Let’s be real: being a doctor is rad. If you have what it takes to get into and through med school, if you can look at blood and guts and other gross stuff and feel enthralled instead of nauseated, if you feel called to help people get and stay healthy—do it.
Medical school is no cake walk.
And then when you’re done with med school?
We’ve all seen Grey’s Anatomy and Scrubs. Residency…whew.
Not to mention you’re looking at hundreds of thousands of dollars to get through it all. For a lot of people, that kind of time and financial commitment is out of reach.
(There are other reasons to not choose the MD, which we’ll talk about later.)
Luckily, there are tons of other careers in health care that are more attainable. One of them is Physician Assistant.
A Physician Assistant, or PA, is a highly-trained, licensed health care professional who works with a team that focuses on patient-centered care. Laws vary state to state, but typically PAs work collaboratively and “under the supervision” of a licensed physician (i.e., someone with an MD).
Nowadays, when you make an appointment with your primary care physician—especially if it’s something routine, like an annual wellness checkup—you might see a PA instead, depending on the practice. They are trained to get medical histories, perform physical exams, diagnose illnesses, interpret standard test results, and educate patients on illness, health promotion and disease prevention. Depending on the state, they may also prescribe medication. They can also do minor surgeries, suture wounds, set fractures, and assist in more major surgeries. And they are trained to recognize when a case is beyond their scope and needs to be referred to a physician or specialist.
You’ll find PAs just about anywhere—private practices, hospitals, clinics, nursing homes, schools and university-based facilities, the VA, other government agencies…basically anywhere you find other health care professionals like doctors or nurses.
Physician assistants are currently playing a huge key role in the country’s health care industry. The Affordable Care Act recognized them as one of three primary care providers (along with Nurse Practitioners and physicians), and they are frequently used to “lighten the load” for doctors—a PA can handle the “normal” cases, freeing the doctor to focus on the more complicated or challenging cases. Demand for PAs is high and growing—the Bureau of Labor Statistics expects employment to grow by 38% from 2012 to 2022, which is just insane. They’re especially valuable rural communities because they help increase people’s access to care. Several PA programs have tracks that specifically prepare students to work in rural areas.
The main difference between a PA and an MD is the education and training they get. After earning their bachelor’s degree, doctors go to medical school for four years, then go through residency for several years after that—up to seven years, depending on what specialty they choose.
Most PA programs last 26 months—typically six semesters. There’s no residency or internship component, though all states require PAs to get licensed, which means passing an exam. Once they graduate, they’re ready to join a health care team and start practicing medicine.
Because PAs have to work with a licensed physician, it may seem like their options are more limited. But in fact, they may get more flexibility when it comes to choosing different specialties. They get a well-rounded medical education, so a PA could start her career in pediatrics and switch to obstetrics without getting additional training. For doctors, once they finish residency, they’re pretty much set in their specialty.
Working as a PA can get frustrating because state laws may restrict how much you can actually do for your patients. And the pay, while pretty great, is nothing compared to what you could potentially earn as a doctor.
Danielle Kraemer, who’s currently at Oregon Health & Science University, chose PA over MD because she wanted to just practice medicine and not deal with the “business” side of running a medical practice. “Just getting to show up, do the medicine, and go home was appealing to me,” she said, “rather than have to worry about all the business side of medicine.” This varies widely, but generally, PAs can expect a better work/life balance than doctors. They’re less likely to be on call or spend nights and weekends handling paperwork and other administrative duties.
Your best bet is to major in something science related while you’re an undergrad. PA programs typically don’t require certain degrees (just that you get one from an accredited university), but they do require applicants to take (and perform well) in a slew of science courses, including chemistry, anatomy and physiology, biology, psychology, and statistics. Many also require or at least highly recommend upper level courses in these areas.
Study hard—for most schools, the minimum GPA for all those science classes is 3.0, but accepted students average somewhere around 3.5.
Then, you’ll want to get all the health care experience you can. Schools require at least 1,000 hours of what’s called “direct patient care experience” (some require 2,000), and again, you really want to be well above that minimum.
