Jump to content

More Patient Care Experience?


Recommended Posts

How can I get more patient care experience besides volunteering? I don't have many direct patient care hours (only about 100 hours volunteering and 130 shadowing hours). I applied this cycle, but it is looking like I'm going to have to re-apply next cycle. I was rejected by one school and waitlisted at two. I'm still waiting to hear from another one but I feel like I'm waitlisted. Some schools don't count volunteering as direct patient care experience since you don't really do much as a volunteer. I'm trying to apply for jobs with direct patient care, but it is hard since I'm not a CNA or anything like that. I don't have time to take a CNA course and find a job doing that before the next application cycle. I applied for an ER scribe position, but I didn't get it. What are some other entry level positions that I should look for?

Link to comment
Share on other sites

Audrey - I don't know how strong your overall application is, but it seems safe to say that you need more quality patient experience hours. Assuming that is the case, I would do whatever I needed to do in order to get the best patient experience possible. If you can find that opportunity right away; awesome. However, you may have to start somewhere else. I started out as a CNA at an assisted living home, which was very hands on but could only teach me so much. I kept my eye out for other opportunities and eventually found a great position that didn't require an official certification, but my previous CNA experience helped me land the interview. Good luck figuring things out. 

Link to comment
Share on other sites

  • Moderator

most folks either get experience in school, after graduation or both. you have done neither. it's a big part of the app. and 230 hrs of volunteering/ shadowing will not cut it at any reputable program, sorry. most programs will count that as zero hce. many requiring shadowing but don't count it towards hours. even with a 4.0, perfect gre, and a letter from the surgeon general you would not get into 95% of programs. the average accepted pa student per the aapa has THREE years of hce....that doesn't mean you need 3 years, it means many folks have that much or more and some folks have less(thus an avg).

1000 hrs is really the basement level for most respectable programs. a couple will allow 500 hrs but shoot for 1000. you will be 1 yr older next year whatever you do. stuff worth while is worth planning and working for.

I'm slogging through a 4 yr doctorate program right now. one class at a time. eyes on the prize.

Link to comment
Share on other sites

As an ER Scribe and EMT-B, I actually have to disagree with EMEDPA a little.  I was an ER scribe and I think it was much better than working as an EMT-B.  You really get to know the entire healthcare team, and are also a part of that team.  EMT's are certainly part of that team, but you don't really see much of the hospital side unless you are a EMT-P, or EMT-I.  CNA is a really good job as well.  Lets not forget you can always be a home healthcare aide.  Many of these positions don't require training, just compassion and things like CPR and BLS training.  

 

I think it is funny how everyone talks about a "respectable program"/"reputable program" and tries to knock all the other ones that require less hours.  At the end of the day, no matter what program you attend, if you pass the program and then PANCE you are a PA-C.  Where you went to school, in my opinion, has no bearing on how compassionate you are, or your quality as a healthcare provider in the end-- it all comes down to you.  Of course you want to make sure your program is stable though.   I would suggest getting more hours until you at least feel comfortable applying to schools.  

 

There are plenty of programs out there that require 200-500 hours.  Sure, they might not be MEDEX, or Stony Brook, but who cares.  If you find a program you like, have researched it well, and feel confident in its direction-- go for it.  You do not need 3000 hours to know you want to be a PA, or to get an interview.  However you need to have a comfort level when you apply.  You do not want to waste your time applying if you are not confident in your experience.  I think what helped my application was that I had many experiences besides healthcare that gave me transferable skills-- I was very well-rounded with many different life experiences.  

 

I was an ER Scribe for 450 hours, EMT volunteered for about 100 (disliked shuttling elderly people around), shadowed 3 PA's for 300 hours.  Total of about 800 hours.  I also shadowed in other fields as well, so I knew I wanted to be a PA.  I applied to seven schools, received 6 interviews.  They were not Emory, Duke, MEDEX, SBU, or Stanford-- but they were still schools I could see myself going to.  For me I never wanted to go to a fancy, big name school, with a high-reputation-- I wanted to go to a school I could see myself at, and with classmates and a faculty that fit with my personality.  PA school is difficult enough to get into... even with 3000 hours it won't guarantee you a spot in any of these "respectable" programs.  Take Dr. David Jackson, faculty member of NYIT-- he is a board member of the AAPA, former president of NYSSPA, and received his PA degree from Touro College in New York.  This school requires 100 hours or so I believe.     

 

One of the brightest individuals I have ever met when I worked as a scribe told me that it doesn't matter where you go to school.  He stressed finding a school that fits you, and if you can, find one that is cheap as well.  He went to some rinky-dink noname college and now works at NY Presbyterian/Weill/Columbia Medical, hes published, and an associate professor at Cornell.   

