In 2016, the Physician Assistant Educational Association (PAEA) for the first time surveyed graduating PA students at the conclusion of their programs.
Though the Matriculating Student Survey (MSS) has been conducted on incoming PA students for several years, the End of Program Survey (EOPS) is the first of its kind to look at the collective PA school experience, attitudes toward future practice, and financial information of those completing PA school.
The new PAEA Student Report combines the MSS and EOPS and allows for a more holistic view of the PA school experience.
Last week, we focused on the MSS, outlining the stats and attitudes of incoming PA students. This week, we take a detailed look at the PA school experience and perspectives of near-graduates through the EOPS.
The vast majority of PA students felt prepared to practice as they approached graduation. The survey looked at six core PA competencies: Medical Knowledge, Professionalism, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, Patient Care, and Systems-Based Practice (defined below).
Over 90% of students responded that they felt confident or very confident in five of these six core competencies, with 84.3% feeling confident/very confident in Systems-Based Practice.
When asked how challenging they found PA school, 58.6% said it was what they expected, 36.1% said it was more challenging than expected, and 5.3% said it was less challenging than expected.
Just over three quarters (76.8%) of PA students participated in required interprofessional education activities with other students, most commonly from nursing, physical therapy, pharmacy and medical programs.
Respondents felt that courses in patient communication skills/history taking, physical examinations/patient assessment, and clinical medicine taught during the didactic year were the most helpful (ranked "excellent" or "good" by 94%, 92.9%, and 90.2%, respectively) in equipping them for clinical rotations.
These particular data can be helpful if you have the opportunity to speak with any current students at a PA program you are considering. If they find the same courses to be the most helpful, then you'd have a good sense the program is doing the right things to prepare you for the clinical year.
PA students felt least prepared for clinical rotations by genetics, biochemistry, and biostatistics/epidemiology courses ("poor" or "fair" of 54.3%, 48.3%, and 48%, respectively).
Survey respondents were asked to rank the adequacy of instruction in different areas as either inadequate, appropriate, or excessive. The Goldilocks areas, where students felt programs most often got it "just right," included diagnosis of disease (95.2%), disease prevention/health maintenance (93.5%), and management of disease (93.4%).
The most commons areas where students felt instruction was inadequate included oral health (28.6%) and palliative/end of life care (29.1%). Less than 8% of students per area found instruction to be excessive.
The majority of PA students were content with their experience in PA school. Most students would recommend their PA program to others (78.7%), were pleased with the quality of their education (90.6%), would choose to attend PA school again (91.5%), and would recommend the PA career to others (97.5%).
While this section was overwhelmingly positive, I want to draw your attention to one part. When asked if they could revisit their career again, would they attend school to become a PA, 98 (3%) disagreed, and 178 (5.5%) were neutral.
These percentages are small, but they still represent 276 people who got into and through PA school yet are not sure they made the right decision. Getting a degree to become a PA does not qualify you for any other career, it only helps you to become a PA. It is so important (especially before you are in a position to be taking this survey at the end of PA school) that you consider what a career as a PA means.
Taking prerequisite courses, gaining health care experience, spending an intense two years of your life, and paying boatloads of money is quite a commitment for a career that doesn't excite you. Being a PA is much more than a good salary and a "work-life balance."
It means you will likely spend 20-30 years focused on patient care. You should be as sure as possible that is what you are looking to do.
I found that exploring the future practice preferences of PA students to be one of the most interesting parts of the Student Report.
To start, students who were near graduation ranked the factor that most influenced their specialty preference was its fit with their personality, interests, and skills (82.3% strong influence, 15.8% moderate influence). Experience in clinical rotations came in as the second most influential factor (63% strong influence, 29.7% moderate influence).
Though it is a stand alone category, I think there's some percentage owed to "experience in clinical rotations" from other influences. Students often better understand that a specialty is a fit for their personality, has a scope of practice they want, and accommodates future family plans (other factors included in the survey) due being exposed to a specialty through a clinical rotation.
The Student Report also includes a direct comparison between the MSS and EOPS to show how students' attitudes towards specialties shift during PA school. This was my favorite part of the EOPS section.
As you can see above, most specialties were ranked as higher percentages for "desirable" on the MSS compared to the EOPS. On the EOPS, there are near universally higher rates of specialties being "undesirable."
What I take away from this, and what I think is true for many students, is that while we're in PA school, we get very clear on which specialties we DON'T want. And, we become more open to other possible specialties as our experience expands through clinical rotations, which may account for increases in neutrality in most areas.
The report also examined shifts in attitudes in practicing in medically underserved areas after graduation between entering and graduating PA students. Overall, the desirability of practicing overseas (41% → 30%), in the inner city (42%→ 36%), and in medically underserved areas (70% → 56%) decreased during PA school.
The desire to practice in urban or rural areas slightly increased over time, and the largest increase was observed in those hoping to practice in the suburbs (79% with new PA students vs. 84% among those nearing graduation).
At the time of the survey, 36.7% of graduating PA students had accepted a job offer, 20.9% had interviewed without an offer yet, and 18.6% had at least one offer but had not yet accepted a position.
Of the students who accepted a position, 89.3% were set to practice in their first choice discipline.
The MSS covered the expected cost of PA school for incoming PA students, while the EOPS captured the end cost for graduating students.
Of those surveyed, 33.5% received scholarships, stipends, or grants for PA school, a median amount of $5,000 (mean=$16,405).
The average PA education loan debt for PA students at the end of their programs was $93,000 (mean=$94,947), which does not include any pre-PA school educational debt.
Additionally, 68.4% of PA students had further supplemental loans from PA school, most commonly through Parent PLUS loans, Direct PLUS loans, credit cards, and private loans.
Just because most people are doing it doesn't mean you have to go this route. There are other ways to go to PA school. It may take more time and planning, but if you want to avoid going deeply into debt, there are other ways to do it.
The PAEA Student Report is interesting in many ways. I enjoyed seeing the differences between incoming and outgoing PA students. Showing the MSS and EOPS together reflects how the PA school experience can influence your attitudes and change your future goals.
Subsequent Student Reports will be able to show us even more as the same cohorts of students take both the MSS and, eventually, the EOPS in the next few years.
Physician Assistant Education Association. 2017. By the Numbers: Student Report 1. Washington, DC: PAEA. doi: 10.17538/SR2017.0001 (All graphs adapted from data, tables, and graphs within report.)
Physician Assistant Education Association, By the Numbers: Matriculating Students 2015, Washington, D.C.: PAEA, 2016. doi: 10.17538/MSS2015.003
Physician Assistant Education Association, By the Numbers: Matriculating Students 2014, Washington, D.C.: PAEA, 2015. doi:10.17538/mss2015.002