Posted 21 hours ago
What is the difference between a PA and a RN? They sound very similar to me am I right or wrong?
Anonymous asked

Oh naw you didn’t! …

Sorry, you probably are asking this question very innocently but PAs get very disheartened by sentiments like this. No, we are not the same. PAs are educated and trained to diagnose and treat diseases. We are trained to take complete medical histories, do physical exams, order and interpret lab tests and imaging, write prescriptions, and know how and when to ask for further help from specialists, therapists, etc.

Could a good, proactive, experienced RN eventually figure out how to do many of these things? Probably, but it would be based mostly on protocol-type knowledge gained and algorithms vs well-rounded, organized medical training. This is why some RNs choose to become NPs, they want to expand on their on-the-job knowledge and fill it out more formally to fit the provider role.

Don’t get me wrong, RNs have an extremely important job. They are the ones who take care of all of the patient care orders I’ve requested, call me when I screw something up or when they know something is just not right with our patient, and deal with the real life poop, vomit, and tears situations in health care. In the inpatient world, they spend far more time with my patients than I do. I would want them to be the ones to insert your Foley catheter, start your IV and check for compatibilities, and know just how to give you your meds, because those are skills that RNs are much better trained on than I have been.

But the bottom line is that our roles and training are completely different.

Posted 21 hours ago
Hi! I'm curious about your thoughts on undergraduate vs a masters in PA. I'm thinking about going back to PA school and have seen through my research that some schools offer either a masters or an undergrad degree. Is there a practical difference? Pay scale? etc. Would love your perspective! Thanks! Sarah
Anonymous asked

I think the job you end up doing would be the same. However, your background coming into the job may be affected somewhat by bachelor’s vs master’s. Master’s programs tend to have a research component. In my situation, I had to write a research paper and take a few courses in statistics and evidence based medicine. While I found it really boring as a PA student, the research component has really come in handy. You’ll learn that medicine is constantly evolving. Things we are taught as fact and standard in medical school are often not based in evidence or consistent scientific studies and it is REALLY difficult as a new PA to ascertain that sometimes. You will butt head to head with many a crusty provider who insists on doing things their way or that this way is the standard of care when a little research will reveal that they are super old skool and their practice is not based in evidence. I think I would have struggled in that aspect without the background my master’s provided me (statistics, how to tell a good research study from a bad one, how to search online databases and journals, etc).

Other than that, it seems that the curriculum is very similar. I’m not sure about the pay scale thing, you may want to ask over the PA Forum website about that. I do think recruiters who would probably choose someone with a master’s over an undergrad degree but again not 100% on that one.

Posted 22 hours ago
I'm going into Cegep this year.. (it's two years and pretty much like college if you don't know about it) I have to choose between med school and pa school.. I like surgery and psychiatry especially, and I really do have a passion for the health field but my parents are telling me I'll definitely regret not being a doctor if I work with them for the rest of my life with them having more power when it's an option I considered. Do you think going for med school is better? I do want free time...
Anonymous asked

Committing yourself to a likely expensive, long-term educational investment like medical school because your parents are advising it may be setting you up for disaster. You should only do this because you are certain that’s what you want because you don’t want to invest all that time and energy and end up doing something you hate. I’m assuming you’re in Quebec, so it seems like it would be 2 years CEGEP + 3-4 years med school + residency +/- fellowship versus 2 years CEGEP + 2 years for PA school? 

It’s up to you to research what PAs do in your area vs physicians and decide what your priorities are. Neither med school nor PA school allow much free time. I would take your time in CEGEP and figure out what you really enjoy. Don’t even choose medicine as your ultimate career now because it seems like it’s too soon for you to be certain.

And honestly unless your parents work in the medical field (and unless you absolutely can’t stand to not be 100% in control all of the time) I don’t think they really understand the physican/PA relationship. It’s not about who has more power. We pretty much have the same power in terms of prescriptive ability, patient care orders, legal responsibility, etc. Physicians don’t boss us around. It’s about working as a team to take care of patients and knowing your limits and scope of practice and what kinds of patients should be seeing someone with more experience or training.

