The Physician Assistant Life

The Audio PANCE and PANRE Board Review Podcast Episode 13

The Audio PANCE and PANRE Episode 13 - The Physician Assistant LifeWelcome to episode 13 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series 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, download the transcript and take an interactive quiz of the questions below.
Download a Free PDF Transcript of the Questions and Answers

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 13

1. During a baseball game, a 22 year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye, and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen?

A. Fracture of the medial orbital wall
B. Prolapse of orbital soft tissue
C. Hematoma of the orbit
D. Orbital emphysema

Click here to see the answer

2. Which of the following physical findings is suggestive of atrial septal defect?

A. Fixed split S2
B. Increased pulse pressure
C. Continuous mechanical murmur
D. Difference in blood pressure between the left and right arm

Click here to see the answer

3. Which of the following is essential to make a diagnosis of cystic fibrosis?

A. Positive family history
B. Elevated sweat chloride
C. Recurrent respiratory infections
D. Elevated trypsinogen levels

Click here to see the answer

4. In infants, the eyes should move in parallel without deviation by the age of

A. 2 weeks.
B. 3 months.
C. 6 months.
D. 1 year.

Click here to see the answer

5. Which of the following physical exam findings is consistent with moderate emphysema?

A. Increased tactile fremitus
B. Dullness to percussion
C. Distant heart sounds
D. Deviated trachea

Click here to see the answer

6. Which of the following is the most common indication for operative intervention in patients with chronic pancreatitis?

A. Weight loss
B. Intractable pain
C. Exocrine deficiency
D. To decrease risk of cancer

Click here to see the answer

7. A 22 year old male presents to the ED with pain that radiates to his shoulders and is relieved with sitting forward. The patient admits to recent upper respiratory symptoms. On examination vital signs are BP 126/68, HR 86, RR 20, temp 100.3 degrees F. There is no JVD noted. Heart exam reveals regular rate and rhythm with no S3 or S4. There is a friction rub noted. Lungs are clear to auscultation. EKG shows diffuse ST segment elevation. What is the treatment of choice in this patient?

A. Pericardiocentesis
B. Nitroglycerin
C. Percutaneous coronary intervention
D. Indomethacin (Indocin)

Click here to see the answer

8. As a general rule, sutures in the face should be removed in

A. 3 days.
B. 5 days.
C. 7 days.
D. 10 days.

Click here to see the answer

9. Patient education for a 23 year-old using oral contraceptives should include which of the following?

A. Rifampin may decrease the effectiveness of the oral contraceptives.
B. Acetaminophen may decrease the effectiveness of the oral contraceptives.
C. Oral contraceptives may provide some protection from coronary artery disease.
D. Changing to the “minipill” (progestin only) will inhibit ovulation more consistently than combination oral contraceptives.

Click here to see the answer

10. When performing a rectal examination, prostatic massage is contraindicated in

A. acute bacterial prostatitis.
B. chronic bacterial prostatitis.
C. nonbacterial prostatitis.
D. prostatodynia.

Click here to see the answer

Looking for all the 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 be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

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


Physician Assistant Salary by State: 2015 Comparison Table


Click here to view the table.

What capital city should you move to if you want the highest median Physician Assistant salary in the United States?

I will give you a hint, In 2013, this city also set a new record with 37 homicides!

State and Capital with the highest median Physician Assistant Salary

What capital city should you move to if you want the lowest median Physician Assistant salary in the US?  Hint, in the 2010 census it was the second least populous state capital after Montpelier, Vermont.

State and Capital with the lowest median Physician Assistant Salary

The most recent data (May 2012) from the Bureau of labor statistics reports the median annual wage for physician assistants was $90,930 ($43.72 per hour). The lowest 10 percent earned less than $62,430, and the top 10 percent earned more than $124,770.

Compare this to the 2013 AAPA Census based on 951 PA responses which reports the median Physician Assistant Salary to be $107,268 ($54.05 per hour). As you can see in the table below there has been a steady increase over time.

Physician Assistant Salary Table

According to the 2013 AAPA Salary Report, the median annual wages for physician assistants in the top industries in which these assistants worked were as follows:

  • Hospitals (Non teaching) $95,000
  • University Hospital $102,000
  • Outpatient care centers $93,520
  • Offices of health practitioners (solo practice) $85,000
  • Government $86,870
  • Multi-Specialty Practice Group $91,400
  • Single Specialty Practice Group $89,000

Physician Assistant Salary Comparison Table: by State and Capital City (Updated January 8, 2015)

*The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less.

Salary data is from salary.com – you can read more about their methodology here. Click on the corresponding links below see the most updated salary information for the particular region.

STATE + CAPITAL 10% 20% MEDIAN 75% 90%
Alabama, Montgomery $71,695  $78,220  $85,386  $93,786 $101,434
 Alaska Juneau  $89,461  $97,602  $106,544  $117,025  $126,569
Arizona, Phoenix  $77,359  $84,398  $92,131  $101,194  $109,44
Arkansas, Little Rock  $70,793  $77,236  $84,312  $92,606 $100,158
California, Sacramento  $85,917  $93,736  $102,323  $112,390  $121,555
Colorado, Denver  $79,945  $87,220  $95,211  $104,578  $113,106
Connecticut, Hartford  $82,808  $90,344  $98,621  $108,324  $117,15
Delaware, Dover  $82,097  $89,568  $97,773  $107,392  $116,150
Florida, Tallahassee  $71,743 $78,271  $85,442  $93,848  $101,501
Georgia, Atlanta  $79,771  $87,030  $95,004  $104,350 $112,860
Hawaii, Honolulu $85,862  $93,675  $102,257  $112,318  $121,477
Idaho, Boise  $76,386  $83,337  $90,972  $99,922  $108,070
Illinois, Springfield  $71,221  $77,702  $84,820  $93,165  $100,763
Indiana, Indianapolis  $76,077  $83,000  $90,605  $99,518  $107,634
Iowa, Des Moines  $75,832  $82,733  $90,312  $99,197  $107,287
Kansas, Topeka  $73,949  $80,679  $88,070  $96,735  $104,623
Kentucky, Frankfort  $75,595  $82,474  $90,030  $98,887  $106,951
Louisiana, Baton Rouge  $68,737  $74,992  $81,862  $89,916  $97,249
Maine, Augusta  $81,511  $88,929  $97,076  $106,627  $115,322
Maryland, Annapolis  $81,250  $88,644  $96,765  $106,285  $114,953
Massachusetts, Boston  $85,427  $93,201  $101,739  $111,748  $120,861
Michigan, Lansing  $74,827  $81,637  $89,116  $97,883 $105,866
Minnesota, St. Paul  $73,016  $79,661 $86,959  $95,514  $103,303
Mississippi, Jackson  $73,008  $79,652  $86,949  $95,504  $103,292
Missouri, Jefferson City  $71,221  $77,702  $84,820  $93,165  $100,763
Montana, Helena  $63,334  $69,098  $75,428  $82,849  $89,605
Nebraska, Lincoln  $68,658  $74,906  $81,768  $89,813  $97,137
Nevada, Carson City  $81,804  $89,248  $97,425  $107,010  $115,736
New Hampshire, Concord  $83,528  $91,130  $99,478  $109,265  $118,175
New Jersey, Trenton  $93,265  $101,753  $111,075  $122,002  $131,951
New Mexico, Santa Fe $70,556  $76,977  $84,029  $92,296  $99,822
New York, Albany  $76,053  $82,974  $90,576  $99,487  $107,600
North Carolina, Raleigh  $78,782  $85,952  $93,826  $103,057  $111,461
North Dakota, Bismarck  $71,743  $78,271  $85,442  $93,848  $101,501
Ohio, Columbus  $77,675  $84,744  $92,507  $101,608  $109,894
Oklahoma, Oklahoma City  $74,329  $81,093  $88,523  $97,232  $105,161
Oregon, Salem  $78,221  $85,339  $93,157  $102,322  $110,666
Pennsylvania, Harrisburg  $78,695  $85,857  $93,723  $102,943  $111,338
Rhode Island, Providence  $83,085  $90,646  $98,951  $108,686  $117,549
South Carolina, Columbia  $74,092  $80,834  $88,240  $96,921  $104,825
South Dakota, Pierre  $61,539  $67,139  $73,290  $80,500  $87,065
Tennessee, Nashville  $74,732  $81,533  $89,003  $97,759  $105,731
Texas, Austin  $76,196  $83,130  $90,746  $99,673  $107,802
Utah, Salt Lake City  $75,199  $82,042  $89,559  $98,370  $106,392
Vermont, Montpelier  $79,312  $86,530  $94,457  $103,750  $112,211
Virginia, Richmond  $79,312  $86,530  $94,457  $103,750  $112,211
Washington, Olympia  $81,408  $88,817  $96,954  $106,492  $115,176
West Virginia, Charleston  $69,441  $75,760  $82,701  $90,837  $98,245
Wisconsin, Madison  $73,593  $80,291  $87,647  $96,269  $104,120
Wyoming, Cheyenne  $71,458  $77,961  $85,103  $93,476  $101,098


Are you looking for salary data to lean on while negotiating a new or existing contract?

