Duke’s Physician Assistant Program

Show Summary

Dr. April Stouder, Associate Program Director and Director of Admissions at the Duke Physician Assistant Program, discusses what it takes to gain a spot in the competitive program. She discusses Duke PA program’s emphasis on community service, particularly in underserved communities and healthcare roles. April highlights the value of non-clinical volunteering, especially in healthcare or with underserved populations. She explains the admissions process, including the CASPA application and the GPA and GRE requirements. April walks us through the interview process, which is designed to assess both cognitive and non-cognitive attributes like maturity and resilience.

Show Notes

Welcome to the 591st episode of Admissions Straight Talk. Thanks for joining me today. This interview is all about getting accepted to PA School, specifically the Duke PA program. In addition to listening to today’s interview, I’d like to invite you to download Accepted’s free guide, The Ultimate Guide to Becoming a Physician Assistant. Grab your free copy for advice on selecting the best PA program for you, writing your personal statement, handling secondary supplemental essays, interviewing effectively, and simply presenting the best application you possibly can.

Today’s guest, Dr. April Stouder, earned her bachelor’s at Manchester College and her Master’s of Health Sciences at Duke’s PA program in 2000. She earned her Doctorate in Education from A.T. Still University in 2023. And from 2002 to 2012, she worked as a PA at Duke. From 2012 to 2018, she was Director of Clinical Education at Duke University, and she has served as the Associate Program Director since June 2018. She’s also the Admissions Director for Duke’s PA program, which is the capacity in which she’s here today.

April, welcome back to Admissions Straight Talk. [2:21]

Thank you, Linda. Thanks for inviting me back again. I’m glad to be here.

Can you give us an overview of the Duke PA program, focusing on its more distinctive elements? [2:24]

Sure. The Duke PA program is housed at an academic medical center at a private institution. We are one of the larger programs in the country. Each cohort has about 90 students, so we have roughly 180 students enrolled at any given time, which I think does distinguish us from a number of the smaller programs around the country. We are a primary care, mission-driven program, so our goal is to train primary care PAs to go out into the workforce and meet the healthcare needs of North Carolinians in the country. Of course, not everybody goes into primary care, but we do have a relatively high percentage of our graduates that do. So, our curriculum is really focused on that goal and that mission.

Is there anything particularly new that you’d like to highlight? We last spoke in 2021. I think it was the height of the pandemic and kind of crazy times. [3:11]

Gosh, I feel like the world is so different altogether. And I think PA education has changed, higher education has changed, just so many things are different. But I think from a program standpoint, we sort of took the lessons of the pandemic, and having to be forced to go virtual, and really took that opportunity to train our faculty and staff, to really further incorporate technology into our training.

We are an in-person program, but we do have some hybrid opportunities to allow our adult learners to sort of take care of themselves and do life in addition to being a PA student. We’ve incorporated additional hands-on things into our curriculum, like point-of-care ultrasound, which is super popular with our students and increasingly needed in the workforce.

And then, from an admissions standpoint, we opted to remain virtual for our interviews. That was largely driven by very positive feedback from applicants and from our faculty and staff, but also equity-driven, because we know that it costs a lot for students to travel around the country and interview at PA programs. And we’re committed to recruiting disadvantaged students into our cohort.

I think many medical schools, I think even more so than law schools and business schools, did make that change. [4:34]

And I think for PA programs, many have gone back to in-person, but we interview a relatively large number of folks, roughly 250 to 260, so the logistics of having them on site is nothing to sneeze at, either. So, I think we have found a process that works. We feel like we get to know our applicants, and they get to know us, and like I said, the feedback has been very positive.

I believe that Duke’s PA program uses the CASPA application. Is that correct? [5:05]

Yep, we sure do, and we also have a supplemental application as well.

Can you review the timeline for application to Duke’s PA program with the CASPA application and then the secondary? [5:14]

We open up our CASPA in the spring, so this year it opened on April 27th. CASPA applications are due by September 1st, so that needs to be both a completed and a verified CASPA application. You can’t just submit it on that deadline, because it needs to go through that verification process and have that done by September 1st. So, we always encourage people to plan ahead and build in enough time for that verification.

Once we get a completed and verified CASPA application, that starts our supplemental application process, so we’ll send those out automatically. Supplementals are due by September 15th, and that’s also the date that we need people to have sat for the GRE exam so that we can get those scores as well.

People are obviously submitting the secondaries before September 15th as well. When are interview invitations going to go out? [6:09]

We do some rolling admissions. We have four weeks of interviews. It starts usually mid-September and it runs through about Thanksgiving, so we’re constantly reading applications all the way through mid-October and sending out interview invites all throughout that process.

