or nominate someone: Download the Student Academy PAragon Student Award application

If you have any questions about these scholarships and grants, you can contact the Student Academy Staff at the following email address: students@aapa.org.

Unites States Military Service and Loan Repayment Programs

  • National Guard Healthcare Bonuses and Loans
    • Physician Assistants and Social Workers:
      • $20,000 per year for a three-year contract
      • $15,000 per year for a two-year contract
      • $10,000 per year for a one-year contract
  • National Guard Student Loan Repayment Program
    • Must have 1 or more qualifying and disbursed Title IV federal loans
    • State and private loans are ineligible for repayment
    • PLUS loans are eligible
    • Loans must be listed on the Department of Education National Student Loan Data System (NSLDS) aid summary website
    • Must enlist for a minimum 6 year term of service
    • Must enlist for a critical skills (CS) vacancy in the grade of E-4 or below
    • Information:
      • Payments will not exceed $50,000 with annual repayments not to exceed the maximum amount established by law
      • Must enlist into a qualifying position in an MTOE or Medical TDA unit only
      • Must score a minimum of 50 on the Armed Forces Qualifying Test (AFQT)
  • Navy Clinical Care Provider
    • To qualify for Active Duty employment consideration as a Physician Assistant in the Navy Medical Service Corps, you must meet these basic requirements:
      • Be a U.S. citizen currently practicing in the U.S.
      • Bachelor's degree from an accredited college or university
        Completion of a physician assistant education program approved by the Committee on Allied Health Education and Accreditation (CAHEA)
      • Certification by the National Commission on Certification of Physician Assistants (NCCPA)
      • Be willing to serve a minimum of three years of Active Duty
      • Be between the ages of 18 and 41
      • Be in good physical condition and pass a full medical examination
      • General qualifications may vary depending upon whether you intend to serve Active Duty or Reserve Duty, and whether you are currently serving, have served before or have never served before.

Who Gets the Most Financial Aid?

You might think that the families who receive the most financial aid would be the families with the most need. In fact, this is not necessarily true. The people who receive the most aid are the people who best understand the aid process.

Can I afford Not To Go To PA School?

Can I afford to go to PA school? The question you should be asking is: can I afford not to go to PA school? If your goal is to become a PA, then the answer to this question is easy. The worst thing you can do is shy away from applying because you think you won’t be able to afford it, and then live the rest of your life wondering, What if?

When I applied to the Rutgers Physician Assistant Program and spoke with students at the open house, they explained that if I were to be accepted the program would do its best to ensure I got through financially. They were right.

I may have borrowed a little more than I intended, but the money was available and after an initial setback I ended up with a highly coveted NHSC Scholarship.

As you will soon find out, there are plenty of opportunities for loans, grants, scholarships, etc. It does, however, take a little work on your part. But since you have set your goals and you’re focused, you are prepared for anything.

References:

Bonus: The Today Show recently had a very good program about loan refinancing and avoiding debt. Take a look at the video here and review their 7 ways to stop loans from ruining your life.

A Surgeon Speaks: 7 Reasons Why You Should Choose PA Over MD

A Fellowship Trained Surgeon Shares 7 Reasons You Should Choose PA over MD

I am a fellowship-trained surgeon.

Besides the financial aspect, the following 7 points will make your decision of PA vs. MD easy:

1.  It takes on an average at least 15 years (after high school) of head in the sand (books) to complete fellowship and reach the $200,000 debt figure that you are quoting.

2.  A 40-50 hour work week is a dream for most MDs. Most of my colleagues work 60 hrs and some up to 80 hours a week.

3.  Not counting the hours after you go home and come back for ’emergencies’.

4.  Family life is a ‘possibility’ for PAs. Look around and see how many MDs have kids before 30. You will be surprised by the small number.

5.  Most of my PA friends work two jobs (totaling 60-80hrs/week), so their salaries go up accordingly. Ever heard of an MD working two jobs. I guess 120-160 hrs/week is kinda difficult. Huh..

6.  PAs work just as well and earn just as much respect by their patients and colleagues.

7.  The only trajectory this trend is going is upwards. Mid-level providers’ need and utilization has been increasing exponentially.

