Let's talk letters and numbers. Kindergarten had its fair share of ABC's and so will college. Here's an encouraging story for all of the college students out there who have been told "you can't". It's a story for those of you who were told to give up on your dreams of becoming a PA all because of one bad letter grade in a science course. Towards the tail end of my freshman year, I went to the Rutgers Health Professions Office (HPO) to meet with a counselor. I wanted to proactively go over the next courses and steps I should be taking in order stay on track for applying to the Rutgers accelerated 3+3 program. The counselor looked at my transcript and scanned through my course grades briefly. For the most part, I was a straight A student with an occasional B here and there. But nobody's perfect. General chemistry 2 was a really rough course for me, to say the least. The exams were high intensity, fast-paced, and very complex after hours of poor instruction in the classroom and self-taught studying in the library. Everyone has that one course and this just happened to be mine.
A quick interruption to present a sneak-peak into the nightmare that was chemistry:
To this day, I still have nightmares. I simply did not have good chemistry with chemistry, if you will. My chem 2 final exam was ridiculously, stupidly hard. That's the only way I can describe it in words. It was the type of hard where your stomach just sinks as soon as the professor says "pencils down". The chemistry department made us hand in our scantrons at the end, but would allow us to take home our answer booklets so that we could grade our work at home. The professor would post the answers up on our school site about 30 minutes after every exam. I pulled up the answer key and started to grade my test in my dorm room. As I went through the first two pages of my exam, every single answer was wrong. Every. Single. Answer. I stopped. I couldn't even continue grading knowing I probably failed the final exam and therefore the course. I went into full panic mode at this point. I called my mom sobbing because what else is a stressed out student to do. As any good mother should, she started coming up with 300+ plan B's for my future. I looked intently at the answer key in disbelief as my mom rambled on in comfort and my eyes linked with the year "2012" on the top of the pdf.
Me: "Mom, it is 2012 right?"
Mom: "No, it's 2013."
Me: "Wrong answer key."
It turns out I started grading my exam with the wrong answer key. This is a great way to give a parent a heart attack in case anyone was wondering! I did end up passing my final exam, but I certainly did not perform well enough to maintain that grade in the B range. At that point I was honestly just glad I didn't have to retake the course. I mentally don't think I could have handled taking it twice, so I'm thankful it never came down to that. But just like that, my transcript got the dreaded C+ stamped on it for good.
What were my stats?
As a pre-PA student, I was always curious about what other PA students "stats" were like when they applied and how my stats compared to theirs. It's really an impossible thing to do. You can't just compare stats because there's an actual person behind those stats and that matters equally as much if not more. Remember, I am just one example of a student from my program and every year the standards are raised that much higher. Regardless, here were my stats upon applying to PA school:
Undergrad GPA: 3.65
Science GPA: 3.41
Volunteer hours: 1,000+ hours
Patient care hours: 250+ hours. PA Programs are a little more lenient on patient care hours for 3+3 students considering we are coming directly from undergrad with limited time to work minus weekends or summers. Most programs expect close to 2,000 hours.
Shadowing hours: 300+ hours
Stay tuned for my blog posts on how I acquired my volunteer, patient care, and shadowing hours!
Anyways, back to the HPO counselor meeting, she took one look at that C+ and told me very bluntly that I should not even bother applying to PA school because of it. Did I listen to her? No. But what if I had? This just goes to show you that one professor, one course, one advisor should never be the end all be all of your future. Is PA school extremely competitive to get into? Absolutely. My classes average undergrad GPA upon their acceptance into the program was a 3.75. Many of us had one poor letter grade, but we also all took harder science courses after that and performed better to redeem ourselves. Organic chemistry1&2, for example, is one of the hardest courses at Rutgers and our exams were comparable with the Ivy leagues. I took three science courses at once during my orgo years and still managed to pull through with A's and B's. One thing I will say about your grades in undergrad is that thick skin and grit are two things most programs rank above actual letter grades. If you do poorly in a course take two harder courses and prove you can do better. Take more than one science course at a time. Anyone can pass just one, so try handling two or three per semester. You have to keep in mind that if you're accepted into PA school someday, you'll be juggling 9 core sciences at a time, and they need to know you can handle their rigor; so it's your job as a pre-PA student to show them you can.
Don't let anyone ever tell you "you can't". Never give up on a dream, no matter how big or small. Try again, fail again, fail better.
I know I would have greatly appreciated a sample college course layout of a student in my shoes when I was pre-PA. Here are some commonly asked questions I get from pre-PA students who are trying to be proactive and plan out their 4-year college schedule in preparation of applying to PA school:
What college courses should I be taking to apply to PA school?
