What is the Best Health Care Experience For PA School?

Posted By: Paul   |   Health Care Experience   |   220 Comments

health care experience

Getting good health care experience (HCE) is crucial to getting into PA school and to one day becoming a solid PA.

What’s the best form of health care experience (HCE) if you want to get into Physician Assistant School?  To answer this question, you need to know a little history…

How The PA Profession Got It’s Start

Here’s a very very brief history of the birth of the PA profession:

  • 1961: Responding to a nationwide shortage of physicians and medical support personnel, Charles Hudson, MD in the Journal of the American Medical Association, calls for a “mid-level” provider from the ranks of former military corpsmen.  Corpsmen are experienced in providing medicine on the battlefield more or less independently of physicians.
  • 1965: Eugene A. Stead Jr., MD announces the nation’s first “physician assistant” educational program is inaugurated at Duke University. The Program accepts four Navy Medical Corpsmen.
  • 1967: The first class of three PAs, Victor H. Germino, Kenneth F. Ferrell, and Richard J. Scheele, graduates from Duke University on October 6th.
  • In subsequent years, fresh from Vietnam, more military corpsmen return to the US and begin training to become PAs.  This new training allows them to continue to make use of their already extensive medical experience at home in the US.

Notice from this that the first PAs were all medics,  trained in part because they had significant medical experience and had practiced more or less independently already.  There was also no existing profession in the US that would allow war-tested paramedics to continue to practice at their level without graduating from college and medical school.

The Modern Health Care Experience Requirement

Times have definitely changed.  These days, college (at least some of it) is a requirement to train to become a PA.  Soon a bachelor’s degree will become a functional minimum.  Ironically, this means that none of the original PA candidates from the 1960’s would be eligible for PA school today.  Along with the increase in education required to enter the profession, the health experience requirement has softened; you don’t need to be a battle-seasoned medic to be a PA.

There are now many more ways to fill the PA school health care experience requirement.  Although some schools have no firm requirement, most schools now require between 200 and 3000 hours of previous health care experience.  So where do you get that, particularly if you are trying to break into a PA career from another field such as business, education, or stay-at-home parenting?

Here’s what you should strive for.  You may not get all of these, but the more you get, the better:

  1. Working directly with patients.  This means being with them in person, talking to them, touching them.
  2. Assessing these patients medically or psychologically.  What are their problems?  What are their needs?
  3. Providing some form of medical or psychological treatment.  Psychotherapy, CPR, a nutrition plan, administering medication, taking vitals, etc.
  4. Use of your own professional judgement.  This means that you make at least some of the decisions  yourself, as opposed to carrying out only decisions made by others.

Again, not every form of health care experience will give you all 4 of these, but this is your shopping list.

Health Care Experiences Rated

Below are some of the most common forms of HCE that we are asked about.  There are certainly many others.  PA schools have their own preferences, so we can’t be exact.  All ratings are given according to jobs, certifications, and licenses in the United States.  All jobs that require certification are entered by completing an accredited course and passing a certification exam.  The value of each job in terms of PA school applications varies somewhat by the setting in which the work is done.  The jobs below are not listed in any particular order.

CNA (Certified Nurse’s Aid)

CNAs provide nursing support to patients in hospitals, skilled nursing facilities, and sometimes clinics.  Their work allows a registered nurse to do more, follow more patients, and do so more efficiently.  Typical duties include: taking vitals, collecting specimens, helping with patient ADLs (Activities of Daily Living) such as bathing, toileting, eating, shopping, etc.  They also assist with therapeutic activities such as bed exercise, whirlpools, and providing patients with self-administered medications.  Their activities are supervised by a Registered Nurse or Licensed Vocational Nurse.

  • Works Directly with patients: Yes. (A)
  • Performs assessment: Yes – some (B-)
  • Provides treatment: yes, some.  (B-)
  • Uses professional medical judgment: yes – some, but mostly carries out the decisions made by higher medical authorities. (C)
  • Overall Grade: B-

Registered Nurse (RN)

RNs care for patients in clinics, hospitals, and Skilled Nursing Facilities.  They have heavy interaction with patients, monitoring their general condition through assessment of vitals, wounds, mental state, etc.  They start IVs, administer medications by pill, injection, and IV as directed by MDs, PAs, and NPs (Nurse Practitioners).  They make frequent use of professional medical judgment, particularly with regard to assessment.

