Physician Assistant

Description of the Profession

A physician assistant (PA) is a health care professional licensed to practice medicine with physician supervision. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses and injuries, order and interpret lab tests and x-rays, counsel on preventative health care, assist in surgery, and write prescriptions. (Indiana is one of two states that currently do not allow PAs to write prescriptions.) PAs work in all areas of medicine, practicing in primary care (e.g., family medicine, internal medicine, pediatrics, obstetrics and gynecology) as well as surgery and the surgical sub-specialties.

The American Academy of Physician Assistants provides this useful FAQ:

Q: "Where do PAs 'draw the line' as far as what they can treat and what a physician can treat?"
A: "What a physician assistant does varies with training, experience, and state law. In addition, the scope of the PA's practice corresponds to the supervising physician's practice. In general, a physician assistant will see many of the same types of patients as the physician. The cases handled by physicians are generally the more complicated medical cases or those cases which require care that is not a routine part of the PA's scope of work. Referral to the physician, or close consultation between the patient-PA-physician, is done for unusual or hard to manage cases. Physician assistants are taught to 'know our limits' and refer to physicians appropriately."

Students often ask about the differences between PAs and nurse practitioners (NPs). Patient care responsibilities are similar, but NPs may have their own practice and can often function more independently than PAs, both in terms of setting and the kinds of responsibilities they undertake. At the same time, in some settings a PA may also be the primary health care provider when the physician is not present. NPs may need to be on call, while PAs may have more predictable schedules. PAs are covered by the physician's insurance and can specialize by working with different kinds of physicians. Depending on the setting, NPs often must have their own insurance, and in order to specialize further schooling may be necessary.

Skills and Characteristics Important to this Profession

Critical thinking and problem-solving skills, empathy, ability to work quickly and make good decisions under pressure, effective interpersonal communication, and the ability to work with a team of care givers. These and other professional development components are a critical part of any undergraduate degree. Carefully consider the suggestions on the HPPLC Professional Development page.

Description of Physician Assistant Programs

Indiana University does not offer a physician assistant program. Butler University and the University of Saint Frances offer the only Indiana PA programs. Requirements for becoming a certified or licensed PA vary by state. Different PA programs award different types of credentials, including certificates of completion, associate's degrees, bachelor's degrees, or master's degrees. Which credential you pursue depends on your current level of education and other circumstances, as well as your career goals. Further information below.

Because of the close working relationship PAs have with physicians, PAs are educated in a medical model designed to complement physician training. The average PA program curriculum runs approximately 26 months. There are currently about 135 accredited programs in the US.

Education consists of classroom and laboratory instruction in the basic medical and behavioral sciences (such as anatomy, pharmacology, pathophysiology, clinical medicine, and physical diagnosis), followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine. Master's degree programs usually include a research component as well. PAs specialize by working with different kinds of physicians, so it is possible to gain multiple areas of specialization over time.

There are two main paths to PA studies: A) Some students enter an undergraduate preprofessional program which, depending on the state's licensure rules, may itself prepare the student to take the PA licensure exams; may lead to further credentialing programs, like a certificate or an associate's degree, which then prepares the student to sit for licensure exams; or may lead to post-undergraduate PA training such as a master's degree. B) Other pre-PA students earn an undergraduate degree while also completing the prerequisite courses for the graduate-level PA programs in which they are interested, and then apply to such programs during their senior year in college. In the latter case, biology, chemistry, and general studies baccalaureate degrees have historically been common choices, but this is mostly a matter of preference. If you choose this route you should probably major in whatever you are most interested while also working in your PA prerequisites and professional development activities. Prerequisite courses can be worked into most undergraduate majors. (For prerequisite information, refer to the HPPLC Physician Assistant handout, linked from the bottom of this page.)

Researching Physician Assistant Education and Career Possibilities

To begin researching the PA profession, start shadowing PAs immediately. (See Shadowing and Observation, below.)

