What is the U. of Iowa’s PA program all about [Show Summary]
The role of Physician Assistant was introduced less than 60 years ago and the University of Iowa’s Physician Assistant Program has been at the forefront since day one. Tony Brenneman, the Program Director shares what the program offers and how applicants can gain an invitation to the 25-student cohort.
Interview with Anthony Brenneman, Program Director at University of Iowa’s Physician Assistant Program [Show Notes]
Welcome to the 462nd episode of Admissions Straight Talk. Thanks for joining me today. This interview is all about getting accepted to PA school, specifically the University of Iowa’s PA program, which began a half-century ago in 1972. In addition to listening to today’s interview, I’d like to invite you to download Accepted’s free guide, 10 Tips For Acceptance to a Physician Assistant Program. Grab your free copy for advice on selecting the best PA program for you, writing your personal statement, interviewing effectively, and simply presenting the best application you possibly can. It’s a competitive field out there, so you need to do the best you can.
Today’s guest, Tony Brenneman, grew up in Oregon where he also earned his Bachelor’s in Psychology and Piano Performance from Linfield College and an MSW from Portland State University. He worked as a social worker until he learned about the PA profession and joined the University of Iowa’s PA program graduating with his Master’s of Physician Assistant Studies in 1996. He worked in Bone Marrow Transplant, and in 2004, joined the UIPA program and became the Program Director in 2012 and a professor at the University of Iowa’s Carver College of Medicine in 2014.
Before we dive into Iowa’s PA program, can you talk a little bit about your own journey, from studying piano performance to social work in Oregon to then becoming a PA in Iowa? [2:19]
It does seem a bit convoluted, doesn’t it? I think I had a journey that in some respects is very much like other people that have been thinking about joining the PA profession – they’ve started off in one career pathway or had bumps along the road, and thought, “Well, this isn’t a field that I can get into anymore so I’m going to go off and try other things.” I will say when I headed off to my undergraduate experience, I thought for sure I was going to go into medicine. As a 17-year-old, I was a young one going off into college, I wasn’t quite ready to put my foot down to the pedal the way I needed to at that point in time. I’d always enjoyed playing the piano so I had enrolled with a biology and piano performance plan.
When I decided I needed to think about other things, I decided to switch it to piano performance and psychology thinking along the lines of music therapy. I still really wanted to be in that healthcare background so that’s where that was going at the time. Once I graduated and learned more about music therapy, I decided it probably wasn’t a field that fit who I was so I looked around to see what I could do with that psych degree, and a Master’s of Social Work was one of the things that I could do. There were social workers that worked in hospital settings, so that was what really intrigued me.
After I graduated, I went on to a hospital there in Portland, Oregon. I started off working in the emergency room, working a 1:00 AM shift on the floor so I really got to see a lot of different experiences and different roles. After that, I worked at their rehabilitation center for several years before moving to Iowa in the neurology department. I did that because I was ready for a change of pace and thought, “Why not Iowa?” So I moved to Iowa, and through my wife, I learned about the PA profession. She’s not a PA, but her friend’s husband went through the program just before I did. She introduced me to that idea because I told her about that desire to be in healthcare so I looked more into it and thought, “Yeah, this is something I’m really interested in.” I went back to school, completed my bio and chem major needs and requirements, and now the rest is history.
It seems to me like there are two relatively common pathways I hear from students who become PAs. One is “I tried something else and it wasn’t quite right and then I decided I wanted to become a PA.” The other is, “I started out premed, and it’s just not happening. This is something I can be happy with too.” [5:19]
I will say a lot of our applicants now have decided way before that they really want to be PAs. I think it’s part of the maturation of the profession. We started in 1967, so we’re really not that old of a profession.
