Shadow a Physician Assistant the Right Way

We’ve talked about why you need to shadow a physician assistant, and how to find a physician assistant to shadow.  When it’s time to actually shadow a physician assistant, there is definitely a right way to go about it.  First, know the four Cardinal Rules.

Cardinal Rules to Shadow A Physician Assistant:

  1. Be professional; first impressions are lasting.
  2. Stay out of the way; PAs are busy folks.
  3. Learn all you can; shadowing is a great opportunity.
  4. Be grateful; they’re taking time out of their day for  you.


  1. Before you shadow a physician assistant, get clear with the PA you will be observing about when you will join them, and for how long.  Ask where it would be most convenient for them to meet you.
  2. Find out if there is any special hospital or clinic permission you need to obtain.  Some settings will have you complete a HIPPA confidentiality agreement, since you will be exposed to people’s protected health information (PHI).
  3. Spend some time thinking about the big questions you have about the PA field.  Write these down, bring them with you, and make sure you get them answered.
  4. Wear appropriate, professional clothing (no jeans of any kind!)  Men: khakis with a collared, button-up shirt without a tie.  Women: slacks or skirt and blouse without heels.  Note: if you shadow a physician assistant in an emergency room, things are more casual (but still no jeans).
  5. If you have a stethoscope, leave it at home.  If the opportunity arises to listen to a patient’s lungs or heart, someone will let you use theirs.  You’re not there to treat patients, you’re there to learn about the work that PAs do.
  6. Show up early; on-time is late. Getting there early gives you time to get oriented, use the restroom, meet the staff, and get settled.  It also shows your motivation.


  1. Introduce yourself and be friendly to everyone you come across.
  2. Use a pen and notebook to write down questions about what you observe.  Don’t write while you’re with patients, and don’t write any private information about patients.
  3. Stay out of the way, and don’t touch patients unless specifically asked to.
  4. Avoid talking too much.  All PAs are different, and you’ll have to play this one by ear.  But when in doubt, remember the old adage: there’s a good reason we all have two eyes and two ears but only one mouth.
  5. When you shadow a physician assistant, questions are okay, but avoid baraging your PA with them.  Save them for between patients, or until you are asked if you have any.
  6. Be yourself and don’t try to impress anyone.  It’s natural to want to appear competent and knowledgeable, but you don’t need to.  If you feel you must demonstrate that you’re not an idiot, ask a question that shows you’re thinking about what see.
  7. If you can be helpful, do so.  Little things like going to get a gown, or finding a medical assistant when one is needed are always appreciated.
  8. If you have a chance, two great questions to ask are “What do you love about your work?” and “What part of your work could you do without?”
  9. If things get hectic, hang back and be understanding.
  10. There will be times when you aren’t sure what to do.  You might feel like a “fifth wheel.”  That’s okay.  These are good times to write down questions and make observations.
  11. Before you leave, give a big thanks to the clinician and shake his or her hand.  They’ve done you a big favor.


  1. A day or two after you shadow a physician assistant, send a brief thank you note (not an email).  Consider including a $10 gift card for Starbucks or iTunes (iTunes is great if they use an iPhone while they work).
  2. Keep the PA you followed informed of your progress.  When you get into a school, be sure to let them know about it.  There could even be a preceptorship or a job for you down the line if you do.
  3. Keep track of the time and locations for your shadowing experiences.  Some schools will accept these as patient contact hours.  If not, they still count as “Health Care Shadowing” on your CASPA application.
  4. If you shadow a physician assistant who isn’t particularly helpful or interesting, don’t get discouraged.  Seek out others to shadow – it will give you a broader experience of the field.

To shadow a physician assistant is to be open to the experience.  Don’t worry if it turns out differently than you expected.  That’s the whole point of shadowing – to see what working as a PA is really like.

  • ZMD February 28, 2011, 9:20 pm

    Excellent outline!

  • N July 16, 2011, 10:24 am

    It sounds good with the exception of a $10 gift card. I would never include a monetary gift. It could imply that you are trying to “buy them off”. At best, it is awkward.

