How to Survive PA School: A Guide for Physician Assistant Students

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Author: Tom Coombe
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Reviewer:

Matt Kohls

Matt Kohls is a 2020 graduate of Slippery Rock University in Pennsylvania currently looking for a PA position.

As licensed medical professionals who may work independently from doctors, physician assistants (PAs) are required to successfully complete rigorous education and training programs. Get advice and tips on the best ways to survive and thrive in PA school.

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A female doctor using a stethoscope to listen to the back of a female patient in a PA School clinical setting.

Some of the descriptions physician assistants in training use to describe their education experience include: “Demanding,” “Intense,” and “Like drinking from a fire hose.”

This makes sense. You’re embarking on a career that will require you to diagnose illnesses, prescribe medication, develop treatment plans, and, in many cases, serve as your patients’ chief healthcare provider. You would expect this type of career path to require a depth and breadth of medical knowledge that can only be obtained by completing thousands of hours of education and training. It’s challenging, but the end result is a career that is ultimately rewarding and important, especially in an era where there is an urgent need for qualified healthcare professionals.

This isn’t a road you’ll have to travel alone. Current and former PA students who stressed the importance of relying on your classmates for support, both academic and emotional. We’re here to help, too. We’ve created this guide to offer you the solutions, tools and expert advice you’ll need to survive — and thrive — as you enter PA school.

PA School Study Survival

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“Three weeks in and I am drowning in the material. First semester anatomy is insane! I feel like I have been staying up on the material really well, but at the same time it is so overwhelming.”

– A PA student discussing their first-year challenges on a web forum.

While it’s not uncommon to feel overwhelmed in PA school, the good news is that there are numerous tips, apps, and other resources to help PA students get into the groove.

Study Checklist

Perhaps not surprisingly, PA classes come with a mountain of material to sift through. When you’re confronted by the thought of “Where do I even start?,” step back, take a few deep breaths, and know that there are things you can do to get the most out of your study sessions.

Use flash cards

Many PA students swear by flash cards, whether that means home-made note cards or virtual ones created on apps like Quizlet.

Flash cards encourage active recall, which requires you to actively engage your memory to find the information you need. It’s one of the most important things students can do to learn new skills or cement new information.

Embrace visual learning

PA and blogger Paul Gonzales recommends creating charts, diagrams, and lists, particularly for courses such as pharmacology and clinical medicine. “Drawing comparisons between drugs, indications, or treatments can mean the difference between knowing something and understanding something,” he writes.

And remember that your understanding of this material needs to last beyond your exams. Memorize this information, review your visual aids, quiz yourself, and have your friends or classmates quiz you as well. By learning this way, you’ll have a better chance of ensuring this important information stays with you long after the course concludes.

Discover a new way of note taking

Gonzales also suggests finding an efficient way note taking, whether that means reorganizing your notes, highlighting important concepts of putting extra information in red.

If your professor speaks too quickly for handwritten notes, consider taking them digitally or typing them up. He also says that many students opt to use note-taking apps as Notability and Evernote for iPad.

Join study groups

If there’s a common thread running through discussions about surviving PA school, it’s these four words: Find a study group.

There are a number of benefits to studying with your fellow students. You might gain a new understanding of the material in question or help your classmates do the same. When you’re studying with others, you’ll probably find yourself challenged to do better than you would while studying on your own.

You shouldn’t feel obligated to go this route, however. Some PA students recommend waiting until you have some familiarity with the material before joining a group. You might find that you do better with a group of two than with five of your six fellow students.

Learn through storytelling

Stories are how we make sense of the world, and our brains are programmed to remember them. When trying to memorize facts or remember difficult material, it may help to create a story around what you’re trying to learn. For example, if you’re trying to remember the areas of the body to listen to the heart, just remember that all pigs eat too much.

  • All = Aortic
  • Pigs = Pulmonic
  • Eat = Erb’s Point
  • Too = Tricuspid
  • Much = Mitral

You can also learn how to explain things instead of just memorizing them. Learn the material in different ways and via different modes, such as through a textbook, notes taken in class, Power Point slides, etc., and then practice describing the concept you’re striving to learn.

Study Apps and Tools

Physician assistant training might seem daunting, but take heart; technology is on your side. For studying with flashcards, getting the most up-to-date medical news, and finding peer-reviewed disease indexes, like the old iPhone ads used to say, there’s an app for that.

Osmosis

This website is designed as a resource for professionals in a variety of fields, including future PAs, nurses, dentists, and pharmacists.

