Working with plenty of PA school applicants over the years has shown me that many of the same misperceptions I had when entering PA school are still going strong among aspiring PAs.
Though many PA students financing their education envision a future where their student loans are forgiven, a small fraction of new PA grads take roles that offer loan forgiveness.
The number of pre-PAs who believe their future will involve hopping from family practice to dermatology to the OR dwarfs the number of practicing PAs who swap specialties at any point in their career.
But of all of the misconceptions common among future PAs, there's nothing I encounter more frequently misinterpreted than the meaning of PA program accreditation statuses.
If that statement made your eyes widen a bit and second-guess your knowledge of accreditation, you’re not alone. I have this conversation multiple times a week with my clients. It goes something like this:
Me: Do you have some target programs in mind?
Future PA: I'm pretty open with where I might apply, so I've only narrowed some down so far.
Me: How have you narrowed down?
Future PA: Well, I want to stay on the East Coast, so I've been looking mostly into programs there.
Me: Great. Have you eliminated any of those programs?
Future PA: I'd prefer a school with a January start. And, of course, I'm only including schools with continued accreditation.
Me: Why's that?
Future PA: I thought...well, I want to be safe, and I don’t want to go to a program that’s not accredited. Isn't it risky otherwise?
So, let's first understand what each status means because there have been some new sub-categories added in the past year.
Accreditation categories that matter for you
Physician assistant programs in the U.S. are sanctioned by The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The process of accreditation helps to ensure that students of every PA program are being held to the same standards of training and that all programs are providing quality education.
ARC-PA grants or withholds an accreditation status for each PA program on a set review cycle, a length of time determined by the findings of their previous review.
There are eight potential accreditation statuses for PA programs, but we'll concentrate only on the types that might matter at application time.
Developing programs are brand new PA programs not yet reviewed for accreditation. You won’t find these programs listed on the ARC-PA website — "developing" is a term used by CASPA.
A program listed by CASPA as “developing” is open to receive applications, has a planned start date for their first cohort, and has a scheduled review for accreditation.
So, let’s say you apply to a developing program that’s slated to start in May and the program is scheduled for their accreditation review in January.
If you interview in December and are offered a seat for the starting class in May, your offer would be contingent upon the outcome of the program review in January.
If the planned January review is delayed or the program doesn’t pass muster with ARC-PA, the program wouldn’t be accredited and, therefore, your class wouldn’t start in May.
There’d be no long-term danger to you in this scenario as the program simply wouldn’t start. Though, if you receive a tentative offer before the program’s accreditation review, you may, potentially, spend a couple of months anxiously waiting for news.
Once a developing program receives accreditation, it becomes "provisional."
Provisional is an accreditation status granted to programs that have, so far, met the ARC-PA standards. But, given that this status is initially granted before a program starts its first class, it takes a bit of time before a provisional program is eligible for "continued" status.
In short, PA programs with "provisional" status are younger PA programs. Provisional programs can be in existence for 3-5 years before they’re eligible to graduate to accreditation-continued.
But there's a common misinterpretation that provisional means not fully accredited, which isn't the case.
Provisional programs are accredited PA programs, but, as they are newer programs, their review process is a bit more intense than a program with “continued” accreditation.
Programs with a provisional designation go through a three-phase process before reaching continued status. The first review phase is from developing to provisional and takes place 6-12 months before the planned start of the first student cohort.
The second review is done about six months before the graduation of the first class. And the third and final review, after which a program is eligible to move from provisional to continued, takes place 18-24 months after the second review.
If a provisional program fails to meet the standards of ARC-PA during a second or third provisional review, they may be put on "provisional probation" and be scheduled for an interim, focused site visit to reassess any issues identified in the review earlier than would be routine.
Continued is an accreditation status granted to a currently accredited program that complies with the ARC-PA standards. "Currently accredited" programs include those that are continued, provisional, or probationary.
If a program with any of these three designations at the time of their accreditation review meets the requirements, they'll be granted "continued" status.
A program granted continued accreditation may be accredited for a maximum length of ten years before the next comprehensive review is required.
Many prospective PAs interpret "continued" status to mean these are the highest quality programs. But, these are simply the ones that have demonstrated their ability to meet the required standards at the time of their most recent review.
In theory, it's possible that a continued status program is careening toward probation, but no one will be the wiser for a few years. And continued status programs may have had temporary lapses in the accreditation requirements that went undetected because they were able to recover before a review period.