    • Paul July 16, 2011, 11:20 am

      It’s really no different than taking them out for coffee, but they can do it when it’s convenient for them. The way I see it, they’ve done something for you and this is a nice (small) way to show your appreciation.

  • Renata Castelo November 15, 2011, 12:29 pm

    Great website! I’m looking in applying for PA school next year. I have an opportunity to shadow an NP. What’s your take on that? Should I concentrate on shadowing a PA instead?

  • carmi January 13, 2012, 12:40 pm

    when should you start seeking a PA to shadow?
    should you do it right when you think you have a interest for this field?
    or when you are half way through your studies and have an understanding of some science?

    • Paul January 13, 2012, 3:10 pm

      The sooner the better. This way if it turns out to be different than you expected, you arent locked into it. Also, the more you shadow, the better idea you get about what kind of PA you want to be.

  • Sara January 21, 2012, 6:52 pm

    I’m having a difficult time finding a PA to shadow in my area (Boca Raton, Fl), any suggestions?

    • Paul January 21, 2012, 9:42 pm

      There’s a link to a PA shadowing site on our links page. They’re not huge yet, so I can’t tell you if they have anything in that area.

      I think most shadowing gigs come using your personal contacts. Know someone who works in a doctors office or hospital? Use that connection to your advantage – have them ask around for you. I’ll be coming out with a podcast in the next week that will cover this topic, so keep your ears open for it!

    • Tesha March 2, 2012, 2:51 pm

      I contacted the closest PA program and asked if their hospital had any PA’s that wouldn’t mind being shadowed and they sent me a list.

      • Paul March 2, 2012, 3:39 pm

        That’s a simple but elegant solution!

  • Jack February 17, 2012, 8:24 am

    Hey, I am looking into being a PA, I know I want to do something in the medical field. My science GPA is 3.1 and my overall is about 3.4. Is this good enough? I am graduating in the next couple months. What should I do right now to start on the path to becoming a PA?

    • Paul February 17, 2012, 9:52 am

      Hi, Jack. Definitely, with the GPA numbers you mentioned it would be a challenge to get into a PA program at this point. I don’t know what you majored in, but if you have PA school prerequisites to take, I would start there, and plan on getting A’s. If not, you may need to take some other science courses and do well to demonstrate that you can handle the challenging courseload of PA school.

      Another option is to work in medicine in another capacity for a while, take some time away from school to regroup, and then restart as a pre-pa student when you have a little more perspective. Its a little easier to make the case that you’ve turned things around if you give it some time. That way you can argue, “I wasn’t a hugely motivated student coming out of school, but after some time working in health care, I have reprioritized and I’m ready to tear this thing up.” This will also get you going on the needed health care experience front in the mean time.



  • Lauren March 30, 2012, 9:33 am

    Great outline, thank you! Question though, is shadowing only something you do for a few days or weeks? You see I am a freshmen in college right now majoring in biology and I am considering becoming a PA. I found an office near my home that offers shadowing and wanted to know if shadowing is something you can do over an extended amount of time, like during the summer, or is that considered volunteering?

    • Paul March 30, 2012, 1:05 pm

      Great question, Lauren. I recommend you do as much shadowing as you can up to the point where you have a job. In most cases, I wouldn’t continue to shadow if you can do paid work instead (unless it’s to see another specialty that interests you). Make sure to reach an understanding with the PA or MD beforehand so that everyone’s on the same page. You can do a few days, or you can do a summer. I also like longer term because they have a chance to get to know you, which often leads to letters of reference, and even a job, down the line.

  • Phil April 19, 2012, 9:51 am

    Thanks for all the information on the website, it is very helpful and much appreciated. I am looking into applying for the next round of PA application. I had a 3.49 GPA and 1370 GRE. Are these scores about average for most schools? I know they are all different but just trying to get an idea. I interned at a doctor’s office for a summer a few years ago and I am trying to shadow as many PA’s as possible this summer. With work, though, it is tough to schedule a lengthy time with any one PA. Would it be rude to ask for a letter after 3-4 sessions (schools I am considering are asking for at least one and prefer 2-3)?
    Thanks again

  • Kate May 31, 2012, 4:57 am

    Excellent advice!! Thank you!