Because of this requirement, it’s really unusual for someone to start a PA program right after graduating—most spend at least a year working full-time as a medical assistant, EMT, paramedic, lab assistant, nurse, surgical tech or emergency room tech. Schools are picky about what “direct patient care experience” means—shadowing hours definitely do not count (you can include them in your application, but they won’t count towards those all-important health care experience hours.
Danielle took an accelerated program for medical assisting through San Diego State’s Extended Studies Program. It “was not really accredited,” she said, but eventually she found a “per diem” job, where she got called in occasionally to assist. “Sometimes I would miss school just to get the hours,” she said. After graduating, she worked full-time at a neurology office. “That’s where I got the best patient care experience I could have asked for,” she said. The HCE hours are about you getting hands-on experience, sure, but they’re also to help you make sure you’re pursuing the right career.
If you’re still in school, it’s probably going to be challenging for you to get enough hours—look for a volunteer or part-time position that can become a full-time position after you graduate and plan on working their for a year or two. If your school has counselors or resources for pre-med students, use them. Be persistent.
So you’ve got your degree and all those prerequisites and health care experience. Time to hop on CASPA, the Central Application for Physician Assistants. You’ll complete one application that will get sent to all the schools you’re applying to. Some may require additional supplemental materials as well, so check each school’s website for specific requirements.
CASPA applications typically open in April, and most schools have a final deadline sometime in fall. But—we really cannot stress this enough:
Apply early. Apply early. Apply early.
Why is this so important? Because most, if not all, of the top schools, offer rolling acceptance, often starting in August, despite final deadlines not coming until the fall. Some, like Duke, even give priority to applicants who get their stuff in by mid-August. So...apply early. Take your GRE tests, work on your personal statements, request those letters of recommendation. Get on it.
After you apply, you get to wait nervously until you get contacted for an interview. Most schools require them, and most require them to be in-person. George Washington University has quite a bit of information about their interview process to give you an idea of what you might encounter.
Every school, of course, will be different, but you can probably expect a full-day experience where you’ll meet with multiple faculty and staff, plus current students. Remember, the interview is just as much for you to learn whether the program is a good fit for you as it is for the admissions people to decide whether you’re a good fit for the program. Danielle said that Duke was originally her top choice, but her interviews there and at Oregon changed her mind. “The vibe the students gave off [at Oregon]…they just seemed like they were a lot happier, a lot less stressed,” she said.
Yay, you’re in! The next 26 months of your life are going to be jam-packed ride of medical knowledge.
The way each school structures its program will vary, but curriculums—which are modeled after medical school—are more or less the same. You’ll start with your academic year, where you’re taking classes pretty much full-time that range from basic medical sciences to pharmacology to patient assessment to surgery to clinical and professional skills.
“Your first year is everyday, Monday through Friday, you’re in the classroom pretty much from eight to five p.m.,” Danielle said about Oregon. “There’s a test every week [on Friday] on that week’s material. So Wednesday and Thursday are big study nights, then you take the test Friday, then you get to relax over the weekend and come back Monday ready to go again.” Other programs have a similar structure, but may have tests on different days—Danielle mentioned that she’d heard about other programs giving tests on Monday on the previous week’s material, so students would spend most of the weekend studying.
Then you get to move onto clinical year, where you’ll go through a bunch of rotations that focus on different specialties. The exact rotations you’ll complete will vary slightly depending on your program and what electives you take.
At Oregon, for example, students are required to take pediatrics, orthopedic, behavioral, emergency medicine, inpatient, general surgery, and primary care (which you do four times). “We’re supposed to be as autonomous as possible with preceptor supervision,” Danielle said.
Be prepared to move around a lot this year—you won’t just be working on different floors of your school’s hospital, you’ll be working at different locations all over the region. “They send you all over Oregon, and some of them are in Idaho,” Danielle said. Generally, your school will provide housing for rotations when you’re a significant distance away. This just adds to the breadth of your experience and will help you make decisions about where and in what professional setting you’ll want to work when you graduate.
It may not be the full gamut of medical school, but becoming a PA is still super challenging (and with good reason!). It’s a rewarding career that’s in extremely high demand right now, and you’ll have lots of options when looking for jobs after school. If you think it’s right for you, start getting some experience in medicine (remember, “direct patient care” is key), like, yesterday.