Posted 22 hours ago
Hello! I have a couple questions. I am actually finishing my AS in computer science this year. After a bit of soul searching i decided what i really want to do is help people and thus came upon the career choice of a PA. I will be changing my major to biochem or the pre-med route. My question is how would you recommend getting my patient care experience while finishing my undergrad? i do want to go to PA school right after undergrad if possible. Do most people wait 1-2 years before PA school?
Anonymous asked

For specific ideas about patient care experience routes and why I recommend time in between undergrad and PA school, I would check out my q&a section as I’ve covered this topic in several posts. The bottom line is, I would focus on your undergrad education right now. Science majors are tough and you will want to do well for your own background and sanity while finally in PA school and to just get into PA school to begin with. If you feel you have time to work a little bit while doing undergrad, by all means go ahead. I think it might be tough to get in the required hours, though. And remember that most admissions committees won’t count volunteer hours towards their patient care requirement. I would take a year or two off after undergrad, work, save some money for PA school application expenses (plan on at least a couple thousand), enjoy your life because you won’t have one during PA school. People go to PA school in their 30s, 40s, 50s, and beyond so even if you’re older you’ve got plenty of time.

Posted 22 hours ago
Hi! I'm wondering if you have any recommendations about finding a PA to shadow. I have shadowed a number of MDs in different settings, but haven't had the chance to shadow a PA yet. I currently work in clinical research, but despite that connection, there are several bureaucratic issues with the clinic that don't allow "shadowing" so I'm back to flying blind! Any suggestions for making contacts to shadow?
Anonymous asked

I had the same problem. Everyone was freaked out about HIPAA. I called around to several hospitals and clinics and talked to their HR people and everyone turned me down. I ended up using my CNA work email at the time to contact specific providers via their clinic email, and I think every PA got back to me. I ended up shadowing with 3. They just had me sign some HIPAA paperwork with their practice managers. True story: one PA was super snooty and demanded that I read a book about Dr. Eugene Stead (founder of the PA profession) before she would even speak further with me about shadowing. I honestly couldn’t afford the hard cover book (it was like $70 or something!) and when I asked her if I could borrow her own copy I think she wrote back that I wasn’t serious enough about the profession or something… Bottom line you wouldn’t want to shadow with someone like that anyways!

It may take signing a few papers or watching a short stupid HR video but typically if you contact providers directly you’ll have better success with shadowing and it shows initiative on your part. Tell them exactly why you’re interested in their particular specialty and I’m sure they’ll make the effort to get you in with them.

Posted 1 week ago
Were your clinical rotations done mostly in the same city as your school? I have heard some frustrating accounts of PAs who have done rotations several hours from their home base and had no help from the program finding temporary housing. Especially when your rotations are so brief- was housing/commuting during your clinical year an issue?
Anonymous asked

We specifically had to do at least 2 rotations outside the area in “underserved” communities. I chose to do an additional away rotation in Ecuador. The program always secured housing for us in these instances and had established leases with private landlords or partnered with state-run organizations for medical learners. We did have to pay a small additional fee for this that was included in our tuition and enrollment charges for the semester, so student loans covered it. I also had a few local rotations that were still a 30-45 minute drive from my home base so in that case I wasn’t reimbursed anything, I just had to suck it up. BUT if there were any required inservice days at the PA program while we were stationed at an away rotation, then the program did reimburse us for mileage which I think is a nice gesture.

I personally think it would be ridiculous for a program to expect you to find your own housing for an away rotation. You have enough more important things to worry about and finding something month to month all the while not knowing how much to budget for it is way too much stress. This would be a REALLY important question to ask about during your interview! I personally would not consider a program that did not provide housing.