  • Works directly with patients: Yes (A)
  • Performs assessment: Yes – lots  (A)
  • Provides treatment: Yes – lots, as directed by MDs, NPs, and PAs (A-)
  • Uses professional medical judgement: Yes, particularly in assessment (B-)
  • Overall Grade: B+

Medical Technician/Therapist

This group includes Emergency Medical Technicians (Basic and Paramedic), Cardiology TechniciansRadiology Technicians, and Respiratory Therapists.  EMTs, CT, and RTs provide specialized medical services to patients in acute care settings (hospitals, patient homes, Emergency Rooms, and ambulances).  They are trained in an official program at a community college or universities.  Depending on their area of specialty, medical technicians use advanced medical equipment and often work directly under a physician.

EMT-Bs assess, monitor, and provide basic medical interventions such as oxygen, glucose, and basic airways while “in the field.”  They often transport patients who are in stable condition.  EMT-paramedics do the same, plus provide advanced, emergent care.  They are knowledgeable with EKG rhythm strips, cardiac and respiratory drugs, trauma care, etc.

Cardiology Technicians perform and help interpret 12-lead EKGs, and assist in cardiac procedures, such as cardiac catheterization, treadmill stress testing, and Holter Monitoring.

Radiology Technicians perform x-rays and other forms of advanced imaging such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI).  They also sometimes assist radiologists with interventional radiology procedures, such as vertebroplasty and embolization.  Their knowledge of anatomy is usually extensive.

Respiratory Therapists assess and monitor patient airways, control and monitor ventilator settings, supervise respiratory rehabilitation, and treat patients with chronic lung disease who require oxygen and respiratory medications.  They perform these duties under the supervision of a physician – usually a pulmonologist or intensivist.

  • Works directly with patients: Yes (A)
  • Performs Assessment: Yes (A)
  • Provides Treatment: Yes (A)
  • Uses professional medical judgement: Yes (B+)
  • Overall grade: EMT-B (B), EMT-Paramedic (A), Cardiology Tech (B+), Respiratory Therapist (A-), Radiology Tech (B+ for plain film only, A- for advanced imaging such as ultrasound, MRI, CT, etc.)

Medical Assistant (MA)

Medical Assistant is both an unofficial job title, as well as a formal national certificate.  Becoming certified is not required to obtain job experience as a medical assistant, but it does make the medical training official and therefore may help in getting hired.  The general term of MA (not certified) usually implies that the MA works directly with patients in a medical setting, and are trained on the job.  Responsibilities may include taking vitals, documenting patient information in charts, cleaning and dressing wounds, giving routine immunizations, splinting injuries, performing simple lab tests, calling in prescriptions on behalf of a provider, obtaining EKGs, and helping providers with exams.  This may sound like the ideal job – many responsibilities, no certificate required – but all of an MA’s duties are under the direction of a provider, so there are definite limits.

  • Works directly with patients: Yes (A)
  • Performs assessment: Yes, some (B)
  • Provides treatment: Yes (B-)
  • Uses professional judgment: yes, but limited (C)
  • Overall grade: B- (uncertified), B (certified)

Phlebotomist

Phlebotomists are certified providers of venipuncture, the process of obtaining blood samples.  They typically work in hospitals, since only there are there enough blood draws to support one or more phlebotomists full-time.  Phlebotomy is skill that is perfected only with practice.

  • Works directly with patients: Yes (A)
  • Performs Assessment: limited only (C-)
  • Provides treatment: yes, but very limited (B-)
  • Uses professional medical judgment: limited only (C+)
  • Overall grade: C

Caregiver / Home Health Aid

In the same way that MA can be unofficial or official, so can the job title of Caregiver or Home Health Aid – a course and passage of a certification exam is required for those who work in certified facilities.  The majority of Caregivers and Home Health Aids work in homes with elderly, chronically ill, or disabled persons, where they assist with daily living activities.  These may include bathing, dressing, shopping for, helping to transport, and otherwise assist clients.  Notice here that rather than patients, they work with clients, which is an indication of the limited nature of the medical work they provide.

