Things I did - Shadowing

Whenever a PrePA gets through the prelimanary questions, the conversation turns to shadowing and usually grinds to a halt.  It's required or advised by many program and difficult to obtain. The sad news is that there is no easy answer. HIPAA and its increasingly restrictive interpretations have made shadowing at large entities (hospitals) almost impossible.

I was fortunate enough to work with several PAs and use some of our time together as shadowing. If I had a spare minute or a lunch break I would sit with a Pa and talk about current patients, the profession, how inpatient practice worked, etc. In CASPA, I listed that time as shadowing. One of those PAs worked in an Urgent Care/Family practice and I was able to also shadow there. The only reason I have shadowing hours on my application is because I was around enough PAs for it to happen.

Here's a few thoughts on shadowing:

- Do your homework. If you meet a PA and talk to them about shadowing, be sure to have learned some things about the profession first. Shadowing is at best a first hand look at what you already know about PAs.

- Look everywhere and ask everyone. Go in person (dressed professionally) to ask about shadowing. Bring a resume. Even better, don't ask about shadowing, just ask to talk to or email the PA. Have some questions ready. Offer to meet them on their schedule. At the end of a conversation, ask about shadowing. If its not an option, you've still been able to learn from a PA and network. Ask who they know that would allow shadowing.

- Join state organization and AAPA. Go to the conferences. Attend a meeting. There are tons of people to connect with through these organizations. After attending TAPA a conference, I had 4 shadowing offers.

- Don't expect everyone to be available for you. I was a little surprised at how often I encountered this perception. Remember that a PA is at work when you are shadowing, and the decision to allow shadowing isn't always just up to them. There could be an office manager, group policy, supervising physicians, and the patients who don;t allow shadowing. You are asking them a big favor, so be grateful for their time.

- Be careful not to get discouraged when people tell you no. You'll have a LOT of people tell you know if you're looking for shadowing. One of the key things PA admissions committees look for is persistence. Keep track of who you talked to while shadowing. Make notes of the conversation and share them with your PrePA group at school or on a blog.

- Hopefully more schools will have programs like this. Let your advisers know about this program and push to see it happen more and more. Internships are extremely valuable, and one that lets you shadow a PA would be ideal.

Advice

There are over 50 interviews on this site, and many people have some advise for future applicants. As we approach CASPA's opening, I wanted to gathering all those together for one post. Here are the responses form PA-Cs and PA-Ss when asked for advice to give a future applicant. 

I think my advice would be to remain open to career changing opportunities, but don't be a afraid to take that first job in primary care, for those who are so inclined. I believe it has been a really valuable experience, and I think that physician assistant scope of practice can really be utilized to its full extend in that setting.  Second, I would say to make sure to try and maintain a work/life balance that will help you stay grounded and prevent burnout, especially during the first few years of practice. 

Study hard.  Ask lots of questions.  Listen to the nurses.  They can teach you a LOT.  Don't take things personally if people look at you like you're "just a PA" and "not a doctor."  I'm amazed daily how few people know what PAs are and what we do.  Don't stop learning.  Most patients just want someone who actually listens to them.  Try to really listen to people rather than just waiting for your time to talk.  Do what you enjoy and enjoy what you do.

My advice to future PA students is to stay committed during the didactic year. It gets really tough trying to keep up with everything, but it will be worth it in the end. When students would complain about exams, my program director would always say "Every patient is a test." This statement could not be more true. The information learned in school will be vital later as your future patient looks at you and asks what is wrong with them. In preparing for a program I would suggest refreshing on your anatomy and physiology, which are the basis for what you will learn. Beyond that you will find out what you need to know in school. In preparing for the "real world," just remember that you should never stop learning. Medicine is a constantly evolving field and will pass you by if you don't keep up. Read journals and take the time to read a few of the emails with which your account will be flooded after graduation regarding new medications and treatments. Most importantly, keep in mind the reason you chose to go into PA school in the first place.

Remember PA school is a great experience but is just the beginning.  Being a PA is a commitment, and very fulfilling.  Getting good grades is important, but once out of school, thinking quickly about how to solve problems is extremely important, and the ability to do so under stress. 

The programs take every aspect of the application as a whole so they want a well rounded applicant. So take the opportunity in the personal letter to show how you set yourself apart from others, many programs want to broaden their student profiles. Be sure you get STRONG letter of recommendations. Many times letter of recommendations are "B" strength and some even harmful.

Have diverse life experiences outside of medicine and science. Become a mentor or if you are taking time off between undergrad and PA school and are looking for work- try teaching with Teach for America. If you haven’t picked a major yet, then try something outside of the realm of science and medicine- I have a Bachelor’s in Journalism.

