PA Programs with optional sites for clinical year

[andersonk]

Hi! I'm looking into PA schools to apply for in the next year. Having the option to choose where I want to go during the clinical year is very important, however I can't find a list of schools that offers this option. I realize there are schools that have more flexibility on their clinical year than others. What are some programs, or does somebody know a site that has a list, that offer their students to travel to different areas of the country during their clinical year, upon approval of a program? Thank you!!

[south]

I don't know, but I will say that it's fairly rare to have more than just one or two optional choices, and usually you're just picking from a couple.  A lot of programs actually tell you this, and two years later, it turns out to not be the case.  This happened to us, but of course my program had all kinds of other problems.  A few of my classmates got some choice, most did not. 

I have heard of PROMISES of great flexibility at other programs, which turned out to be untrue.  Now I'm curious and I hope someone comes by and verifies that they actually did this. 

Getting a preceptor and/or site approved is not a quick or easy process like everyone thinks it is.  It is very involved with legal and liability issues, and takes several weeks to several months.  A lot of people think that since their relative or family friend is a MD, that they can just fill out a form and it's a done deal.  Far from true. 

Anyway, interesting question...anyone?

[Randito]

In my program we were allowed to set up 2 rotations on our own. I set up one and several of my classmates set up 1-2. This was especially helpful to those students that knew they were moving "back home" after the finishing the program. We also had a great variety of established sites. Specifically IM and surgical specialties.

I think there is a balance. You probably don't want to be responsible for setting up most of your sites as it can be a lot of work. But if you already know what field you're interested in, it would be nice to tailor your rotations to that interest. 

I will also say that there is usually a beneficial to go to the established sites/preceptors. They are used to having students and most likely the preceptor enjoys teaching, otherwise why would they continue to do so. 

[SHU-CH]

Most programs are probably willing to try to help you set up a rotation at a distant site, but it can be a very complex process. 

First up, you usually need to have someone on the inside that will tell the site they are willing to serve as a preceptor. If you or your school calls from the outside with no contact or advocate, your chance is usually pretty small. Your school will generally be told by the site that the site is committeed to students from other schools. 

If the site seems promising, your school needs to ensure that they can provide a quality rotation. This may be a little tricker than it sounds, especially with differences in PA practice laws between states. Your school will need to discuss patient load, types of patients, procedures, rotation goals/objectives, etc. If the site has a history of being a teaching site for PA or med students, that is usually reassuring.

After there is a go-ahead to prceed, a contract/affiliation agreement needs to be established. How complex this will be depends on the site. If it is a solo practitioner office it can go very quickly ( a few months). If it is a big healthcare system, there will be a lot of back and forth with lawyers that can easily take 12+ months and might not ever be successful due to circummstances beyond your school's control. I tried to set up an out of state rotation for a student and it took 18 months to get approved - unfortunately about 6 months after she had graduated.

Be sure to factor in the expense of travel and housing for your destination - it can add up quickly.

[amwillaert]

You can likely find a program that will allow you this flexibility. However I can tell you (as a clinical coordinator with 2.5 years of experience) that unless you have very strong personal connections (ie you’ve worked in a single healthcare system for 5 years and have a wide range of contacts) and/or multiple family members within a healthcare system who are willing to go to bat for you, the chances of getting all your rotations outside of the program’s primary sites are slim. It also is very dependent on that states you are looking to go. Certain states make it almost impossible to place out of state students due to unrealistic regulations or HUGE fees. Also worth checking out if the sites you are interested in are even taking new affiliation agreements. This is a common issue at sites in larger cities that are saturated already.

[gbrothers98]

On 12/30/2017 at 5:52 PM, amwillaert said:

You can likely find a program that will allow you this flexibility. However I can tell you (as a clinical coordinator with 2.5 years of experience) that unless you have very strong personal connections (ie you’ve worked in a single healthcare system for 5 years and have a wide range of contacts) and/or multiple family members within a healthcare system who are willing to go to bat for you, the chances of getting all your rotations outside of the program’s primary sites are slim. It also is very dependent on that states you are looking to go. Certain states make it almost impossible to place out of state students due to unrealistic regulations or HUGE fees. Also worth checking out if the sites you are interested in are even taking new affiliation agreements. This is a common issue at sites in larger cities that are saturated already.

If you find a program that will depend upon this for some/all your clinical rotations then they have set you and them up with a thin margin of success and have increased the workload logistically for you, support and clinical staff. This means more site visits to be done, more contracts and paperwork to corral, more orientations and computer training prior to actually starting a clinical experience. As a student, regardless of what you think you want, what you need are each and every clinical experience to leverage you closer to becoming a entry level PA. Concurrently, if a program has easy access to multiple specialty clinical experiences in a system a student would already be rotating with, then that is an easy choice to make. But the OP made it sound like there were specific geographic regions that clinical experiences were desired in. If that is the case, attend one of the PA programs that serve those geographic areas. Using the clinical year as a chance to travel to regions one may wish to relocate to in the future is fallacy on many levels. Essentially, the student is asking the clinical training staff and faculty to act as a travel agency. Savvy clinical faculty and coordinators will shoot that down quickly, all it does is add another to do on an already overwhelming list. 

George

[amwillaert]

Hi George - I agree with you on most points. As our program is located within 30 miles of a state border we naturally have many students who comes from both states. So “out of state” for us is relative. I agree that if you choose to go to PA school (for example) on the east coast that to expect a program to set up all of your rotations in California is unrealistic. I also make them choose one geographic region- no traveling around the country :) This is one of those situations though that I think requires a frank conversation with the student upfront- both to set expectations and to ascertain their level of connectedness in their geographic area of choice. If it’s an area I’m interested in developing more sites (i.e rural location in a neighboring state) then I’m willingly to work a bit harder because this will benefit students in the future as well. If they want every rotation located in a metropolis where we aren’t located - hard stop! I typically run into this situation when the student applied to schools in their geographic region of choice but for whatever reason didn’t get accepted. 

[jlumsden]

Programs need the ability to travel to the site, to ensure it is legitimate, and possibly to support the student in the event problems arise.  My program also did a site visit to my primary care rotation.  Having to travel to these sites presents a logistical challenge, which is only complicated if students are allowed to go to any area of the country.  You're likely to experience difficulties for this reason.

Also, there is something to be said about letting the program choose your sites for you.  You run into experiences that you might not have picked on your own.  I spent time in Wenatchee, Washington -- a community I might not have considered on my own.  I came to love it, and considered getting a job there.  I told my closest friend in my class, he was hired, and he is happy.  Good things come out of these unexpected placements.