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tracerswarner

So, Real Talk: Do you actually need HCE?

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I know this seems like a silly question. I'm only looking at one PA school (which seems crazy after reading this forum) and that school doesn't require HCE. Do you think that I ACTUALLY need it?

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YES! Without it, you really don't know what working in healthcare is going to feel like and what everyone else in it does for a living. Also a lot of what you'll be learning probably won't make as much sense.

Don't let your first day as a PA be your first day in healthcare. There will be enough surprises!


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@UGoLong I get that it's a great idea for me to learn more about the medical field. But in terms of getting accepted to a PA program that doesn't require it, do you think they're not asking for HCE hours but are really secretly expecting it?

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I would be surprised if any school doesn't still weigh in PCE even if it isn't a requirement. If you have two applicants with the same GPA, PCE will still be an important parameter they use to gauge different applicants. I would also add that it is more likely that programs who do not specifically require PCE may, on average, have applicants whos PCE hours are lower. So if you have a lower amount of hours, schools like this would be good ones to focus on, generally.

At the end of the day, everything you do as a pre-PA is still preparing you to be a clinician. Regardless of any program requirements, previous patient care hours is so important! 

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To be all that honest, I'm not entirely sure how you even know you want to be in the medical field if you haven't experienced it to even a shadowing level.. The medical field has the obvious academic and mental challenges associated with it, but even more so important, it carries a lot of hidden emotional, psychological, and personal intensities that not your everyday Joe is able to handle..

All I'm saying is, good luck explaining why you want to be a PA, let alone work in the healthcare field without ever having witnessed any part of the field.

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Great! This is awesome, everyone. I appreciate your candidness. I just saw all these people on here getting rejected with like 2000+ hours of HCE and I'm likely to have only 300-500 AT BEST. So, based on everyone's feedback, I think it's just important to have some and not necessarily the quantity. 

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3 minutes ago, tracerswarner said:

Great! This is awesome, everyone. I appreciate your candidness. I just saw all these people on here getting rejected with like 2000+ hours of HCE and I'm likely to have only 300-500 AT BEST. So, based on everyone's feedback, I think it's just important to have some and not necessarily the quantity. 

Quantity definitely matters. And quality. You were asking if you needed any at all, to which the answer is always yes. But HCE is as important as everything else within one's application which is why someone with 2000+ hours, but lacking elsewhere, may never get an interview.

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2 minutes ago, mmchick said:

Quantity definitely matters. And quality. You were asking if you needed any at all, to which the answer is always yes. But HCE is as important as everything else within one's application which is why someone with 2000+ hours, but lacking elsewhere, may never get an interview.

Gah! If I got 500 awesome, rewarding, life-affirming hours, why would I have to worry that it wasn't enough?  Just asking mostly in hypothetical frustration, not necessarily blaming you for relaying info. :)

 

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Disclaimer: Not a PA.

It's my opinion that you should also be looking for HCE, like UGoLong said, so you have a better feel for healthcare. Once you are exposed you may change your mind. Additionally, I can only imagine that having more, and higher quality, HCE prior to going to PA school will not only make PA school easier, but it will make you a better PA (at least initially). My $0.02. 

If it just isn't possible, then sure, settle for the minimum. But I can't imagine ever just wanting the minimum on something like that when there is SO much to learn.

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1 hour ago, tracerswarner said:

Gah! If I got 500 awesome, rewarding, life-affirming hours, why would I have to worry that it wasn't enough?  Just asking mostly in hypothetical frustration, not necessarily blaming you for relaying info. :)

 

500 hours just can't give you a REAL look at healthcare no matter how awesome, rewarding, life affirming they are.  You're still in the honeymoon phase at 500 hours.  You need to understand the long term lifestyle of working in healthcare.  You can read about and imagine it all you want but you won't really 'get it' until you've spent a SIGNIFICANT amount of time in it.  Until you understand the bureaucracy of it.  The politics of it.  The frustration of dealing with patients who KNOW they need to quit smoking but refuse.  The ones who will never be satisfied no matter what you do.  The ones you yell at you even though you did nothing wrong.  The dynamics of being part of a team where your role can change immediately depending on who else is in the room.  Everyone can handle the rosy, cheery patients who make you feel good about helping people.

HCE/PCE isn't completely about figuring out if you'll LIKE working in medicine, but figuring out if you can HANDLE working in medicine.  The middle of your clinical year if the WRONG time find out you don't enjoy it; that's a waste of time and money for you and a PA program.  There's a recent thread in the student PA forum about someone almost done with clinical year who is really having to dig deep and figure out if they even want to practice medicine.

