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Dr. Valerie Wherley, Accepted consultant and past Assistant Dean of Student Affairs and Career Development at William Beaumont School of Medicine, and former Director of Pre-Health Advisement and Director of the Pre-Health Postbac Certificate Program at Sacred Heart University, speaks in depth about the path to becoming a physician assistant. [Show Summary]
Healthcare is a field that is growing, but what areas are really booming? According to US News citing Bureau of Labor Statics’ projections, between 2021 and 2031 “an estimated 38,400 jobs should open up” for physician assistants. Sound good? Let’s learn more about becoming a physician assistant.
Interview with Dr. Valerie Wherley, Accepted consultant. Dr. Wherley earned her BS and MS at the University of Maine in kinesiology and her PhD in higher education administration from the University of Connecticut. [Show Notes]
Welcome to the 515th episode of AdmissionsStraight Talk. Thanks for tuning in. This interview is all about getting accepted to PA school and giving you tips on how you can do it. In addition to listening to today’s interview, I invite you to download Accepted’s free guide, 10 Tips For Acceptance to a Physician Assistant Program. Grab your free guide for advice on selecting the best PA programs for you, writing your personal statement, interviewing effectively and simply presenting the best application you possibly can.
Over the last 20 years, she has served as the Assistant Dean of Student Affairs and Career Development at William Beaumont School of Medicine, director of pre-health post-bacc certificate program at Sacred Heart University, and the director of the pre-health advisement also at Sacred Heart University. In those roles and before joining Accepted earlier this year, she advised thousands of students in the following pre-health tracks: pre-med, pre-PA, pre-vet, pre-dental, pre-pharmacy, pre-PT, pre-OT, pre-accelerated nursing and pre-optometry, as well as applicants to master’s programs in exercise science, biomedical sciences, occupational therapy, speech language pathology, athletic training, public health, and applied nutrition. That’s her breadth. Right now, we’re going to go in depth and we’re going to focus on physician assistant admissions.
Dr. Wherley, welcome to Admissions Straight Talk. [2:32]
Thank you for having me.
What do physician assistants do? [2:36]
Sure. Great question. So a physician assistant or PA, which I may use during this podcast is a licensed medical professional, first and foremost, who holds an advanced degree beyond their undergrad, which is typically a master’s degree, and they’re licensed to provide direct patient care. So if you’ve ever received care from a PA, it’s important to know they are fully qualified and fully trained, and their scope of practice really encompasses quite a bit. And so their scope of practice starts with the ability to take medical histories, to conduct physical exams, to diagnose and treat illnesses.
They can also develop treatment plans and order and interpret tests. They can prescribe medication, which sometimes people may or may not know. They can counsel on preventative care, they can perform certain procedures that’s very specific. They can assist in surgeries. They are not the primary care provider in surgeries, but they can assist. They can make rounds in hospitals and nursing homes, and they can also do clinical research. So while that is a long list of their scope of practice, I’m sure it’s not exhaustive, but PAs are certainly a team player and a welcome provider on a healthcare team.
What are some of the restrictions on what they can do? [4:20]
Well, in most states, PAs do not operate or practice, and by I say operate, I mean independently practice. PAs are restricted to be practicing under the supervision of a physician, an MD typically, and again, that’s in most states. And one of my specific things that I noted is they can assist in surgery. So you will not find PAs being the primary care provider in performing surgery again, independently.
What are some of the other differences in actual responsibilities and required education between let’s say a physician assistant and a physician? [4:58]
So I covered the responsibilities of a PA, and I’ll talk about education and then I’ll go into a very specific thing about the PA title if I can, because that’s very important to the profession, and I want to make sure I recognize that very clearly. So while MDs and DOs can work independently, the required education for MDs and DOs is of course, they will complete an undergraduate degree, which will take somewhere between three and four years, depending on if they’re an accelerated undergraduate curriculum. And then they’ll go to medical school for an additional four years, and then they will further go into a residency program for somewhere between three to seven years. So you can add up all of those years of education and also the finances and the financial support that it would take to get through all of those years of education. PA school is very different.
