The Essential Guide to Getting into PA School

So you’ve decided you want to be a PA–now what? Read this article, of course! This is the essential guide to getting into PA school. 

Why Should I Become a PA?

There are many reasons to become a PA. It might be job security, earning a decent income, or helping others. You’re not alone, however. You might have noticed that Physician Assistants (PAs) seem to have one of the top jobs in the country. And for good reason! With a Master’s degree in medicine, PAs do much of what a physician does. Instead of 3-5 years of residency training, PAs complement their training with an on-the-job apprenticeship model. 

Traditionally, PAs have remained in a state of dependent practice for the rest of their careers. But with the need for healthcare providers at an all-time high, PAs are stepping up and rising to the challenge

Patients need PAs practicing at the height of their training and experience. As a result, it’s necessary that PAs are not dependent on any other individual to do what they’ve been trained to do. It won’t be long before PAs are expected to get a doctoral degree

What Does it Take to be a PA?

Pre-med is pre-med. There isn’t much difference between applicants for PA school and medical school. Except that PA students are traditionally older with previous careers in healthcare. This is rapidly changing, however. 

Traditional medical education is also evolving. Medical schools are realizing that there’s redundancy in the system and that PA students receive much of the same education as medical students in less time. You might even ask if some physicians aren’t over-trained

Grades

Whether you plan on attending PA school or medical school, you need to be a top student. Most schools require no less than a 3.0 but you’re not going to be competitive with a lower GPA. Plan on other applicants coming in with a 3.5 or better.

PA education is rigorous. You must learn to practice medicine in 2 years. While medical students have 3-4 years to absorb the required material, PAs must do it in 2-3. Now that’s not to say that PA school grads are ready to practice independently after 2 years–med school grads aren’t even capable of that. But your academic foundation must be just as robust. 

Captain Larry Aguirre of the California Army National Guard, is a PA and Doctor of Medical Science. He agrees that PA schools are highly competitive. “A promising pre-PA student must make high marks in both science and non-science courses. They should be sure to ace all required core prerequisite courses, but especially fundamental courses like anatomy and physiology.”

Experience

The first PAs were battle-tested Navy Corpsmen who learned their first lessons in combat. These were not 21-year-old college grads who get queasy at the sight of blood. Almost all PA programs still honor this heritage by requiring between 1,000 and 4,000 hours of direct patient contact. 

What type of experience counts as direct patient contact for PA school?

Direct patient contact is just that–directly caring for patients. That doesn’t mean that time as an ER scribe is worthless or won’t look good on an application, but it not be considered actual patient care. 

The best experiences, and the students who are the most prepared for PA education, are those with a background in nursing, paramedicine, and research. “Techs” may also be charged with patient care duties such as obtaining vital signs, scribing, administering injections, and performing basic studies such as spirometry and EKG. 

Will volunteer work help me get into PA school? 

Of course, it will help and it doesn’t even half to be medically-oriented either. PA school is grueling and actually being a PA isn’t much more relaxed. It’s easy to get burned out. Having some volunteer experience not only shows that you value service but that you’re a well-rounded person. Well-rounded students and PAs are less likely to feel trapped and unhappy. 

Will shadowing help me get into PA school? 

Yes, but shadowing several PAs is the way to go! Without actually spending some time with a working PA, you have no idea what you’re getting yourself into. It’s also important to get an accurate picture of the profession and what PAs themselves are fighting for

The day-to-day life of PA can differ drastically depending on their medical specialty. For example, a pediatric PA might work 9-5, Monday through Friday just as any other outpatient PA but they’ll typically see 30+ patients a day. They may or may not have to take call which ranges from answering a  call phone to admitting patients to the hospital. 

An internal medicine PA might only see 15 patients a day but those patients tend to be older and medically complicated. They may also be required to round on patients in a hospital or nursing home as well as performing or interpreting stress tests or sleep studies. 

