Just Your Average PA Program, 3.0

Unless you've compiled a spreadsheet detailing the characteristics of all 230+ currently accredited PA programs, knowing what's typical and what's unique among the PA programs you are considering may be difficult to discern.

Luckily, the Physician Assistant Education Association (PAEA) releases a report annually that helps to demonstrate trends in PA education. In the latest survey, By the Numbers: Program Report 33: Data from the 2017 Program Survey, we get a glimpse of these PA program characteristics.

This report covered the 2016-2017 academic year and had an overall response rate of 100% with all 223 PA programs that were accredited at the time of the survey participating.

Here are some of the highlights.

PA PROGRAM FACTORS

REGIONAL DISTRIBUTION

The number of PA programs has continued to climb year over year from 209 in the prior year's survey to 223 programs in the most current survey (though this number has increased even more since the survey was administered).

 Geographic Distribution of PA ProgramslBe a Physician Assistant

PA programs are more often associated with private universities (67.3%) compared to public ones (30.5%). And, the highest concentration of PA programs continues to be in the South (75, 33.6%) and Northeast (65, 29.1%), trailed by the Midwest (53, 23.8%) and the West (30, 13.5%).

Growth trends in the number of new PA programs also followed a similar distribution: the South not only had the greatest number of PA programs, but it also added more programs overall between the 2016 and 2017 surveys, previously clocking in at 69 programs, a total that increased to 75 in the current report.

The West, however, did not add any new programs between the 2016 and 2017 surveys.

TIMING

The vast majority of PA programs surveyed operate on a semester system (79.4%), though some use trimeter (9.4%) or quarter (8.5%) academic terms.

August remains the most common program-start month, followed by May and January. Programs wrapped up in May more often than any other month, though August and December were nearly tied for the second most popular month to graduate from PA school.

The median PA program length remained steady from prior surveys at 27 months, with a median didactic phase of 56 weeks and clinical phase of 52 weeks. Other than the didactic and clinical stretches, a median of 8 weeks was given for vacation (aka, blinking, sleeping, breathing).

COST

The median tuition cost for a PA program at a public school was $42,792 for in-state residents and $79,552 for out-of-state students.

For programs at private schools, the median (Mdn) tuition cost was $85,430 for the duration of the program. When averages were compared, the rate of increase was more substantial for public universities (10% for in-state, 9.2% for out-of-state) compared to private schools (3.3%) compared to the 2015-2016 survey.

 Average PA School Tuition CostlBe a Physician Assistant

In addition to tuition, program-related fees, including things like ACLS training fees, background checks, lab fees, student health services, textbooks, computers, and the like, add to the overall expense of attending a PA program. The estimated additional costs incurred by students averaged $4,927 (Mdn $3,800).

When these average fees were separated by public and private programs, the survey showed that public programs had higher average costs ($12,152; Mdn $6,000) than private programs ($4,556; Mdn $3,696).

When these itemized student fees were analyzed by AHC versus non-AHC programs, the averages were a bit more comparable between the two groups, $6,817 (Mdn $4,800) and $6,824 (Mdn $3,800), respectively.

CLINICAL EXPOSURE

Eighty-one programs (36.3%) offered clinical experiences during the didactic phase for, on average, 15.8 days. This experience usually means that first-year PA students get the chance to observe a PA or other provider practice clinically for a few hours a week during their first year of PA school.

Having clinical exposure in your first year of PA school can help cement concepts you learn in the classroom with living, breathing patients. It's something to keep in mind when you're searching for target PA programs or when you're trying to come up with an essay or interview response to "Why did you choose to apply to this program?"

But providing clinical opportunities in the first year isn't easy. There is a nationwide clinical training site shortage, which means finding placements for students in the clinical year, when they absolutely need them, can be tough for programs.

 PAEA PA Program Survey, 2017lBe a Physician Assistant

It's becoming more common for programs to pay for PA students to train at clinical sites. Compared to the prior year's survey, there was an increase (42.1% from 35.4%) in PA programs who reported paying for some or all clinical rotations for students.

Programs at private institutions were more likely to pay for clinical rotations than private universities (52.7% vs. 22.1%).

Likewise, programs at non-academic health centers (non-AHC) were more likely to pay for clinical training sites than those at academic health centers (52.6% vs. 15.9%).

This split makes sense because an academic health center is designed to teach medical trainees as part of their health care model (think: University of ______ Medical Center).

Of the geographic regions, Northeast programs (and especially those in New England) are more likely to pay for clinical rotations sites (57.8%) compared to the South (41.3), West (33.3%) and Midwest (28.8%).

Paying for rotations may be necessitated by a number of factors.

Some programs are in areas saturated with other medical trainees—nursing, medical, and other health care students—which can make finding spots for PA students tricky. Additionally, medical providers face increasing demands to see more patients and be more productive; taking on students can be disruptive to these goals.

Incentivizing preceptors or facilities can help mitigate the issue of decreased provider productivity and aid programs in finding placements for PA students.

