FORGET Med School, I wanna be a PA :)

[ThinkTooMuch]

so after months of thinking ive decided id rather have a life, and have a family earlier than my late 30's (im 26 now), and want to age normally. But I still want to enter health care. But, Ive noticed PA programs require 1000-2000 hours of "hands on" patient care experience. Just looking for some guidance on the most efficient route I can take to fulfill this requirement to becoming a PA? I have zero experience in anything health care related. I DO have a bachelors degree...but in Marketing . thanks in advance for any help.

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[deleted6669]

traditional routes include emt, cna, lpn, rt, etc
keep in mind that the prereqs for pa school are different than med school so you may need to go back and take a few other classes if you have been preparing for medschol.
for more pa info see:
www.aapa.org
www.physicianassistantforum.com
www.appap.org
also keep in mind that pa's tend to work the same hrs as the docs they work with(or sometimes more) so going pa does not always equal free time. you will have more free time up front but down the line the hrs are not all that different and keep in mind an md can work 2 days/week to make 100k but a pa needs to work full time to do this so who ends up with more free time....?
personal example: docs in my em group work no more than 108 hrs/mo(they are not allowed to work more than this) and most of them work less than this. docs do 8 hr shifts. and make around 225+k/yr
typical pa in our group works around 180 hrs/mo. many do more than this. pa's work 10-12 hr shifts...and make 110-130 k/yr

 

[niko327]

traditional routes include emt, cna, lpn, rt, etc
keep in mind that the prereqs for pa school are different than med school so you may need to go back and take a few other classes if you have been preparing for medschol.
for more pa info see:
www.aapa.org
www.physicianassistantforum.com
www.appap.org
also keep in mind that pa's tend to work the same hrs as the docs they work with(or sometimes more) so going pa does not always equal free time. you will have more free time up front but down the line the hrs are not all that different and keep in mind an md can work 2 days/week to make 100k but a pa needs to work full time to do this so who ends up with more free time....?
personal example: docs in my em group work no more than 108 hrs/mo(they are not allowed to work more than this) and most of them work less than this. docs do 8 hr shifts. and make around 225+k/yr
typical pa in our group works around 180 hrs/mo. many do more than this. pa's work 10-12 hr shifts...and make 110-130 k/yr

I'd imagine you don't even need to think about the response to the same questions over and over and over again. Your fingers are probably just moving around the keyboard due to some strange and complex reflex arc in response to minimal visual input of word fragments like pre-req, reimbrsmnt, clncl hrs, shft, hw mny yrs, fre tme, pa tking ovr, pa thnk he dctr, etc. Am I wrong? Can a brother get a sticky already, You can call it emedpa's greatest hits.

 

[sylvanthus]

I am a bit biased, but I recommend the EMT or ER tech route. I think you learn a lot more practical skills than if you were to go through a CNA course.

 

[foreverLaur]

I am a bit biased, but I recommend the EMT or ER tech route. I think you learn a lot more practical skills than if you were to go through a CNA course.

I agree, but make sure those jobs are attainable in your area. I would have preferred that route as well, but a job as an EMT-B or ER Tech are next to impossible to get in my area. I went the CNA route because it was MUCH easier to get a job.

 

[NPEMTIV]

Not all PA programs require clinical experience before matriculation, it's just a plus. If you have to go back and get several pre-req courses out of the way before starting as it is I'd advise looking towards programs that don't require the clinical experience. Yes it's helpful but not an absolute.

 

[Chocolate Bear]

Yeah, I looked into the issue a while back:

http://forums.studentdoctor.net/showpost.php?p=6932509&postcount=1188

Not sure what happened to the link in the post (now outdated), but the source was a PDF they published with all the admissions stats from across all PA schools in the US. I'm sure it's still available from the AAPA.

 

[foreverLaur]

current link ('07 still)

http://www.aapa.org/images/stories/2007studentcensusregionalreport.pdf

 

[Chocolate Bear]

current link ('07 still)

http://www.aapa.org/images/stories/2007studentcensusregionalreport.pdf

 

[Snake Doctor]

current link ('07 still)

http://www.aapa.org/images/stories/2007studentcensusregionalreport.pdf

I'm reading page 15 right now and see that 20 people were pharmacists and 3 were optometrists prior to beginning their PA programs. That is interesting

 

[deleted6669]

I'm reading page 15 right now and see that 20 people were pharmacists and 3 were optometrists prior to beginning their PA programs. That is interesting

lots of psychologists, nutritionists, and believe it or not, lawyers too....

