In July, the Physician Assistant Education Association (PAEA) released their second Student Report, comprised of data from the 2017 Matriculating Student and End of Program Surveys.
While the Matriculating Student Survey (MSS) has been conducted for a number of years now, this is just the second year for the End of Program Survey (EOPS), which gathers responses from PA students near the completion of their program.
The addition of the EOPS allows for a more holistic picture of the PA student experience and, when paired with the MSS, shows some interesting changes in views and attitudes of PA students that can take place over the course of their training.
PAEA is continually working to gather additional relevant information on PA students and incorporating new survey topics and details into each year’s report.
My favorite newbie item from this year: the percentage of first-year PA students who had previously applied to PA school. Can you believe that information has never before been available?
Occasionally, the way information is reported also changes year to year. Previous reports showed that people going directly to PA school after their most recent degree (usually meaning directly after undergrad) went down and the percentage of people waiting 3-4 years had increased.
But, whereas prior reports categorized respondents by the number of years since their previous degree, this year’s report only gives the average number of years for all respondents. So there’s no trend to follow now, which is a bummer.
But there’s also a growing focus on health and well being, diversity, and financial issues of PA students. So the report is undoubtedly becoming more inclusive of things that are probably more meaningful to the individual PA student experience.
The number of programs eligible for student responses varied between the MSS and the EOPS as new programs did not have a graduating class to participate in the EOPS.
Overall, students from 163 of 215 eligible programs (75.8%) responded to the MSS and students from 150 of 199 eligible programs (75.8%) responded to the EOPS. Based on the number of respondents, the overall matriculating student response rate was an estimated 42.1%, down from 51% in 2016, and graduating student response rate was an estimated 31.8%, down from 41% in 2016.
PAEA notes the lower response rates as a limitation to the surveys as many incoming and outgoing PA students’ experiences are not accounted for. However, there are plenty of compelling results to dissect from the PA students who did respond.
Given the abundance of information included in the overall Student Report and so we have a chance to cover as much as we can, I'm detailing the results of the incoming PA students from the MSS this week, and we’ll dive into graduating students and the EOPS in next week’s installment.
For now, let’s take a look at the experience of the “average” incoming PA student of 2017.
As with the prior survey, the distribution of PA students and programs represented in the MSS closely aligned with the ratio of PA schools by region — the highest percentage was located in the South, followed by the Northeast, Midwest, and West regions.
Of those entering PA school in 2017, 46.5% attended a PA school outside of their home state (up from 44.4% the prior year), while 38.9% of those graduating PA school in 2017 (from the EOPS) attended an out of state program (steady from 39.2% the prior year).
PA students remain mostly female (75.2%), non-Hispanic (91.9%), and white (86.8%). These proportions are basically unchanged from prior surveys of matriculating students going back to 2014.
However, the most recent MSS provided opportunities for more inclusive reporting of race that allowed for selection of single or combined races. In 2017, the MSS showed increasing numbers of students who identified as American Indian (1.3% compared to 0.1%), Asian (11.5% compared to 8.1%), Black or African American (3.7% compared to 2.6%), and Native Hawaiian or other Pacific Islander (0.3% compared to 0.1%) either as a single race or in combination with another race.
This year’s Student Report also identified an underrepresented minority status (URM) and an underrepresented (UR) in medicine status, which were new additions. URM status was attributed to those who identified as Hispanic, a single non-White race, or a non-White race in combination with White race in the survey. Based on this categorization, 23.5% of respondents were classified as having URM status.
Additionally, UR in medicine status was defined as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” PAEA defined this group by excluding non-Hispanic, single-race Asian, single-race White, and biracial Asian/White individuals. Based on these parameters, 12.8% of respondents were considered to have UR in medicine status.
The average age of incoming PA students in 2017 was 25.7 years old (median(Mdn)=24.0), which was similar to the prior year (26.0, Mdn=24.0).
The percentage of students who are single when entering PA school continues to increase slowly over time to 76.4% in 2017, previously 75.8% in 2016, 72.2% in 2015 and 70.2% in 2014. Fewer new PA students had legal dependents (10.3%) compared to prior survey years with 12.7% in 2016, 13.5% in 2015, and 14% in 2014.