Health care experience is great because it shows that you can take care of patients. It takes a semester to become certified as an EMT-Basic, and depending on your location, you can work in the 911 service, an ER, or for an ambulance transport service

1-Get to know healthcare, its delivery system and how it works. As a PA (esp as a PA in the future) it is very important to know they system in which you work... if you don't ... you are a less effective provider. 
2-Know the history of the profession
3-Become a member of your state PA chapter or the AAPA to gain professional information about the profession

I highly suggest that pre-PA students become involved with TAPA, the Texas Academy of Physician Assistants. The benefit is great for students because it allows you to stay informed about the profession (which is more important now more than ever because of health care reform) and along with your membership, you get a seriously reduced registration price for the TAPA Conferences. Going to at least one TAPA Conference would be a really good idea because there are student tracks that are focused on enriching lives of students before entering PA school, during school, and in the transition from school to practice. Additionally, there are a ton of faculty members from all the schools there. In fact, I was asked during one of my interviews if I ever attended one of the conferences.

Volunteer at a hospital. Be an orderly or unit clerk or nursing assistant. Hands-on patient care is much more meaningful than shadowing. Reply Forward

Brag confidently but also humbly in your essay about the reasons why you will make an excellent PA. Say things other than I want to help people. Mention your medical/clinical experience but don't focus on listing your resume. Talk about how they have changed and shaped your mind and attitude towards being a PA. Be well rounded. Do something other than just shadow. It could be something completely unrelated to medicine. Be yourself and confident in your interviews. Ask as many questions as you can. Be enthusiastic.

I have seen people in my profession who have a really hard time having to work under someone and the ultimate decision being up to the physician.  I always wonder why these people just didn’t go to med school.  I would just recommend that you realize at the end of the day that we work under a physician and although we normally get a lot of autonomy that is not always the case.  
     I think PA schools are looking for those well rounded people (grades are decent, medical experience, passion for healthcare, volunteering, shadowing a PA to show you are familiar with the profession and know what you are getting into!) – having just one of these things is not going to cut it.  
     Don’t give up.  Reapply!  Our profession is worth it!  Good luck!

 I didn’t realize it was as intense until in hindsight. College seemed difficult but in reality it was not as rigorous as PA school. I also realized that time does fly quickly once you’re in so school was over before I knew it! 

 If you don't get in, call the schools and see where you can improve your application.  Be yourself, they know you are nervous in interviews and will be making mistakes, but if you stay positive and show you can handle tough situations then they will strongly consider you.  Don't write the typical "I've wanted to work in medicine since I was a kid". It gets boring.  Share an experience that made you who you are today and why that has made you want to do medicine. 

When I started PA school, I assumed that I would fail out or be struggling to keep up. That attitude actually served me well. It jump-started me to begin PA school studying harder that I ever had before. Also, you need to assume (and let nearby family and friends know) that you are generally not available. Of course, you need time away from school, but it needs to be sparing. I would advise making friends with your classmates. They are some of the only people who will know what you are going through. Also, you will be speaking "medicine" for 2-3 years. Non-medical friends and family grow very tired of that. Study in groups and individually. Group-studying was actually the most efficient studying I did, even when we were off-track. We came up with silly songs or sayings to help us remember things. Have a non-school book, or some non-school hobby, going at all times. The people that struggled the hardest where those who didn't study enough or those who studied non-stop. Do not worry about what other people's grades are. At the end of the day, yours is the only one that matters.

My advice is definitely to mentally prepare yourself and never give up.  I knew going into my first round of applications that there was a definite possibility that I would not get into a program on my first shot.  I knew I had little HCE compared to others but I knew I had a great GPA...just like all the other applicants applying this cycle.  Just go into the CASPA cycle knowing that you will get into a program, either this cycle or maybe the next, you will do it.  Have that dedication knowing that this is what you want to do and you will accomplish it one way or another.  Also, prepare yourself for the fastest yet slowest two years of your life.  It will be hard, trying, and amazing all rolled into one.  Just roll with the punches and know that it is all worth it.

Take your personal essay and letters of recommendation seriously. Have several different people read your essay and provide feedback. As for the letters of recommendation, choose people that you are confident will write a strong and meaningful letter. If you are planning to ask one or more of your professors to write one for you, make certain you stand out in class as a contributor to class discussions. Do not expect to get a stellar personalized letter based on top grades alone. 

Also, if you get rejected, contact the program as soon as possible and ask to meet with someone, ideally a faculty member, regarding your application. When you do meet, go in with an idea of what you think were your weaknesses and a plan to address each of them. Review that plan and confirm that it would make you a stronger candidate for next year. Who know's? Maybe they'll reconsider you for this year.

*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.

Gosh, I don't know what advice I would give a future PA since I'm not there yet. I'm guessing there is a lot PAs could tell me. As far as future PA students, I would say not to give up on the application process or the PA school dream. If you are worried you don't have the right qualifications to apply review the program websites, talk to their admissions coordinators and go to their information sessions. One of my big concerns before applying was financial aid since I have loans from undergrad and my masters. I contacted the financial aid office and health professions welcome center months before I decided to apply. They were incredibly helpful! If you don't get in the first time you apply don't get discouraged. Learn from the interview process, figure out what it is you need to make yourself more competitive and try again. Volunteer with a cause that means something to you.