I want to thank you for raising that because it’s true that it’s not just a default or a second choice for unsuccessful pre-meds. PA is a profession in its own right that has its own strengths and appeals. [6:26]
Can you give an overview of the University of Iowa’s PA program focusing on its more distinctive elements? [6:58]
I think the most distinctive element is how much our program is embedded within the medical school. Our first class was admitted in 1972 so we’re only five years out from when the first PA enrolled in a program nationally. When our program was first brought to the attention of the Carver College of Medicine and they were told what PAs were supposed to do, the College of Medicine said, “So they’re going to be doing medicine, why wouldn’t they learn what the medical students are learning?” From that time on, we’ve really been embraced by the College of Medicine, not only to have our students embedded within the framework, but with our faculty, and in the clinical setting. We really are practicing to the top of our licenses here at the university.
We started off with fewer students but it has grown over time. In 2014, the curriculum changed. So our medical school really looked at, “What are we doing well?” and “How could we do things better?” Much like a lot of programs out there, they went to a more integrated curriculum. Instead of having pre-courses like biochemistry or pharmacology, it’s now integrated into the physiologic models that we are doing. So for example we’ll show the cardiac system working well and then it’s not working well and students need to think about that from all of the foundational sciences, through the treatments and care of their patients. I think that’s a really great way for our students to learn because it does give them a solid framework for the human that they’re going to be taking care of and seeing in front of them.
When they did that, we were no longer able to choose discrete courses that we wanted to have our students in. The PA students had roughly 65% of their courses taken with medical students to now 100% of their coursework is together. The traditional medical school is a 2+2 model, two years of didactic and two years of clinical experience. Our college moved to 18 months (three semesters) of didactic experience and two and a half years (five semesters) of clinical experience. When we shifted this way, we realized our students had been doing really well in this system so we decided to add them to the medical school and do the same coursework. Our students will take the first two semesters with the medical students. They’re sitting side by side. When our lecturers come in, no one can tell a PA student from a medical student. They’re graded on the same curves. They are expected to achieve at the same levels. And they do, there’s no difference. We’ve done a number of studies looking to see if there is a difference between the two and there really aren’t.
During the summer then when many medical students go off to do clinical experiences in their home community or research projects, our students take PA-specific coursework for the summer. That fall, they come back and finish up the medical didactic portion of the classwork, and then we do another year of clinical experience before graduating. In our program, it would be 28 months total from admission to graduation.
What is the advantage of PA students completing courses alongside medical students? [11:08]
There are so many advantages. Certainly, the obvious ones are we get to have top performers in their fields lecturing to our students to provide a really strong foundation in both scientific and clinical practice and learn the best ways to care for patients in those settings. We have the full resources available to us that the College of Medicine has. We use simulation within our program for our students to learn how to do physical exams. And then there’s that wonderful synergy that you get with sitting side by side and recognizing, “We know the same information.”
It really does allow for a change in perspective in practice as well. A PA isn’t less than and is not in competition either. I think that students begin to understand that there’s a balance to this healthcare system and that one size doesn’t fit all. They see many different opportunities through this process. I think it’s a very nice balance for both the medical students and for our PA students to be learning from each others’ perspectives.
What is a common misconception about Iowa’s PA program that you would like to dispel? [13:29]
That’s a great question. I think people think, “Oh, I’ll never get into that program,” and that’s not true. Absolutely not. The only way you’ll find out is if you apply. Don’t defeat yourself ahead of time.
We look for a lot of different people because you can bring in really brilliant people who can basically learn medicine from a book, take a test, and pass it. That’s not the best healthcare provider, all the time.
I will say that there’s definitely room for that as well, but we really want to see a well-rounded individual that has had life experiences. Maybe they don’t have the perfect GPA or they don’t think they have all the boxes ticked in just the right way, because that to me brings so much more to the table, not only to the conversations that we have when we’re in our small groups and the activities that go around that, but when it comes to relating to patients. It gives you another perspective. If you’ve never been challenged in your life, it’s hard to relate to people that are feeling very challenged and vulnerable because of their healthcare status at that moment in time.