Or maybe, you’re doing reconnaissance to assess your future earnings if you do decide to pursue a career as a physicians assistant?

So many factors dictate your base salary and should be taken into consideration when you are in contract negotiations with your employer or while discussing a pay raise.

Some Factors That Determine Base Salary

  • Is your place of work in a remote or less desirable location?
  • Do you have to take call or work weekends?
  • Do you have a lot of support or are you flying solo?

If the employer does not offer the highest salary are there other benefits worth considering such as a great healthcare or retirement package?  Or better yet, does the work line up with your personal goals as a healthcare practitioner?

At my last job we had a high hourly wage coupled with a lackluster family health care plan and a poor retirement benefits package. After being swayed to sign on the dotted line by a higher than average salary offering the mid-levels across the organization were red-lined for the next 4 years. Sadly, we lost a number of very talented practitioners because of this.

A poor benefits package may seem like “no big deal” if you are tempted with the allure of a high salary, but be careful, a high salary with poor benefits can be fools gold, especially when it comes to long-term employment, dependent health care coverage or retirement planning.

I predict we will continue to see a rise in median pay (especially in specialty practice).  When I look at PA salary compared to nursing salary in my home State of California, for example, it seems the sky is the limit. But be forewarned, there are always trade-offs; such as longer hours, mandatory call or the addition of weekends.

Make sure to check the average salaries in your region and be open to salary discussions with your colleagues.

I am well aware that nothing is more miserable than having the salary comparison talk.  You are either going to be paid more which makes you a target, less which will make you angry, or the same which can make you angry or happy depending on the circumstances.

Keep in mind, this is not about comparisons, it is about mid-levels being on the same page, I am a believer that we are stronger when united which will benefit the profession as a whole.

The Audio PANCE and PANRE Board Review Podcast Episode 11

Welcome to episode 11 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series 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, download the transcript and take an interactive quiz of the questions below.
Download a Free PDF Transcript of the Questions and Answers

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 11

1. What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient?

A. No treatment is necessary.
B. Propylthiouracil (PTU)
C. Radioiodine treatment
D. Subtotal thyroidectomy

Click here to see the answer

2. A patient presents with eye pain and blurred vision. Snellen testing reveals vision of 20/200 in the affected eye and 20/20 in the unaffected eye. Fluorescein staining reveals the presence of a dendritic ulcer. Which of the following is the most likely diagnosis?

A. Viral keratitis
B. Fungal corneal ulcer
C. Acanthamoeba keratitis
D. Bacterial corneal ulcer

Click here to see the answer

And in case you were wondering:

B. Fungal corneal ulcers have an indolent course with intraocular infection being common but fluorescein staining is negative for a dendritic pattern.

C. Acanthamoeba keratitis has a waxing and waning course over several months and has no fluorescein staining in a dendritic pattern.

D. Bacterial corneal ulcers can progress aggressively resulting in corneal perforation. Fluorescein staining does not occur in a dendritic pattern.

3. A 63 year-old female with history of diabetes mellitus presents for blood pressure follow-up. At her last two visits her blood pressure was 150/92 and 152/96. Today in the office her blood pressure is 146/92. Recent blood work shows a Sodium 140 mEq/L, Potassium 4.2 mEq/L, BUN of 23 mg/dL, and Creatinine of 1.1 mg/dL. Which of the following is the most appropriate initial medication in this patient?

A. Terazosin (Hytrin)
B. Atenolol (Tenormin)
C. Lisinopril (Zestril)
D. Hydrochlorothiazide (HCTZ)

Click here to see the answer

4. What is the EKG manifestation of cardiac end-organ damage due to hypertension?

A. Right bundle branch block
B. Left ventricular hypertrophy
C. Right ventricular hypertrophy
D. ST segment elevation in lateral precordial leads

Click here to see the answer

5. Annual blood pressure determinations should be obtained beginning at the age of

A. 3 years.
B. 5 years.
C. 12 years.
D. 18 years.

Click here to see the answer

6. In adults and intravenous drug abusers, which of the following bones is most commonly affected with acute osteomyelitis?

A. Femur
B. Humerus
C. Vertebral spine
D. Tibia

Click here to see the answer

7. Treatment of the patient with Pediculosis pubis consists of which of the following?

A. Permethrin (Nix) cream
B. Clotrimazole (Gyne-Lotrimin)
C. Podofilox (Condylox) solution
D. Selenium sulfide (Selsun) suspension

Click here to see the answer

8. A 43 year-old asymptomatic diabetic female is found to have an elevated total calcium level of 12.4 mg/dL. Which of the following tests must be assessed in order to evaluate this laboratory abnormality?

A. Intact parathyroid hormone
B. Serum albumin
C. 24 hour urine calcium level
D. Complete blood count

Click here to see the answer

9. Which of the following conditions would cause a positive Kussmaul’s sign on physical examination?

A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta
D. Constrictive pericarditis

Click here to see the answer

10. Treatment of Bell’s palsy includes which of the following?

A. Acyclovir
B. Reassurance of the patient’s recovery
C. Referral to a neurosurgeon
D. Electromyography

Click here to see the answer

Looking for all the 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 be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

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


Prerequisite Coursework: How to Design the Perfect Pre-PA School Curriculum

* To compare top ranking PA schools and download your FREE  PA School Prerequisite Worksheet click here

Step 1 Prerequisite Coursework - The 5 Steps to PA School

There are 5 steps you must take to go from zero to PA school hero:

  1. Complete the necessary prerequisite coursework
  2. Obtain the required medical and hands-on patient care experience
  3. Successfully prepare for and take the GRE
  4. Obtain at least 3 High Quality Letters of Recommendation
  5. Complete the CASPA application and all additional supplemental materials on time. 

Over the next several weeks I am going to walk you carefully through each of the above steps.

Today we are going to tackle STEP 1: 

Identifying and Completing the Necessary Prerequisite Coursework

Is there a Perfect Undergraduate Course Curriculum to Get into PA School?

If you are serious about PA school these are just some of the questions you should be asking yourself:

  • What courses, if any, are considered standard prerequisite course requirements across many different PA schools?
  • What schools do I want to apply to?  Do they have special prerequisite course requirements in addition to the standard prerequisites I identified above?
  • What courses should I take that go above and beyond the required prerequisites that will help me to stand out to the PA school admissions committee?
  • What major should I choose that would allow me to complete all my perquisite coursework and still have a career if I do not get into PA school or change my mind later?

Designing the Perfect Pre-PA School Course Curriculum to Get into any PA School

Let’s start with the basics.

Prerequisite course requirements vary from school to school. That being said, there is a general curriculum that most PA schools require before matriculation.

Most programs will require at least:

  • One year of chemistry with labs*
  • One course each of human anatomy and physiology with labs
  • One course in microbiology with lab
  • One course in statistics
  • One course in psychology

*Schools can be very particular about which chemistry series they prefer.  It is important to consult websites of schools you are interested in, and then check with your academic adviser.

Other frequently required or recommended courses: 

  • general biology
  • genetics
  • organic chemistry
  • biochemistry
  • additional courses in social/behavioral sciences
  • languages (some schools require coursework in Spanish)
  • medical terminology
  • public speaking
Remember that even though one school’s prerequisite list may look light compared to another’s, PA programs nation-wide are highly competitive, and the coursework in the program will be quite rigorous.

My Undergraduate Pre-Physician Assistant Prerequisite Coursework

As a real-world example I am going to show you my 4-year undergraduate course schedule at The University of Washington.

I was following a pre-medical track through spring semester of my junior year. It was at this point that I spoke with an academic adviser about my career choice to be a Physician Assistant and changed majors (You will see this highlighted in yellow below).

I declared my new major in Zoology with a renewed focus on completing my pre-PA coursework. Leaving the pre-medical track opened up many options I had not previously had.  I was now able to take courses in genetics, physiology, biomechanics, and microbiology, among other courses, that both increased my GPA and strengthened my PA school application.

My prerequisite coursework

  1. Anatomy and Physiology
  2. Upper level Biology – 1 year
  3. Cellular Biology elective
  4. Microbiology with lab
  5. Upper Level General Chemistry with lab – 1 year (3 quarters)
  6. Upper Level Organic Chemistry 2 quarters with a change to the short program my senior year.
  7. Upper Level Physics with lab – 3 Quarters
  8. Genetics
  9. Math – Qualitative Science” Calculus – 2 quarters with 1 quarter of statistics
  10. Sociobiology
  11. Biomechanics
  12. Foreign Language – 1 year
  13. General and Abnormal Psychology
  14. English Composition

Here is a detailed breakdown of my 4 years at the University of Washington (based on a quarter system)

Sample Pre Physician Assistant Schedule 4 yer BS Degree in Zoology University of Washington

* Finding myself:  During my first quarter at the University of Washington I joined a freshmen interest group (F.I.G) with a liberal arts focus.  I had hoped to join a “FIG” focused on pre-medical sciences but, in my typical “procrastinator” fashion, I signed up too late.  I spent my first quarter in college with a group of wonderful students and soon to be close friends. Although I knew I was going to pursue a degree in medicine from the start, this first quarter was not a wash. It gave me a strong supportive community of like-minded individuals and taught me that there was a world beyond the hard sciences. I then started winter quarter of my freshman year ready to tackle my medical prerequisites.