Posted 1 week ago
I'm gearing up to apply to PA school in the next cycle, and I'm wondering where you attended school, how many schools you applied to, and how you made your choice? What was important to you in choosing a program?
Anonymous asked

In the name of HIPAA and anonymity my prior schools and residences are a secret, but I can answer your other questions.

Number of schools applied to = 7 (4 interviews; accepted into 2, rejected from 2, waiting list/waiting game for 3)

I focused where I applied to based on location (my husband nixed certain areas), PANCE first time pass rates, quality of their web sites and resources (hey if that sucks just imagine how great their technology for teaching could be…), option to do international rotations, availability of local running paths, and ABOVE ALL the vibe I got during my interview from the faculty and current students (were they welcoming? were they a community? did I feel at home? etc).

Honestly, the 2 programs I was accepted into I got a really good vibe from. I wasn’t sad about being waitlisted by the others because the vibe wasn’t as good. The faculty seemed stuffy, or it seemed like a suitcase campus (pack up after class and run away to various suburbs, no study groups or hanging out), etc.

Of course this was just what was important to me personally and you will have to weigh the pros and cons for yourself. Hope this helps!

Posted 1 week ago
is it possible to have a dating life in PA school?
Anonymous asked

Yes, so long as the sig other is not too clingy and doesn’t expect ridiculous things of you (having dinner with them every night, spending all weekend together, etc). It’s good to get out and do things with someone. Even if you don’t think you have the time it’s good for you, trust me!

Posted 1 week ago
I'm going to college next year, haven't quite figured out what I want to do, I've considered physician assistant or forensics. Was wondering if you could tell me about physician assistant. I heard you have to get a undergraduate degree first. What kind of undergraduate degree should I get?Do you think a biology degree would work? Just wondering since Im stuck with PA or forensics that way if I want to do forensics I can a biology degree or if I want to be a PA i can continue my education
Anonymous asked

It seems like you know that you’re interested in the sciences but not quite sure which aspect. I’m not going to lie, when you say forensics all I can picture is Bones and CSI and obvs real life is not that glam but hopefully that’s kind of sort of the career you’re thinking of? In any event, I think everyone going into the sciences has to decide if they’re more into the research/experimentation aspect of it (IE clinical lab science, forensics, academic research) or the implementation of that science/hands on bringing it to people (IE health care providers, government or professional health recommendation board) or a mixture of both (IE public health, research-based physician, biomedical engineer perhaps?).

When I started college I also did not know which aspect of science I was most interested in. I dabbled in research and worked in a plant genetics lab for a while and did some papers and stuff and decided that lab ratting was not my thing. Neat, but not enough people interaction and too much waiting to make discoveries and not enough practical implementation of the science for my taste. I wanted to do hands-on care of patients and someone suggested the PA track since I wasn’t interested in committing 10 more years of my life to med school and residency and fellowship.

Then came deciding my major, cuz you have to do that at some point. Plain biology seemed like too much memorization of a zillion weird pathways for me. I was really interested in human pathogenic microbiology at the time (thank you Richard Preston and your Hot Zone book) so I took that route and chose to memorize a zillion dumb names of microbes and their Gram stains and growth patterns instead. It boils down to, you need to study something you’re interested in so you don’t suffer through college and want to blow your brains out. Hopefully this means you are interested in things that overlap with requirements for PA school admissions (chemistry, biology, anatomy, physiology, etc). If not, that’s fine, but you may need to take an extra year to finish all that stuff. I’m sure a forensics degree track would cover similar things.

You’re right, in becoming a PA you generally are entering a master’s level program, which means you need the undergrad degree first. There are some programs left that are bachelor’s or associate’s programs but I’m not sure I would recommend that.

