Pre-PA

2020 Gift Guide

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It's that time of year again! When we get to celebrate our loved ones by getting them heartfelt gifts. We've compiled a list of our favorite choices for the pre-PA students, current PA students, and practicing physician assistants. It's been such a strange year with the pandemic and everything shutdown, so even if you can't see your loved ones in person, you can show them love this season through your "presents." (Feel free to forward this list to friends and family to give them some ideas. That is what I will be doing also.) This post does include some affiliate links, which doesn't increase the price for you, but gives us a small percentage of some purchases. Follow us on social media @thepaplatform on Instagram to be on the lookout for deals and sales.

Pre-PA Gift Ideas

For school: To make the pre-PA journey a little easier, here are some gifts to consider gifting to take some of the stress away.

Interview Package - Interview Guide and Course - When it's time to apply for PA school, the interview is one of the most important parts and it's never too soon to start preparing.

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  • Med Couture Scrubs - Getting patient care hours is required for almost every program, and many positions have a dress code of scrubs. These ones on the right are some of my favorite affordable one

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For self care: When focused on becoming a PA, it can be easy to forget about taking care of yourself. Help your pre-PA student focus on themselves during the process.

  • Big water bottle - One change I've made this year is increasing my water intake, and it's made me feel so much better. Highly recommend this half gallon water bottle.

  • Workout clothes - Getting active and moving your body is a great energy booster. Here are some of my favorite Amazon Lululemon dupes.

  • Sound machine and gentle alarm clock - Sleep is essential! This sound machine and gentle light/alarm clock duo is perfect for the anxious student.



PA Student Gift Ideas

For school:

To study - The study 24/7 lifestyle is just a part of PA school, but here are some things that can make it just a little bit easier.

  • Smarty Pance - Studying for the PANCE starts on day 1 of PA school. Smarty Pance is a great option to study throughout school. - thepaplatform 10% off

  • PANCE prep pearls - AKA the PA school Bible. I'm honored to call the author Dwayne a friend, and he is also a practicing PA, so he knows exactly what's needed to get through PA school.

  • PANCE review book - For a quick review, this was my go-to during PA school, and a book that every student needs.

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Tech - Since the majority of PA school consists of hours of lectures, pen and paper may not cut it anymore.

  • iPad - In the Pre-PA Club group on Facebook, it's overwhelmingly recommended to have an iPad for taking notes during PA school.

  • Apple pen. If your student already has the iPad covered, the apple pen is a great companion and you're saving trees!

  • iPad case with keyboard - Personally speaking, it's the worst when an accidental drop wipes out a device. This case provides protection and a keyboard.

For rotations: Clinical rotations can be stressful with long hours, so being ready to take them on is essential.

  • Medelita scrub jacket - My absolute favorite thing to wear at work 24/7.

  • Crocs for work - Crocs have become my go-to work shoe. They're light, supportive, and comfortable. Don't knock them 'til you try them!

  • Apple Watch - I got an apple watch last year from a family member, and I never thought I would love it as much as I do. Super convenient.

    • Having an extra band is always helpful, and I love this one. It's affordable and easy to clean.

For survival: Help your PA students in your life focus on some things outside of school and get through the tough weeks with some of these gifts.

  • Keurig mini - Coffee. Because PA school.

  • Kindle - My personal lifesaver. My kindle goes everywhere with me and is a great distraction. See below for favorite books.

  • Cashflow Cornerstones online course - One thing we didn't really learn about in PA school is finances. This course created by a PA is a lifesaver for getting the basics down.

Physician Assistant Gift Ideas

For work: While the PA in your life may not specifically request something for work, here are some things they may not have invested in themselves yet.

  • White coat - When it comes to white coats, Medelita has set the standard. The Rebecca is my absolute favorite and I recommend Sprite for thread color!

  • New Balance Nergize - Good-looking comfy shoes are a must for working in medicine. These are some of my favorites. I might have 4 colors.

  • Blue light glasses - Thanks to EMRs, we stare at computers and screens all day long and could use some eye relief.

  • Scrubs - If you have any guy PAs in your life, my husband's favorite scrubs are Figs. Use this link for $20 off your first purchase.

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For life: To separate from work life, here are some fun things that I've loved this year and think any PA (or person) would be happy to get.

Skin category: Being a dermatology PA, I have to give some skin recommendations of course.

  • Babe Lash - Using a lash serum and not having to use mascara everyday has been a game changer. Use code SAVANNA for 20% off.

  • Revision block - For an updated, but basic skincare routine, Revision skincare is my favorite cosmeceutical line. With these 3 products, you'll be set.

    • Brightening Wash - This vitamin C and glycolic acid based wash is a great first step.

    • Vitamin C - Dull skin? No problem! This topical vitamin C will brighten skin and lighten dark spots.

    • Retinol Complete - Retinols are the best for slowing down fine lines and wrinkles. This one is very tolerable.

  • Dyson Airwrap - Ok. The price tag is high, but the time saving is so worth it. Wet to styled hair in 10 minutes.

To read: Book club is the highlight of my month, and here are some of the favorites from the past year.

  • The Silent Patient - The biggest thriller and twist we read all year.

  • One True Loves - Taylor Jenkins Reid is my new favorite author of 2020, and this is a nice, lighter romantic read.

  • The Nightingale - A historical fiction set in WWII and one of our most favorites of all time.

Fun Category: Here are some fun stocking stuffers (kind of) that anyone should be thrilled to receive.

  • Starbucks gift card - No one will ever turn down coffee! And those chocolate croissants aren't too bad either.

  • Corksicle - Best cup ever. I got one of these for my birthday this year and now I"m obsessed.

  • Loungewear - A fun robe has been my quarantine dress code this year.

  • Peloton - Ok, I know. We hear about them all the time and there's a big price tag, but with the financing options, it's so worth it. Total fitness game changer. Use code UFSYCC for a free accessory package! If you get this for a significant other, brownie points forever.

For even more gift ideas (or to just see what I am eyeing and buying) check out our Amazon Storefront!


How to Pay for PA School

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I am really excited about this post because it is highly requested -- learning more about the financial part of paying for PA school. I brought on one of our interview coaches, Hanna, to share her experience with you because we have different experiences as far as the type of PA schools we went to, the cost associated and how we each paid for it. My hope is that this episode will help you plan for the future and understand the process of how people pay for these HUGE price tags that come with PA school. 


Before we do a deep dive, I want to point out that this is a very extensive topic, there's a lot that goes into this. We are not experts, we are not financial advisors. We're not going to share logistics of how to apply for these things or what exactly a certain program covers. For that you need to go to your registrar's office program websites. A lot of times your school will have this information, they'll tell you how much a program cost, what's involved, the fees, tuition, etc… and how to apply for aide and whatnot. Just know that everyone’s situation is different and this is a very personalized topic. 

Savanna (S): Hanna's going to start us off with talking about just what does it cost to go to PA school? What are the fees involved?


Hanna (H): In regards to cost a PA school and just as you just said, this is super expensive, there's a lot of different aspects to take into consideration. With the 223 programs, and varying private versus public programs in state versus out of the state that in general, right there is going to really bring down or hike up the cost of your program. I'm at the median cost going back to 2015/16 school year was about $89,000, for a private PA program. That, in comparison to where I went to school, it was a private program -- I was at $102,000 and that was six years ago. Clearly, that's kind of under marketing some of the programs out there. We also looked at the public median cost, and that was about 52,000. Stepping back, really look what schools are you applying to and doing your research on their website. Most schools have a wonderful cost breakdown of their tuition, the cost expected for fees and lab coats, didactic versus clinical years, and really getting a true idea of what the basis is going to be for your specific program. 


S: Just to jump in, you're $102k was for your total tuition for the whole time your in PA school? 


H: Correct. 


S: That's what these numbers are referring to , i.e., $89,000 as a median cost is your entire tuition fee for the two/three years, you're in school. Because schools are different lengths, you're going to have different amounts you owe each semester. In comparison to Hanna's private program, I went to a public in state program as an in-state resident. My final tuition was around $45,000 for my 27 months program. That's a pretty big difference. But hey, we're both PA. 


H: That's another great point that you mentioned in regards to length of program, my program was a 26 month program. Definitely something else to consider is how long are you going to be in the program, because that will definitely change the cost. 


S: Yeah, and I think also, just for people who are maybe in the process right now of deciding what school to go to, I think cost should be a factor -- I don't think it should be the only factor because you should choose somewhere where you're going to be happy. Also think about when you start school, especially going into application season -- if you're able to start a program in January compared to September, and then you're going to potentially graduate earlier, and especially if it's a shorter program, that can essentially give you eight extra months of income. It might make it more financial sense to go with the program that starts sooner if you're just looking at the cost of everything.

I thought this was interesting, the PAEA did a survey in 2015 of students starting PA school and one question was, “What do you expect your total debt from PA school to be, not including personal debt just from school?” 21.9% said they expected $100k to $125k, 20.8% said $75k to $100k, 14.5% said $50k to $75k. That's a pretty good spread and a lot of money. I know it sounds like a lot of money and something to mention, coming out of school right now, the average salary for a new grad PA is around $75k to $80k. There are a lot of factors that go into that, such as where you live, cost of living and specialty and all that. This is just an average. 

Let's talk in-state versus out-of-state program costs. I decided to go in-state and the cost was part of it. That price tag looked a lot better than another program I was considering that was four times as expensive when it came to tuition and cost of living and all that. 


H: I knew that I wanted to go out of state and there was a big push for me to stay in. I grew up in Georgia from Atlanta. I've always wanted to go out of state and I made that decision applying to graduate school programs, specifically out of state. One of my biggest regrets was not taking into account the finance, the process, and not really having a full grasp of how the various costs of the PA schools. And I didn't realize that much further into my application process. Ultimately I didn't end up taking that into consideration with my school choice. And I'm paying that off now. 


S: I think a lot of people are at this point are so eager to get in that they don’t look at that and it’s ok! Like I mentioned earlier, I don’t think it should be the biggest deciding factor, but it should play a role. One question we got on The Pre-PA Club Facebook group is, “Can you switch from out-of-state to  in-state, so if you apply to a school that has a cheaper option for in-state residents, can you technically become a resident?” You know, for Georgia, I think there were a few people who were able to do this, I think you have to live in Georgia for over a year and have a good amount of documentation in your name, you have a license and bills, to show that you're truly a Georgia resident. Now, if you're only gonna be there another year, is it worth it? I mean, you're probably saving $10-15,000 but then you're gonna have to move and do all that again, most likely. Each state's going to have their own rules. Hanna, your school didn't have an in state option?


H: Correct. A lot of the states are very happy to have lived in that state for one year client, Most states and again, a very, that you have to live there for one year prior to starting your program. With that being said, most of us are finding out that we're getting into a program until under that one year mark, and it's very specific in regards to one year, so not, a school year but rather one full year. In many schools, once you've come in as an out of state resident, you cannot switch to an end state further along in the years. Schools have become very strict on following this, looking at where you're paying your taxes with, where you're registered to vote. It's not so much “Oh, my grandmother, or my sister who lived in New York”, which is where I went to school. It is definitely something that you really have to take the time to look at what your state requirements are and to talking to the school because some of them are willing to help make it work, especially it's, you know, come close to qualify. 


S: Yeah, and I think that, again, is something to look at. Just from an application standpoint, if you're applying to schools, because that process is expensive, too. That's a whole other post. If you are applying to schools, I strongly discourage applying to in-state programs, if you are not a resident of that state or if you don't have an extremely competitive application, and you know, some of these schools, they set 90% in state residents. At my school, we had 44 people, and it was 90% in state residents, we had, I think four or five people who are out of state. That wasn't something that was negotiable, they had a certain number of spots, because they got public funding. You could apply there if you're out-of-state, but your chances compared to an in state resident were so, so much less. You don't really want to waste your time and money applying to a bunch of programs that you are really only competing for a few spots. 