The most common health care positions for future PA students included nursing assistant (28.8%), medical assistant (25.7%), scribe (moving from fourth place in 2016 to third on the recent survey at 20.3%), and EMT/paramedic (18.3%).
The amount of health care experience gained by new PA students in preparing for PA school increased overall from recent years, including direct patient contact experience (PCE) averaging 120.7 weeks (Mdn=96 weeks) and average health care experience (HCE, meaning experience in the medical world without direct responsibility in patient care) nearly doubling from the prior year to average 90 weeks (from 49.1 weeks in 2016) (Mdn=52 weeks).
This year, the survey also included a total number of experience hours, which is super helpful information for prospective PA students. The average PCE hours of new PA students was 4152.7 (Mdn=2880), and average HCE was 2605.6 hours (Mdn=1500).
More than half of respondents (55%) participated in paid or voluntary community service work, up from 49.7% in 2016, 49% in 2015, and 44.4% in 2014. Total hours were not provided; however, an average of 85.6 weeks of service (Mdn=30 weeks) was reported for those who had experience.
Now for my favorite new item in the Student Report: reapplicant numbers. Of the incoming PA students of 2017, 33% had previously applied to PA school. A full third of current PA students had tried and failed to get into PA school previously.
From the report, we don’t know if students applied multiple times in the past or if they had any gaps between a prior application and their most recent cycle. We also don’t know what changed between their prior attempt and their successful one, and this is not enough information to say that first-time applications are more or less likely to be accepted than repeat applicants.
But still, this makes a pretty good case for not giving up if you don’t get in on your first try.
Before entering PA school, the majority of incoming PA students (70.8%) completed a bachelor of science degree as their highest level of education. A bachelor of arts was second most common (14.1%), followed by a health- or science-related master's degree (5.7%).
The most common undergraduate discipline among PA students continues to be natural sciences (e.g., biology, chemistry) (48.3%), which was relatively stable compared to prior years (48.1% in 2016, 46.9% in 2015, and 50.8% in 2014). Biology remains the single most common primary major (42.3%) among incoming PA students (previously 41.1% in 2016).
In 2016 and 2017, the MSS allowed for greater specification of undergraduate major (including exercise science, kinesiology, and nutrition) compared to previously, which may impact the ability to compare responses from earlier surveys. With these new categories, health science is now the second most common primary major at 13.7% (12.9% in 2016).
The median overall undergraduate GPA of new PA students was 3.6 (mean=3.59) with a standard deviation of 0.26 (which means most students reported a GPA somewhere between 3.33 and 3.85).
Curiously, when comparing the 2016 Student Report to the 2016 Program Report, the student-reported GPAs were slightly higher than those reported directly from PA programs in the Program Report.
The 2017 Program Report won’t be out for a few more months. But the difference between the 2016 reports may be due to the limitation in the number of respondents on the Student Report or an overly optimistic view of respondents of what their GPA really was. Either way, I’m inclined to trust the program-reported GPA (3.55 overall undergraduate GPA in 2016) data a bit more than the GPAs that are self-reported.
The most recent report did not include categories (<1 year, 1-2 years, 3-4 years, 5+ years) for how long ago new PA students earned their prior degree, as had been reported in prior surveys. However, the average number of years between earning a prior degree and matriculation was 2.9, with a median of 2 years. The overall range for all respondents was zero to 32 years since their prior degree.
So if you think you're too young or too old to become a PA, you're probably wrong.
Decision to Become a PA
The vast majority of new PA students (71.1%) decided to become a PA before or during college, increased from 63.2% in the year prior, with a decent portion of this increase (4.7%) coming from those who decided to pursue the PA career before college. And, it seems the reasons for wanting to be a PA were plentiful.
Students were given a selection of 16 possible reasons that influenced their decision to become a PA. They were allowed to choose multiple reasons, and seven of these reasons connected with the majority of students. The top reasons given were:
- Desired to care for patients (83.2%)
- Mobility within PA specialties (75.4%)
- Work-life balance (72.6%)
- A “calling” to the health care profession (64.7%)
- Financial stability (58.1%)
- Length of education (55.6%)
- Excitement of health care (54.7%)
A less appreciated reason for becoming a PA was geographic mobility (18.3%). I think this aspect of being a PA is severely underrated.
