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Question on prompt....

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Personally, I think if you write a well written answer either way it will be fine. They can't ding you for not answering the prompt if you answer about something in your past, as your academic success has been built up over time and is not something you are going to start in PA school, for example. If the question was what is the greatest barrier to you as a PA student, it would be obviously looking towards the future. Also, schools seemingly want to know more about the challenges you have overcome as opposed to the ones you perceive facing in the future. I would write it for the tense that you have the most solid answer for, but I don't think there's a right or wrong answer since the question is rather vague.

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