H: One thing that I found really interesting that I didn't know existed when I applied to PA school. and now that I'm living on the West Coast I have been interested in because I've been helping do mock interviews, and watching these acceptances start to roll in, which is very exciting, is that a lot of states participate in regional programs. Although you may be from California, I know that there's a Western Regional graduate program that allows Western applicants to apply to other schools within the region and your aren’t stuck to just your home state and still get in-state tuition. There's a regional one for the southern region,  Western, New England that I was able to find. These do apply for graduate school. I would definitely recommend looking into these and seeing if you qualify for those qualifications.


S: My school kind of did that because we're right on the border of Georgia and South Carolina, I went to Augusta University -- if you were from a few certain counties in South Carolina, you were considered an in-state resident for tuition purposes which was awesome for them. 

This was something that I thought was worth talking about, switching to in-state, if that's an option for you, you're going to try to become an in-resident, if you are still being filed on your parents taxes, you may not be able to switch. My parents claimed me on their taxes until I got married and I was 23. They were helping out with my school. As a parent helping out with my school, they got a little bit of tax benefit from that. They wanted me on their taxes to be able to write that off and get that reimbursement or whatever they got, I don't really understand taxes. They would not have probably let me switch or wanting me to unless I wanted to start buying my own taxes and paying for the rest of my school, which I did not. 


H: Definitely communication is key with that one with your parents. I know my parents and I went back and forth on that for a little bit because they can save I think it's up to like $2,500 per tax season so that can definitely add up pretty quickly. You also don't want to get caught doing tax fraud by both trying to file for that. Definitely having good communication is key. 


S: Definitely. Okay, so how do people pay for PA school? 

H: The number one thing you need to do is you need to apply for FAFSA. For FAFSA, that's your federal aid for for students across the board. It's that kind of the best way to start and it's broken down into direct subsidized loans and unsubsidized They have a great website called FAFSA forecaster that predicts your expected contribution of your fees to graduate school. In graduate school, you don't actually qualify for direct subsidized loans, that's no longer available, they cut it out in 2012. Basically, in a lot of applicants, probably do have loans from undergraduate but during undergrad when you got these loans, all that meant was the government was helping pay for the interest on these loans, so that was not accruing. This is a really big deal and would be really nice to have for graduate school but now for graduate school, you can only apply for direct unsubsidized loans, also known as Stafford loans. What that means is that you can take up to $20,000- $20,500 for a year, I believe. As soon as you take out that money, you start to accrue interest on that money and you're responsible for paying that once you get out of that program. You get a six month leeway with that, but the interest is accruing the moment that you receive that loan. 

With that, let's talk a little bit in terms of what that money does. When you go through the FAFSA application, which I don’t know about you, Savanna, but I felt like it, it's very straightforward. Name, DOB, --  very straightforward application. Once you get approved, which is relatively easy, that money goes directly to your program. You don't ever touch the money that goes directly into your program. It gets immediately applied to tuition and fees. If there's money left over from that, it falls into your room and board if you are rooming with the school, then after that they reach out to you for permission to put it towards other charges that may come with the program. If there's still money left over from that point, then you get a check, or somehow receive that money back and use that towards your education costs. Savanna, I’ll let you take it over for a little talk about your experience with FAFSA and a scholarship. 


S: I applied for FAFSA, I didn't have any debt from undergrad, which was great. Georgia has something called the HOPE Scholarship where if you qualified, and it’s changed a little bit since I got it, but they essentially cover all of your tuition and fees. The only thing that I had to pay for, or my parents helped me pay for, in undergrad was living expenses, which was amazing. I had to obviously keep my grades up and all kinds of other qualifications but going into grad school, I did have to take out loans.  I took out these Stafford loans, I filled out FAFSA. I was actually the last or at the tail end of when you got subsidized loans. I had one semester where I got a little portion that was subsidized, which I'm thankful for but the rest of my loans were unsubsidized. I took out the $20,500 for the year. Now my tuition for the year was a little bit and fees was a little bit more than this. I ended up taking out total $45,000 in I guess I took $40,100 but my tuition was $45,000. My parents did help out with you few thousand here and there, which I appreciate and I was living with them which helped save on expenses. These loans did end up getting interest right away. Now, you put the current rate here, which is 6.6% -- that is a very high interest rate. Just FYI, I think mine was around that, too. My supervisor physician talks about her loans from medical school and her percentage was like 1% -- it's so so low, and it has changed so much since then. 

I'll talk a little bit about my experience FAFSA, because when I applied, I was awarded a scholarship randomly, and I didn't know that I was applying for scholarships, but some of them do pull your information from FAFSA. About a semester into PA school, I got a check in the mail for $1,500 dollars and a little letter saying I was part of this Lettie Pate Whitehead Scholarship, and a few other people in my class also got it. I received those checks, I think three times during school, which was crazy -- it was just out of nowhere. It was one of those things where you get the check in the mail and you kind of question it, is this real? Is this a scam? What is it? When I looked it up, it was a real thing. It's a special scholarship for women in the Southeast who are pursuing medical degrees -- that was awesome. That helped out a ton with my fees and extra expenses here in there -- you've got to pay for equipment, all kinds of things. Luckily for me, I didn't have to take out any additional loans. Just to clear things up, the way that most people pay for PA School is loans and that's okay. I mean, I would say there are a few extremely lucky people who maybe their parents can help them out completely, or they were able to save a ton of money, but for the most part, everyone's going to have loans. Would you agree, Hanna? 


H: Absolutely. I think one, you know, the bright light at the end of the tunnel is that we're going into a career where we should be making money to pay back those loans. That's incredibly rewarding and exciting, because a lot of people do not have, necessarily that guarantee when they get out of graduate school. I do think that it's you know, and most people have already made this decision that it is an investment that is worth making. You definitely have to make sure that you're ready for that because it is a lot of money. If you're not going to follow through on it, you don't even want that first $20,000 of debt sitting on you. 


S: I mentioned that at the beginning, before we started that, I was just getting my loan money went straight to my tuition and fees. I never saw a penny of that. I did not check my interest before or throughout school -- I just didn't want to know, I didn't want to look. I knew it was accruing interest. By the time I graduated that $40,000ish had turned into $75,000 that I owed and that was a little shocking to me. That is what it is what it is.

H:  It definitely stings and is motivation to get that job. 


S: Oh, yeah, I went to work right away. I was like no vacations here, put me to work! 

One question was, how do you know what to do? How do you know how to get these loans? How do you know how to pay for this stuff? Is this something that schools help with? 


H: I would head to the financial aid office, they're definitely going to point you in the direction of FASFA first. They may also be aware of certain scholarships, it really depends on how involved the financial aid section of your schools involved in the graduate program, I felt where I went to school, it was not as involved as it was in the undergrad program, because they had a massive undergrad program. You're really able to find some better systems online, and they can definitely at least point you in the right direction. I think it's a great place to start. How about you? How did you go with that? 


S: I felt like our school was very helpful. The first thing they tell you to do is fill out FAFSA. They kind of tell you that and then give you a little bit direction as far as loans after that. What would what would be the next step after you got your Stafford loans, they paid for your tuition fees, but now how are you going to pay for living expenses? 


H: Absolutely. So definitely, with the cost of my program, the $20,500 did not cover my tuition and fees so that's when I started to look at grad PLUS loans. Those loans are at a higher interest rate, they are at a higher fee, I believe the interest rate is about 7.12% don't quote me on that, but it is still high, but it's not 12-13%, which you may see some private loans at, and this is going to change year to year. With the with the grad PLUS loans, they will cover for the rest of your fees for your program, minus of course, they take a look at what other loans you've already received and subtract that from what they will finally get to you. That can be used towards living expenses. For example, I was living in New York, paying for a studio apartment in Manhattan is not cheap. My sister shared the studio apartment for a little while because of expenses, and really just did whatever we could to get the costs down. But you know, those loans went towards that and for food and those coffees that I probably should have cut out a little bit more, but they just surviving PA school. 


S: When people ask, how much should they took out loans. In my mind, you want to take out the most minimal amount possible. Everyone's going to be a little bit different in their kind of thoughts on this because I definitely had people in my class who ate out every single meal, and I knew that they were living on loans. Then after school, usually they were the first ones to go buy a brand new car. You have to make your own I think financial decisions but you want to make sure you have enough money to live on to.

H: I think you just kind of have to learn semester to semester, I know that some of my really close friends in PA school, we talked about this a lot. It was like how much are you taking out? Calculating our rent and our expenses? I think it should be an open conversation because it you know, it is the same cost to attend this program across the board. Are you kind of keeping in mind but like, are you paying $2,000 more per rent than your friend? Do you need a roommate? Should you save those expenses, but also just making sure, like the cost of your stethoscope and your books and other fees are kind of keeping in line and holding each other accountable for some sort of budget to figure out what you should be taking out and trying to live off.


S: I agree. Plus, you can always take out money and then give it back. You don't have to use it all or you don't have to let it sit there. If it's in your savings account that makes what like 0.05% interest rates, like those that nickel you make over six months is not going to counteract the interest that you paid on it. This is not money that you want to take out and try to invest. It's not fair investing, your return is not going to be higher than your interest rates. Again, I'm not a financial advisor, but I've read enough White Coat Investor to know that that is not a good idea. 

I don't know what your thoughts are or if you have any experience, but do you know if people are paying back loans for undergrad, if they go into deferment?  I feel like this is going to depend on where that came from? 

H: Exactly. So This is definitely dependent on where the loan came from.  We're talking about the terms of the subsidized loans earlier meaning government's paying your interest. If you are enrolled in school, at least half time, those direct loans will be placed into different banks. You don't have to make any payments on those until six months, just kind of like your other your first a new loans give you this grace period. If they're private loans, if you're not sure what type of loan they are, you kind of need to do the research. These things are changing constantly. In regards to something we didn't mention earlier, but there was a Federal Perkins loan for a while and that no longer exists. So laws come in and out based on the year. You really have to do your due diligence, following up on what's going to happen with your student loans. 


S: I love Google who doesn't. I mean, just kind of searching for things, you can find stuff on the PA forums, and there's a lot of information out there. But again, your school is going to be the best person to talk to, and talk to the class above you and see what advice they have as far as what they've done and maybe mistakes they made just so you can try to avoid that. 


H: We want to close off This episode in regards to talking about refinancing. After you've made it through PA school, and you've got multiple different types of loans, possibly public and private, really looking over those loans and more specifically, the interest that you've accrued on them and the interest rate at which they're accruing. So for myself, I think I had six or seven different loans come after the completion of PA school. The loans really varied year by year. I might have had one that was kind of had a 4%, 6%, 7%, I had a 12% and a 15%. Then I had another one that was relatively low, 4-5%. The first thing that I did was sat down and talked with my parents about them and again. This is an important aspect to remind you guys that we're not financial advisors, you really should consider speaking to someone about this, but knowing that you can refinance these loans and basically group them together as one specific, total sum of money and reduce the overall interest rate. That way, you're paying maybe 6% on all of your loans rather than possibly the high 12-15% loan. That's really going to change year to year. If you guys want to really follow this market, you've seen that this year, interest rates have gone up quite a bit, last year they were much lower. Watching to see what they do over the course of your PA school career. SOFI is one of the refinancing tools and there's Earnest and Common Bond, there are so many out there, but a lot of these specific businesses, they look at graduate students who are coming out of programs that they know are going to make a good salary.

The reason why that they aim their businesses towards us, because they know if you're making a good salary, you should be able to pay off your debt, that you shouldn't become bankrupt and go out on your loans. With that, they're really willing to work with you and set a low interest rate in comparison to what you've been sitting on for the past, let's say 26-27 months. So it's definitely something to look at multiple at these different options and companies to see what the lowest possible interest rate you can get. So that you can ultimately start paying off these loans and paying off as little interest as possible. 