Posted 2 weeks ago
Hi:) I'm having trouble deciding on weather I should become a PA, MD, or Nurse Practitioner. I know that I wanna work in medicine and be a part of treating the patient as well as have a flexible work schedule. I also want a family one day and was wondering if you could give me advice? Thanks so much! <3
Anonymous asked

If treating the patient, having a flexible work schedule, and having plenty of family time are your priorities I would do a good amount of research not just on NP, PA, or MD/DO, but on other related healthcare jobs where you are actively treating the patient but not necessarily making the majority of orders/treatment decisions such as RN, respiratory therapist, physical therapist, etc.

I would say that going the MD/DO course would be most difficult in attaining your goals, but not impossible. During your 4 years of med school and 4-8 years of residency +/- fellowship afterwords, it is very difficult to have any sort of flexible work schedule or to have a family, but many choose to have their kids during residency so that they are not 30+ years old before they can start that business. Fields like primary care, dermatology, and radiology often have the most consistent work hours, but often times you may have to take call certain nights or weekends (being available to phone to answer patient questions or to come in and see patients).

Whether to do NP or PA would be up to your education experience and personal goals. If you don’t already have a nursing degree, the NP route means getting your bachelor’s (or possibly associate’s) degree, then generally 2-4 more years of education for NP programs, many of which are transitioning to doctoral degree programs. On the other hand, working as a nurse to start with would be great experience and would probably meet your career goals so this may be a good option for you.

NPs and PAs ultimately do very similar jobs. NP education relies heavily on experience as a nurse and focuses on nursing theory with a more narrow scope of pathophysiology and pharmacology background, such as family medicine, psychiatric medicine, or neonatology. Many programs are part-time. PA education is more broad and covers surgical topics as well, and programs tend to be full-time master’s degree programs running 2-3 years in length. This background prepares you as a generalist, and the specialization comes later in on-the-job training, if needed.

Posted 2 weeks ago
Hello :) I am glad to have found your lovely blog. I am currently in the process of applying to PA school. I have the academic prerequisites and a few healthcare hours. My GPA isn't particularly strong. I will still apply because anything can happen. What else can I do to become a stronger applicant?
daydreames asked

Hi there, I’m not sure what exactly you mean when you say you don’t have a particularly strong GPA (I’ve known a few folks who say a 3.8 is substandard as they are crazy overachievers where only 4.0 suffices!). Most PA schools will advertise outright what their lower limits are, I think usually it’s around 3.0 or a B average in most academic systems. So if your GPA is less than what your schools are requiring this would probably mean some additional coursework or retaking courses to bring that average up, which shows that you are committed to bettering yourself, and so long as you have a good explanation for the lower initial GPA (took on too much at once, had a family or personal emergency or illness, took some time to figure out your passions, etc) most admissions committees are willing to overlook the past.

Other than grades (which I feel are unfairly overrated in some PA programs’ admissions processes), your healthcare experience and interview skills probably tie in equal importance. Honestly, less than 1000 paid healthcare hours are probably not enough to optimally get you ready for PA school, even if a program accepts you. Many times my knowledge gained as a CNA helped me deal with frustrating patients, snippy nurses, and miscellaneous healthcare drama and navigation as a PA student than any volunteering or course work that I did. It also made great fodder for my interviews, where tons of questions about difficult patient experiences and how to handle coworker drama were asked.

It may be hard to get an interview with a marginal GPA and limited paid healthcare experience, but you seem very driven and optimistic, and if you do get an interview and feel you are ready for PA school, let that be your guide and shine through in your interview. Be real about why you want to be a PA and what formative experiences you’ve had that solidify this goal.

And above all, if you don’t get in the first time, work on what you can and try, try again!

Posted 2 weeks ago
Hi I currently am working in a pharmacy as a pharm tech and I mean i enjoy it but this isn't what I wanna do long term. I've considered Being a PA because I love that I can help ppl and be there for them and get to know them and be hands on. Unfortunately I dislike the idea of having to work under anyone just cause I like to do my own thing and have people respect and trust my judgment. Sorry I'm rambling lol but just wanna know what got you through pa school and what you enjoy about it. Thanks
Anonymous asked

Hello Anonymous, welcome to the world of control freak healthcare professionals! We are all kind of alike in that respect… However with being a PA you need to balance your training and desire for a certain amount of autonomy with the understanding that at times you are limited in your practice, especially fresh out of school, by not having that 5+ years of extra education and residency to help you make certain clinical decisions, and that this is the reason for having a supervising physician that you collaborate with.