Link to comment
Share on other sites

  • Administrator

The thing about being a scribe is that you don't have any decision making responsibility.  It's great for understanding healthcare, I get that, but a scribe is not in any way responsible for independent patient care.  PAs don't just need to understand things, they need to exercise leadership capability, and no amount of scribing will give you that.

Link to comment
Share on other sites

comany9,

 

Well said! And leadership can come from lots of different life experiences, Rev, even beyond healthcare. 

 

While there is a tendency to see PA applicants as a homogenous pool who differ only in the amount of healthcare experience they have, that is often not the case. Everyone has their own story. It is difficult to read anyone's post and decide if they would be a good applicant. And there are many good programs out there.

 

What I don't think you can do is decide to become a PA without really understanding the job and its demands. That requires some significant shadowing and those of us with PA jobs need to be open to doing that. And it requires some healthcare experience. It should be as relevant as possible, but chances are, it won't teach you all that would be nice to know about healthcare. Hopefully it will let you know whether a life among patients and multiple healthcare providers is for you.

 

Find what you can find and do your best. You are not just checking boxes on an application; you are trying to find your own way in life.

Link to comment
Share on other sites

Thanks everyone. I was thinking about doing a CNA program, but I'm trying to save money...I'd rather find something that I don't need to spend a lot of money first. What should I be searching for on job websites when trying to find a job? It is annoying because I live in a small town so there aren't many opportunities.

Link to comment
Share on other sites

  • Moderator

As an ER Scribe and EMT-B, I actually have to disagree with EMEDPA a little.  I was an ER scribe and I think it was much better than working as an EMT-B. 

it was the emt-b experience and the overall package that got you interviews, not the scribe time. good emt-b/er tech jobs are awesome. as an er tech I was used for everything the rns were with the exception of placing foleys and hanging blood. I started IVs, gave breathing tx, did ekgs, participated in codes, etc

we go round and round here about scribe experience. most places do not count it at all. look for a recent thread by wesr gordon( a scribe proponent) about how he applied to multiple programs with scribe experience and didn't get in anywhere and now is looking for something else so he can reapply. scribe is mobile transcriptionist/shadowing for pay.. no decision making at all. no hands on at all. it is watching other people work. while that has value(like shadowing) there is no sense of taking responsibility for pt care even in a minor way like cna. there is no touching pts.

Link to comment
Share on other sites

Audrey,

 

There are a fair number of PAs that believe it is impossible to turn someone without a ton of clinical experience into a good PA and you will never change their mind. Period. They believe that Eugene Stead created the PA as a second-career profession and that is how it must be. (Of course, many of these same folks overlook the fact that Dr. Stead envisioned us as a primary care profession but they support fracturing the PA profession into all kinds of specialty practices and CAQs.)

 

I can tell you that in terms of performance during the program and in program outcomes, we have seen no difference between people with lots of experience and those with close to none. (And I am talking about people like army medics with combat experience - not trivial experience.) There is no data linking experience to outcomes. It would be a great dissertation topic if the data could be easily had.

 

I like Rev and EMED and you will almost always do well to listen to them, but respectfully: they are wrong here. Work on getting experience and in the meanwhile apply to programs that do not share this mindset.

Link to comment
Share on other sites

  • Moderator

I have to disagree on outcomes. sure, students from lots of different backgrounds do fine in school and on pance.

it is the first yr in practice where you can see the difference. I have seen hundreds of new grads from varying backgrounds enter various fields and I call always tell who had significant prior experience and who did not. the prior medics/etc hit the ground running with significantly less oversight and significantly more comfort with patients. they are more efficient, have  better interactions with patients and make fewer mistakes. many new grads from low hce programs, even those with great grades, need a lot of hand holding for the first yr or 2. we hired a new grad from one of these programs a few years ago and everyone who worked with her the first yr (including the docs) described the experience as "painful" and we decided thereafter to not hire any more inexperienced new grads. I just had a medex student for his last rotation and he was already beyond the level of this other licensed pa who has now been out of school for 2 years.

Link to comment
Share on other sites

I know it is not ideal, but I would strongly consider taking the time to obtain a position as a CNA or EMT. You could look for a PCA position which often does not require any formal training, but I have known other applicants who received feedback from certain schools saying that this position did not have the desired level of direct patient care. However, if you directly contacted the schools you are interested in you may find that this experience fulfills their requirements although you may have fewer options. Another option is a physical therapy aide, but I have volunteered as an aide and it involves very little decision making. I am working as a scribe, but as others have already stated this does not fulfill the health care requirement of many schools and I am also going to take another year to obtain CNA experience if I do not get in on my first attempt. If you have not already I would check with your state and see if there is a test out option in to allow you to avoid taking the class. Whatever position you decide to obtain contact the schools you are interested in directly to avoid any potential problems.