S: I only have federal loans so I was not able to refinance, I have looked into it. With some of the kind of repayment or federal programs, if you do end up refinancing your loans, they kind of lose eligibility for some of that. So you really have to look at it and think about it, talk to someone who knows what they're talking about, like a financial advisor before you decide to do that. I have heard really good things about the SOFI. 

Anyway, another thing that people sometimes talk about is, and this is just a way to pay back your loans afterwards is, will jobs pay for your loans? Is there a way for your employer or your supervising position to pay back your loans or help you out with those? It's not out of the question, I've heard of that happening. In my mind, you never know until you ask and so when you're in your contract negotiations, why not throw it out there you know, see if there's options for some loan repayment. Usually the way I've heard it work use you know, through there for a year you get a certain amount or two years or three years that go straight towards your loans, or it's given as a bonus for your loans, essentially. That's something to think about. It doesn't happen that often, I don't think so. Didn't happen for me, you never know. 

Thank you so much, Hanna for taking the time to share your experience!

Make sure to check out my Youtube channel to learn about more ways to pay for PA school! Here are some videos you may be interested in: Student Loan Options for PA School, How to Afford to Pay for PA School, Learn How to pay for PA School with Stride Funding, and How to pay for PA School.

To listen to this interview as a podcast, click here!

Let us know other topics you would like for The PA Platform to cover in the comments below.



What You Need To Know About The Interservice Physician Assistant Program (IPAP) - Guest Post from Chris Walerysiak

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What is the IPAP program?
The Interservice Physician Assistant Program is a program for members of the department of defense, all branches, to become a PA. It is accredited through the University of Nebraska's Medical Center and consists of a 16 month didactic period (phase 1) at Fort Sam Houston in San Antonio, TX. Upon graduation of Phase 1 students receive a bachelors degree. Phase 2 consists of a 12 month clinical rotation. The locations of clinical is dependent upon your service, but will most likely be at military treatment facilities. The Navy does their rotations in San Diego. Upon completion of phase 2, students graduate with a MPAS and are eligible to take the PANCE.

Who is eligible to apply?
The Navy and Marine Corps only accept active duty applicants. I believe the Army and Air Force allow reserves and national guard to apply. It is an Army run program, therefore the seats for Army and Air Force are greater in numbers. I think roughly the Navy and MC have 15-17 seats once a year and the Army and Air Force have ~30 seats three times a year.

What is the application process?
The first step is to apply on a LiasonCAS which is a system very similar to CASPA, where UNMC determines your eligibility to apply. The second half of the application is branch specific consisting of roughly the same things. They include a personal statement, letters of recommendation, a commanding officer's endorsement, review of military record, transcripts, possibly shadowing hours (Army/Air Force), and a few interviews with appraisal sheets.

What are the basic requirements?
Here are the basic requirements:

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Chris also granted us permission to share his academic review from UNMC that has a clean look to it. The italics are not required.

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What are the benefits of the IPAP program?
The benefits for IPAP are amazing. It has consistently been a top performing school (top 15 more or less) for the past 5 or so years. They have had if 100% very near it first time PANCE pass rate. If accepted into the program, not only is it free but you also get paid your current pay rate in the military during school along with all other benefits that come with being in the military (housing allowance, healthcare, ect). Once you graduate you become a commissioned officer which is another pay raise and your time in school also counts towards retirement from the military. Also, applicants to not need to posses a bachelors degree, nor take the GRE to apply. You just simply need the specific required prerequisites.

Are there any disadvantages?
The program, at least for the Navy, is very, very competitive. Even more competitive than civilian programs. I would highly discourage someone from joining the military just to get into this program. There are certain rank requirements to apply that may take a few years to get there as well as other things that would make you competitive like leadership/deployments/awards that will take years to accumulate. In the Navy there is only one time a year that you can apply so not getting accepted puts you on hold for a whole other year.

How long is the program?
16 month didactic phase in San Antonio (Phase 1) and a 12 month clinical rotation phase in various locations dependent on your branch of service, usually MTFs (Phase 2).

What made you stand out to gain acceptance?
The biggest things that board members look at are grades, SAT scores, personal statement (why you want to be a PA), and interview appraisals. So make sure those are all top notch to stand out. I stood out by having sustained superior performance on my annual evaluations for work as well as dedicating down time and off time to do some shadowing/OJT with family practice and the ED. I also work in the OR so that helps. Leadership helped me, being in charge of X amount of people or running different programs, like being a BLS program coordinator and instructor. My previous duty stations to include being deployed with the Marines. (Side note, PAs in the military are one of the most deployed medical assets to include deployments with the Army, Marines and on ships. Board members also want well rounded individuals so extra curricular activities helped. I coach/play soccer and rugby and volunteer a lot with the boy scouts.)

What advice would you give someone who is interested in the IPAP program?
Again, do not join the military to try to get into the program. It would be much easier to get into a civilian program. If you already in the military then step out and start shadowing PAs in family practice, try and get into an OR, or shadow some people in specialty clinics. The best resource a person can have trying to get into this program is to get in contact with someone that has gone through the program. There are facebook pages out there that have a ton of information on them about specific branch requirements, down to the tiniest details, and full with people that are willing and wanting to help. If anyone wants more information about the program or where to find more resources or specific questions I authorize you to give out my email to people and they can contact me.

Bonus note-this link will take you to the IPAP website operated by the Army where you can find things like the school's mission statement, goals, curriculum, past PANCE rates, and other helpful links.

My Everyday Essentials as a Dermatology PA, Mom, and Blogger

This post has been sponsored by Zebra Pen. All thoughts and opinions are my own.

Working as a dermatology physician assistant for the past five years, I know what works and how to make my day more efficient. As a busy PA, blogger, wife and mom, people constantly ask, “How do you do it all?” It’s time for me to share what my days look like and what makes my life easier.

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I’m a pen and paper kind of girl, but I’m very picky about my pens. Luckily, I recently found a favorite with the Sarasa® Grand Gel Retractable Pen from Zebra Pen. It’s got a good weight to it with a metal barrel, dries quickly, and even looks stylish. As an added bonus, no one in the office can steal my pen since they know it’s my trademark. I need a to-do list to keep my life organized. I’ve experimented with apps, but if I physically write something down, I’m much more likely to remember it. If you’re a pen junkie like me and on the lookout for a new go-to pen, check out more information here to see how you can Choose Different!

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My planner goes everywhere with me so I can stay on top of deadlines and tasks. Each week, I take some time to review everything I need to get done for the week, as well as the things I would like to start working on. Goal planning is important, and breaking down bigger goals into small steps makes them seem more achievable.

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For making a new podcast episode or video, I have to plan out a topic, title, talking points, images, and links. It seems like a lot until I take it one step at a time. I also like to look at my list daily and write down anything I need to do or put on my shopping list as soon as I think of it.

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Once I get to work, there are a few tasks I do everyday. The first thing is my pathology reports. Since I do a lot of biopsies in dermatology, once the results are faxed over, I decide on a treatment and mark it on the report. I also have to check the schedule from the previous day and send letters to patients who missed their appointments.

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Once I start clinic, it’s really busy and I see on average 30 patients each day. They range from acne and eczema to skin checks and biopsies. If you are ever involved in doing biopsies, make sure to get consent from the patient, and mark a skin map so we can find the lesion again in the future.

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I think it’s funny when I have patients sign consent and they ask to keep my Sarasa® Grand Gel Retractable Pen. Having nice pens like this one from Zebra Pen is actually something my patients notice, and I view it as an accessory. They like the way it writes, but also that it dries fast without smudging. 

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After I’m done seeing patients in clinic, I finally head home to see my baby girl, but I always keep my planner and pens in hand. You have to find systems and tools that work for you and stick to them!

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Should the Title “Physician Assistant” Be Changed? Research Points to Maybe.

While at the 2019 AAPA conference in Denver, CO this week, I sat in a session titled “Title Change Investigation Update.” The hour-long presentation came from WPP, the research firm behind the exploration of whether the name of the PA profession should be changed. AAPA has released an article with an update as well, but I want to help you understand the information that was shared during the session and how it was received. This presentation was not made available after the session (so far), but my seven pages of notes will suffice. If you want the summarized version and don’t care about the logistics, scroll to the end.

For a little background, the title change investigation comes from a resolution that was passed in the 2018 House of Delegates that resulted in a vote of starting a further investigation on whether the physician assistant title should be changed, whether it was feasible, and what were potential alternatives. Over the past year, this has been a topic of much discussion of PAs, but in the spring a 45-minute survey was sent out to begin this investigation. This survey received some backlash for length and lack of seemingly relevant questions, which was (somewhat) addressed in the presentation.

Upon arrival, we were urged to shift to the center of rows to make room for more attendees as it was expected to be packed, but as the presentation started I found myself one of only 3 PAs sitting in my row. I’m not sure if the unexpectedly lower attendance was due to the session timing at the end of the day or a reflection of PAs having other priorities, such as learning about information they can apply to their daily jobs with patients.

The presentation started with Pandora, the project lead from WPP. She was joined by Rich Durante, the research and analytics lead, and Jasmine Tansy, the title lead.I have to admit, at this point I almost felt as if I was sitting in an Apple keynote between the very well-rehearsed talk and fancy PowerPoint. The goal of the talk was shared - review and give clarification of project to date, share and inform on the research, and share conclusions and next steps moving forward. This would be followed by addressing questions from the PA community.

They also addressed what would not be covered - full quantitative findings report (meaning we only saw two solid data points from the study), presentation of brand strategy and title options (there were no mentions of contending alternative titles), and financial outcomes. There is a legal team that is also on board, but was not in attendance, responsible for researching the legal and financial ramifications of a potential title change. They will review laws and regulation to avoid confusion in the marketplace and advise on legal and legislative steps with a goal of bringing outcomes to fruition and avoid changes in billing, scope, and responsibility. 

As the presentation began, it was noted that the PA profession would be referred to only as “physician assistant” throughout the talk, with no use of acronyms. Pandora made a point to address that the use of this title “may be difficult to hear” for some of the audience members. Personally, I found this bizarre as I attended physician assistant school and I am fine with being referred to as such. I will be using the PA acronym for the remainder of this article.

WPP made a point to recognize that PAs play a role, and will continue to play a role, in delivering high quality health care. Their stated goal with this project is to “position PAs to compete in an ever-changing healthcare marketplace, and increase relevance with state groups and patients now, and in the future.” There was no discussion of how WPP was chosen for this task, but the resources allotted to the project (thus far) were a million dollars to put the vast cost of this type of project into perspective. WPP stated the challenges they found for determining an appropriate title include the variety of PAs in scope and specialty, competition for space in patient’s minds from other providers, and a lack of a good understanding of what PA stands for. Pandora presented two key questions to address:

  • Is there a need to evolve the PA brand based on objective well-informed data and analysis driven view?

  • If so, how do we redefine how the PA profession is positioned in healthcare today and in the future?

The set up of the research process was discussed as a 5 phase process including discover and design, research and analytics, insights and strategy, title development, and validation. At this point, phase 1 and 2 have been completed, and we are in phase 3 with an estimated timeline of May to December 2019. 

Phase 1 - Discover and Design

The purpose of this phase was to set the foundation for learning by reviewing research for relevant industry trends, publications, and regulations to see how PAs operate today. To begin this process, WPP met with a council of 12 volunteers that all represent PAs, including members from influencing organizations like NCCPA and ARC-PA. It was decided at this point that there was not enough “data” available to indicate that a name change should be investigated further, leading to phase 2 and the survey portion.