Most physician assistant programs provide you with a list of their course requirements on their website and each program's pre-reqs are different, so keep that in mind when scheduling your courses! I was a Biology major in the School of Arts & Sciences at Rutgers. Here is a layout of my college courses for those of you who like to plan ahead or see if you are on the right track:
(#)= number of credits
AP Credits from High School
AP credits can be very helpful especially at a large university where it's often difficult to get a seat in major science courses like General Biology or General Chemistry as a freshman. One thing I will say about AP credits is, if you are coming in with a lot of science credits, try not to take easier courses in their place, just because you can with all those extra credits under your belt. Use AP credits to your advantage and take higher level science courses that you might otherwise not have had the opportunity or the time to take. Now I'm sure the type of student coming in with multiple science AP class credits is not the same type of student that needs to be told to challenge themselves, but just in case, it's been said.
Biology 1 & Lab & Extra Study Group Recitation (5)
Chemistry 1 (4)
Calculus 1 (4)
Expository Writing (3)
First Year Seminar for Health & Medicine (FIGS course) (1)
Total Credits: 20 (including 3 AP credits)
Biology 2 & Lab (4)
Chemistry 2 & Lab (5)
Scientific and Technical Writing (3)
Intro to Communications (gotta add some "fluff" for your sanity) (3)
Byrne Seminar (1 credit Research Course) (1)
Total Credits: 16
Organic Chemistry 1 (4)
Basic Statistics for Research (3)
Ethics of Eating Right (Philosophy Course) (4)
Info Tech (Communications Course) (3)
Psychology Research with a Faculty Member for Credit (1)
Total Credits: 15
Organic Chemistry 2 (4)
Extended General Physics 1 & Lab (5)
Principles of Ecology (3)
Art History (3)
Psychology Research with a Faculty Member for Credit (1)
Total Credits: 16
Extended General Physics 2 & Lab (5)
Organic Chemistry Lab (2)
Medical Terminology (3)
Total Credits: 14
EKG Use and Interpretation (3)
Intro to Cancer (3)
Intro to Biochemistry (3)
Genetics Lab (1)
Infant and Child Development (3)
Total Credits: 13
Since I was accepted into a 3+3 Program, I started PA school my senior year of undergrad, but here are some courses I would have considered taking as a senior, if I applied the normal route, to better prepare myself for the first year of PA school:
Functional Human Anatomy
Essentials of Cell Biology and Neuroscience
Sociology of Health and Medicine
Which course was most helpful for PA school?
EKG was actually taught by a faculty member of the Rutgers PA program who teaches the PA students how to interpret EKGs, so I would have to say taking this course was most helpful. Learning something once is good, but learning it twice is even better. It really helps solidifies the material, and by the end I felt confident enough to help teach some of my classmates. And as the expression goes in PA school, "See one, Do one, Teach one". Teaching is proven to be an excellent way to test your knowledge and gain a better understanding on a particular subject matter.
The other course I would highly recommend was Intro to Cancer. I never really understood as a college student how PA school could be any harder than undergrad, given that I was already killing myself trying to keep up with my school work. This is how it's harder. In our Pathology course in PA school, we had one 4-hour lecture on cancer. I kid you not, we went over my entire undergrad Intro to Cancer syllabus front to back in 4 hours. The amount of material and the pace you are learning at is 10-fold. This course gave me a really nice background foundation to fall back on, and I felt a little less lost throughout the lecture. Any advantage in PA school is a good one when you have four lectures of material to go over that night.
Which course was the hardest?
I tell a lot of people that Organic Chemistry 1 and 2 is more of a "lifestyle" than a college course. It completely consumes all hours of your day. It takes hours and hours of practice, just like learning a new language. You have to attend extra review courses every Friday and 5-7 hour long review sessions before exams just to stay on top of the class curve and not fall behind. The exams were long, fast-paced, open ended, and high intensity stress wise. Just as a reference, a Columbia orgo professor took a look at my final exam and said it was comparable if not harder, given the time frame I was allotted to complete the exam in, to the orgo exams given at their Ivy League institution. And from what I've seen, orgo at Rutgers is not anywhere near comparable difficulty wise to other universities either, so it is a lot of extra effort for the same level of recognition. Not ideal. Especially if you are applying to PA school out of state where they may not recognize the rigor of the course. I honestly believe you have to go to Rutgers and experience this course first hand to truly understand what it takes to get through it in one piece. That being said, if you can get through Rutgers orgo 1 & 2 with B's or better while additionally taking one or two other major science courses, I strongly believe this is a good indicator that you can get through the rigor of PA school.
Which course was a good "Rutgers" selection?