I am totally happy with what I am doing. But if I were to advise an aspiring student for MD vs. PA, I would totally refer him/her to this post. I think the round 1 showdown is won by PAs, not MDs.

- Dr. S

Dr. S is a fellowship trained surgeon who was kind enough to weigh in on the PA vs. MD debate in the comments section of this blog.

What do you think? Is Dr. S spot on or dead wrong? I would love to hear your thoughts in the comments section.  You probably know where I stand on this debate. 🙂

Who Gets Into PA School? Here’s What You Need to Know

What Does it Take to Get Into PA School? Here's What You Need to KnowLeslie Mean is a 26 year old single white female who presents to the PA school admissions committee on her first attempt to get into PA school.

She has a 3.5 overall GPA and a 3.47 science GPA. She is holding a bachelors of science degree in biochemistry, had an SAT score in the 1000-1100 range and above average GRE scores.

She has 2 years of hands-on clinical experience working as a CNA and a long history of volunteer work which exemplifies her desire to help her fellow man.

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

She was accepted into PA school on her first 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, a perfectly average PA school student.

She also embodies what PA school's all 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 applicants and students enrolled 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 is good to know what average is. Average provides a baseline by which you can measure your own 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 of all, 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 myself 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 less 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 pretty sure you will be accepted into PA School, although I have no data on religious preference and PA school acceptance rates. 🙂

So what does an average PA school applicant who is admitted to PA school (i.e student) look like?

Let's take a look:

→ The average PA school students age is 27 years old

  • The average age of first-year students ranged between 25 and 28 for all categories
  • The average age at application is 26 years old

Average age of Physician Assistant School Applicant

→ The average PA school student is female

The gender distribution of first-year students has started to stabilize after nearly a 20-year trend of a gradually increasing proportion of females:

  • Female: 72.4%
  • Male: 27.6% (mean)

First Year Enrollment in PA School by Gender

→ The Average PA school applicant has a bachelor’s degree

The 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%

→ Most students had four years of hands-on clinical experience prior to applying*

PA school applicants come to the table with a variety of medical experience, especially if they are strong applicants. On average, four years of prior 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

 

Average healthcare experience years and hours of PA School Student or Applicant

* 2015-2016 update: Some recent data suggests HCE hours are significantly declining with a new average of 1.88 years of health care experience among matriculating (accepted) students.

→ SAT/GRE scores of those accepted tend to be in the above-average range

  • GRE Percentile Math: 50%
  • GRE Percentile Verbal: 42%
  • GRE Percentile Analytical: 48%
  • SAT scores are in the 1000-1100 range.

→ The average PA school student has between a 3.36 and 3.47 overall GPA and an undergraduate science GPA between 3.36 and 3.47

  • The average undergraduate overall GPA for PA school applicants who WERE ACCEPTED into PA school was 3.49, undergraduate science GPA was 3.36 and non science GPA was 3.56.
  • The average GPA for students who WERE NOT ACCEPTED into PA school was 3.16

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

Average GPA for PA School Student Undergraduate and Science

→ Most PA school students are White

Skin color has nothing to do with acceptance rates, but it is interesting (and maybe a bit sad) to know that the vast majority of first year students were White (86.5%) followed by Asian (11.1%) and Black or African American 4.1%.

First Year Student PA School By Race and Ethnicity

→ 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 acceptance
  3. Average number of PA programs applied to is 8

Interesting factoid: There is no additional benefit for applying to 12 programs or more!

→ Pucker up baby, most PA students are single!

Most students are single (67.7%), though just over a quarter were married (26.4%). A little over two percent were divorced and over one percent were in a domestic partnership/civil union. Most students (85.1%) have no legal dependents. For the nearly 15% of students that reported having legal dependents other than themselves, the average number of dependents was 2.02, with a range of 1 to 7 dependents. Over 30% of respondents said they were considered a dependent of their parents.

→ Most PA students are from "The Burbs"

Half of 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.

Where do PA School Students Come From

→ PA school students don't smoke pot and are not drug dealers or part of the Italian Mafia

Over three-quarters (82.8%) of programs reported that students were required to have a background check upon matriculation to the program, while 78.7% of responding programs now mandate drug testing.

