PA School Application Tip #4: Get Great Health Care Experience

Posted By: Kubin   |   Health Care Experience

After your grades, the most important aspect of your pa school application is your health care experience.

PA school is a relatively brief two years.  In that time you need to learn so many things – physiology, disease processes, pharmacology, behavioral health, health care policy, and so much more.  The only way you can learn it in such a short span is if you already know something about medicine when you start.

Unlike new medical students, most new PA students have some health care experience, and many have extensive experience.  Experience will be your ace in the hole, the one thing that makes it possible to become a clinician in such a short time.  It is nearly impossible to get into PA school without it.

Great Health Care Experience (HCE)

First off, know this: there are few if any short cuts to accumulating HCE. They want to see that you have put some time into preparing for your new career, and they can smell rushed, irrelevant, or low quality HCE a mile away.  Just to get an idea what some schools are looking for, check out the HCE page on the University of Florida PA program’s website.

To maximize your chances of getting into PA school, your health care experience (HCE) ideally should:

  • Be long enough.  You should accumulate enough total hours to show your commitment to medicine (500-3000+, depending on the school to which you are applying).
    • Some programs strictly require a certain number of hours, while other programs only recommend a number.
    • We have heard tales of people getting into PA school with little or no HCE, but we’ve never met one. Put simply, to show that you are committed to a career in medicine, you need to put in some time preparing.
  • patient contact experience
    The best HCE will have you working closely with patients.

    Be in-depth enough.  You should do it over a period of months or years, not days or weeks.  Start early!

  • Be broad enough.  Provided you have the previous two points covered, having varied HCEs shows your versatility and will come in handy in PA school.
  • Put you into direct contact with patients.
    • Many schools will want to know what percentage of your HCE involved working directly with patients – the higher percentage the better.
    • These can be patients of just about any kind, so long as they are human.  Veterinary medicine may be useful, but schools want to see that you have worked with people.
    • “Direct contact” means that you are talking with and/or touching patients yourself.  You don’t need to be running the show, but you need to at least be a member of the cast.
  • Involve assessment and treatment. 
    • Assessment is the act of trying to determine what the patient needs (by interviewing them, examining them, etc.), and treatment is providing it.  Gigs that have you doing one but not the other aren’t going to help as much as jobs that have you doing both.  Gigs that have you doing neither are of questionable value.
  • Relate to Western (allopathic) medicine.
    • acupuncture, acupressure, massage, Rolfing, Reiki, and other complimentary medical fields are not ideal, and many schools will not count them toward your HCE.  Check with the schools to which you will apply.
    • No energy healing, no aromatherapy, etc.  You may like it and believe in it, but PA schools don’t consider things like these HCE.

“But What If My Health Care Experience Isn’t All Those Things?”

Don’t panic.  The above guidelines describe the theoretical ideal for HCE, and few if any applicants have HCE that covers all of the above.  But let this list guide you in your efforts to find the best health care experience that you can.

Check out the Creative Ways to Get Health Care Experience thread on Inside PA Training’s Physician Assistant Forum.

237 comments

  1. Nice article! This can be one of the most challenging aspects of putting together that great PA school application, especially if you are volunteering to get your HCE hours. Good advice here!

  2. Great article. This has been one of the challenging aspects of the PA school process for me. As a CLS I have a good clinical background but my direct patient care experience is very limited. I have been looking at volunteer positions in a local hospital as well and a nursing home in order to meet this requirement.

    1. Thanks. I think you’re going about it the right way. Be sure to tell your friends that you’re looking for healthcare experience – sometimes those connections will really pay off.

    2. @TitanEAG – I am also a CLS. True we do not generally have a lot of patient contact and but an excellent clinical background! Keep in mind any phlebotomy that you do or collecting of specimens can be counted as patient contact time. All in all, I think CLS make great PA students! We have already been trained in anatomy, physiology, hematology, microbiology, blood bank (immunochemistry), disease processes and phlebotomy. You have a running start!!

      1. Hi Buff!
        Thank you! It is nice to see another CLS aspiring to become a PA. I got some great ideas from you through our e-mail conversation! I agree that CLS make great PA students and have a great appreciation for the depth of clinical knowledge I have gained as a CLS. Because of this background I feel I can provide good quality care as a PA and am looking forward to the future.

  3. Hi. i am a full time student working on my AA what if i dont have any medical experiance? what can i do? would volenteer work count? should i study to become a nurse first and then go for a PA. Can i get in without any medical experience? pleas help i am very interested in this field. thank you.

    1. Jacky-
      I would encourage you to volunteer to get some healthcare experience. Your college may have some healthcare related clubs that you could join and volunteer with. Or a charitable organization that puts on blood drives or community cholesterol screenings may need volunteers. This experience will be very valuable to you!

  4. Hello. I am a paramedic. I have a bachelor’s in biology with all the required pre reqs. Will being a paramedic help me get into school? I didn’t become a paramedic so that I could get into anything else. I just want a change in careers. opinions?

    1. Hi, Saul! For most PA programs, paramedic is a solid pre-PA career. You should have no difficulty convincing them that you are interested in medicine, and that you have many hours of health care experience. My suggestion: research the schools that interest you and see what other requirements they like to see. Do some PA shadowing so you don’t look like you just rolled out of bed one morning and decided to become a PA. Then lock in some instructors and/or supervisors to write letters of reference for you.

      1. Thank you very much Paul. This website is awesome. I’ve taken the GRE and done almost everything. The only thing I need to do is shadow some physician assistants and prepare for some interviews hopefully. Your deeds here are greatly appreciated.

  5. Right now I am currently a registered nursing assistant in order to build my HCE. I think it’s a job that people should consider if they are unsure what to do for their HCE–my job is all hands-on patient care work, and I’ve found myself picking up on medical treatments and terminology from the nurses I work under in a way I never could from a book or class. Also, I am a primary in the memory care unit, which I think will be helpful in the future as a PA that will be working with the baby-boomer generation when dementia rates on the rise.

  6. Hi Paul! I’m in school right now working towards a B.S in cardiovascular technology to be a cardiac sonographer and after I work for a few years I want apply to PA school. Would that be good HCE to apply to a PA program? Also I was wondering what are ideal GRE scores or if those don’t matter as much as GPA and HCE? Thank you for making this website! It is extremely helpful.

    1. Echocardiography is great HCE, in my opinion. You are 1) working directly with patients, 2) observing their cardiac anatomy and function, and 3) with the intent to help with the patients’ treatment. Cardio is one of the core competencies for every PA, and it’s very useful body of knowledge you will have when you’re through. Ultrasound, incidentally, is one of the highest paying specialties for those studying to be radiological technologists – it requires a more complete understanding of anatomy, and even how to manipulate it (“Turn on your side and raise your arm a little more so that I can get a better visual on…”).

  7. Hi Paul! I am currently a sophomore in college getting a degree in Kinesiology. I have been debating between PA school and PT school. I have a family friend who is a PT. Do you think I could put hours shadowing a PT on my PA application?

    1. Definitely. But definitely put it in the correct section on the CASPA application. It should go under “Health Care Shadowing.”

  8. Hi Paul~ I currently have a B.S. in Health Science Studies with the hopes of applying to PA school in the spring. I have severely lacking on my HCE hours though. I am currently a vet tech and was considering getting my Phlebotomy certification as a way to accumulate HCE hours as well as shadowing. Do you think this would be beneficial to the application process?

    1. If you plan to apply this Spring, then I don’t see your phlebotomy cert being that much help. It will take you 1/2 that time to complete it. And what they want is not certs – they want experience with patients. If that’s the best route you have to health care experience, take it. But it may be too late for this application cycle to make a huge difference.

  9. I started my HCE as a sophomore in college, I hope that the two to three years of experience I will have when I apply is enough! I am a CNA in a rehabilitation nursing home. I think the job is really helping me to develop certain skills. For instance I feel like I can communicate with patients easier, I can look at someone and am able to recognize how they are feeling just by looking at them. The job is introducing me to various medical problems, I take care of people with heart problems, cancer, broken bones, and even other rare diseases. Also, I have had people die right in front of me, which is probably something to get ready for entering the health care field. Do you think it would be a good idea to get recommendations from my bosses (aka nurses) at work when I apply? Also, would writing about an experience at work be a good application essay?

    1. I think one letter from a clinician who supervises you would be appropriate. Yes, an anecdote from your work could serve the purpose in your essay. Choose something that happened to you that says something important and central to who you are.

  10. Hi Paul! I like your blog! Do you think HCE as a phlebotomy technician is a good way to gain HCE?

    1. I think phlebotomy is a good way. There are others that may be better, and others that may be worse. EMT/Paramedic tends to be the best training, and it’s a well-established course that often leads to PA school.

      1. Thanks. Well I would do EMT training buts its costs almost $3000 where I live. I was also considering CNA training, but Phlebotomy pays more per hour.

        1. They don’t have an EMT course at a local community college? I suggest you call your local county EMS office and make sure you are aware of ALL the EMT programs in your area. There may be one or more that you haven’t found yet.

      2. I agree, Paul. Phlebotomy is a good skill set and a solid source of HCE. It is in my background and I put it on my application. You get to interact with a lot of patients and you must be consistent in reliable in your ability to access a vein, work hard and deal with people in a variety of stressed situations.

  11. Health care experience is what I am stressing most about. I am EMT certified, but have yet put it to use since I finished the EMT course. My husband is in the army, and he and I were relocated shortly after I finished my EMT class. I am a full-time first-semester junior in college (taking 18 credit hours this semester.) I still need to explore the EMS system here, but I suppose my concern is whether or not most PA schools prefer “paid” work over “volunteer” work. I’m just afraid that as a full-time student, I won’t be able to meet the demands of an EMT job, with my school schedule as busy as it is. I’d like to start volunteering in EMS maybe two nights a week to collect my hours. I’m just wondering whether or not most PA schools would be impressed that I volunteered as a medic at a rescue squad or fire department.

  12. Hello!

    Would a position as a Health Educator (at Planned Parenthood) be suitable for gaining HCE for PA school? I understand it’s more “talking” and not so much “touching” patients, but I’m looking to be more versatile as well.

    I do have ~300 hours bedside experience as a nurse aid at a hospital and ~200 hours in a clinic setting. I also work as a medical assistant (front and back office) at a physician’s office, as well.

    Thanks!

    1. Yes, I think that would count as patient care experience. You alluded to the less-touching aspect, and I think that’s the only concern. But if you have other HCE, that’s good. I always recommend a variety of different types of HCE.

  13. hi paul?
    i was wondering if a volunteer position like,holding baby patients will count as an HCE for PA?i have a biology degree too.
    i didn’t apply yet,but i just want to make sure i have everything i need for the program,

    1. I don’t think so. BUT: I hope you wouldn’t list your experience as “holding baby patients.” Instead, find the most official and accurate term for what you do – one that includes all the other things you do. NICU volunteer, L&D Nursery Aid, etc., and remember to describe the other little things you do that affect those little patients’ treatment. I bet there’s plenty you do that you may not see as medical experience, but when couched properly may be.

  14. Hi Paul,

    Like everyone else here, I am so glad that you created this blog. It has helped me tremendously through my application process. I gained my direct patient care at a mental health clinic, but I didn’t even know that what I was doing was considered direct patient care until I spoke with a rep at GW, where I applied. She told me to be very clear about what I do as it relates to patients (i.e. taking patient history, medical history, medication history, bp, weight, etc.) because as it’s a mental health clinic and not an ER, the whole “direct patient” aspect is more tricky. I already sent my apps out, but do you think they will discriminate because its mental health and not a hospital setting?

    I also have shadowing hours at hospitals with a PA and Docs, but I’m just a little nervous about how legitimate they will consider my hours. Any advice?

    1. I think they will accept your hours. They may wish you had some more traditionally “medical” hours to go with them, but they should count. And I agree: be clear and specific about any activities you do that relate to 1) assessment (not necessarily diagnosis – measuring a patients shoulder range of motion of blood pressure are both forms of assessment) and 2) treatment, whether medicinal or other types of intervention – hydrotherapy, PT, speech therapy, counseling, health education, etc etc.

      1. Thanks Paul,

        One more thing: How long should I expect to wait before being contacted about my app? I’m sweating :-/ Thanks alot for your website, again.