Do you have rolling admissions between April when CASPA opens and October 1 which is your deadline? Is it advantageous to apply earlier in the cycle? [15:10]
We do use rolling admissions, and as you’ve said, it’s more advantageous to apply earlier. We usually do five sets of interviews, sometimes six, depending on the year. We start interviewing in July and will typically wrap up in December. Occasionally we’ve gone into January for this set of interviews. If you’re not selected in the first group, you stay in the mix and you may be selected in the second or the third. It’s so interesting how much the pool can change from year-to-year. It’s advantageous to apply earlier because we do keep going back through and looking over our entire group because we do want to see, as I said, a diverse class of individuals. We believe you learn as much from each other as you do from the knowledge we tend to pour into people’s head while they’re here.
What kind of clinical experience is the Iowa PA program seeking? [16:33]
Our preference is hands-on kinds of care like nursing assistant, medical assistant, anywhere where you are laying hands on patients really helps you understand what healthcare means and what you might need to do. It gives students a good perspective of the people they’ll be working with as well and how they need to hold everybody up in the process. Every job has its challenges and they need to recognize those things. We really do like to see the hands-on and we give percentages based on the different kinds of activities. We offer hour-for-hour credit for those hands-on roles that we know of for sure like the nursing assistant or the medical assistant.
Do you give credit for scribing experience? [17:36]
I think we give about 50% of the total hours. I would direct anybody that’s listening to this to contact our program administrator, Dr. Tom O’Shea. He is more than happy to tell you how this would count if you’re at all concerned. We also have EMTs who apply to the program and that can be very hands-on, or it can be very little hands-on, depending on the role. An EMT in downtown Chicago is likely a very busy individual putting their hands on a lot of people while an EMT in rural Iowa may not get so much interaction. There is a little bit of varying on how much credit each role might get.
Is there a minimum number of clinical hours that are required? [18:29]
750 is what we’re looking for as a minimum.
How do you view nonclinical community service? [18:39]
All of those things add to the richness of who we are looking for. I think those kinds of activities really say a lot about who you are as a person and add to the experiences that you will benefit from and your patients will eventually benefit from as well. I think any of those kinds of activities are valued from our standpoint.
The University of Iowa PA class is 25 students. How many applications do you receive for those 25 spots? Is there any preference for Iowa residents from the Carver Medical School? Do you have any plans to increase that size as the profession grows? [19:28]
At this point, we do not plan on growing any bigger. We have had classes of 25 since we began, and we really do like that. We feel like we get a chance to connect with each individual student and we really get to know them in this process. We see that as our mission and the way we feel that we function in the best way.
The number of applications will vary year to year and it goes up and down. As I think probably anybody applying to PA school is aware, applications just keep increasing, and the number that people are applying is increasing. On average, we get around 800 to 900 applications for our 25 positions. And we narrow that down and eventually, we’ll interview about 120 individuals for our 25 positions.
Again, I don’t want to scare anybody off because what I tell all of the people that are coming for an interview is, “You clearly have the capability, because you’ve demonstrated that. We want to see that capability, but really who are you? And that’s why we have you come for an interview.”
I know it might be of interest to people that are applying, we are doing in-person interviews. We went virtual during the first year that COVID hit, but we are back to doing in-person now. I want to say we had great success with virtual interviews, but it’s really helpful, especially for Iowa to have people to come and see it. They’ll often say, “Oh, it’s not what I thought it was.” Iowa is a beautiful place. I think getting people here just to see what Iowa looks like is really helpful. They can imagine how they would enjoy it here and also get to see our amazing facilities. I think those two things are huge selling points for people to consider in the process of interviewing.
The other thing I often tell our applicants is that it’s not only us interviewing you; you’re also interviewing us. You need to find the program that fits you best and that you think you’ll succeed and thrive in. Getting people here is really important for those people that just can’t imagine living in the Midwest. I actually grew up in Oregon and lived there 28 years before I moved and swore there were two things I would never do: live in the Midwest and teach. I guess you should never swear.