Some Important Points

It's not Rocket Science: It is important that a candidate demonstrates reasonable aptitude in the hard sciences such as anatomy and 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,"

Quote Run of a Ladder Thomas Henry HuxleyIt's an easy race to the bottom, so set your sights at the top: Many people will be set aback when they read that only 25% of applicants will be accepted into PA school on any given year, but this should actually 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 applicant 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 28'th and 29'th PAEA Annual Report

No Experience Required! 84 PA Schools That Don’t Require Healthcare Experience

84-pa-schools-that-do-not-require-healthcare-experience

The following is a list of 84 PA programs in the United States that do not require patient care experience for PA school admissions.

I use "require" lightly because many of these schools which claim no healthcare experience requirement do "strongly recommend" or "prefer" PA school candidates with a certain amount of experience prior to application.

In other words, you can apply, but you may not stand a chance against an increasingly capable PA school applicant pool.

I recommend 2,000 hours (1 year of full-time hands on patient care experience) to be competitive.

As you can see from this table many schools claim to require much less.

Does this mean you should wait to apply until you have a load of HCE under your belt?

The answer to this question depends on your background, your age, your prior experience and what else you bring to the table.

Are you a 21-year-old recent college graduate with no prior healthcare experience? Then the answer is yes,  you should get out there and find some hands on patient care experience... no excuses!

Are you a 35-year-old mother of two with ten years working as a licensed acupuncturist and tons of PA shadowing experience? Then you may have some wiggle room.

You can browse this interactive, geographical list of PA schools that don't require healthcare experience on my PA School Finder website.

You will see that most of these schools reside on the East Coast.

Remember, PA schools change their requirements all the time, so make sure to contact the PA program in question and reference their website before you make any rash decisions. If you have updated information or corrections on any of these programs please let me know in the comments section!

PA Programs That Don't Require Healthcare Experience

1. Adventist University of Health Sciences Physician Assistant Program

  • Our program seeks to educate individuals in becoming knowledgeable, compassionate and spiritually uplifting healthcare providers. Whether…
  • Address: Adventist University of Health Sciences 671 Winyah Drive Orlando, FL 32803
  • Web: http://www.adu.edu/academics/ms-physician-assistant

2. Anne Arundel Community College Physician Assistant Program

  • Anne Arundel Community College (AACC) and University of Maryland Baltimore Graduate School (UMB)prepares students to become competent,…
  • Address: Admission Office School of Health Professions, FLR 306101 College ParkwayArnold, MD 21012
  • Web: http://www.aacc.edu/physassist/

3. Arizona School Of Health Sciences Physician Assistant Program

  • The A.T. Still University Department of Physician Assistant Studies provides a learning-centered education that develops exemplary…
  • Address: Arizona School of Health Sciences 5850 E. Still Circle Mesa, AZ 85206
  • Web: http://www.atsu.edu/ashs/programs/physician_assistant/

4. Augsburg College Physician Assistant Program

  • The Augsburg PA Program was the first in the state of Minnesota. We have a long history of success with our graduates consistently passing…
  • Address: Augsburg College 2211 Riverside Avenue Campus Box 149 Minneapolis, MN 55454
  • Web: http://www.augsburg.edu/pa/

5. Barry University Physician Assistant Program

  • The Program seats students at the Barry University campus in Miami Shores, at St. Petersburg College, through a partnership with the…
  • Address: Barry University 11300 NE 2nd Avenue Miami, FL 33161
  • Web: http://www.barry.edu/physician-assistant/

6. Baylor College of Medicine Physician Assistant Program

  • Baylor College of Medicine is committed to being a national leader in advancing human health through the integration of patient care,…
  • Address: Baylor College of Medicine One Baylor Plaza M108 Houston, TX 77030
  • Web: http://www.bcm.edu/pap/

7. Bethel University Physician Assistant Program (Tennessee)

  • Bethel University’s mission is to create opportunities for members of the learning community to develop to their highest potential as whole…
  • Address: Bethel University 302B Tyson Avenue Paris, TN 38242
  • Web: http://www.bethelu.edu/academics/colleges