It includes an extensive library of medical videos, flash cards, board-style test questions, and group study and discussion capabilities. It can also give students recommendations on what to study based on how they fared on practice tests.

Medscape

This free app is a clearinghouse for information on diseases and pharmacotherapeutics and dosage and interaction information. There is also a wealth of quizzes and educational material as well as recent headlines from the medical world.

UpToDate

This is a subscription service — although America Academy of Physician Assistants (AAP) members get a discount — that provides information on clinical topics, medication, treatment recommendations, and more. PA students rely on it during both the teaching and clinical portions of their coursework.

Picmonic

This website, which students can also access in app form, employs a visual learning system with the goal of improving recall — and thus test scores — by putting concepts in the form of images, hence its name.

Quizlet

PA students who want to create their own flashcards swear by Quizlet, an app that lets you fashion your own flashcards, share them with your study group, and use them to quiz yourself.

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Surviving PA Clinical Hours

When you begin your clinical rotations, you’ll take the knowledge you learned in the didactic (teaching) portion of your PA training and apply it to the real world.

The things you learn during this period will help you gain the certainty you need to be an effective part of a healthcare team and gain a better understanding of a specialty you might want to pursue once your schooling ends.

Here are some tips to help you survive during this hectic time.

Hacks for Clinical Rotations

Carry these things with you

Writing on Rosh Review, PA-C Kelsey Taylor lists the things she was glad to have in her pockets during her clinical rotations. They include:

  • A stethoscope, penlight and pocket Snellen chart.
  • Medical supplies such as tape, gauze, and extra butterfly needles.
  • Multiple highlighters and colored pens.
  • Granola bar or other healthy, on-the-go snack.
  • A small notebook, plus pocket medical books.

Exam time is different

Taylor writes that studying for clinical year exams was somewhat different than preparing for didactic exams, and she recommends starting earlier and tackling a little at a time.

“I went from having two exams every week to having one exam at the end of every rotation, or every five weeks,” she said.

That change in schedule can make studying difficult, as you might be tempted to put off studying thinking that you have more time, leaving you scrambling in the days before the exam.

Taylor stuck to the EOR topic list and blueprint and crafted two-column study guides, one with the disease and the other relevant information about that disease.

Pay attention to topic lists

Taylor also stresses that students should pay close attention to topic lists and blueprints as topics and contents change along with clinical rotations.

“For example, on the pediatric exam, dermatology and EONT make up 30% of the exam, while these topics are not even on the internal medicine exam,” she wrote.

Have a spirit of flexibility

The PA program directors interviewed by the AAPA advise students to stay flexible, paying close attention to instructions given by the program, and at clinical observation and rotation sites.

It’s important to adapt to your setting and to helping the preceptor. “The more interest and curiosity you show, the more likely they are to teach you,” one director said.

Consider the three Ps — prepared, professional, and proactive

Those same directors say they like their students to be:

  • Professional — “Always show up early to your rotation site,” one of them said. “On time is 15 minutes before you were asked to be there.”
  • Prepared — Students should learn ahead of time the patient conditions on the next day’s schedule so they can study them and be ready to answer questions about the condition from the preceptor.
  • Proactive — The directors the AAPA spoke to suggested looking at every experience during rotation as a chance to learn. Good students are ones who volunteer whenever they can.

Another director noted: “Although a strong medical knowledge base will make up an important part of being a competent PA, always keep in mind that it will be your empathy, communication skills, cultural competency, integrity, common sense, and your service to your patients that will make you a great PA.”

Apps and Tools for Clinicals

Don’t feel like you need to tackle your clinical hours on your own. The AAPA recommends these apps and resources to help you through portion of your PA training.

Maxwell Reference

Student AAPA members get this useful pocket guide as a gift when they join. It’s filled with crucial info for every day medical practice, making it easier to write patient histories, analyze lab results, and conduct exams.

Canopy Speak Medical Translator

Your clinical rotations could find you in an ER in a busy urban center where many of the patients speak a language you don’t. That won’t be an issue with this app from Canopy, which translates clinical encounters in 15 languages, including Spanish, Russian, French, Arabic, and Chinese.

Epocrates

Users of this app can review clinical practice guidelines, look for possible drug interactions, and get news alerts from the medical world.

Learning Central

This service includes more than 250 clinical education activities, many of which are free to AAPA members.