  • jessica October 22, 2012, 4:34 pm

    seems like good advice, but do you think it’s ok to not bring the notebook? i don’t want to seem like i don’t care, but i’ve shadowed without it and asked my questions, etc, without writing them down, or the answers. AND, what about a PA you’ll be shadowing for a long time?

    • Paul October 22, 2012, 8:42 pm

      It’s not going to hurt you in their eyes, but if you don’t write things down, you may forget them, and you may get less out of the experience. You don’t need to bring a big old folio. Just a little pad or some post its in your pocket so that the little questions don’t escape you.

  • Rina December 10, 2012, 8:16 pm

    I’m currently working in a completely different field than the health industry and looking into new career opportunities. Can I shadow a PA without any historic experience that’s health-care related or no science classes taken? If not, what type of back ground is necessary to shadow – curious if this differs by hospital? Any advice is greatly appreciate, thank you

    • Paul December 11, 2012, 8:09 pm

      Yes you can. In fact, that’s what shadowing is for – to give you exposure to the field to help you see if it’s for you. Just tell whomever you end up shadowing that you know you want some type of a career in medicine, but you don’t know if PA is the one until you see it a little more closely.

  • m December 27, 2012, 4:19 pm

    Hi Paul,
    I am curious if there is an upper age limit to becoming a PA? As far as shadowing, I am very interested in 3 or 4 areas, neurosurgery, pulmanology, ER, and Psychiatry. Each are above the 4.0 on the msat, when will this make a difference?

    • Paul December 27, 2012, 10:04 pm

      There is no official age limit. I was among the older students in my class at 41, but a friend in my class was 53. It depends on the applicant and the school. But age can be an asset if sold properly.

      I’m not sure what the msat is and what 4.0 represents in your question. If these specialties interest you, you can work in them. There is no “matching” like in medical school; if you get a job in one of these fields, you will learn about it and develop it as a specialty if you choose to.

      There is a new development in the area of specialties: CAQs.

      A CAQ is a “Certificate of Added Qualification.” Already licensed PAs, after fulfilling the experience and testing requirements, can earn a CAQ, which reflects specialist knowledge in a particular area of medicine. Starting in Septemeber of 2011, the following CAQs were made available:

      – Cardiovascular/thoracic surgery
      – Emergency medicine
      – Nephrology
      – Orthopaedic surgery
      – Psychiatry

      I hope this helps!

  • Mudassira February 8, 2013, 2:20 pm

    Can I shadow a Physician if i dont find any PA’s as I have far relative of mine who is Physician and hope she could help me with shadowing.So is it allowed to shadow a physician in PA program?

    • Paul February 9, 2013, 12:38 am

      Yes, it’s fine. But you should try to do at least a little time with a PA if possible so you’ll know what to say if they ask you to describe the PA role.

  • Monique February 15, 2013, 2:15 pm

    Do you think I would be a at disadvantage since i’m doing my first two years of school at a Community College? I plan on getting a bachelors degree but that wont be for another year. Should I shadow now or wait until I have completed my associates degree?

    • Paul February 15, 2013, 2:21 pm

      For the vast majority of PA schools, community college is fine. Do it however you need to in order to assure that your GPA is as high as you can get it.

  • Eryn May 17, 2013, 11:16 am

    Hello Paul,

    i am looking to get an Associates of Nursing degree from a community college and then transfer to PA program. Would this be practical? Could this plan possibly work? I have a Bachelors degree but am looking for a change in my career path. Would it be beneficial for me to go back and get another Bachelors in nursing and then go to a PA program? My thought process was actually to go to a program that offered both a B.S and M.S degree for Physician Assisting. I thought that the practical experience with patients a nursing degree would offer me may give me a leg up. Also I have no idea where I would like to specialize as a P.A, although I believe I would enjoy Pediatrics. I would like to start shadowing to get a feel. What would your suggestions be?

    Please let me know if I am thinking straight on this one or not.