8. CCNY Sophie Davis School of Biomedical Education Physician Assistant Program

  • The mission of The Sophie Davis School of Biomedical Education at The City College of New York is to produce broadly-educated, highly…
  • Address: CCNY Sophie Davis School of Biomedical Education PA Admissions Committee 160 Convent Avenue, HR 15 New York, NY 10031
  • Web: http://www.ccny.cuny.edu/sophiedavis/index.cfm

9. Chapman University Physician Assistant Program (California)

10. Chatham University Physician Assistant Program

  • The Master of Physician Assistant Studies (MPAS) program at Chatham University provides academic and clinical training that will prepare…
  • Address: Chatham University MPAS Program, Office of Graduate Admissions, Berry Hall Woodland Road Pittsburgh, PA 15232
  • Web: http://www.chatham.edu/mpas/

11. Christian Brothers University Physician Assistant Program

  • The CBU Master of Science in Physician Assistant Studies is located on the University campus. The cohort-based program consists of 110…
  • Address: Christian Brothers University 650 East Parkway South Memphis, TN 38104
  • Web: http://www.cbu.edu/PAS

12. College of Saint Mary Physician Assistant Program

13. College of Saint Scholastica Physician Assistant Program

14. Cuyahoga Community College Cleveland State University Physician Assistant Program

15. Eastern Virginia Medical School Physician Assistant Program

16. Florida International University Herbert Wertheim College of Medicine Physician Assistant Program

17. Gardner Webb University Physician Assistant Program

18. Hardin-Simmons University Physician Assistant Program

19. Howard University Physician Assistant Program

20. Idaho State University Physician Assistant Program

  • The mission of the Idaho State Physician Assistant program is to train PAs through service-oriented, multimodal, innovative learning.…
  • Address: Idaho State University 921 S. 8th Avenue Stop 8253 Pocatello, ID 83209
  • Web: http://www.isu.edu/PAprog/

21. Indiana State University Physician Assistant Program

  • The mission of the Indiana State University Physician Assistant Program is to create a student-centered educational environment that…
  • Address: Indiana State University 567 N. 5th Street Terre Haute, IN 47809
  • Web: http://www.indstate.edu/amr/physician-assistant

22. Keiser University Physician Assistant Program

23. Kettering College Physician Assistant Program

  • The physician assistant (PA) program at Kettering College is the school’s first on-campus master’s degree, accredited as such…
  • Address: Kettering College 3737 Southern Boulevard Kettering, OH 45429
  • Web: http://www.kc.edu/pa

24. Lenoir-Rhyne University Physician Assistant Program

25. Lock Haven University Physician Assistant Program

  • The Lock Haven University Physician Assistant Program represents the first Master Degree entry level program within the Commonwealth of…
  • Address: Lock Haven University Physician Assistant Program 401 N. Fairview Street Lock Haven, PA 17745
  • Web: http://portal.lhup.edu/pa/

26. Marietta College Physician Assistant Program

27. Marshall B. Ketchum University Physician Assistant Program

28. MCPHS University Physician Assistant Program (Boston)

29. MCPHS University Physician Assistant Program (Manchester) New Hampshire

  • Designed for students holding a bachelor’s degree in any field, the accredited Master of Physician Assistant Studies (MPAS) program…
  • Address: 1260 Elm Street Room 122 Manchester, NH 3101
  • Web: http://www.mcphs.edu/academics/programs

30. MCPHS University Physician Assistant Program (Worcester) Massachusetts

  • The program prepares highly-qualified physician assistants who regardless of practice settings, are sensitive to both individual and…
  • Address: 19 Foster Street Worcester, MA 1608
  • Web: http://www.mcphs.edu/Academics/Programs

31. Medical University of South Carolina Physician Assistant Program

  • To educate highly competent physician assistants who are compassionate, culturally aware, and attuned to the primary health care needs of…
  • Address: Medical University of South Carolina Education and Student Life 171 Ashley Avenue Charleston , SC 29425
  • Web: http://www.musc.edu/chp/pa

32. Midwestern University Physician Assistant Program (Downers Grove)

33. Midwestern University Physician Assistant Program (Glendale)

  • Our rigorous program immerses you in basic and clinical sciences as you prepare to participate in 13.5 months of clinical rotations in…
  • Address: Midwestern University 19555 59th Avenue Glendale, AZ 85254
  • Web: https://www.midwestern.edu