But, if a program is paying for rotations, it's an expense to the program that will likely be passed along to students in the form of tuition. And it may mean that adding additional clinical experiences in the didactic year may be next to impossible for some programs.

The clinical site shortage also means that programs often rely on placing students at remote clinical sites to complete their required training.

At the time of the survey, 64.8% of programs placed students at remote clinical locations, with remote placement more common among public (71.6%) versus private (61.9%) programs and in AHC (69.8%) versus non-AHC (62.8) affiliated schools.

Remote clinical site placement costs a student a median of $2,000 in out-of-pocket expenses. Keep these kinds of costs in mind when weighing program choices. The costs of attending a program go beyond the tuition and are typically laid out clearly on a program website, as required by accreditation standards.

Of the programs surveyed, there were 11 accelerated programs among those surveyed. In these programs, a student enters as a college freshman and receives both a bachelor's and master's degree.

These programs are typically designed on a 3+2 model with the first three years spent obtaining a health-related bachelor's degree and the following years representing the "professional" phase of the program including the traditional didactic and clinical years similar to other PA programs.

PRE-PROFESSIONAL PHASES

A total of 35 programs reported having a pre-professional phase, which includes the 11 accelerated programs. Having a "pre-professional" phase may indicate that prerequisite classes are offered or that students who become members of the pre-PA program are guaranteed an interview for the professional phase of the program.

 Average PA Program Stats 2017lBe a Physician Assistant

However, non-accelerated programs with a pre-professional phase are typically less formal than an accelerated program, may offer opportunities but not guarantees (accelerated programs will often guarantee entry to professional phase if certain standards are maintained during the pre-professional phase), and may not grant a degree as part of the pre-professional phase.

When programs have them, there's a lot of variation in the pre-professional phases from program to program, so digging into the specifics of any single school is a must if you are considering one.

DEGREES

PA programs that reported awarding graduates a master's degree (not all do yet, but they will be required to by 2020) most often (60.6%) granted a degree with a title specific to physician assistants — Master of Physician Assistant Studies (MPAS), Master of Science in Physician Assistant Studies (MSPAS), Master of Physician Assistant Practice (MPAP), or Master of Physician Assistant (MPA).

The type of master's degree doesn't matter for licensing or practice, and one is not better than the other, but this variety is why you'll find PAs with different letter combinations in their titles.


STUDENT-TO-FACULTY RATIOS

Overall, student-to-faculty ratios of PA programs are rather small, with a median of 13.4 students for every full-time faculty member. But if this ratio is important to you, there are some details that you'll want to know about programs you are considering.

To understand why these ratios are provided and why they are reported two ways, you first have to know that it's incredibly common for PA educators also to continue to work clinically. So often, programs will have at least several part-time faculty members and instructors.

Therefore, reporting faculty numbers as "full-time equivalents" or "headcounts" helps to give a more accurate representation of the amount of faculty support per student available rather than just a total number of individuals on staff.

A full-time equivalent (FTE) can describe a single full-time faculty member or several individuals whose work collectively amounts to a full-time position, like if four part-time faculty members each fulfill a quarter of a full-time role.

With me? Great!

For the survey, PAEA counted any faculty member who had a role that was at least a 0.5 FTE as a faculty headcount. So, say you have three faculty members that each work 30 hours a week in a program (0.75 FTE each). The FTE of these three instructors would be 2.25, but the headcount is three.

Now that we have our bearings, we can look at the differences. Overall student-to-faculty ratios using FTEs (Mdn 12.1) were not much different than when headcounts were used (Mdn 13.4).

Ratios held pretty steadily when AHC versus non-AHC and public versus private programs were looked at by both headcount and FTE.

There was some more variability in the median ratios by region, though not much difference when looking at headcount versus FTE (Northeast 14.4 vs. 12.9; Midwest 13.5 vs. 11.9; South 12.7 vs. 12.5; West 11.5 vs. 10.4).

 PAEA PA Program Survey, 2017lBe a Physician Assistant

So why did I just put you through that if things are pretty similar?

Collectively, programs do have similar ratios. But a significant discrepancy between FTE and headcount student-to-faculty ratios of any particular program may cue you to ask better questions about the makeup of the program faculty.

Understanding what goes into a program's ratio (FTE, headcount, or a simple tally of all part-time and full-time faculty members) will allow you to know how many instructors you can expect to work with on a regular basis.

In the survey, the median percentage of the didactic curriculum taught by core faculty members was 70%, so that's a good bar. Even if there are many guest lecturers and part-time faculty members who help with instruction, PA students often have a high level of consistency in their professors.

As a final point around faculty members, the survey showed that some level of turnover and open positions were common within programs. At least one faculty member left in the 2016-2017 academic year in 52.7% of programs and 32% of programs reported a vacant faculty FTE.

Remember, the PA profession is a flexible one and often attracts those drawn to variety. An average level of turnover is not a sign of issues with a program.

