Physician Assistant School

As of 2007, at least seven countries are in various stages of expansion of PA-like medical workers that function under the supervision of a doctor.

  1. Australia
  2. Canada
  3. England
  4. the Netherlands
  5. Scotland
  6. South Africa
  7. Taiwan

With the exception of Taiwan and South Africa, these countries have American-trained PAs working as expatriates, and most are developing educational programs that produce a health care provider functioning as an addition to the doctor.

Each country has made its PA a distinct entity, with cultural and educational influences shaping their roles. Common denominators of these PAs are: they function as semi-autonomous clinicians under the direct supervision of a doctor and have roles that tend to complement those of the doctor.

Historical observations suggest the development of the PA profession in different countries tends to follow a similar path and that lessons learned from these nations may be useful in further expansion of the profession.

Those countries mentioned above are just some of the countries that have recently recognized the progress of PAs and have developed their own PA programs. Yet, assistants to doctors and prototypes of PAs are not new.

Eastern European countries such as Russia and the Ukraine; Asian countries such as China and Malaysia; much of Oceania (eg, Australia, New Guinea, Micronesia, Melanesia, and Polynesia); as well as parts of Africa and South America have employed medical aides for decades.

Even in the United States, the Alaskan Community Health Aides project, inaugurated during World War II and continuing today, produces what can be referred to as prototype PAs.

Common Denominators

Excluding the Netherlands, every country falls short of the desired 3/1,000 doctor-to-population ratio that is recommended by the World Health Organization (WHO).  All use English in the classroom, although for Taiwan and the Netherlands, English is a secondary language. Table 1 shows the population and doctor-to-population ratios of these countries, as well as those of the United States for comparison.

Canada, Australia, South Africa, and Scotland have remote and/or widely separated and sparse populations. In some countries, the size or dispersal of rural populations present formidable challenges to health care delivery.

Educational Development

Education programs have developed in different ways and by different means in the nations described here. The established PA programs in these countries range from 2 to 3 years in length, with a didactic component followed by a clinical component.


This is just a brief summary of a wonderful article published by the Journal of Physician Assistant Education in 2007. I was undable to find more up to date research about PA’s practicing abroad but hope to work on this more, especially as I am contemplating a 2 year hiatus to Australia. Please see the full article with a breakdown of practice and education requirements in each of the above 7 countries: The Globalization of Physician Assistant’s (PDF).

Post image for Finding a Physician Assistant Mentor
Find a Physician Assistant to shadow or sign up to precept: Physician Assistant Shadow Online

When I first contemplated a career as a Physician Assistant I was hard pressed to find one.

I was dying to find a PA and pick their brain. Learn about what they do, possibly shadow for a day.

Every single PA I know would absolutely love to be approached by a potential applicant.

I have never met a PA who does not love to talk about their profession.

In fact every time I hear one of my patients discuss the dream of a career in the medical profession (usually as an MD) I make sure to mention “have you ever thought of going to PA school”.

Many still believe that a Physician Assistant is a stepping stone on a career path to Medical Doctor.

If you are interested in a career as a Physician Assistant finding a mentor is simple:

JUST ASK A PHYSICIAN ASSISTANT

Go to a local clinic, urgent care or hospital. Search online for medical facilities in your region.  Drop me a line on this blog.

When you see the PA-C next to their name, reach out and contact them.

Tell them that you dream of a career as a Phsyician Assitant. Tell them why, let them know that you would like to interview them, learn more about their career and what they do.

I can guarantee that they will be flattered.

This may pave the way for a letter of recommendation in the future. It may help you solidify your career goals, it will help you in your PA school interviews and essays.

So if you are thinking of a career as a Physician Assistant the first step it to reach out and find one. Don’t hesitate, you will be met with big smiles from PA’s who will be happy to take you under their wing and teach you everything they know.

Post image for The Future of Physician Assistant Education: Stop Stealing Dreams

I am reading Seth Godin’s free manifesto titled: Stop Stealing Dreams.