The CDC mobile apps

The CDC website contains a number of useful resources for clinical students, but many students also value the centers various apps, which include CDC vaccine schedules, CDC statistics, and CDC antibiotics information.

Surviving PA School Time Management

PA school is demanding, with many students juggling their course work, jobs, and family life. In this next section, we’ll look at some of the dos and don’ts of time management and share a few apps that can help physician assistants in training better manage their time.

Time Management Do’s and Don’ts

Ask for help. Whether it’s consulting with a study group or turning to one of your instructors for insight, if you feel like you’re pressed for time, it’s OK to get others to help you through a busy week.

Set daily or weekly goals for yourself. In a clinical setting, you might bump into unexpected challenges, and having a checklist will help you keep on top of the benchmarks you hope to reach.

Even before you begin PA school, get into the habit of reading ahead before your classes so you have a basic understanding of each lecture topic. It will help you better absorb the material and be able to ask more thoughtful questions in class.

Cook meals ahead of time, perhaps on the weekend, so you don’t need to spend time each night preparing dinner. This may mean making enough soup to last four or five nights, but you’ll gain an extra hour or so for studying each day.

Don’t be afraid to say no. Be realistic about your workload and don’t bite off more than you can chew helping others with their projects.

Don’t procrastinate. It might be tempting during your clinical year to put off studying for exams, as they won’t happen as frequently as during the didactic year, but resist the urge.

Don’t feel pressured to study the same way everyone else does. Choose a method that works for you and fits your schedule. You might find that the study habits you developed in your undergrad years don’t work as well at PA school and that’s OK.

Don’t skip meals so you can study or try to subsist on snack foods. You wouldn’t tell patients to live this way. If it’s unhealthy for them, it’s unhealthy for you.

Time Management Apps and Tools

Does it feel like time gets away from you during the course of your day? Get back on track with the help of these time management apps.

Studious

Input your class schedule into this app, and it silences your phones during class and sends you reminders for when assignments are due.

Self-Control and AppDetox

These apps (the former for Apple devices, the latter for Androids) blocks access to the web or apps that you choose to help you concentrate while you’re doing schoolwork.

Remember the Milk

Regular life doesn’t stop when you start PA school. Keep on top of all the other things you need to worry about outside of school like family life, work, groceries, and chores with this scheduling app.

Evernote

Organize your thoughts and your schedule with this app, which lets you take notes in text, photo, and audio forms. You can also collaborate with your classmates or study groups and share ideas.

SimpleMind+

Are you having trouble organizing your thoughts? This app helps you cut through the fog by creating mind maps. Download the pro version to transfer the maps you make to Dropbox or Google.

Stress Survival for PA Students

PA students experience greater levels of stress than most people in America, according to a 2012 study published in The Journal of Physician Assistant Education. It’s safe to assume that in 2021 and beyond, PA students are still experiencing similar stress levels. The good news is that in a study by the Physician Assistant Education Association, 74% of PA students reported that they sometimes or always felt that things were going their way. In that same study, only 2.1% of students reporting always feeling like difficulties were piling up so high that they could not overcome them. It’s important for all students in these programs to find coping strategies.

Stress Management Strategies

Stress can affect PA students at different times in their school career and in different ways. Writing on her blog, veteran PA and PA student coach Ryanne Coulson says that this stress can last long after your schooling ends.

But she also notes there are ways to deal with some of the more common stressors you’ll face during this time.

Engage in shorter study sessions

For example, many students are stressed by the sheer amount of work they encounter. However, “PA students tend to pile on the stress by feeling guilty over what they aren’t accomplishing,” Coulson writes.

“You can devote the entire day to studying and still feel you came up short because you didn’t absorb the material well enough or didn’t get to the other subject you intended to cover.”

So rather than devoting an entire day to studying, she recommends setting limits for yourself, committing to studying for 60–90 minute blocks for no more than four hours total.

“When you place a limit on how long you have to work on something, you’ll have greater focus, and the self-imposed pressure can light a fire under you,” Coulson writes. “If you have only 2 hours to commit knee anatomy and exam techniques to memory, you’re more likely to do it.”

Break your tasks into bite-size chunks

If you’re feeling overwhelmed by your workload, try to make a list of everything you need to accomplish that day and that week.

It will make it seem like several smaller tasks spread over a longer period of time rather than one looming task.

That’s the method PA John Belinski used and discusses in a blog post.

“It was easier to see a bunch of little things like “study antibiotics part I packet” and “practice clinical skills” written down that were spread out over a few days rather than one big tasks like “study for Clin Med & Physical Diagnosis Lab exam,’” he writes.