Surgical, emergency medicine, and critical care PAs will obviously have a much different lifestyle. These PAs often work long hours as well and nights and weekends but they are paid well. That’s not for everyone but some of these PAs are likely to tell you that they wouldn’t have it any other way. 

Dr. Aguirre also encourages pre-PA students to shadow PAs as well as other professionals. “Shadowing offers a student the opportunity to get a better idea about what life in medicine is really like. It is also a great way to network and may provide a reference or even a job opportunity down the road.”

Dr. Aguirre shadowed many different medical professionals and credits those experiences for cementing his decision to join the PA profession. “Shadowing also offers an opportunity to start to decide what areas of medicine you’re interested in or what areas you may want to avoid. I remain grateful for all the PAs that allowed me to learn from them as a pre-PA student. I am also grateful to the many physicians that gave wise advice against becoming a physician,” he adds. 

How do I find people to shadow?

“I simply put together a CV that included my GPA and relevant experience (including courses) and an introductory letter,” Dr. Aguirre remembers. “I went to local clinics dressed in professional clothing (as for an interview) and discussed my intention with the front reception. The receptionists would kindly take my documents and often go ask the PA if they would talk with me. In almost every instance the PA was able to find time to talk with me and usually allowed me to shadow them. Of course, if you must use this method try to be sure to introduce yourself when the office does not appear busy. Once you have completed your experience be sure to write a thank you note and perhaps send a small gift of appreciation (I sometimes gave a book with a note written on the inside),” says Aguirre.

What type of undergraduate degree is best for getting into PA school? 

There’s no real “best degree” when it comes to getting accepted into PA school. More emphasis placed on prerequisites and science GPAs. 

That being said, it’s a good idea to incorporate prerequisites into your overall degree which will save time and money. Better yet, get a degree that gives you some skills and a potential career path if you don’t make it into PA school. A degree in Laboratory Science would be more helpful than Health Science if you need work for a year while reapplying, for example. 

Dr. Aguirre doesn’t believe in any single best pre-PA college degree either.  “Major in whatever interests you,” he says. “It is often asked what is a ‘good major’ for PA school. I don’t think it matters so long as one demonstrates competency and passion in whatever course of study one pursues.”

Dr. Aguirre encourages undergraduate students to have diverse experiences as it’s the best opportunity to gain a wide breadth of knowledge. “I strongly encourage students not to waste this time studying a discipline they don’t find interesting just because they think it will ‘look good.’ They should keep in mind that all pre-PA students will have to take similar prerequisite classes to be eligible for admission.”

Should I join PA organizations like AAPA? 

Absolutely! Not only does it get you into the habit of supporting your professional organization but it shows commitment. The future of the PA profession is not certain. Some physicians and laypeople mistakenly believe that you have to be an MD to practice good medicine. And the nursing lobby is aggressively battling for independence. If PAs don’t evolve, they will be left behind. 

According to Dr. Aguirre, membership in AAPA as a student can be invaluable by helping pre-PAs learn more about the profession and the different specialties where PAs work. “Joining PA forums and Facebook groups allows pre-PA students access to a lot of information about being a PA that one might not find on an ‘official site,’ he says. “As a pre-PA, I spent time learning about the diversity of opinions about our maturing profession from posts on the PA Forum. Today pre-PA students should understand the debates regarding our name change, Optimal Team Practice (OTP), and the evolving future of the PA role.”

“Join PA societies and forums,” adds Dr. Aguirre. “I learned a great deal about the history of being a PA in California just by having access to the California Academy of PAs website as a student member. It also allowed me to gain an understanding of the practice laws in that state and how far PA practice had come.” The California Academy of PAs website also had valuable information about the different schools in the state with direct links to their programs.

Supporting your state organization will have the largest impact on your day-to-day practice. Joining your state’s AAPA affiliate organization could also open doors to network with future colleagues and employers. 

PAs and pre-PAs alike should consider also donating to the PA PAC, a fund devoted to lobbying efforts. 

How many PA schools should I apply to?