In this manifesto he discusses the history of education in American. How it was tailored to create cogs in an industrial machine rather than the much-needed linchpin’s necessary to drive future innovations.

School has become an industrialized system, working on a huge scale, that has significant byproducts, including the destruction of many of  attitudes and emotions we’d like to build our culture around.

In order to efficiently jam as much testable data into a generation of kids, we push to make those children compliant, competitive zombies.

At times I fear the education of doctors and PA’s has headed in a similar direction.

While attending conferences or reading through required CME I feel we have become cogs in a pharmaceutical machine.

One trick ponies taught to think pill first, everything else a distant second.

If we want to create great PA’s of the future it starts with giving our current generation of students the tools they need to overcome the cognitive dissonance that resonates in today’s medical field.

The one that sees an obese, diabetic patient with hypertension as the perfect candidate for Metformin and a new script for Lipitor. Rather than a perfect case for the intense lifestyle interventions and hard work necessary to actually IMPROVE LONG TERM health.

I am afraid many in today’s generation have allowed themselves to be limited by fear.

Industrial, scaled-up, measurable structure means that fear must be used to keep the masses in line. There’s no other way to get hundreds or thousands of kids to comply, to process that many bodies, en masse, without simultaneous coordination.

A Physician Assistant Education of the Future:

Now students have access to more than just the medical textbooks and the best advertising big Pharm has to offer.

We can break the cycle of  prescriptions and compliance.

With this comes empowerment and better health care for our future patients.

Also, a greater responsibility.

To be advocates for our patients, pioneers of new innovations  that offers integrated approaches to health care solutions.

Not passive observers to a health care industry plagued by misinformation, a pharmaceutical focused approach to patient health at a cost to our patients that is truly non-sustainable.

Post image for How Much Does it Cost to go to Physician Assistant (PA) School?

 

When I was attending PA School in 2001 the annual tuition was in the range of $9000 per year.

As we know most college costs have nearly doubled or tripled since that time. So I decided to take a look and do some math. Here is the breakdown of my school (UMDNJ) and the projected annual cost of tuition in 2012.

Cost of PA School in 2012:

  • $572 per credit for MS Physician Assistant year 1 students
  • $556 per credit for MS Physician Assistant year 2 students
  • $572 per credit for MS Physician Assistant year 3 students

Classes and Credits:

Breakdown of Cost:

First Professional Year

Fall Semester

Credits

Spring Semester

Credits

Microbiology 7 Integrated Anatomy & Physiology 5
Integrated Anatomy & Physiology 5 Pathology 5
Cellular & Genetic Mechanisms 4 Human Development/ Health Maintenance 3
Biochemistry 3 Neuroanatomy 2
Professionalism I 1 Electrocardiography 2
Introduction to Scientific Inquiry 1 Clinical Laboratory 3
Medical Ethics 1 Systems Histology 1
Total Credits
22
Total Credits
21
   

Summer Semester

Credits

 

 

Applied Clinical Research
3
 
 

Second Professional Year

Fall Semester

Credits

Spring Semester

Credits

Clinical Medicine I 11 Clinical Medicine II 2
Physical Diagnosis 3 Clinical Nutrition 1
Introduction to Radiology I 2 Psychiatry 3
Pharmacology 3 Introduction to Radiology II 1
Medical Interviewing 3 Introduction to Clinical Clerkships 2
Applied Clinical Correlates
1
Physician Assistant Internship I
12
Total Credits
23
Total Credits
21
   

Summer Semester

Credits

 

 

Physician Assistant Internship II
8
 
   

Third Professional Year

Fall Semester

Credits

Spring Semester

Credits

Physician Assistant Internship III
12
Physician Assistant Internship IV
12
    Professionalism II 1
Total Credits
12
Total Credits
13

 

Breakdown of Tuition Cost:

First Professional Year

22 + 21 + 3 = 46 credits x $572 per credit = $26,312

Second Professional Year

23 + 21 + 8 = 52 credits x $556 per credit = $28,912

Third Professional Year

12 + 13 = 25 credits x $572 per credit = $14,300

Total Credits: 123

Total Cost: $26,312 + $28,912 + $14,300

Total Cost Tuition:$69,524

Fees

  • $10.00 Program fee per credit x 123 credits = $1,230
  • $250.00 Technology Fee with a course load of 6 credits or more
  • $50.00 General Service Fee *one time fee
  • $75.00 Non-Refundable Registration Fee for Non-Matriculated students
  • $50.00 for Late Registration for Matriculated students
  • $100.00 Continuing Program Status Fee
  • $100.00 Maintaining Matriculation Fee
  • $ 85.00 Criminal Background Check Fee
  • The Student Health Services Fee is $350

Total in Fees:  $ 2,290

In a later blog post I will be discussing the cost of books, medical supplies and general living expenses. Unless you attend part time I think it is impossible to have a job along with the full time PA curriculum.

Also many may have noticed that UMDNJ is a three year curriculum. How does this compare with shorter programs?

by Justin Marty

I am turning back the clock 10 years to 2001. I can’t believe that. It seems like just yesterday I was holding that small rain-soaked letter in my hand. The one that said: You have been accepted for an interview.

I was living in Seattle at the time… I was two years removed from my undergraduate degree in Biology from the University of Washington. I was working long hours for the Puget Sound Blood Center and taking night courses to get certified as an EMT.

I had already received two letters of denial: One from Oregon Health Sciences University and the other from Stony Brook University in NY.

It was late and it was pouring down rain.  I remember the street lights and I remember the acceptance letter. Rarely in life do things play out like a true story book ending, but there I stood in the rain, under the streetlights and I shed for the first time in my life real tears of joy.

It is weird to think that acceptance into a college can invoke such emotion. But I knew as I held that letter that I would someday sit here, as I do today, writing about how I get to practice medicine.

The Journey

I am on a plane to New Jersey I feel sick to my stomach. Just about a month earlier I had received notice from the University of Medicine and Dentistry of New Jersey that I had been accepted for an interview. Being from California and living in Seattle for 6 years I had spent little time on the East Coast. I had traveled to NJ once as a teenager with my parents on an around the country RV trip.

Jersey I thought? They don’t have trees in New Jersey.

I did not know at the time it was the Garden State.

I arrived at approximately 2pm in Albany NY. I chose Albany because I was able to score an incredibly cheap ticket and I had very little money at the time. I didn’t know how far away it was from NJ, but I had heard that I could take a train to NY and from there to NJ,  and that sounded fun. It was 22 degrees the dayI arrived. That first night I walked to a small bar about 2 blocks from my hotel room and had a beer. I kept to myself and thought about the upcoming 3 days.

The following day I boarded a train to NY City, it was spectacular. In a window seat my cold red nose pushed up to the glass, holding a cup of coffee and a good book. I put the book aside to stare out the window. The trees where white and the tips were clear like glass. The repetitive clock like click of the train car on the tracks slowly faded as we passed into dark endless tunnels and then into Grand Central Station. Where the normal now gave way to the surreal: The beauty and the sharp cold edges of NY City.

I walked all day, non-stop. I took a free ferry ride to Staten Island and back, then walked from the very tip of the Manhattan to the end of central park and halfway back again to Times Square. In Times Square I passed a young intern on the street who asked me if I wanted to attend Late Night with David Letterman. I thought “I have an interview tomorrow in NJ I can’t be on the David Letterman Show”.  But I couldn’t pass this up. So I returned at 5pm and attended the show. Again it was surreal; I was already falling deeply in love.

How I got to Piscataway NJ (the home to UMDNJ), into my hotel room and ready for the next morning perplexes me to this day.  First of all because I remember that no-one in the train station knew where Piscataway was, and because I can’t imagine that I decided to wait till that night so late to try to get to the location of my interview. But I guess it was a different time in my life.