Talk it out

Stressful situations become less stressful when you have help, or at least someone to talk to. It’s part of the reason so many PA program veterans talk about finding a study group. Consider talking to a school counselor. Belinski notes that one of his professors told the class that PA students were the most frequent visitors to his school’s counselors.

Get enough sleep

You might have heard stories about PA program students pulling all-nighters to catch up with their work. While it might be tempting to get into this habit, lack of sleep will eventually add to your stress levels over time.

Consider guided meditation, sleep-aid podcasts or, after consulting with your healthcare provider, taking melatonin.

Get out and move around

Your busy schedule may have cut into that hour you’d set aside each day to hit the gym, but you should still find some time to get regular exercise. Even a brisk walk for a half hour during your study break can go a long way to reducing stress.

Look at what you’re eating

Some people lose their appetites when they get stressed. Others find themselves eating too much. Neither is really good for you, so nip this problem in the bud by preparing meals ahead of time, which is also a good time-management tactic, and packing healthy snacks.

Get to know your triggers

Knowing your stress triggers is the first step to dealing with stress. Maybe it’s deadlines, or the long stretches in the classroom, or a specific person. Keep a record of times when your stress is high and find the common denominators. Once you’ve pinpointed the stressor, you can get to work on addressing it.

Stress Management Apps and Tools

There are a number of apps designed to help PA students deal with stress and overcome anxiety during this busy time. Some of the more popular ones include:

Happify

Physician assistant students dealing with stress and anxiety can use Happify’s games, journal prompts, and other tools while tackling specific issues such as overcoming feelings of negativity.

Sanvello

This app is designed for people experiencing depression, anxiety, and other mental health issues. It’s a popular tool thanks to its mood tracking mechanism, guided practice towards better mental health, and a large, supportive community.

T2 Mood Tracker

This app allows users dealing with issues like stress, depression, and anxiety to track their emotions overtime, with graphs and charts that can easily be shared with your doctor or therapist.

Anxiety Coach

This Mayo Clinic app uses self-testing, to-do lists, and other tools to allow students to gradually face, manage, and reduce their feelings of anxiety.

Calm

Perhaps the most well-known relaxation app, Calm offers lessons in meditation, mindful movement, and gentle stretching, as well as soothing music and imagery to help you sleep, relax, and for PA students, study.

Surviving Financially in PA School

As you consider a career as a physician assistant, you’ll likely find yourself asking the same question your peers who want to be lawyers or nurses or dentists ask themselves: “How will I pay for this?”

Below, you’ll find answers to some of the most frequently asked questions about financial aid for PA school.

Financial FAQs

Q: Is financial aid available for PA school?

A: Absolutely. Once you’re accepted to a PA program, you’ll fill out a FAFSA, or Free Application for Federal Student Aid, which will help determine what federal programs are open to you to help finance your education.

The school’s financial aid office will let you know how much you are eligible to borrow based on this application.

Some common federal loans include:

  • Direct subsidized and unsubsidized loans.
  • The Federal Perkins Loan Program, which is offered through schools.
  • The Stafford Loan Program, which is offered by banks and other lending institutions.

In addition, there are also a number of state-level loan programs. Your school’s financial aid office will likely have more information.

However, keep in mind that there are also a wide variety of grants and scholarships available to PA students.

Q: Is it possible to go to PA school without going into debt?

A: Yes, but don’t get discouraged if you must rely on loans to finance part of your education. Many PA students take on some debt to finance their education. According to a report by the Physician Assistant Education Association, average in-state tuition for PA public programs increased from $38,794 to $52,585 from 2014 to 2019, while average tuition for private programs increased from $74,475 to 95,058 during that same timeframe.

By coming up with a sound financial plan, applying for scholarships, and choosing a school that fits your budget, you can go to PA school without taking on too much debt.

Q: What scholarships are available for PA school?

A: The American Association of Physician Assistants offers a number of different scholarships to its members. There are also several scholarships designed for students who represent different groups, such as students from underrepresented minority groups, students who are the children or veterans or students who want to work in rural health.

Q: Can I work while attending PA school?

A: Many students do hold down jobs while attending PA school. However, several veterans of PA programs warn that it’s a lot to take on during such a busy time. And some PA programs simply don’t allow their students to work outside the program.

Q: How much do physician assistants get paid?