If you are currently an IUB student or a graduate of IUB, and have not yet met with the HPPLC pre-PA advisor, call 812.855.1873 to set up an initial appointment. It is never too early or too late to do so; though the sooner the better. Even if you have not decided for sure that you will pursue this profession, we strongly suggest meeting with a HPPLC advisor to discuss your options. We can help you with your decision.

As you continue shadowing, also begin your initial research into PA programs (see resources below, and at the bottom of this page). The HPPLC handout, Questions to Ask Health Professions Programs, can help you during this process. You could, for instance, use the questions to vet programs, eliminating some programs based upon the answers you find, and perhaps gravitating towards others. Program web sites will provide some answers, but phone calls and / or email will be necessary to garner more specific information. Be sure to keep close track of the people you contact and where you find each piece of information.

After completing your preliminary research, talk with an admissions representative from each and every program you are considering. While there are still about fifteen undergraduate PA training programs in the US, the most common educational path is to earn and undergraduate degree in a major that interests you (most any major is fine), and then earn a master of science (MS) PA degree. The MS route is the most flexible. Discuss your situation and your goals with the given program and ask whether they feel their program would be a good fit for you. Even if you have not met some of the admission requirements, do not rule out a given program. PA programs want to speak with potential applicants to discuss their circumstances and what they might do to become a viable candidate.

The American Academy of Physician Assistants (AAPA) provides a simple list of accredited PA programs. You can in turn use this list to perform a search for program web sites. However, if you are seriously contemplating PA you could pay the nominal fee for a one-year subscription to the full database of information published online by the Physician Assistant Education Association (PAEA). Doing so can save you much time and labor as you do preliminary research into what kind of PA program best suites your situation and goals and which programs you might apply to or consider transferring to. A link to the subscription service is available from the AAPA site.

One of the simplest ways to become familiar with PA education and career possibilities is to explore and read through related web resources. Other people have already done much of the research for you, so take advantage of it! At the bottom of this page you will find a list of links to PA professional organizations, career web sites, and other resources.

Finally, utilize the HPPLC Physician Assistant Handout, linked from the bottom of this page, which provides many more suggestions for how to efficiently and thoroughly research programs.

Admission Information

Overview

In addition to specific undergraduate prerequisite courses, many graduate PA programs require that you take the Graduate Record Exam (GRE), some will accept the Medical College Admissions Test (MCAT), and some require neither. Letters of recommendation, a personal statement, and an admissions interview are also commonly required. Priority is usually given to applicants with extensive healthcare experience and other patient contact, leadership experience, and other professional development and experience. To be a competitive applicant, you must build a substantial portfolio of these activities. GPA remains an important factor as well. You will need to research each program you are interested in and assemble a list of requirements, preferences, and recommendations.

The typical applicant to graduate-level PA programs is 24 years old and has significant health care experience / patient contact. This is not to say that those who are younger or who have less experience cannot become viable applicants. Nurses, CNAs, EMTs, and paramedics commonly apply to PA programs, but PAs come from a wide variety of professional backgrounds, including non-health fields.

Admission philosophies vary across programs. Some prefer that students have a more well-rounded set of experiences, including humanities and social science courses, volunteer experience, and the like; others prefer that applicants have professional healthcare experience and a deeper science background; and other programs do not have a set of such preferences. Researching the programs and talking to admissions representatives is the best way to learn about their admission philosophy.

Job Shadowing / Observation

Because many programs require a letter of reference from a PA with whom you have spent considerable time observing, discussing the profession, and so on, it is extremely important that you begin doing so now. Shadowing / observation is also the best way to determine whether a PA career is something you wish to pursue.

Students interested in PA should take advantage of any connections they might have, such as family members or friends of the family who are members of the profession, or anyone who knows someone who is a PA. These connections can sometimes open the door to shadowing, service, or internship opportunities. Also, pre-PA students can simply scour the yellow pages for health care providers who might employ PAs. Mail, email, or better yet, hand deliver to each office a professionally written résumé and a well-written cover letter in which you talk a little about yourself and your goals, and why you are interested in the PA profession and in shadowing. Doing this can help you establish some credibility. A couple of days later, make a follow-up phone call to see if they have received your résumé or if they have had a chance to review it for consideration. In light of HIPAA, students are finding it more challenging to find providers who are willing to allow shadowing. Persistence is your best strategy. If you have the option of utilizing summers for shadowing in Indianapolis or another location, you should pursue those avenues as well.