        Anoa

  15. Hi Paul! I have a BS in Biology and currently work in a Laboratory now (it doesn’t count for HCE unfortunately). I recently obtained my EMT-B and am applying everywhere so I can start to build my HCE hours. One of the jobs I came across was for a Sleep Technologist. I’m wondering, would this count towards HCE??

    1. That would be cool. If you’re working with patients doing some form of assessment and/or treatment, then yes, that should count.

  16. Hi Paul,
    Thank you so much for creating this blog.
    I don’t have much Health Care Experience but I do have really good grades. I wanted to get more experience, however the “Creative Ways to Get Health Care Experience ” page is not working. Can you please relink to please add some suggestions here? Thank you!!

  17. I work in the wellness industry for a hospital with their corporate wellness program. Basically, I focus more around fitness and lifestyle modification to help lower risk for disease like HTN, obesity, CHD ect. Daily activities include working one on one with people, reading lab work, taking BP and prescribing proper exercise for a variety of conditions. Do you think that this is a reasonable type of HCE? I work long hours and 6 days a week and don’t have time to pick up a second job as a med tech or something.

    1. Yes, I think that’s good HCE. But to round things out, you might want to get some time in a traditionally medical setting, such as a hospital. Volunteering might provide that.

  18. Hi,

    I am currently a Licensed Social Worker and got my Masters of Social Work last year. I have worked primarily in mental health 1-1 with clients. Prior to social work I was an electrical engineer. I have both a social science and a hard science background, but I feel like I am a long ways off from meeting the requirements of a PA school. Would you recommend completing a pre-med post bacc? Getting a job in health care and taking night classes? Not really sure where to start? Can mental health work count towards Health Care Experience?

    Thanks for the help,
    Thomas

    1. Yes, mental health counts as health care experience, but I was in a similar boat and I made sure to get some non-mental-health health care health care experience just to round things out. My advice: spend a little time volunteering in an ER or possibly get certified as an EMT.

      I don’t recommend a pre-med postbacc degree – that’s going to put your chasing other requirements and not filling some that you will need. Just go to your local community college and take the courses you need for your prerequisites 1 by 1 or 2 at a time if you feel confident enough to do that. If you don’t go at it too aggressively, you can probably do a little health care experience on the side while you complete them.

  19. Hello Paul,

    This is a great thread for all the aspiring PA students. I am about to graduate this year with a degree in chemistry and I wanna go to PA school. I shadowed a doctor for 2 months and I started volunteering in the Physical therapy dept in a hospital recently. I am thinking to get a nurse aid certificate and work as a CNA. Do you think I would be able to get in any school for the fall 2013 (since I don’t have a good HCE) or I would have to wait for 2014? My GPA is 3.9.

    1. No way of knowing unless you apply. But you should get on it – they’re probably beginning interviews very soon.

    1. It counts as “Other Health Care Experience” in most cases because it is not providing direct patient care. Filling prescriptions is listed as one of the examples of OHCE.

  21. I’m debating whether I should choose the career of being an EMT or CNA. Do PA schools have a preference on either? Thank you so much!

  22. Hi Paul,
    I’m going to submit my application for the 2014 cycle and am debating on whether or not to get certified as an EMT. The program I am debating starting lasts from January to May 2013. I work full time as a dental hygienist, and while the dental field and the medical field are quite different, there are many similarities. The pros that I see from some of the other HCE’s listed here relate directly to my field. We take vitals on each pt, evaluate medical hx, evaluate pharm effects on oral cavity, dispense abx prn, evaluate objective/subjective symptoms, perform an assessment and create a treatment plan for each pt, etc. While I understand that this experience does not demonstrate a knowledge or even a desire to enter the medical field, it is direct patient contact and I feel it should carry some weight. Maybe that’s just wishful thinking though.
    Would that experience along with volunteer work in a hospital setting and PA shadowing experience be enough, or would you pursue the EMT cert?

  23. Hi,

    I am a late bloomer and have after many years giving up on my dream to be a PA going for it. I am wondering what is my best means of getting my HCE? I am a full-time Biology teacher, and in college I volunteered in hospitals but left that after I became a teacher. I was a pharmacy tech for sometime as well. Would a patient-care tech be a good experience? If I volunteer what should I try to look for? Would working in a front office of a medical office or hospital count? I just want to give this a real shot. Please advise.
    Thanks

  24. Hello, I’m planning to pursue a career as a PA. Right now, I am in a short CNA program. Afterward, I hope I will find a job in a hospital. Is CNA experience enough?
    I also plan to enroll in an RN (from CC) program or an LVN program if CNA experience is not enough.

  25. Hi Paul,

    Thank you for putting together such an incredibly helpful website! I have a few questions about how to best prepare for PA school.

    I am currently a Junior in college working on an Interdisciplinary Studies major with a depth study in Global Health. This program has allowed me to take the prerequisites for PA school while also taking internationally focused classes such as Chinese and French. I became certified as an EMT this past summer and have been working since October to begin accumulating my HCE hours. Do you think I should continue on to become a Paramedic before applying? I also plan on applying for a Fullbright grant to do research in Global Health after I graduate. Do you think that this will strengthen my application as well? My goal is to get into one of the most competitive PA programs in the country (ie Duke, Emory, Univ. of Utah, etc.) and would greatly appreciate your advice in how to best achieve this.

    Thanks,
    Lindsay

    1. Hmmm. Interesting question. Usually, doing work as an EMT relates more directly to PA school than any kind of research (they want health care experience with patients). But Fulbrights have a heavyweight name, and that might be a plus to a high-end PA program. If you go that route, you will still need some very solid medical experience. So I guess my answer is: if you really want to be in a top tier school, it might take longer, but doing BOTH will increase your chances of acceptance for sure. Just be certain that the school you are lusting after isn’t just a big name; once you graduate, the name doesn’t matter much. What’s most important (to me, anyway) is the quality of your education and the learning environment. Sometimes the most competitive schools aren’t the experience that students imagine they will be. So do your research.

  26. Christine says:

    Hi Paul,

    I’ve graduated from college in 2009 and was pre-med for the first half of college. But for the past 3 years I’ve been working in health care policy with a focus on low-income adults and children. I’ve recently realized that I want to pursue a career as a PA. I don’t have much hands on clinical experience. I did take classes at GW, where I went for undergrad, that allowed work as a scribe in the ER for a few months and also allowed me, for a semester, to perform oral HIV testing to patients who came through the ER, but that was about 5 years ago. Would I be able to use those hours to count towards my clinical experience for PA school?

    Also, I’m currently looking into EMT training programs and Scribe training programs to fulfill the clinical experience requirement that most school require. Do you think PA school would have a preference of one over the other?

    Thanks!
    Christine

    1. Yes, these would count. Usually EMT has more direct patient care experience than a scribe, but both are strong experiences.

  27. Would Patient care experience count if you are related the owner of the practice? Or not?

    1. I think it would, but I wouldn’t emphasize that aspect of it if I were you. Just be honest about it if they ask you.

  28. Do schools want completed HCE hours before the application deadline? I am planning on working right after I get my BS but the app deadline for the following academic year is just 2 months after so I won’t have enough hours although I will be working up until enrolling in PA school

    1. Some will be okay with this. Be sure to mention it on your CASPA App (how many hours you will have accumulated by the time you would start PA school).

  29. Paul,
    First of all thanks for this very helpful website. Second, I have experience for my country that I worked as a midwife for two years about 13 years ago. Do you think it is acceptable?
    Thanks

  30. Paul,
    I currently work at a dental office as an assistant. It’s a specialist office, so I assist in surgery, remove sutures and review pre-op and post-op instructions.
    Would this count as patient care experience?
    Thanks for your help.
    Becca

    1. Yes, definitely. It might do you some good to get some slightly different patient care experience just to round things out, but what you’re doing is great.

  31. Hi Paul,
    I’m about to graduate with my BS soon and have been looking for jobs to fulfill my clinical experience requirement. Would being a chiropractic assistant be something schools will accept or is that non-Western medicine?

    Thank you for your help.

    1. Some schools might, but some definitely won’t. I advise you to find different experience if possible. Traditional (allopathic) medicine has a sometimes strained relationship with chiropractic.

  32. Hi Paul,

    Thank you for your time in answering our questions. I have a BS in biochemistry (graduated in 2004) and MS in Biotechnology (08). I have been working in Cancer Genomics lab for 7 and half years doing mainly a bench work for PI’s that are doing cancer research. I have all the prereq that PA school required but i am a little on down side of HCE hours. I did work during my under grad at my School Health Center for 4 years (over1200 hrs ) because i had health care related field in mind at that time but it took me this long to finally making it happen. Do you think they will consider that hours toward HCE hours? I am also planning on volunteering at my local hospital soon but i know i won’t accumulate enough hours in the next 8 month that they are expecting as i am still working full time. Please advice what i should do. Thank you for your time again!

    1. Yes, if you list them correctly (I’m assuming you’re referring to your clinic hours, not you research hours), they should count them. But you should do as much HCE that is current as you can.

  33. Is there anyway I can get health care experience if I’m still a teenager (17)? I know this is a silly question, but becoming/going to a PA school is my passion, and I plan on applying to a PA school that requires 2000 HCE hours, when I’m 21.

    1. It’s EARLY. Your passion is commendable. If this is what you want to do, you will get there. For now, focus on getting good grades. Rather than “HCE,” which implies employment, you might dabble A LITTLE in volunteering. ER volunteers get great exposure. You can also get CPR and First Aid certified. When you turn 18 you can get certified as an EMT over the summer. All these are good. But DON’T NEGLECT YOUR STUDIES, or it’s all wasted time.

      1. Definitely! Studies are always number one. So far a few hospitals haven’t have any direct patient care spots, but this clinic I’m going to call tomorrow seems very promising. I’m going to be volunteering every Saturday for maybe the next 3-4 years, so that’s why I want this task out of the way because I’ve been stressing this part a bit. Getting good grades is no problem, just the HCE part of the pre-reqs.

        By the way, I want to thank you Paul for everything you’ve been doing here! It’s been nothing but a blessing. Keep up the good work!

  34. First of all, I love this site!! Extremely informative and helpful.

    I have a degree in Psychology and I am currently working on my PA school prerequisites part time while I work. I currently have a health care experience that certainly counts but is a but irregular. I work full-time in a residential behavioral health care facility for children with intellectual and developmental disabilities (moderate to severe autism and MR). I’ve worked there for close to a year and a half now. The kids we care for live there, because their behaviors are often very dangerous (they will attack others when they become upset) and make living at home unsafe for their families. It is direct care of these children, and is an extremely hands-on job. Some need physical assistance with personal care and hygiene. We are fully trained in physical restraints for use in behavioral crisis situations, which we unfortunately have to use regularly. All staff are involved in the assessment and treatment of the children’s behavior.

    This is a medical environment, each child has a medical side to their behavioral treatment and children with these needs require constant medical care (for illness, injuries, med administration, ect.) and we have full time nurses there. However, I don’t really have direct contact with the doctors (they work from a separate building). My ultimate goal is to be a physician assistant in psychiatry, and I would love to work with children like the ones I work with now. How would physician assistant programs value this type of experience? My GPA is in the 3.35 range and I am hoping my health care experience will help me to stand out despite a GPA on the lower end. Thanks for your help!!

    1. First, let me say that you are getting great experience. Mental health, nursing, ADLs (activities of daily living), etc. It will make great material for your application essay if you choose to write about it. The requirement isn’t that you work with doctors, it’s that you work with patients. I think they will count your experience.

      That said, you would do well to get some additional experience in a more acute care setting (hospital). The work that you do with the clients/patients is less assessment and treatment and more management. That’s okay, but you need to show that you have both aspects. Doubtless there will be some schools that will give you less than full credit for your work. They’re missing the point – you’ll learn tons about medicine and working with patients. But to be on the safe side, you should diversify your HCE a little. Can you volunteer in an ER?

      1. Hey Paul,

        I am currently doing the exact same position as the poster above (Jack). I am looking to go to OHSU which requires 2000 hours of experience. By the time I apply I will have 2000 hours in this position and 2000 hours of a more traditional setting: worked in a school health clinic, which involved placing patients in rooms, taking height, weight, vitals, pre-screening, eye exams, conducting in house saliva and UA laboratory tests (pregnancy, uti, strep, flu tests), managing and restocking all in house medications, and preparing patient samples for out of clinic testing (post blood collection – CBC, lipid panels, etc.). My clinic experience was between 2008-2011, but OHSU counts experience within the last 10 years. Is 2008-2011 going to be frowned upon as too old even though it is technically accepted? I took off two and half years (2012 to 2014) to conduct NIH grant funded research, but I doubt that counts for anything. Other stats (cGPA 3.73, sGPA 3.85, GRE 159, 159, 4.5). I’m just concerned about having competitive HCE and would greatly appreciate any help!

