What is most important in life? (or choosing a PA school)

[rev ronin]

About twice a month, someone will PM me a question that really should have been asked in public.  I'm flattered that all'y'all think I have specific insight into your individual circumstances, but the truth is, I'm going to be answering based on a set of general principles.  The other truth is, I can't take time to answer everything individually (I'm down to four jobs and two college programs, but still) and so many of these questions I simply redirect to the public fora here.  The third and most important truth is that I am just one perspective of many.  Of all the moderators/admin staff, I have the least (or next to least, I forget) PA experience; I'm Banuchi's deputy administrator because I have an extensive IT background and know what buttons NOT to press on the admin interface, that's all. And of course there are plenty of long-time PAs here NOT on the site staff who have exceptionally valuable insight, so if you ask me, or any one of the other moderators, a question in a PM, you're going to get a GOOD answer, but only one such answer.

Having said all that, the kernel of the question asked of me most recently is: "What do I weigh first?  Rank (is this real?), cost, clinical rotations, 5-year PANCE, feel for the program." (This is coming from a pre-PA with multiple acceptances)

My answer, to which I expect to hear agreements, refinements, contradictions, and outright disagreement from the rest of the site's members, is:

1) Feel for the program.  It sounds weird to start with the least quantifiable, but you're going to be using your intuition every single clinical day.  IF you can't trust it to be the final arbiter of your life choices... we've got a problem.  By all means, don't just limit this to how nice people were on interview day. Look at the totality of a school and its impression upon you: physical plant, faculty CVs, campus location and environment, and everything else listed here.  Does it all gel? Does it seem real, or is something hiding somewhere?

2) 5-Year PANCE, but only in combination with attrition.  People drop out of PA school for a reason, but the best schools will have low attrition AND high PANCE pass rates.  I'd propose multiplying the two (5-year matriculation to graduation average, 5 year PANCE pass rate) to get a better feel for the school's actual performance.  Thus, school 'A' that only graduates 80% but has a 100% PANCE first-time pass rate, school 'B' that graduates 100% with an 80% first-time PANCE pass rate, and school 'C' that has a 90% graduation rate and a 90% first-time PANCE pass rate are all roughly equivalent in my book. ETA: Oh, and this isn't private!  The names and circumstances of the students who didn't graduate aren't any of your business, but the number of seats authorized for a given year is an ARC-PA set number and essentially a public record.  If a school refuses to disclose this to you, assume that it's BAD and go somewhere else.

3) cost. Debt sucks. Tuition-repayment programs trap PA new grads in out-of-the-way places with very questionable learning and growth opportunities.  NOT having tuition-repayment programs trap PA new grads in high-paying, ethically-questionable indentured servitude with 'profitable' practices that likely do not reflect why you wanted to go into medicine in the first place.

4) clinical rotations.  This is lower on the list because it is so hard for a pre-PA student to appraise effectively without a mentor who can help the pre-PA ask the right questions of a program.  If you are totally lost in this realm, age of program makes a reasonable proxy measure: all other things being equal, the older program will have the better rotations. This can be a bigger deal if you're going for one specific area (e.g., cardiothoracic surgery) but even then, that often changes drastically.  I went from EM to FM, but one woman in my class went from Oncology to Orthopedic surgery.

5) Rank.  Like all U.S. News & World Report rankings, PA School rankings are really internal surveys of the schools themselves.  They are a popularity contest, and do not reflect clinical outcomes.  Most of the objective data that goes into the popularity contest is already listed above.

So, those are my answers.  What do the rest of the board's participants think?

[EMEDPA]

agree. rank means nothing. UWa went from unranked to #2 in 1 year by changing the degree they conferred.  age of the program is a fairly good indicator of rotation quality as bad sites(one would hope) have been weeded out. 5 yr pance rate is a non-issue. the test is about you, not your program. I know great PAs from programs with low avg pass rates and bad pas from great programs. honestly, if you got into pa school, passed everything, and COMMITTED to the program and the educational process you should pass on the first if not the 2nd time. these folks who take it 7 times before they pass are making up for lost time partying/working/etc when they should have been studying. if someone fails multiple times, they probably should not have been admitted in the first place. harsh, but true.

feel is important. if you hate where you are or can't get along with the faculty then it does not matter how good your program is. cost is obviously an issue, but as with everything this is about priorities. If you got into the best/most expensive program in the country(whatever that is) passed pance the first time, and got a great job with loan repayment then the 200k/yr is worthwhile. if you attend booby jo and charlie's pa program for 5 k/yr and fail pance 5 times then no one hires you because of the poor reputation of the program and your 1 yr delay in getting licensed  then you will probably wish you had been at the university of megabuck tuition

[EMEDPA]

or this:

 

[Ejohns20]

2 hours ago, EMEDPA said:

If you got into the best/most expensive program in the country(whatever that is) passed pance the first time, and got a great job with loan repayment then the 200k/yr is worthwhile. if you attend booby jo and charlie's pa program for 5 k/yr and fail pance 5 times then no one hires you because of the poor reputation of the program and your 1 yr delay in getting licensed  then you will probably wish you had been at the university of megabuck tuition

Is there a way pre-PA students can get a sense of a program's reputation? There's three programs in my area and I swear, in each interview, staff or faculty or students or someone said, "preceptors here will only take students from our program." I take this with a grain of salt, but I really am curious. 