Extended General Physics was an "off-season" course starting in the Spring with a phenomenal teacher. It is considered extended because you meet more times a week to go over the material and a better pace and the lab is included in the course grade itself. The slower pace was way more conducive to learning. And those A+ lab report grades really give you that extra boost on your exam scores you crave. The professor, Dr. Brahmia, also holds Friday review sessions, which really helped me master the material. Again, learning something twice is almost always better.
Which courses would you recommend against?
I took Art History as one of my liberal arts requirements and it was way more of a headache than initially anticipated. I figured hey, I like going to museums and looking at art and taking art classes, how hard can it be. I mean I did survive Organic Chemistry 1, so it can't be THAT bad. It was bad. Really bad. There I was staying up late trying to memorize my Organic Chemistry 2 equations while trying to squeeze in specific dates and mediums of HUNDREDS of paintings. "The guy in the middle of this painting looks about 78 years old, so it must have been painted in 1678, oil on canvas obviously"… Not one of my finer course selections.
Can I take science classes at a community college to get better grades?
Try to limit the number of science courses you take at a community college. It is no secret that sciences at well-known universities are much more challenging than they are at a community college. It is important to show your ability to handle difficult science courses at a university level. A lot of times students who are taking science courses at a community college are taking only one tough class, like organic chemistry, to ease the burden of their course load for the following year. Other students know that taking a certain course at their university could tank their high GPA given the rigor. This is sort of the "easy way out" and programs will recognize this on your application. It's important to take risks and test your strengths. PA school is not the "easy way out" of medical school. They still want to see you challenge yourself, given that you will have to do so numerous times in PA school. Programs may try to convince you that they will not look at your application any differently, but let's be honest, they definitely have to take things like this into consideration when sorting through an increasingly competitive applicant pool of shining stars.
Can I take science classes over the summer to ease my course load?
The same thing goes for summer classes. Try to limit the number of solo science courses you take over the summer. As I mentioned in my previous blog post, anyone can take one science class by itself and get an A. It's undoubtedly easier to succeed when all of your focus is on one thing. But multitasking is a skill you need not only in PA school, but also as a future health care provider. To excel while taking three university level science courses at a time takes a special kind of student. The kind of student programs strive to accept. It demonstrates your organization skills. It demonstrates your time management skills. It demonstrates your drive well past simply just being smart or "gifted". Your ability to handle more than one science course at a time is a true testament of your academic success past, present, and future.
A fair warning to all of my readers up front: this blog post is obviously going to have a gentle biased undertone to it, so as much as I want to encourage students to go PA, I also want to encourage students to visit other NP and MD blogs to get their perspective on this topic. This post is going to be short and sweet. You already know what a PA is from my latest post. So what's the difference between a PA vs. a nurse practitioner (NP) vs. a physician (MD)? This question is so common amongst high schoolers and undergraduate students who are trying to decide on a career path best suited for them. I'm asked about the PA vs. NP question the most given that they are both considered "mid-level providers" (an often cringe-worthy term that's almost never used verbally in practice). But it's true, we ARE mid-level providers. There are so many similarities between the three from taking a medical history to completing a physical exam to ordering diagnostic tests to coming up with an appropriate diagnosis and treatment plan to prescribing medications, that often times patients can hardly tell who is who. It's the key differences that I want to focus on throughout this post to help my readers make an educated decision. And if you're not pre-PA and you just find yourself reading my blog for fun/to keep up, I think it's equally as important to shed light, educate, and bring awareness to the general public on what it is that separates the three. You just never know when you or a loved one could end up as the patient, and it's nice to know the role of each medical provider on your treatment team. It's also so important to keep in mind that there are good and bad PAs, MDs, and NPs. Don't let one provider ruin your image of an entire group of providers. At the end of the day, all providers share a common goal with one another: to ensure high-quality care, safety, and life longevity to patients. Here are the reasons why I personally went PA:
NPs are trained through a nursing model. The nursing model was first established by Stockwell in 1985 and he defined this model as "a simplified way of organizing a complex phenomenon". The nursing model focuses on the patient. It's very practical. You look at the patient's mental, emotional and physical needs at present. You look at the patient in a cyclical way: assessing the patient's individuality, planning to treat and prevent recurrence, implementing plans and setting goals, and evaluating care to analyze where improvements can be made. There are a lot of benefits to looking at the whole patient and not just the disease. You look at holistic treatments, alternative medicine, nutrition, health, and wellness. You look at the patient's ability to perform activities of daily living (breathing, eating, drinking, sleeping, communicating, going to the bathroom), the patient's life span, the level of dependence on others to survive, the biologic, psychological, sociocultural, environmental, and politicoeconomic factors, and the patient's individuality. Both PAs and MDs are trained through a medical model. The medical model dissects disease processes into their most intimate layers. You look at the pathology, what the cells, the tissues, the muscles, and the bones look like under a microscope, both normally and abnormally. You look at the complex anatomy and the detailed physiology of all body systems, in addition to the pathophysiology (seeking to understand physiological process development and future progression). You look at the biochemical pathways of hormones, neurotransmitters, regulatory mechanisms, and molecular properties. You look at clinical medicine and how the patient presents in terms of signs, symptoms, and physical exam findings. You look at the pharmacology, not just what to give a patient or how to administer it, but why, why one specific antibiotic is preferable to another for a particular microorganism. The medical model uses an evidence-based approach to treatment, which means providers are constantly learning and adapting to new research trials. For these reasons, I find that the medical model allows PAs and MDs to have a deeper understanding of physiologic mechanisms and pathologic aspects of medicine. From my experience thus far, I have found that this background knowledge allows PAs and MDs to provide a better description of disease processes to their patients.