For the last part of your question, we’re always interested in Iowa applicants. That being said, we frequently have more out-of-state admitted to our program than in-state. When we look at the 800 applicants to our program, probably about 700 of them are from out-of-state and 100 are from in-state. So the percentages maybe weigh a little bit more towards Iowa in those two different categories.
Is there anything that you look for in applicants now that you didn’t look for 5-10 years ago? [24:50]
That’s a wonderful question. I think two things that I really look for are grit and resilience. That’s something that we’ve all talked about, I would rather take that student that may need extra help to get through the program, but their background and life experiences demonstrate that they have that grit and resilience to get through really difficult times and really challenging times. These students know how to refocus and to handle what’s being thrown in front of them because let’s be honest, it was always this way in medicine. There are always things that are getting thrown in front of you. The day is never exactly as you hope it would go. And now COVID has more than put that into evidence.
I would rather have that person that has struggled a bit than one that it just was so easy all the way through because once that first hiccup happens, and it will, it’s a big tragedy. It’s really hard to change direction or to refocus because the skills haven’t been learned yet. That’s sometimes why a student may not be selected. We sometimes say, “They’ll be a fantastic PA with a little more cooking.”
I think sometimes people are concerned about talking about a challenge and what they learned from it and how they moved forward because they don’t want to point out that there was a struggle. Programs get really good at looking at applications and seeing, “There’s something interesting here. I wonder if they explained it or talked about it.” When it’s not, it raises additional questions so just be upfront about that and talk about that in your letter.
This is not to say to go out and look for a horrible thing to happen or to make something big out of something that really wasn’t that eventful. But if you have been able to go through it, wonderful. We definitely have people that come into our program as well that way. But I think it’s just one of those things that we’re looking for in a well-rounded individual who brings a lot to the table. It’s that resilience and grit that show they know how to stay focused even if the sky is falling down around you a little bit.
The other piece that comes out of this is if an applicant has the ability to self-reflect because it is really important in any role in healthcare to be able to self-reflect. Asking questions like, “Could I have approached this patient in a different way? Could I have said something different? This outcome was bad, what do we need to take away from this so that this doesn’t happen again?” It’s no reflection on whether you are a good care provider. This process will make the person an even better healthcare provider because they don’t want to do those things again and they want to reflect on to do it better. I think it’s hard when everything keeps going extremely well to reflect on that because where do you take it from there? That’s great if that has been your experience, but I think even in those good times, there are things to self-reflect about. Demonstrating that self-reflection is an important piece.
Do you accept letters of intent from applicants at any point? [30:54]
Absolutely. We always welcome those. We add them to their files. We do consider them as they come through, so I would encourage that. Once we get to the place where we have filled our class, we still have a waitlist because occasionally, students will say, “I just found out that there’s this program right next door to me, and I don’t have to move. And I think I’m going to go there.” And then somebody will come off the waitlist and be offered that position. Any of those updates help us keep track of what’s going on in your life and what is of interest to you. Maybe those are things that just move you up a little bit on that waitlist.
On a forward-looking note, what advice would you give to potential PA applicants who want to apply this upcoming cycle? [31:50]
Be sure that you’ve achieved all the things that you need to qualify for our program. Please go to our website, we have all the things that you need to know about for admissions listed right there. For instance, we want biochemistry to be completed before December 31st. Now, some of the other science courses may be able to be completed after that 31st, because you’re not going to come in until the next fall. Sometimes some of our classes are required to be completed at the time of application so be sure that you’re looking at the application and are you doing all those things that will qualify you at the basic level.
Consider what things you want to highlight. Are there activities that you think are particularly helpful? Are there challenges that you’ve overcome? As with any application, be sure that you can count on your letters of reference being good ones. We want to see one that is an academic reference and then one can be work, one can be whoever else you would like as a reference. Be sure that those pieces are all in place in order for your application to keep moving through at the speed that you would like it to be moved through our system.