“I only applied to a few schools in California,” says Dr. Aguirre. “This was probably my greatest error when applying to PA school.” Dr. Aguirre admits he was probably overconfident and didn’t realize how competitive PA programs were. “My undergraduate GPA was 3.8 general and 3.9 science,” he says. “I had numerous shadowing hours and a year of medically related work under my belt but I failed to realize that there are plenty of students that were just as competitive and there are far fewer spots than there are qualified applicants.” Dr. Aguirre considers himself fortunate to have been offered a spot at one of those schools, but he feels that there was a good deal of luck involved as well.

Is there an entrance exam for PA school?

Up until recently, the GRE was the most commonly required entrance exam for PA school. The GRE, or Graduate Record Examination, is a general grad school exam and has nothing to do with science or medicine. 

The GRE is divided into 3 sections:

  • Verbal Reasoning
  • Quantitative Reasoning 
  • Analytical Writing 

The strength of the GRE is that it requires “skills that have been developed over a long period of time and are not related to a specific field of study but are important for all.”

The obvious weakness of the GRE, besides the fact that it has nothing to do with medicine, is that it’s hard to study for. While it’s possible to brush up on some algebra and geometry, it’s much harder to increase your vocabulary or become a better writer in a matter of weeks or months.

The PA-CAT, or Physician Assistant College Admission Test, is an attempt but the Exam Master corporation to create a standardized entrance exam for PA schools. It’s important to note that at this time, very few schools actually require it. 

Similar to the MCAT, the PA-CAT is designed to “providing admissions committees with an objective, normed assessment of what their applicants do and do not know in the foundational science subjects key to success in the PA curriculum.”

According to the PA-CAT, the foundational sciences include:

  • Anatomy
  • Genetics
  • General and Organic Chemistry
  • Biochemistry
  • Microbiology
  • Behavioral Sciences
  • Physiology
  • General Biology
  • Statistics

Noticeably absent from the PA-CAT are questions testing the applicant’s knowledge of physics. 

The PA-CAT is administered over four and a half hours and 240 questions. Testing begins May 2020 and will set you back $228. You can download a practice test here

What should I write in my personal statement for PA school?

The PA school personal statement serves a few general purposes:

  1. Allows you to explain why you’ve decided to become a PA.
  2. Offers a chance to let admissions committees know why you are unique. 
  3. Separtes applicants who are effective communicators and those who can’t put two sentences together. 

Number one is personal. While it can be helpful to see others’ examples, this needs to come from the heart. If you don’t have a good answer to this question, you should probably rethink you decision to apply to PA school. Getting though the program unscathed is one thing, creating a successful and fulfilling career is another. 

Number two is also obviously personal. You are unique. This is another good reason to be wary of trying to hard to make your PA school personal statement like someone elses. Just be honest. Tell the ad com how you got to be where you are today–what aren’t you doing something else

This is also where you volunteer and shadowing hours can really help you out. If you have’t put in the time to have distinctive experiences, you probably aren’t ready to be a PA. You can’t draw from an empty well. 

Number three can go either way. Perhaps you’re already a talented writer. That’s great. PAs must be effective communicators. Part of being a PA is educating patients and peruading them to give up some things or incorporate others. 

If you’re a bit lacking in this area, there is hope. Again, don’t worry about what others are doing (they’re probably not doing it right either). 

How can I be a better writer?

  • Read more! Remember the empty well thing?
  • Consider taking a creative writing or public speaking class.
  • Practice, practice, practice. Just start writing and learn to let it flow without worrying about spelling and grammar at first. 

Dr. Aguirre believes that any serious pre-PA student should be familiar with the following books:

  • Atul Gawande’s Complications
  • T.R. Reid’s The Healing of America
  • Samuel Shem’s The House of God

“Historical works of medicine are also great to gain a better appreciation and context for the art and science of medicine and its social ramifications,” says Aguirre. Other good works include Paul Starr’s The Social Transformation of American Medicine, Roy Porter’s The Greatest Benefit to Mankind, and The Discovery of the Germ by John Waller.

