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    How to Become a Physician Assistant

    Learn the steps needed to begin a career as a physician assistant, from education to licensure. Explore the possibilities a career as a physician assistant can offer today.

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    Gabby Hyman

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    Physician Assistant

    Picture this: you just got your undergraduate degree in biology or anatomy and are wondering what to do next. While you took the undergraduate requirements for medical school, you’re unsure if that’s the path for you. Luckily, there is another option: become a physician assistant (PA). PAs are licensed healthcare professionals who practice under the direction of a medical doctor. While duties can vary based on where a PA works, they often assess a patient’s health and diagnose and treat medical conditions, under the supervision of a doctor. Thanks to their specialized training, PAs often play a big role in patient care, but don’t have to attend medical school or take on the same liability level as doctors. However, while they don’t have to attend medical school, the journey to becoming a PA can still be a long one. This guide covers the necessary steps to begin your career as a licensed PA and gives tips to navigate each step with ease. From earning your degree, to passing the Physician Assistant National Certifying Exam (PANCE), to landing your first job, here’s the skinny on how to become a PA.

    Is Becoming a Physician Assistant Right for You?

    Before deciding on a PA training program, make sure that this career is right for you. Students may enter the profession only to discover that they’re not cut out for it. The rigorous education and demands of the job can be overwhelming. Here are ten questions to evaluate your aptitude for earning a PA degree and thriving in the profession:

    • Are you passionate about helping people?
    • Can you commit time and money toward a comprehensive degree program?
    • Are you a nurturing person?
    • Are you comfortable working with patients who are terminally ill or gravely injured?
    • Do you thrive in an often fast-paced environment packed with stress and pressure?
    • Would you be squeamish about handling body fluids or blood?
    • Can you work long hours without succumbing to burnout?
    • Are you comfortable working with angry or hostile patients?
    • Are you capable of protecting the rights and confidentiality of your patients?
    • Can you admit your mistakes and seek guidance from your superiors?

    If you answer “Yes” to most or all of these questions, it is a good sign that becoming a physician assistant could be a great move for you.

    Research Physician Assistant Programs

    In order to register for the PANCE exam, applicants must have graduated from one of the 238 education programs approved by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The ARC-PA maintains a listing of all accredited PA programs. Programs average 24-27 months to complete. Prospective students have a broad choice among college learning modes (campus and online) and types of PA programs. The right choice depends on where you are along the path to licensing. For example, if you already have a bachelor’s degree, you are prepared to enter a two-year postgraduate program required for taking the PANCE. If you don’t, getting an associate’s or bachelor’s degree in a related field would be your first step. When looking at PA programs, be sure to evaluate all prospective programs to ensure they are ARC-PA accredited. Let’s break down the decisions.

    Deciding Between Campus & Online Learning

    Many students considering their PA education should know there are viable online, hybrid, and in-person options. It’s critical that any degree program–whether online or in-person–is accredited. It’s the only way to qualify for the PANCE exam. Beyond accreditation, you also want to choose a program with student support resources and a high-quality curriculum. Here’s how the various degree programs work in PA education.

    Campus-based programs combine didactic learning with clinical rotations. Some campus programs allow students to take didactic training along with college medical students. Depending on the extent of prerequisites, programs typically take from 24-27 months to complete. Benefits of undertaking a campus program include direct face-to-face time with faculty, college academic advisers and fellow students. On the other hand, campus students must adhere to a regular schedule without the scheduling flexibility common to online learning. The campus option is best for students who live near the school, are able to commute, and can wrap their schedule around their busy lives. In taking time off from work, students can lose income.

    Mostly online programs combine the first year of virtual classes with onsite clinicals and field internships. Like campus programs, PA programs last 24-27 months on average. The courses contain the same content as their campus counterparts. Some classes include labs, requiring onsite attendance. For most attending PA school, a mostly online program with in-person labs is the most virtual option–it’s very rare to find a fully online PA program.
    Since most classes are online, they offer students exceptional flexibility, making them ideal for students who cannot commute often or adhere to class schedules. Usually, there are online components requiring attendance at synchronous online courses that entail regular attendance via live video conferencing. During the first year, online students may also work asynchronously, completing coursework at the time and place of their choosing. Since online learning is often self-paced, online students must create their own schedules and stick to them, with a commitment to completing their work on schedule.

    Hybrid PA programs combine the best of both instructional worlds. They can be completed within the same time frame common to strictly on-campus PA degrees. Some didactic coursework is completed online, but training and clinicals are conducted in-person. Hybrid degrees allow students to attend on-campus courses to gain face-time with their instructors and academic counselors. PA hybrids may speed up time to completion since students can finish coursework ahead of schedule. And the online courses allow students to review videos and presentations as many times as they need. A PA hybrid is right for students who want to combine required attendance with the online flexibility to work when they choose. There are some limitations to hybrid learning. For instance, hybrid programs require a learning curve to master the technology and the college class delivery systems in the self-paced component. Hybrids require the student’s commitment to attend some campus courses despite their existing schedules.