So potential PA students can think about going to their undergraduate degree for, again, three to four years. And then a PA degree is a master’s program that usually is completed in somewhere between 24 and 27 months and at the end of a PA program, they sit for their licensing degree and then they are ready to go to work. So depending on a student’s thoughts about how quickly they want to become clinically relevant and able to get into the workforce, what is their financial support and how many years do they want to be in their education, PA school or MD school could be the path for them. Now, I do want to make a note about the title of physician assistant. So in 2021, the governing body did vote and say, we want to officially change the title from “physician assistant” to “physician associate.” So the official title of this clinical practitioner is “physician associate”. So the moniker is still PA, right?
And the reason for that was they wanted to be very clear that these healthcare practitioners don’t simply assist physicians.
They’re associates, they’re colleagues. [7:35]
Right. So they are associates, they are colleagues, they are a fully vetted member of the healthcare team. Now, further in the research, when you look at some of these PA websites, they do say, and I quote, “PAs should continue to use physician assistant as their legal title because changing the entire moniker over to physician associate will take time.” So in clinical practice, you will still see them referring to themselves as physicians assistants.
When did the change take place? [8:05]
I believe it was May of 2021.
Yeah, when the vote happened. But of course, to see it in fully vetted practice is just going to take time.
Another, I think path that physician associates or assistants are sometimes compared with would be nurse practitioner. [8:16]
Correct.
What are some of the differences there? I think the difference between nurse and PAs is much clearer, but what about a nurse practitioner? I mean, they can see patients. [8:30]
True. So it’s also a very good question. So I’ll go back to the training of a PA and I’ll get a little bit more specific about the training of PAs. So again, PAs will complete a master’s degree and they will complete 2000 hours of clinical training. And that 2000 hours is standard for the over 300 accredited PA programs that exist.
And that’s part of their training, that 2000 hours is part of the program or training as a prior to? [9:09]
Nope, as part of their clinical training. So PA programs will have a didactic component, and that’s the classroom work. And then they will have a clinical component. And that clinical component is 2000 hours of training.
That’s roughly a year. [9:26]
Yeah, correct. So their 2000 hours of clinical training has a wide breadth of clinical rotations. And I am going to read these because I don’t have them memorized, but their clinical training will be in family medicine, internal medicine, general surgery, pediatrics, OB-GYN, emergency medicine and psychiatry. So they get training and exposure in all of those clinical areas. So we’ll note that. I’ll move over to nurse practitioners. So nurse practitioners must complete a master’s degree or a doctoral degree depending on their program. And they’re specifically trained in the advanced practice of nursing, which I’ll talk about a little bit more. Students in NP school complete 1000 hours of supervised clinical training.
That’s compared to the 2000 hours for PA, and they’re trained in a chosen health population focus area. So this differs from the clinical hours that I just talked about in PA school. So their focus area tends to be in these domains, family, adult or gerontology, neonatal, pediatrics, women’s health, psychiatry or mental health. So their concentration of clinical work tends to be a little bit more focused. And the PA clinical hours, as you can see, really mirrors medical clinical rotations.
It seems like the nurse practitioner’s focus is more as you put it on different communities of patients. [11:04]
True.
And the PA is more like medical treatment options or systems. [11:12]
Absolutely. Now two more notes about this. In 22 states, nurse practitioners have approved “full” practice. I put “full” in quotes and full practice for NPs in those states allows nurse practitioners to prescribe, diagnose, and treat patients without physician oversight. So if you are a student who lives in one of those 22 states and you are looking to practice clinically and autonomously without going to medical school and you’re looking for a different path, nurse practitioner might be the way you want to go because you have full autonomy to prescribe, diagnose and treat patients. The other thing PA schools or a PA training allows students to do, and PA schools really have a lot of pride in this is something called lateral mobility. Lateral mobility in the PA profession means that students have the ability to change their specialty area at different points in their career.
So once a student gets out of their PA program and they’re trained as a generalist, then once they start working, they can subspecialize as a surgical PA and they can work as a surgical PA for a period of time. That’s sort of on the job training. And then if they decide that they want to move laterally in the PA field, then they could change jobs and subspecialize as a pediatric PA. So that lateral mobility for some students is very appealing because they think, Hey, I might want to change my specialty in 10 years or in 15 years. And as we know in the world of medicine, once you hang your hat on a specialty area, that’s your work.