Phase 2 - Research and Analytics

This “world class research” has a stated purpose to “inform understanding of how PAs are perceived as part of healthcare and understand what drives perceptions,” as well as how PAs are linked to broader perceptions of healthcare value. This survey will serve as the “backbone of strategy and title recommendation.” In addressing why this particular survey design in the quantitative portion, specifically length and format, Rich stated there had to be “trade-offs” for comprehensiveness and length of survey. Based on WPP’s experience, they have a good sense of number and types of questions that can be asked before causing people to drop out or compromise data quality. Rich informed the audience that the survey questions were pre-tested with PAs to get feedback from individuals, which influenced adjustments to “flow and length.”

This process began with qualitative research of discussions with 55 individuals, including PAs, PA students, NPs, physicians, patients, employers, “think tanks,” professional societies, medical boards, government agencies, and legislators across 20 states. One of the main findings across all constituents in the qualitative portion is that overall, PAs are well regarded. According to patients, PAs are trusted with good communication skills, but sometimes they don’t know what the PA roles and responsibilities are. With other healthcare providers, PAs are “capable allies” who help manage patient care, are trusted, and sought for counsel. Employers appreciate the financial access and patient care benefits of PAs. All of this indicates a “clear value in today’s healthcare system with access and improved economics.” Some of the stated benefits of PAs include:

  • Increased access with extending quality care to more patients by allowing quicker appointment scheduling, as well as less appointments with more time than physician colleagues leading to greater patient communication

  • From an economic standpoint, PAs are hired at “significant discount” to help healthcare facilities see more patients, offering more revenue at a lower cost expenditure

  • Value will grow in the future, due to an aging population leading to more demand for healthcare

Based on these benefits, WPP would like to highlight the opportunity for PAs to add value to the healthcare system by further extending access to care, particularly in rural areas in an economical way. 

Despite these benefits, it was found that there is a significant difference in the “perceived role” of PAs. Patients feel that PAs have more capabilities than NPs, stemming from the word “physician” in the title, which provides a “halo,” while NPs are viewed as “nurses with a lower order” from a patient perceived hierarchy. In contrast, other healthcare providers see PAs and NPs as the same in responsibilities and capabilities, with differences in how they are trained, while employers feel that PAs are more focused on procedures and surgical support, but NPs are more focused on preventative care and patient education.

From these results, it appears that perceptions are driven by the amount of direct contact PAs have with their constituencies. If a health care provider or employer has worked with PAs, they knew exactly what they did, but without that contact, they did not have a strong understanding of the capabilities. Patient understanding varies based on factors, such as exposure and age. Overall, PAs have a high degree of satisfaction and enjoy the role and its benefits, including direct patient contact, less debt, earlier start than medical school, flexibility, fewer “non-patient care” headaches, and are overall collaborative, not competitive, with physicians. 

The tension surrounding the profession stems from a lack of autonomy being an issue with many PAs, and while they feel physicians are mentors, many PAs feel micro-managed and that they spend too much time in non-patient care duties. The research then looked at the AAPA’s definition of PAs to determine how this description is perceived. 

“PAs are medical providers who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. With thousands of hours of medical training, PAs are versatile and collaborative. PAs practice in every state and in every medical setting and specialty, improving healthcare access and quality.”

Respondents familiar with PAs found this to be very accurate, and in general felt positively motivated to work with PAs after sharing this description. PAs find this definition aspirational, while other healthcare providers view it as accurate and reflective of reality, and employers view the versatility and collaboration as true benefits. Individuals with less familiarity were surprised by the description “in a positive way” because they were unaware PAs could prescribe or serve as a principal health care provider.

From a patient perspective, there were two barriers that seem to lessen patient interest in “seeking out a PA.” The first is the title, which is not seen as a good fit with PA role and responsibilities, and most find it demeaning to the capabilities to see the word “assistant” in the title. Patients, other healthcare professionals, and employers all agreed and felt that it was confusing and sent the wrong signals. From an emotional perspective, PAs don’t want to be looked at as “assistants,” but respected as peers.

The second barrier is a general lack of education and awareness about what a PA does as it is a relatively young profession and many non-healthcare providers have limited exposure and understanding of a PA’s capabilities. According to WPP’s presentation, a patient in the qualitative portion stated that the name “does a disservice to the knowledge of a PA, while providing a boost to the physician’s ego.” Personally, I can’t think of a patient in my practice who would be familiar enough to share these eloquent sentiments. 

For employers, the barriers have a different focus. Institutions find that PAs have a “lack of experience when new” compared to “NPs with several years of clinical experience as a nurse,” and feel that PAs require more time and supervision when new. Employers do recognize there are some driving factors that are beneficial in hiring PAs including extending access, great bedside manner, helping to improve efficiency, as well as being economically viable.

To summarize the qualitative portion of the survey, the results indicate that PAs are valued in the healthcare system and offer true benefits to health care providers, patients, and employers. We all knew this right? The study finds these benefits to include extended access, particularly to rural areas, increased system efficiency, lower cost to employers, and a growing contribution to the increase in an aging population with fewer physicians and a growing cost of healthcare.

So what issues limit this PA potential? A lack of a universal understanding of the PA role, a title that creates confusing with limited awareness and connotes less responsibility than PAs believe leading to tension within the profession, and employers perceiving that PAs need significant training out of school and laws requiring extra administrative time for supervision of PAs.

Moving on the the survey. For the quantitative portion, the survey was sent out to a list provided by the AAPA, and completed by 6,845 PAs and 1,357 PA students. This is a response rate of 6%, which sounds low, but AAPA states is in line with most research studies and provides a “good sample size and is robust for analysis.” The purpose of this part was stated as developing a deeper understanding of PA roles in clinical practice and determining the impact of PAs and other providers in delivery of healthcare. Basically, the goal was to figure out what are the perceptions of PAs and what drives value.

In order to do this, WPP explored the following themes:

  • How important is education awareness in increasing understanding of PAs roles and capacities

  • Demographic facts influencing knowledge of the PA role

  • Misalignment of fit between the PA title and role 

  • Tension between PA autonomy and connection to physicians

  • How employer perceptions impact hiring

  • Gauge differences in perceptions of what PAs are capable of and legally able to do

Only two data points were shared during the presentation. The first one was regarding the AAPA definition stated previously. Most PAs found that the definition fits with the roles and responsibilities, but the title “physician assistant” does not. This is the main point addressed in the AAPA’s article. Basically, we’re okay with the definition of what we do. If you ask if the name “physician assistant” describes that definition, it’s not a match.

Main conclusion - “Based on research and analysis findings, it is strongly suggested that an exploration of an alternative title should be pursued, and quantitative findings from physician assistants alone warrant this exploration.”

What’s Next?

Phase 3 - Insights and Strategy - This portion will begin in the August-September timeframe to leverage research to develop a strategic foundation to position and PA brand and inform title development.

Phase 4 - Title Development - WPP will try to leverage insights and strategy to explore new title opportunities. For title strategy, it’s essential to define intent to figure out what title should communicate and then figure out what’s available by looking into validating information and seeking legal counsel. (More on this at the end.)

Phase 5 - Variation and Implications - WPP will use field quantitative survey results to validate a new title option, and assess legal and financial ramifications.

The timeline for delivery is early 2020 with a brand position and title recommendation to be presented for HOD consideration with full quantitative findings beyond the data points that were presented at this year’s conference, as well as an evaluation of related business and legislative cost estimates. And with that, it was time for questions.

PA Concerns

So why didn’t the survey ask about what titles we recommend? While the survey was active, one of the main complaints among PAs was the 45 minutes it took to complete, as well as the lack of questions directly addressing a new title. At this point, WPP clarified that not only are they looking at the title issues, but the PA profession as a brand, and how these perceptions align with the ideal role of a PA to determine what it will take to move the profession in that direction. After those determinations, they will try to pick a potential title. If you were wondering during the survey why you had to rank various professions, the goal was to understand how PAs, physicians, and NPs are perceived along the same dimensions. Not to assert that one provider is more valuable than another, but to determine what makes PAs unique. This 360 degree perspective is meant to highlight PA strengths and the aspects of the role considered most important in providing care, pinpoint what differentiates PAs, and attempt to transcend the title for a “holistic brand strategy.” 

A researcher from Duke was first at the microphone, and questioned why the available peer-reviewed literature regarding the title change wasn’t used to come to the same conclusions without using significant resources, and WPP responded that their literature review didn’t provide the spectrum of what they needed to investigate since it did not link the perceptions of value to healthcare. She offered to point them in the right direction to resources.

Evelyn, a Pacific University PA student, asked about the brand positioning strategy and if that was something WPP would be assisting with, which they responded they would be happy to do, but had not been asked to stay on at this point to develop any advertising strategy beyond the foundation of strategy. This will be up to the HOD, which is why it’s important to make sure your delegates have your best interests in mind.

Someone asked if they included PAs outside of the United States, and they did not.

Betty, a PA from Arizona, questioned why they were waiting to look at legal ramifications until after making these decisions. As something that is in thousands of policies and regulations at many different levels, what is going to happen? WPP deferred to the Foley law firm that was not present, and Donna from AAPA stepped in to state that the first step was coming to the conclusion that there needed to be an investigation to look into titles first, and now the necessary steps are being outlined if a name change were to move forward. The name must be identified before looking at trademarks, and the path is starting so those discussions will unfold at what would happen at a state and federal level.

Another PA asked if the WPP firm had experienced a similar title change in another profession that was launched successfully. The response - “We have done extensive work in the healthcare field and title change is uncommon and not frequent because the decision has already been made so an outside group isn’t needed. We have hundreds of credentials across the globe with naming credentials and experts in titles and how people perceive language to gain clarity and get preference.” Short answer - No. 

The last PA to speak stated she wasn’t worried about the sample size or response rate, but the length of the study. In her opinion, a 45-minute study in the PA world will get a response bias because the only people who will answer are the ones who are biased. (This gained an applause from the audience.) She admits that people know it is a “lousy title,” but questions if the cost is worth it to change it at this point. She also stated that she feels the survey lost some credibility with the types of questions because PAs didn’t understand why they were being asked about things that didn’t seem related. WPP stated that not all data was shared and that the purpose of the survey wasn’t just to see if a title change was needed, and Rich felt that individuals who take the longer study will be more motivated, but won’t just be PAs in favor of the change.

The summary given by WPP is obviously going to be politically correct and not give too much direction, but the main takeaway is that according to PAs, other healthcare professionals, and patients, the “physician assistant” title doesn’t particularly fit with the definition, while most PAs do agree that the description in appropriate. Whether or not that should lead to an official title change is the next step.

I agreed with Betty’s concerns of why the legal and financial ramifications are not being looked at until resources are being poured into this study. A name change will not bring in more revenue, for AAPA, employers, or PAs, and may be detrimental as the study showed one of the desirable qualities of a PA includes the economic benefit. Will this cause our AAPA dues to increase? How much of the budget will this consume, while we continue to lag behind legislative financial support in comparison to other professions, including NPs? At the end of the day, this is a business decision, not an ego issue, and the questions of how this will have a financial benefit should be considered. Personally, I don’t believe a different title will result in a higher salary for myself, and will likely cost my practice money (that I hope they don’t take from me). While it may change patient perceptions over a long period of time, PAs may be inflicted with the burden of the cost. This should not be an emotional response or decision, similar to giving results to a patient, it should be based on well-thought out research and what makes sense from a legal and economical standpoint.

So if it is determined to be a feasible option, what should the “physician assistant” title be changed to? This research indicates that the term “physician” should remain as part of the name, which would rule out suggestions such as “medical practitioner.” I guess we’ll all wait on the edge of our seats until the next survey to see what our options are, but I would love to hear your suggestions in the comments.

#healthyinmedicine - Staying Healthy as a Physician Assistant

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With the rigorous process of becoming a PA, it can be way too easy to lose sight of our own health when caring for others. This is something I’ve definitely struggled with, but continue to work on. We should be encouraging each other to be #healthyinmedicine instead of just focusing on our patient’s health. Here are some of the practices I’ve found to be helpful. I would love to hear about your habits and tricks for self-care in the comments or on social media. Make your own #healthyinmedicine post, tag @thePAplatform, and I’ll be sure to check it out!