  • Works directly with patients: although their work is direct, it is with “clients,” not patients (C-).
  • Performs Assessment: limited only (C)
  • Provides Treatment: Yes, but very limited (C)
  • Uses professional judgment: limited only (C)
  • Overall grade: C-

Clinical Lab Technician

Clinical Lab Techs are certified professionals who conduct lab testing with patient specimens.  Duties include running a large array of blood cytology and chemical analysis tests,  viral/bacterial/tissue cultures, microscopy, and tests such as Polymerase Chain Reaction (PCR), Western Blot, and many others.

  • Works directly with patients: No, but we give some credit for knowledge of medical procedures (D)
  • Performs assessment: of specimens, but not patients (C)
  • Provides treatment: No (F)
  • Uses professional medical judgment: again, no, but we offer some credit for medical skills like microscopy, which is relevant to PAs. (C)
  • Overall grade: D

Summary

Obviously, there are many other medical jobs that we just don’t have the time and space to cover here (PT assistant, hospice volunteer, chiropractor, massage therapist, etc.) but if you’ve read the above, you should have a good understanding of how to “rate” these jobs.

Of the jobs listed, the most valuable pre-PA health care experience belongs to paramedics.  Medics were the first to become PAs, and it was for good reason.  Their job requires much direct patient contact, assessment, treatment, and medical professional judgment.  Nurses are a close second.  This isn’t to say that you can’t get excellent HCE in another profession, but work as a paramedic to us is probably the most accepted, unassailable kind to have when applying to PA school.

For more information on obtaining Health Care Experience, visit the topic on our forum, or our other articles.

 

220 Comments

  1. Rob April 24, 2013 at 2:16 pm - Reply

    While I agree that a paramedic probably gives future PA applicants the best experience, I don’t think this is the best route for all to follow. In my state and area (Chicago Illinois), becoming a paramedic is a 2 year ordeal (assuming you have no trouble getting accepted into one of the already over filled paramedic programs). After completing this, you now need to get onto either a fire department or work for a private company (in and of itself can take over a year). While paramedic is a great experience for those that are already ones, I would not recommend that people try to become paramedics before the become PAs–the process is just too long. Future PA students need to consider the length of training (and the ease of getting into a training program): CNA takes 6 weeks: easy to get in, an EMT a semester: fairly easy (usually bound to a traditional academic calendar), a RN 2 years (very difficult in the Chicago region), and I don’t really know enough on the other professions you listed.

    TL;DR: If your goal is PA, don’t become a paramedic–the training takes too long. Future PA applicants need to consider not only the length of training, but also the difficulty to get to your first “patient contact hour” before choosing a ‘patient contact pre-PA career’.

    • Paul April 24, 2013 at 9:41 pm - Reply

      You raise good points – in some regions, it’s very hard to become a paramedic. But in terms of the time it takes, by the time you become a medic, you have been an EMT for some time, and will have much good patient care experience. With good grades, medic is almost a sure ticket into PA school. If you do enough hours as an EMT basic, you will be in good shape as well.

      • Eric June 11, 2013 at 7:12 pm - Reply

        Paul,

        Did you have any paramedics in your class? If so, how well did they transition into PA school and future career? I am a paramedic with over 11 years of experience with a good GPA. Just hope my essays can help me make the cut. I’ve been told that paramedics who apply to PA school are highly looked upon and extremely competitive. What’s your take?

        • Paul June 12, 2013 at 1:08 pm - Reply

          I would generally agree. We had one civilian and two military medics, and all were very experienced. One was our strongest student. The other two were excellent clinically, but struggled academically.