In any job, you will have to work to build mutual respect and trust with both your supervising physicians and your patients; I wouldn’t expect that immediately. Be wary of taking a job as a new PA that promises a lot of autonomy or minimal supervision (and they’ll be out there trying to lure you in!), because you need a few years to get your feet wet and to have other providers close by to bounce plans and ideas off of. You are ultimately responsible for your medical decisions as a PA and will have the medical board to answer to if you don’t ask for help you when you need it and it comes back to bite you in the butt.

But if a mostly independent practice is what you crave and you’re willing to put that off for a few years in order to first build a solid start to your career, then there are certainly positions out there that will be able to offer you this (provided your state legislation does not change drastically on rules for PA practice). I have a sneaking suspicion that these would be mostly rural emergency departments or primary care clinics, but I’m sure if you’re open to relocation and finding the right supervising physician you would be able to find something satisfactory to you in most kinds of positions.

Posted 2 weeks ago
Hi, I am incredibly interested in becoming a PA. My main concern right now is CME or continuing medical education. I'm just wondering if it's worth it? Obviously CME isn't free and you have to have a certain number of hours completed every 2 years. Is it worth becoming a PA financially because I'm not sure how much CME credits cost or anything. Thanks for the response!
Anonymous asked

Don’t sweat the CME. Yeah, you need to have x hours completed every 2 years, and now certain amounts need to be of a particular more hands-on variety per AAPA rules, blah blah blah…

In most normal PA job offers, CME reimbursement will be provided as part of your offer and compensation. Typically it is a least a few thousand dollars. More than enough to get you to a conference where they lecture at you all day and you get to count it as CME. Even if you didn’t have a job that reimbursed you for CME every year, there are enough free or minimally expensive ways to get it in. The AAPA has a bunch of free stuff on their website. The AAPA magazine has CME you can complete in it monthly. Where there’s a will, there’s a way.

Personally, I’m obtaining my CME by going to conferences, and additionally by logging into and answering short questions on UpToDate (a clinical reference) while I work every day.

Trust me, the negligible or more likely than not FREE cost of CME balanced with the generally good salary and career demand for PAs still makes becoming a PA a good and financially solvent career choice.

Posted 2 weeks ago
Hi running PA! Thanks so much for your blog--it's been a great resource. I have my first PA school interview in a few weeks and I was wondering if you have any advice? I get crazy nervous in interviews so any advice would be appreciated!
Anonymous asked

Eek, I hope I’m not writing this too late! Sorry if I am… Anyways, those interview days are always a complete crisis in your head that you somehow need to keep contained with lots of smiles and a never ending supply of well thought-out questions…

You’ll here this all the time, but it’s for reals, the best advice is to be yourself. If you made it to the interview, they already know you’re not a total wreck and you have what it takes to make it through their program. They just want to make sure you are properly socialized and have some unique traits that would make you a good fit to their group of students.

So answer questions honestly. Sometimes they asked me shit I didn’t have an answer to (tell me about a time when you had a serious conflict with someone and what you did to resolve it blah blah blah) and so sometimes you may need to embellish existing stories in your head. It helps to avoid moments like these by writing down a list of possible questions and thinking of answers ahead of time, the night before the interview.

If interviews make you obscenely nervous and you just know you won’t be able to relax and be any semblance of your normal self, do what you need to do to chill out. Lay off the caffeine, take your PRN Ativan (BUT FOR THE LOVE OF GOD ONLY IF YOU’VE TRIED IT BEFORE), go for a run before hand, do some kumbaya in the bathroom stall, whatever it takes.