I’m kind of chuckling because, among med school applicants, there’s this meme out there that if you don’t have an interview invitation by Thanksgiving, you’re toast. And it’s complete nonsense because interview invitations usually go out until January, and for some schools, even until March. But for your case, it’s really true. [6:35]

It is. We’re done by Thanksgiving.

What kind of academic background are you looking for in your students? That would be both coursework and GPA. [7:04]

I think the beauty of PA school is you don’t need to be a science major to apply for a PA school, you just need to have completed the science prerequisites. And I think our prerequisites probably look very similar to pre-reqs at a number of PA schools. I think applicants absolutely need to do their homework and double check PA program websites to see specific requirements, but for ours, pre-reqs need to be 10 years or less old. If they’re more than 10 years old, we need more updated pre-req courses.

We require a C or better, although I will give a caveat that we’re in the process of reviewing our own program outcome data, and that we might be revising the minimal acceptable score. But for this cycle, that’s what it is.

They have to have anatomy and physiology courses with labs, microbiology, two upper-level bio courses, two chemistry courses, and a stats course.

Is organic chemistry required? [8:09]

We don’t specifically require organic chemistry, just two chemistry courses with labs.

I’m gathering that there’s no overall GPA requirement? [8:20]

There’s not an overall GPA or GRE requirement. We try to post every year, for the newly seated class, the middle 50% stats so that an applicant can sort of self-assess where they fall. And if they’re in that bottom 25, chances are their scores are going to be lower, and probably less chance to be invited for an interview and move forward in the process.

So, that self-assessment and kind of how an applicant compares to our seated cohort I think is really important. But we don’t automatically say, “Oh, if somebody has a GRE below this cutoff score, we’re not even going to look at them.”

What about clinical exposure? I know those requirements are very important in the PA landscape. Could you go over them a little bit? [9:04]

We do require hands-on patient care experience. Our requirement is 1,000 hours, which sort of equates to about six months. Although, I will say that if an applicant has just that bare 1,000 hours, they’re not very competitive, because most of our applicants have somewhere between 1,800 and 3,500 hours, and some as many as 10,000 or more if they really had truly worked in healthcare for a long time.

We do really encourage that hands-on patient care experience, so roles like patient care techs in a hospital, an EMT or a paramedic, we have had nurses apply, respiratory therapists, even physical therapists. But we see an awful lot of EMTs, medical assistants, patient care techs in a hospital setting, just something that really gets you that face-to-face, hands-on interaction with patients.

I’m going to guess that scribing would not really be what you’re looking for, because they’re interacting more with the doctors. Is that correct? [10:02]

Well, actually we do accept scribing. We don’t accept virtual scribing, which is sort of a thing that has emerged since the pandemic. But what we have found is that scribes, emergency room scribes, primary care scribes, they’re in the room when it happens. They’re helping to ensure they have excellent medical documentation and medical vocabulary skills.

But many times, what we’re seeing is sort of this scribe hybrid with medical assistant role, and so many times they’re rooming patients, taking vital signs, and they’re doing medical documentation, and they’re also coordinating labs and outcomes with the clinician. So, many times, because the person they’re working with knows they’re interested in PA school, they’re sort of part of the conversation, and it’s become a big teaching opportunity for the scribe. So, in our experience, scribes really know their stuff and are great students.

That’s good to know. What about non-clinical community service and volunteering? Is that something that you like to see? [11:03]

Oh, we absolutely do, and that is part of our core mission and identity at our program. And so, we love applicants that have community service experience, particularly if it involves underserved communities, if it’s in sort of a healthcare role. Although, we do have people who certainly have volunteered at their church, or with animal shelters, or other volunteer capacities, tutoring or working with kids. But I think we just want to see that spirit of service and giving to others. It’s a double bonus if it’s in sort of a healthcare capacity.

How would you advise applicants to distinguish between the personal statement and the personal information essay as part of the application? [11:51]

So, the CASPA application, we use sort of the “Why PA” essay that students will write for CASPA. That goes to all programs. We did revise some of our essay questions this cycle in our supplemental, and so we added an essay to allow an applicant to talk about their academic readiness. And that is part of our holistic review of someone’s academic journey, recognizing that some applicants have had barriers or challenges that may have impacted their academic performance, and so it gives them an opportunity to really speak to their readiness, perhaps in the setting of having a rocky freshman year or maybe a lower GPA. So, that piece I think is an excellent opportunity for an applicant to really speak to their academic journey and their own self-assessment of their readiness for the rigors and the pace of PA school.