Are there different types of physician assistant programs or perhaps a better question will be what are some of the different types of physician assistant programs, associate programs, I should say? [13:19]
This is a really good question because oftentimes I think that some PA students just think I’m going to apply to all PA schools because they all are created equal. So right now, prospective PA students can choose from over 300 accredited PA programs that are in the United States, and most of these programs take between 24 and 27 months. But there are some differences between these programs that I would just like to highlight. There are 11 PA programs in the country that are either online or hybrid. So the didactic component would be online or have a combination between online and then come to campus at some points. And then the clinical component, of course would be in person. So that’s one option to consider depending on who you are and what your learning style is like.
Some schools use traditional lecture lab models for their didactic component and other schools use case-based learning. So just lots and lots of case studies to bring this content alive and to enlighten students instead of traditional lectures. So if you are more a case-based learning style student, you want to look for a program that uses those case-based learning models. Some schools offer interprofessional learning with other healthcare students on the premises. So PA students go into the cadaver lab with the pre-med students and with the nursing students and offer lots of this interprofessional learning, which I personally think is quite nice.
I think the University of Iowa does that, doesn’t it? [15:08]
Yeah, potentially. So I think it’s great to have a PA student right next to a medical student, right next to a nursing student, potentially right next to a dental student all looking at the same cadaver and really trying to figure things out. Now, while some PA schools and curriculum don’t offer clinical exposure until year two, there are some programs out there that offer early clinical exposure, which again, I think brings the didactic curriculum to life. And so I would suggest look for those programs out there that offer early clinical exposure. And then my last point would be there’s a difference between programs out there that are connected with a large teaching hospital or that are more community-based medicine, and that would offer students different exposure to access to procedures or things like emergency medicine or rural medicine. So it’s really what are you looking for in your PA school curriculum.
What should they be looking for? [16:09]
I think it depends on their vision of what kind of practitioner they want to become. So if they’re looking for a really urban sort of based environment and they think that they might want to work in surgery or critical care or emergency based medicine, they might want to look to be connected with a large teaching hospital that would give them exposure to a wide variety of patients. And if they’re really looking for a more rural setting and providing care to patients who may not get care otherwise, they would be looking for a community-based medicine program.
What would be some other things that they should be considering? [17:15]
I think the other things that students should consider would be what I talk to students about, whether they’re PA students or pre-med students or pre-dental students and those are things like the mission statement of the school. Does it resonate with you? School fit, size of the school, size of the cohort that you might be joining, the location of the school. Certainly going to an open house of the school and hearing the dean speak, hear other students speak, taking a tour of the campus and a tour of the facility to see if you could envision yourself being there and being part of the community and feeling like it’s a good overall fit for you.
What should PA applicants have in their academic background before they apply? We’ll get to the experiential qualifications in a second. [17:15]
Yes. Academically, there tends to be a general list of prerequisites that PA students should be aware of. However, schools vary school by school in terms of specific recommendations. So it’s always suggested that you’re checking with the school’s website to make sure you’re covering your prerequisites very specifically. But in general, pre-PA students need to take anatomy and physiology, typically a full year. Biology and chemistry, usually organic chemistry and then a few upper level classes like biochemistry and microbiology are usually recommended. English composition and or writing, usually two semesters are necessary on your transcript. One or two semesters of psychology, statistics or biostatistics. And then two specific courses I’m seeing required by more PA schools are genetics and medical terminology.
What about experientially? Getting into a PA program is not easy. [19:28]
So experientially is the point that really differentiates my pre-PA applicants, usually from my med school applicants. And the reason why is the PA curriculum is abbreviated. So it is a master’s program and it is completed in 27 months. And what PA schools are expecting is that when students walk in the door, they have had a large number of patient care hours and healthcare experience, which has provided a foundation of knowledge that will prepare them for this rigorous PA school curriculum. So having said that, a data point that I found said the average number of direct patient contact hours PA matriculates had on their application last year was 3000.