PA STUDENT FACTORS

FIRST-YEAR CLASS

A majority of PA programs filled their incoming first-year class capacity, but 19% (40 programs) did not, up from 14% the prior year. This represented a total of 286 vacant seats. Reasons for not reaching capacity were not included in this survey report, though, in the preceding year's report, the most common cause was "students voluntarily withdrawing."

 PA Student Characteristics for Incoming Class of 2017lBe a Physician Assistant

The average first-year capacity of PA programs was 45.6 students. (In 1984-1985, the average first-year class enrollment was 24.1 students.) There was a total of 9,751 first-year students enrolled, up from the prior year's total of 8,939.

Did you catch that? Over eight hundred extra seats were added from the prior year!

The average age of first-year PA students was 25.4 (Mdn of 25-years-old). The average age of the youngest matriculant per program was 21.6 (Mdn 21), and oldest was 40.7 (Mdn 40).

Most first-year PA students were female (72.9%) and non-Hispanic (83.9%). (Though the recent PAEA student report released earlier this year showed some growing demographic variety of PA students.)

An interesting aspect of the survey asked programs if they had AT LEAST one student of a particular race, which can help to demonstrate diversity within a program a bit better than the nationwide averages.

When compiling the responses of programs with at least one first-year student of a racial group, the survey showed that 14.4% of programs included American Indian or Alaskan Native students, 76.4% included Asian students, 60.2% included Black or African American students, 31% included "Multiracial" students, 4.2% included Native Hawaiian or Pacific Islander students, 90.7% included White students, 29.2% included students of "Other" races, and 29.% reported students of "Unknown" races.

Both the average (and median) undergraduate GPA of first-year students was 3.51 and science was 3.56, every so slightly up from 3.5 and 3.55, respectively, from the prior survey.

 Average Health Care Experience of PA StudentslBe a Physician Assistant

The GRE was a required prerequisite exam in 59.9% of programs, increased from 51.2% last year, and only 1.4% of programs accepted either the GRE or MCAT (down from 7.2%).

Median GRE scores of the first-year class included 154.0 in verbal reasoning, 153.0 in quantitative reasoning, and 4.0 in analytical writing.

One-hundred forty-seven programs (69.7%) reported that they collected data on the average number of health care experience and work/volunteer hours for their first-year class.

There were broad ranges in reported experience, like patient contact experience covering anywhere from 30 to 12,241 hours. So, to get the clearest picture, it's best to look at the medians rather than the mathematical averages for these categories.

These programs reported a median of 2,310.5 hours of patient contact experience, 100 hours of health care shadowing, and 747 hours of other health care experience for their first-year classes. Additionally, students had a median of 338 hours of community service as well as 1,682 hours of "other" work experience.

2017 COHORT

In addition to the first-year class information, the survey also looked at the 2017 cohort—the students enrolled in a class expected to graduate in 2017. Because PA programs are different lengths and categorizing groups as second-year or second-and-a-half year is difficult, dividing students into first-year and outgoing classes is the cleanest way to collect data.

 GRE Scores of Accepted PA StudentslBe a Physician Assistant

For students slated for graduation in 2017, a median of 91% (average 87.4%) were receiving federal financial aid.

Of the 2017 cohort, which was comprised of 8,895 students, 93.9% (n=8,351) graduated or were expected to graduate on time, 1.7% (n=155) were dismissed for academic reasons, 0.2% (n=18) were dismissed for non-academic reasons (e.g., professionalism sanction), 1.4% (n=123) withdrew for medical or personal reasons, 1.3% (n=115) were on short-term deceleration and expected to graduate less than a year late, and 1.5% (n=133) were on long-term deceleration and moved to the next cohort.

Overall, the withdrawal/dismissal rate (aka, students who thought they'd become PAs and didn't) was 4.0%, slightly up from last year's 3.2%.

The full PAEA Program Report does a deep dive into graduation, dismissal, and withdrawal rates by gender, ethnicity, and race.

There was some missing information in the demographic reporting by programs, with 2.17% lacking gender, 10.1% missing ethnicity, and 9.6% omitting race information on their students.

However, across all analyzed groups, graduation rates were high, and dismissal/withdrawal rates were low.

Reading more into these stats by category is a bit tricky, at least for now, because PA student demographics are heavy in white, non-Hispanic females and other groups are not as well represented. But, if you'd like to see the full breakdown, you can check out the PAEA Program Report 33.


Are you in PA school now and have information to share on your program? Considering a program and wondering if someone could share their personal experience with the program?

Connect with other future PAs in our Be-a-PA Community to share and learn about programs.

References

Physician Assistant Education Association, By the Numbers: Program Report 33: Data from the 2017 Program Survey, Washington, DC: PAEA; 2018. doi: 10.17538/PR33.2018

Physician Assistant Education Association, By the Numbers: Program Report 32: Data from the 2016 Program Survey, Washington, DC: PAEA; 2017. doi: 10.17538/PR32.2017

Accreditation Review Commission on Education for the Physician Assistant, Inc. ARC-PA Standards Degree Deadline Issue. http://www.arc-pa.org/documents/Degree%20issue10.2011fnl.pdf