Have you always wanted to be a PA, but did circumstances in your life just not allow for it? Yale might have just the right program for you – a PA program delivered primarily online, with clinical experience in or near your hometown.
First, listen to our Admissions Straight Talk podcast episode with Yale School of Medicine PA Program Director James Van Rhee, and then check out our interview with Yale PA student Macy, as part of our What is Graduate School Really Like? series.
An Inside Look at Yale’s Online PA Program with Yale PA Program Director James Van Rhee
It gives me great pleasure to welcome back to AST Jim van Rhee, Director of Yale PA Online. Jim became a PA in 1989 and after several years of working in patient care returned to academia. Since 2006 he has been Physician Assistant Program Director at first Wake Forest, then Northwestern, and now Yale, which he joined in 2013 as Director of the Yale Physician Associate Program. In 2016 he became Director of the Yale PA Online Program.
Can you give us an overview of Yale’s Online Physician Assistant Program? [2:01]
It is a blended program with a lot of different teaching methodologies. We have synchronous and asynchronous coursework, so students learn via video lectures, problem-based learning in small groups, immersions on campus for a week at a time where students learn the hands on skills that need to be taught face-to-face, and clinical rotations just like any other program. We do lectures online, small groups online, and use technology to the fullest extent.
The lecture portion of our curriculum is recorded. When we are online, students are doing application work in small groups – doing a case history, a physical exam applying what they learned in the lectures. It is really important to show and teach students how to utilize information, and we use all of our face-to-face time in application, not delivering content.
For our in-person immersions, the first one is 10 weeks, which is anatomy and physical exam skills. Right before rotation (12 months in) we have a procedural immersion – how to draw blood, how to give a shot, start an IV, etc. The last immersion is right before graduation to give a final assessment to make sure students are ready for clinical practice and boards.
A lot of programs frontload basic science, but we divide the curriculum by organ system. For example, students learn about congestive heart failure having just studied the physiology of the heart. They learn basic science and within days apply it to clinical medicine in cases with small groups
How many students are in each class of the Yale Online PA program? [6:00]
Our first cohort was 41 students, the second was 59. We plan to grow but are more interested in keeping at 60 for now to see the outcomes of our students. Our first cohort was January of 2018 and they just started clinical rotations and our second year students just started January 7th. Our first class graduate
What does it take to get into the program? [7:40]
Just like every PA program, you have to have the academic skills to be in PA school. Our students tend to be a little older, so we are looking for people who have really thought this through. It really can take time to decide if you want to be a PA. When I went to PA school I had been a medical technologist for years. More and more we are seeing individuals coming to this as their second career. Part of our interview process is for applicants to explain how they can meet our mission, and since we are online, how they think they are going to be able to handle an online curriculum. You have to be self-disciplined to be successful in our program.
We strongly encourage (but don’t require) applicants to have at least 500 hours of clinical exposure, but in our first cohort we had applicants with zero and one with 69,000 hours. Our average is about 8,000 hours, but we try to look holistically at an application rather than at the total number of hours.
We spoke roughly five years ago when the program was just getting going. How has it evolved since then? [10:40]
It’s been an interesting process. Today is the five-year anniversary of the first meeting we had discussing this program. Over those five years we have gone through a lot – accreditation, development of curriculum, sites, faculty, and overall it’s been really rewarding. We’ve started dabbling with virtual reality and there is so much more to go. We are also working with our students on standardized patients online. We had students practice how to share bad news using the computer. The comments related by the standardized patients were excellent – they felt they were able to connect with the students, and students felt engaged in the process as well. We are really thinking about changing the way to deliver medical education.
How does the program handle labs and clinical exposure? [12:43]
We have the immersions using the Yale Simulation Center and Yale Anatomy Lab and we have developed CEED, which stands for Clinical Experience and Early Didactic. After students have been in the program for 10 weeks and figured the basics out, we find clinical sites in their communities where they go ½ day per week to utilize skills they are learning – they are mentored by a PA or Nurse Practitioner, for example, practice physical exam skills, and work with other members of a healthcare team. We didn’t want to wait until the clinical year to develop that.
We have students watch a lot of things ahead of time so when they come to an actual session they can get a much bigger bang for their time because they are coming prepared and know the nuances already and are just practicing the skill.
We have just started our clinical year, and we have found a large number of sites around the country, but obviously we never know where the students are going to live who come to the program. I have a placement team whose sole job is to find clinical placement sites. With our first cohort, 2/3 of students are within 25 miles of their home, 10% are between 25-50, another 10% are 50-75, and just a few have to travel further. We have been lucky to find sites relatively close, but if a student lives in a rural location and wants to do a cardiothoracic rotation there might not be one for hundreds of miles so applicants need to think about that.
Are online PA students typically a little older (and more settled) than the off-line program? Did you consider your own experience when developing this program? [16:47]
Our students are older (about 32-33) and typically have more clinical experience. I think it was just natural to get the older student. We have an offering that can work for someone who might not be able to move for a program due to family concerns, for example, so we are offering an opportunity that might not otherwise exist. Our group naturally migrated that way due to the format.