Find ways to stay active. As a full-time physician assistant, wife to a busy medical resident, mom to a 10 month old, and blogger, sometimes I get a little tired or overwhelmed. (Understatement of the year.) I’ve had to get creative to find ways to keep myself moving and still be able to spend time with my family. Back in undergrad at the University of Georgia, I walked everywhere. Buses were available, but the campus was beautiful, so I only took advantage of hopping a ride maybe 10 times total. I took that built in exercise for granted, and realized how great it was once I was sitting in the same classroom for 8 hours a day in PA school. That changed things. I would never have made it to the gym if it wasn’t for two of my classmates. We were close friends, and they didn’t really give me a choice. I wasn’t always the best sport, but they encouraged me to at least put forth some effort in making my health a priority. Now, as a family, we love to go on walks and get outside. My baby certainly keeps me moving and chasing her, so that helps too. My medical assistant is great at walking during lunch, even if it’s only for 10 or 15 minutes. Find your small pockets of time and try to dedicate at least some of that to moving your body. I know some of these fancy Fitbits and Apple watches will even tell you when you’ve been sitting for too long.

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Make the best food decisions you can with the resources available. With fast food (that is delicious) on every street corner, I find myself jumping to the easy option most times. This is something I’ve really been working on this year. I’ve even found that some salads and wraps are just as good, if not better, than the burger or fried chicken I would have previously ordered. Does this mean I always “eat clean?” Definitely not! I love the good stuff too much. I am trying to live in moderation though instead of indulgence. Less sugar, watching portions, and trying to actually understand what’s in my food and what it does for my body. We get so busy with school and work and life, and our food choices tend to be the last thing on our minds. In Emily Freeman’s new book about decision making, The Next Right Thing, she states that we make over 200 decisions a day just in relation to food! Planning out meals, even just for the next day, can make a huge difference.

Schedule dedicated workout time. With some trial and error, I’ve figured out that if I want to get an actual work out in, it’s more likely to happen in the morning. I’m not a night owl. Definitely more of a grandma/early bird. If I put it off and wait until the end of the day, there are too many distractions. I’m too exhausted from seeing tons of patients at work and all I want to do when I get home is love on my baby. Not my body. From making this shift to morning workouts, it helps me start the day on a good note. I feel energized and productive and ready to take on the day. That encouragement keeps me going and helps me continue my streak. You may find that night time or even at lunch works better for you, but make a commitment. Write it in your planner or put it in your phone so you make sure to prioritize dedicated workout time.

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Invest in tools that hold you accountable. Another thing I’ve found that I pretty much have to do is put some skin in the game, aka pay for things. I’ve tried the On Demand and YouTube workouts and read tons of blogs on staying healthy, but because I’m really good at convincing myself out of things, I usually give up. I recently bought a spin bike for my house and invested in nutritional coaching with a fellow PA. Guess what? It’s the first time I’ve actually stuck to something for longer than a week or two! Having the accountability of a coach checking in to see how I’m doing and encourage me, and my husband saying I better get my money’s worth out of that bike have both made me actually take steps in the right direction. I hope you have better self control and more determination than I do, but it’s okay if you need a little motivation. There are a lot of great facebook groups centered around accountability that you could join or find a friend who is trying to live a healthier lifestyle as well and partner on helping each other out. Taking these steps has also removed some of the frustration of trying to figure everything out myself.

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Take time off mentally and physically. I’m a proponent of vacations and “treat yoself.” We carry so much responsibility and mental load in our daily lives, that you have to give yourself a break. I’ll take days off where I don’t touch social media or even a computer. While those things are great for connecting, it can also be discouraging to see an illusion of someone else’s life if you’re not where you want to be. I also tend to always have a vacation planned. While I would love to go on elaborate trips all the time, usually it’s just a weekend at the beach or visiting with family. Taking these opportunities to invest in your mental health is so important for preventing burnout. Working in medicine is tough and very taxing. We have a lot on our plates and it’s okay to take some time off.

If you have tips for how you stay #healthyinmedicine, please share in the comments or on social media! Let’s encourage each other to take time for ourselves this week.

Read how other PAs stay healthy:

Erin - Stethoscope and Sparkle

Tips for the Second Time Applicant – From a Second Time Applicant - Guest Post from Meghan in Medicine

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Meghan is a current 2nd year PA student at UTMB, and she blog at Meghan in Medicine. Since it’s becoming more common for applicants to have to reapply to PA school before gaining acceptance, this is a timely post to reshare because many people may be in a similar situation. Don’t take this advice lightly, but use it to make yourself more competitive for the next time. You can follow Megan on Instagram - @meghaninmedicine


As some of you may know, I applied to PA school straight from undergraduate school and DID NOT get in on my first try. Although I knew it was a big possibility after reading all the forums, blog posts, and hearing about different peoples experiences along the way, I was obviously disappointed. I remember consciously giving myself a couple of days off from the entire process, but then immediately diving back into grind by thinking of ways to elevate my application to the next level. So that brings me to my first tip:

1. Give yourself a break, then turn the motivation back on but up a notch

Being rejected in any format does not feel great. Being rejected in the one thing that you’ve been working hard for years for definitely does not feel great! I’m a big believer of giving yourself the smallest of pity parties. Whether that be treating yourself to something you normally wouldn’t do like getting your nails done, a full body massage, a night in with zero responsibilities, whatever it is just do it for your own sanity.

After you’ve spent some time on yourself, it’s time to kick it back into high gear because life waits for no one. Remind yourself that you are blessed to be where you are, wherever you are. Remind yourself that you are capable!

2. Find a way to even slightly improve EVERY aspect of your application

This has to be my biggest piece of advise to those applying a second time around, and it was the piece of advice given to me from a PA-C working in academia. The best way to improve your chances of getting into PA school after not getting in the first time around is to somehow improve every single aspect of your application. That means improving: personal statement, patient care hours, volunteering, GPA, supplemental applications, shadowing, and GRE. After I received this advice, it all really did click for me. These schools have to see that you’ve given extra effort to stand out during the year that you’ve been waiting for the next cycle, so go for it!

Possible ways to enhance every facet of your application:

  • Editing your personal statement to better encompass who you are and who you want to be as a PA

  • Increasing your amount of patient care hours

  • CHANGING the way you’re obtaining patient care hours (EMT, CNA, Scribe, MA)

  • Volunteer with a program/company that you’re GENUINELY interested in and stick with the same place to show your long-term commitment

  • Retake a few of your lowest scoring classes from undergraduate school. If you received two C’s, retake them and shoot for two B’s.

  • Use Kaplan, Magoosh, or other GRE preparatory books and programs to improve your GRE score

  • Shadow every single chance you get to show your curiosity and commitment to the PA profession and medicine in general

3. Reach out to those that have gone through this

I never would’ve known where to begin without the PA-C in academia giving me advice for what to do. The entire process of applying to any professional school can be extremely overwhelming at times. All of the comparison is especially stressful. Make it a point to reach out to some schools that you applied to and see if they offer any personalized application reviews. If they do not, I would then reach out to PA’s that you’ve previously shadowed or have connections with for them to review your application and offer up their advice for any improvements.

If you are a reapplicant make sure to check out my Youtube video PA School Reapplicant FAQ - What You Need to Know to Reapply to PA School where I answer helpful questions about reapplying to PA school!


Interview with Ngan - ENT Physician Assistant, PA Advocate, and Interview Coach

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Ngan is one of our rockstar coaches, and I’m excited to share some of the insights she provided on her job and role with AAPA. She has an interesting educational background and some insights into how legislation works in advocating for the PA profession.

Tell us a little bit about yourself.

My name is Ngan, and I am a fairly new PA working in ENT. I was part of the inaugural PA class from Florida International University in Miami, and graduated December 2017. Prior to PA school, I received my Masters in Public Health, and worked with a local health department as an epidemiologist investigating infectious diseases. I have also worked as a medical assistant at an HIV clinic.

Do you feel like having a background in public health helped you with getting into PA school or has helped you as a PA?

I would say that my Masters in Public Health did not necessarily get me any more interviews, but it definitely was a conversation starter while I was in the interviews. As a PA, I really do believe that it has changed my thought process to looking more to socio-economic status or factors that affect patient care. So because of that, I do believe that it does make me a better healthcare provider.

I definitely recommend that if you can, or anyone really, should take a few courses in public health. But as far as obtaining a second masters degree, I would say do it only if you are truly interested in working with the underserved population or contributing to greater health in public health.

You went to Florida International University and you were in the inaugural class – did you apply when it was provisional? Did you have any reservations about going to a provisional program? Or did you see any benefits of being in a provisional program?

Correct! I did apply when it was provisional and I am the first graduating class.

I think I was a little reserved applying without knowing much about it, but having been through the whole process, actually sitting in and being interviewed by the ARC-PA (accrediting committee for PA schools), I was confident. It takes a lot for a PA school to become accredited. And to new PA students out there, I definitely encourage you to look into it. One of the great things, I would say, about being in a brand new program, you have the opportunity to provide feedback and kind of mold the program and really make an impact for future PA students. If that is something you are interested in, to make an impact and leave a legacy, then I do encourage students to also look at provisionally accredited programs.

When it came time to apply to PA school, what did that process look like for you and how did you come to the decision of wanting to be a PA?

I will be honest, I did not do my research well. My journey to PA school was challenging, and I would even say that one of the hardest things to me was the whole application. At that time, I didn’t really know anyone going through this process so I had to do this process on my own. What really got me interested was working as an epidemiologist, and I was just frustrated. At that time, I was working on this specific project interviewing young adults that recently tested positive for hepatitis C. During these interviews, I would call the patients and notify them of their test results – here they are crying thinking this is like a life sentence, it was awful, and I was frustrated that these providers were the first ones to get into contact with these patients to notify them. I felt like I wanted to be the voice for these patients, do more and be there for them. And so that’s what trickled into wanting to be a PA.

When it came time to apply, how many schools did you apply to and what did that look like?

I applied in total to 10 schools, and like I said, I didn’t do my research - this is not something that I recommend to other students, so learn from my mistakes – I just pretty much applied to schools based on locations I thought I would want to live in. Majority of them, I wanted to stay locally, so I did apply to mostly Florida schools. Really, it was just that I compared my GPA to see what the schools requirements were and if I met them, typically that is where I would apply. Moving forward, I think for students that are out there, it‘s really important to do your research and also look into the program’s missions and values, I feel that it’s just as important. You are spending two or more years in these programs, you’re investing yourself into your career as well. I think with that you have to do your research and make sure the school is a good fit for you and not just go because it’s in easy reach.

Because of my lack of preparation and failing to really do the research, I was only offered the one interview at FIU, and fortunately, that was the only one school that I needed.

What advice do you have for somebody going into an interview?

I would say the most important thing, or the easiest thing really, is just to be yourself. Be genuine, don’t make up answers that you think the the interviewers would want to know. Speak from the heart and that will translate so much better. What I do notice with a lot of these applicants’ interviews, don’t discredit yourself. Every little thing you do, I think, brings a lot to the table and your weaknesses or strengths, play that up. Like for me, I will be honest, I didn’t have a strong GPA and that is probably what limited me in most my interviews. Yes, like I said, I have my Masters, but the schools really didn’t care. They looked at my undergrad GPA and they were like, yeah we don’t know. For me, I played up my public health strength a lot and I think that’s what ultimately what got me through the interview. So if there is any particular thing that you have that you think is unique, play that to your advantage and I think that will take you far. Speak from the heart and smile!

What was most difficult during PA school?