If you would be selected for an interview, we use the MMI Models, the multiple mini interviews. I do know that there are lots of products out there on the market for you to practice MMI questions and they have very canned ways of doing things. I will say it’s recognizable when it’s a canned response. We want to see you, we don’t want to see the canned response. I will say, even though you can have a good answer with all of the pretty frames around it, that probably won’t get you where you need to go. I would rather have that person that’s just showing us who they are and talking about how they would respond to that particular scenario or question, or topic that we’re having them talk about because that’s who you are.
Are there other mistakes that applicants should be aware of and avoid when they apply? [35:24]
That’s a great question. I think for us, that is probably the biggest one that they should try to avoid. Don’t over practice or over-prepare, be who you are. We try to keep it very relaxed and friendly. We ask for anonymous feedback after interviewees have left us and that is something we often hear back is. They say, “I just felt so comfortable. Thank you for making me feel relaxed.” Again, it’s a two-way street here. I want to know who you are, and I want you to know who I am as well so we really try to practice what we preach.
Are you looking for a particular major in applicants? [36:36]
No, as long as they have met all of the course requirements. We’ve had English majors. We have had PhDs in Public Health. We have all sorts of different backgrounds coming through our program. I think it goes back to what I talked about earlier. It just adds to the richness of who our classes are because everybody brings their own skill sets. Once they get into our program, we are a pass-fail program. You do not have to have a 3.0 or 3.5, whatever those requirements are.
What I love to tell our students is P equals PA because just like medical school, the person that graduates last in their medical school program is called doctor. Nobody asked me, “Were you at the top of your PA class? In the middle of the PA class?” You graduated from an accredited PA program and you have met the requirements that are needed to be a PA. The pass-fail really takes away that competitiveness that frankly existed in the undergraduate experience in order to achieve and rank above X or Y. You can take those skills that they’re all bringing in order to teach each other and help each other through the program. This month you may be sailing and at the top of the class, and you helping others. The next month, the roles may be reversed. We really want them to be able to reach out and rely on each other where they’re bringing in those special learning backgrounds that they carry with them.
I do like to see solid coursework in the sciences. Sometimes I see applications where they have a 4.0, but they’ve taken 13 semester hours each semester, and one science course. To me, that doesn’t tell me that you are capable of the amount of science you’re going to have to take at one time in our program or in any program whether you’re embedded completely in a medical school or not. What I really want to see is students juggling many balls at one time. You took four science courses at a time and did exceedingly well. And then you did the fun courses at one time, however you do that. But I think that it’s so important to demonstrate you can do that and you can do it with a fairly good semester hour load, whether that’s 15 or 16 hours because you’re going to jump into most programs where you’re going to be taking 20 or 22 semester hours of coursework. The majority of it is science, we do have some that are less science-heavy, but it’s certainly all related to the same thing. You don’t want to go from 0 to 90 without having had some idea of what that means in preparation.
What would you have liked me to ask you? [40:09]
I think sometimes Iowa can be discounted as a little farm country area. I will say, as I said earlier, I came from Oregon where I didn’t think I’d ever live in the Midwest. And now I’ve lived here longer than I did in Oregon. There is a lot going on here and a lot in its favor. People may not know this, but you can ski in Iowa. There’s lots of great biking. There are lots of great outdoor activities. It’s just a wonderful community, the Iowa City area, so don’t dismiss it because it’s the Midwest. There’s a lot going on here.
Where can listeners learn more about the University of Iowa’s Physician Assistant program? [41:45]
- University of Iowa Physician Assistant Program
- 10 Tips for Acceptance to a Physician Assistant (PA) Program
- That PA Girl with Can’t-Miss Advice for Aspiring Physician Assistants
- Accepted’s PA Admissions Services
- Duke PA Program
- How Did This Successful PA Applicant Get Accepted?
- Yale’s Online PA Program
- Andrea Benedict: Life as a Physician Assistant