        1. I don’t know. If they say in the last 10 years (and mean it) then you should be okay.

  35. Hi Paul,
    Thanks for all your tips. I am currently taking the prerequisite classes for PA school. I worked as an EMT for 2 years about 6 years ago. My EMT license lapsed so I’m thinking about getting certified as a phlebotomist to get more HCE hours. I believe this will help me to be competitive. Is this a good route to go?
    Also, I am taking 3 classes at a time to get all the prerequisite classes in. Should I take less of a load so I can get the HCE hours in?

    1. Phlebotomy is good – just make sure that you get time with patients. Or you could recert as an EMT. I know that’s a pain, but it’s a better cert with more patient interaction than phlebotomy.

      It’s okay to take the courses in groups AS LONG AS YOU CAN STILL GET EXCELLENT GRADES IN THEM. Protect your GPA.

  36. I worked three years in a clinical research lab (about 5200 hrs). I did benchwork for the majority of the time, but also interacted with patients to test out new treatments. I spoke with patients and helped with the imaging of their body for after treatment. Do I have to break it down and say I only interacted with patients a quarter of the time?

    And I currently work at a hospital for a crisis hotline. I am not in direct hands-on contact with patients, but I am speaking with them on the phone and assessing their crisis level and an appropriate referral, sometimes to emergency services. Is this considered HCE?

    I graduated back in 2007 and finished with barely a 3.0, so I’ve decided to retake the classes at a community college to save money. Do you have any advice on what additional HCE (or other things) I could have to get into a highly competitive PA program? My husband is getting his PhD at Duke and that’s the only school I can apply to in the area, as relocating is not an option for another 5+ years.

    1. I’m just going to be real about it – your chances of getting into Duke are not good. It’s a HIGHLY competitive program (it’s really where it all started for PAs).

      With that said, yes, your CASPA app will ask you to break down the specifics of your HCE. Be sure to list anything that you have done with patients, and be honest about how much of your time was with them. Crisis hotline work should count somewhat – it does involve interviewing and psychiatry. But most schools want direct contact with patients, so in this way, phone work will not give you a lot of cache.

      My advice: CRUSH your prerequisite courses. Make friends with your profs and really impress them in the hope that you might be able to get glowing letters of reference from one or more of them. Finally, you need time spent in the presence of patients. There are many ways to do this. Realistically, you may need to spend 2 years after completing your prerequisites to accumulate the necessary HCE to fulfill their requirement. Be sure to visit the forum’s section on HCE, and the post near the start of the section called “Creative Ways to Get Healthcare Experience.”

      Good luck, and as always, let us know how it goes.

  37. Hi Paul, Like everyone else I want to thank you for this posting! I am going to graduate in 2015 with my bachelor in Science and am having a hard time trying to fulfill my HCE hours. The school I want to attend looks more so on paid experience than volunteering.

    I know that EMTs and CNAs are good ways to gain HCE hours but are there any others? I’m not sure EMTor CNA is the correct type of fit for me.

    Thank you for your help!

  38. Paul,

    I’m a Mom of two young boys with a full-time job as a Civil Engineer (BSCE). Between my husband being a Type 1 Diabetic and every health concern I’ve been through with my kids, I’ve started researching a career as a PA. I always did well in regards to medical related classes (Anatomy, Biology, any Math, etc.) and I just feel that it is where I need to be. I’m a people person and I crave helping people. I have some friends that are PA’s and from what I hear, it seems like the perfect fit for me. I like my current job, but don’t love it. I know it would be hard to apply since I have no actual experience, have two young kids at home and work full-time (I would have to leave my job but I could figure the money situation out if I had to) but I am looking for some advice. It appears I would be at a severe disadvantage and time is against me. Since I have a BSCE, where does that put me? Would it be a 2 year or more commitment? Would they accept me with minimal experience hours? Is it worth being away from my kids? As an adult, how would I even go about applying? All questions I have to think about. I am 8 years out of school. Thanks for any advice in advance!

    1. Kari – You will need health care experience. Being a civil engineer won’t directly help you, but it does demonstrate that you’re no dumb bunny, and you have academic ability. I suggest that you investigate this field more by doing some shadowing. It’s low commitment, it will give you a sense for what you might be getting yourself into, and if you decide to pursue it further, it will get you networking and talking to people who can help you with more direction/advice/mentoring, etc.

      As for “Is this the career for me?” I say

        Follow your passion

      And follow it wherever it takes you. Is it worth the time you will spend away from your kids? That’s really a question you need to figure out yourself. You may also consider the possibility that this is the career for you, but that the timing is not right right now.

      I will say that PA school is a big commitment. It will require many hours of studying and working with patients. But it only takes two years to complete. When you finish you will be employable in a medical career that (my opinion) is very satisfying, is well compensated, flexible, in-demand, and offers far more life balance than being a physician.

  39. Hi Paul,
    I have been volunteering in the NICU department for 2 years. Pretty much all I do is feeding, rocking, changing diapers, holding, refill supplies and clean the cribs. I will be switching to other departments soon to learn more for about 3 more years + shadowing. Do you think those experiences count as hands on patient care and whether they’re enough to be a competitive applicant? If not, what do you recommend? Should I take an EMT class or anything as such to further increase my chance? Thank you (:

    1. YES! Any school that does not see great commitment and medical experience in what you are doing and plan to do is crazy and DOES NOT DESERVE YOU.

      A couple questions:
      Is neonatal medicine a long-term interest of yours?
      What departments do you plan on moving on to?
      Any chance of a paid position? This isn’t an absolute requirement for HCE, but it improves the credit you get for it.
      Be sure to think of your volunteer work in terms of what you have learned medically. Have you learned to assess when a baby (patient) is dehydrated, sick, low on oxygen, etc.? These are probably things you have been exposed to that you may take for granted. DON’T.

      EMT would be a nice addition to what you do. Also basic first aid and CPR. Many hospitals and medical centers offer one-day classes in basic EKG rhythm strip interpretation. Take one if you can. You can include that you watch the monitors to help identify cardiac problems as they arise.

      Finally, I think to be competitive, you need some BREADTH of health care experience. So find other different experiences to tack onto your application. They make you look more well-rounded, and “3-D” as opposed to 2-D.

      SUCCESS.

      p

  40. Rachel Waldman says:

    Hi Paul,

    Just found your blog today and I have to say it has been extremely fruitful reading. Thanks for taking the time to do this. I just wanted to comment about your statement that acupuncture might not be considered HCE by PA programs. I am currently a licensed acupuncturist and all of the PA programs I have contacted say that acupuncture experience most certainly qualifies as HCE.

    I don’t think it belongs in the same category as massage, acupressure or “reiki” as you list it in your post. Acupuncturists study full-time for 4 years, earning a master of science degree before taking state and national board licensing exams. The curricula for these masters programs include 2 years of biomedicine. Acupuncturists are responsible for assessing vitals, performing physical exams, correct diagnosis/evaluation, making appropriate referrals, maintaining proper medical records and oh yeah, insertion of needles into the body!

    Sure, there are acupuncturists out there who work at places with names like Moon Energy Healing Center, but they are nonetheless responsible for inserting needles into people, and that requires a whole lot of training and knowledge. Personally, I have worked in mainly integrative settings including hospitals where acupuncture is used as a complementary treatment and I get to collaborate with MD’s.

    I haven’t applied to PA school yet, so I guess we’ll see (I’ve been doing acupuncture full-time for about 6 years) but I just wanted to point out how much training and experience acupuncturists actually have and that their responsibilities on a day to day basis bear little similarity to a massage therapist. Recognize.

    Thanks,

    Rachel

    1. Hi, Rachel – Sorry if my comments seemed to impeach acupuncture; not my intention at all. In fact, I frequently prescribe acupuncture for pain management in my current position. It’s the best alternative to opioids that I can think of, and not because opioids are better.

      My experience with PA schools is that they don’t like acupuncture as much as other forms of allopathic medicine. I did work with a PA who graduated from Stanford after doing most of her pre-PA HCE in acupuncture, so you aren’t wrong that they accept it. But it’s a discipline that is often viewed as somewhere between alternative therapies and allopathic therapies. That notwithstanding, you’re right: it doesn’t belong with Reiki, Energy healing, and the like.

      Thanks for your impassioned defense – if the schools that interest you are good with acupuncture, then I’m glad to hear it.

      Paul

  41. Hi Paul, I just wanted to get your thoughts regarding HCE. I’m trying to get a job as either an ER tech or an ER scribe. I spoke to someone in both positions and an ER physician who uses a scribe. Both the scribe and the tech loved their jobs and both said that either position would be great HCE. But when I spoke with the ER physician, he claimed undoubtedly that I would learn a whole lot more about medicine as a scribe than I would as a tech because you get to follow the thought process of the doc and follow the whole treatment plan. The problem is that its not “hands on” experience. In your opinion, is scribing a valid form of HCE?

    1. Yes, it definitely is. I agree that you would get more of the clinical thought process as a scribe. But you will get more one-on-one treatment time with patients as an ER tech. If I had the choice, I would go with scribe. 1) you’ll get into the thinking of a provider, and 2) you’ll make a strong connection that may lead to a letter of recommendation.

      Either would be adequate though.

      Go get ’em!

      Paul

    2. Rachel Waldman says:

      Paul,

      Thanks for your reply regarding acupuncture. Like PAs, acupuncturists often have to explain their training/expertise.

      I also started working as a medical scribe in an ER last year. I have found that working as a scribe has radically increased my confidence in what I know within biomedicine and I’ve also learned a lot. Since scribes typically accompanies the MD on each patient encounter and are responsible for creating proper and complete documentation, this is great real world experience. Scribes are responsible for recording HPI/ROS/PE etc.. and success in the position speaks to a requisite knowledge base of medical language and observational/interpersonal/teamwork skills. Many programs I have spoken to have said that ER scribing is a good way to gain experience.

      1. Rachel Waldman,

        Hi, :)

        Which programs agreed that Scribing was a great way to gain experience? I am currently a Scribe and am applying to PA school this round, I was looking into the schools I’m interested in and most of them list Scribe as HCE, but I am not sure about San Antonio, Tx.

        They say in their prereqs that Scribe “doesn’t count since it’s not direct patient contact”, but in the CASPA, the only way to list Scribe is under HCE, so does that mean it does count? Plus I called them today to ask, and the lady said “it counts if it’s hands on”, but this didn’t really clarify since the application sounds like it does. I’m just more confused now!!

        1. This is a gray area. I can’t comment on specific schools, since they are all different. But here’s what you do:
          list it as patient care experience and let them decide. Per CASPA’s FAQ, patient care experience are:

          “Experiences in which you are directly responsible for a patient’s care; for example: prescribing medication, performing procedures, directing a course of treatment, working on patients as an active nurse or EMT, etc.”

          But you are working directly with patients (meaning in their presence), and you’re learning a ton. So I say interpret it the way you want. If they agree with you, they’re count it, and if they don’t they won’t. I personally think not counting it as patient experience is just stupid, but some schools do stupid things.

  42. Hi Paul,
    As of right now i have been shadowing an MD (that’s all I could find to let me shadow them for the time being). Does this look bad since I am interested in the PA program, or is it still strong for my HCE. He also lectures me and has me study on topics each week which helps me learn. (He also teaches medical students at the hospital). Thanks!

    1. It’s fine to shadow a physician (I did). But try to do at least a day or two shadowing a PA so that you will be very clear on the job duties and you can deftly answer the question “What do you know about what PAs do?”

  43. Hi, this is a nice thread!!
    so, which would be more appropriate to be a certificate on?
    EMT, EKG tech or Clinical medical assistant?
    Since I am graduating this may I want to get certified and get my HCE as quick as possible.

    thanks.

    1. By preference, in order of most to least preferred: EMT, EKG, CMA. EMT puts you out there independently, making decisions about life and death. It’s a limited set of decisions, mind you, but they are still life and death decisions.