[hmtpnw]

1 hour ago, Ejohns20 said:

Is there a way pre-PA students can get a sense of a program's reputation? There's three programs in my area and I swear, in each interview, staff or faculty or students or someone said, "preceptors here will only take students from our program." I take this with a grain of salt, but I really am curious. 

I have found that the best thing to do is to try and speak with current and past students. 

Many current students and alumni post in the school specific forums. I have had good luck with reaching out and getting honest answers to my questions and getting a better idea of the quality of a program. 

Usually there are students available to talk to on interview day but of course they’re only pointing out the positives. I found my discussions on this forum much more honest and helpful. 

[Bubbles]

Great advice!! For me, location also played a major role (due to family). Even if you aren’t married or have children, often times, it’s nice to have a support system in the vicinity. 

[kuriousPA]

I will post my scenario because I was one of the ones that emailed Reb, which led to this thread. Essentially rank question got answered... doesn't matter. PANCE says something about the program, but in the end it is about your own discipline that gets you through. Cost/debt sucks. Feel is all about you. If this was you, which one would you pick? Florida felt the best overall, but the cost is the most. Looking for feedback from anyone! 

 

[Bubbles]

1 hour ago, kuriousPA said:

I will post my scenario because I was one of the ones that emailed Reb, which led to this thread. Essentially rank question got answered... doesn't matter. PANCE says something about the program, but in the end it is about your own discipline that gets you through. Cost/debt sucks. Feel is all about you. If this was you, which one would you pick? Florida felt the best overall, but the cost is the most. Looking for feedback from anyone! 

 

This is a hard one. Will you be happy at school 2? If yes, definitely consider it. Almost 1/3 the cost of UF (yikes)! A lot of new programs start with lower first time PANCE rate and increase as they grow and change methods. 

I was accepted at Duke (ranked #1) and UNC (new program, unranked) and chose UNC mostly due to “feel”. Loved the faculty, interview experience, etc... AND it is $40k less in tuition. However, it IS associated with a hospital (unlike your choice #2). I felt like I would receive a quality education at UNC and it would become a strong program. Do you feel like you’d be getting a good education and experience at #2? If no, #1 may be worth the extra cost. 

[kuriousPA]

17 minutes ago, Bubbles said:

This is a hard one. Will you be happy at school 2? If yes, definitely consider it. Almost 1/3 the cost of UF (yikes)! A lot of new programs start with lower first time PANCE rate and increase as they grow and change methods. 

I was accepted at Duke (ranked #1) and UNC (new program, unranked) and chose UNC mostly due to “feel”. Loved the faculty, interview experience, etc... AND it is $40k less in tuition. However, it IS associated with a hospital (unlike your choice #2). I felt like I would receive a quality education at UNC and it would become a strong program. Do you feel like you’d be getting a good education and experience at #2? If no, #1 may be worth the extra cost. 

Bubbles - I am guessing you are referring to UTGRV as my #2? Did you see the MUSC option? Seeing that you went to school just north of there, what do you think/know about that. That is more in the middle ground between Florida and UTRGV. 

[Bubbles]

1 hour ago, kuriousPA said:

Bubbles - I am guessing you are referring to UTGRV as my #2? Did you see the MUSC option? Seeing that you went to school just north of there, what do you think/know about that. That is more in the middle ground between Florida and UTRGV. 

Sorry I skipped right by the middle option So I was referring to UTRGV as #2. I’m sorry to say I don’t know a ton about MUSC. I think cost is important though, along with location. Where do you want to live after graduation? It would be helpful to build relationships where you’d like to practice so that’s something to consider. Also- how long UTRGV and when do the programs for each start? Shorter program and/or earlier start = earning higher salary sooner = bigger “price” difference than just tuition considerations. So UF, though more $ in tuition, would end sooner, thus could possibly be considered similar in price to MUSC. You need to weigh if the first two choices are much better than the last and if worth the price difference to you. If you don’t think #3 will give you a solid education and experience, I would rule it out. 

[Blynn12]

I would rule out UTRGV based on the fact that students feel "meh" about rotations.  I guess I'd want to know what their exact thoughts were, but could be hard to figure out as a pre-PA.  The other schools sound better in regard to this particular option, as well as regarding PANCE and your overall personal feel.

[EMEDPA]

2 minutes ago, Blynn12 said:

I would rule out UTRGV based on the fact that students feel "meh" about rotations.  I guess I'd want to know what their exact thoughts were, but could be hard to figure out as a pre-PA.  The other schools sound better in regard to this particular option, as well as regarding PANCE and your overall personal feel.

yup, rotations make the program. I hated the city my program was in, but had the best possible rotations for a future career in EM. They had established rotations in trauma surgery, peds em, etc that were invaluable experience. I could not have gotten both of these anywhere else at the time(I checked). In fact, I don't know any other program still that allows for a peds em rotation to count as the required peds exposure.