    Understand (and Complete) Prereqs

    According to the American Academy of PAs, the majority of degree programs have prerequisite requirements for labs in anatomy/physiology, biology, chemistry, microbiology, and physiology. Other required preparation courses may include studies in psychology, statistics, genetics, medical terminology, math, and biomechanics. Applicants should have completed a four-year science or medical degree with a minimum undergraduate GPA of 3.0. In addition, most physician assistant programs require applicants to have at least three years of hands-on healthcare experience. Experience can include — but is not limited to — patient care as a medical assistant, emergency medical technician (EMT), certified nursing assistant (CNA), medic or medical corpsman, or registered nurse. Prerequisites may vary from school to school. Prospective PA students should check the prerequisites at their institution of choice.

    Apply to Your PA Schools of Choice

    Once you have completed your program research and completed your prerequisites, it’s time to apply to your schools of choice. A limited number of schools have their own application process. 95 percent of accredited PA colleges use the online Central Application Service for Physician Assistants (CASPA). CASPA allows you to apply to multiple PA schools simultaneously from any online device. The fee varies based on the number of schools you apply to. As you apply, here are key things to keep in mind:

    Application documents

    Depending upon the institution, application requirements may include:

    Application fees

    Considering the total cost of a PA degree program, students would be remiss for ruling out a school with a relatively low application fee. Evaluate whether the school uses the CASPA system where fees are based on the number of schools. The school may also accept completed paper applications to the school admissions office, where fees typically cost $40-$50. Each state has a limited number of PA degree programs that require no application fees.

    Deadline requirements

    It is crucial to keep all deadlines in mind when applying to physician assistant programs. According to CASPA, every school sets their own deadlines. Contact each prospective degree program to find out the final date to apply. CASPA deadlines fall into two major categories:

    Applications are due by 11:59 PM ET on the school’s deadline. No supporting documentation due at the time of application, to be submitted later.

    Application, transcripts, a minimum of two letters of evaluation, and payments must be received by 11:59 PM ET on the school’s deadline.

    Program tuition

    Tuition and fees are directly tied to the kind of university, its ranking, and whether it is a private or public institution. A survey from The Physician Assistant Life found that the average total cost for in-state tuition is $79,941. Non-residents pay an average of $90,659 for tuition. There’s a wide range of total costs between private and public institutions. For comparison’s sake, the private University of Southern California’s total tuition is $69,974 a year while tuition for the same degree at Wichita State University is $14,321.

    Scholarships & grants

    There are scholarships to offset the cost of PA programs. You’ll find scholarships and grants available from your college, from PA associations, and PA career-related corporations. Top scholarships include the Susan Vincent Memorial Scholarship, $1,000; the Air Force Health Professions Scholarship Program, annual tuition of $28,000 plus monthly stipend, and The National Health Service Corps Scholarship Program, offering two-year financial support for full-time enrollment in exchange for two years of service.

    Financial aid

    Students can apply for financial aid by completing the online Department of Education’s FAFSA application. Federal Direct PLUS Loans are designed to aid graduate students. You can borrow $20,500 per academic year. The maximum lifetime borrowing limit is $138,500. The Federal William D. Ford Federal Direct Loan Program is the nation’s largest lending program. The Ford program offers the Federal Perkins Loan Program, open to graduate students and offered through the U.S. Department of Education. These are low-interest loans, with a 7 percent rate. There are also private lenders, however their interest rates can run as high as 14.05 percent.

    Complete Your Coursework & Field Internship

    A PA degree program lasts up to 27 months, totaling 150 or more credits. The curriculum is divided into two main phases: didactic instruction and clinical rotations. Prospective students may also need to complete an 18-credit summer prerequisite program prior to their first semester/quarter. That means that you should block out a calendar and strategy for completing all graduation requirements on time. The second 12-months of a program usually consist of required field internships and more than 2,000 hours of clinical rotations. The process involves finding a healthcare facility in or near your location that accepts interns. You may want to identify a mentor PA with whom you can shadow during clinical rotations.

    Earn Your Physician Assistant Certification & Licensure

    PA’s must gain certification and licensing in order to work in the profession. Credentials can only be secured by passing the PANCE exam. Here are detailed steps to earn a PA license, detailing the content of the exam:

    Becoming Certified

    Before you’re qualified to take the Physician Assistant National Certifying (PANCE) Exam, you must graduate from a Physician Assistant Program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). College preparation pays off. According to the National Commission on Certification of Physician Assistants, the 2018 pass rate for the PANCE exam was 97 percent, with a 98 percent pass rate for first-time takers. Eligible PAs can register for PANCE online; the exam registration fee is $475. The five-hour computer-based exam is made up of 300 multiple-choice questions. The exam assesses each graduate’s medical knowledge. Students will encounter questions on 460+ topics and 13 individual organ systems. Questions cover Cardiology, Pulmonary, Hematology Psychiatry, ENT, Nutrition and GI, Musculoskeletal, Dermatology, Reproductive, Genitourinary, Infectious Disease, and Endocrinology.

    Certification Resources: The American Academy of PAs (AAPA) maintains a listing of organizations providing help and guidance for taking the PANCE exam. You’ll find exam-preparation advice below.