  44. gkaur1970 says:

    Hi Paul,
    I have a MS in Microbiology(1991). Currently taking some prereqs (Anatomy, physiology, Microbiology)to get in PA school. I always wanted to be a physician. I have a passion to help others and so I would like to become a PA. I currently work as a data analyst at a big hospital providing data to improve patient care. It feels great when the data is used to make decisions to improve health care of our veterans. Now in order to get hands on direct patient care experience do I need to get MA certificate/license or I can volunteer in a doctor’s office and shadow a physician and PA, go to hospital rounds with them and see patients in the office is ok? I will not be allowed to touch patients because I am not a licenced care provider but is shadowing a provider considered hands on experience? Interviewing patients, talking to them. Thanks in advance for your help in this matter.

    1. If you aren’t laying on hands, you aren’t getting HCE. Of course, shadowing is an important experience that you should have.

      That said, getting hands-on health care experience doesn’t necessarily mean that you need a certificate or a license. For instance you can work in the back of a medical office with patients without a certificate in anything. Sure, you can get a certificate in medical assisting, but it isn’t an absolute requirement. You can still meet and greet patients, talk with them about what brings them in, take their vitals, etc. without a certificate. Some clinics will let you give immunization injections without a certificate.

      Don’t focus so much on the certificate. There’s NOTHING about finishing an EMT class that helps you get HCE. HCE is about working with patients. So the EMT cert is just a convenient way to get working with patients – it’s still the work with patients WHEN YOU ARE DONE that gets you the HCE credit.

      Get it? Good luck!

  45. Thank you Paul,
    Will volunteering in a dental clinic with hygienists also count towards HCE, since I do check blood pressures of the patients.

  46. Hi,

    I graduated with a BS in Biology from a great undergraduate university about two years ago, unsure of what came next for me. I love science (especially the human body and how it works from the smallest details of a cell to us having consciousness and abilities to have humor, love, etc. it’s awesome), but more than that I love relating to people. After college, in an effort to deal with debt I looked for a job right away and found one in the biopharmaceutical services industry. Here, I work in a lab day in and day out, and have found that though I am good at it, I don’t love my work or come alive at work. I love being part of a team, learning new things when I get the chance, and training others. My greatest joy at work is working with people (and learning more about science… And potential treatments to disease). After assessing my strengths and what I love to learn about, I decided PA would be one of the Best fits for me. However, I need to continue to work full time to pay of my loans. How can I go about getting valuable healthcare experience while I work full time? I’ve looked through the creative ideas page, and it is difficult to find a valuable volunteer position other than the times when I am working. Most hospitals and treatment centers are looking for those available to help Monday through Friday, 9-5.(from what I’ve found so far). Any suggestions?/is it doable to gain HCE while maintaining a full time job as a laboratory technician? Or is it more realistic that I will need to quit my job in order to get a more sustained and in depth HCE experience (and this option to me right now doesn’t look financially feasible). I’d love to hear your thoughts. Thank you!

    1. Hi, Alicia.

      It’s hard. How does one get training in a new field while maintaining the income that they need in order to get training in a new field?

      The answer is a tough one to hear: I think if you are serious about doing this, you need to be planning how you can get a job in health care. You will be paid less. But it will be an investment in your long term plan. This way you are killing two birds with one stone (or at least 1-1/2 birds). It’s not a sexy answer, but I think it’s the only good one. Tech programs don’t usually take very long to complete, and lead to pretty good paying jobs that offer excellent health care experience.

      1. Hi Alicia and Paul,

        Paul I’m a little confused about your answer. Im a laboratory technician at a hospital and although I work with clinical samples, from what I’m seeing on most PA programs requirements, hours worked here do not count toward the hands-on experience. I’m in the same boat as Alicia as far as paying off loans and as far as I know I don’t think the bank will be ok with me stopping payments or not paying the minimum amount because I quit my job to volunteer or quit to take a job earning less working as an EMT or a CNA. What I’m starting to realize is unless you figure out in college or right after you graduate that you want to become a PA, the hands-on patient experience requirement is almost impossible to complete.

        1. It can be very tough if you aren’t independently wealthy. But it’s worth it to think less black/white and more gray. Maybe you could cut back your current hours and supplement with EMT school/work one day per week. Have you considered moving from clinical lab tech to phlebotomy? This jump isn’t so tough, as you already have lab skills and knowledge. Like the forum post says, you need to get creative to fulfill this requirement.

          1. Paul,
            Appreciate the response. It’s definitely a tough/frustrating requirement to fulfill. I’m looking into some options for phlebotomy as you mentioned however I’m currently locked into a contract with my employer for 40 hours per week so I can’t cut down on work even if I could afford to. At this point I think I’m going to have to look at schools with lower hour requirements or postpone applying for two years and work a year in a clinic. Thanks again for the advice.

        2. I also come from a clinical lab background, and this can be a challenging one to fit patient contact hours into. My suggestions: -if you can volunteer on your job for every patient interaction opportunity there have, such as collecting a strep throat screen, or drawing an outpatient, etc. you may quickly be called upon to do these tasks that sometimes other lab personnel do not relish. If you perform such tasks consistently, you can break down the hours per month and record that as patient HCE. In addition, seek every volunteer opportunity (I had some through the hospital I worked at) to take BP, collect cholesterol screening samples etc. at their health fairs. These things worked for me! Good luck and keep at it!

          1. I was hired as a research technician working on the cellular and molecular side of the lab (ELISA’s, protein isolation, flow cytometry, processing clinical samples) so even though one side of the lab does see patients, my boss wants me to work on the bench side since that’s what she hired me for. I wish it was that simple….

  47. Hi Paul,
    I live in Maine and am currently in my undergraduate studies for medical biology. I’m looking into taking a course over the summer, and am debating between CNA and EMT. I know that you have been saying that EMT is this best experience, but in Maine, as an EMT-B, their responsibilities are extremely limited. In this case, would you recommend taking the CNA route? Thanks, Paige

    1. I think I would need to see what they can do. The reason we like EMT better is that 1) you are alone with patients, 2) you are making the treatment/care decisions yourself, and 3) they are more emergent conditions. This is the case even if you are doing more routine interfacility transfers – you still need to be prepared to provide life-saving measures.

  48. I have been a cardiac monitor technician for several years and have finished a B.S. in Biology. I sometimes go into patient rooms for 12-lead EKG assessments but spend most of my time working with nurses and physicians outside the patient room, constantly monitering their EKGs in real time and reporting/recording changes/emergencies.

    I wanted to know if my job experience counted as valuable HCE, or if this work is too inderect to be valuable for PA school applications. I ask this because most people I talk to do not know what this job is.

    1. I have not heard of the term Cardiac Monitor Technician. Have you checked around to see what they are called elsewhere? I assume you have patient interaction responsibilities. If not, you should ask the nurses and physicians if you could do more of that. This is a great piece of experience. Now all you need to do is find a way to describe it that tells them how much you really do. It sounds like you may be underselling it.

      Failing that, consider it a good piece of experience and move to get a different experience under you belt, even if part time. CNA/EMT would be excellent. Back office work in a clinic would be fine too.

      1. Wow, my husband also tells me I sell myself short in writing, and so I appreciate the comment. As an EKG tech (a different term) my reports on patient’s EKG patterns have a direct impact on patient outcomes. I have other pt contact experience, and will be published this year for developing a murine model on a human disease. I love research, but I am only truly happy when I am at the patient’s bedside. Thank you again for your reply, you have a fantastic website.

  49. I recently just got my EMT-B license and have just started working at my college as a student EMT. I am always going to be working at a summer camp as an EMT this summer. My GPA is a 3.25 and I’m a junior. Do you think these jobs will help better my chances or would it be better if I worked for a service on an ambulance?

    1. I think they will help. But you should find a way to get some acute care experience (I can’t imagine you get many heart attacks or serious trauma at camp!). Maybe you could volunteer at an ER? Ambulance work would suffice too…

  50. Thanks for another article, which helps to answer questions for us.

    I am a Registered Therapist and by the time I apply, Lord willing next Spring, I will have over 10k hours of HCE (7 years experience) in ICU, E.D., Auto-transfusion in the O.R., labor and delivery, PCU, bit of neo and moderate in Peds. Does having “too much” HCE hinder your chances to get in? I am currently retaking some old classes to improve my GPA as outlines in another one of your threads but wanted to make sure that having 7 years experience won’t hinder my opportunity.

    Thanks in advanced.

  51. This website has been very insightful so far! For the majority of my health care experience I have worked with an orthopedic surgeon doing various tasks similar to a medical assistant. The surgeon I am working with just so happens to be my aunt and I am at a loss about using her as a reference. I know on many of the sites it is stated that applicants are not suppose to use relatives and i’m not quite sure what to do. She is the physician that has seen me working with patients and in a health care setting so her reference is one that I would really like to have. Any wisdom or words of advice?

    Thank you!

    1. You’re in a tough spot. They are pretty clear about not wanting references from family members. Even though she’s your aunt, the assumption is that anyone’s aunt would give you a positive reference.

    2. Rachel Waldman says:

      Kalya,

      I think Paul is right – you should never use a relative as a professional reference. But, your aunt probably has some good connections that you could use to your advantage. Perhaps she could recommend you to a colleague that you could go work/shadow/volunteer with for a while and eventually get a reference from. If she makes a strong case for you, that could work and give you even broader HCE by getting in with another physician instead of having all your hours from the same place. Just an idea.

  52. How does dental assisting apply towards HCE? Does it apply at all? I’ve volunteered many hours in the dental, I hope I’m not wasting my time.

    Thanks
    Charlene

    1. You will get some credit for dental assisting. But you should try to branch out by adding some non-dental medicine experiences to your application. Something acute would be ideal – ER maybe?

  53. Hello,
    I have just gotten a job as a medical scribe in the ER. However, I realize that while scribes see patients with the doctor, they don’t have direct contact with them. Therefore, I know it will be wise of me to get certified in a profession that will allow me to get direct patient hands on experiennce. I am wanting to apply to PA school next year so I want to rack up as many health care hours as I can. One of the short summer programs I’m interested in is the EKG technician program. However, I’m worried that because of the limited direct hands on HCE EKG techs have, it wouldn’t be smart of me to consider it. The majority of direct patient care EKG techs get would be limited to preparing the patients for holter and ambulatory care. I would plan on working as a scribe and EKG tech at the same time so I’d be getting different forms of HCE but I’m not sure this would be sufficient. Any thoughts?

    Thanks!

    1. I think your instinct is right; yYou will learn a lot as a scribe, and you will definitely get some credit for it, but that probably isn’t enough. To round things out, I suggest you consider getting certified and working as an EMT, or looking for a job as a medical assistant. EKG tech would be more of the same: good medical experience, but weak patient care experience.

  54. Hi Paul: This is a great blog you have! I have been working on completing pre-reqs for PA school and I have been working on diversifying my HCE. I have 300 hrs as a cardiac rehabilitation intern, and am now accruing 200+ hours as a CNA as a nursing home and assisted living facility. I also have 7 years experience as a personal trainer, and have worked with healthy people and persons with IBS, rheumatoid arthirits, bariatric surgery, and coronary bypass surgery. Should I include this personal training experience – it was hands-on and required taking vitals, doing stress tests (treadmill Bruce protocol in some cases) and designing, monitoring and implementing fitness plans. I also have a BS in biology and an MS in kinesiology. I am applying to other CNA jobs that are in a hospital or clinic setting, but I am wondering where / how I should categorize the personal training experience. It is where the seeds of medicine where first planted in my mind. Thanks so much!

    1. To the extent that you were assessing and treating the people you worked with, you were doing patient care experience. I’m not convinced that working as a personal trainer quite fits that definition. But if you were doing any type of rehabilitative work with patients, then it probably would. Unfortunately, I think to be rehabilitative, it would probably need to by physical or occupational therapy.

      Outside of this, your work with clients would be classified as “Other Work Experience,” which is still helpful.