 

I think many schools will look at your willingness to improve your application and apply a second time in a positive light and see someone with determination and perservence. However, if you do not have the appropriate experience and have to apply a third time I am not sure how this would be viewed by the board of admissions. Certainly people get in after applying a third time, but I don't think that is a position I would want to be in.

Link to comment
Share on other sites

I have to disagree on outcomes. sure, students from lots of different backgrounds do fine in school and on pance.

it is the first yr in practice where you can see the difference....

 

So please, I implore you: find me some data to back this up other than anecdotal observations. There must be something. Malpractice stastistics? Anything? We survery our grad employers a year out of school and have not discovered a difference.

 

I am of course not knocking experience. It is one component that contributes to success in PA school. (At times, it also provides a challenge - It has been tricky on occasion to convince former medics and EMTs that there is a substantial difference between a run report and a full H&P.)

Link to comment
Share on other sites

  • Moderator

I agree that there are some folks, especially medics, who can not get out of the mindset of being medics. those folks don't end up graduating.

as far as data, I wish there were some as well. I think the study would have to be double blinded. docs would not know the backgrounds of new hires and new hires in the study would be forbidden to discuss their prior life. SPs would work with them for a month(or more) and then rate them on some scale with regards to clinical acumen, ability to be self-directed, etc. You would need probably at least 100 sp-pa groups with 50 of each and to avoid bias should use folks of about the same age(say look at grads in their mid 30s both with and without experience as a bunch of 23 yr olds and a bunch of 45 yr olds would be a bit obvious)

I think that study would favor prior hce folks> non-hce folks.

would make for a great masters thesis if any students out there are looking for a topic.

Link to comment
Share on other sites

  • Moderator

I would disagree. an fmg certainly has more book knowledge than anyone else but they only have student rotations for experience and these can be of varying quality, especially overseas.

if you were arguing for a licensed fmg with 5 yrs experience practicing in their home country in primary care then I agree they would be good candidates. many programs such as medex admit these folks.

Link to comment
Share on other sites

  • Moderator

my only potential concern with fmgs is that they were trained as docs and the mindset has to be a bit different as a pa. also there are ways for fmgs to become licensed docs here already. pass usmle and do a residency or do a program like the nycom  3 yr fmg to do program.

language proficiency can be an issue as well.

for the older fmg who does not want to start over as a doc here I am ok with them applying for pa programs. I know several who did this and are great pas today.

Link to comment
Share on other sites

it was the emt-b experience and the overall package that got you interviews, not the scribe time. good emt-b/er tech jobs are awesome. as an er tech I was used for everything the rns were with the exception of placing foleys and hanging blood. I started IVs, gave breathing tx, did ekgs, participated in codes, etc

we go round and round here about scribe experience. most places do not count it at all. look for a recent thread by wesr gordon( a scribe proponent) about how he applied to multiple programs with scribe experience and didn't get in anywhere and now is looking for something else so he can reapply. scribe is mobile transcriptionist/shadowing for pay.. no decision making at all. no hands on at all. it is watching other people work. while that has value(like shadowing) there is no sense of taking responsibility for pt care even in a minor way like cna. there is no touching pts.

 

I didn't even put my EMT hours on my CASPA... so I must be really special I guess.  The problem with Wesr Gordon is he obviously didn't research his schools enough and call to ask about HCE.  Also more schools now are accepting scribe hours.  Also I don't know why you are hating on scribes so much.  Just because you don't make decisions, and get hands on, doesn't make you useless-- do you talk down to your patients like that?  I did more than shadow... and I didn't just watch other people work-- I WORKED.  I had to juggle 10 patients at a time, all there paperwork, make phone calls, referrals, communicate between everyone.  

 

I think scribe is good because you are taught by many people how to think, and how they make decisions.  Just cause you were an EMT doesn't make you good at making decisions.  Even admissions counselor I talk to has told me the value in being a scribe over EMT in many cases... but according to you these admissions counselors are probably not real-- right?  

 

Were you ever a scribe... no.  So how can you tell me what I did for my job, and how unimportant I was, "paid for shadowing".  

 

You think EMT is good cause you are a ER PA... you have always thought the same.  Different clinicians, think differently... open your mind.  

Link to comment
Share on other sites

Well said, UGoLong.

 

There are three issues at hand:

1.) How can one become a good PA without prior HCE that involves decision making and doing procedures?

I will defer to the seasoned PAs and let them respectfully (or not) and vehemently disagree with each other regarding that question.  However, as a future applicant, knowing that it is debated would make me choose the more conservative option so as to avoid having this argument with admissions when I apply.

 

2.) How can someone with little to no HCE even consider becoming a PA?