    Thanks for your wonderful insight,


    • Paul May 17, 2013, 4:15 pm

      If you get an AA, I tend to think you can major in nursing without too much problem. But you WILL need a bachelor’s degree of some sort, and at that point I don’t recommend a BSN. You could start in nursing and maybe carry over to health/health education/nutrition/communication/public health/biology, etc.

      Speak with an advisor about this to make sure that your ASN coursework will transfer for the most part.

      I guess I should come out and be clear – it would be very hard indeed to get into a PA program with an ASN. But if you get your ASN and continue on to a relevant bachelors degree, this seems like an okay choice.

  • Emily July 6, 2013, 5:47 pm

    I will be shadowing a PA for at least 50 hours this up coming month and I am interested in asking her for a letter of recommendation. Do you think this is enough time for her to feel comfortable enough to write one for me? How could I go about asking her? Because I don’t want to wait until the last day/week or so to bring it up, so how do I prepare her so she knows that I am interested in a LOR?

    Thanks for you help and insight.

    • Paul July 8, 2013, 10:02 am

      I would put it to her:

      “I’m in the process of applying to PA school. Would you feel comfortable writing a letter in support of my application?

      It depends on 1) how she feels about you and your ability, 2) if she feels she has had enough time to get to know you, 3) her other time commitments.

  • J Philip Festa October 24, 2013, 4:13 pm

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  • Hannah November 16, 2013, 9:14 am

    Hi Paul,
    First of all, thank you so much for making this awesome website. I am currently a first year PA student, and I am thinking about shadowing some PAs during my school break to learn about different specialties out there, and also start making connection for future job opportunities. Do you think that is a good idea? I am a bit concerned about them thinking that I am looking for a preceptor. Also I don’t know if they will think I am stupid if I cannot answer some questions as a PA student. I would really appreciate your input.

    • Paul November 28, 2013, 4:33 pm

      I understand your concern, but don’t let that stop you from asking. If you already have preceptors lined up, you can tell them that to put them at ease. I think your desire to shadow while on break shows your motivation, which would be attractive to just about any employer.

      Don’t worry about not being able to come up with the answers; everyone goes though the “pimping” process (when you are asked questions as a part of the learnning). They really don’t care TOO much how well you answer them. Usually pimping is a way for them to assess where you are in your learning, and to teach you new concepts. Not much sense in asking questions about things you already know, right? When they pimp you, they “feel out” the boundaries of your clinical knowledge.

  • Asad March 13, 2014, 10:55 am

    Hi Paul, this is a great website, I’ve looked through most of the info here is it’s given me some great insight.

    For me it’s just been hard trying to find a P.A to shadow, I’ve done most of what you suggested, and now I’m volunteering at my local hospital, that has a Shadow program, and the Chief- P.A introduced herself to me the other day. But my main concern is asking them for something like shadowing, because I know they are extremely busy. If you can offer any additional guidelines I would appreciate it.

    • Paul March 24, 2014, 1:14 pm

      I think you are on the right track. In general, you need to make a personal connection with a PA or physician in order for them to be motivated enough to offer up their time to you for shadowing. People find it hard to say no to those whom they know personally, even if it’s just a face and a name. Don’t despair – you’ll find a gig.

  • Genesis May 22, 2014, 11:02 am

    Hi, I am only a high school graduate (going to college in the fall) but I am strongly interested in the PA profession. I currently volunteer at a hospital and I had the opportunity to speak to two PA’s and ask them a few questions. In the end, one of the PA’s gave me the Chief PA’s phone number and told me to call him the next day if I was interested in shadowing. But when I spoke to the second PA, she told me that it was too early and that I should wait until my sophomore year of college. So my question is: when should I call? Is 17/18 too young to shadow or should I start now?

    • Paul May 24, 2014, 11:17 am

      I don’t think it’s too young to be willing to shadow, but for practical reasons, it’s probably not going to happen until you’re older. Hospitals these days have pretty strict requirements set by their insurance carriers, and state law. The clinics that legally could take you probably won’t feel that it’s worth the liability to do so. My advice: get your CPR and First Aid, do well in school, and volunteer your summers where you can see some medicine. Then you will be ready for shadowing when you’re an undergrad.

      Good for you for planning ahead!


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