As an aside I'll add this:  you aren't competing for a spot in a program against the posted minimums.  You're competing against other applicants.  So even if the program requires none, remember that most applicants are applying to several other programs that likely have higher minimums that those students meet.  So yea.  There are students with 2000+ hrs getting rejected.  And there might be other issues with their apps, but it could also be bc they are being passed over for applicants with even MORE HCE.  That logic doesn't bode well for you.

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HCE may not be required, but it is always considered.  As you stated, someone can have 2000+ hours and still get rejected.  The average applicant has HCE.  So, to have none puts you behind average.  If you have something else outstanding about your academic life/career that makes up for it, then it could be possible. 

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13 minutes ago, MT2PA said:

500 hours just can't give you a REAL look at healthcare no matter how awesome, rewarding, life affirming they are.  You're still in the honeymoon phase at 500 hours.  You need to understand the long term lifestyle of working in healthcare.  You can read about and imagine it all you want but you won't really 'get it' until you've spent a SIGNIFICANT amount of time in it.  Until you understand the bureaucracy of it.  The politics of it.  The frustration of dealing with patients who KNOW they need to quit smoking but refuse.  The ones who will never be satisfied no matter what you do.  The ones you yell at you even though you did nothing wrong.  The dynamics of being part of a team where your role can change immediately depending on who else is in the room.  Everyone can handle the rosy, cheery patients who make you feel good about helping people.

HCE/PCE isn't completely about figuring out if you'll LIKE working in medicine, but figuring out if you can HANDLE working in medicine.  The middle of your clinical year if the WRONG time find out you don't enjoy it; that's a waste of time and money for you and a PA program.  There's a recent thread in the student PA forum about someone almost done with clinical year who is really having to dig deep and figure out if they even want to practice medicine.

As an aside I'll add this:  you aren't competing for a spot in a program against the posted minimums.  You're competing against other applicants.  So even if the program requires none, remember that most applicants are applying to several other programs that likely have higher minimums that those students meet.  So yea.  There are students with 2000+ hrs getting rejected.  And there might be other issues with their apps, but it could also be bc they are being passed over for applicants with even MORE HCE.  That logic doesn't bode well for you.

Wow...if we understood this before PA school, then only politicians would go into medicine.  You can not have a grasp on this until you are a provider and facing it.  I still to this day (10 years in practice) don't understand all the bureaucracy and politics. 

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I was an ICU nurse for 5 years before I figured out exactly what I wanted to do.  I had pretty much ruled out medical school and was 99% sure I wanted to do CRNA.  But then I took a job doing conscious sedation and working alongside CRNAs and I realized how much I would haaaaate it and how bored I would be.  

 

You really need to get some real HCE.  Certainly not scribing or even CNA/MA.  IMO - you need to be responsible for patient care.  You need to feel a bit of stress taking care of patients.  Don't rush into any career in medicine.  There are many professions and you don't want to pick the wrong one because you weren't willing to take a little time in your decision making process.

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3 minutes ago, dizzyjon said:

Wow...if we understood this before PA school, then only politicians would go into medicine.  You can not have a grasp on this until you are a provider and facing it.  I still to this day (10 years in practice) don't understand all the bureaucracy and politics. 

Agree to disagree.  My point remains.  500 hours isn't enough to even begin to grasp what you are getting yourself into.  

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1 minute ago, MT2PA said:

Agree to disagree.  My point remains.  500 hours isn't enough to even begin to grasp what you are getting yourself into.  

Agree with the hours for sure.  As ACNPstudent mentioned above about wanting to be CRNA but then made the wise choice and actually seeing what one does and then hated it.  I think HCE should be required. 

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31 minutes ago, ACNPstudent said:

 

You really need to get some real HCE.  Certainly not scribing or even CNA/MA.  IMO - you need to be responsible for patient care.  You need to feel a bit of stress taking care of patients. 

Current PA student here. First off, to answer the OP's question, healthcare experience is essential not only in the admissions process (regardless of what the school's website says), but it is also necessary in order to succeed in PA school. If I hadn't worked in the ER between undergrad and PA school, I would be having a much harder time comprehending and applying what I'm learning in the classroom. Besides, you want to be 100% sure about your career choice, and the best way to make an informed decision is by spending time in the field. Honestly, I'm surprised more medical schools don't require some sort of clinical experience to be considered for admission for that reason alone. 

I also want to (respectfully) disagree with the advice above and share one of my posts from a different thread. I was a medical scribe for two years prior to PA school.  If I had to do it all over, I would hands-down be a scribe again. This was the best pre-PA school job I could have ever asked for. As a scribe, you gain insight into the medical decision making of a healthcare provider that no other experience offers.