The other supplemental essay we have is that life experience essay, and so what we’re trying to get there is not so much the “why do I want to be a PA,” but “What is it about some experience in my life that has really informed how I approach patient care?’, or their personal growth. And so, it’s an opportunity to see a different side of an applicant and for them to share a little bit more of themselves, so we can get to know them on a deeper level.

You say it’s a personal background. Is it more about them as human beings? [13:21]

Absolutely, and that’s really what we’re trying to get at. We can look at their academic numbers and see what kind of healthcare experience they’ve had. We read their references. But really, who are they, and what would they bring to a cohort and a classroom, and how might they really meet the needs of patient populations? How do they identify with certain populations, and what kind of skills do they bring to the table, like language skills or things like that?

You mentioned that the interview is virtual. What’s it like? [13:51]

So, you’re assigned to an interview week, and on Monday we have a Q&A session that’s hosted by faculty. It’s an opportunity to get to meet program leadership, sort of get a sense of what does the week going to entail, and then applicants can ask questions from representatives from the preclinical year curriculum and the clinical year curriculum. And that’s a really lively back-and-forth held in sort of a group setting. People can submit questions ahead of time, or they can ask them in real time via the chat, and we address those.

We have two different info sessions during the week that are student-led. One is just sort of a day in the life of a Duke PA student, and so, what can you expect in the first year? What does the schedule look like? What do rotations look like? And because there’s no faculty or staff present, they can really get to questions like, what kind of support does the program provide? What’s the culture and climate like? And we haven’t given our students any sort of, “Oh, you can’t say this, you can’t say that,” so it’s the real deal. What does it look like to be a Duke student?

And then we have another session that really gets at diversity, and we have very diverse cohorts. We have folks who are married and have families, they’re parents, maybe they’re taking care of other loved ones, they’re veterans, they’re first generation. And so, this is to get a sense of what kind of students are at Duke, what is Duke University as a whole like, what kind of supports are there? And so, a little bit less the day in the life of a PA student, and more sort of getting at that culture and belonging, which I think is really important for students as they’re assessing programs.

On top of that, they’re assigned an interview day, so that’s the day that they’ll show up, and they have two one-on-one interviews, and that can be with either a faculty member or an alum that’s working as part of our committee. And then, they also engage in a team process exercise, and that’s a small-group activity where the group is given a case scenario to discuss.

And then there are two observers. One is a faculty staff or an alum, and the other is a current second-year student. So, we kind of turn our camera off, we mute ourselves, and we’re just sort of watching interpersonal dynamics. Applicants aren’t rated on their knowledge of the case. It really is just sort of looking to see team skills and interpersonal skills.

Those are fun, aren’t they? [16:28]

Yeah, they are. It’s interesting how people show up in those spaces.

Duke’s website says that it received just over 4,600 applications, of which 3,069 were verified from the matriculating class. That was 2023, so that was almost a year ago now. You interviewed 245 for that class and matriculated, as you said, 90 students. What is the review process that anapplication typically goes through? How do you decide whom to interview? When you decide whom to interview?Do you go first through the CASPA, and then the secondary? Is there a specific process?

When applicants are trying to figure out what to put in the application, they need to know the order in which you’re going to read it. Otherwise, they’re going to duplicate, or you’re not going to understand the context. [16:40]

So, I’ll give you a little bit of updated stats, Linda. I just looked these up before our session because we are seeing some trends nationally, I think we had a real peak immediately after the pandemic, which makes sense. People felt called to enter healthcare, and that has leveled out. And so, for the first time, we’re starting to see just a little bit of a decline overall nationally in applicants in our numbers. And we saw that at our program, as well.

So, for the incoming class that’s coming just next week, we had I think roughly 3,500 CASPA applications, and that number includes CASPA applications that were opened and not submitted. But the real number is sort of those supplemental applications, so we had 2,200 supplemental applications that were completed. So, we don’t look at anybody until they have a completed CASPA and a completed supplemental, and that’s sort of considered a complete application that can move forward in the process.

Of those 2,200 completed supplementals, about 850 were fully reviewed by our faculty. So, all applications that are received go through an initial process in which they get a score, and that’s based on objective measures such as GPA, number of natural science credits, patient care hours, GRE score. So, that’s all sort of calculated.

If that score meets a certain threshold, then it moves forward, and the admissions team verifies that all the prereqs are met. They have all those pre-req classes, the required number of hours. If that box is checked and they meet those criteria, then they’ll move forward and they’ll be read by at least two faculty. We have faculty readers. All of our faculty are involved in reading applications, and then we have a small number of alums who are involved in our admissions process as interviewers and readers. So, two people will read those, and then that score is combined with that objective score. And then, if a certain threshold is met, on a rolling basis we invite people for interviews.