Early on, I struggled a lot with mental, like personal blocks. What I mean is early on, you are comparing yourself to others. I think that is something easier said than done, but you really just have to work on it. The only competition is yourself, to be a better version of yourself from the person you were yesterday. That was challenging. Of course, I think the volume overload with information that is provided - you hear often that PA school is like drinking water from a water hydrant. It is just challenging. Just trust yourself and trust the process. Whatever it is at the end of the day, everyone is in the same boat. Be your own cheerleader and motivate yourself to continue to study and not be so hard on yourself.

How did you end up in ENT (ear, nose and throat/otolaryngology)?

During PA school, when we had our ENT block, we had a great professor, Jose Mercado, and he was just really amazing. He was someone that was so passionate about ENT. I think I just fed off of that. He introduced us to the ENT conferences that I attended as a student. So that is ultimately how I got my interview and landed my job where I am at now. I just recalled going, as a student, and one of the doctors jokingly told me if you’re someone who likes to play with toys, ENT field is the way to go. That was another reason that caused me to pursue ENT.

Did you have trouble finding a job, or was that pretty easy?

I applied for jobs about 3 months prior to the end of PA school. I would say it was challenging at the time because a lot of the places wanted to see that you were certified. I think it all depends on when you apply, but still would encourage the students out there that are near the end of school to consider looking early. I ended up with two interviews prior to graduation and both of these opportunities came from networking, whether through a conference or just being involved with the state academy.

How has that adjustment been as a new grad? Did you feel prepared coming out of school? At this point, do you feel like you have a handle on things?

Not at all! I feel like there are good days and bad days. It is rough. The feeling walking across the stage knowing that you are now a PA graduate is amazing, but unfortunately, that does not translate well to you getting a job. It is going to be very similar to starting a new clinical rotation. You’re going to feel lost. It has definitely been a challenge. I think I’ve gone through one hurdle, but there is still so much to learn. Kind of what I said earlier about not comparing yourself to others, I have to remind myself frequently, it is not fair for compare my knowledge to my attendings -  someone who’s had seven years of residency training on top of medical school, plus years of experience. Again, that’s something that I will have to continue reminding myself and just continue to push myself to learn and grow each day. But I am hanging in there!

What does a typical day at your job look like?

My current position is interesting. We are affiliated with an academic center and I work closely with our residents and our attendings. Also, I would say, my ENT practice is different from others in the fact that we are very subspecialized – we have a specialist that works in otology, who is only dealing with the ears, rhinology, such as dealing with the nose, pediatric clinic and also, plastics/reconstruction provider. I feel like we are so spread out, whereas if you talk to most ENT providers, they are like, “Oh I am only an otologist and I only deal with ear issues.” Each day is different. I work Monday to Friday, 8- 5. Depending on my assignment, I may work with our ear doctor in the morning and then switch to a different clinic in the afternoon. As far as autonomy, I am still in the process of learning how to do the nasal endoscopies. At this time, as part of our training, the goal or what is expected, is for me to see every new or extended return patient, get a full history, perform the physical exam, maybe perform ear debridement if necessary, come up and discuss with my attending, come up with a plan, and then together we’ll go back to the patients room and discuss. The goal once the training phase is over, I’m expected to see patients on my own, then discharge them out, and ultimately have my own set of patients.

How did you first get involved with AAPA, and why was that something you wanted to do?

I was pretty involved as a student leader at FIU. I was diversity chair for my class. That also led me to work with our state academy. Really, just trying to get involved more as a leader. I got my start in lobbying years ago in college when I lobbied with Planned Parenthood for women’s reproductive rights. After getting my Masters in Public Health, I kind of needed a goal to use my PA title as a platform to advocate for patients health. Sure enough, I was browsing around on Facebook one day and I saw that the AAPA was looking for students to apply to become a delegate for the student academy. Typically, if selected, you will serve for a whole year – that begins in August/September and those duties will end at the conference.

If you are a delegate, what does that mean? What do you do?

As part of a delegate, you have the authority on behalf of the AAPA, to enact policies and principles for the PA profession. To kind of give you some background, there are 57 chapters representing 50 states, 26 recognized specialty organizations, such as dermatology and otolaryngology, and 8 organizations that share a common goal or interest in healthcare delivery. For us as the student academy, we have the largest voting body and have 16 seats, or in other words, 16 voting privileges. Every year, we meet at the AAPA conference for about 3 days – for the first 2 days we are discussing the different policies that are presented, ways that these policies may affect healthcare delivery, whether there is Medicare coverage, PA privileges, health promoting, and disease prevention. The final day is when we vote on these issues.

What are some current hot topics for physician assistants?

I would say one of the hottest topics right now, still is changing the professional title of physician assistants. I will agree where most people feel that the name change isn’t necessary and that it is silly that the AAPA is spending so much money investigating this issue. But in a way, do feel like the title or word the assistant does hinder our practice and confuses the general population. What this policy says is that it’s not necessary to vote whether or not we’ll go with the name change, but to kind of further investigate it and see what the general consensus is on whether a title change would be appropriate.

We voted to not necessarily change the name at this time, just to see what everyone thinks about changing the name and offer suggestions. Whether Physician Associate would be appropriate, or whatever it is. They are just investigating this at the moment. But I feel, at the end of the day, you just have to educate, not just your patients, but everyone - even if it is someone you meet on the street or on the elevator – just educate on who and what it is. Whether a name change will truly change that, I don’t know. We just have to do more work to get the general public to know who we are.

Another hot debate in the house this year was the standards requiring in person instruction. The original policy pretty much stated AAPA supports standards to requiring that PA training programs provide at least 80% of didactic instruction as in person or live lectures. I think it was a great topic started and may have been targeting Yale’s online program, as they are the only online program currently. At the end of the day, what it really boils down to is whether or not there will be a flood market available with online programs popping everywhere. Maybe the title or the way the policy was written didn’t clearly state that, but that is really what the underlying issue is. Unfortunately, that policy did get rejected in the house and down the line this is something we will need to talk about. Yes, I do believe that with technology advances that online components can be great for students, but I think we’d have to kind of light fires for the accrediting bodies, the PAEA, those that are in charge of PA education to really make sure there is a policy in place that not every university can create their own online PA program.

As far as any other major recommendations, there are two that will affect students in a way. One of them got passed this year, and this was an initiative started by the student academy, increasing PA diversity. That did get passed and what that policy states is that there needs to be an initiative for increased funding for development and operation for PA programs at historically black colleges and universities, predominantly black institutions, Hispanic serving institutions, and rural serving institutions. The last one here, support for PA federal loan limits. I see now that with the increasing challenges or competitiveness to get into PA school, there will be more students that come in with a Masters beforehand, and sometimes these loan limitations can affect these students. That is something I think will benefit future PA students.

Ultimate Physician Assistant Gift Guide - 2018

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Wondering what to get for all of the PAs in your life? Whether Pre-PA, current students, or practicing PAs, we’ve got you covered with this 2018 Holiday Gift Guide. We’ve broken it down by category and you’ll find more practical options to go with some of the more fun choices. Feel free to pass this guide along to your family and friends to give them some hints about what’s on your shopping list. Some of the links in this post are affiliate links, which means we get a small percentage if you make a purchase as no extra cost to you. This list is just in time for Black Friday so make sure to keep your eyes peeled for deals!

To Wear

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Looking professional is a staple as a physician assistant! Medelita is my go-to brand for medical wear in clinic. A gift card will provide a choice between the various scrubs, white coats, or scrub jackets, but I’ll share some of my favorites.

Medelita offers free shipping, the option of embroidery, a 1-year warranty, and at-home try-on. What more could you ask for? I recommend any of the scrubs, and my favorite white coats are the Ellody or the Rebecca. If you’ve never bought anything from Medelita, you can set up a new account and get $20 off your first purchase over $70. Use the code PAPLATFORM4 for a 20% discount.

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If you’re looking for something more casual, check out Medthusiast for the cutest and comfiest T-shirts and sweatshirts. Both Medelita and Medthusiast are companies that were created by PAs, which makes them even cooler!

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To Read

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For the Pre-PA Student - To help future PA students reach their goals, there are some must have resources out there to make the process much easier. The Applicant’s Manual of Physician Assistant Programs provides information about all of the current PA programs. This is a huge time saver because it can be difficult to track down that info. After applying, the interview is the next step, so the Physician Assistant School Interview Guide is a great present for anyone in the application process.

For the current or soon-to-be PA Student - There were 2 books that were extremely helpful to me while I was in PA school - the “green” book and Lange Q&A. I used these the entire time and particularly when studying for boards. I’ve also heard great things about PANCE Prep Pearls.

For anyone and everyone - Dr. Atul Gawande is my favorite non-fiction/medical author. His books should be mandatory reading for anyone in medicine. Better and Complications would be welcome stocking stuffers for any PA!

For School

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While PA school is thankfully a somewhat distant memory for me, there are a few things I couldn’t have survived without.

A great computer. If you really love your PA student (or soon-to-be student), make sure they have a functioning laptop. I’ve heard great things about the iPad Pro and Notability for taking notes, so that’s a good option too. I started school with a MacBook Pro and ended with a Microsoft Surface. I wish I had my Surface at the beginning of my program so I could have taken notes directly on our never ending PowerPoints. I’m back to a MacBook now, but the Surface was great for studying for boards.

A functioning printer. Even though everything is online these days, I’m still a pen and paper type of person at times. I like to write things out and take notes by hand, particularly for last minute studying before a test. I have the HP Envy, and it’s wireless, and does the job.

A water bottle. I’m the first to admit I’m the worst at staying hydrated. At work I use one of the large Tervis tumblers to keep my drinks cold or a good Yeti cup. I love this water bottle that helps to remind you to drink frequently by glowing to help increase water intake.

Amazon Prime. Having 2-day shipping was a lifesaver during PA school and clinical year. When my feet and back were so sore during my surgery rotation, I was able to get some compression socks and better shoes on the way ASAP because by the time I got off work nothing was open and I just wanted to sleep.

For Clinic

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If you’re in the market for a new stethoscope, and want one that functions excellently and looks sharp, check out the ERKA stethoscopes from Medelita. I don’t use a stethoscope frequently in dermatology, but my husband has claimed by ERKA as his own and uses it daily at the hospital. There are plenty of color options, and the tubing holds up nicely even with frequent use.

For a coffee drinker, Medthusiast has amazing ceramic coffee mugs with gorgeous artwork on them. These mugs will be the envy of everyone else in the office!

For CME

While I wouldn’t recommend booking a full CME trip for someone else, travel essentials are always a great gift. After going to a few conferences this year, I’ve realized I don’t have great luggage or carry-ons, so those are at the top of my list this Christmas.

Lecture halls at conferences are always freezing for some reason. While I dress business casual and professional when I go to CME events, I’ve been carrying my Medelita Ionic scrub jacket with me to keep me warm. It’s a great weight and still looks professional, so I’ll just leave it at my seat in between sessions. Mine is embroidered so I don’t worry about it going missing. These are available for men and women, and they fit true to size. This is also my husband’s favorite jacket to wear at the hospital, even more than his white coat. (And don’t tell, but even all of the non-medical people in my family are getting these jackets this year!)

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At conference, I always take a good size purse or bookbag to lectures, and I have my trusty Lilly Pulitzer notebook and a ton of pens. You could create a little conference survival kit and that would be an awesome present. Don’t forget the candy and snacks!

For Fun

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Makeup and skincare are always a nice present because who doesn’t love a little pampering. Put together a basket with some bath bombs, sunscreen, and skincare kit for someone who needs to relax a little bit. I’m the first to admit that I’m a product junkie, but most recently, I’ve been using the FRÉ Skincare line. Being a dermatology PA, I’m very picky about products, but these are easy to use, gentle, and leave my skin feeling fresh. The choices aren’t overwhelming and I love that I only have to leave the Detox mask on for a few minutes. You can use the code SAVANNA1 for 15% off, and make sure you’re following me on social media for extra deals (and there’s a really good one coming for Black Friday!)