Yale Online does not use the CASPA. Why and what is the application process like at Yale Online? [18:18]
We wanted to make it simpler. We are a different program, our cycle is open year round, and we wanted to make it easier and cheaper. It is a $50 fee, we have an online application that asks for demographic info, work experience, and where you went to school, but more importantly we interview online everyone we want to. We just were trying to make it easier. If you are doing a brick and mortar program you want to see the program in action. Since we don’t have that, we want to show the students our technology, which saves them a lot of money.
Can you discuss the 3 required essays that are part of the Yale online app? [19:40]
The essays help us identify fit with the program, but also for the student to gauge whether we are a match for them. One question relates to their experience with online education, as we want them to make sure they have thought about the self-motivation necessary to succeed in the program. Another question is about how they are going to meet the mission, which is related to high quality, patient-centered care, working in teams, and so we want to make sure they’ve thought that through as well. Our final question has to do with diversity and their experience with it. We want them to think through all of these areas. Yes, we are using it for scoring for fit but it really has a twofold outcome.
Yale PA Online is now accepting applicants for the cohort starting in Jan. 2020. The early decision deadline for that cohort is approaching rapidly and will happen on April 15. The priority deadline is July 1 and the final Deadline is Sept 1. What are differences between these deadlines and what advice would you have for someone starting the Yale PA application? [21:32]
We have the three deadlines because we want people to apply early. April 15 is our early decision, and we will decide quickly so the student will know really early in the process and not have to wait 8-9 months while we go through other students. The priority deadline is the same thing – the earlier the application gets in, the quicker the response. We try to get back within 4-8 weeks with everyone. It’s also helpful for us so we don’t get overwhelmed with applications at any one time.
My main advice is to be yourself. There are so many times when applicants are trying to tell me what they think we want to hear. Don’t try to answer questions or interview with what you think I want to hear as the answer. Give us YOUR answer. Be you. That tells us a lot more. Also, don’t be afraid to ask questions. You are making a big decision, and you need to make sure you have all the information you need. Make sure you check out the program you are applying to, not just the program website but accreditation website as well. Make sure the program is a good fit.
How can students or potential PA applicants prepare themselves and make themselves into more attractive PA applicants if they are eyeing a 2021 or later application? [26:13]
Reach out to us. I have an admissions team that will gladly speak to you. You don’t have to be applying for this next cycle to talk to them. You can enter info online and have them call you. Get in the system early. We do webinars all year and are more than happy to work with you. The team can help you develop a plan so you can put forward the best application possible when the time is right for you.
What would you have liked me to ask that I didn’t ask? [27:39]
“Why did you do this online program?” The reason I did this is because not everyone can move to go to PA school, and not everyone gets accepted to the program close by. If you really want to be a PA, we are providing that opportunity. We need primary care providers so badly. PA school is hard enough – we like keeping students where their support system is.
Learn how real students navigate their way through the graduate school admissions process and grad school itself with our What is Graduate School Really Like? series.
Meet Macy, a student in a uniquely flexible, Ivy League PA program
Macy, thank you for sharing your story with us!
Was there a particular person or experience that inspired your interest in medicine?
Macy: When I was 6 years old, I was involved in a car accident that left me with multiple traumatic injuries, the worst being a fractured skull. I was told the chances of me walking again were slim and went through weeks of physical and psychological therapy. It was scarier for my family than it was for me, as I was sleeping during the wreck and don’t remember anything except for the recovery process.
It was even harder for them to recall details of the accident or my injury as it would bring back painful memories, so when I was 18 I asked the Children’s Hospital for my medical records so I could learn about my case myself. I actually ended up contacting my surgeon, meeting him, and shadowing him in the OR. I’ll now be working with him and his team as a PA student at the end of this year!
I was always drawn to medicine – the need and desire to take care of people who couldn’t take care of themselves really was my calling. It wasn’t until after I graduated undergrad that I realized that the PA role was best suited for me and my career goals.
Why a PA, as opposed to another type of medical professional?
Macy: I remember after graduating college being so stressed out about my future. The idea of medical school wasn’t exciting to me anymore, even though I’d worked so hard and prepared myself for a career in medicine. The thought of choosing one specialty, having to match into it, and risk not getting matched and settling for something else terrified me. I also didn’t want to be 35 and finally starting my career. I didn’t want to be miles deep in debt. It just all around wasn’t what I wanted.
It wasn’t until my aunt was visiting from out of town and caught me during one of my breakdowns that I realized that the MD route wasn’t the only one out there. For months, I pondered about being a physical or speech therapist or applying to nursing school, until finally I narrowed down that the PA route was best for me.
As a PA, I could still help people and fulfill my goal of taking care of others, while being able to appreciate the lateral mobility of the profession (I didn’t have to specialize and could choose another specialty to practice in, whenever I wanted to), as well as start my career within a few years, rather than 10+ years.