NPs can get a doctorate level degree. NPs first earn a 4 year BSN (bachelor of science in nursing) degree where they cover anatomy, physiology, patient health assessment, basic pharmacology, basic pathophysiology, stage of life care, and supervised clinical rotations. They then take a national licensure examination (NCLEX-RN) to become a registered nurse (RN). Aspiring NPs then must gain 1-2 years of experience as an RN in the specialty of their choice. After gaining that experience, they can go on to a 1-3 year long master's degree program (depending on the specialty) and apply for certification to become an NP. NPs also always have the option to move into administration, organizational leadership, nursing informatics, health care policy, teaching, or medical research. So where does the DNP title come into play? There are several different types of programs and paths to get there, which is what I think people find most confusing. Here's my attempt to explain it. There are accelerated BSN to DNP programs that are approximately 65-95 credits + 1,000 clinical hours. This can take 3-4 years to earn either a DNP or sometimes an MSN/DNP dual degree. These programs often require a bridge year or an additional non-nursing bachelor's degree to qualify for this route. There are also MSN to DNP programs that are approximately 33-43 credits + 500 clinical hours (+500 hours from the BSN). This can take 1-2 years to complete. It's also important to know that there are part-time options (not uncommon amongst already working RNs) and full-time options, which drastically changes the length of time to earn a degree. In contrast, PAs obtain a 4 year bachelor's degree in a major of their choosing and attend a 2-3 year PA program. It can definitely be discouraging at times that other professions like physical therapists, for example, are granted a doctorate level degree. You put in the same, if not more, credits and clinical hours for a master's level degree. But at the same time, students would not have chosen a PA career if they really cared about the Dr. title before and after your name. Doctorate level PA programs have been a discussion topic highly debated for years, but honestly I believe it would just cause a lot of confusion in the work place for both providers and patients who are just finally starting to understand our current role as a mid-level provider.
NPs must work as a registered nurse first. PAs can start their training straight out of college, however most PA programs require hours of patient care experience, so this is really more of a similarity than a difference. And don't get me wrong, there is a definite benefit to working and earning some money/ gaining some real life experience in between your years of schooling. In comparison, it's ultimately impossible to work during PA school and during undergrad as a biology major, for that matter. So here I am, a poor PA student who hasn't had a job in 7 years, living off my parent's salary. Not ideal. If you're trying to decide between PA vs. NP, I would base your decision on where you are in your schooling. If you are already enrolled in nursing school or are planning on transferring into an accelerated nursing program, NP may be the route for you. If you originally thought you may be pre-med and are currently a biology major (or something along those lines), PA may be a better path for you to follow. The professions are entirely too similar for you to completely swap paths, at this point if you are already on one. Life is too short to waste excess years in school to reach the same goal. And for those of you who are fresh and have not chosen a path yet, it's really all based on if the differences in this post are deal breakers for you and your personal preference.
NPs must specialize in one area of medicine. During their master's/ doctoral degree program, NPs are trained in either family medicine, adult medicine, geriatrics, pediatrics, NICU, anesthesia, psychiatry, or midwifery. PAs are trained in all specialties and can change specialties as they please after graduation. As a result, NPs are more often going into primary care and PAs are more often specializing. 80% of NPs are educated and trained in primary care. PAs have clinical rotations in almost all areas of medicine, whereas NPs only get exposure to other specialties from their clinical rotations as a nursing student. Are you the type of person that wants to go into one field forever? It's really a personal choice. You have to know yourself, your own level of boredom with monotony, and your projected satisfaction.