  55. Hey Paul,

    I was wondering if my degree and HCE would be legitamate as good PA applicant background. I have a BS in health service administration, working on the pre reqs and GRE. As for my HCE, it all starts a lifeguard, then a CPR instructor, then I became a restorative therapy tech at nursing home for over a year where I had direct patient care, following care plans from physical and occupational therapist, assessing and treating patients with physical and occupational rehab after discharge from skilled therapy (including all tasks that licensed therapist due minus billing and evaluations), charting patient progression each day, then discharging these patients into nursing restorative relaying the initial plan from the therapist to nursing staff. This only lasted about a year where I got just less than 2,000 hours. I was then transferred to another nursing facility after a therapy company took over our department. I was a rehab aid, but was not as hands on as I used to be. I have been here for about a year and now volunteering asa rehab aid in a hospital to broaded my experience. The main point and question I have is if medical transportation would count as good experience too? I want get into a hospital setting to experience and connect with different patients than just geriatric patients. I have an interview as a transporter tomorrow and I am unsure if I should or should not give up my nursing home rehab aid job to transport patients? Please let me know your opinion on this predictiment. Your responses seem very knowledeable on this blog and I would really respect your opinion. Thank you

    1. Thanks for your trust, Aaron.

      You have had some relevant experiences for sure. Patient transportation can vary. Driving a wheelchair van isn’t as good as driving an ambulance, etc. I sounds like you could use some acute care experience. EMT / ER tech is a nice way to get that, but there are others.

  56. I want to be a Derm PA…i have not applied to PA school yet but i have my B.A. in Biology. Should I try to get my HCE in the dermatology field? does it matter?

    1. No, it doesn’t matter. Get into PA school. You really don’t need to think about your specialty until you are nearing graduation. Your specialty is sort of unofficial – it’s pretty much whatever setting you end up working in after you graduate.

      1. Thank you Paul. I have gained a lot of information through mypatraining.com and I am sure I will have many many more questions to come. Thank you again.

  57. Hi Paul!

    I stumbled on this fantastic website. I’ve recently had doubts into applying and going to medical school and this website has really pushed me into the PA profession. The balance between work and life, being able to offer care to a wider range of patients, and being involved in the care of patients all make the PA profession an excellent choice for me. As a full time college student, working in a healthcare setting is a difficult option. Instead, I have volunteered extensively at a variety of clinical settings from the lab to the Intensive Care Units at hospitals. What constitutes HCE? Does assisting nurses and nurse techs with delivering medication, food, helping feed patients, transporting patients to other areas in the hospital count? Do I have to get some sort of certification (EMT, CNA, etc.) to gain valuable HCE? Thank you so much for your time!

    1. oh, and I’m looking at a lot of schools in Texas where HCE isn’t really required.

    2. Volunteering is good experience, particularly if you do a lot of it in multiple settings. It’s better experience if you are in a position to actually do things for patients. Ask the facility if you can interview, take vitals, etc.

      Most schools don’t give as much credit for volunteer work as they do for paid work.

      You don’t necessarily need a certificate to get HCE, but it will make it easier to get hired. If you’re having trouble finding patient care jobs that have you interacting with patients, then a certificate is the way to go.

  58. Molly Patel says:

    Hey, I was wondering if doing undergraduate research in a laboratory will help with my HCE. I have an internship at a genetic immunology lab in the immunoregulation department. There is a large focus on molecular and cell biology. We aim to target biomarkers to help find therapeutic methods for asthma. There is no patient care involved, simply lab protocol. The lab work is extremely tedious, boring and I get quizzed three times a day. Should I tough it out? Will it be impressive on my application? Please help :(

    1. It will not be particularly helpful for getting into PA school. I’m sure you’ve learned a lot, which IS good. But in terms of what PA schools want, this is not considered HCE. You CAN enter it into your CASPA application in the “Research” section.

      But I think you would be much better off working with patients in some capacity.

  59. Great blog! I found your site while taking a break from writing my narrative for CASPA. I noticed in several posts the suggestion of becoming an EMT to garner HCE in order to apply to PA programs. Having been a paramedic myself for 15 years, it’s not that simple to “go out and get your EMT certification”. Most EMTs and medics where I live are also firefighters since EMS (in the first responder sense) is provided by the fire department. If you work for a non-first-responder type service, then the extent of your HCE is going to be limited to transporting patients from A to B.

    EMS experience is invaluable when making the transition to PA. The caveat is EMS is its own career. It would be like becoming a PA to go to medical school. I’m sure there are former PAs who are now stellar physicians, but I am doubtful they became PAs to springboard to medical school. I have had a wonderful career in the fire service and am ready to make the transition. My extensive and varied experience will serve me well as a PA. If you want to get into EMS, go for it! Medics are basically PAs out on the streets.

    1. I can’t really agree, though I respect your opinion. It’s not hard at all to “got out and get EMT certified.” It’s a semester course at a community college, or less time and more money at a private school. Certification is completed by skills and written testing, and if you have studied and practiced, these aren’t too hard.

      WORKING as an EMT isn’t as easy, and it depends where you live. In urban/suburban areas, there are many EMT jobs. If you live in a small town, you may have to settle for volunteer work or EMT work for a private company, such as a CPR training company.

      EMS can be it’s own career, but it definitely doesn’t have to be. I worked as an EMT for three years and I’m pretty sure I had more hours as an EMT than they needed to see. GOING ON to medic school can also be a career, but it doesn’t have to be (some do it for 20+ years, and some for 2). We had several former medics in my PA class, so it definitely is done. Just don’t expect the doors to fly open the second you get certified – you need experience with patients.

      Also, I think transporting patients from point A to point B, though probably less exciting than most people hope for, is INVALUABLE experience. I can’t count the number of times a routine call turned into something less than routine. My PA school essay was about just such an experience (if you read our ebook on essays, you can read among with others.

      At times patients will decompensate and that why your’e there, instead of some bus driver or yahoo. They need further evaluation and treatment. Even the routine things can be great learning experiences. ExampleX: you are transporting an elderly patient to another care home and they become pale and mildly short of breath. If you are doing your job, you need to assess their situation, provide oxygen (without anyone else telling you too) and make sure they don’t tank on you. 5150’s, code 2 trips to the ER, working at a rock concert or county fair – ALL these, though they sound small, are how you begin to think about your job of keeping people alive and healthy. I still use the skills I learned as an EMT every day in urgent care. In fact, I think the easiest way to learn to care for patients is to start by learning how to prevent the things that will make them die on you today.

  60. I was wondering if there was a time limit on the experience. I worked as a CNA/ER Tech at my hospital Full-time for 2 years before they transitioned me to being a Monitor Technician. I have now been a monitor tech for 3 years and I am worried that the schools are looking for recent hands-on HCE. I still work in the hospital but not in a clinical role. Do they want current HCE?

    1. There is no official “time limit.” But your intuition is correct: more recent is probably better.

      You should DEFINITELY claim even your oldest health care experience (everyone should), but to combat the question of its expiration from being an issue, have some recent experience as well. Working now and can’t take a different job? That’s okay – volunteer at least a little to make it clear that your head is still in the game.

      As always, though, working with patient is better. Is there with-patient work you could be switched to / switched back to?

  61. Hey Paul,

    Awesome article. I currently have my BBA in Business Management but am tired of navigating a huge, ambiguous job market and feel I have a passion for Health Care. After talking with a close friend of mine who is a D.O. I decided PA is the way to go. I still have to go back and do about a year or so of undergrad prerequisite science courses. Also, for the HCE i saw in previous comments questions about phlebotomy. I know that that is good direct patient contact but will the PA school want to see that I was a certified phlebotomist? From my understanding you don’t need any certification of formal education so long as the doctor or hospital you’re working under is willing to train you and feels you’re competent to draw blood and such. So if I were to work under my friend who is a D.O. and get my HCE experience that way, as I took my undergrad prerequisite courses, would that be acceptable to most programs? Thanks so much for your time and help!

    1. The laws differ on this from state to state. Generally speaking, if you are a medical assistant who is trained on the job to draw blood, you’re okay to do so. Is that good enough for PA programs? Not good enough to call yourself a phlebotomist. But usually being a medical assistant is considered good health care experience. And even better, you can then add a list of phlebotomy-related skills to your job description, which is good. You should be fine.

  62. Hi, I was just curious on where you would place being an Activity Coordinator assistant on CASPA. As an assistant I spend time running activity for the residents, assist residents with participation in activities, assist residents who need help eating snacks ect. I’m not sure if it is included under “Other health care experience” or “direct patient care.” Thanks for your opinion!

    1. Hi, Jes – if you are working in the presence of patients, I would consider this direct patient care. Doing/planning activities with them is a form of therapy; assisting with meals and snacks is “dietary therapy.” We might not think of it as therapy, but these are treatments, without which, the patient would suffer.

  63. I am an x-ray technologist and has been working at 2 hospitals for the past three years. So I have plenty of direct patient care experience. I was just wondering does being an x-ray technologist weigh heavy in my favor….

  64. Hello, thank you so much for your website.
    I will applying for PA school in 2015.
    Along with the others who have posted, I am worried about my HCE. I am trying to get started to build my hours now. I am a CPR/first aid instructor, counsel on nutrition, and volunteer at a hospice. I am wondering of these activities, which would be considered HCE? Can I count the hours I spend teaching CPR and First Aid classes as HCE?
    Thanks in Advance,
    Lydia

    1. They will all be counted as experience. But CPR/first aid instructor won’t count as patient care experience (it will be counted as “Other Health Care Experience”). Counseling on nutrition will count as patient care experience if you are working with patients (in a medical setting like a hospital, clinic, or similar). Volunteering at hospice is perfectly good patient care experience. Do you have any acute care experience? It would be a nice addition, if you have time. Volunteer in the ER, get your EMT and work as one, etc.

      In other words, all your work and volunteer time will count, it’s just a question of how it is categorized. See the following page on CASPA for details: https://portal.caspaonline.org/caspaHelpPages/frequently-asked-questions/additional-information/index.html

  65. Leah Fauth says:

    Hey Paul,

    Thank you so much for answering questions! I really appreciate reading all your feedback. I am struggling to decide between a patient care technician or EMT certification as my HCE. I graduated 2 years ago and have worked as a specimen processor and chemist, but nothing with direct patient contact. I’ve emailed all the admissions of the PA schools I plan on applying to for the 2015 cycle, however most are very vague about their answers. Have any input?

    Sincerely,

    Leah

    1. Patient care technician is vague, so it’s hard to say if it would be better than EMT. I would go with the known quantity: EMT.

  66. Hi Paul,

    I must say that this website has been so helpful in preparing me for the daunting task of applying to PA school. I am a MPH graduate who is currently working as a health educator/resource coordinator with a state program at a public hospital. I work with newborns and their families, providing health education related to safe sleep, SIDS, breastfeeding, family planning etc. I also do in depth assessments to put families is supportive programs. I have also done home visiting services with pregnant women/NICU families- high risk and provided education on prenatal care issues/drug use etc.. To add to that I am a certified lactation counselor. I am really concerned about my HCE being relevant to my application due to the lack of “touching” patients. Do you think my breastfeeding support services with a mom, ie: helping her latch, assessing baby’s weight etc. would be helpful? Or should I just try shadowing a PA instead?

    Your response is much appreciated :-)

    Thanks in advance,
    Melissa

    1. Oh, absolutely. Remember, you don’t necessarily need to lay hands on patients. It’s a good thing to show you have done, but the mandate is that you have worked directly with patients, which really means in person, as opposed to on the phone or indirectly, such as a medical lab tech. So I think your health care experience will be accepted.

      I should add that to make yourself even more competitive, you would do well to supplement with another type of health care experience (meaning something that is not baby/maternal/lactation – you’ve done plenty of that). Work in an ER or primary care clinic would be an excellent thing to be able to show them.

  67. What about working in the nutrition dept. at the county hospital? I work in the patients side and build up the patient trays depending in their conditons and diets. I then deliver all these trays to each and every patient . Could this count towarda my experience for the PA program?

    1. I would definitely call that patient care experience. I wouldn’t call it good patient care experience. In other words, it’s a starting point. You are being exposed to patients and their medical conditions, and you are learning to talk to them.

      What you aren’t doing is assessing and treating them, and that’s really what PA programs want to see. After you have done that for any length of time (6 months or more) I would recommend you start looking for something that is more involved, like EMT, CNA, PT Aid, respiratry tech, cardiology tech, nursing, or psychiatric tech.

      In short, it’s worth some “credit,” but by itself, it won’t be (nearly) enough.

  68. How should I total my hours as a firefighter-paramedic? Should I calculate it as I work 120 days a year roughly x 24 hours in a shift x 5 years= 14400? Obviously, as a firefighter/paramedic I am not in direct patient care for every minute of that 14400 hours, but getting statistics on every call I ran over 5 years between two fire departments would be a challenge.

    1. Good question. What % of the time would you say your with patients? Even if it’s 30%, that a still impressive ~ 5k hours. Just make sure you say 5 years somewhere in your essay – that will definitely mean something to them.