Switching specialties sounds cool, but in practice, not a lot of PAs end up doing it. And those who do take advantage of changing specialties typically switch and stay, rather than hopping around different disciplines every few years, which is what many of us envision when deciding to be a PA.
So, while I get the appeal of specialty switching as a draw to the profession, I’m hoping that geographic flexibility gains some traction as a reason to be a PA.
I think more practicing PAs take advantage of it overall, and it’s a huge contributor to that elusive “work-life balance” that’s so often touted as a reason to be a PA.
Additionally, the survey asked about how incoming PA students chose what programs to apply to. Students were asked to rank 16 influences that impacted their school choice. The top ranking choices included:
- Good program reputation (98.9%)
- Many opportunities to gain clinical experience (97.9%)
- Desirable program location (97.7%)
- High PANCE pass rates (97.0%)
- Quality program facilities (96.7%)
- Good faculty reputation (96.7%)
- Rigorous clinical curriculum (94.6%)
- Program mission consistent with personal values (94.2%)
- Small class size/Student-faculty ratio (92.7%)
- Low tuition (86.7%)
I think most of these are pretty good ways to judge a program. And if you’re applying to PA programs, these are the characteristics that should be considered.
But, I’m willing to bet that if PA school applicants were surveyed and given the option, application deadline dates, prerequisite requirements, and whether or not the GRE was needed would rank in the top 10.
However, the survey was given to students who got into PA school successfully, so if you’re looking at what to consider when choosing PA programs, take the cue from those who've been successful on how to evaluate PA programs to accomplish the same results.
The financial elements of the Student Report have been some of my favorite parts of the combination survey report since it started last year. Too often, the overwhelming cost of PA school makes students want to ignore finances until after they’ve completed training, assuming they can face the music once they have a “real job.”
Speaking from experience, that’s a huge mistake.
Both the MSS and EOPS cover financial aspects of PA school, including application costs, PA school loans, pre-PA educational debt, attendance costs, grants and scholarships, and anticipated salaries. We’ll cover the graduating PA student finances next week, but there’s still plenty of interesting information on those just starting out as PA students.
For expenses leading up to PA school, the largest percentage of students (25.3%) spent $500-999 applying to PA school in the year they successfully applied and were accepted to PA school, which included the cost of interviewing.
Before you feel inclined to spend your life savings on applying to every PA school in sight, know that 81.8% of incoming PA students spent a total of less than $2000 for the entire application process, interview costs included.
Also in the column for expenses-incurred-prior-to-PA school are outstanding pre-PA educational loans, with 47.9% of incoming students reporting debt in this category, which averaged $31,109 (Mdn=$25,000). This is before the hefty PA school bills start coming.
Once in PA school, there was a near 50/50 split for those considered dependent (2921 students) by their parents and those who were not dependent (3088 students).
Nearly three quarters (74.1%) of incoming PA students had already taken out loans to pay for their graduate PA education, averaging $61,668 (Mdn=$54,000). You don’t have to pay for PA school as a single, up-front payment, so this is only the beginning for these students. On average, incoming PA students expected to use student loans to finance 85.8% of their total cost of PA school.
Only about 17.8% of students had some form of scholarship or award. But scholarships for PA students are out there, so don’t assume they are impossible to get.
Outside of educational debt, new PA students were also asked about non-educational consumer debt including car loans, credit card debt, and mortgages. The 29.2% of students who reported non-educational debt owed an average of $10,246 (Mdn=$12,000) excluding mortgages.
Whew! That’s a lot of data, but having some baseline information can help you set some parameters to create your own pre-PA plan. Understanding the averages can help you know when you’re on track, develop a plan to exceed what’s common, or avoid detrimental things that are normalized because everyone else is doing them (like creating piles of debt).
If you want to check out the full PAEA Student Report, it’s available to the public.
Next week, we’ll take a look at the second-ever End of Program Survey of PA students and dive into how things change for students between the start of PA school and the end. I’m pretty sure you’re gonna love it.
Physician Assistant Education Association, By the Numbers: Student Report 2: Data from the 2017 Matriculating Student and End of Program Surveys, Washington, DC: PAEA; 2018. doi: 10.17538/SR2018.0002
Physician Assistant Education Association. 2017. By the Numbers: Student Report 1. Washington, DC: PAEA. doi: 10.17538/SR2017.0001
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