NPs can open and run their own practice. PAs must practice under the "supervision" of an MD. The term supervision is often misunderstood. If you are just a phone call away from your attending who is in another state, that is considered "supervision". Attendings are not hovering over you as you type every note or see every patient. Just recently in January 2016, legislation was passed by the former governor of NJ to forego MD/DO co-signatures on PA notes. The autonomy is there. With running your own practice also comes a lot of added responsibilities separate from the medicine aspect. If the printer is broken, I personally do not want to be the one to have to fix it or the one to have to hire someone from IT to take care of it. I also prefer the inpatient hospital setting to the outpatient office setting, so owning my own private practice was never a goal of mine.
MDs are independent practitioners. They are the most prestigious of the medical providers by nature. If you are seeking that MD title, the recognition, the specialization, and the autonomy that comes with it, medical school may be the path for you. Your dreams of being like the surgeons on Grey's Anatomy performing once-in-a-lifetime solo surgeries may not be quite as fulfilled if you decide to become a PA.
MDs have to take the MCATs. The MCAT is a 7.5 hour long standardized examination students commonly take during their junior year of college. The exam consists of biology, biochemistry, general chemistry, organic chemistry, physics, psychology, sociology, and critical analysis and reasoning. I've always been a really strong exam taker, but standardized exams are in a whole different category. From NJ ASK to HSPA to the SATs, it's just never been my strong suit. This was a huge deterrent for me. To be completely honest, I did not want to take a review course class every Saturday and spend 7.5 hours every Sunday doing practice exams to try and improve my score or make myself "smarter". I'm a firm believer that intellectual ability is much better measured by four years worth of honorable course grades and grit than a 7.5 hour exam that I had to train myself to be good at. As a side note, since I applied as a 3+3 student, I did not have to take the GRE either and I am proud to say Rutgers is a GRE optional program.
MDs are not required to have patient care experience prior to medical school. Most PA programs require thousands of hours of patient care experience to apply, which more often than not leads to taking a year or more off between college and PA school. Now this may seem like a disadvantage to going the PA route, but I'm pleased to share with you all that's not the case. My classmates and I all came from very different backgrounds with experiences ranging across all fields of medicine prior to school, which added so much character and diversity to my class. Patient care experience tests your ability to handle gruesome scenes and uncomfortable situations, while giving you a front row seat to the health care provider dynamic. I also strongly believe those hours give students the humility necessary to develop into the best version of a PA you can be. I mean how can you fully appreciate where you're at and how far you've come if you haven't started from the bottom. I'll be making a post very soon on some unique ways to gain patient care experience, so stay tuned!
MDs have a significantly longer schooling/ training process. Point blank, I cannot imagine myself signing up for 10+ years of extra schooling and not getting my first real big girl job until I was in my 30s. I felt like I'd just never see the light at the end of the tunnel in medical school, given that just 3 years of PA school seems like a long commitment to my textbooks. My priorities are more family oriented, and working 80 hours per week, taking call, and working the night shift doesn't give me much opportunity to spend time with my future children.
MDs make significantly more money. If the above statement paragraph is true, then it is inevitable (and only fair) that MDs are compensated for such a long life sacrifice. There's not much else to say about that, it's the #1 best paying job in America. In 2017, the average salary of a medical doctor is $294,000 compared to $104,131 for PAs. And if you're considering primary care, the average salary drops to $217,000 compared to specialists making an average of $316,000. Some additional things to factor in concerning money are as follows. Medical school tuition is much higher than PA school. The average in-state PA program tuition is $71,369 for a 3 year program and even less for a 2 year program. If you apply to an accelerated PA program you can sometimes even get undergraduate tuition for your first year of PA school. The average medical school tuition is $207,866 for a public school and $278,455 for a private school. MDs also have to pay for malpractice insurance. The cost of malpractice insurance varies greatly depending on what state you practice in and how high risk your specialty of choice is. In Minnesota in a lower risk specialty you may pay just $4,000 a year. In California in a higher risk specialty you may have to pay $34,000 a year. Most of the time a physician's salary does correlate with these costs. Taking an MCAT review course, applying to medical schools, applying to residencies, and applying to fellowships is expensive between application fees and flight/ hotel costs for out-of-state interviews. The MCAT costs $310 to take. An MCAT review course can cost anywhere from $2,000 for a self-taught course and $4,000 for a private tutor. Every medical school application costs $160 +$38 for every school you want to apply to +$150 for each secondary application + the cost to submit you MCAT scores and official transcripts + $406.15 for interviews +$100 for an acceptance deposit. The average medical student applies to an average of 14 programs and receives an average of 4.5 interviews, which makes the cost to apply to medical school over $8,129. And it doesn't stop there. Applying to residencies and fellowships are even more expensive than applying to medical school. A resident physician only makes an average of $51,000 per year. You also do not start making that $294,000 salary until you're around age 30. And that salary is not just handed to them. MDs are often exceeding 60-80 hours/ week. Remember some of these unspoken numbers when the general public is raving about a physician's salary.