[Ejohns20]

3 hours ago, kuriousPA said:

I will post my scenario because I was one of the ones that emailed Reb, which led to this thread. Essentially rank question got answered... doesn't matter. PANCE says something about the program, but in the end it is about your own discipline that gets you through. Cost/debt sucks. Feel is all about you. If this was you, which one would you pick? Florida felt the best overall, but the cost is the most. Looking for feedback from anyone! 

 

#2 MUSC. Happy wife happy life IMHO. Only half-joking. Plus the combo of cost/rotations/PANCE

[Guest HanSolo]

If what you are saying is true about lack of inpatient rotations at UT Rio Grade, then I think you can scratch that one off the list. Even if you never plan on working inpatient it is still important to have that experience.  Frankly, I can't believe they'd even have a PA program with that option. 

[kuriousPA]

2 hours ago, HanSolo said:

If what you are saying is true about lack of inpatient rotations at UT Rio Grade, then I think you can scratch that one off the list. Even if you never plan on working inpatient it is still important to have that experience.  Frankly, I can't believe they'd even have a PA program with that option. 

Yeah one of the current 2nd year students said that was something to consider. One of the clinical coordinators said that they were looking into making that possible, but no guarantee...

[SrTaM]

As a current didactic student, there are a few things I didn’t even consider (or gave very little weight to) when considering my options that I now wish I had. I know that in the big picture, didactic is short and it’s going to be tough no matter where you are, but these are things I wish i had given more consideration to:

- class size and average class age 

- policies on what qualifies as passing grades and systems in place for remediation 

- organ system based vs traditional curriculum 

Class size and average age are obvious. I learned in undergrad that I do better in small class sizes, but figured in PA school that even in a large class size I’d be able to find a small group of core people. This has turned out to be true, but most days I find myself wishing our class was smaller and had a bit higher of an average age. 

Passing vs failing can vary widely by program. Of course, all schools want you to succeed and most use grades as a method of gauging that no student is falling behind. However, there are always going to be a circumstance(s) where the testing/grading system in place isn’t accurately reflecting student comprehension. A program that is very rigid about high grades and won’t work with students in order to best help them succeed is much less appealing to me than a program who is invested in providing help and guidance to each student. For example, some programs require above 80% on ALL exams, whereas other programs allow remediation for a failing grade, in some cases meaning the student can revise and retake the exam for a passing grade. For me, the program that is allowing students to revise and figure out what material they weren’t understanding, and remediate to show they’ve revisited the material, is more interested in student success. 

Finally, I didn’t give much consideration to curriculum. I figured I’d learn the material I need to know at any PA program. However, now that I’m in a traditional curriculum program, I strongly wish we were organ system based. I simply learn better that way. I’d encourage all pre-PA’s to really consider what style of instruction best suits them. Even if a program doesn’t specially detail their method of instruction on their site, pretty much all of them have information on didactic curriculum, so look through that information and compare between program. 

[rev ronin]

6 hours ago, BaxLN said:

As a current didactic student, there are a few things I didn’t even consider (or gave very little weight to) when considering my options that I now wish I had. I know that in the big picture, didactic is short and it’s going to be tough no matter where you are, but these are things I wish i had given more consideration to:

- class size and average class age 

- policies on what qualifies as passing grades and systems in place for remediation 

- organ system based vs traditional curriculum 

Class size and average age are obvious. I learned in undergrad that I do better in small class sizes, but figured in PA school that even in a large class size I’d be able to find a small group of core people. This has turned out to be true, but most days I find myself wishing our class was smaller and had a bit higher of an average age. 

Passing vs failing can vary widely by program. Of course, all schools want you to succeed and most use grades as a method of gauging that no student is falling behind. However, there are always going to be a circumstance(s) where the testing/grading system in place isn’t accurately reflecting student comprehension. A program that is very rigid about high grades and won’t work with students in order to best help them succeed is much less appealing to me than a program who is invested in providing help and guidance to each student. For example, some programs require above 80% on ALL exams, whereas other programs allow remediation for a failing grade, in some cases meaning the student can revise and retake the exam for a passing grade. For me, the program that is allowing students to revise and figure out what material they weren’t understanding, and remediate to show they’ve revisited the material, is more interested in student success. 

Finally, I didn’t give much consideration to curriculum. I figured I’d learn the material I need to know at any PA program. However, now that I’m in a traditional curriculum program, I strongly wish we were organ system based. I simply learn better that way. I’d encourage all pre-PA’s to really consider what style of instruction best suits them. Even if a program doesn’t specially detail their method of instruction on their site, pretty much all of them have information on didactic curriculum, so look through that information and compare between program. 

This is exactly what I had in mind when I said there were plenty of great other perspectives out there.