34. Misericordia University Physician Assistant Program

  • The mission of the Misericordia University pre-professional Bachelor of Science in Medical Science program is to prepare exceptional…
  • Address: Misericordia University 301 Lake Street Dallas, PA 18612
  • Web: http://www.misericordia.edu/page.cfm?p=655

35. North Greenville University Physician Assistant Program

  • Affiliated with and committed to the South Carolina Baptist Convention, North Greenville University is a co-educational liberal arts…
  • Address: 405 Lancaster Avenue Greer, S.C. 29650
  • Web: http://www.ngu.edu/pa-medicine.php

36. Northeastern Statue University Physician Assistant Program – Oklahoma

  • Northeastern Statue University PA Program – Oklahoma Mission Statement The proposed Master of Science in Physician Assistant Studies program specifically addresses the mission and operational philosophy of the University by: (1) directly…
  • Address: Northeastern University 611 N. Grand Avenue College of Science and Health Professions Tahlequah, OK 74464
  • Web: https://academics.nsuok.edu/healthprofessions

37. Northwestern University Physician Assistant Program

  • The mission of the Northwestern University Feinberg School of Medicine Physician Assistant (PA) Program is to prepare PAs to provide…
  • Address: Northwestern University 240 E. Huron Street Suite 1-200 Chicago, IL 60611
  • Web: http://www.northeastern.edu/bouve/pa/programs/ms.html

38. Nova Southeastern University Physician Assistant Program, Ft. Lauderdale

  • Our program has 14 full time faculty members who actively teach in class and laboratory sessions, as well as participate in various health…
  • Address: Nova Southeastern University Enrollment and Processing Services - PA Admissions 3301 College Avenue, PO Box 29900 Fort Lauderdale, FL 33329-9905
  • Web: http://www.nova.edu/chcs/pa/fortlauderdale/index.html

39. Nova Southeastern University Physician Assistant Program, Jacksonville

  • To provide an exemplary educational experience, which emphasizes primary medical care, yet will enable graduates to manifest competency…
  • Address: Nova Southeastern University 6675 Corporate Center Parkway Suite 115 Jacksonville, FL 32216
  • Web: http://healthsciences.nova.edu/pa/jacksonville/index.html

40. Nova Southeastern University Physician Assistant Program, Orlando

  • The Physician Assistant Program in Orlando offers educational excellence through the extensive experience of its faculty and its facilities…
  • Address: Nova Southeastern University 3301 College Avenue PO Box 299000 Fort Lauderdale, FL 33329-9905
  • Web: http://www.nova.edu/chcs/pa/orlando/index.html

41.  Nova Southeastern University, Fort Myers Physician Assistant Program

  • The NSU PA Program Fort Myers endeavors to provide an educational experience that emphasizes primary medical care, provides healthcare…
  • Address: Nova Southeastern University 3650 Colonial Court Fort Myers, FL 33913
  • Web: http://healthsciences.nova.edu/pa/fort-myers/index.html

42. Ohio University Physician Assistant Program

  • Ohio University PA Program Mission Statement The mission of the Ohio University Master of Physician Assistant Practice Program is to prepare students to be leaders in physician assistant practice in any clinical setting with a particular emphasis on…
  • Address: Ohio University 6805 Bobcat Way Division of Physician Assistant Practice Dublin, OH 43016
  • Web: https://www.ohio.edu/chsp/rcs/pa/

43. Our Lady of the Lake College Physician Assistant Program

  • Our Lady of the Lake College PA Program Mission Statement The purpose of the Physician Assistant (PA) program is to educate outstanding physician assistants who, together with physicians and allied health professionals, will provide quality…
  • Address: Our Lady of the Lake College 5414 Brittany Drive Baton Rouge, LA 70808
  • Web: http://www.ololcollege.edu/academics/academic-programs/physician-assistant-studies

44. Rochester Institute of Technology Physician Assistant Program

45. Rosalind Franklin Univ of Medicine Physician Assistant Program

46. Rutgers University Physician Assistant Program

  • The mission of the University of Medicine and Dentistry of New Jersey Physician Assistant Program is to prepare primary care physician…
  • Address: Rutgers University 675 Hoes Lane West Piscataway, NJ 08854-5635
  • Web: http://shp.rutgers.edu/dept/primary_care/paweb/