That’s a year and a half of full-time work. [20:38]
Correct. Right. So some undergrads are able to balance being an undergrad student and also acquiring these direct patient care hours. More often than not, pre-PA students require a gap year to get this work done. So you graduate, you take a gap year, and you get your direct patient care experience, and then you’re applying to PA school. So actually the average age of students who are applying to PA school is 26.
I think the average for med school is 24, isn’t it? [21:13]
I think so. I think so. And so sometimes students feel like they are falling behind because they still have to acquire this direct patient care experience. But the truth is everybody is in the same situation where they’re out there just working and gaining this valuable experience. So direct patient care is anytime a student is working and providing direct patient contact with somebody in need. So students often gain this experience by working as a paramedic, an EMT, an athletic trainer, a CNA, a medical assistant who’s really providing care and not doing clerical work.
Some RNs will work as an RN and then apply to medical PA school. So all of their hours working as an RN count as direct patient care. So there’s a fairly long list of sort of what, quote unquote, ‘counts’ as direct patients.
What about scribe? [22:25]
Medical scribing tends to be this very gray area. It seems like maybe over 50% of PA schools out there that I am aware of will count scribing as direct patient care and the other 50% do not. But on the CASPA application, so the CASPA application is the official application for PA school, and CASPA stands for Centralized Application Service For Physician Assistant, still Assistant.
There are two different categories among the extracurricular experiences where students are available to add, there is direct patient care where students can chronicle, and there’s also healthcare experience. So healthcare experience is where you have worked in a healthcare environment, but the experience is not directly involving patient care. So if you apply to a school that does not consider medical scribing patient care experience, you’re allowed to put it in this other bucket called healthcare experience. So it will sort of count in a holistic application review.
How many programs do students typically apply to? Or is there a typical? [23:46]
I don’t know if there is a typical If there is, I’m not aware of it.
What would you recommend to somebody who’s reasonably competitive? [23:59]
I would recommend anywhere between 10 and 15.
Should PA applicants take the MCAT, the GRE or the new kid on the block, the PA-CAT? [24:09]
Yes. Great question. So as I’ve mentioned, there are 300… Oh, I think a little over 300 accredited PA programs. The last that I knew, just a few over 100 do not require the GRE.
Do they not require any test or just not require the GRE? [24:32]
They do not require any test. Most do not accept the MCAT.
So there’s usually no reason for PA students to be embarking on the MCAT and less than 20 schools at this point in time require the PA-CAT.
So there is a list of schools out there that are requiring the PA-CAT. I think we are going to see that number grow year to year to year, but right now we’re under 20. But as that PA-CAT, for those of you who might be new to this information, the PA-CAT is a newer standardized test. It was beta tested maybe two years ago. And as we see it become more reliable and more data comes out about its validity, I believe we are going to see more PA schools accepting it as a standardized test and requiring it.
Do you see the PA-CAT and the GRE kind of coexisting where students will be able to choose which one to take, or do you see one ultimately winning out? [25:46]
I predict that the PA-CAT will become the new standardized measure and the GRE will become obsolete.
The PA-CAT is based on questions pulled from prerequisite courses required of PA students. So it seems to be more linear in terms of questions that are being asked based on foundational knowledge that students should have, where the GRE seems to be much more broad and not linearly correlated with their foundational content knowledge.
In that regard, I assume that the P-CAT is much more like the MCAT, the PA-CAT rather. [26:37]
Correct. Correct. And so I should say, in an effort of full disclosure, I was a part of the PA-CAT development team where I was an anatomy and physiology expert, and I helped write some of the content questions for A&P.
What is a competitive GPA, either number or range for PA programs? [27:05]
Sure. So some PA programs just look at cumulative GPA, but in order to answer this question thoroughly, I wanted to say PA programs can look at and evaluate up to four different GPAs overall GPA, a science GPA, a non-science GPA, and then what’s called a BCP GPA, which I will explain.
So an overall GPA is your cumulative GPA and a competitive cumulative GPA for PA school is a 3.6 in that range. And of course there’s always a standard deviation.