For more of my recommendations and favorites, check out my Amazon list.

80 Study Tips for PA School

A while back on Instagram, I asked for your best study tips, and you guys delivered. I compiled them into a list so if you're feeling stuck, unmotivated, or just need a new study idea to get the juices flowing you'll be able to refer back and find some inspiration. These are great study tips no matter if you are in undergrad or PA school. If you have another study tip to add, comment below to share with others! You may find some Amazon affiliate links in these tips!

  1. Study in groups

  2. Draw out material and make diagrams to visualize it

  3. Rewrite notes on material you don’t understand

  4. White boards!

  5. Use colorful highlighters and pens

  6. Quizlet

  7. Study in the morning

  8. Study after a workout to help clear your head

  9. Study alone first

  10. Make up mnemonics for material retention

  11. Study in a library

  12. Start studying before the night before the test

  13. Make flashcards

  14. Choose a location with no distractions

  15. Talk concepts out

  16. Make visual study guides with colors and pictures

  17. Find videos on YouTube to explain things differently

  18. Highlight your notes for important buzzwords

  19. Take turns teaching the material to someone else

  20. When you feel distracted write down what is distracting your mind on a piece of paper and then come back to it later

  21. Write the material over and over

  22. Practice taking exams in a setting that is similar to your actual testing environment

  23. Take a break when you feel burnt out

  24. Share your resources with your study group and see what they use

  25. If you can’t get motivated, just start and then you’ll get momentum to keep going

  26. Change up your environment to freshen your mind and keep from getting stale

  27. Unplug from all distractions = phone off

  28. Tell your friends and family the periods of time when you’ll be busy studying

  29. Limit your time on social media to designated break times

  30. Use “Focus Keeper” app on your phone or laptop to track your study session and tell you when it’s time for a break

  31. Evaluate whether studying in groups is the best option for you

  32. Snacks!

  33. Find a quiet location

  34. Take breaks every 20 minutes or so

  35. Make a chart so you can compare similar topics

  36. Use different color post-its to keep track of what you understand and what you need to review more

  37. Block time in your planner for studying

  38. Make sure you get good sleep

  39. Eat healthy

  40. Teach the material - even if it’s to an empty room

  41. Use friends to keep you accountable

  42. Record lectures and listen to them again

  43. Review the material each night to keep up the workload

  44. Focus on the material that you don’t know instead of covering what you’re familiar with

  45. Go on a walk to exercise and think through the material

  46. Listen to classical music

  47. Make a summary sheet of the main topics

  48. Listen to podcasts

  49. Use the Pomodoro technique - set a timer and divide your work into intervals with small breaks in between

  50. Make a last minute review sheet for the morning of the test to have a quick review

  51. Study for a shorter amount of time, but more often

  52. Actually pay attention in class instead of having to try to learn it afterwards

  53. Keep snacks and drinks nearby

  54. Drink lots of water

  55. Drink a specific drink or chew a specific gum when studying and do the same thing before the exam to help you recall the material more effectively

  56. Coffee!

  57. Use Google Excel to keep track of important facts

  58. Go over practice questions to practice applying your knowledge

  59. Quiz each other

  60. Take a nap if you are feeling tired

  61. Make up your own questions as you study

  62. Study at a stand up desk

  63. Take mental health breaks

  64. Buy cute study supplies so you want to use them

  65. Remember why you’re studying. What’s the end goal?

  66. Get rid of the computer or internet if it’s distracting you too much

  67. Read about the topic before going to the class or lecture

  68. Figure out your study methods and stick to them

  69. If you’re bilingual, try to think about the material in another language and translate it so you are studying it twice

  70. Use flash card apps if you don’t want to use index cards

  71. Don’t give up!

  72. If all else fails, cram.

  73. Put candy on your notes so when you make it to the next section, you get a treat

  74. Have confidence in yourself and your study skills

  75. Go study outside to get some fresh air

  76. Use Google docs to collaborate with others to make a study guide

  77. Don’t study where you sleep

  78. Link a difficult concept with an interesting story or life event

  79. Use ear plugs

  80. Don’t forget that you got this!


Advice From Current PA Students - From White Coat Dreaming

I recently connected with Alex on Instagram (@whitecoatdreaming), and she introduced me to her awesome PA blog - White Coat Dreaming. Apart from sharing her own awesome advice, Alex has also interviewed her fellow classmates in PA school to get their advice as well.  In this post, I'm going to share some of the best points to help you succeed in PA school! If you want to see more, make sure you head over to her blog to see the interviews in their entirety. 


Interview Tips:

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I think that schools like to see that you have other interests besides medicine and that you make time for the things you care about.  - Megan

I would really recommend going on a mission trip before PA school starts because it gives you an opportunity to learn more about the medical field and prepares you for PA school. Not to mention, it shows the interview committee that you are well rounded and more than just your grades. -Norin

Career change?  Be totally honest with yourself about who you are deep down, what you like, what all of your motivations are, whether you could get what it is you think you’re looking for while staying in your current spot or with a less drastic change. -Craig

The number one tip I can give you is to just be yourself! And I know that probably sounds super cliché, but it’s so true. Don’t try to be someone you’re not. Don’t try to put on an act, or memorize all the right answers to ace an interview or personal statement.
— Giftson from White Coat Dreaming

I didn’t do anything to practice so I just showed up thinking I could charm some people. And then they were tough and I bawled in my car after 2 or 3 of them. - Megan

I would truly recommend helping out the community as much as you can. During interviews, they look at more than just your grades. They want to see that you are a caring individual that does more than just study.  -Norin

There is a lot of competition for spots in PA school for good reasons, you’ve got to show that you are the cream of the crop and are a good bet for the school in terms of being able to one day be a skillful, practicing PA. -Craig 

It is so easy to compare to others and feel like you fall short, but it is so not true. We are all worth so much more than how we perform or measure up to the world’s standards. Finding my worth in Christ and knowing that He loves me no matter how small I feel was the biggest game changer. -Michelle


Applying Tips: 

Don’t get discouraged if you are waitlisted! I know plenty of people who were waitlisted and got in as late as April. -Megan

I took a year off before starting PA school because there were still some pre-requisites that I needed to complete and volunteer hours that I needed to add into my application. This really helped me focus on my application and make it stronger. -Norin

While getting into school and becoming a PA might seem like the most important thing in your life right now, don’t fall into the belief that whether you become a PA or not determines your value. You are so much more than your career! Work hard, but rest in the idea that you are going to end up exactly where you are meant to be. You are no more valuable as a PA or less valuable as something else! -Jill

Find yourself a good group of friends who will provide you with love, tissues and wine nights. They will be your backbone throughout the ‘process.’ - Alexa

People are afraid to major in something non traditional (like English, Poli Sci or philosophy), but I think it’s best to follow your own passions and interests. That will show that you are true to yourself, and are not just trying to do what you think you are ‘supposed’ to do.
— Erica from White Coat Dreaming

For me the hardest thing about applying was the cost.  - Erica

I’ve tried to make the best out of every situation. I know right now school is kind of rough, and you have to give up a lot of things that you used to have, but in the end it’ll all be worth it. -Giftson

 It is good to always have a plan B after you apply and focus on areas that you need to work on before you know if you got in that cycle or not! -Norin

The hardest part of applying was sorting through all the various requirements and prerequisites for each program. -Jill

Also, I would recommend a strong personal statement. It summarizes who you are as a person and your purpose for wanting to pursue medicine. Every part of the application is important, however, the personal statements gives them insight into your life so make sure it is strong. -Norin

I feel like location was a big factor in my decision. I knew I wanted to be in an area where I could still be around family, and having a support group nearby definitely influenced that decision but I also was excited to be out of my comfort zone. -Giftson

When the competition is so steep, you want to have as good of chances as you can, and applying to multiple programs is one way to do that! - Jill


PA School Tips: 

Know what you are getting into before you come to PA school. I was not mentally prepared for the amount of dedication that it would take to be a PA student, and it took me about 2-3 months to truly grasp how much my life was going to revolve around studying. - Erica

If your heart is not in it and this is not something you truly want to do, then stop yourself before it gets too late. PA school is hard, and honestly the pressures of the program is going to take a huge toll on you…physically, mentally, emotionally, and spiritually. If you’re not doing it for yourself, then you’re going to crack under pressure. - Giftson

Once you get accepted, stop trying to ‘better yourself’ academically or otherwise– and just relax and enjoy yourself, as much as logistically and financially possible. If you can take a vacation beforehand or some time off, definitely do- you will be so glad later. - Erica

PA school ends up taking all of your time, so you don’t really get a chance to think about how much time you’re not spending with family and friends.  -Giftson

I faced some of my darkest moments in PA school, because, surprise…it’s hard.  And the thing that kept me going above all else was having compassion for where these long nights of studying would take me.
— Silas from White Coat Dreaming

It helped to have a running schedule that I would try my best to stick to. That forced me to workout most days after class even when I didn’t feel like it. -Michelle

Being professional and acting in a way that shows respect to others is honestly far more important than the number of years you have under your belt. I was always worried that patients or even other classmates wouldn’t take me seriously because I was so young, but over time I’ve learned not to worry about things I can’t change. -Giftson

Also, make efforts to stay balanced while in school. So many people seem to put everything aside for their grades- mental health, relationships, exercise, sleep– but those things are necessary to be successful. -Erica

We all are starting at different parts of our life, and just because you don’t have experience doesn’t mean you can’t do well. You have to understand your limitations, and strive to push those limits every day! You’re going to make mistakes. Learn from them, and keep pushing forward so you can be the best PA you can be! -Giftson

I realized when I ate healthy, it definitely helped my energy level and helped me focus better and not get so tired studying. -Michelle

Self-doubt was a huge problem for me. I would always see other people that knew so much, and wonder if I would ever get there (still haven’t got there by the way). -Giftson

Sometimes it can be challenging when you compare and think how far ahead your kiddo classmates are in terms of being about to start their career when you would have still been waking up at noon on a Wednesday to go do a half-shift of bagging liquor- but hey, whatever path you take, you are bound to have learned something that someone on another path hasn’t. - Craig

You learn quickly that your classmates are in the trenches there with you, and you depend on each other far more than for just explaining a concept you didn’t understand in lecture.  -Silas

How I Paid Off my PA School Debt

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So have you heard that PA school is expensive?  Well, that might be an understatement.  Any graduate program is going to be a little pricey, but medical programs tend to be on the higher end of things.  If you look at estimated costs for PA school, you'll see a broad range from 5-digits all the way to hundreds of thousands of dollars.  That's a lot of zeros.  And you have to look at tuition + fees + books and other resources + tools + traveling for clinicals + housing + food + everything else!

Thankfully, I went to a public program so that initially cut my costs.  My second choice school would have cost 4x as much as my program cost.  Unfortunately, that's the norm.  I had a few other advantages that helped me to cut back on the amount of loans I had.  Which brings me to Tip #1 - Take the minimum amount of loans possible!  I was able to live with my parents for the first year, and although they couldn't cover all of my expenses, they covered my fees.  I only had to take out loans to cover my tuition.  I also went to a public program, and that decreased costs significantly.  Tip #2 - Don't take out extra money to put into savings.   The amount of return you get in savings is so much less than the amount you're being charged in interest, so it's just not a smart financial move.  

I took out federal loans though Sallie Mae, which is now Navient.  I made an interesting, somewhat subconscious, decision to not ever look at how much I owed until the end of PA school when they make you do financial literacy training.  I guess I figured that it wouldn't make any difference since I wasn't able to start paying them off yet anyways.  And although I was not able to do this, here's Tip #3 - If there's any way that you can make payments during PA school, do it.  (Even if it's a small amount.)  If you get any extra income, have a spouse who works, or have savings you're sitting on, think about putting some of it towards your loans.  Those small payments make a big difference in the long run, especially with high interest rates.  