The wonderful thing was that by the time of the interview I was in love. Not just with the idea of PA school but the idea of PA school here. And the journey here lit a fire in my soul and changed my focus:  From one of worry to one of great hope and optimism.

The Interview

6 am holding bagels and cream cheese I met another young applicant in the hotel lobby. We took a cab together to the school where we were ushered into a room with about 30 other applicants.

There were students there at the time volunteering as part of the “meet and greet”. We were in that room for a long time, we had nametags, we introduced ourselves, talked about our goals and why we were there, we then spoke one on one with several of the students and each other…

I remember thinking how amazing it was to be here all the way across the country. I was one of only a handful of applicants from out of state.

From the meet and greet our name was called, we were given a small packet (I can’t remember what was in there at the time) probably just some general info about the program and we were taken to one of the small classrooms where I was placed in a chair sitting directly in front of three instructors and a student who would be asking me questions.

Boy was I nervous, but somehow at the same time I felt this sense of calm.

The night before I had told myself this, and this is something that I have used every time I have an interview or am in a new situation: Be yourself, be humble, be extremely honest, you have skills that this organization/school needs. Let them see who you are.

The first thing they asked me was an icebreaker: “How has your trip here been” “Did you have any trouble getting here”?

What a great first question, because I couldn’t wait to tell them about the beautiful train ride, the lights of NY City, my ferry ride to Staten Island culminated by my stint on the Letterman Show. I could see how their eyes lit up as I talked about it. It was brining something back for them; I was like a baby who had found a new toy. And it was my enthusiasm that shined through.

Then they asked me about my work experience: I was a phlebotomist now; I traveled all over the city of Seattle and the outskirts on a mobile bus. I had worked during the summers at a Special needs youth summer camp with kids with disabilities, I had finished an internship at the University of Washington Laboratory, I had finished my training as and EMT, I held a bachelor’s degree in Zoology. I was engaged to be married.

They asked me about my 2.9 GPA. I explained how my first two years in college had been a part of how I got there that day. How my last 2 years I made dean’s list, how I challenged myself by taking harder classes that interested me. I explained how this gave me a broad base of experience. How this taught me about hard work and the meaning of perseverance.

They asked me about patient care experience. I told them how I hold the hands and arms of patients often when they are the most vulnerable… The job of a phlebotomist seems trivial but I explained to them that it is not. It is about comforting people when they are afraid, easing their worries, taking time to listen to their story. It is what I want to do as a PA.

And last that asked me why I wanted to be a PA not a Doctor. For me this was simple. I had known a Physician Assistant who was changing the world one patient at a time. That is who I wanted to be.

The Letter

Back to the rain soaked night standing on my porch in Seattle, holding that acceptance letter, writing this today.

Life is such a beautiful journey.

You’re Journey!

Wherever this finds you on your path to becoming a Physician Assistant I will say this: It is not just cliché to say that if you want anything bad enough you can get it.

And what I learned during my interview process for PA school was that I had to overcome a fear of failure and many deep rooted feelings of inadequacy that I held onto.

I tell you of my journey because it was the trip around my interview that was the most important part.

It reminded me at an extremely crucial time just how wonderfully amazing life can be. The beauty of simple things and the reason I was there.

Otherwise, had I not had this experience I may have just become another fly on the wal.:

Lost to my insecurities, stifled by a lack of creativity in a moment of intense stress and distraction.

Post image for How to (Really) Get Into the PA School of Your Choice!

“A successful person does what a failure does not like to do”

- My Dad

Everybody’s Journey to becoming a PA is different.

We all have different lives, different upbringings, different barriers to overcome to reach our goals… Different paths that have led us to wanting to become a PA.

There is no single formula that will assure you a ticket to PA school (I am sorry to say). But I can tell you this: Like many things in life there are ways to increase your odds.

Most of them you already know, but you may have forgotten:

Step 1: Start Working Hard, Most Likely for Free!

One of the single most important things you can do is start working hard and yes that will most likely be for free.