Preparing for the PA School Interview

Congratulations on being offered an interview! You made it this far by being a competitive candidate–that phase is over. Now you need to prove why you are somebody they should want to work with. 

Here are some basic tips to help you get through that big day:

  • Be on time, duh.
  • Bring a copy of your resume.
  • Bring water. 
  • Dress professionally but comfortably. 
  • Don’t worry about showing off.
  • Smile, for heaven’s sake–you made it!

Will I have a individual or group interview?

Scott L. Massey, PhD, PA-C has spent 3 decades interviewing pre-PAs wanting to make it into one of his programs. He is now a consultant to PA schools across the country. His best advice? “Act natural and be yourself.”

Dr. Massey continues: “Many programs require group interviews. This consists of specific vignettes in which you have to interact with other applicants. The key thing is to be yourself. Becoming overly aggressive or trying to grandstand never ends well. Pretend that you are interacting in a normal environment. Even if you are introverted, the key takeaway point is to be yourself. Be authentic at all times.”

Some programs may actually have multiple mini interviews that involve asking how you would handle certain ethical and professional scenarios. “Because of the rapid-fire nature of the stations, it is important to be intellectually sharp. It is always a good idea to understand everything about the PA program in which you are interviewing. The mission statement and the focus of the program’s vision may become very important. Read everything available on the website of the program in which you are interviewing. Advanced preparation is key,” says Dr. Massey.

What are some common PA school interview questions?

Sometimes the best advice is pretty basic. So here it goes: If you can tell your story well, it doesn’t matter what they ask you. The absolute worst thing you could do is to try and tell them what you think they want to hear. Be authentic. Be honest. 

Besides the common questions about interests, strengths and weaknesses, you ought to be able to have a conservation with working PAs about issues in the profession. Have you heard of OTP? What about FPA? Where do you stand on a name change and the entry-level doctorate

You need to know what you’re getting into. This goes back to shadowing, but far too many students start PA school only to realize that they’ve made a mistake. Sometimes that mistake is really wanting to be an MD but convicing yourself you can “settle” for PA.

Which brings up one question you are sure to get asked during your PA school interview: Why be a PA and not an NP or MD?

PA vs NP

Rule number one: 

  • Never use the term midlevel. Not only does it lump PAs and NPs together (see rule #2), but it’s actually pretty offensive to PAs and patients alike. No PA sees themselves as offering “midlevel” care. PAs are often preferred to physicians because they are perceived as more approachable, willing to research what they don’t know. Almost as worse as using the term midlevel is not knowing why you shouldn’t use it. The same goes for physician-extender, and non-physician practitioner. 

Rule number two:

  • Don’t lump NPs and PAs together. Terms like APP (Advanced Practice Provider) are certainly less offensive but completely miss critical differences between PAs and NPs. You should know how PAs and NPs differ in terms of training, certification, and regulation. Consider shadowing a few NPs just for context. The single most compelling reason to be an NP is freedom from restrictive bureaucracy. 

PA vs MD

This is better covered elsewhere, so start here and then go here and here and here.

Here’s what not to say about your choice to become a PA and not an MD:

  • “I don’t want to work so much.”
  • “I don’t want the ultimate responsibility of caring for someone.”

Just like their physician colleagues, PAs take call and work long hours. And just like physicians, PA are responsible for the medical decisions they make. 

There is often very little difference in the outpatient between the patients managed by a PA and those by an MD. Each patient demands the right diagnosis and the correct treatment. PAs aren’t issued a separate set of PA-diagnoses and PA-medications. As a PA, you have to make the same call with less formal education than a physician.

What should I wear to my PA school interview?

Dr. Massey has seen one too many students dress too casually. “I have interviewed thousands of students for entrance to PA school. I can remember many students who presented to the interview dressed inappropriately. This can be a tipping point whether you are accepted or not. Dress etiquette for interviews usually involves a dark business suit for both men and women. Avoid powerful colors such as red and green. Bring a business portfolio and a copy of your CV. Read virtually every word from the program website. You need to try to be an expert on that program.”