      1. I’d venture to say we run an average 8 calls a day. When I am on an ambulance it takes about an hour a call on average. which would probably be about 1k hours a year. Is estimating my HCE hours like that OK? I mean even if your a scribe or a nurse you don’t really keep track of how many patient’s you see and submit that right?

        1. Yes, that’s a fine way to do it. They expect you to give an estimate and if this estimate seems realistic, (the will know), they’ll use your numbers.

  69. Hi Paul,
    I’m a biochemistry and microbiology double major (possibly a minor in pharmacology, too) in my senior year. I was thinking of apply to PA school after graduation. I had a baby last year and I’m currently working as a PCA while in school. Do you think that taking care of a baby 24/7 would be considered as patient care too? I’ve also worked in Vet hospital dealing with animals and their owners but that’s pretty much it as far as patient care. Thanks!

    1. Sadly, no. PA programs will likely give you no credit at all for being a parent. That’s not to say that there isn’t anything you can learn from being a parent that could be useful in PA life – far from it! But they want traditional medical experience. Keep doing what you’re doing and possibly consider MA or EMT to better your chances.

  70. I have been an EMT (paid) for a number of years and by next cycle of CASPA applications will have accrued over 3,000 hours of experience. I have assessed patients medical conditions, treated wounds with applications of dressings, monitored baseline vitals, and many other hands-on activities within my scope of practice. At my last school interview though, I was given the impression that my experience was “low level” in terms of acuity. It was suggested I consider returning to school so I could get better experience. In your experience is this a typical feeling of schools towards EMT regarding HCE hours? If so, without spending two years obtaining a new degree and another two accruing hours under the new profession is it possible to improve this area of my application?

    1. Hi, Eric! As PA schools get more competitive, this can happen. I still think EMT is a great way to go, but it also depends on how many hours and in what setting your EMT work is used. In your case, I would highly recommend you consider advancing yourself to become a paramedic. There really isn’t any better experience for PA school, and it is considered high acuity. Respiratory tech might be the only thing that comes close, in my opinion.

  71. Hello Paul,
    Thank you for your valuable insights about this field! I am an international student planning to apply to PA schools..as for HCE I am finding it very hard to even get a voluntary position owing to institutional regulations and visa problems..i was however able to find a podiatrist who was willing to give me a chance in his clinic..although podiatrists do not employ PAs , I would atleast be able to get hands on with taking H&P, preparing the surgical room etc. Can i use this towards my application?

    1. The HCE requirement does not need to be in a profession that employs PAs. For example working in physical therapy or phlebotomy all count toward the HCE requirement. Podiatry should count just as well.

  72. Hi Paul,
    I was wondering if you know whether CASPA (or schools) calls employers for your health care experience. I know CASPA “verifies” applications but I don’t know exactly what that means. I just wanted to give them a heads-up if that was the case.

    1. As of this writing, no they do not call employers to verify health care experience (routinely). I’m sure that if they had reason to believe that you falsified your application information, they would do that. But no, they don’t do that for applicants as a matter of course.

  73. Hi Paul,
    I have been working in an Assisted Living for almost one year now. I started as a CNA and now I mostly work as a Medication Technician. My jobs includes giving routine and PRN meds, both prescription and OTC. I also apply bandages, clean wounds, and follow MD orders for the resident. I decided that I want to go to PA school and I am looking for other HCE I can do to add to my application. But I am wondering if being a Med Tech will be decent work experience for my application? Or would it be better to work just as a CNA in a nursing home?

    1. Both of those are HCE. The trouble is, they aren’t particularly GOOD HCE. You really need some higher level care experience. You might consider the EMT/paramedic route, or the respiratory tech route, both of which provide you with the best HCE you can get. You have enough health experience to get into RT school or similar. And RT pays very well.

  74. Hello!
    I’m an aspiring PA, and I was wondering if a really hands-on lifeguard job (jumping in to rescue swimmers about every hour) would count at all. I mean, we have to be CPR certified and we go through Ellis Lifeguard training… Okay, it’s at Walt Disney World- I was accepted to the college program and was wondering if this would hurt to include/if it could potentially count, since I’ll be working nearly full time there from August through January.
    Also, I do have my EMT certification (NREMT and state level). I am currently applying to jobs at local hospitals- would a mental health worker job be considered patient care? The job description is: “Under the direction of a Registered Nurse (RN), the Mental Health Worker will assist in the delivery of care to patients and their family. The Mental Health Worker fulfills these duties to contribute to the continuity and quality of care that fosters the best interest and well-being of the patient and family.” I’m not sure about applying to it, but I meet all of the qualifications, and it’s in a hospital/working with patients in SOME way, so I just figured I would ask. The rest of the jobs are pretty straightforward (phlebotomist, patient care assistant, ultrasound assistant, etc.).
    Thank you!
    -Lindsay

    1. You should definitely list your lifeguard work on your CASPA application. But instead of it counting as patient care experience, it would be counted as “Other Work Experience.”

      Psychiatry is HCE, as long as you are working directly with patients, as opposed to being behind a counter or something. I had psychiatry for much of my HCE. But I would suggest you don’t do it for ALL your HCE. Supplement it with other more “traditional” medical experience. But, yes, if you can get that job, I think it would be worth applying. Be sure to write about it thoughtfully in your essay so the admissions committees see all of the health care you have been apart of.

  75. Paul,

    I have an associates in nursing and am a registered nurse. I have a bachelors in health and exercise science and am an ACSM Exercise Specialist. I for the last 8 years have worked full time in both orthopedics and cardiology/pulmonology in the inpatient and outpatient settings. In my current role I manage the hospital’s health and wellness center, cardiac rehab, and chf clinics. I am a certified ACLS instructor and have even been on medical missions trips and have been a winner of my hospital’s annual “service of the poor” award. I am a regular speaker at luncheons and dinners for my hospital on different health topics as well.
    I told you all of that to tell you this, I have a passion for medicine and helping others so I have decided to further my education by applying to PA school this year and my cumulative gpa is 3.1.
    Having met all of the requirements, I was wondering how much my gpa would hurt with my application process against others with higher gpa s but with much less experience? And what my chances would be to get in a program with a 3.0 minimum?

    1. Your GPA is on the low side, there’s no two ways about that. Your health care experience is a huge plus, but it probably won’t “make up for” your GPA. I don’t know your chances – it’s just too subjective a question, with too many variables. Do your best, apply, and let them decide.

  76. Jeremiah McKee says:

    I just found this website today and it is fan-freakin-tastic! Looks like this thread has been going for quite some time! I also have a question about my current HCE. I am actually two years into my bachelors in Nutrition Science and I’m really wanting to go to PA school. It is the perfect route for me. I currently work as a Donor Processor at the local plasma center here in Logan, UT. Basically what I do is about 20-30 mini-physicals a day. I draw a small blood sample (testing for protein and hematocrit levels), measure their blood pressure, body temperature, weight, pulse and then ask them a series of medical history questions. Again, this happens about 20-30 times a day. Currently I have about 1200 recorded hours and by the time I graduate I’ll have roughly 2800-3200 hours or so. Does this sound like adequate HCE or does it still fall short of that category and should I look else where for experience?? Again, thank you so much for this great website and I look forward to your reply! Thanks!

    1. That sounds like good HCE. I do always recommend that your HCE come from at least two different types of medical experiences. The other one needn’t be thousands of hours, but something different is always nice to show that you are well rounded and interested in a variety of things.

      1. Jeremiah McKEe says:

        I really appreciate the time you took to answer my questions!! Thanks again!

  77. I am a CML (Case Management Liaison) or “Discharge Planner”, as known by other hospitals. I have a BA is Psychology. I know I will need the basic pre reqs like anatomy, micro biology, and the like. So I have constant patient interaction. I work closely with nurses and doctors (ie. I go to rounds). I basically make sure patient’s have “everything” for a safe discharge home or to a skilled facility. This includes they get their durable medical equipment, home health, out patient dialysis, and so on. However, I don’t actually “touch” the patients, and this has me worried. I was told “Scribes” get credit, but can’t find a clear answer about “discharge planners”. Any insight would be helpful and appreciated. Thanks.

    1. Bob – I haven’t considered this type of HCE before. As you describe it, it sounds like it would be okay. Remember that “working directly” with patients doesn’t mean that you have to touch them. But you can’t just be on the phone with them or reviewing paperwork about them (those would be indirect patient contact).

  78. I am really glad that I found this website. I am a freshman at a community college. I graduated from high school last year. I am majoring in biology and will transfer in fall 2015 to a CSU campus. A recent talk with my councilor made me worried because he pointed out that I don’t need a bachelor’s degree to apply for the designated school and I am not fulfilling the pre-reqs. I am taking cell and molecular bio, general chem (04A), statistics, psychology honors, physics 2A(intro physics). But anatomy and physiology I and II and microbiology is needed instead. I can finish up bachelor’s degree in four years but then I don’t have any clinical experience after graduating. I planned on taking summer CNA class to satisfy the requirements but acceptable clinical requirements for most PA schools are LVN, RN etc. A certified nursing aide or home health care aide is not acceptable. It is not possible for me to do paramedic or EMT courses and major required classes at the same time as my classes are long with a three hour lab. My classes start at 8 and I don’t get home until 5 in the evening. I am studying so hard but it seems like it is a waste of my time. I know it is very competitive and tremendously difficult out there, there is so many qualified applicants with extensive clinical experience and I am just a beginner with zero experience, so I am wondering would it be better for me to complete this semester, then drop from bio major and start LVN program which will give me clinical experience and as well as fulfill as the requirements as both LVN and PA have same pre-reqs. Would you suggest anything please?

    1. I don’t you think you’re as far off track as you seem to think you are. It’s early. Get your degree in a relevant science. Those are some hard courses, which is great, as long as you get great grades. If you think taking courses like that might jeopardize your grades, then back off or mix the harder ones in with the easier ones. Get your degree with good grades first. THEN go and get your health care experience. Very few PA students are admitted right out of college – there just isn’t time to get a degree (with great grades) while working on health care experience hours. The average age of students accepted to PA school in 2013 was nearly 27 years old!
      School first (focus on academics over everything else, except maybe family)
      then health care experience.
      If you follow these steps, you are very likely to achieve your goal.

  79. Hello! My name is Quinton. I just graduated college with a Psychology degree. I was also a biology minor. My original plan was to go to medical school, but I realized that PA school would be better for me. I am an emergency medical scribe at the moment, and I am applying to become a radiology tech assistant. Would both of these jobs help with HCE? Thanks!

    1. Hey, Quinton!

      Yes, those are generally good health care experience for PA school. I might even encourage you to stay where you are as a emergency scribe. That can be terrific healthcare experience for PA school. But I’m also a fan of people broadening their healthcare experience – not having just one kind, but many. See as much of the medical field as you can and you’ll know more about what you’re going into than you would if you hadn’t. Good luck.

  80. Hi Paul! I really appreciate all of the information you have provided in this article and throughout your website; I will be using a lot of your tips as I work through the CASPA application. I have a B.H.S. in Public and Community Health and worked as a Community Resource Specialist within the Case Management/Clinical Resource Management Department of a hospital for almost a year. I spoke directly with patients while they were in the Emergency Department then coordinated needed follow up care, working to lower the ED’s recidivism rate. Do you think any part of my experience at my job will count toward HCE? Thanks in advance.

    1. It will count as experience for sure. But only the portion that you were actually working with patients will count as “Patient Care Experience.” It is the most valuable kind. If you didn’t spend a large portion of your time working with patients, you might consider getting more contact hours.

      Think of it this way: everything you do counts as experience. But some things count as the more medically relevant types of HCE. The hardest and most important to obtain are those that have you dealing directly with patients.

  81. Hi Paul, I am currently in the middle of undergrad and am wavering between PA school and PT school. I have already put in a number of hours in different PT backgrounds, but have not been able to have patient contact, which I understand is important for PA. If I would like to use these hours towards PA as well, do you think it would be acceptable or not? I am looking to take an EMT class in order to work part-time to help gain more hours with the hands-on aspect; however, I do not think I will have nearly as much as I would like in time for applications. Do you have any idea if schools accept hours that will be logged after applications have been sent?

    1. No, schools won’t give you credit for hours that have yet to be completed, or are “in progress.” PT and PA are much different fields. If you are torn, I suggest you do enough shadowing that the question becomes easier to answer for you. If you work as a PT assistant you can count that toward PA school patient contact hours, but it’s not the highest quality HCE. Your plan to get your EMT should help, even though you may not be ready to be accepted this year. Keep at it and you will become a strong candidate with time and experience.