So, every application, though, even if that score is below that initial threshold to move forward, the admissions team still takes a look at it. Sometimes, what we find is that people have sort of misfiled something as a non-patient care experience when it’s really patient care, and then that bumps them into the threshold, and they’re allowed to move forward.

So, every application we receive, all 2,200 eyes are laid on it to make sure that they meet our criteria or that they don’t. And so, it’s a hefty amount of work, Linda, to process that many applications and give everybody a fair shake.

What do you think about applicants using Chat GPT or AI in completing their applications? [20:14]

It’s interesting. We’ve had a lot of conversations about this nationally, within our PA education association, and as a faculty here at Duke. Because it comes up in curriculum, it comes up even in just back-and-forth interactions with applicants, we sort of can get a sense if something feels a little bit mechanical or robotic. If it’s an email that’s been sent to us, or an essay that just doesn’t read very authentically, sometimes it just feels like it’s full of buzzwords and doesn’t really portray an applicant in a very authentic manner.

Kind of plastic? [20:55]

Yeah. As a reader, it doesn’t feel very good, and I feel like I’m really missing out on that opportunity to get to know that applicant. Because it seems like they’re trying really hard to kind of be what we want them to be, rather than presenting who they are, and I will take an authentic essay, even if it has some misspellings or grammar issues any day. Ideally, someone has done their proofreading or had someone else help them with that, but I just think AI-generated emails and essays just don’t ring very true, and we can sort of suss that out a little bit.

I think one of the interesting things about AI is, on one hand it can be useful. Sure, when you’re practicing, there are times when you can turn to AI or the computer, whatever. At the same time, if you’re attempting to be personally revealing and thoughtful and authentic, AI is not going to help you. [21:36]

It might be good for idea generation, but then you sort of have to take it from there and make it your own, and that is what we’re really looking for. And more than anything else, Linda, I think as a faculty we’re looking for authenticity, and getting to know who this applicant is, and what they might bring to the cohort or to the profession.

You’ve been doing this for a while, and other than using AI too much, what mistakes do you commonly see? [22:21]

Oh, there are many.

I think not adhering to deadlines, not reading the directions or answering the actual essay prompt. Sometimes even in an interview, we ask a question, and the applicant answers something totally different. And again, it’s sort of like they might have an agenda and it’s filled with buzzwords. And as someone who’s evaluating them, I always wonder, “But that’s not the question I asked you. It wasn’t what I was hoping to hear.”

So, I think deadlines, following directions, and really doing your homework. There are so much resources that we put on our website in our Frequently Asked Questions, or clear deadline information. And so, when we get a lot of questions that are just very obviously answerable if they just would click on our website and do some of their homework. Or people who just maybe don’t even know what our mission is, and so there’s lack of mission alignment in their application. Those are common things that I see.

I just want to add that I look at a lot of websites, obviously school websites. I thought yours was particularly informative. [23:38]

Thank you. We work really hard to make it accessible and try to answer the common questions that we see, because we definitely see those themes over and over, and we’re constantly reviewing it and updating it and trying to make it a valuable resource for applicants.

It is definitely a valuable resource for applicants. And I would encourage any applicant, even if you’re not convinced that you should go to Duke for their PA program, to look at the website because you’ll get advice that is applicable to PA programs in general. [23:59]

I also just want to highlight, and this is something we’ve worked on in the last year or two, Rhiannon Giles, one of our staff who oversees communications, her brainchild was to create some admissions blogs and admissions newsletters. And really, that wasn’t necessarily how to get into the Duke PA program, but it was meant to be a resource that would be valuable and instructive no matter what program you are applying to. So, that’s a great resource on our website as well.

Those are really well-written and informative, and probably eye-opening for a lot of folks who are trying to get into PA school.

How do you view letters of intent or update letters from waitlisted applicants or even applicants early in the process who haven’t heard from you and are getting nervous? [25:04]

We get those all the time, and I will just say, don’t be afraid to reach out to us. Our email address specifically for admissions is paadmission, no S on the end of that, @mc.duke.edu. Our admissions team monitors that, and they’re incredibly responsive. So, if you’re not sure about a pre-req, if you’re not sure about patient care experience, we field those questions all the time.

Similarly, if you just haven’t heard, and you’re wondering where are things in the process, we actually try to proactively communicate with folks as much as we can, particularly once we start interviewing.