I understand you applied to PA school twice. How did you strengthen your application for the second time around?
Macy: The first time I applied, my calculated GPA was lower than I anticipated. Since your GPA is calculated after you submit the CASPA application, it was too late for me to make any changes and I was stuck with my subpar GPA.
From that time until the second time I applied, I took nearly a ton of classes at a community college while working full-time. These classes included pharmacology, pathophysiology, A&P 1 and 2 (I retook these), sociology, Spanish 1 and 2, and genetics. Getting all A’s in these courses boosted my GPA – not by a ton, but enough to make a difference!
I also retook the GRE – the first time I scored a 296, and this time I scored a 306, with all 3 sections above the 50th percentile. I also continued to work as a medical assistant, rewrote my personal statement, and got new letters of recommendation!
After being accepted to several programs, how did you decide between your multiple acceptances (a wonderful problem to have)?
Macy: I basically chose based on location. My husband was applying for MBA programs at the same time that I was applying to PA school. He got waitlisted at schools in cities I got acceptances in and we really didn’t want to spend our first few years of marriage apart.
How many clinical experience hours did you have at the time you applied to PA school? How were these hours accumulated?
Macy: I probably had 4-5000 hours (can’t remember the exact value now). During undergrad, I worked part-time as a medical scribe which is where I accumulated most of my hours (though these counted as healthcare experience, not patient care). From 2015 to the beginning of 2018, I worked full-time as a medical assistant which is where I got my direct patient care hours.
Where do you currently live? How do you manage the commute for courses and rotations? (From what I can see, I’m guessing that you are a student in Yale’s Online PA Program – is that right?)
Macy: I am indeed in the Yale Online PA program! I started the program in Houston and was able to be home with my husband for the first year. Then when he got accepted into MIT, I was able to move to Boston with him and complete clinical rotations there! Moving during the program is not typical, but without the Yale program, we would have been long distance for almost 3 years.
I went to a large public university for undergrad and truly dreaded going to class each day because commuting was so unproductive for me. I really appreciate not having to worry about driving to campus, parking, walking in the heat, getting distracted by friends or other social activities, etc.
For rotations, my commutes have ranged from 5 minutes to 2 hours. Just depends!
PA school is intense! How do you juggle outside interests and important relationships?
Macy: I’ve never been the type of student that lets myself get so stressed and bogged down by school that I forget to take care of myself. It’s important to know when to take breaks, when to relax, and when to just let go and do something fun over the weekend. You have to make the time for yourself!
Of course, there are times where you are hanging by a thread just trying to make it to the next day. Some days you can’t take care of yourself fully – some days are just dedicated to school and studying. But I’ve found it’s really important to have a strong support system.
Luckily I had my husband to help with meals, cleaning, laundry, etc. I got a puppy during the start of didactic year and she has been amazing at keeping me company and a great stress relief.
What are your favorite study tips? Any books or websites you’ve found particularly helpful?
Macy: For didactic year, read the lecture before class. Take notes during class. Then rewrite the lecture notes in your own words. Print it out and study your own notes.
Before an exam, make sure you can either recite the material out loud or be able to teach it to someone else without looking at your notes. Repetition and the ability to recall information is super important when trying to ace tests.
I think it goes without saying that Pance Prep Pearls is the PA school bible. I also used Rosh Review, SmartyPance, and OnlineMedEd! I didn’t really use the required textbooks during didactic year but found myself using UptoDate a lot during clinical year.
What have you enjoyed about the rotations you’ve experienced so far?
Macy: Every rotation has been unique – some I share with other students, others it’s just me. I’ve only done one in the hospital and that was really intense and challenging, so it’s safe to say that I prefer outpatient medicine, LOL.
Preceptors can really make or break your experiences in clinicals and I’ve been lucky in the sense that all of my preceptors have made an effort to foster learning and provide an environment where I can be challenged, be given constructive criticism, and practice hands-on skills.
What specialty do you see yourself practicing after graduation?
Macy: I hope to end up in outpatient pediatrics or dermatology! I have always loved working with kids, and I was a derm medical assistant before PA school, so either option would be really great.
If you could offer one piece of advice to new PA school applicants, what would it be?
Macy: Don’t rush to send in your applications. If it’s not perfect; if there’s anything on there that could knock you down; if there’s anything you’re unsure about – just wait! Wait until you feel confident with all aspects of your application. Applying to PA school is not only time consuming and exhausting, it’s expensive! It’s okay to take a year off to perfect your application. It’s okay to even take 2 years off! During that time, make sure you’re doing something productive. Take upper-level science classes at a community college. Do volunteer work. Make sure you’re working and getting direct patient care hours. Just take your time and when you’re ready to apply, apply early (May/June/Early July).
Do you have questions for Macy? Questions for us? Do you want to be featured in our next What is Graduate School Really Like? post? Know someone else who you’d love to see featured? Are there questions you’d like us to ask our students in this series? LET US KNOW!
You can learn more about Macy by following her on Instagram.
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