Keep an informal journal of your observations. Some of the details and experiences therein can become part of your personal statement and during admission interviews. Refer to the Professional Development section of the HPPLC web page for further suggestions.

Volunteering and Other Professional Development

Professional Development is a critical part of any undergraduate degree. Visit the Professional Development section for detailed suggestions. Some PA programs favor applicants with extensive volunteer experience, leadership skills, and other professional development experience. Applicants to graduate-level programs are usually expected to have substantial healthcare experience and patient contact, and those considering other types of PA training will greatly benefit from such experience. To help you become competitive for admission to a variety of programs, we strongly suggest you build a substantial portfolio of the above activities. Refer to each program's web page for specific requirements, preferences, and recommendations.

Additional Notes and Recommendations

Well-rounded applicants can be at an advantage during the admission process. We suggest you work a variety of coursework into your preparation, including humanities. At the same time, some programs prefer additional upper-level science beyond the required prerequisites. For additional course recommendations and / or requirements, check the web page of each program in which you're interested, and contact them with questions.

Application Information

• IMPORTANT:  All pre-PA students should thoroughly read the HPPLC handout, Application Information for Physician Assistant Programs. The earlier you become aware of this information, the more smoothly your process of gathering letters of reference will go.
• About 2/3 of all US PA programs require applicants to submit an application, letters of reference, and other materials through the Central Application Service for Physician Assistants (CASPA). See details and deadlines at the CASPA home page. (Note that CASPA programs usually require that additional forms or a secondary application be submitted directly to the school itself.)
• The CASPA application deadline falls in the first half of April, but many PA programs have much earlier deadlines. In addition, many programs have "rolling admissions," i.e., they begin filling spaces as soon as the program's application cycle opens for the given year. For programs with rolling admissions, you should submit your application at the beginning of their application cycle instead of waiting until the deadline. Applying late in the rolling admissions cycle can greatly decrease your chances of being admitted to such programs.
• If you have specific questions about CASPA procedures, please contact CASPA directly.
• Don't hesitate to contact PA programs directly to ask questions about their application process or anything else pertaining to their program. They expect and encourage such contact.

Further Information

For detailed information about prerequisite course possibilities, and further application and admission information refer to HPPLC Physician Assistant handout.

Visit the US Department of Labor / Bureau of Labor Statistics / Occupational Outlook Handbook PA entry for projected salary and other career information. Also, the Bureau of Labor Statistics home page and the Handbook's alphabetical listing of careers.

Additional Resources:

• American Academy of Physician Assistants (APA)
• American Academy of Surgical Physician Assistants (AASPA)
• AAPA listing of PA educational programs
• Journal of the American Academy of Physician Assistants (JAAPA) Available for free online. We suggest you read around in the journal each month to help you become familiar with the kinds of issues and topics that are of concern to PAs.
• Central Application Service for Physician Assistants (CASPA)
• CASPA FAQ
• National Commission of Certification of Physician Assistants (NCCPA)
• Physician Assistant Education Association (PAEA)
• Butler University PA home page
• Saint Frances University PA home page, and admission criteria / facts page
  

Professional Development is a critical part of any undergraduate degree. Carefully consider the suggestions on the HPPLC Professional Development page.

If you are interested in other health professions that are advised through HPPLC, we encourage you to sign up for the HPPLC email list associated with your program(s) of interest. Feel free to sign up for more than one list. Also refer to the HPPLC handout, Health Professions Descriptions.

Important

This information was prepared for Indiana University Bloomington students by the Health Professions and Prelaw Center. Please note that specific requirements and policies can change at any time without notice. Students are responsible for obtaining the most current information directly from the application services, and the schools and programs in which they have an interest. Refer to each program's web pages, bulletins, and other publications for the most current information.