What are my chances of getting into PA school?

If you don’t apply to PA school, your chances of getting in are zero. Obvious, right? If you’re looking for statistics, you won’t find them here. What you find, however, is perspective. Yes, PA students are among the top of their undergraduate classes, and yes, PA school is harder than college. If you struggled in the core sciences of chemistry, biology, etc., you will struggle even more in PA school. What’s worse than not getting into PA school? Failing out of PA school. 

On the other hand, you won’t know until you try. And you shouldn’t let anyone tell you what you can or can’t do. There’s certainly a time to be realistic about your chances of getting into PA school but life is too short to not live for your dreams. Start preparing right now. 

What do PA Doctors say about getting into PA school?

Study smarter, not harder. PA school is like drinking from a fire hose, right? I was so stressed during my first semester (I was 19 years old) that I made myself physically sick. When you are that stressed, you can’t retain. It’s important to make time for self-care. The view from the penthouse is so much better than the basement. If we can be in the penthouse (mentally), it’s easier to learn and retain.

Dr. Leona Hamrick, DHSc, PA-C, MSL-BC

Only you know why your dream is to become a PA. Visualize yourself walking across the stage and getting your PA degree. Being tenacious is a very positive attribute for PA program admissions committees. Be honest with yourself about your weaknesses. Your attitude must be that if unsuccessful this year you will make yourself better and apply again next year. Applicants who rise above the odds have impressed me.

Dr. Scott L. Massey, PhD, PA-C

My best advice for students entering PA school is to start with an “all in” mindset. For program and career success, your life will be mostly PA school for the next two years and little else. Prepare for this financially and emotionally well in advance and prepare your family and friends. The need to work and the urge to socialize will be tempting but stressful and can cause you to go through the motions of learning to pass and not to retain. You must commit to learning all information like the life of your patient depends on it (one day it will). This profession, starting with your acceptance letter, is a true commitment full of sacrifices and not a whimsical decision. You must commit to yourself that you are ready to be all-in before you take that coveted admission seat from a future colleague who really wants it.

Dr. Brandi Blevins, DMSc, PA-C, AT-C

Grasp anatomy before going to PA school (even if it means re-taking the course). Get as much experience whether it be phlebotomy, hospital tech, or MA. They all look good on an application. Remember, you are going against candidates with 4.0 GPA’s so the stronger your application looks, the better your chances of getting one of the limited seats.

Dr. Ben Taylor, PhD, PA-C, DFAAPA

Given the landscape in most states, the PA profession is at risk of losing professional footing. Sadly the majority of PAs shy away from full independence even though we are highly skilled and knowledgeable enough, well beyond our NP colleagues. I suppose if I could give any advice to a PA student, it would be to actively participate in legislative affairs from Day 1. PA programs at large need to instill this in the didactic years and prepare PAs to work and think more independently.

Dr. Deborah Thorne, DMSc, MS, PA-C

Apply as early in the cycle as you can because many programs fill up quickly and the early bird, in this case, gets accepted before the one with better credentials who applies later. Another big one is to apply broadly. These programs have many fewer seats than most medical schools so it can be much more difficult to get into one. The shotgun effect with applications significantly increases the likelihood of getting in. Don’t put too much value on the school’s five-year board score or rank. Your top priority should be choosing a program that you’re more likely to make it through because at the end of the day no one will ever care where you went to school. While it is true that some people apply with limited experience, this is a profession built on the backbone of second careers in medicine. Originally military medics and corpsman but now people of all backgrounds. Use your free time to build your resume. Possibly the most important bit of advice is to only apply to programs you meet the minimum qualifications for. CASPA will filter out applications that don’t meet the school’s criteria so while you may feel like spending that money gives you a chance you’re going to wind up in a spam folder And no one will ever see it so put all your attention into programs you qualify for. Last, be honest in your interviews. So often it’s not about your answer but about the fact that we feel you’re a good, trustworthy person. I’d rather have you say something wrong but display your character than for you to tell me what I want to hear.