Science GPA would be the GPA of every single science class you’ve ever taken as an undergrad. And for PA school, competitive science GPA is about a 3.5, and I’m pulling these GPAs from successful matriculates from last year. Non-science GPA is any class you took as an undergrad, which was not science-based. So your English, your psychology, your sociology, your anthropology, and that competitive GPA is a 3.6. Your BCP GPA, that’s your biology, your chemistry, and your physics. Just those three classes, lecture and lab. And that competitive GPA would be a 3.5.
But no M in there. No math. [28:34]
No math.
Does the CASPA application require activity descriptions and/or personal statements? And what are the schools looking for with these materials? [28:42]
Sure. So CASPA offers the opportunity to write several different items in terms of activity descriptions, leadership, volunteer, just to name a few. But the big two, as I mentioned in one of my prior answers are healthcare experience and patient care experience. This is really the opportunity for pre-PA students to demonstrate that they have done the work, they’ve had exposure to the field, they understand what it means to be part of a healthcare team. And writing these descriptions very clearly about skills acquired and understanding of the process of your clinical work is very critical. And this could really help your application shine. So again, healthcare experience is paid and unpaid work in a health or health related field, but it is when you are not directly responsible for a patient’s care.
So you could be filling prescriptions, delivering food to patients rooms, transporting patients in a hospital, and you could be doing some record keeping in an office setting. But that is healthcare work. Direct patient care is very different. And so some PA schools will have on their website, we require X number of hours of paid direct patient care, and they’ll be very, very strict about that number. And that will vary based on schools. So this is where you could be directing a course of treatment, taking vitals, working as an EMT, a phlebotomist, a physical therapy aid. It looks very good if you have some type of certification to back up this clinical work.
I guess the main thing the schools are looking for with the descriptions in the primary application is just evidence that you know what you’re getting into, and this is really a commitment… That you’re making this commitment with good reason. [30:56]
Absolutely.
Based on your personal experience. [31:11]
It’s the exposure to healthcare. It’s the acquisition of new knowledge and new clinical skills. And the other thing is schools want to know that you are coming to PA school because you want to be a PA for the scope of practice of a PA, and that it is not your plan B because you didn’t get into medical school.
It’s so important, and I have counseled students on this before, maybe who didn’t have a positive application cycle for medical school. Well, maybe I’ll just go to PA school and PA admissions committees have been doing this for a long time and they will rake through an application where it is a fallback plan for medical school.
That’s a great warning too. Now, do PA programs have secondary applications as medical schools do? And what is the difference between the CASPA and the primary and the secondaries for PAs? [32:08]
Sure. So CASPA, as we’ve talked about, is the primary application. This will be the application where you submit everything from your biographical information, all of your academic transcripts, your activity descriptions, your personal statement, which I think I have to talk about, and your letters of recommendation. And your secondaries, yes, some schools will have secondary essays or secondary questions attached to their specific application. Secondary essay questions, sometimes they’re just called supplementals, can be an extra essay question asked by an individual PA program. Oftentimes there is a question related directly to the school, such as why are you choosing our school? Why are you choosing our PA program? What makes you particularly interested in our curriculum? Why did you apply to our program? You can think of these supplementals or secondary essay questions as a precursor to an in-person interview. It’s a question that they want to hear you answer or see you answer in writing prior to a face-to-face interview. So I’ll pause here and go back to the question about the personal statement.
So CASPA does require a personal statement. At this time, the length of it is 5,000 characters including spaces. So at first you think, oh, I have a lot of room to write. And then when students start writing, they go, oh, I don’t have very much room to write. And the question for the past couple of years has always been, why PA? And it’s short and sweet into the point and it ends up being one of the most difficult questions to answer.
Well, that kind of gets back to your warning a few minutes ago. [34:22]
That’s right. So of course some of the general guidelines are this is your opportunity to write in a narrative fashion, not a scientific paper, not your opportunity to rehash your CV. It’s not your opportunity to retell the things that are already in your activity descriptions. And it’s really the opportunity to tell your story how you determined that PA is the right fit for you as a future healthcare practitioner.
I sometimes say regarding med school applicants that the primary application is about your fitness to be a physician and the secondary application is about your fit with a specific program. Would you say that’s true with PA programs as well? [34:57]
I think that’s very true. I think that’s very true. I think those secondaries, as I’ve said, and as you indicated, are school specific. So they could be a specific question about the curriculum or about the region or about the institution itself. And they’d really like to hear something specific that has intrigued you. Why are you applying to their program? And they want to know, are you a student that is just applying to 50 programs and you’re hoping something will hit? So you do have to make it very specific.