  82. Jacqueline says:

    Hello,

    I have a question. I am currently finishing my health science Bachelors with concentration in public health. I am in the process of doing my pre-reqs and looking forward to gain some health care experience. I have worked in a clinic for 5 years but doing administrative work. I volunteer at hospitals but I’m thinking in getting a small certification to enhance my knowledge. Will LVN be a good choice to get some medical experience? I’m so confused in what certification to get. I also heard that EMT is good and looks great in PA applications. Whatever advise you have would be great for me. My advisors at school suck literally.

    1. Short answer: get an LVN if what you really want is to become a nurse. Not saying it can’t work, but I don’t recommend it. You wouldn’t get a job as a contractor if your goal was to become an architect (Not that either of these careers is “better,” or “harder.”)
      EMT is good, but it’s not the certificate that does it; it’s the time with patients, which the EMT cert can allow you to do.

      Long, more detailed answer: click here for our forum topic on HCE

  83. Hey Paul,
    Right now am in a CC and i will transfer soon and am planning to take a degree in Athletic training. The university that am applying has a internship program of 1800 hrs. Does that count towards PA school direct patient hours?
    Thank you

    1. It will depend if you’re working directly with patients or not. I suspect at least some of it will be so you should be able to counsel of your hours but definitely not all 1800.

  84. Hello
    I am an international pharmacist taking pre requisites for PA school, I have emt certification but till now don’t have any HCE,what would you suggest and what are my chances to get into PA school having pharmacy background?

    1. It’s really too hard to estimate what your chances are – it has a lot to do with many other variables besides the one you mentioned. Pharmacy experience is good but you will need some experience working directly with patients. That’s the kind of PA schools really look for. EMT would be a good way to get that, but you would need to get some sort of job or volunteer position using your EMT skills with patients in order to make that work.

  85. Hello Paul, great site! Thanks for all the highly useable content! I finished up a bachelors in Health Science 3 years ago with a plan to go on to PT. Well, life got in the way and that path was abandoned. I’m seriously looking at PA now and considering all it will take to get in. I have worked as a Birth Doula and Wellness/Nutrition Coach in the past, and am considering a nursing assistant job to fulfill HCE. Does this seem adequate and do you think my doula and wellness coach work will count at all?

    1. Doula will count. I don’t know exactly what a wellness coach does, but if it’s with patients, then I would think that it would be countable. CNA is OKAY HCE. MA or EMT are probably better, but they have their own issues too.

  86. I am currently in nursing school to receive my BSN. I have no direct patient care experience except for the clinicals I do at school. What are my chances getting accepted into PA school. My GPA is at least a 3.5. I have shadowed a doctor, not a PA. Is that Ok?

    1. That is good, but you really need HCE. Some schools don’t REQUIRE it, but you will be competing against applicants who have it, ans some who have a lot of it. Besides, to be a good PA, you need to familiarize yourself with clinical work.

  87. Hi Paul, I’m currently a sophomore in college looking to gain HCE. I’m looking into a volunteer opportunity that would allow me to measure the BP of elderly persons, inform them about what their numbers mean, and advise them to see a doctor if needed. Do you think this is an acceptable starting point for building HCE? I do intend to search for a position with more responsibilities such as an MA but was wondering if this experience would be worthy of counting towards direct patient care experience. Thank you!

    1. Sure – that sounds fine. Whatever gets you in there with patients and doing some assessment or treatment is a good way to start.

  88. Hi Paul, I’m currently a junior majoring in Health and Wellness. I have completed most of my pre reqs. I’ve worked as a Rehab Tech, Physical Therapy Tech, and Medical Assistant in the past. I’ve been working as a Biometric Screener (finger stick, bp, height, weight, bmi, and health coaching) for the last four years. Do you think that would count as HCE for PA school?

    1. It should. You are 1) working directly with patients, 2) you are doing some assessment (taking vitals, etc.), and 3) you are doing some treatment (counseling).

      You might play to the conservative and get some acute care experience too – ER would be a possibility, either as an EMT, a medical assistant, or volunteer (JUST TO BE ON THE SAFE SIDE).

  89. Jasha Adler says:

    “Experience will be your ace in the hole, the one thing that makes it possible to become a clinician in such a short time. It is nearly impossible to get into PA school without it.”

    Great article, wish I had read it sooner! I’ve just applied to my first program and am awaiting a response, but after researching other PA programs, it quickly dawned on me that “shadowing” alone isn’t going to cut it. I hope to get an interview and get accepted, but in the meantime, I decided to go for the Clinical Medical Assistant career path. In the end I know I will be more competitive, and I will be more confident overall.

    1. Thanks, Jasha! Just keep working on your application and before you know it you’ll be an attractive candidate.

  90. Hi Paul –

    I wonder if you can speak to problem-based learning (PBL) curriculums that are starting to appear in Physician Assistant programs. I’m interested in attending a PA program that utilizes this teaching method. I’m aware of three schools – Chatum College, Southern Illinois University and the University of New Mexico – who utilize these curriculums. Can you speak to this at all? Please see: http://www.paeaonline.org/index.php?ht=action/GetDocumentAction/i/25439

    Many thanks, Hilary

    1. Good question, Hillary!

      Problem-based learning is all the vogue now. It’s basically teaching the material within the context of actual problems (usually patients) that are encountered in medicine, as opposed to teaching it in a theoretical environment and then having to apply it to patients later. It is also usually done along with small group work, and it emphasizes the instructor guiding and facilitating students through cases more than teaching facts. Rather than teaching the principles of kidney disease treatment in lectures, students are given a patient case and asked to research and decide — based on the scenario — what needs to be done. Intuitively, it makes sense that it could better prepare students for working with patients, but the research on its use in the field of medicine is very minimal. In other fields PBL has been shown to increase retention of the curriculum, but only if organized and executed well.

      I had some PBL mixed in with my more traditional lectures in PA school and I thought it was interesting, but I’m skeptical as to whether it was more effective. We even used some software that presented an actual patient case and had you treat the patient “on the computer.” If you decided that you wanted to test the patient’s reflexes with a reflex hammer, you clicked a little icon that did that and then read what happened. It felt gimmicky and (in my opinion) was distracting and at times frustrating.

      I don’t know that I would make a choice of where to go to PA school based solely on their use of PBL. But it’s nice to know which schools are making concerted efforts to improve their curriculum by being progressive and trying new approaches. The jury is still out on whether it is “better” than other types of learning, so I don’t yet put too much faith in it. Evidence based medicine has taught me to be very careful about assuming that what seems intuitively to be the right thing to do actually is the right thing to do. You need to go by the research: what do the studies show? Unfortunately at this point, there is only very limited research on PBL in advanced medical training environments.

  91. somebodywhoisnobody says:

    Hey Paul,
    I wanted to give an insight in my scenario since everybody is different. Can you please give me your opinion? I went to San Jose State University and my grades were awful. 2.9 in pre-nursing for various reasons. I am independent, working full time. Ive recently gone back to a community college to get my head straight and am completing the pre-doctoral health sciences route with a GPA of 3.6 and rising. However as far as hce experience goes i work as a float pool cna in a renown hospital called John Muir for a couple of months now, ive observed a lot by working in departments from med-surg to i.c.u to the acute rehabilitation floor. Would you consider this a good HCE. should i do more than this or continue to pursue my education while working as a CNA and shadowing PA/MD in the ED. please offer any advice. i am thinking of taking an emt course this spring, should i do this though? i feel like the education Ive received more than qualifies me as a candidate but I want to stand out more, my life rides on this. I am 21 years young.

    1. If you are working with patients directly in the jobs that you described, then I think you are getting great HCE. I doubt an EMT certificate would make an impact on your application, unless you intend to work in Emergency Medicine for a year or two. I suggest you stick with what you have.

      Have you repeated the courses that are 1) sciences 2) that are required for PA school 3) that you got less than a B in? If not, that would be my recommendation to make the most improvement on your application. They don’t want to see that you can handle “hard” science courses. They want to see that you have mastered the specific material that they will build on in your PA classes. This means that an A in neuroimmunology won’t be as helpful as an A or B in General Chemistry, if you previously had a C in it or less.

  92. Rabiha Sabir says:

    Hi! I am looking forward to be a physician assistant in the future and I have started volunteering in a local hospital in the Nursery dept. Is this going to lead me anywhere. Also, a doctor has offered me to train me as a medical assistant. I am 17 years old and I am in my senior year. Is medical assistant a good career choice befpre entering the Pa program? Also, can you transfer to PA program after two years from any other major? I want to go in Biology and get my pre-rqs and then transfer from Biology to physicain assistant program in my 2nd or 3rd year. Can i do that or a full bachelor degree is required? How many years does it take overall to be a PA?

    1. The majority of PA schools require a bachelor’s degree. There are a few left that accept an AA, but I don’t recommend them — a bachelor’s degree is a functional minimum education in our society these days. Also, you will be competing against mostly people who have a bachelor’s, so you will be less competitive. If you were to go the AA route, you would get your AA with the necessary prerequisite coursework, then your health care experience (anywhere from a few hundred hours to 3000+ depending on the school) and then apply.

      Medical assistant is good experience, but I HIGHLY encourage you to wait to get that until you are done with your bachelor’s degree. I know, you probably don’t want to wait that long, but that’s what it takes to be a competitive applicant. If you really can’t wait, you might consider doing a little time as a volunteer at your university’s student health clinic. But again, I don’t recommend it — it will take you away from your studies, and there is nothing more important than grades when it comes to getting into PA school.

      1. Rabiha Sabir says:

        The school that I applied for is CUNY:City College of New York i want to go there for biology for two years and then transfer to their Physician assistant program which is in the same college. If I dont get in there, i am looking for a second option which is Suny Downstate medical Center, they also have a physician assistant program.

        1. Rabiha Sabir says:

          Also, can I get both bachelors and masters degree in physician assistant program? Like first I can do four years of biology, then two years of bachelors PA program and then Masters in PA program? Can I do that. Does bachelors have the same value a masters in physician assistant profession? Or masters is better?

  93. I am currently a firefighter in the United States Air Force. For the last 3 years on a day to day basis, I perform emergency medical care to patients including assessment and treatment. I was awarded the navy life saving award with the rest of my responding company for our treatment of a woman with suffering from Pulmonary Edema. I am interested in attending a PA program once I finish my degree. Do you believe that this medical experience is sufficient enough to make a positive impact on my application process? Or would it still be beneficial to volunteer in a clinical environment? Thank you.

    1. YES. That’s probably excellent experience. BUT, you really can only count the part of your firefighting work that was directly with patients, and I’m guessing that’s only 40-50%, maybe? Still could be a lot of hours, but just be aware of that fact.

  94. Hi, I’m going into my second year of undergrad as a Interdisciplinary Science Major with a focus on Health Science and my main concern is HCE. I was in line to take a Phleb class but it conflicted a lot with my college course and I was looking to pursue something else that is not CNA so I was wondering would EKG tech be a credible form of HCE for PA school.

    1. EKG tech is good. Respiratory tech is probably the best tech job (not counting paramedic). Have you looked into EMT?

  95. Hi Paul,
    I am a newcomer to this forum and would like some advice. I have been in the healthcare field for the past 8 years and wanted to know if I needed to gain more experience and what type of other experience would make me competitive for PA school. Below is a segment of experience that I have done:

    1.Psychiatric Technician June 2006-Sept. 2014
    • provided care to individuals with intellectual disabilities, limited skills, and who are mentally impaired
    • Administered antipsychotic and other types of medications; followed physician’s prescription orders
    • Prepared meals, assisted in hygiene care, bathing, toileting, and other activities of daily living
    • Obtained and recorded individual’s vitals in the residential group home
    • Observed individuals to detect behavior changes/patterns, documented, and reported observations to Medical staff
    • Lead individuals in therapeutic and recreational activities
    • Assisted with ambulation, transfers, and other forms of mobility assistance
    • Provided catheter care to individuals with catheters
    • Scheduled medical appointments for individuals living in the group home

    2.Medical Scribe in a ER for 3 months

    4.Caretaker for a month in a private residence
    • Supported a 25 year old female diagnosed with Rett Syndrome, in the comfort of her home
    • Provided enteral nutrition, mobility assistance, administered medications via PEG tube, while being supervised by a home health nurse
    • Identified that parents were experiencing caregiver role strain
    • Nursing care plan for family included assessing family’s support systems, educating family on stress reduction techniques, and providing emotional support

    I have other experience working in a hospital setting, however, I know it will not count because it was when I was a student nurse doing my clinical hours. Do you think I need more hours? I plan on doing non-paid volunteer experiences (first aid booths, missionary trips, for the next few days). My only fear is that my hours (besides those as a nursing student) were not in a hospital setting. Does the healthcare experience have to be in a clinical or hospital setting?