And then, letters of intent or updates, we welcome that. I think in general, the feedback that we get from applicants from start to finish is our admissions team is incredibly friendly, incredibly responsive, and very willing to talk to applicants.

And I sometimes wonder, is that not the case everywhere? And it seems like maybe it’s not, so maybe that’s another way we stand out, Linda, is that we’re very open to applicants and questions.

Maybe it’s not even all of the schools, but just in general, when you try and get an answer to a question, it can be kind of challenging. [26:19]

Yeah.

On a forward-looking note, if somebody wants to apply in spring/summer 2025, what should they be doing now? [26:33]

The best piece of advice I have is to really make sure that you are able to submit the best possible application. I think I said this the last time we talked, too, Linda, and it still rings true to me.

This is an expensive and time-consuming process. And so, if you just barely meet the pre-reqs for our program, or for the program that you’re applying, chances are you’re not going to be the most competitive applicant. And I think applicants don’t like to hear it, but it might behoove you to take a year and retake that GRE, or take some more natural science credits, get more patient care experience, do some volunteering, get exposure to the PA profession, and really strengthen your application.

Because there’s a big difference in the applications that I read and the folks who have taken some time to really hone all of those things. And the folks who are doing it maybe a bit prematurely, their applications are often very thin. And while they might have great grades from undergrad, everything else is pretty thin.

And so, those just don’t measure up to the other folks who have taken the time to really, I think, explore healthcare, to explore the profession, get their hands dirty with patient care experience, and really understand what they’re getting into. Those applicants stand out. So, take your time and really do your homework on programs, look at that middle 50% on our website of the first-year class, and do some self-assessment and see how you measure up, and what you might need to sort of focus on to make sure you’re submitting the best possible application.

Let’s say I didn’t do the self-assessment. I applied, I got rejected, and I still want to go to the Duke PA program. What should I be doing as a re-applicant to the Duke program? [28:39]

So, we are a program that after the cycle closes, we are very willing to offer feedback if somebody was not successful. So, they can reach out to that email address that I mentioned earlier, and a member of the admissions staff will get back to them and give them some focused feedback on things that they could do to improve their application next cycle that’s really based on their own application.

And I know that’s something that not a lot of programs offer, but we do welcome it. And I will say that every year we’re admitting students that it’s their second or third time applying, maybe not just to our program, but to programs in general. And nationally, I think only about a third of PA school applicants get accepted, so I would like to just normalize reapplication, Linda, because it happens to an awful lot of folks who are great applicants. They might just need another year before they’re super ready or they really rise to the top of the heap in terms of competitiveness.

Or, like you said, their first application might have been a little thin, and they just need to put some more meat on it, more substance. [29:56]

So, in every space I can, I try to normalize that, because I think applicants can really beat themselves up if they’re not successful on their first try. And I will just say, two-thirds of those applicants, that’s what happens to them, but we welcome re-applicants and we accept re-applicants every year.

What would you have liked me to ask you? And that’s a question I know I asked last time. Is there something you’d like to highlight about the program or about the application process? [30:19]

This is sort of a national conversation that’s sort of moving away from just grades and patient care experience and some of those objective measures, and really looking at some of those non-cognitive attributes, so things like receptiveness to feedback, or maturity and responsibility.

I think some of the words like grit and resiliency are maybe starting to become a little bit overused in admissions space, but I will say post pandemic, there is something to that, Linda. I think what we’re noticing nationally is that many of our students are struggling after the pandemic with health issues, with mental health issues. They’ve had really sort of disrupted undergrad experiences because of the pandemic.

And so, for an applicant to really think about how can I demonstrate that I possess these skills is important. It’s not just about grades and numbers and hours, but also what I think faculty across the country want to see is, is this somebody who has self-awareness? Is this somebody who’s been able to navigate difficult circumstances in a mature and responsible way? Is this somebody who’s likely to be a great classmate and peer, and somebody who’s going to be receptive to faculty when they provide feedback, and they will.

PA school’s hard, and you sort of have to have a thick skin. Not that it should be brutal, but that’s part of growing and learning. You’re going to be stretched out of your comfort zone, and so, how do you deal with that when that happens?

Those are all really increasingly important things that we’re looking for, and I think applicants should be ready to demonstrate that, both in their written comments and also in the interview.

It’s a great note to end the interview on. Thank you very much for that answer. Where can listeners learn more about the Duke Physician Assistant program and earning a master’s of health science at Duke? [32:15]

Feel free to visit our PA program website. Just Google Duke PA program admissions. It’ll pop right up. And then, again, if you have a very specific question, you can feel free to email one of our admissions staff at paadmission@mc.duke.edu.

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