 

[TexasPhysician]

Not all PA programs require clinical experience before matriculation, it's just a plus. If you have to go back and get several pre-req courses out of the way before starting as it is I'd advise looking towards programs that don't require the clinical experience. Yes it's helpful but not an absolute.

I'd second this. My ex-gf is graduating PA school currently #1 in her class, and she had minimal clinical experience before hand. Maybe 100 hours total. She got accepted straight out of undergrad. PA school will teach you what you need to know to be a talented PA. Clinical experience just shows your dedication to the field.

 

[Paseo Del Norte]

Clinical experience just shows your dedication to the field.

I am not sure it is even that important. It shows that you can approach a patient and deal with health care exposure however. Nothing like blowing a bunch of money only to find out you are unable to deal with the less glamorous aspects of health care.

If PA's are receiving a few thousand hours of experience as stated by members on this board, then a thousand hours of CNA experience is rather trivial IMHO.

 

[deleted6669]

If PA's are receiving a few thousand hours of experience as stated by members on this board, then a thousand hours of CNA experience is rather trivial IMHO.

I would argue( and have seen over the yrs as a preceptor) that several thousand hrs at the rn/medic/rt level still make a better practitioner however.....

 

[TexasPhysician]

I would argue( and have seen over the yrs as a preceptor) that several thousand hrs at the rn/medic/rt level still make a better practitioner however.....

Obviously the more time you spend in a health-care setting, the better provider you will be. I'm just saying the hours aren't required for admission.

Testing your own arguement: Would you answer a cost-benefit analysis?
Would you rather work in your own practice with a freshly graduated PA with 5 years of experience as a medic or a PA with 5 years of experience in the PA world?

Randomly having extra healthcare hours would be nice, but your comment above makes it seem like delaying PA school for a few thousand hours in random healthcare experience is a better option. I'm no PA, but all things being equal, I feel like I would hire the PA with more PA experience.

 

[TexasPhysician]

I am not sure it is even that important. It shows that you can approach a patient and deal with health care exposure however. Nothing like blowing a bunch of money only to find out you are unable to deal with the less glamorous aspects of health care.

If PA's are receiving a few thousand hours of experience as stated by members on this board, then a thousand hours of CNA experience is rather trivial IMHO.

Maybe but if you want it enough, you can desensitize anyone to less glamorous aspects of medicine. I've dragged numerous nurses and medical students out of surgeries for fainting. Eventually they get over it/mentally prepare themselves for it.

There are many aspects of healthcare where you can avoid the areas you dislike the most.

 

[Paseo Del Norte]

I would argue( and have seen over the yrs as a preceptor) that several thousand hrs at the rn/medic/rt level still make a better practitioner however.....

I am in no position to argue your statement and would agree that an experienced nurse or allied health provider is going to bring their knowledge and skill set to the table. I can only assume this knowledge will be helpful to the PA candidate/student in their studies and practice.

However, I would still argue that the minimum thousand hours of nebulous HCE (could be CNA or MA work) is not going to be a deal breaker save knowing that the candidate can function in the health care environment.

 

[deleted6669]

Testing your own arguement: Would you answer a cost-benefit analysis?
Would you rather work in your own practice with a freshly graduated PA with 5 years of experience as a medic or a PA with 5 years of experience in the PA world?

they need both.
what I look for when I hire em pa's is someone with both prior high level experience AND several years of em pa experience. we don't hire new grads and we don't hire pa's without prior em pa experience.the job I'm at now is more of a last job than a first job. it was my 4th job as an em pa. the avg pa in our group now has an avg of 10 yrs em pa experience with a range of 5-30. the associate medical director of our group is a pa with 25 yrs experience. our group has used pa's in the e.d. for 20 yrs. our first pa hire still works for us. we can afford to be picky as we have many more applicants than spots. we cover a busy trauma ctr, an obs unit(where the pa's are credentialed to do exercise treadmills), and a satellite em facility that sees 30k pts/yr that we staff 24/7 with pa's with a doc on day shift only.
most of my current group of 15 em pa's were former medics, rt's, etc for an avg of 5+ yrs before pa school.