What courses are a “standard prerequisite” across many PA schools that I should take to increase my options come application time?

The goal of your undergraduate education in preparation for PA school is simple:  

  • Complete the necessary prerequisite coursework required to pursue your advanced degree as a Physician Assistant.
  • Enjoy the process of learning.
  • Avoid wasting time (and money) on courses that are unnecessary, that do not contribute directly to your primary objective or worse; prolong the time required to obtain your undergraduate degree (which will cost both time and money).
Remember: If you fail to plan early and appropriately, you may find yourself frustrated, having to go back to take courses you missed and in greater debt later on.

Although all PA schools have varying prerequisite coursework requirements, a systematic look into prerequisite requirements across many PA schools will reveal patterns that will help guide you.

The following table compares prerequisite course requirements from 10 different top ranking PA schools in the United States.

The 9 subjects highlighted in yellow represent common core requirements that you should pay attention to.

Overview of Physician Assistant Prerequisite Course Requirements by School (10 Top Ranking PA Schools)

Unless you are superhuman you must click on the image to view in full size or just (click here)

Key:        U = Upper Level Course          L = Lower Level Course          X = General requirement


What courses can I take that go above and beyond the required prerequisites that will help me to stand out as an applicant?

In the above table you will notice there are lots of boxes marked “L” for “lower level”.

You may be thinking “great, that make my life easy”!

But stop for a minute and look at George Washington University, which requires all “Upper Level” coursework.

I could spend the next 20 minutes giving you reasons why you should avoid the low laying fruit, but I think you can probably figure this out for yourself.

The truth is: If you want to stand out while giving yourself the broadest options come application time TAKE UPPER LEVEL COURSES.

The difference between Upper and Lower Level Courses:

Let’s use one of my least favorite subjects, chemistry, as an example.

At the University of Washington (UW), the Chemistry department offers Chem 110 and Chem 120: Introduction to General Chemistry and Principles of Chemistry 1. At UW this would constitute “lower level” general chemistry.

If you were to take a look at the University course catalog you will see that there is another step above Chem 110 and Chem 120: General Chem 142, 152 and 162. This is a more advanced, 1 year general chemistry series with a lab component. It is required by pre-medical students and recommended for science and engineering majors.  This is the general chemistry I would recommend all serious PA school candidates take.

The same holds true for organic chemistry. In the course catalog you will see Principles of Chemistry 2 and 3, Chem 220 and 220 – these are “lower level” courses.  I would suggest Chemistry 237-239 which are upper level.

There is lower level Biology 100 and a more advanced upper level Biology 200 series.

Do you see a pattern? You will find this across most, if not all, course offerings at all major Universities and Community Colleges.

Not convinced? Here is just one example of why you should consider upper level courses: 

My wife, who was pre-nursing, took all “lower level” science courses as a pre-nursing requirement.  This was based on recommendations made by her academic adviser with a pre-nursing focus. When it came time to apply to the UW School of Nursing (the number one nursing school in the country at the time) she was surprised to discover that her prerequisite coursework paled in comparison to many of her colleagues whom had chosen all upper level science courses.  To her boyfriend’s dismay :-) , she was not admitted into the UW School of Nursing and had to apply elsewhere. On a happy note she was accepted to Seattle Pacific University’s School of Nursing later that year!

Reach for the stars: Although upper level courses may not be “required” I would recommend taking upper level coursework across all major prerequisites if you want to be competitive and have the most options.

If you do not, like my wife, you may regret it later!

Sample University Program Pre-PA Curriculum

The following is a sample from Boise State Universities designated Pre-PA School Program curriculum.

With the growth of the PA profession there are now many Universities offering a focused Pre-PA School Program with targeted curriculum designed to help you get into PA school.

You may find that the Universities offering such programs often have their own PA programs and will design their curriculum around their own PA program requirements.

That being said, I have found most of these programs to be well thought out and provide the majority of the prerequisite coursework required by PA schools nationwide.

Sample Pre-Physician Assistant Coursework

What Major Should I Choose to Get into PA School?

The last question I will touch on briefly today is the question of picking your college Major.

PA schools are flexible in the choice of undergraduate major.

Like medical schools, they care that you do well in your major (as well as your prerequisite courses) and that it reflects your interests.

I have counseled students from all different academic backgrounds and majors. Everything from dance to the more common biochemistry.

Hint: It doesn’t matter what major you choose.  What matters is that your major reflect YOUR interests, that you have fulfilled the necessary prerequisite coursework and have excelled in them, that you have a passion for and absolute understanding of the PA profession.

If you have certain areas of academic weakness that is OK, as long as your performance reflects an upward trajectory and a passion for the profession.

When choosing a major, it is wise to also think about alternate future careers in the event that you change your mind, or are not admitted to a PA school.

It is also wise to consider a major that may help you obtain the necessary medical experience upon graduation in preparation to apply to PA school.

Common choices for obtaining medical experience often do not require a college degree.  To work as a phlebotomist as I did, an EMT or a CNA for example, will require additional certification only. Alternatively, one could pursue a 4 year degree in nursing as an undergraduate, obtain the necessary PA school prerequisites prior to graduation, use this degree to work intensively in the field for 4-5 years gaining valuable medical experience and then apply to PA school.

OK, that is a lot of information but what is the prefect Pre-PA curriculum?

Hopefully after reading this post you have a much better idea of how to approach your undergraduate studies. To design the perfect curriculum I have created a worksheet to help you accomplish this goal.

Here are some steps to consider:

  1. Make a list of the top 10 to 15 schools you would consider applying to. Go to the PAEA Program directory (which is now FREE Yeah!) and look up each school. Use the worksheet provided below to make a table of the required courses. Take special note of any “outliers” and decide if these courses are absolutely necessary to meet your application goals and if so, what are you going to do to address these prerequisites? Don’t put this off until later! What if you aren’t sure what PA schools you want to apply to? Start with a geographical preference and work from there. Even if you have a list of 15 random schools this will give you a good idea of what requirements you will need to satisfy.
  2. Where are you right now? This is going to help you build a timeline to complete the necessary prerequisite coursework. Take your worksheet and meet with an academic adviser at your University or the local Community College who can help you design a course curriculum that will meet your needs.
  3. Take upper level courses. You can take the easy road and meet the minimum requirements, but I would avoid this if you can. From my own experience, and as you can see from the chart I created above, upper level courses will not only give you more options come application time, but will also make you much more competitive as an applicant.
  4. Focus on your education: You need to make your academic coursework your top priority. If you are going work while attending school pay careful attention to how it is affecting your academics.  In my case, working part-time at the campus health center 2 hours a day, helped me focus and improved my academic performance. But this is not always the case. If you are a returning student, have a part-time or full-time job or if you are a parent, make sure to schedule time for you studies and make sure everyone else is on board.

The pre-PA prerequisite worksheet

Click here to download your FREE PA Prerequisite Worksheet.

I will be back shortly to discuss number two: Obtaining the required medical and hands-on patient care experience, so stay tuned!

– Stephen

2015 Physician Assistant Program Tuition and Cost Comparison Table


Updated 2015 Physician Assistant Program tuition and cost comparison table.

Tuition and cost data of resident and non-resident tuition including length/duration of the PA program.

Keep in mind that these are estimated costs and variables such as tuition and fees will vary greatly from year to year.

Make sure to visit the appropriate PA program website for the most up-to-date tuition, estimated costs and fees. You can find detailed information on each school as well as links to its corresponding website on my companion website at www.paschoolfinder.com.