  2. Redstone April 25, 2013 at 9:09 am - Reply

    Athletic training has worked well for me. It is a longer process, but also allows for much more in depth training and education. There are 3 ATC’s in my class, and we all seem to be doing well in the program. Our program also emphasizes prior health care experience more than most. I suppose if you just want a fast and easy way to get health care experience, I wouldn’t recommend it. If you are trying to meet the points above: I daily interacted with patients. I daily provided assessment and treatment. I daily had to use medical judgement on how to work with my patients. Just a little insight into the profession.

    • Chris May 3, 2013 at 3:53 pm - Reply

      Redstone, I’m am currently an athletic trainer in Texas and have been taking pre-recs towards applying to a program. How long did it take you to decide you wanted to go to PA school? And did you have to take any pre-recs before getting in, and if so how did you find the time to do so.

      Thanks
      Chris for Texas

      • Redstone May 9, 2013 at 9:51 am - Reply

        Hey Chris,

        I am sorry it took me so long to get back to you! I worked as an ATC for 6 years. I also worked a second job and took prerequisites. It was hard as heck and took eveything I could do to make it. But it also prepared me for the challenges of PA school. Today is our last day of classes for the second semester. I start rotations in June. I suppose I made the decision after working about 5 yrs. I couldn’t support my family even after taking a second job. It took me a year to do prereq’s but I have a master’s and a science background. It has been a very challenging road, but in a couple of years I have drastically changed my family’s outlook and have the opportunity to also make a difference in my patient’s lives. I think that ATC to PA is a great transition.

        • PAEvan April 10, 2014 at 9:22 pm - Reply

          Im glad you guys brought this up, I had a Pre-PT degree from a ATC- heavy college and had many of the same classes, it has helped IMMENSELY in school and I have basically breezed through the orthopedics sections of the course. ATC, X-ray techs, paramedics, and nurses seem to have the best prep for school. And one I haven’t seen much about on this blog have been the lab techs! Man, the understanding of the bacteria and having experience with lab tests has helped them a ton in the course. If I could draw up the deal background, I’d say work as an EMT for a year, quit then work as an ER tech while finishing an undergrad in AT-C…then minor in psych. thats a dream background.

  3. Brian April 25, 2013 at 6:00 pm - Reply

    I like the evaluation, but I agree Paul (above comment), the EMT-P and nursing are careers and not stepping stones to a PA career (unless you decided to pursue another career). It takes a lot of dedication to become either of these. Also, the review does not include surgical technicians. When I was coming through many (STs) were trained OTJ. It requires a certification these days, but I believe there in no better all around patient care experience. But, I am biased.

    • Kelly Marie Haley November 29, 2013 at 11:56 pm - Reply

      What is an ST? Thanks so much!

      • Paul December 7, 2013 at 4:34 pm - Reply

        Not sure which “ST” you’re referring to. It could Surgical Technician. It could also represent RT, Respiratory Therapist.

  4. Bruce April 28, 2013 at 6:17 am - Reply

    I think Rob has made some valid points. If you are aiming for experience, the military still offers the best, but it often comes with the obligation to serve in a war. If you are preparing for PA school, CNA, MA and EMT are your best bets. If you are an experienced Paramedic or RN, then the move to PA is great, but don’t become these if you are not going to work in the field for 5 or more years. I was one of those returning medics and it was great experience for being a PA.

    • Paul April 28, 2013 at 2:51 pm - Reply

      Yes, you bring up another important point that I should have made: don’t become a nurse to prepare you for being a PA. They’re different fields, and neither field wants anyone to use them as a stepping stone. Besides, if your plan doesn’t work out, you could get stuck in a field that maybe you weren’t so enamored with in the first place.

  5. DW April 28, 2013 at 11:32 am - Reply

    I feel you have left out what I think may be one of the absolute best routes for medical experience leading to PA — being a scribe! I can’t imagine a better training setting than seeing the entire process of assessment, planning, diagnosis, treatment while working side by side with a physician in the ED. There is such an immense variety of clinical presentations you get to witness and seeing the tests/imaging/meds ordered lays such a spectacular foundation. You also have a great opportunity to witness interactions between a variety of doctors and patients and are able to pick and choose characteristics you want to include in your approach to patient interaction.