    Thanks in advance for your input. BTW your blog is amazing!!

    1. Thanks for your kind words. Why would you think that you can’t count hours that you accrued while you were a nursing student??? They want time around patients. It doesn’t matter too much if it was official or not, so long as you were doing some form of assessment and/or treatment. Since I don’t know how many hours you have in total, it’s hard for me to say. But you have a nice variety, and I recommend that.

  96. Alexandria says:

    Hi Paul!
    I am so happy to have stumbled upon all of this information! I’m having a real tough time trying to decide between a PA and a DO, leaning towards the PA route though.
    Anyway, I’m starting school in Sept for a Respiratory Therapist program. Hopefully this will give me a little leverage when applying to different PA programs. While in the RT program, I will be doing clinical rotations–do I count these as patient contact hours?
    Thanks for the wonderful postings!

    1. That sounds like it could be very helpful to get into a PA program.

      You count any experience you have. The part of it that you do with patients is “Patient Care Experience,” and the rest is “Health Care Experience.” They used to call the latter “Other Health Care Experience.”

  97. Hello Paul,

    I see you are overwhelmed by questions so I appreciate the time you put into reading this. I would like to share my situation because, as every other potential applicant here, I am searching for some peace of mind. I realize that PA’s come from many backgrounds and there is no specific major required for the undergraduate degree. However I am still concerned that my B.A. in English will cause me to be overlooked. I feel that since my decision to apply to PA school I have poured my heart and soul into the profession (ER volunteer, 2,000 hours of paid HCE, 4.0 GPA thus far in post-bac. prereqs, and shadowing of both PAs and MDs). Will providing sufficient reasoning for the switch in fields in my personal statement be enough to be considered as serious about the medical field or am I putting myself at a disadvantage by not receiving a more traditional pre-pa degree?

    With that worry in mind, I am also a Peace Corps volunteer and will be departing for my service this coming January. If you are unfamiliar with the application process I can tell you that describing it as lengthy would be a laughable understatement. I decided to apply to Peace Corps long before my decision to become a PA and my general duties in my assigned country of Colombia will have little to do with the medical field and instead focus on education. I have talked with Peace Corps officials about the medical opportunities for me during my service and while they have been encouraging there is no way to know what kind of medical impact I will be able to make until I am actually on location. Again I am worried that I will not be take seriously by PA admissions despite my other efforts.

    In your opinion, can my dreams of serving in the Peace Corps and becoming a PA coincide or must I make a decision to go with the Peace Corps or stay and complete an additional, science related, undergrad degree?

    1. Oh, I definitely think they could. English isn’t ideal, but (if I understand correctly that you’ve now graduated) you’ve proven that you can handle the science. Your good GPA will help you. Your Peace Corps time will show that you have a mind for service, which helps too. It won’t give you patient care experience though, plain and simple. You won’t be a medical provider. I work with a PA who served in the Peace Corps, so if you’d like to contact him, let me know and I’ll ask him if he’s okay with that (do this through the Contact link at the top of the main page). In any event, I think you’re worry about it too much. You sound like you have a solid application (obviously I say that with only a skeletal picture). Apply and see what happens.

  98. Hi Paul!
    I was wondering your thoughts on a recent job I have been offered and if it would be helpful for getting into PA school. I would be working one on one with autistic children using ABA therapy techniques, I would also become board certified as a Behavior Analyst. Would this experience be helpful and could I count it as hours? Previous HCE I have is working as a Clinical Assistant at Planned Parenthood for 2.5 years and volunteering with an HIV clinic for 200 hrs. At my current position
    I am a Surgical Recovery Specialist, I harvest ocular tissue for transplantation and research. Since the patients I work with are deceased, can I still count my hours as a Surgical Recovery Specialist as HCE?
    Thanks!

    1. Okay:

      1) that sounds like a good job! If you didn’t have the other more “traditional medical HCE,” I wouldn’t recommend it. But you do, so I think this job offers some rounding out of what you have — some medical, some psychological. I think it would be great to show diversity in your experiences.

      2) work with deceased patients like morgue tech, tissue recovery, etc. is countable as HCE. BUT, it’s the type that matters. This does not count as the most important type, “Patient Care Experience,” but instead as “Healthcare Experience.” Schools count this, but it’s not valued as highly as work done with (living) patients.

      To quote CASPA:

      Patient Care Experience
      Experiences in which you are directly responsible for a patient’s care; for example: prescribing medication, performing procedures, directing a course of treatment, working on patients as an active nurse or EMT, etc.

      Health Care Experience
      Both paid and unpaid work in the health or a health-related field where you are not directly responsible for a patient’s care; for example, filling prescriptions, performing clerical work, delivering patient food, cleaning patient rooms, working as a scribe or hospital volunteer, etc.

      I hope that helps!

  99. Paul, thanks for the site.

    I am currently working as a medical scribe for a cardiologist and family medicine NPs at the same practice. I have a second, part-time job as a pharmacy technician where I meet with patients admitted to the med/surg floor of the hospital to perform medication reconciliation. I confirm their home med lists and provide that information to the nursing and physician staff. I have been curious which position is more valuable as far as HCE as I am contemplating choosing only one of those jobs full-time.

    I value both jobs and would appreciate your input as to which would be better for me in both the application process and succeeding in PA school. Thanks.

    1. Just from what you’ve shared about the jobs, I would say that the scribe position is much better HCE than your pharmacy tech job, but that’s just my opinion. Pharmacy technician isn’t considered great HCE because of the limited role with patients. I understand that your particular position allows you to interact directly with patients, but it still doesn’t sound as relevant as working in a family practice and cardiology office.

  100. Hi Paul!
    Greetings from South Florida :) I am currently in the process of applying to PA schools and would very much value your advice on my current predicament :)… I graduated in May of 2015 with my B.S. in Biology (shocker lol) and have been working for the past year as a medical assistant at a dermatology office. I have accumulated almost 1500 hours of direct patient care (taking pt history, treating minor conditions i.e. warts, responsible for biopsy set-up, after care, and directly contacting pts by phone with results, etc.) and I absolutely love my job. The wonderful physician and CMA have each written a stellar LOR for me and I could not be more grateful… Anyway, I had previously shadowed a PA in California (just once) last Fall, but have now been presented with the opportunity to shadow said PA for ~ a month in August (in one month). I have a close bond with this PA and I think the shadowing hours and a recommendation letter from her would look great. So, my question to you is: would it be better to stay at my current MA position and rack more HCE hours OR quit this current position and shadow a PA for a month, accumulating PA shadowing hours and a LOR. This would leave me with just enough time to submit my CASPA app mid-September. Do you think I have accumulated enough HCE to quit and shadow a PA? I very much value your opinion. Thank you in advance!

    1. Sorry for the late reply, Paula, but I can’t advise you to leave a paying HCE job to shadow. I would advise you to stay where you are and consider a letter from someone else. Let me know what you ended up doing.

    1. Hi, Oge! You will get some credit for it. You should describe it as “medically” as you can — interviewing patients, etc. But that won’t by itself be enough, no matter how many hours you have as a chaplain. I suggest you get some additional experience in acute care (EMT, for example), or maybe CNA/MA. Well rounded is good.

  102. Hi Paul!
    I’ve been reading a few of your blogs during my search for PA schools and related HCE. I must say that they are very useful and helpful, keep them coming! Right now, I’m currently in school working on my BA in psychology and will graduate this December. After graduation I plan to enroll in a training school for phlebotomy and ekg where I can hopefully get a job. After gaining a some experience in phlebotomy and ekg on the job, I plan on enrolling in a LPN program as I feel it will better prepare me to become a PA. As you can probably tell, I am very interested in the healthcare field especially nursing and PA. Lately, I find myself being more attracted to the PA field for the ability to change specialities without needing any additional schooling (ex: a NP who wants to change from midwife to anesthesia has to go back to school). So my questions to you are: Will being a LPN count as a good HCE for applying to a PA school or will it be used against me (I might as well continue to become a RN)? Along with training to become a phlebotomist and ekg tech, should I just add CNA and become a PCT instead? Which of these healthcare titles you think will provide the best HCE to become a PA? Please respond as I am having difficulties on which route to take. I would really appreciate your input and advice!!

    1. I don’t recommend that anyone go to nursing school (LPN or RN) unless their ultimate goal is to become a nurse. PA schools might wonder why you are applying to PA school and not nursing school! Phlebotomy and EKG tech are good. EMT is excellent too. Stick with those, and you should do fine. You might contact the schools where you want to go most and ask them. Some really like CNA/PCT, and others don’t think it’s good HCE at all. It really depends.

      1. So I guess I’ll just forget about doing LPN based on your advice & also because LPNs are not usually hired in hospitals. I feel that working on a hospital would give me lots of exposure in different health care specialties. Like you said I’ll talk to the schools I’m interested in & see what they say. Thanks so much for responding Paul, I really appreciate it!

  103. Samantha Williams says:

    Hello,
    I am a junior in college and I became interested and decided to become a PA a few months ago. The only HCE i have is when I went to Honduras on a global medical brigade for a week last year and that was about 40 hours total of shadowing local and American doctors, doing patient data entry, and triage. I signed up for an EKG interpretation class which then prepares us for to sit for the ACSM certification exams. However, I will probably just take a CET certification exam online. I was wondering if the EKG certification is a good idea and then working as a Cardiology Technician in a hospital considered strong HCE? Or should i get another certification? Everyone has either a CNA or EMT certification and I thought EKG might be something different in a good way. Also, they’re very expensive.

    Thank you.

    1. Yes, EKG tech is good HCE. Just remember, though, it’s the time with patients that gets you credit, not just having the certificate. A certificate by itself isn’t HCE.

  104. Hi,

    I’m 24 years old and I’m currently obtaining a bachelors of science. I’m a junior in college. My major is health science. I’m a C.N.A and I worked in a nursing home for two years but I’m currently I’m a private C.N.A because I wanted more time to study. I’ve been a private C.N.A. for an additional two years. I graduate in about 1 and a half years to get my bachelors. My C.N.A expires in 4 months from today. My question is should I look for a hospital job with my C.N.A to maintain it to get into PA school? Or get a certificate in ekg/phlebotomy or do a EMT class and work on an ambulance/er tech room? I don’t know what to do.

    1. I’m looking to leave my private care job because I know private care isn’t really considered a HCE for PA school. I also don’t want to lose my C.N.A. but I heard the work that a C.N.A. does wouldn’t prepare me well for PA school nor would it probably get me in the program unless I add some other certificate with it like ekg/phlebotomy/EMT/ER tech with it. Is that true? That’s why considering which certificate would be beneficial for me to add onto my C.N.A.

      1. Sorry

        Also what are your thoughts on medical assisting to get into PA school?

        1. Medical mission trips are a great way to get exposure to medicine. They are generally short (several weeks at most, usually). But they can be and AMAZING learning experience. You really can’t use them for all your HCE because you will need many more hours with patients than that. BUT: they do keep you fired up, interested, and (my favorite thing) exposed to a wider breadth of medicine. So do a mission trip if it calls you to. Then use that to parlez another position back home that will get you more HCE.

      2. Some schools don’t like CNA, but some love it. My suggestion is you call the schools you are considering applying to to get their specific stance in relation to CNA. Also, try to vary the kinds of HCE you get. Variety will improve your understanding of medicine, and show your commitment to learning. If you can get an additional certificate along the way, great. Just remember, it’s not the certificate that gets you credit with PA school, it’s the TIME WITH PATIENTS USING THAT CERTIFICATE.

    2. I would advise you to hold on to your CNA certificate for sure! You might want to add EMT to that, or try to find a CNA job in a different setting. think of it this way: the more different skills and experiences you can show them, the better. Don’t go crazy, but broaden what you know. CNA and EMT is a nice mix of acute and non-acute care experience.

  105. I just heard about medical mission trips. It’s volunteer work. Would that be a good HCE?

Leave a comment