  • Red = Top 3 most expensive Physician Assistant Programs
  • Green = Top 3 least expensive Physician Assistant Programs

* Correction 10/2014:  Stony Brook University has recently listed on their website: Resident tuition $35,000 Non resident tuition $58,000

 Program  State Resident Tuition Non Resident Tuition Months
Adventist University of Health Sciences Florida  see site  see site  27
Albany Medical College New York  $53,144  $53,144  28
Alderson-Broaddus University West Virginia  $79,880  $79,880  27
Anne Arundel Community College Maryland  see site  see site  25
Arcadia University Pennsylvania  $72,000  $72,000  24
Arizona School of Health Sciences Arizona  $73,840  $73,840  26
Augsburg College Minnesota  $80,000  $80,000  31
Baldwin Wallace University Ohio  $72,000  $72,000  24
Barry University Florida, Virgin Islands  $76,600  $76,600  28
Bay Path College Massachusetts  $97,000  $97,000  24
Baylor College of Medicine Texas  see site  see site  30
Bethel University Tennessee  $75,600  $75,600  27
Bethel University Minnesota  $85,000  $85,000  27
Boston University Massachusetts  $85,800  $85,800  28
Bryant University Rhode Island  $85,000  $85,000  27
Butler University Indiana  $36,000  $36,000  24
Campbell University North Carolina  $70,875  $70,875  28
Carroll University Wisconsin  $61,218  $61,218  24
CCNY Sophie Davis School of Biomedical Education New York  $16,530  $41,820  28
Central Michigan University Michigan  $63,050  $99,580  27
Chapman University California  $96,000  $96,000  24
Chatham University Pennsylvania  $78,870  $78,870  24
Christian Brothers University Tennessee  $79,000  $79,000  27
Clarkson University New York  see site  see site  28
Concordia University Wisconsin  $76,764  $76,764  26
Cornell University New York  $74,982  $74,982  26
CUNY York College New York  $13,041  $22,290  24
Cuyahoga Community College/Cleveland State University Ohio  $26,908  $50,900  28
D’youville College New York  $23,000  $23,000  54
Daemen College New York  $93,080  $93,080  33
Des Moines University Iowa  $30,420  $30,420  25
Desales University Pennsylvania  $63,000  $63,000  24
Drexel University Pennsylvania  $79,326  $79,326  27
Duke University Medical Center North Carolina  $76,190  $76,190  24
Duquesne University Pennsylvania  $94,000  $94,000  27
East Carolina University North Carolina  $30,581  $71,963  27
Eastern Michigan University Michigan  $61,020  $107,474  24
Eastern Virginia Medical School Virginia  $69,356  $76,573  28
Elon University North Carolina  $78,030  $78,030  27
Emory University Georgia  $94,731  $94,731  29
Franklin Pierce University New Hampshire  $86,562  $86,562  27
Gannon University Pennsylvania  see site  see site  24
Gardner Webb University North Carolina  $71,132  $71,132  28
George Washington University District of Columbia  $78,288  $78,288  24
Georgia Regents University Georgia  $46,473  $95,732  27
Grand Valley State University Michigan  $56,341  $75,190  28
Harding University Arkansas  $71,778  $71,778  28
Herbert Wertheim College of Medicine (FIU) Florida  $62,997  $62,997  27
Heritage University Washington  $71,000  $71,000  24
High Point University North Carolina  $71,000  $71,000  27
Hofstra University New York  $86,900  $86,900  28
Howard University District of Columbia  see site  see site  33
Idaho State University Idaho  $61,272  $102,708  24
Indiana State University Indiana  $39,843  $78,800  29
Indiana University School of Health and Rehabilitation Sciences Indiana  $56,584  $84,875  27
Interservice Texas  see site  see site  29
James Madison University Virginia  $40,016  $86,428  28
Jefferson College of Health Sciences Virginia  $72,720  $72,720  27
Johnson & Wales University Rhode Island  $79,872  $79,872  24
Keiser University Florida  $57,564  $57,564  24
Kettering College Ohio  $74,550  $74,550  27
King’s College Pennsylvania  $37,500  $37,500  24
Lake Erie College Ohio  $70,000  $70,000  27
Le Moyne College New York  $77,162  $77,162  24
Lenoir-Rhyne University North Carolina  see site  see site  27
Lincoln Memorial Tennessee  $90,290  $90,290  27
Lock Haven University Pennsylvania  $26,789  $38,275  24
Loma Linda University California  $81,500  $81,500  24
Long Island University New York  $106,000  $106,000  28
Louisiana State University – New Orleans Louisiana  $43,632  $92,321  29
Louisiana State University – Shreveport Louisiana  $30,000  $44,000  27
Lynchburg College Virginia  $77,000  $77,000  27
Marietta College Ohio  $71,656  $71,656  26
Marist College New York  $85,500  $85,500  24
Marquette University Wisconsin  $102,600  $102,600  33
Marshall B. Ketchum University California  $89,775  $89,775  27
Mary Baldwin College Virginia  see site  see site  27
Marywood University Pennsylvania  $57,275  $57,275  27
MCPHS University (Boston) Massachusetts  see site  see site  30
MCPHS University (Manchester/Worcester) New Hampshire  $81,900  $81,900  24
MCPHS University (Manchester/Worcester) Massachusetts  $81,900  $81,900  24
Medical University of South Carolina South Carolina  $22,941  $32,865  27
Mercer University Georgia  $65,478  $65,478  28
Mercy College New York  $83,250  $83,250  27
Mercyhurst University Pennsylvania  $75,185  $75,185  24
Methodist University North Carolina  $73,430  $73,430  27
MGH Institute of Health Professions Massachusetts  see site  see site  25
Miami-Dade College Florida  $25,000  $45,000  27
Midwestern University (Downers Grove) Illinois  $90,254  $90,254  27
Midwestern University (Glendale) Arizona  $95,193  $95,193  27
Misericordia University Pennsylvania  $76,800  $76,800  24
Mississippi College Mississippi  $67,080  $67,080  30
Missouri State University Missouri  $35,240  $56,073  24
Monmouth University New Jersey  $102,265  $102,265  31
New York Institute of Technology New York  $102,900  $102,900  30
Northeastern University Massachusetts  $69,000  $69,000  24
Northern Arizona University Arizona  see site  see site  24
Northwestern University Illinois  $80,082  $80,082  24
Nova Southeastern University, Fort Lauderdale Florida  see site  see site  27
Nova Southeastern University, Jacksonville Florida  see site  see site  27
Nova Southeastern University, Orlando Florida   $28,960   $28,960  27
Nova Southeastern University, Southwest Florida Florida  $70,953  $70,953  27
Ohio Dominican University Ohio  $71,370  $71,370  27
Oregon Health & Science University Oregon  $78,408  $78,408  26
Our Lady of the Lake College Florida  $92,000  $92,000  28
Pace University New York  $84,588  $84,588  27
Pacific University Oregon  $73,374  $73,374  28
Penn State University Pennsylvania  $70,000  $70,000  24
Pennsylvania College of Technology Pennsylvania  $44,850  $56,982  24
Philadelphia College of Osteopathic Medicine Pennsylvania  $66,000  $66,000  26
Phladelphia University Pennsylvania  $76,000  $76,000  25
Quinnipiac University Connecticut  $84,991  $84,991  27
Red Rocks Community College Colorado  see site  see site  25
Riverside Community College California  $4,623  $18,134  24
Rochester Institute of Technology New York  $76,500  $76,500  30
Rocky Mountain College Montana  $93,861  $93,846  26
Rocky Mountain University Utah  $88,500  $88,500  31
Rosalind Franklin Univ of Medicine Illinois  $63,176  $63,176  24
Rush University Illinois  $93,150  $93,150  33
Rutgers University New Jersey  see site  see site  30
Saint Catherine University Minnesota  $73,920  $73,920  28
Saint Francis University Pennsylvania  $86,900  $86,900  24
Saint Louis University Missouri  $75,550  $75,550  27
Salus University Pennsylvania  $63,175  $63,175  25
Samuel Merritt College California  $88,000  $88,000  27
San Joaquin Valley College California  see site  see site  see site
Seton Hall University New Jersey  $102,336  $102,336  33
Seton Hill University Pennsylvania  see site  see site  27
Shenandoah University Virginia  $68,714  $68,714  30
South College Tennessee  see site  see site  27
South University Georgia  $68,535  $68,535  27
South University, Tampa Florida  see site  see site  26
Southern Illinois University Illinois  $69,210  $103,815  26
Springfield College Massachusetts  see site  see site  see site
St. Ambrose University Iowa  $87,000  $87,000  29
St. John’s University New York  $72,900  $72,900  24
Stanford University California  $53,042  $63,581  21
Stony Brook University New York  $22,500  $36,000  24
Sullivan University Kentucky  see site  see site  24
SUNY Downstate Medical Center New York  see site  see site  see site
SUNY Upstate Medical Center New York  see site  see site  see site
Texas Tech University Health Sciences Center Texas  $32,392  $78,460  27
Thomas Jefferson University Pennsylvania  see site  see site  27
Touro College (Bay Shore) New York  $73,200  $73,200  24
Touro College (Manhattan) New York  see site  see site  32
Touro University – California California  $59,000  $59,000  33
Touro University Las Vegas Nevada  $36,150  see site  28
Towson University CCBC – Essex Maryland  $24,000  $51,000  26
Trevecca Nazarene University Tennessee  $78,532  $78,532  27
Tufts University School of Medicine Massachusetts  $71,050  $71,050  25
Union College Nebraska  $108,160  $108,160  33
University of Alabama at Birmingham Alabama  $77,535  $146,959  27
University of Arkansas Arkansas  $42,000  $70,000  28
University of Bridgeport Connecticut  $75,000  $75,000  28
University of California-Davis California  see site  see site  27
University of Charleston West Virginia  $78,634  $78,634  28
University of Colorado Colorado  $53,550  $115,950  36
University of Dayton Ohio  $75,500  $75,500  27
University of Detroit/Mercy Michigan  $89,988  $89,988  24
University of Findlay Ohio  $85,057  $85,057  28
University of Florida Florida  $54,080  $120,754  24
University of Iowa Iowa  $45,290  $91,142  28
University of Kentucky Kentucky  $41,300  $84,900  29
University of Maryland Eastern Shore Maryland  $39,320  $66,109  28
University of Missouri – Kansas City Missouri  $65,075  $78,090  27
University of Mount Union Ohio  $66,325  $66,325  27
University of Nebraska Nebraska  $35,055  $104,511  28
University of New England Maine  $88,000  $88,000  24
University of New Mexico New Mexico  $28,902  $51,926  27
University of North Carolina North Carolina  see site  see site  24
University of North Dakota North Dakota  $34,287  $34,287  24
University of North Texas HS Center Ft Worth Texas  $33,260  $89,285  34
University Of Oklahoma, Oklahoma City Oklahoma  $30,000  $60,000  30
University of Oklahoma, Tulsa Oklahoma  see site  see site  30
University of Pittsburgh Pennsylvania  $72,601  see site  24
University of South Alabama Alabama  $56,335  $104,009  27
University of South Dakota South Dakota  $44,604  $86,049  24
University of South Florida – Tampa Florida  $69,267  $111,267  24
University of Southern California California  $47,562  $47,562  33
University of St. Francis New Mexico  $79,343  $79,343  27
University of St. Francis (Fort Wayne) Indiana  $60,000  $60,000  27
University of Tennessee Health Science Center Tennessee  $100,979  $130,979  24
University of Texas – HS Center at San Antonio Texas  $36,000  $76,000  24
University of Texas – Medical Branch at Galveston Texas  $36,000  $74,000  25
University of Texas – Pan American Texas  $68,000  $96,000  28
University of Texas – SW School of Health Professions Texas  $28,436  $69,503  30
University of the Cumberlands  Kentucky  $79,331  $79,331  27
University of the Sciences of Philadelphia Pennsylvania  see site  see site  34
University of Toledo Ohio  see site  see site  27
University of Utah Utah  $59,150  $87,970  27
University of Washington Washington  see site  see site  26
University of Wisconsin – La Crosse Wisconsin  $42,813  $79,671  24
University of Wisconsin – Madison Wisconsin  $35,031  $71,680  24
Wagner College New York  see site  see site  see site
Wake Forest University North Carolina  $66,662  $66,662  24
Wayne State University Michigan  $36,000  $72,000  24
West Liberty University West Virginia  $48,000  $72,000  24
Western Michigan University Michigan  see site  see site  24
Western University of Health Sciences California  $71,480  $71,480  24
Wichita State University Kansas  $24,022  $55,948  26
Wingate University North Carolina  $75,000  $75,000  27
Yale University School of Medicine Connecticut  $83,162  $83,162  27


