Shadow a physician assistantHow To 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 for Shadowing A PA:

  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.