47. Saint Catherine University Physician Assistant Program

48. Seton Hill University Physician Assistant Program

49. Shenandoah University Physician Assistant Program

  • The Physician Assistant (PA) Program is an accredited, eight-semester, 30-month, graduate-level program leading to a Master of Science in…
  • Address: Shenandoah University 1460 University Drive Winchester, VA 22601
  • Web: http://www.su.edu/physician-assistant/

50. Slippery Rock University Physician Assistant Program

51. South College Physician Assistant Program

52. South University (Georgia) Physician Assistant Program

53. South University Physician Assistant Program (Tampa)

54. South University Physician Assistant Program (West Palm Beach)

55. Southern Illinois University Physician Assistant Program

  • The mission of the Southern Illinois University Physician Assistant Program is to prepare healthcare professionals to provide primary…
  • Address: SIU PA Program 600 Agriculture Drive Carbondale, IL 62901
  • Web: http://www.siumed.edu/paprogram/

 

56. Thomas Jefferson University Physician Assistant Program

  • The Jefferson School of Health Professions is committed to educating healthcare professionals of the highest quality and ethical standards…
  • Address: Thomas Jefferson University 130 S. 9th Street Suite 100 Philadelphia, PA 19107
  • Web: http://www.jefferson.edu/pa

57. Touro University (Las Vegas) Physician Assistant Program

  • The Master of Physician Assistant Studies Program is committed to the education of highly qualified compassionate Physician Assistants who…
  • Address: Touro University 874 American Pacific Drive Henderson, NV 89011
  • Web: http://www.tun.touro.edu/

58. Touro University Nevada Physician Assistant Program

59. University of Alabama at Birmingham Physician Assistant Program

  • The mission of the UAB Surgical Physician Assistant Program is to provide qualified individuals with the knowledge, skills, and judgment…
  • Address: University of Alabama at Birmingham SHPB 437 1720 2nd Avenue South Birmingham, AL 35294-1212
  • Web: http://www.uab.edu/shp/cds/physician-assistant

60. University of Charleston Physician Assistant Program

  • The mission of the University of Charleston Physician Assistant Program is to prepare competent physician assistants who value and provide…
  • Address: University of Charleston 2300 MacCorckle Avenue SE Charleston, WV 25304
  • Web: http://www.ucwv.edu/PA/

61. University of Colorado Physician Assistant Program

  • The mission of the Child Health Associate/Physician Assistant Program is to provide comprehensive physician assistant education in primary…
  • Address: University of Colorado 13001 E. 17th Place Mail Stop F543 Aurora, CO 80045
  • Web: http://www.medschool.ucdenver.edu/paprogram

62. University of Evansville Physician Assistant Program

63. University of Findlay Physician Assistant Program

64. University of Florida Physician Assistant Program

  • The mission of the School of Physician Assistant Studies is to recruit high quality students to become exemplary physician assistants who…
  • Address: University of Florida College of Medicine Box 100176 Gainesville, FL 32610
  • Web: http://pap.med.ufl.edu/

65. University of Missouri – Kansas City Physician Assistant Program

  • To educate competent, compassionate, and culturally-aware Physician Assistants who are prepared to meet the healthcare needs of our…
  • Address: University of Missouri - Kansas City 2411 Holmes Street M1-103 Kansas City, MO 64108
  • Web: http://med.umkc.edu/pa/

66. University Of Nebraska Physician Assistant Program

67. University Of North Texas HS Center Ft Worth

68. University Of Oklahoma, Oklahoma City Physician Assistant Program

69. University Of Oklahoma, Tulsa Physician Assistant Program

  • The mission of the Physician Assistant Program at the University of Oklahoma School of Community Medicine, is to train physician assistants…
  • Address: OUHSC Office of Admissions and Records 4502 E. 41st St. Tulsa, OK 74135
  • Web: http://www.ou.edu/content/tulsa/pa.html