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The Number 1 Regret People Have in Life is…


The ward was bleak.

Always eerily quiet.

A clinical world where clock ticks seemed to scream, and that vile smell attacked more than the air, the walls, and the floors.

It attached itself to the people themselves as if they, too, had been harshly scrubbed down with disinfectant.

The worst part was the uncertainty.

You never really knew who would survive the night. Forming relationships felt as futile as trying to build a house in hurricane season.

The foundations could be swept away at any time.

The morning would come and the bed would be empty. Then, in a blink of an eye, a new soul on the verge of departure would fill the space.

There was one woman in particular. Her gaze alone stripped me down to my very core. She oozed fear, regret, and sadness.

Our time together was deeply confronting and undeniably life altering.

The woman that changed me could barely speak English. Her condition was incurable. She seemed to have some idea of who I was but it really didn’t matter.

As the young, “gung ho” PA student on clinical rotations part of my job was to assist on the Palliative Care ward.

Naively, I thought I was ready to go in and help solve the problems of the dying.  Only it wasn’t I who would be offering the greatest life lessons, instead, I would be receiving them.

After all, how much counselling can you give to a woman you can barely speak to?

As it turned out, it wouldn’t be an issue.  The majority of our time together was spent in silence, holding hands, with her squeezing mine at increasingly irregular intervals.

Hand in hand, mostly in silence, we contemplated life.

I wondered why her family never seemed to be around, how she had come to this ward, and why she hadn’t taken the time to learn English, having been in the country for many years.

Occasionally, she would speak in her broken tongue, and almost every word was tainted with regret.

She would frequently apologize about her English, speak about doing work she used to hate, family relationships that had soured, and I would listen.

It really was too late to do anything about it.

I thought about the other people I worked with on the ward. It was strange. Those in the most physical pain almost always were in the greatest emotional pain and had the biggest regrets. Their language was littered with “should have”, “could have”, “wished I’d,” “why didn’t I” …

Then there were the few patients I came across who were at peace.

Despite their circumstances they would smile often, joke, and ask about me with great curiosity.  Even though their bodies were on the verge of final retirement, their eyes were bright and alive.

Often surrounded by friends and family, these people would tell fascinating stories about the risks they had taken, failures learnt from and the great rewards received.

Just like me, they didn’t know what would happen tomorrow, but they seemed ready.

Her name was Maria


After what would be my final session with her, I actually knew I wouldn’t be seeing her again.

I had done my best to assist her, and I could tell she appreciated it, and yet we both knew she had not found peace.

Following the last time we spoke, I sensed she would be leaving soon, and I became very angry. I stormed out of the hospital, and with a red-hot face and clenched fists I started walking. My head was swirling with confusion.

I had no idea why I was so angry. I soon realized what it was. I hated the feeling of helplessness.

I was angry at the truth. All those life clichés had punched me straight in the face. You only live once, follow your dreams, blah, blah, blah; it was all excruciatingly true.

After that day, I thought more and more about the importance of happiness and the meaning of time.

Maria had shaken me out of my naivety.

I had become afraid! But I was not afraid of death. Rather, I was afraid of not living. Not living fully, openly, and wholeheartedly.

Then I heard her last words to me:

“The Number 1 regret people have in their life is not taking enough leaps of faith!”

The reality inside that statement floored me. I struggled to breathe as the realization sunk into my body. It wasn’t just statistically true; a vocal arrow had struck a personal bull’s- eye.

My mind pulled me back to the hospital.

I took a deep breath, lifted my head to sky… and jumped.

Physician Assistant School and Program Directory eBook

Physician Assistant Programs eBook

Are you Looking for a good end of the summer read?

I am so happy to offer my newly compiled PA Programs eBook to you for FREE.

The Physician Assistant School and Program Directory is a complete list of every accredited Physician Assistant Programs in the United States.

And best of all: It’s been fully updated for 2015!

This eBook will help make your search for the right PA school painless.

The 2015 PA Programs eBook includes the most pertinent and up-to-date information on tuition, fees, application deadlines, GRE requirements, GPA requirements, medical experience requirements and CASPA participation.

This interactive PDF document includes direct links to each corresponding PA program website so you can search and explore every school in depth, and with a click of your mouse.

Oh, and did I mention, I am giving it away for free?

You can download the book here.


Why the eBook?

In 2001 I left my hometown of Seattle, WA and ventured 3,000 miles across country to Piscataway, New Jersey.

I had been accepted to the Rutgers Physician Assistant Program and I was ecstatic.

In those days, I don’t remember searching the internet much to find a PA program that fit my application requirements and if I did, it was incredibly slow over dial-up internet.

Instead I opened a book, sent letter’s to each school and waited patiently to receive the application packet in the mail. It was painful.

Now, 13 years later, things are a little bit different.

I dreamed of an online directory where I could perform a categorical search to find a program that not only fit my geographical preferences but also was affordable, didn’t require the GRE and met my GPA requirements.

I built the Physician Assistant Schoolfinder Directory with this in mind.

That being said, many people have emailed me asking for a print version of the directory.

And now, it’s all yours for free.

I hope you find this to be a useful resource and a valuable companion to the paschoolfinder website.

You can download the eBook through Noisetrade.

This book is available FREE, but if you like what you find, please leave a tip. A little generosity goes a long way. 


And if you haven’t already, make sure to sign up for my free email newsletter where you can receive updates from the blog and notification of new releases by email.  Just enter your info over there in the sidebar or below this post.

Have a great day, and best of luck on your PA School search.

Stephen Pasquini PA-C

Do You Recognize These 7 Common Mistakes in Your Personal Statement?

7 Common Mistakes People Make on Their PA School Essay and How to Correct Them

You’ve written your essay.

You know what you want to say.

But will the admissions committee get your message?

You’ve chopped and changed the order of the paragraphs. You’ve polished each sentence.