    Requirements for Licensing

    All 50 states require PAs to graduate from an accredited program and pass the PANCE before starting to practice. Eligible PAs can register for the PANCE online; the exam registration fee is $500. Following registration, PA graduates have a 180-day time frame to take the five-hour PANCE exam consisting of 300 multiple-choice questions.

    State Laws and Regulations: Each state sets its own scope of practice for PAs, including the requirement to work under the supervision of a physician. The American Medical Association offers a free chart that lists PA requirements by state.

    Statutory and Regulatory Requirements for Initial Licensure and License Renewal:

    The American Academy of PAs (AAPA) lists licensure requirements for each state for first-time licensing and renewals.

    List of Licensing Boards:

    The AAPA provides a listing of licensing boards for each state, including links to the boards, board addresses and phone numbers.

    Preparing for Your PA Exam

    Before getting your license, you must take the multiple-choice, computer-based PANCE exam. Offered throughout the year, the PANCE exam assesses each applicant’s medical knowledge. Remember: You must be a graduate of an accredited program to register for the test. Students may take the exam up to six times before they lose their eligibility. Fortunately, you don’t have to do it alone. There are solid resources that help students prepare for PANCE, including practice tests and review courses to get you ready.

    Identify your areas of weakness: The first step in preparation is to identify weak areas where you need further review. Taking practice exams can red-flag your potential difficulties. The National Commission on Certification of Physician Assistants (NCCPA) offers a mock PANCE exam to students for $50. You may take the practice exam as many times as you want, but you should take the mock test within the 180-day window for taking the real exam.

    Gather study material: Books, websites, professional journals, podcasts and eBooks can be a great way of studying for PANCE. Some of these include:

    Books:

    Websites:

    Journals:

    Consider a review course: Books, websites, professional journals, podcasts and eBooks can be a great way of studying for PANCE. Some of these include:

    • RoshReview: 3,000 NCCPA-formatted questions and comprehensive explanations. $199.
    • Haymarket Medical: Rutgers University Review Course. $579, free to try.
    • Hippo Education: 72 hours of videos and 1,800 practice questions. $495.

    Keep Your Certification Up-to-Date

    In order to maintain your PA certificate, you must take the Physician Assistant National Recertifying Exam. Under recent regulation, PA-C holders must recertify every ten years and meet the requirements of at least 100 CME credits. It costs $350 for the recertification exam. There’s an additional $50 reactivation fee if your certification has expired.

    For practicing PAs with certifications due for renewal in 2023, there’s a special Alternative to PANRE program. Find out more about renewal eligibility.

    Earn a Certificate of Added Qualification

    The National Commission on Certification of Physician Assistants (NCCPA) is the United States’ sole certifying and testing organization. Earning a certificate of qualifications (CAQ) indicates to the healthcare community that you have been prepared for the additional skills and PA roles required for promotions or the expansion of your job duties. It can lead to higher earnings as well. Applicants for the Emergency Medicine application must hold a current PA-C certification and an unrestricted PA license. Certificate candidates must earn a minimum of 150 credits of CME focusing on emergency medicine practice and including 3,000 hours of experience in emergency medicine. The seven specialties offered are in Invasive Cardiovascular & Thoracic Surgery, Emergency Medicine, Hospital Medicine, Nephrology, Orthopedic Surgery, Pediatrics, and Psychiatry. The exam consists of 120 multiple-choice questions in the practice of your specialty. The NCCPA provides sample exam questions and practice exams. The registration cost is $50 per exam.

    Prepare Your Resume & Job Applications

    When creating and submitting your resume, be sure to emphasize your role in health organizations and your PA achievements. Leading with achievements, licenses, and concrete examples of how you solved problems can separate you from other applicants. Cite your rotations, research, procedures/skills, licenses and certifications. You don’t have to reinvent the wheel in building effective resumes; there are plenty of useful examples from job boards and professional organizations. Be sure to revise your resume to specifically address the requirements outlined in the employer’s job posting. Here are a few examples of PA resumes:

    1. New Graduate Physician Assistant Sample Resume by ThePALife
    2. Resume Tips from Physicians Assistant Solutions
    3. Sample Resume and Curriculum Vitae from Physician Assistant Life
    4. Physician Assistant Sample Resume for Job Seekers from the PA Life
    5. Physician Assistant Cover Letter Sample from Indeed

    Get Ready for Your Interviews

    Your job interview is multifold, examining your training experience and personality profile. Always put your best foot forward. You also have an opportunity to learn more about the employer. Even if you’re not hired, you can learn how to improve your interviewing skills. Even if the hospital or clinic has a casual dress code, impress the employer and wear a suit, not scrubs. Shake hands and make eye contact. Be sure to ask your own questions. Ask about the organization’s ranking, the workplace culture, and how your performance will be evaluated. Here are seven job-specific questions you may face:

    1. Why do you want to join this hospital/clinic?
    2. Do you feel comfortable working without a physician in the office?
    3. How have you resolved differences with a colleague?
    4. Do you prefer working independently or as part of a team?
    5. How have you improved patient safety in the workplace?
    6. How do you deal with a difficult patient?
    7. How do you respond to stress?

    Sources