    • Paul April 28, 2013 at 2:49 pm - Reply

      Yes, there are many other ways to get health care experience that we didn’t mention in this article.

      Being a scribe is an excellent experience for learning about medicine. Some schools don’t look at it as direct patient contact, but in my mind they should. The other reason that working as a scribe is helpful is that you have a good chance at developing a relationship with a physician who could write a letter in support of your application.

  6. K April 29, 2013 at 5:59 pm - Reply

    This site is so helpful! Thank you! 🙂 I do have a question though, and I was wondering if you could answer it for me. I’m a rising sophomore in college considering becoming a PA, but I have mild cerebral palsy that only affects my legs. I can walk independently, but I tire more quickly than most and my balance isn’t that great. I looked at your list of HCE options and it makes me a bit nervous because most of these seem quite physically demanding. This also makes me wonder if being a PA would be too physically demanding for me as well. Could you offer some insight on this? I excel academically, the sciences interest me, and I would love a career where I can help people, but I’m just wondering if all of this (the HCE and being a PA) is something I’d be physically unable to do. Thanks in advance for any response…I really appreciate it!

    • Paul May 4, 2013 at 2:13 pm - Reply

      If your CP is mild (you can ambulate, carry weights up to 10 lbs), I don’t think there’s much about being a PA that you would have a problem with. Surgery is probably not a good choice for you. But any of the internal medicine specialties (medical cardiology, GI, endo, rheumatology, etc.) would be fine. It’s a job that requires your brain, not your brawn.

      Your point is quite correct though, that the HCE requirement presents some challenges for you. Psychiatry might be one option. Have you spoken with your school counselor and/or disability resource center? They should be able to give you some specific guidance about what you could do in your area.

  7. Jason May 2, 2013 at 7:12 pm - Reply

    In your “overall grades” for medical technicians, you didn’t give a letter grade for radiology technicians… How would you rate the quality of those hours?

    • Paul May 4, 2013 at 2:41 pm - Reply

      Thank you for catching that. I have added that to the article – just check out that section again.

  8. Kelsey May 9, 2013 at 11:40 pm - Reply

    I have another quick question: I graduated with a BS in Biology 2 years ago, and I would still need to take various pre-reqs like anatomy, physiology, and microbiology. Since I’m still undecided, and possibly want to work abroad or in research, do I have to worry about my undergraduate chemistry, o-chem, biology, that I took freshman or sophomore year (4+ years ago) and other classes expiring for medical/PA school applications?

    • Paul May 14, 2013 at 10:40 pm - Reply

      The short answer is yes. Many schools will only accept grades from courses you took in the last 5 years. Others won’t fuss over it too much as long as ALL your grades aren’t old. Contact the schools that interest you and they will tell you how to handle this.

  9. kash May 10, 2013 at 8:09 pm - Reply

    I was searching for this everywhere. Thanks for breaking it down. I recently got my phlebotomy certification and have few years of lab experience but not having any luck with phlebotomy jobs. So I started looking into EMT programs to get patient care experience. I have B.S. in Biology and have to retake few chemistry classes to get better grades, any recommendations on how to go about this, I would be really appreciated it. Thanks.

    • Paul May 14, 2013 at 10:46 pm - Reply

      Don’t try to retake everything. Start with the most important prereqs that you did mediocre on. Kill those classes this time around. EMT is great if you can get work doing it. Do well in your EMT class so that you will knock their socks off when you interview for jobs. There are plenty of bad and mediocre EMTs. They are always looking for good ones.

  10. Catrina May 13, 2013 at 12:24 pm - Reply

    I have been a CNA and plan to update my registration but currently I am a licensed Massage Practitioner with my own private practice. What do you think that my experience of fifteen years will do on my PA application?

    • Paul May 14, 2013 at 10:52 pm - Reply

      They will give you some credit for it, but it’s not generally considered health care (at least to PA schools). But you will need some more “traditional” medical experiences to supplement. See our articles on health care experience for ideas.

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