 

[TexasPhysician]

they need both.
what I look for when I hire em pa's is someone with both prior high level experience AND several years of em pa experience. we don't hire new grads and we don't hire pa's without prior em pa experience.the job I'm at now is more of a last job than a first job. it was my 4th job as an em pa. the avg pa in our group now has an avg of 10 yrs em pa experience with a range of 5-30. the associate medical director of our group is a pa with 25 yrs experience. our group has used pa's in the e.d. for 20 yrs. our first pa hire still works for us. we can afford to be picky as we have many more applicants than spots. we cover a busy trauma ctr, an obs unit(where the pa's are credentialed to do exercise treadmills), and a satellite em facility that sees 30k pts/yr that we staff 24/7 with pa's with a doc on day shift only.
most of my current group of 15 em pa's were former medics, rt's, etc for an avg of 5+ yrs before pa school.

"They need both" is your answer to my question? Meaning all the PA's that work with you had to work as a medic or similar BEFORE PA school? I'm not talking about PA experience in an ER.

My question was merely about training PRIOR to PA school.

 

[zenman]

Testing your own arguement: Would you answer a cost-benefit analysis?
Would you rather work in your own practice with a freshly graduated PA with 5 years of experience as a medic or a PA with 5 years of experience in the PA world?

The big difference will be when both have five years of experience as a PA.

 

[TexasPhysician]

The big difference will be when both have five years of experience as a PA.

I don't think you people understand cost-benefit or opportunity cost.

Obviously, the more healthcare experience you have - the better provider you will be.

People on this thread are saying that 1000-2000 healthcare hours PRIOR to PA school are important. I think its useless based on opportunity cost - meaning I would rather work with the PA with 2000 more hours of PA experience v someone who took time to accumlate 2000 hours working as a respiratory technician. Both of these PA's, have spent equal amounts of time.

As an undergrad or whatever, I thoroughly agree that someone should put in volunteer healthcare hours. After undergrad, it is a waste of time to spend 2 years as a respiratory technician/EMT before applying to PA school (my opinion). Those same two years would be better spent in PA school - he/she would graduate 2 years earlier than the equivalent respiratory technician route. More years as a PA = higher pay and more experience as a PA.

Summary: If you plan to get your PA degree or equivalent NP, don't waste time in other lowel level avenues unless you have no choice or just have random spare time. It is more worth your while to enter PA school as soon as you possibly can.

 

[Paseo Del Norte]

Not that I necessarily disagree; however, respiratory technicians no longer exist in the United States. I know, nit picking, but maybe I can score a few points from my RT instructors with this post. I am not beyond a little brown nosing.

 

[Aerin Sol]

It's not exactly hard to work as a CNA/EMT-B part-time while in undergrad.

 

[deleted6669]

I don't really care about "opportunity cost", I care about the quality of the final product.
yes, the fastest route to anything is to do the bare minimum. big surprise. yes, this would make the individual more money over the long run. big surprise.
as a pt who do you want taking care of you:
pa #1 did a 5 YR BS/MS program right out of high school and is a pa at 23. you are their first pt on their first day.
pa #2 was an emt at 18, a paramedic at 23, finished their bs at 28 and finished pa school at 30. you are their first pt on their first day.

it takes the inexperienced new grad several years to catch up with the experienced new grad and in some areas they never catch up.

take it from someone who is a long time pa clinical preceptor. the final product(the graduate) is a better practitioner when you start with someone with significant experience. pa school has always been designed to be a second medical career which builds on prior education and experience.

 

[deleted6669]

It's not exactly hard to work as a CNA/EMT-B part-time while in undergrad.

exactly. I was an er tech 20 hrs/week as an undergrad and 60 hrs/week in the summers. I went to medic school right after finishing my bs and worked as a medic for 5 yrs before becoming a pa.

 

[core0]

The big difference will be when both have five years of experience as a PA.

