Interview with a PA-C

Here's an interview with a PA-C who has worked extensively in the Emergency Department.


1) Why did you choose to be a PA?

The experiences I had with PA's prior to becoming one was that they universally seemed to be more down-to-earth, common sense professionals, which fit more in line with how I was raised. It seemed also like a natural extension from my prior career as an EMT.


2) What was your application process like (how many schools, how many interviews, how did you choose)?

I applied to schools in Texas only, since that is where I lived, and Texas is an absolute bargain for higher education. I applied to all state public schools except for UT Pan Am, was granted interviews at 4 of them. One of the schools I was offered was Texas Tech, but the date they offered was right in the middle of a trip to Las Vegas. I gambled (no pun intended) on getting accepted somewhere else, and thusly turned down the Tech interview. Thankfully I DID get in somewhere else, and I don't recommend doing what I did :)

The interview process at each school was very different. The most comfortable I felt was at UNT in Fort Worth, which is where I ultimately was accepted and chose to go to school. UT San Antonio was by far the hardest, and lasted all day from 8-5: an impromptu essay writing, followed by four individual interviews (with an impromptu spanish-language thrown in additionally), and ended with a panel interview with 4 different PA's.


3) Since graduating, what areas have you worked in?

I have only worked in emergency medicine since graduating, and at the original place I began working after becoming certified. I took a bit different course after PA school though, as I immediately entered a residency program in ER for PA's, which was 18 months in duration. I was hired on as staff at the same hospital after completing the residency, and have been there ever since. I don't see myself going into any other specialty in the near future.


4) What has surprised you about being a practicing PA so far?

What has surprised me the most is how much I was able to learn and absorb simply by being in the PA residency out of school- the first year after graduating is definitely an experience in exponential learning potential. Before PA school, I never thought I could have done medical school if I wanted to. After having gone through that, as well as training alongside emergency medicine physician residents, I know that I could do it if I wanted to....but I have no desire to go beyond being a PA.

On another note, it has shocked me at how many of my classmates switched jobs within a year after graduating from PA school. There's only a very small handful of us, myself included, who are still at our original jobs. But then, this is the uniqueness of being a PA- the ability to move into another field if you so desire.


5) You've done some research on emergency medical practices and PA roles there. I know that a PA will do very different things in one Emergency department versus another. How has that role evolved and where is it heading?


In general, there has been a trend towards more autonomy for the PA in the emergency department. We have several in our specialty who are running rural ER's on their own, although this will likely continue to be the exception rather than the rule. I am thankful that in my own practice, that the physician whom I work with on any particular day and I will just trade off who is seeing which patient- there is no defined limitation on which patients I am able to see or not see.

Because of this trend towards more autonomy, there has been a measured push towards more formalized training for PA's in emergency medicine. Just in the three years since I graduated PA school, we have gone from 3-4 PA residencies in the ER to approximately 10 (with more in the pipeline), and the first standardized test for PA's in emergency medicine- the CAQ exam. While residencies and specialized testing is still optional, it would not surprise me that in the distant future you would not be able to switch specialties without at least passing a CAQ exam, if not also completing some sort of post-graduate training. At the very least, the emergency physicians (ACEP) advocate for us to acquire additional training specific to the ER in whatever form that may take, and there are plenty of options out there other than a formalized residency program.


6) You trained in Texas and now practice in a different state. How are the regulations different in your current state? What was the licensing process like for someone from an out of state school?

Pennsylvania is definitely unique in that there are actually two boards of medicine- one for allopathic and one for osteopathic. As a PA, you choose one or the other based on your supervising physician (although you are not limited to one or the other based on who your substitute supervising physicians are). PA's in Pennsylvania are also able to write for DEA combination Schedule II opiate medications, whereas in Texas you are limited to Schedule III and lower. There is also a bill currently going through the legislature that will take away the requirement for all PA charts to be co-signed by a physician.

The licensing process was actually very painless- it's always easier to get your initial license than it is to acquire an additional one after practicing for a few years. Most states enable you to acquire a temporary license that's valid just as soon as you graduate from an accredited PA program, and last until you pass the PANCE (when it automatically rolls over to a permanent license). So as soon as I graduated from PA school, I had my program director sign my license application and sent it straight to Pennsylvania, and within a week I had a temporary license. Unlike in Texas, there is no additional exam such as the Jurisprudence exam that needs to be passed in order to acquire a permanent license.


7) Besides shadowing and good grades, what advice would you give future applicants?

*PRACTICE INTERVIEWING! It will truly make you more relaxed when you're in that one-on-one situation come crunch time.

Other than that, there is a vast wealth of information at the PA Forum to help future applicants. It's helped me and countless other PA's get to where we are today.