As someone with little HCE considering PA in the distant future, I would say that I started researching the profession because of life experiences. I have had leadership roles, collaborative roles, and experience in using first responder training in an unofficial capacity (treating hypoglycemia, minor wound care, administering various meds such as Epi-Pen, nebulizer, etc.).  Shadowing a PA convinced me it was a job I would enjoy and could do well.  However, I was also convinced that for me, personally, I would feel underprepared if I did not have a few years of good HCE under my belt before I applied.  It was not whether admissions would consider me a good candidate, but whether I felt I was ready to apply.  I read somewhere that there are few unreachable goals, just unrealistic deadlines.

 

3.) The original issue: How can someone with limited HCE improve their application? 

Many have suggested EMT-B and/or CNA certification and take some time working in one of these fields before reapplying.  Seeing this information repeated in multiple forums by a variety of experienced PAs and individuals suggests it is a universal truth.  While it has been debated how much minimal experience with direct patient care including decision-making and procedural skills can impact PA-S and PA-Cs in their first few years of practice, it is nearly impossible to figure how a large amount of quality HCE could hurt an aspiring PA. As for FMGs, I would consider the fact that I would be competing with them for a seat to be motivation to exceed the average HCE for an admitted student prior to applying.

 

comany9,

 

Well said! And leadership can come from lots of different life experiences, Rev, even beyond healthcare. 

 

While there is a tendency to see PA applicants as a homogenous pool who differ only in the amount of healthcare experience they have, that is often not the case. Everyone has their own story. It is difficult to read anyone's post and decide if they would be a good applicant. And there are many good programs out there.

 

What I don't think you can do is decide to become a PA without really understanding the job and its demands. That requires some significant shadowing and those of us with PA jobs need to be open to doing that. And it requires some healthcare experience. It should be as relevant as possible, but chances are, it won't teach you all that would be nice to know about healthcare. Hopefully it will let you know whether a life among patients and multiple healthcare providers is for you.

 

Find what you can find and do your best. You are not just checking boxes on an application; you are trying to find your own way in life.

Link to comment
Share on other sites

I have to disagree on outcomes. sure, students from lots of different backgrounds do fine in school and on pance.

it is the first yr in practice where you can see the difference. I have seen hundreds of new grads from varying backgrounds enter various fields and I call always tell who had significant prior experience and who did not. the prior medics/etc hit the ground running with significantly less oversight and significantly more comfort with patients. they are more efficient, have  better interactions with patients and make fewer mistakes. many new grads from low hce programs, even those with great grades, need a lot of hand holding for the first yr or 2. we hired a new grad from one of these programs a few years ago and everyone who worked with her the first yr (including the docs) described the experience as "painful" and we decided thereafter to not hire any more inexperienced new grads. I just had a medex student for his last rotation and he was already beyond the level of this other licensed pa who has now been out of school for 2 years.

 

 

What is funny is that... just because a clinician is efficient doesn't mean he/she makes the right diagnoses-- what does the healthcare system consider a mistake?  Its easy to tell someone to take antibiotics and just send them home and have someone else like the PCP take care of it.  

Link to comment
Share on other sites

Well said, UGoLong.

 

There are three issues at hand:

1.) How can one become a good PA without prior HCE that involves decision making and doing procedures?

I will defer to the seasoned PAs and let them respectfully (or not) and vehemently disagree with each other regarding that question.  However, as a future applicant, knowing that it is debated would make me choose the more conservative option so as to avoid having this argument with admissions when I apply.

 

2.) How can someone with little to no HCE even consider becoming a PA?

As someone with little HCE considering PA in the distant future, I would say that I started researching the profession because of life experiences. I have had leadership roles, collaborative roles, and experience in using first responder training in an unofficial capacity (treating hypoglycemia, minor wound care, administering various meds such as Epi-Pen, nebulizer, etc.).  Shadowing a PA convinced me it was a job I would enjoy and could do well.  However, I was also convinced that for me, personally, I would feel underprepared if I did not have a few years of good HCE under my belt before I applied.  It was not whether admissions would consider me a good candidate, but whether I felt I was ready to apply.  I read somewhere that there are few unreachable goals, just unrealistic deadlines.

 

3.) The original issue: How can someone with limited HCE improve their application? 

Many have suggested EMT-B and/or CNA certification and take some time working in one of these fields before reapplying.  Seeing this information repeated in multiple forums by a variety of experienced PAs and individuals suggests it is a universal truth.  While it has been debated how much minimal experience with direct patient care including decision-making and procedural skills can impact PA-S and PA-Cs in their first few years of practice, it is nearly impossible to figure how a large amount of quality HCE could hurt an aspiring PA. As for FMGs, I would consider the fact that I would be competing with them for a seat to be motivation to exceed the average HCE for an admitted student prior to applying.

 

 

#2 ... well said... its all about the individual.  Thats all I am trying to say.  If you feel ready, you are probably ready.  If you don't think you can handle sitting in an interview room with a army nurse, paramedic, or former chiropractor and think you can hold your own.  Go for it.  

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More