MDs must specialize in one area of medicine. Before starting residency, a decision must be made as to which field of medicine an MD wishes to practice in for the rest of their life. Specialty flexibility is one of the greatest aspects of the PA profession, in my opinion. I did not want to be locked-in to one field of medicine forever, given that as life goes on some schedules are better than others and interests fluctuate. As a PA, I can work in a fast paced ED while I'm young with no children and have a lot of energy. I can pick up per diem shifts or night shifts for extra money as my empty schedule allows. In the same respect, once I have school-aged children, a 9-5pm M-F Dermatology position may be more desirable. I'm not glued to one specialty or one set of hours as I would be with a career as a physician, and that for me is ideal. My mom was a stay-at-home mom while I was a child and as a result, family time is something that's really important to me. And this may not be as much of a priority for others who are more career driven which is just as respectable, but I want balance in my life.
MDs have a lower job satisfaction rate. PAs like what they do. I feel like I have to repeat that. PAs LIKE WHAT THEY DO. Over 96% of PAs would recommend their career path to others. Only 64% of MDs would choose a career as a physician again. One statistic that surprised me most was that family medicine statistics are rather different. 73% of family medicine doctors would choose a career as a physician again. And yet, family medicine docs are one of the lowest paying specialties. This just goes to show you, money doesn't equal happiness. Only 45% of MDs would choose the same specialty again, which again just further proves the value of PA specialty flexibility through life. PAs were ranked the #3 best healthcare job and physicians were ranked the #14 best healthcare job. The rate of burnout for MDs is 37.9% compared to the general public working population at 27.8%. The rate of dissatisfaction with work-life balance is 40.2%, which is almost double when compared to the general public working population at 23.2%. Do what you love and do it for yourself.
MDs are constantly needing to be accepted into the next stage of their career. From medical school, to residency, to fellowships, to board exams, there's a lot of pressure to make it to the next level. In addition, the stress of applying to medical school, then applying to residencies, and then applying to fellowships seemed like a never ending cycle of applications, crossed fingers, and worry. I'm thankful I don't have to worry about scoring high enough on the step1/step2 exams or the medical board exams (written and verbal), and I'm really thankful I don't have to worry about "placing" into my dream specialty. I have the power to choose. Life is too short to spend years of my life studying your second choice specialty. And life is too precious for that many years of high-intensity stress. With that being said, you can't have PAs without MDs, and PAs have the utmost respect for all of the physicians out there in the world who dedicate their entire lives to medicine.
So much for short and sweet, I tried. Choose what you may, & "namaste a PA"…
I'm sure a lot of my readers already know what a physician assistant is or have the capability of googling it themselves, but my blog just won't feel complete without a decent explanation. It's basically a PA student's obligation to inform the world whenever given the opportunity. According to the American Academy of PAs (AAPA), a physician assistant (PA) is a nationally certified and state-licensed medical professional who practices medicine on a healthcare team with physicians and other providers.
PAs are vital to healthcare. The Affordable Care Act, which was enacted in 2010, recognized PAs for the first time as one of three primary care providers (PAs, NPs, and Physicians). The law also empowered PAs to lead patient-centered medical teams. Team-based care is at the core of a PAs training. PAs can practice autonomously or in a collaborative relationship with other members of a patient’s healthcare team. This combination is a major source of their strength.
PAs are experts in general medicine. They undergo rigorous medical training. PAs must take a test in general medicine in order to be licensed and certified. They must graduate from an accredited PA program and pass a certification exam. Like physicians and NPs, PAs must complete extensive continuing medical education throughout their careers.
PAs diagnose, treat, and prescribe medicine. Thanks to an education modeled on the medical school curriculum, PAs learn to make life saving diagnostic and therapeutic decisions while working autonomously or in collaboration with other members of the healthcare team. PAs are certified as medical generalists with a foundation in primary care. Over the course of their careers, many PAs practice in two or three specialty areas, giving them deep experience and the flexibility to meet the changing needs of their patients, employers, and communities.
PAs are trusted healthcare providers. Studies have shown that when PAs practice to the full extent of their abilities and training, hospital readmission rates and lengths of stay decrease and infection rates go down. A Harris Poll found extremely high satisfaction rates among Americans who interact with PAs. The survey found that 93% regard PAs as trusted healthcare providers, 92% said that having a PA makes it easier to get a medical appointment and 91% believe that PAs improve the quality of healthcare.