70. University of Saint Francis (Fort Wayne) Physician Assistant Program

  • The Department of Physician Assistant Studies provides education in medical knowledge and skills needed by individuals to serve effectively…
  • Address: University of Saint Francis 2701 Spring Street Fort Wayne, IN 46808
  • Web: http://pa.sf.edu/

71. University of South Dakota Physician Assistant Program

  • The Physician Assistant Studies Program at the University of South Dakota provides a comprehensive primary care education that prepares…
  • Address: Physician Assistant Studies Julian Hall Room 120 414 E. Clark St. Vermillion, SD 57069
  • Web: http://www.usd.edu/health-sciences/physician-assistant/

72. University of Southern California Physician Assistant Program

  • The Primary Care Physician Assistant Program at USC is dedicated to the advancement of physician assistant education and emphasizes service…
  • Address: University of Southern California 1000 S. Fremont Avenue Unit 7, Building A-11, Room 150 Alhambra, CA 91803
  • Web: http://keck.usc.edu/Education

73. University of Texas – Medical Branch at Galveston Physician Assistant Program

  • To recruit, enroll, and graduate an academically, talented student body who will reflect the cultural, geographical, and socio-economical…
  • Address: The School of Health Professions The University of Texas Medical Branch 301 University Boulevard Galveston, Texas 77555-1145
  • Web: http://shp.utmb.edu/PhysicianAssistantStudies/

74. University of Texas – Pan American Physician Assistant Program

  • The mission of the Physician Assistant Department (PAD) at the University of Texas – Pan American (UTPA) is to provide an advanced…
  • Address: The University of Texas-Pan American 1201 W. University Drive Edinburg, TX 78539-2999
  • Web: http://www.utpa.edu/pad

75. University of Texas – SW School of Health Professions

  • Established in 1972, the Master of Physician Assistant Studies Program is a full-time, post-baccalaureate program that begins once a year…
  • Address: 6011 Harry Hines Blvd. Suite V4.114 Dallas TX 75390
  • Web: http://www.utsouthwestern.edu/pa

76. University of Wisconsin – La Crosse Physician Assistant Program

77. UT Southwestern Physician Assistant Program

78. West Liberty University Physician Assistant Program

  • West Liberty University began its Master of Science in Physician Assistant Studies (MSPAS) program in July 2012. Students accepted into the…
  • Address: West Liberty University 208 University Drive CUB 173 West Liberty, WV 26074
  • Web: http://www.westliberty.edu/physician-assistant/

79. Yale University School of Medicine Physician Assistant Program

  • The mission of the Yale University School of Medicine Physician Associate Program is to educate individuals to become outstanding…
  • Address: Yale University School of Medicine Physician Associate Program, PO Box 208083 New Haven, CT 06520-8083
  • Web: http://www.paprogram.yale.edu/

80. Interservice Physician Assistant Program

  • The IPAP mission is to educate and train PAs for the uniformed services. Our graduates are commissioned into the officer corps of their…
  • Address: Interservice PA Program 3599 Winfield Scott Road Academy of Health Sciences, Graduate School JBSA Fort Sam Houston, TX 78234-6130
  • Web: http://www.cs.amedd.army.mil/ipap/

81. Quinnipiac University Physician Assistant Program

  • Fully licensed by the state of Connecticut, Quinnipiac’s physician assistant program leads to an MHS degree and provides the clinical…
  • Address: Quinnipiac University Office of Graduate Admissions 275 Mt. Carmel Avenue NH-GRD Hamden, CT 6518
  • Web: http://www.quinnipiac.edu/gradphysicianasst

82. Trine University Physician Assistant Program

83. University of Mount Union Physician Assistant Program

  • The mission of the Mount Union Physician Assistant Studies Program is to educate knowledgeable, competent, and compassionate physician…
  • Address: University of Mount Union Physician Assisant Studies Program, 1972 Clark Avenue Alliance, OH 44601
  • Web: http://www.mountunion.edu/physician-assistant-program

84. Wichita State University Physician Assistant Program

  • With more than 100 years of combined clinical and more than 80 years of healthcare education experience, the department of Physician…
  • Address: Wichita State University 1845 Fairmount Wichita, KS 67260-0043
  • Web: http://www.wichita.edu/thisis/home/?u=pa

 

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