And be well prepared for anything to help reduce the anxiety. Ladies have it especially easily because we can take those big folio bag things and make having all our necessary shit on hand look classy. Bring copies of your resume, a notebook for taking notes, breath mints/tooth brush, deodorant, comb, bobby pins, face powder to get the sweats off, Tide pen, etc…

Dress well. A suit is pretty much standard, although one of the ladies in my PA class purposely avoided one in order to be different and chose a nice sweater instead. Try to wear an accent that makes you stand out, a unique tie, Grandma’s watch, your running watch, etc. And maybe I’m super crusty, but sensible shoes make me feel like a candidate knows what they’re getting into, whereas spiky platforms make me think someone is into the flashy glamorous portrayal of medicine that isn’t very accurate (yeah yeah super judgmental I know but I’m just being honest).

Good luck!

Posted 3 weeks ago
Thank you for the fantastic site and great resources. I'm a third year PA student graduating in December and have a few questions about the job hunt. When did you start looking for jobs? Did you focus your search locally or expand it to other states? Were there one or two things that you learned during that time that you wish you had known earlier?
Anonymous asked

These are some really EXCELLENT questions! My PA program tried pretty decently to guide us and ready us for graduation and the job hunt real world medical board stuff and I still was like a lost puppy after stumbling out of the testing site for the PANCE…

In my situation, I wanted to work in a hospital doing internal medicine or critical care. Didn’t matter too much where, and I couldn’t be too picky as a new grad. But my hubs wanted to be a little closer to his family so I limited my search to a 6 hour driving radius from there. This crossed multiple states unfortunately, which brings me to my first lesson. Get your medical license crap taken care of in all of the states where you are seriously looking before you even have the job offer. In my case it was 2-3 states. This was expensive, but what’s even more expensive is trying to stretch out your student loan money when it was supposed to have run out 3 months ago all the while knowing you have a signed job contract but CAN’T START until some committee reviews your paperwork in a month and then meets again a month later to decide you aren’t a total wreck and can have your medical license. And if you miss a deadline (or your PA program adviser’s letter of recommendation gets lost in a snow storm like me) you may have to wait another 2-3 months beyond that for the next lame meeting.

I searched high and low over the internets for jobs. They say personal connections are the best way to a job. Well, I didn’t have much for local connections since I’d moved away from my PA program. I put my stuff out there for recruiters and made a profile on LinkedIn. This is for good and for bad. The private recruiting companies will HUNT YOU GOOD. Even after you have a job somewhere else. I am STILL getting emails and calls asking if I’m interested in another job they have. For me it was worth it. One got me a really great offer. If you value your privacy, don’t go that route.

Oh, and speaking of privacy, it doesn’t hurt to anonymize your FB and Pinterest and politically charged Twitter pages. Better not have that friend of a friend share something unsavory to the person who was supposed to be hiring you for your dream job. As my luck would have it, my maiden name was very unusual and a surprising google search told me that the one chick in the world who had my same first and last name also happened to slightly resemble me and had public MySpace and FB pages with pics of her in bikinis lamenting about her baby daddy cheating on her… Aw nawww! And I got hired anyways… there’s hope for us all!

These are the sites I used:

www.healthecareers.com

http://www.healthecareers.com/aapa//

http://www.physicianassistantsolutions.com/PA_Jobs.aspx

http://www.practicelink.com/jobs/

https://www.usajobs.gov

www.doccafe.com

You can also search the job sites or listings provided by your PA program, google all hospitals and health systems in your area to find their websites.

I found the app JobAware pretty useful, too. I think it led me to the job I eventually took.

Also keep in mind that even if you get your medical license squared away, if you plan to do inpatient work hospitals have their own anal-retentive credentialing system to make sure for themselves you’re not a total wreck and won’t practice sketchy medicine, and this usually takes a month at the best and could be as long as 2-3 months. And don’t plan on using that time to get your medical license because they typically can’t start the process until they have your license on file. Wahhhh!

Hope these help!