PAs are in heavy demand. The US is currently still facing a shortage of health care professionals and PAs are a cost-effective way to fill this void. The profession has grown by 44% in the last year alone, keeping the workforce fairly young, and the demand for PAs has increased by 300% from 2011-2014. The BLS projects 30% growth from 2014-2024 creating over 28,7000 new jobs for the profession. Three quarters of PAs receive multiple job offers upon passing their initial licensing and certification exams. Studies show that the most financially successful hospitals maximize their use of PAs. The PA profession has been named by several top media outlets as the most promising job in America. As of January 2016, there were more than 115,547 certified PAs nationwide who interact with patients upwards of 350 million times annually.
How did the PA profession first begin?
The PA profession was created to improve and expand healthcare by addressing a shortage of primary care physicians. Eugene A. Stead Jr., MD, of the Duke University Medical Center, put together the first class of PAs in 1965. He selected four Navy Hospital Corpsmen who had received considerable medical training during their military service. Stead based the curriculum of the PA program on his knowledge of the fast-track training of doctors during World War II. The first PA class graduated from the Duke University PA program on October 6, 1967. Every year, PAs celebrate PA week from October 6th- October 12th in honor of the first graduating class. Several of these graduates went to work at the Durham VA. The VA was the first employer of PAs and to this day is the single largest employer of PAs in the country. The PA concept gained federal acceptance and backing as early as the 1970s as a creative solution to the physician shortage. The medical community helped support the new profession and quickly developed accreditation standards, a national certification process, and continuing medical education requirements.
How are PAs educated and trained?
Students must first acquire a bachelor's degree followed by a master's degree from an accredited PA program. Most physician assistant programs are approximately 26 months (three academic years) in length and require the same prerequisite courses as medical schools. Students take courses in basic sciences, behavioral science, medical ethics, clinical research, and clinical medicine. Some programs are only 2 years long, foregoing the first year of basic science courses and jumping right into clinical medicine. Most programs also require students to have about three years of healthcare training and experience before applying. Students then complete a total of more than 2,000 hours of clinical rotations.
How are PAs certified and licensed?
Before PAs can practice, they must graduate from an accredited program, pass the PA National Certifying Exam (PANCE) administered by the National Commission on Certification of PAs, and get licensed by the state they wish to practice in. In order to maintain certification, PAs must complete a recertification exam every 10 years and complete 100 hours of continuing medical education (CME) every two years. The PA-C after a PAs name means they are currently certified.
What can a PA do?
PAs work in all settings.
PAs work in all specialties.
The #1 most common specialty for a PA to work in is surgery.
Breakdown by specialty:
Surgical subspecialty 18.5%
Orthopedic surgery 10.9%
Cardiothoracic surgery 3.4%
General surgery 3%
Family medicine 20.6%
Emergency medicine 13.2%
Internal medicine 5.2%
Occupational medicine 1.5%
Critical care 1.3%
Pain Management 0.6%
Preventative medicine 0.2%
Radiation oncology 0.2%
Palliative care <0.1%
PAs work in all US states.
Top 20 states with the most practicing PAs:
New York 8,717
North Carolina 4,512
New Jersey 1,982 (yay!)
The PA profession was ranked #1 "Best Master's Degree for Jobs" in 2014 and #1 "Most Promising Jobs" in 2015 by Forbes. This type of recognition year after year has helped spread awareness tremendously.
The PA profession is ranked #3 "Top 100 Best Jobs" in 2017 by US News. They looked as jobs that pay well, challenge you year after year, match your talents and skills, aren't too stressful, offer room to advance throughout your career, and provide a satisfying work-life balance. Here's how the PA profession ranked on a scale of 1-10 in these categories placing them as best job #3.
Job market 10
Future growth 6
Work life balance 8
Total Score: 35.8/50
NCCPA Statistical Profile from 2016:
Number of certified PAs: 115,547
Gender: 67.7% Female
Age: 12.2% <30
Average age: 38 years old
Average number of patients seen per week: 74 patients
Unemployment rate: 0.6%
How much money does a PA make?
Average salary: $104,131
Breakdown by mean salary:
Emergency medicine $116,661
Critical care $114,235
Surgical subspecialty $113,752
General surgery $106,504
Pain management $103,154
Occupational medicine $101,924
Radiation oncology $100,211
Palliative care $97,778
Internal medicine $96,575
Family medicine $96,468
Preventative medicine $93,231
PA Myth Busting:
So what does all of this mean to me?