After all that hard work, you’re still not sure whether your essay flows along nicely. Will readers stumble over a paragraph? Or effortlessly glide through your text?

Creating a hypnotic flow doesn’t have to be so difficult.

Let’s have a look at 7 of the most common mistakes I see people make while reading and editing PA school applicants’ essays.

We will also discuss how to correct them.

* The following was written by Duke Pasquini – Physician Assistant Essay Collaborative editor.

1.  Most Essays are too long

You want to tell everything about your life and you hate leaving anything you think is important out.

How to correct this:  If you are on the admission committee and are reading your 75th essay in three days, would you rather read a short concise essay or a long rambling one?  I think you already know the answer.  I refer to this as “Don’t get lost in the library.”  You don’t want who you are to get lost in too many details.  You don’t want to be just another book on the library shelf.

2.  Paragraphs are too Long

How to correct this: Always put yourself in the admission committees place.  If you look at an essay and see large blocks of text, are you inclined to think, “Oh, this will be an easy read.”  OR  “This is going to be a hard read.  Look at all those words crammed into two or three long paragraphs.”   You want to make a good first impression on the reader before they ever begin reading your essay.   Create more open space by using shorter paragraphs.  Break long paragraphs into shorter ones.

3. Applicants Prefer Telling

You want to tell the reader every wonderful thing you’ve done in a long list of accomplishments rather than showing them.  This is similar to number 1, but let me explain further.

How to correct this:  A picture is worth a thousand words.  You need to paint a picture for the reader that will make them identify with you and the patient.  This requires an anecdote.  Tell them about Johnny (be sure to use his or her name) who came into the hospital unconscious.  You came into his room every day and said a few words to him and one day you came in and he was awake or he died or moved his fingers or toes or whatever.  Tell us what Johnny looked like and how you felt when he awakened or died.  Did you feel like you failed him or that it was the first time you faced death.  All these things will grab the admission committee’s attention.  Always remember the admission committee has read a lot of these essays and you want yours to stand out from the rest.  Refer to #5 below for a more detailed example.

4. Applicants Love to Talk in Glowing Platitudes

What is a platitude?  A platitude is a remark or statement, especially one with a moral content, that has been used too often to be interesting or thoughtful.

Synonyms:  clichétruismcommonplace –  trite, hackneyed, stock phrase.

Here are a couple examples:

The first is a statement by a teacher who is applying for a teaching certificate.  Sometimes is it easier to recognize platitudes in a field other than your own.

The second is an example of a statement filled with platitudes from one of our PA School applicants.

Example 1: 

The example below is from someone who wants to be a teacher.  I’m using it because I think it’s a great example of what I’m talking about.  You probably won’t want to finish reading it.  The point is, don’t write like this when you’re writing your PA essay.

My goals are to consistently and constantly better myself as a teacher.  To help achieve this goal, I am constantly looking to my peers for suggestions and will continue my personal strategy to their emulate creativity, procedures, methods, and techniques that I witness or hear of; my current master teacher serves well as an example of how much there is that I can learn.  My desire is to be the most effective and proficient teacher I can be.  Charged with curriculum that is extensive in classroom time that is limited, I commit myself to achieve the best functioning classroom possible and through my experience as a student teacher, I have seen the benefits of this; through my experiences as a substitute teacher, I have witnessed the deterrents to learning in environments with discipline and behavior are not properly handled with effective routines and procedures.  The classroom is a learning community and needs to be addressed as a joint effort of students and teacher.  The developmental ages of the students being taught needs to bear great consideration when implementing instruction, I will continue my efforts to understand my students, their motivations, and their shortcomings to the best of my ability.  I will continue educating myself, not just in content, but in strategies and means to differentiate and modify so that each individual child placed in my care stands the best opportunity to learn to their maximal abilities.

Example 2:

I have always wanted to be a PA since I was a child.  It is the type of profession that will allow me to help people and helping others is the highest calling anyone can have.  I have had this desire in my heart for many year beyond my childhood.  The medical field offers a person a chance to make a difference in a person’s life.  The PA is given a chance to feel like they have made a positive difference in a patient’s life every day.  This is why I want to be a PA.  PAs also have the advantage of working as a team member with a doctor.  I like the idea of having a mentor to guide me.  I am a willing learner.  Patients need someone with patience.  This is something I have in spades.  If given the chance to become a PA, I will bring enthusiasm, love, and a caring heart to the job.

Note:  All this may sound great to the writer, but there isn’t one example that would lead the reader to believe the applicant is capable of doing any of what he/she says they can do or shows they actually believe in the statement they wrote.  They are just generalizations that sound good but mean nothing.

As Shakespeare said in the final soliloquy in Macbeth, It is “a tale… full of sound and fury signifying nothing”

Life’s but a walking shadow, a poor player,
That struts and frets his hour upon the stage,
And then is heard no more. It is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.

Macbeth Act 5, scene 5, 19–28

How to correct this:  If you are on the admissions committee, would you ask this person to come in for an interview?  Did they create any images in your head or show you how they will do all the things they say they will do?  No, they just put a bunch of words on the paper that sound good, but in the end, makes the reader believe they’re just trying to impress them with glowing platitudes that say nothing.  What the reader will probably ask is so what?  And who cares?

5.  Poor First Paragraphs

The first paragraph has to grab the reader’s attention and give them some idea of what will follow.  It is great if you can lead with an anecdote that summarizes what is in the rest of your essay.

Here’s a bad example.  “I want to help people and save lives.  Becoming a PA will give me a chance to do that.  One of my best qualities is that I take initiative and don’t stand back and wait for someone else to do what needs to be done.  As a PA I will also be helping families who could have lost a loved one if I hadn’t been there to help.”  This is filled with platitudes.

Here’s a good example of an anecdote that shows the same thing.  “I heard a car crash and ran out of the restaurant to see what happened.  A man was lying on the ground and wasn’t breathing.  His wife had her arms around their two little boys and was screaming, “Someone please help.”    People gathered around but no one did anything.  I ran to him, gave him chest compressions, and mouth to mouth resuscitation.  I had never done this before, but I kept him alive until the ambulance arrived, they restarted his heart, and took him to the hospital.

Let’s examine what the anecdote tells us:

  1. There is an accident.
  2. No one did anything.
  3. You take the initiative to do something.
  4. You saved the man’s life.
  5. You kept a woman from becoming a widow.
  6. You kept the children from losing their father.

You said all of that in the anecdote.  Your theme for the rest of the essay could easily be how you take initiative (shown through other examples) and how by being a PA you can save lives and help families.

The bad example paragraph said the same thing, but what a difference.  Which one would grab your attention?  Which applicant would you call in for an interview?

6.  Incorrect use of the Word I:

How to correct this:  You want to avoid the use of the word I in most cases, but not in all cases.  You don’t want to say “I did this” and “I did that.”  “I am a dedicated person who will give everything to the job.”  “I am hard working and resourceful.”  “I inspire my co-workers with my dedication to my job.” etc.  What you want to say is “I spent three months working in an orphanage and the children inspired me with their cheerfulness.”  OR  “I had no idea the experience would change my life.”  OR “I have often failed, but failure has made me better at what I do.”

 7. Incorrect use of Contractions, Poor Grammar, Punctuation, or Spelling

How to correct this:  It is only acceptable to use these when you quote someone.  For example:

Johnny said, “And I ain’t going to eat none of this hospital food cus I didn’t ask for it, don’t want it, and won’t eat it even if you force me to.”

We used “ain’t, began the sentence with a conjunction, ended the sentence with a preposition, shortened because to cus, and used the contractions didn’t and don’t.”  This is acceptable in a quote but never in the body of your essay.

As you can see, I’ve broken many of these rules myself, but I have the freedom to do so because I’m not applying to PA school.

I wouldn’t call these the seven deadly sins of writing the PA essay, but they are the most common and often fatal mistakes I’ve found in reading and editing essays. 

This was a guest post by Duke Pasquini 

IDuke-Imagef you are struggling to write an effective personal statement or you have an essay that is in desperate need of help please consider signing up for our Physician Assistant personal statement collaborate.  We have worked with over 50 applicants to date and the results have been amazing.

 If you are interested, you can read more about the essay collaborative or submit your essay for review here.  We have helped many applicants not only complete their essay’s, but actualize their dream of admissions to PA school. Which is why we do this in the first place.


The Daily Eponym – A FREE Email Series That Will Impress Your Preceptor and Save Lives – All From Your Inbox!

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An invaluable daily email series with a short description of the most common medical eponyms. Impress your preceptors with your vast abundance of medical knowledge :-)


The Case of The Missing Eponym

A Clinical Case: by Eve Purdy

An otherwise healthy 44 y/o male presents with R ankle pain and inability to weight-bear after falling off a horse. The exact mechanism of injury (external/internal rotation or pronation/supination) is unclear. R ankle is diffusely swollen with tenderness over the tip of the medial malleolus. Neurovascular intact. He has no other injuries.