Are there some generalities that you can give on about PA interviews? [36:00]
PA interviews, the feedback that I have heard over time is they have changed during sort of this age of COVID.
And maybe it’s true for other disciplines as well, but pre-COVID PA interviews, my students were telling me I’m not part of an admissions committee, but my students were telling me, were very formal and sort of very intimidating. Through COVID with a lot of the online interviewing formats, my students have found them to be quite conversational with admissions committees members focusing their questions on students’ clinical experiences for sure. And with questions regarding maybe something like describe a patient interaction that was very impactful, certainly questions regarding an ethical situation that maybe was difficult for the student and how he, she, or them handled it. Questions about working together in groups and then asking them to verbalize, what do you know about the PA profession? Do you know about the history? Do you know how it came to be? And why did you choose PA? Why did you choose PA instead of medicine or nursing or any other healthcare member? Why PA for you? So be prepared in your interviews to answer any of those questions.
Great tips. Thank you. What are some of the common mistakes that you see PA applicants making? [36:06]
Common mistakes would be either over inflating your roles and responsibilities in a patient care experience or a healthcare experience. And that’s number one. I would say number two, having a personal statement that does not truly answer the question why PA or is not compelling to answer the question why PA or number three, which we have not talked about, is not having any shadowing hours.
So not all schools have a requirement of shadowing, and some schools say there is no requirement to shadow a PA. I, in the work that I’ve done for all of these years, think that shadowing is critically important. I think that you need to at some point in your journey, shadow somebody who is doing the work that you think you want to do in your career. And I also think it’s important to shadow somebody in several different disciplines. So if you think you want to be a PA, I think it would be great to shadow a PA in internal medicine and then shadow an OB-GYN PA if you’re allowed to, and then shadow a surgical PA. Even if it’s just for 10 hours, 10 hours, 10 hours.
So you can see PAs who are doing different types of work in different types of settings. And so you understand lateral mobility like I talked about before. And then you can actually sit with the person that you’re shadowing and ask some questions, do you like what you’re doing? Do you like your scope of practice? What type of patients do you see? That will give you more information about this potential career that you have chosen and then that will give you some data to answer potential interview questions or even to put into your narrative of why PA. And so I think having no shadowing on your application is a real pitfall.
What do you wish I would’ve asked you? [40:23]
Gee, Dr. Wherley, is there going to be growth in the PA profession?
Gee, Linda. Yes, there is. So the PA profession is this really wonderful market I highly encourage students to look at because according to the US Bureau of Labor Statistics, there is going to be tremendous growth for the PA profession. So for students who are looking to get into a healthcare related field and who don’t want to go through all of those years of medical school and don’t want to have that financial burden, want to get into the workforce quickly and want to know that they are employable after having a master’s degree, the PA profession is the right fit because the data says that this profession will increase 28% from 2021 to 2031.
The United States is just going to be looking for more and more PAs.
A physician shortage. [42:50]
Right. The physician shortage and the healthcare market is looking for more workers. And with our aging population needing more healthcare, PAs are going to be needed. And so if you are someone who’s listening to this podcast and you’re thinking, I wasn’t really sure what track I might go down, strongly consider PA, physician associate.
Relevant Links:
- Dr. Valerie Wherley Bio
- Contact Dr Valerie Wherley so that she can help you apply
- 10 Tips For Acceptance to a Physician Assistant Program
- PA Application Package
- That PA Girl with Can’t-Miss Advice for Aspiring Physician Assistants
Related shows:
- How To Get Accepted To the University of Iowa’s PA Program [Episode 462]
- All About Duke’s Top-Ranked PA Program [Episode 416]
- An Inside Look at USC’s Herman Ostrow School of Dentistry [Episode 414]
- Yale’s Online PA Program: Is an Online Ivy League PA Program Too Good to Be True? [Episode 298]
- Andrea Benedict: Life as a Physician Assistant [Episode 234]
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