Make sure you have all of your prerequisites in order.
Volunteer or work in health care.
Take the GRE and fill out your CASPA application as early as possible.
Shadow somebody.
Be yourself at interviews.

I would say to never give up! We all have our own challenges and struggles in our journey to acceptance into PA school and while we are there completing the journey to becoming a PA. It will be difficult at times but nothing worth having ever comes easy. So, stay focused and determined and you will achieve one of the greatest accomplishments of your life!

For the pre-PA students I think you are preparing well for a future in PA school. I never had a pre-PA society to join so I had to do my research on my own. Research as much as you can about the PA profession, different specialties, PA programs, and the curriculum. You are already a step ahead of the game by being a member of a pre-PA society! I would also say to be aware of the way healthcare works and how you feel PAs play a role in the delivery of healthcare, especially underserved areas. If
you are looking for loan repayment options, the National Health Service Corps is a great place to apply for a scholarship or loan repayment after graduation. PAs are one branch of the NHSC. The NHSC serves medically underserved areas throughout the nation. Finally, if you can go on a medical mission trip, this is another great opportunity to expand your medical and cultural knowledge and improve your resume
Plus they are super fun!

Wise advice would be to always consider the big picture. When you are in school do not just study to prepare for exams, but attain an understanding of a disease from primary manifestations to final treatment. Be organized. Be methodical. Be thoughtful. Learn from your patients. Students have the luxury of time to spend with a patient to really understand how this disease has evolved for them and how it is affecting them. Practicing MDs and PAs rarely have the time to really understand some of these things about one particular patients, but an understanding of those little details really helps you to provide care for the patient and understand the disease to help your future patients once you are licensed and practicing.

You have to REALLY REALLY want it, badly. I still feel like I got lucky because there were people smarter than me who didn't get in. But I stuck with it, applied again, kept after it. Second round applicants can have a better shot because it shows how much you want it to apply again. Its so competetive that you really have to stand out somehow and be passionate about it.

Concentrate on grades in school. It is pretty competitive, so don't slack on studying. Also, I think now they are wanting some type of experience/exposure, so volunteer, work or shadow when you can.

Advise: You will never know it all. Keep learning every day. If you don't, you will never know enough.

Besides the obvious (study hard, good GPA, average GRE score) keep a well-rounded life. PA programs want to see that you get along with people in any scenario (family, work, volunteerism) because, after all, PAs serve as a midlevel provider and come into contact with everyone. Schools also want to see you have extracurricular activities that help you balance the stressors of school and our demanding career. 
Shadow shadow shadow. You need to know what a PA does, how we function in the field, and it is a “requirement” on CASPA. If you don’t have shadow hours, you have less likelihood of getting an interview. Know why you want to be a PA and not a nurse or physician. 
Use people who know you well for your letters of recommendation. I used a physician from my past with whom I worked, an old research mentor, and my boss at the time of application. All of them could truly speak of my personality, nature, and work ethic. I would not advise getting all college professors. We have all been to college, and we all know that one does not really experience a lot of one-on-one and close-knit relationships with professors. 

I can think of tons of advice, but I'll try to limit it. Foremost, maintain your life outside of school. It can be tempting to feel as if you have to study all the time, but don't neglect your significant other, pets, family, or friends. Many of you will be living in a new place, so you should build some relationships. You will not do well emotionally or academically if you push yourself to the breaking point; set aside some time for fun. Also, always ask if you need help: Your classmates and faculty want you to succeed, but they may not know if you're falling behind until it's too late. On a similar note, when you're on rotations, ask as many questions as come to mind - This is your chance! Soon enough you'll be in the same scary situation as me, on the verge of being the PA!

-If you are young and just finishing undergrad, make sure that you do not want to go to medical school instead. I think it’s easy to think that PA might be a shorter route, but if you love the practice of medicine, then becoming a physician might be the way to go. Not saying this is true for everyone, but just take a hard look at why you are going to PA school and not medical school. I’ve seen time and time again people working as PAs for a while and realizing they had wished they had gone to medical school to begin with

-Apply to as many schools as possible, but only apply to the schools you see yourself going to. Don’t put all your eggs in one basket 

-The path to becoming a PA can be tough at times, but it will be a blast…enjoy the ride!!

Hmm. Probably to have some volunteer hours. I know a lot of people who came straight out of college, and they got in because of being "well-rounded", with volunteer hours, and other interesting backgrounds. Just emphasize your "whole package" thing. Yes, a good GPA is great, but can you interact with people, do you have a good bedside manner? Can you talk to all sorts of people? Also, reference letters can make or break you. Meet the right people, and their letter can do wonders.

The PA profession is very challenging and competitive. Don't give up if you encounter set backs.