The single most important thing I did was to work and volunteer in hospitals and clinics throughout my pre-pa life. When I was in college I walked into the campus health center and asked if they needed help. I began volunteering, which led to a job in medical records which led to a position working in the campus lab where I trained as a phlebotomist. I was being paid $4.25 an hour and this was in 1997.  But the takeaway… I met every-single Doctor, PA, Nurse, MA, NP, Midwife  in the entire clinic and many throughout the hospital.

The thing was that it was never about the money. It was about making important connections that would later serve me extremely well and become the single reason I did get into PA school. The letters of recommendation from these wonderful people were the reason I landed my first PA school interview and is the main reason I get to do what I love to do today.

So my advice:

Get out there and find something good to do. Start for free if you need to. It could be volunteering, candy striping, visiting the cancer wards, transferring patients, helping out at blood drives etc. etc.

Volunteer Match is a great resources to find that perfect volunteer position. They also make a free iPhone App.

Step 2: Be Passionate and CARE!

This goes back to step 1. If you are going to volunteer, don’t just show up and wait for somebody to tell you what to do. Make volunteering your work and do it with pride. Show up every day on time, with a smile and be fully present. Make it your job to bring more passion to this than anyone else.

I had my first “real” job at the age of 16 at Burger King. There I learned to make Whoppers. I was trained by a gentleman who despite extremely poor pay and no benefits whatsoever was passionate about his job.  After 6 weeks I could make a darn fine Whopper. The management took notice and next thing I knew I was being promoted. The reason was that unlike many of my colleagues I truly cared about the customer experience, and when I showed up I made it a point to be fully present.

If you care about your customers experience even in the simple things,  as you grow in your field you will leave a trail of people who take notice. This will pay many future dividends.

Step 3: Go Beyond the Minimum Requirements

There is a minimum of prerequisites you need to get into PA school. Make it your goal to exceed these minimums.

Like many PA’s, before I learned about the profession I was actually on a pre-med track… I wasn’t doing all that well mind you, but I was working my behind off. Luckily, a benefit of this was that I had already met many of the prerequisites I needed for PA school.

The best part is that when I knew my junior year that I wanted to be a PA I was so happy I had put in all that hard work. Yes, I could have easily stopped the process and taken easier classes that would have met my prerequisites but I didn’t. I continued to take challenging classes that pushed me to my limits.

This did two things:

  1. It set me apart from many of the other applicants (although many had done the same).
  2. It  really prepared me for the rigors of PA school.

Make it a point to go beyond the minimum. Don’t focus so much on grades and getting a 4.0. I am proud to say I had a 2.9 by the time I applied to PA school.  But I had a trail of extremely challenging classes that I still carry with me today. Am I failure because I didn’t have a 3.9 or a 4.0?  No!  And when I sat in front of my future instructors in PA school and told them about myself I did it with pride. Because I knew that I challenged myself and was prepared for anything they could throw at me. And you know what? This was true!

Step 4: Just Apply! And Cut Out the BS

I attended the University of Medicine and Dentistry of New Jersey. I applied to 4 PA Schools and the last was UMDNJ.  I wasn’t going to apply because I failed to meet the minimum requirement of a 3.0 GPA (as noted above).  I was going to throw the application in the garbage when my Mom of all people stopped me and said: “It never hurts to apply”. Boy was she right.

And why was it this application that got accepted?  Because I cut out the BS!

In my previous applications I feared failure so much that I let it guide my writing on the application. My essays were routine and uninteresting.  But for UMDNJ,  because I figured I had no chance whatsoever,  I threw caution to the wind.  I wrote from my heart and used my true voice which was rooted deeply in:

  1. Hard Work
  2. Passion
  3. Caring
  4. A willingness to go beyond the minimum

I will write more about this in the future. But the point is: Don’t over-analyze, start thinking outside the box, work extremely hard for what you want and don’t follow the herd!

P.S I actually did read this book prior to applying for PA School…

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