Actually there if there is any difference (different studies and anectdotal experience show different things) it largely disappears after two years. Two PAs with equivalent five year experience as PAs will preform in a similar manner. Experienced educators and PA supervisors almost universally feel that it takes two years as a PA to hit your stride.

While I respect EMEDPAs opinion it also comes from working on the West Coast. In the East there are many more programs that don't require HCE (although students often have some). HCE helps students understand the health care environment and engage patients more quickly. This is an advantage in clinicals but largely disappears in practice. The program I went to mixed students with HCE and direct entry PA students. The differences largely disappeared at graduation (anectdotally). The only HCE that we really look at where I'm at is in the OR (which directly impacts OR training). Otherwise the only thing that we really look at is experience as a PA. Everything else is window dressing.

Fundamentally all PA programs teach to the same standard. Some programs historically find it easier or more efficient to teach those with HCE. Other programs have found that HCE really doesn't matter in how the student does. The one study on this found that those with HCE do no better on the PANCE than those without. In fact most of the studies done found that very little of the success rate on the PANCE is due to program characteristics.

David Carpenter, PA-C

 

[deleted6669]

Summary: If you plan to get your PA degree or equivalent NP, don't waste time in other lowel level avenues unless you have no choice or just have random spare time. It is more worth your while to enter PA school as soon as you possibly can.

could not disagree more. time spent getting health care experience paves the way for success in pa school and makes you a better clinician in the long run. you limit your future job prospects as a pa by having no relevant( and I don't mean cna) experience before pa school.
(relevant = medic, rn, rt, cardiac exercise physiologist, surg tech, ortho tech, etc.)

 

[deleted6669]

David and I have this discussion frequently on several different forums and I do respect his opinion as well. I work at several different facilities with different requirements for pa staff membership and have been able to compare/contrast pa's based on a number of characteristics..
it is possible that my view is skewed by seeing it through the lens of emergency medicine but I notice a big difference, even at 5 yrs, between my colleagues who had prior em experience and those that did not. there are procedures and situations that former medics, rn's or resp. therapists are more comfortable with from doing them thousands of times before pa school than someone who did them a few times( or never) as a pa student. intubation, code management, IO placement, rapid trauma eval/tx, critically ill kids and adults, etc are all much more comfortable to deal with with significant exposure.I have been doing this long enough that I now have several partners who were my students> 5-10 yrs ago. I have watched them evolve as providers and know their inherent strengths and weaknesses. there are also folks I work with who have been pa's longer than I have who are not as comfortable as I am with some aspects of emergency medicine due to my prior exposure.
I would agree with those who say 6 months as a cna doesn't make a difference but I will always believe that prior high/career level experience makes for a better provider in the long run and that advantage spans the entire career. in some fields those without experience never catch up....if I decided today to switch to general surgery I don't think I would ever be as good as a guy who was a surg tech for 10 yrs before pa school. specific career related exposure matters....
Frequent transitions among previously experienced pa's:
emt/medic: em/critical care
surg tech or surg rn: surgery
ortho/physical therapy tech: ortho
cardiac tech/physiologist: cardiology
resp. therapy: pulmonology/critical care/em
medical asst: primary care
ob rn: ob/gyn

folks who follow this progression have a huge advantage over those without prior experience trying to enter these fields as an inexperienced new grad.

 

[TexasPhysician]

could not disagree more. time spent getting health care experience paves the way for success in pa school and makes you a better clinician in the long run. you limit your future job prospects as a pa by having no relevant( and I don't mean cna) experience before pa school.
(relevant = medic, rn, rt, cardiac exercise physiologist, surg tech, ortho tech, etc.)

The only PA's I know came straight from undergrad with limited experience beforehand, so I have little to compare them too. Maybe it is geography or just the overall shortage of PA's, but the few PA's I am close to have more job prospects than they know what to do with. As a newly starting resident, I am very jeolous of the situation they are in right now. Great field to get into right now.

I completely agree that if you have the time, health care experience in general benefits you in the long run. From the PA's I know without the experience, they are still doing quite well. One in particular I would fight to have come work with me.