Dr. Mike Sacks, DMSc, PA-C

My best advice to pre-PA students would be to develop good study habits in the realm of understanding how you learn a large amount of information in a short amount of time.  If you are in tune with how you learn and process the information presented to you as a pre-PA student in an efficient and succinct manner, then the even higher volume of information as a PA student will hopefully not be as overwhelming.

Dr. Erin Oakley McKown, DSc, PA-C

As an undergraduate student, I followed a physician who told me his three C’s to success in medicine: cheerfulness, competence, and compassion. I consistently try to employ these principles in my practice. As a PA, you will be a leader in medicine, and your attitude directly affects those working with you. No one wants to work with someone in a bad mood; no matter what has happened, always try to be cheerful. Be competent; there is no such thing as a “stupid question” as a PA. If you do not know what to do, ask someone; the last thing you want is a poor patient outcome. Finally, be compassionate. This can be difficult the longer you practice medicine, but keep in mind everyone who comes to see you has a health problem they need help with. They could have gone to see anyone, but they came to see you. Remember to respect the privilege of working with people who may be at some of their lowest moments.

Miri A. Pelc, DMSc (fellow), PA-C

If become a PA is truly your goal then I recommend being strategic with your approach and resolute in your execution. Make sure you have the time to devote yourself to all the prerequisite coursework. Have a plan to ensure shadowing opportunities and to obtain relevant work experience. Good opportunities for work experience include medical assistant, EMT, and of course military services such as a medic or corpsman. I strongly encourage pre-PA students to read widely and take time to learn about the profession and its history.

Dr. Larry Aguirre, DMSc, PA-C, CAQ-PSY

Do not underestimate the interview there is a tremendous amount is riding on it!  I recommend practicing with your friends, family, coworkers. There are plenty of resources to come up with practice questions. Take it seriously, treat it like a real interview and record your responses on camera. This will help understand how you come across.  Always answer questions honestly and make eye contact. Speak slowly, clearly, and professionally. Do not be afraid to take time to think about your answers. There is no need to rush an answer; take a minute to formulate your response. You can, in a small way, control the pace of the interview when you do this. Finally, If they ask you if you have any questions, be prepared to have something. Ask the faculty what they feel is the greatest benefit of the program, how long they have been with the program, deadlines for notification etc. When you are in PA School, joining an organization is vital. I would suggest AAPA and your state organization at a minimum. Once you determine your practice area, some specialty organizations have mentor programs for students and new graduates to help you get on your feet. 

Dr. Phil DaVisio, DMSc, PA-C

Many undergraduate students desire to become a physician assistant because, why wouldn’t they, it has been named, after all, the top career choice in the United States. What they don’t realize is the level of grit, determination, perseverance, and desire it takes to get there. I will liken it to various levels of hiking escapades. In our area of the country, one may join a group of fitness fanatics and decide to take the eight-mile round trip hike to the top of White Rocks, Virginia and that shows determination and ability. But, the grit, determination, perseverance, and desire one needs for PA school would be likened more to the training and physical and mental preparedness that it takes for that same person to hike the Appalachian Trail. First, one would need to have a strong desire and proclivity for what they are aiming to do. They need to completely understand what is needed beforehand, during, and afterward to be able to accomplish such a task. They need to know that they are in it for the long haul, and most days will not be easy. They need to understand, that for a time they will need to give up some hobbies, their favorite Netflix shows, and even spending time with family members to focus on the task at hand. Next, they need to concentrate on doing everything they possibly can to train their mind and body and prepare for the task. Finally, they need to execute their goal, knowing that for all the hard work, determination, and grit they had to put in along the way, there will be a reward at the end and that is what makes everything worth it.

Dr. Jennifer Harrington, DMSc, MHS, PA-C

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