There are a lot of false perceptions about what PAs can and cannot do in a health care setting. It's important for our patients and for the public in general to become better educated on our abilities, so we can provide them with the highest quality of care. My class had a surgical PA specializing in spinal surgery come in and speak on a panel one day, and I like to share what he said with people to better paint the picture. "I work on the right side of the spine while the doctor does the left." PA's have much more autonomy and responsibility than some people realize. It is very natural for your attending to trust you with greater and greater responsibilities the more years you work with them. Share this quote with others when they question what a PA is actually capable of. Spread the word to a family member or friend, a college roommate or a grandparent, and little by little this up and coming profession will soon hold the full recognition it so deserves.
Sources: AAPA, NCCPA Statistics Profile 2016, Forbes, US News
This is my very first blog post! I'm super excited to start sharing my story with you all. I decided to make my first post about being a pre-PA student in college, and I want to talk about what the pre-PA lifestyle was like for me. Being a physician assistant is one of the most satisfying, flexible, and happening professions in the country right now, so naturally the path to get there is not a simple one. Bottom line is: being a pre-PA student is HARD. If you know me on a personal level, you know I've never been good at sugar coating things, and I made a promise to myself to be fully transparent about my experiences on my blog.
What was it like being a pre-PA student?
I was amongst aspiring physicians, nurses, pharmacists, biologists, chemists, veterinarians, physical therapists, and other pre-PA students in all of my core science classes. I think it goes without saying that's not a stupid bunch of peers, so the bell-shaped curve is not always your best friend. I was taking some of the most challenging exams on campus, while also trying to fit in shadowing hours, patient care hours, volunteering hours, and extra-curricular activities that would make my application stand out. Not to mention, I was trying to safe haven my GPA at the same time. It's a lot of pressure knowing that every exam grade matters, and there was definitely some unhealthy amounts of stress associated. It is nearly impossible for pre-PA students to avoid the big three: test-taking anxiety, social exile, and tears (don't worry everyone's doing it). I quickly noticed my priorities shifting from social scenes to the library, and I had to reassure myself on a daily basis that I was making the right decision. But Negative Nancy aside, no one said it wouldn't all be worth it someday. I mean seriously, no one would put themselves through all of this if the end goal wasn't rewarding. And the trek to get there was not all full of misery. I felt great reward with every small accomplishment, I made great strides in both personal growth and maturity, and I met lifelong friends who share my same passion. It was worth it.
What should I major in?
I was a Biology major because I felt that it would best prepare me for the rigor of PA school. This major covered all of the necessary pre-requisite courses, while also testing my ability to handle multiple science classes at one time. That being said, major is not a determining factor in getting accepted into PA school. You can major in whatever you want! From chemistry to exercise science to public health, really, it does not matter. Now it is obviously much easier to major in something science-related if you're on the four year plan, and it definitely makes more sense, but it is by no means a requirement to be a biology major. This does not mean that if you are a business major that programs won't question this choice during your interviews, but it also doesn’t mean you'll get rejected all because of a major title. With that being said, I am constantly recommending pre-PA students to major in Biology because it is known for its challenging curriculum. It makes your GPA that much more impressive. Those courses like organic chemistry 1&2, physics 1&2, and biochemistry really do test your academic strengths and demonstrate that you can handle the course load of PA school.
What kind of characteristics do I have to have to go pre-PA?
Sacrifice was a huge theme of my college experience. You need to be dedicated to your studies day in and day out. You need to be determined enough to keep going when exam material doesn't come easy to you. You need to have the grit to muster through the tough days, while always keeping the long term goal in sight. You need to have passion for the soul reason you're perusing a career in medicine. Simply going into a profession for recognition or money will never be enough. That's a promise. You need the heart, the compassion, and the empathy to care for others, but the mental strength to handle tragedy gracefully. You need to be outgoing enough to ace an interview or work in a team, but reserved enough to show your maturity. And you need a support system to help pick up the pieces every time something doesn't go as planned. It definitely takes a special kind of personality to go pre-PA, but the qualities of the people that are accepted to and graduate from PA school are the same qualities that title PAs as a more "patient-centered" provider.
What if people don't understand the pre-PA path I've chosen?
Don't ever get bogged down by all of the "Why didn't you just become a doctor?" or the "So are you going to medical school after PA school?" questions from friends and family members. Half of the time people just simply don't understand the role of the PA. The other half will realize you made the right choice three years later when you're making a healthy starting salary at a young age, when you're not drowning in student loans, and when you are able to raise a family comfortably while working a full time job. Educate others! The more they know about this profession and all it has to offer, the more acceptance it will receive. And at the end of the day, the healthcare system is nothing without ALL of its team members.