Just like any other job, as a scribe, you get out of it what you put into it. I told the physicians I worked with that I wanted to learn as much as possible --- so they taught me how to interpret labs, EKG's, x-rays, etc. After the physician looked at the EKG, they would hand it to me and ask me what I thought. If a patient was wheezing, they would say, "come over here and take a listen to this person's lungs and tell me what you hear. What tests do you think I'll order?" For two years, I strived to learn something new from every patient encounter, and I never hesitated to ask questions if I didn't understand the provider's train of thought. 

By the time I started PA school, I already had a basic knowledge of differential diagnoses for just about any complaint. I already knew the doses and indications for common drugs. After spending literally thousands of hours attached at the hip with an ER doctor, I had already been exposed to the presentation, work-up, and treatment for a variety of diseases and injuries. Yes, I still have plenty to learn. But I have a very solid foundation on which to expand my knowledge. 

I am not saying that hands-on experience isn't valuable --- it certainly is. I agree that there is something to be said for "feeling the stress of taking care of patients," but you will begin learning this during your clinical year and grow more comfortable under pressure with experience. I firmly believe scribing can be outstanding preparation for PA school if you're willing to make the most out of it. 

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I'll chime in with a dissenting vote to the popular opinion on this board. Does HCE help you succeed: absolutely. Is HCE mandatory? In my opinion, no. I firmly believe you can still be a perfectly successful PA with no prior HCE. However, it's totally on you if you find out you don't like patient care 7 minutes into your first rotation. You might also feel wildly out of place, and you'll have no prior background to at least somewhat pull from. I still think you can be very successful, though. 

You also don't need HCE to know if you want to be a PA. I knew I wanted to be a PA prior to having any HCE. Several years of HCE after that moment only served to reinforce that decision. 

Thus, to answer the question at hand, I would say no, you do not need prior HCE. All the points above are completely valid in terms of helping you get in to school and giving you a likely acceptance, though, but I do believe you can still get admitted (and succeed) without it. 

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I go to a school that doesn't require HCE but they don't really look at an application unless it has 500-1000 hours of HCE.

As others have stated you need the experience to not only get the admissions department to consider your application but also to prepare yourself for the program and working as a PA. PA students get very minimal training considering their scope of practice, make it easier on yourself by bringing something to the table.


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I think there is a lot of truth in what HanSolo said. Our physician counterparts tend to start school with significantly fewer hours (my former collegiate doubles partner is currently working on his MD/PhD with only 90 hours of HCE at the time of his application)  for what turns out to be a far longer educational and financial commitment. I don't think we are any more compassionate than they are, or intelligent than they are, or have a better idea of what healthcare is than they do. I suppose Natalie has a point in terms of the brevity of our education versus theirs, but there is no career that offers a proxy for the experience of being a PA. Your 2,000 hours of being a CNA are not going to land you a dream job at some coveted derm clinic - it'll be completing a residency or making big impressions on your derm rotation that do that.

But of course, try and get some hours. I would never encourage you not to. But if you're a 3.75 GPA+ student who got over a 310 on the GRE... there are going to be many schools that are willing to look the other way when someone points out that your HCE hours are low. It's all the rage right now to show that we're academically on par (at least on paper) with med school hopefuls. 

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physicians get a 3+ year residency to learn about medicine. I like thinking of HCE as "pre-training". I could not do my current job without the skills I learned and the experiences I had working as a paramedic.

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I agree w/ what everyone has been saying above about the benefits and necessity of HCE. But I have definitely seen accepted applicants stats with close to zero hours of HCE, but a 4.0 with a 320 GRE (or something like that). Some schools see those stats and decide to choose them regardless of the fact they have no HCE. Just saying what I've seen occasionally around the forum  

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my program has switched to requiring more HCE. There's a clear delineation between those with and without. Frankly, it boarders irritation sometimes in situations when most of the class with quality HCE knows what's going on and the rest do not and causes a bottleneck. This delineation is perceived more during OSLERs/PE and clinical skills. 

I guess my main gripe with the "No HCE" argument is that it detracts to the grass roots of this profession which seems to happen day by day. I was a Corpsman so I feel a strong attachment and respect to how and why this profession exists and when I see 21 y/o without any HCE (or very little - like a scribe or CNA for 1 year) getting in to a program, I shake my head and anticipate Dr Stead rolling in his grave. 

 

PS. I think scribing is the lowliest of HCE, and shouldn't be "counted" because it's not true hands on nor any clinical judgment is really involved - you don't impact the patients outcome directly. Sure your efforts may result in proper documentation to prevent a problem but you didn't directly affect the patient with some form of care.  Yes, you get a grasp for things but its realistically more like being paid to shadow and you're taking notes.

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