Working to get and keep a program up to the ARC-PA standards is no easy feat. Achieving "continued" status is a massive accomplishment for a program.
But as an applicant, it's important to understand the limitations of using a program's “continued” status as a stand-in for program quality.
We've finally arrived at the most feared and, by far, the most misunderstood accreditation status: probation.
When most future PAs think of a program on probation, they believe that there's a possibility they’ll show up for class one day and find the windows boarded up.
In reality, it doesn't happen like that. As long as your program is on probation on day 1 (the very first day you start PA school), you'd be attending an accredited program, even if the accreditation were later lost.
You'd be able to finish out your PA program and graduate — there are regional accreditation requirements and federal regulations that govern this. After graduation, you'd be able to sit for your boards, get licensed, and practice as a PA, just as with any other program.
PA programs can be on probation for up to two years. For an accreditation review to affect you, it would have to happen in the window between being accepted to and starting with a PA program.
Given all of this, two questions remain:
1. Would a poorly timed ARC-PA review potentially affect your ability to start the program?
2. Why is the program on probation?
How to do some digging into accreditation status
If you're interested in a PA program that seems like a good fit, you may want to check into the timing of its next accreditation review.
Even if it's a continued status program, if it's up for review before you'd start, there's a possibility it could go on probation, and, if it does, you should want to understand why before accepting a seat.
Every program should list their current accreditation status as well as the anticipated date of their next review on their website. You can also find the next scheduled review date for all programs at the ARC-PA website.
If the next accreditation review is scheduled between when you'd interview and when you'd start a program, it's possible that the current accreditation status could change in that window.
Because continued accreditation status programs are infrequently reviewed (remember, every ten years), it's less likely that a review would be happening in that short time frame, but it's not impossible.
But, worst case scenario (aside from a program in total mayhem): a continued program goes on probation and still has a valid accreditation status that would allow you to attend.
If a PA school on probation is up for review in the span between being accepted and starting, it's possible that the program could lose accreditation before you’d start. In this case, you wouldn't be able to attend, as happens when a developing program doesn’t achieve accreditation.
However, this is only a real risk when the accreditation review date falls in the short stretch of time between being accepted to a program and matriculation. Even for probationary programs, applicants rarely are faced with this potential for uncertainty based on the timing of the review.
So, if the strategic risk is small or you know that the review date would not potentially jeopardize your ability to start a program, the final battle is to figure out why a program is on probation.
This information should be crucial to a decision, but the specifics are often not considered by applicants. Probation seems bad, and it scares away many prospective students.
Would it matter to you if a program didn't have full-time coverage for an administrative position? Or if a program didn't pay their accreditations fees on time?
Would those things matter more or less to you than not having enough full-time faculty members for the class size?
Because all of these things are ARC-PA standards, which guide accreditation. And, if they're not met, a program can be placed on probation.
The ARC-PA requirements of accreditation are wide-reaching and help to ensure consistent quality in PA programs across the country. But, not all probationary statuses mean that programs violated standards of similar gravity.
Assuming all programs on probation are lacking in quality is a sweeping generalization that doesn't come close to being accurate.
Some very well-established, high-quality PA programs have been on probation in the past. And unless you knew where to find this information, you'd never be the wiser.
So, before discounting a PA program that's otherwise a good fit because of their accreditation status, dig into the "why" behind it and, importantly, what their plan is to course correct.
Some programs do a fantastic job of laying out the details of their probation status on their websites, including the plan for improvement and a timeline of the upcoming reviews.
You can also find details behind the causes of a program's probation by using the list of accredited PA programs on the ARC-PA website and looking at the "Actions" document for a given program. This document will list the exact rule or rules violated, which you can then compare with the Program Standards.
But, a program's transparency with this information is vital. Not all programs have the ability to create an online guide for prospective students, but the reason behind the probation should be something they're willing to discuss with you by the time you get to an interview.
If by that point, the cause of the probation remains opaque or you feel that a program is being less than forthcoming, it might be a red flag that it's not the program for you.
While there are plenty of PA programs to choose from for most applicants, you want to make sure that your best matches stay in the mix.
To accomplish this, avoid eliminating programs without thinking through what their accreditation status might mean for you.
Exploring the potential impact of a review date or digging a bit deeper into a program's accreditation status can allow you to choose target PA schools more thoughtfully.