So anyways, when I pulled up my loan summary, I owed around $75,000, and that was shocking to me.  Now I know that PA school costs a lot more for a lot of people, but you can't deny that 75K is a big chunk of money.  I mean, that's the average starting salary for a new grad PA.  About 55K was principal (meaning that I had actually borrowed that much), and the other 20K was interest (the fee for the money I borrowed).  My interest rates were varied, but averaged at about 6%.  

After you graduate, there's a grace period where you are not required to make payments on your loans.  Tip #4 - If possible, start making payments during your grace period.  While you don't have to make payments, your interest is compounding and growing.  From day 1 of getting a paycheck, it helps if you start making payments right away.  You won't miss the money if you already have it dedicated to your loans.  I committed to this at first, but then I got a little lazy.  My original goal was to put at least 1/2 of my salary each month towards my loans.  But then I got the great idea that I would just put whatever was left over at the end of the month towards them.  Just kidding.  Not a great idea.  That only lasted about 2 months before I got myself back in check.  After working so hard for 2 years in school with no compensation, it can be easy to go a little crazy.  I would love to tell you to make a budget and stick with it, but I'm personally terrible at budgets, so I can't give you much advice in that area.  

So I went back to committing at least half of my salary to go straight towards my debt.  Tip #5 - Decide how much you want to put towards loans each month, and do it.  As you see the amount you owe decrease, it's so reassuring.  There are differing views on what loans to pay off first.  Dave Ramsey has the "Snowball" plan, meaning you pay the one you owe the least on, without regard to the interest percentage, and go from there to gain momentum.  I paid off the one with the highest interest rate first, and then worked my way down.  If you do automatic payments, you may get a decrease in the interest amount.  

After you've put your committed amount towards loans, if you have any extra money coming in, consider putting it towards your loans.  Tip #6 - Try to put extra funds towards your loans.   Every little bit makes a big difference.  It may not seem like it at the time, but I don't think I would have paid off my loans as quickly as I did if I hadn't done that.  And I can think of specific purchases that I made that delayed my final payment, and they probably could have waited.  

So back to my loans.  After I found out how much I owed, I committed to paying half of my salary each month to my loans, and any bonuses I got.  There were a few hiccups along the way, but I got better at it with time.  I tried to put any extra funds to my loans.  I started working in August 2014, and this past January 2016 I made my last loan payment!  It felt awesome.  Took my entire bonus/commission, and drained our bank account, but it was worth it.  I feel like a weight has been lifted off my shoulders, and I have a lot more freedom at this point.  Instead of going to the beach a few hours away, I can afford the trip to the DR without feeling guilty for not paying towards my loans.  Tip #7 - Make frugal choices while paying your loans, not extravagant ones.  

Everyone is different, and I'm sure not everyone will agree with how I did things.  But that's ok, and I'm extremely happy with where I'm at.  Debt-free, and able to start saving more and making good financial decisions.  Tip #8 - Do what works for you.  I'm a generally frugal person anyways, but I can splurge on something like a vacation or good meal.  Making big purchases, like furniture, are a lot more fun now too.  

At the end of the day, whether you're still in undergrad or worried about affording PA school, your loans will be paid off at some point.  It may not be as soon as you would like, and you'll probably make some mistakes, but it will happen!  If you have any other tips for others about paying off loans, please comment!  Or if you've paid off you're loans, I would love to share your story and help others to have confidence that it is possible!  

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1 Year Out

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I just recently realized that I've officially been a graduate for 1 full year, and it was about this time last year where I was nervously awaiting PANCE results.  It's been somewhat of a whirlwind year, and I wanted to reflect and share some advice to you guys as I look back.  It's amazing how time flies in PA school, and then it still goes as fast when you're busy working.  I went to a pharmaceutical dinner last night for PAs, and some of my past professors, and now colleagues, were there.  It was so funny because one of the teachers couldn't even remember when I graduated!  And she wanted me to call her by her first name, which just still seems weird to me.  It's amazing what a difference a year can make.  

This time last year, I had officially graduated, taken PANCE, and was training at my dermatology job.  I was almost as nervous to check my board results as I was to actually take the test.  I was at work that day and as soon as I got the e-mail that scores were posted, I went outside of the building to check them.  I had pretty much decided that if I failed, I would just leave and not go back.  Luckily, I didn't have to do that, but passing boards is what made it feel real, like I had finally made it.  I'm dreading retaking them in 10 years, but I just won't think about that for now.  

Some advice to Pre-PA students - Being a PA is a great job, and I definitely recommend it, but look at all of your options closely and decide why being a PA will be a good job for you personally.  Although in many fields, you do most of what the physician does, PAs are not physicians, and some people will never be happy in that role.  It takes hard work to become a PA and you have to decide that it's worth it you.  While you're doing all of the prerequisites for PA school, have some fun.  Looking back, I had a great college experience, but I was almost too goal focused and I do wish I was a little more laid back at times.  The stress and tears weren't really worth it.  

Advice to current PA students - Eventually, you will be done with classes and rotations and boards and you will be a PA too!  It does end, so just remember that during the weeks that you think you might just not make it.   There are still about 2 weeks that I remember as just being terrible, but we all made it through.  I would encourage you to still take care of yourself and your passions.  It can be easy to lose those things when you're so microfocused on school all the time.  I don't think I read a single book for fun while I was in PA school, instead I would read study material until I fell asleep.  Was that necessary?  Probably not.  Also take time to invest in your friendships and family.  The first 2 semesters of PA school, I wouldn't even go out to eat with my family because I "had to study."  Looking back, it would have taken probably 30 min- 1 hour, given my brain a rest, and given me nourishment and fellowship.  Maybe I got 1 point higher on the test by skipping dinner?  But I think I would have rather gone to dinner.  So don't be so uptight that you let things slip away.  Become friends with your classmates too, and hang out with them outside of school!  Some of my best friends are girls I met in PA school, and most of the things we did were unplanned and random, but just what we needed to survive.  Like buying last minute floor seats to see Taylor Swift 2 days before the show, with multiple tests the next week...maybe not the best plan, but exactly what we needed at the time.  (And it was so worth it.)  One last thing, you will find a job.  So no need to cry over that like I did either.  Your first job probably will not be your last job, but there are plenty to go around.  While job searching, I would recommend not discussing specifics of jobs with your friends or close classmates because it can get a little uncomfortable if you and your best friend are interviewing for the same job.  So just make a plan to hold off until you've signed the contract.  

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Advice to new grads - Congrats, you made it!  Welcome to the real world!  Vacation is something different now, and if you're working in a clinic with a set schedule, be prepared to ask off months in advance because they really don't like having to move 20-30 patients when you decide you're ready to go to the beach. Be wise with your money.  I had a great plan right out of school that I would just buy whatever I want and then whatever was left would go to my student loans.  Yeah, that's  a terrible plan.  Look into paying off your loans early and investing as soon as possible.  (A great resource - White Coat Investor).  While being wise with your money, don't be afraid to have some fun too.  You've deserved it!  Like if you want to plan a random trip to Las Vegas with your spouse or buddies, do it!  And keep up with your classmates.  It takes a family to get through PA school, and now that you have a bunch of new colleagues, use those resources to make each other better PAs.  If you hate your current job, look for a new one.  I once heard that you should never stop looking for a job, and there are tons out there so don't stay somewhere that you are unhappy.  Don't forget to give back to your program either, and not necessarily financially.  If you are able to lecture or be a preceptor for students, that's a huge help to the program and even more to the students.  

Overall, I'm extremely happy with my decision to become a PA and I love my job.  There are still some days when I feel overly stressed and exhausted, but there are far less than when I first started working.  I'm excited to see where our profession is heading, and how it will change and evolve.  I'm still figuring everything out, but it's getting much easier.  And I'm just happy to not be studying for the PANCE right now.  


Resources for Anatomy

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Anatomy and Physiology is not only required to get into PA school, but will be one of the courses you'll have to require while in the program, usually near the beginning.  The A&P of PA school is a whole different level from most undergraduate programs, in both amount of material and intensity.  My program was done over the summer.  We had lecture 4 days a week and then switched off lab time each day so 2 days were spent in the cadaver lab.  The experience was great, but that's a smell I don't wish to revisit.  It's still hard for me to wrap my head around the way all of the structures of the body function together, and that I actually have all of those muscles and nerves!  We had 3 tests during that first challenging course, which I achieved a C, then a B, then an A.  Progress is great, but I wish I knew which tools were going to be the most beneficial for my limited study time.  Below are the resources I used outside of our required textbook, and I hope you will find them helpful!  I've included links to the most updated sources, but for most of these the previous editions will likely be sufficient (and cheaper).  Comment below with any other books or websites you've used during anatomy. This post contains some Amazon affiliate links. 

Netter's -  This is one of the classic resources.  It's an atlas of drawings of every single part of the body.  This is an essential book for learning the structures, and if you are able to know these pictures when it comes to practical time you should be prepared.  I had a copy I kept at home and then my lab group had one as well to keep in the lab (this one gets a little messy).  These are hand-drawn pictures by the way!

Color Atlas -  This book is also a collection of pictures of anatomy, but it's actual pictures of cadavers.  If you have a real cadaver lab, this book is invaluable.  It makes it much easier to identify the structures when you know what colors they actually appear, instead of blue, green, purple, and yellow.  I preferred studying from this book once I figured out what I was doing.

Netter's Flashcards -  There are flashcards of essential structures that have Netter's drawings and all of the important material on the back.  I didn't know these existed until my husband went through medical school, and they are pretty awesome.  He used them a ton.

Thieme Atlas - This is another atlas set that actually has little blurbs of information as well instead of just pictures.  Here is a link to the book on Google Books.  There are a few pages missing, but most of the content is there if you want to check it out!

University of Michigan Practice Questions -  These questions are amazing!  There are also practical identification questions.  I didn't do these for the first test and I truly regret it.  They are vignette style questions on high-yield material and give explanations for why an answer is wrong.  Great, free practice!

Lippincott's Illustrated Q&A of Anatomy and Embryology -  Lippincott has a great series of Q&A books, and this one may be the first one you use.  It has explanations for why answers are right or wrong, and these are also vignette-style.

Netter's App -  If you're more advanced technologically, you will love this app.  You can choose which structures you want to view and quiz yourself on different parts of the body.  It's a 3-D view and my husband still uses this to study.

Zygote Body -  This is similar to the Netter's app, but available on the internet.  There are different levels you can subscribe to, but sometimes it helps to get a different view and be able to customize quizzes.


Respecting Patients

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There has been a lot of press about a news story that came out recently.  Basically, during a routine colonoscopy, the patient accidentally had his phone recording, and happened to hear some very insulting remarks being made by the anesthesiologist during his procedure.  The things that were said were pretty outrageous, but unfortunately it is not too uncommon in many medical settings to hear negative comments about patients at times.  There were many things wrong with this case, including that the physician was making inappropriate comments, no one tried to protect the patient, and the physician made comments about billing for diagnoses that weren't present.

This case is a good reminder that it is our job as healthcare providers to protect our patients, and not just because you could lose money over it.  Working in the medical field day after day can be exhausting and sometimes it is easier to complain and rant then to just keep the frustrations in.  Whether it's the late patient, the difficult patient, or a drug seeker, it is not our job to judge the person who comes to us for help.  Even if you're not the initiator, you can help to be a positive influence in your workplace.

A story like this gives medical providers a bad wrap, and makes patients even more skeptical about whether we are really there to help them.  Especially if a patient is going under for a procedure, there's a good chance they are nervous about it, and the focus needs to be on "doing no harm" at all times, even when it's hard.  I hope you keep this in mind when you are out in clinic or hospitals and let's be more aware of how we are treating our patients.