The important historical fact that this man was thrown off a horse and positive screening with the Ottawa ankle rules which make me think that he needs an x-ray. I present to the attending with this plan.

screen-shot-2013-03-03-at-3-22-13-pmAfter discussing our fear of horses, she agrees and we order the ankle series. This is more or less what we get back.

A perfectly normal looking ankle…on x-ray at least →

There is no way- I don’t believe it. I express my surprise at the negative x-ray given the patient’s presentation to the attending and she asks, “well did he have any proximal fibula tenderness?”. I had checked, and he did.

screen-shot-2013-03-03-at-3-31-00-pm← So we order an AP proximal fibula. This is what we get next.

A spiral fracture of the proximal fibula. So now we are working with: medial malleolar tenderness, bruising and swelling and a fibula fracture.

With the new knowledge in mind we review the original ankle films and are able to convince ourselves (maybe with a little confirmation bias) that the joint space might be a tiny bit wide.

screen-shot-2013-03-03-at-5-57-59-pmNothing like some more impressive Maisonneuve’s that look like this  →

We consult ortho and sure enough they agree. He is scheduled for follow up, and likely surgery (necessary for most Maisonneuve fractures) the next day.

A discussion of the treatment is beyond the scope of this article but a nice review of evidence-based management of this injury can be found here.

So what about the Eponym? 

This whole clinical encounter would have been much smoother if I had just known the eponym.

At the time I didn’t know what a Maisonneuve fracture was. I knew enough to look for proximal fibula tenderness in my initial physical exam because I had remembered learning something about energy transfer through the interosseous membrane in ankle injuries, but I couldn’t put it all together. I didn’t know the words to describe what I was worried about. The word Maisonneuve would have really helped me express what I was thinking.

In the online Clinical Problem Solving course through Coursera you can learn about the importance of problem processing. The importance of taking a patient’s complaint and turning it into medical language that triggers our memory about the condition and that allows us to communicate efficiently.

I know they are a hot subject but like it or not in this case and for many other conditions eponyms are an important part of problem processing.

Instead of sending the patient back and forth to x-ray and taking up time and space in a busy ED if I had said the first time, “I am worried about a Maisonneuve fracture” he could have had both x-rays at once.

What is an Eponym?

If you are, or ever have been a PA student and you are not familiar with eponyms then you just may be living under a rock.

“Eponyms” is best known as an app that gives a short description of more than 1,700 common and obscure medical eponyms.

Medical eponyms are terms used in medicine which are named after people (and occasionally places or things). New discoveries are often attached to the people who made the discovery because of the nature of the history of medicine. This has produced a large number of medical eponyms:Wikipedia

Why are Eponyms Important?

The case above gives a beautiful demonstrations of why knowing medical eponymous can save dollars, unnecessary testing and even lives.

The Daily Eponym

The Daily Eponym on your iPhone

Eponyms come up all the time, they are hot topics during preceptor pimping sessions on your PA school rotations and they make excellent post rotational and PANCE or PANRE exam questions.

In the old days when I was toting around my beloved palm zire 71 eponyms was one of the most talked about and downloaded (or “beamed” – shout out to my fellow gen X’ers out there) of every medical students arsenal. Well that, and the infamous Palma Sutra :-)

The problem with eponyms is that there really are only a handful of those 1,700 medical  terms that are important to know and seem to come up all the time.

So, in the spirit of the daily PANCE and PANRE I wanted to do something for all you hard working, nose to the grindstone PA students out there (and maybe even help save a life along the way).  And with this intention I am delighted to bring to you The Daily Eponym.

This is an email series designed to do exactly what it sounds like, send you an eponym a day to your inbox for the rest of your life. (ok not really, but until I run out of good ones to send you)

Who knows, you might wake up one day to the answer that will save you from your next surgical rotation pimp session (read the section about “ego dementor’s” and doctor Dick) or make that inspirational diagnosis that you can tell at dinner parties.

Better yet, it is FREE!

You can sign up to start the series using the form at the top of this post.

When you know everything, or you are just sick of it, cancel your subscription, I won’t be hurt although don’t blame me if you miss that surprise question about The Apley Scratch Test.

Sign Up For The FREE Daily Eponym

My PA School Rejection Letters – How to Turn Your “Set Back” into a “Set Up”

small__6811140195“If I fail more often than you, I win.” – Seth Godin

I have written before about the importance of becoming an epic failure and how this is a fundamental part of becoming an epic success.

I was cleaning out some of my old file cabinets today and came across my PA school application documents from 2001.

I will be sharing three of them below.

If you are experiencing setbacks on your path to becoming a Physician Assistant I want you to know that this is a normal part of the process.

Do not be discouraged: failure, met with perseverance, is the key to long-term, sustainable success.


My PA School Rejection Letter #1 (Ouch!)


In order to help you reach your goals it is important that you see my failures along with my successes.

Otherwise, you will be fooled into believing that success is a simple, pain-free process, when in reality the path to each of my successes has been lined with the road kill of my many epic failures.

Got a Moment for Some Inspiration?

Weather it is God or otherwise, how we perceive a setback matters!  (Listen 25 minutes)

This week, I won two free tickets as part of my daughters kindergarten raffle to see James Durbin, an American Idol “outcast”, play here on our shared home town stage of Santa Cruz, California.

Although I am not that familiar with all of James’ music, last night as he stood on stage I realized just how much I respected this 25-year-old rocker.

Knowing all the public criticism he had to endure during his time on the Idol stage, the sting of being “voted off” and rejected by his peers, not to mention the many obstacles he had to overcome in a lifelong battle with Tourette’s and Asperger’s syndrome.

Last night, he spoke to the sold out crowd (many of whom were young, screaming teenage girls) and divulged his story of how his pediatrician told his parents to keep their expectations low. Just goes to show what you can do with a dream and a whole lot of grit.

Don’t even get me started on the Olympics!

It may sound cliché to say that we learn more from our failures than from our successes, but nevertheless this is true.

Because life is a process of trial and error, and error, and even more error until finally you succeed!

The key is to hang in their long enough, don’t give up with the struggling masses, there is light at the end of the tunnel no matter how dim and distant it may seem.

PA Rejection Letter #2 (Your Killing me)


So success is simply the end result of a long series of epic failures if you have done things right.

Reading the above rejection letter so many years later I am almost embarrassed to admit that I didn’t have a 3.0 GPA, but there is a back-story not written on this rejection letter. This proves the point that an isolated number outside of any context is just a point along a curve that when seen alone is pretty much useless.

Don’t become a point on a curve, the trend is what matters! In what direction are you trending?

And just when you thought the pain and suffering couldn’t go on…

My Rejection Letter to the National Health Service Corps (The kick in my proverbial balls)


Yes, I was even rejected by the National Health Service Corps the first time I applied. Although not the second

And yes, I received even another rejection letter from OHSU, but I must have thrown that one into the fire.

My Acceptance Letter to PA School

At first it seemed odd to me that among this stack of failed attempts I could not find my acceptance letter into pa school.

I remember it so well, that simple single sheet of white paper with red and black-ink letterhead, about 4 sentences long sporting an official UMDNJ seal.

I read it in the rain, on a cold Seattle evening by streetlight, heart beating, exhausted after a long day of work. The feeling of nausea rose to my chest as I held the two corners of that letter, and I said a short prayer before I tore it open.

I made a promise to God and myself that if this dream would come true I would use my training always to relieve the suffering of others and to make the world a better place.

Spoiler alert… I was accepted and I am still working hard to keep my promise.

My Message to You

If you have received a rejection letter fear not my fellow epic failures, I too have stood demoralized in your shoes.

But do not let that define you, let it guide you, let it be the road kill that you can look back upon with pride years later when you are writing a blog post hanging out your dirty underwear with pride for all the world to see.

Here are my rejection letters. I am posting them as a reminder of what should make you stronger. I saved them because they gave me motivation, and I hope they can be a part of yours as well.

If you can learn to see adversity as a tool to help you reach your goals you can turn what seemed to be a “set back” into a “set up” for something truly wonderful.

Thank you for reading, and I wish you the best wherever you may be on your journey to PA-C.

–  Stephen

photo credit: venspired

MD Versus PA Showdown Round 1 – Show Me The Money!


Before you read this post I want you to take a quick survey.

What do you think?

Physician Assistant vs. MD – Show Me The Money

Often the decision between PA and MD is considered a difficult one, but should it be?

Today I am posting the first in a series of posts to help prove to you why this age-old debate is not a debate at all.

And since the biggest search phrase in Google following the word “Physician Assistant” is “Salary” I thought I would start by addressing the elephant in the room and show you the numbers.

Annual salary numbers themselves are useless, as they are not a good representation of salary in relation to all the hidden variables such as time spent in training, debt, residency, and average hours worked per week.

This post is going to address all of these variables using an elegant equation and we will calculate a more important indicator:

True Hourly Wage!