 

[deleted6669]

there are 5-7 jobs for every new pa grad. some of these jobs as might be expected are much better than others. the best jobs tend to go to folks with the most prior experience because they require the least training and are more likely to "hit the ground running" right from the start.
there are actually jobs posted that say " 2-3 yrs experience as a pa or new grads with former medic/rn experience may also apply".

 

[Dwindlin]

While I see emdpa's point of view I too tend to disagree with it. As core0 said most disparities vanish after a time in practice. You see the same thing in medical school. The people who come in with any pt care experience are easy to pick out amongst 3rd years, but before residency is over I would bet you would be hard pressed to tell the difference.

 

[deleted6669]

While I see emdpa's point of view I too tend to disagree with it. As core0 said most disparities vanish after a time in practice. You see the same thing in medical school. The people who come in with any pt care experience are easy to pick out amongst 3rd years, but before residency is over I would bet you would be hard pressed to tell the difference.

the great equalizer for physicians is the residency. most pa's don't do a residency so prior training plays a greater role. In a residency there is a standardized format for procedures required, #s of intubations, etc whereas on the job training is more random. you could be a pa for 10 yrs working in internal medicine and never put in a central line for example while the resident would have been required to do X central lines before graduation. if we were to compare a residency trained pa vs a pa who was a prior medic vs someone with no prior experience I would think the residency trained pa and the medic would have more in common than either would have with the no experience pa school graduate. the best overall would be the prior experienced individual who also did a residency.
I am a big fan of pa residencies, especially with the influx of pa grads with no prior experience or low level experience. I would be in favor of a mandatory 1 yr residency for all pa's or increasing pa school to 3 yrs(like usc has done) to add more clinical time in the form of a specialty or rotating internship. this might limit our lateral mobility between specialties but I think that is coming sooner than later anyway with the "optional" specialty certifications being rolled out next yr.
for links to all accredited pa residencies in a variety of fields see www.appap.org

 

[jrob8503]

Not that I necessarily disagree; however, respiratory technicians no longer exist in the United States. I know, nit picking, but maybe I can score a few points from my RT instructors with this post. I am not beyond a little brown nosing.

Yes, doctor. Please step out of your time machine.

 

[zenman]

I don't think you people understand cost-benefit or opportunity cost.

Obviously, the more healthcare experience you have - the better provider you will be.

Yes, I do. I have an MBA;I just try not to use it.

I understand your point, as well as CoreO and emedpa's points. In the NP arena prior experience is a plus since our clinical hours are shorter, although all in one area. Some physicians won't hire an NP unless they have prior experience because they recognize the "out the door" performance. Sure you may equal out after five years experience, but with my 37 years experience prior to going to NP school, I'll bet I can drag up something from the past that will help me....I just saying....

 

[LobotomyPlzThx]

If PA's are receiving a few thousand hours of experience as stated by members on this board, then a thousand hours of CNA experience is rather trivial IMHO.

PA school is the real mccoy. It's a fast-paced and abbreviated medical school and nobody has time to hold your hand if it's your first time doing simple medical procedures (such as drawing blood). You want to have prior experience in a health field so you can do all of your newbie errors there so you can stay afloat when it's go time in PA school.

It's good to get about a year's worth of experience in something like nursing(RN, LPN, or at least CNA) or phlebotomy. Anything with patient contact (what they're really looking for) and time to familiarize oneself with procedures.

 

[Paseo Del Norte]

PA school is the real mccoy. It's a fast-paced and abbreviated medical school and nobody has time to hold your hand...

I am considering breaking my one face palm comment a day limitation. PA school is not mini med school or med school light. PA school is PA school. I have no doubt that PA school is quite difficult and very intense; however, it is not "abbreviated medical school."

 

[Starpower]

I have no doubt that PA school is quite difficult and very intense; however, it is not "abbreviated medical school."

You are the winner. PA school is a tornado to get through, but it is in no way a replacement for medical school. When I rotated in Surgery and sat in on grand rounds lectures, I learned things about physiology that I had no idea existed. PA school does what it can to get people ready quickly for primary care and the basics out of graduation. That's where Lobotomy is correct that previous experience can play a large part in the educational experience, as well as how things go after one has graduated.