This post is heavy with numbers so you may need to grab your glasses (and a calculator), but as you will see the results are interesting!

So lets get going…


Medical Doctors (MD) – True Hourly Wage

Becoming a physician is expensive!

For the 2013-2014 academic year, the average total student budget for public and private undergraduate universities was $19,338 and $39,028, respectively.

If one attends an average priced institution, receives subsidized loans and graduates in four years they will have about $100,000 of student loan debt from undergraduate college.

For the 2013-2014 academic year, the median cost of tuition and fees for public and private medical schools was $24,384 and $43,002 per year, respectively.

This does not include the cost of rent, utilities, food, transportation, health insurance, books, professional attire, licensing exams fees or residency interview expenses.

Therefore, the average medical student budget is about $45,000 per year; $30,000 for tuition and $15,000 for living expenses.

If one attends an average priced medical school, receives 1/3 subsidized loans and graduates in 4 years; at a 7% APR they will have $200,527 of debt from medical school at graduation.

If one borrows $22,500 bi-annually and two-thirds of this accrues interest compounded bi-annually at 3.5% – their total student loan debt for both college and medical school will then be $300,527. Forbearing this debt through 5 years of residency and paying it off over 20 years will cost about $788,880 of one’s net income.

Loan repayment programs such as those offered by the military are not a solution for the majority. Each year, about 22,000 medical students graduate from U.S. allopathic and osteopathic medical schools. Each year the military matches 800 students into its residency training programs, because that is the military’s anticipated future need for physicians.

The U.S. tax code allows taxpayers to deduct a maximum of $2,500 per year of student loan interest paid to their lender.

This deduction is phased out between incomes of $115,000 and $145,000. Therefore, this benefit is of no help to most physicians.

If one were to start a business, they could deduct nearly all of their expenses. Yet for unclear reasons, one cannot deduct the cost of becoming a physician; not the tuition or even the interest on the money they borrowed to pay their tuition.

During residency, if one makes payments of $1,753 per month, or $21,037 per year, to pay off the accruing interest, their debt will be still be $300,527 at the end of residency.

However, they will have spent $63,111 over the course of a 3 year residency or $126,222 over the course of a 6 year residency to keep their debt from growing.

Though paying off the interest during residency is the responsible thing to do; coming up with $21,037 each year from one’s net pay of $40,000 may be quite difficult.

Time spent training, student loan debt and the U.S. tax code makes the income of physicians deceiving. A board certified internal medicine physician who is married with 2 children, living in California and earning the median internist annual salary of $205,441 will be left with $140,939 after income taxes and $106,571 after student loan payments.

This is assuming a federal Income tax rate of 28%, California state income tax rate of 6.6%, Social Security tax rate of 6.2% and Medicare tax rate of 1.45%.

You can go to paycheckcity.com to get an idea of what one’s net pay would be for different incomes, states of residence, marital status, number of children, etc. Paying off a debt of $369,425 over 20 years at a 7% APR will require annual payments of $34,368.

Those student loan payments will continue to consume about $34,000 of their net income for 20 years until they are finally paid off.

What started off as $300,527 in student loan debt will end up costing $687,360. This debt that consumes one-fourth of their net income for 20 years wasn’t accrued because they bought a house they couldn’t afford – it is because they chose to become a physician.

Believe it or not, the amount of money reaching a physician’s personal bank account per hour worked is only a few dollars more than that of a high school teacher.


In order to make this calculation we will neglect inflation of the U.S. dollar by assuming that inflation will increase at the same rate as the purchasing power of the U.S. dollar decreases.

We will also assume that physician incomes keep pace with inflation. We will also assume that tuition costs, student loan interest rates, resident stipends, physician reimbursements and the U.S. income tax structure are as described above and do not change.

The median gross income (income before taxes) among internal medicine physicians is $205,441.

The median net income (income after taxes) for an internist who is married with two children living in California is then $140,939.

Internal medicine is a three-year residency, so throughout residency they will earn a total net income of about $120,000 and spend about 34,000 hours training after high school.

The total cost of training including interest, forbeared for three years and paid off over 20 years as explained above is $687,260.

One study reported that the average hours worked per week by practicing Internal Medicine physicians was 57 hours per week. Another study reported the mean to be 55.5 hours per week. We will use 56 hours per week and assume they work 48 weeks per year.

If they finish residency at 29 years old and retire at 65 years old they will work for 36 years at that median income.

Lets Run The Numbers:

True Hourly Wage for a Medical Doctor

[(140,939 x 36) + (120,000) – (687,260)] / [(56 x 48 x 36) + (34,000)] = $34.46

The adjusted net hourly wage for an internal medicine physician is then 

$34.46 per hour


And Now The Moment You Have All Been Waiting For…


Physician Assistant – True Hourly Wage

The median gross income (income before taxes) among Physician Assistants is $100,000

The median net income (income after taxes) for a Physician Assistant who is married with two children living in California is then $76,277

Physician Assistants do not have a residency. They spend about 6,400 hours training after high school plus they will need roughly 2,000 hours of direct patient care experience prior to applying to PA School. PA school is roughly 4,300 hours of training. This is made up of 2,000 hours of didactic and 2,000 hours of clinical hours plus the amount of time it takes to get a bachelor’s degree.

The total hours of training for a Physician Assistant is roughly 12,400 hours of training after high school.

The total cost of training if one attends an averaged priced institution and pays off their debt over 20 years at a 6.8% interest rate is roughly $197,176. You can estimate your own payments here.

One study reported that the average hours worked per week by a practicing Physician Assistant was 40 hours per week. Another study reported the mean to be 42 hours per week. We will use 41 hours per week and assume they work 48 weeks per year.

If they finish PA School at 27 years old and retire at 65 years old they will work for 38 years at that median income.

Since most PA’s do not receive a pension we will say our hypothetical PA will get a 3% employer match for 38 years and I am going to ignore interest on this income so it is about $114,000.

Lets Run The Numbers:

True Hourly Wage for a Physician Assistant

[(76,277 x 38) + (114,000) – (197,176)] / [(41 x 48 x 38) + (12,400)] = 42.63

The adjusted net hourly wage for a Physician Assistant is then 

$32.29 per hour


And Just For The Fun of it Because Both of My Parents are Teachers


True Hourly Wage – High School Teacher

The median gross income among high school teachers, including the value of benefits but excluding their pension, is about $50,000.

The median net income for a high school teacher who is married with two children living in California is then $42,791.

This is assuming a federal Income tax rate of 15%, California state income tax rate of 6.6%, Social Security tax rate of 6.2% and Medicare tax rate of 1.45%. You can go to paycheckcity to get an idea of what one’s net pay would be for different incomes, states of residence, marital status, number of children, etc.

Teachers spend about 6,400 hours training after high school, the amount of time it takes to get a bachelor’s degree.

The total cost of training if one attends an averaged priced institution and pays off their debt over 20 years at a 7% interest rate is $186,072.

At this income one would be able to deduct the interest on their student loans from their income taxes; however, those savings are not accounted for in the calculation below.

High school teachers have about 10 weeks off each summer, 2 weeks off during Christmas, 1 week off for spring break and 1 week of personal paid time off. Therefore, high school teachers who work full time average of 40 hours per week for 38 weeks each year.

Yes, teachers spend time “off the clock” preparing for class, correcting papers, etc. However physicians also spend time “off the clock” reading, studying, going to conferences, etc. If a high school teacher finishes college at 22 years old and retires at 65 years old, they will work for 43 years.

Most teachers also receive a pension. We will assume their gross annual pension including the value of benefits is $40,000 which is a net pension of $35,507. If they die at 80 years old they will receive this pension for 15 years.

Lets Run The Numbers:

True Hourly Wage for Teacher

[(42,791 x 43) + (35,507 x 15) – (186,072)] / [(40 x 38 x 43) + (6,400)] = $30.47

The adjusted net hourly wage for a high school teacher is then

$30.47 per hour

For The Love of Money

The median gross income among internal medicine physicians is $205,441.

The median gross income among high school teachers, including the value of benefits but excluding their pension, is about $50,000 per year.

The Median gross income among physician assistants, including the value of benefits is around $115,000 per year.

Accounting for time spent training, student loan debt, years worked, hours worked per year and disproportionate income taxes – the net adjusted hourly wage of an internist is $34.46 per hour, while that of a high school teacher is $30.47 per hour and that of a physician assistant is $32.29.

Though the gross income of an internal medicine physician is 4 times that of a high school teacher, the adjusted net hourly wage of an internal medicine physician is only 1.13 times that of a high school teacher and 1.07 times more than that of a Physician Assistant! Click To Tweet

PA vs. MD Round 1 – goes to MD (but by an extremely narrow margin)

*Oh yeah, and how about that stay at home 35-year-old living in the basement in our poll? If anybody has time to do that calculation please post it in the comments section… We may all be working way to hard!

If you liked this post please feel free to share with a like :-)

– Stephen