According to the U.S. Bureau of Labor Statistics, physician assistants earned a wage of between $36,500 and $175,000 a year in 2019, with a median salary of $80,500.

It’s also a job with much more flexibility than doctors enjoy, offering shorter, more regular hours in a field where your skills will always be in demand.

Financial Management Apps and Tools

You’ve read about apps to manage your time and control your stress levels, so it won’t come as much of a surprise to learn there are apps and tools to help you apply for financial aid and stay on top of your finances. For example:

Mint

With Mint, students can quickly and easily create a budget, get alerts on when bills are due or when they’re going over budget.

My Budget Book

This app lets you set up your own categories of spending, track monthly bills and export monthly expense reports to the cloud, html or cdv.

CheckPlease Lite

You and your study group go out for dinner. When it comes time to split the bill, no one is sure who owes what. That’s where this app comes into play, helping you calculate the tip and split bills for groups as large as 100.

LearnVest

This app simplifies your budgeting, linking securely to your bank account and filing each purchase you make into specific folders (groceries, restaurants, ATM withdrawals, etc.).

Expert Advice

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While there’s plenty of material online about surviving PA school, nothing can compare with hearing from people who have done it themselves. We spoke to two PA program graduates who were kind enough to share their experiences.

Matt Kohls is a 2020 graduate of Slippery Rock University in Pennsylvania currently looking for a PA position.

Rebecca Buckley is an inpatient and outpatient psychiatric physician assistant who has also served on the faculty at the physician assistant program at Drexel University in Philadelphia.

Here’s what they had to say about their experience with PA school.

Q: What are some things you know now about PA school that you wish you had known going in?

Rebecca Buckley: When I went to PA school 35 years ago, it was different than it is now. It was just as rigorous; however, due to the current requirements for a master’s degree, it is even more of a time commitment due to the added courses. I taught in Drexel University’s PA Program for 12 years and it always amazed me how packed the curriculum was. There’s literally no spare time at any point in the training. It is difficult on relationships, and it is difficult financially.

Matthew Kohls: Prior to PA school, I had read many forums on what it is like being a PA student and what to expect. However, there is a difference from just reading a forum and actually being a PA student. PA school is a very rigorous educational experience. The majority of your time is spent in class or out of class studying. I don’t think I truly conceptualized in my head until I was actually doing it.

Q: What was the toughest part of the clinical side of your education? How did you get through it?

Rebecca Buckley: The toughest part of the clinical year was changing sites every six weeks. No sooner had you started to feel competent, then you were done [and] headed to another site and practice you knew little about. The other thing I found challenging was the vast differences in teaching styles, level of autonomy with talking with patients, performing procedures and physical exams. There was quite a range.

I kept my “eye on the prize.” If things were tough, I kept reminding myself it wasn’t forever. I also looked at it as a learning process, I learned what I didn’t want to do, as much as I learned what I wanted to do.

Matthew Kohls: The toughest part of the clinical side of my education was the transition from student to clinician. I found it very challenging in the beginning to talk to the patient while also forming a differential list of everything that could be wrong at the same time. As time went on, I got better at that skill from experience and by consistently going over my notes when I went home to really reinforce concepts in my head.

Q: What advice would you offer to students who are having trouble with time management?

Rebecca Buckley: Don’t procrastinate. Keep up with all reading and assignments because there will always be something that comes up that will need your attention. Be realistic. Know your strengths and weaknesses and plan accordingly. Tackle the most challenging assignment first.

Join a study group, if you find it is distracting, or not as focused as you need to be, venture out on your own.

Spend time in the library (school, local, etc.) or another place that’s quiet without the distractions of home.

Make a schedule, and stick to it.

Matthew Kohls: My advice for students who are having difficulties with time management is to prioritize your work. Oftentimes, there are a lot of assignments, tests, practicals, and projects which can be stress inducing if you look at the big picture. It is important to take it by a week by week basis and focus on that particular week. The work due that week should take a higher priority than something in the following week.

Another advice piece I have is to take small frequent breaks (10 minutes every hour). While it may sound counterproductive, giving yourself that small break can make you more productive the next 50 minutes that you do work.

Q: What methods did you use to help you study?

Rebecca Buckley: I rewrote all my notes at night after the lectures, including rereading the Power Points. Anything I wasn’t totally clear on I would read the textbook to clarify. If I still wasn’t totally sure I went to the professor for clarification.

Repetition is the key. Reviewing new material within 24 hours of first learning it helps solidify the new knowledge.

Matthew Kohls: I’ve always been the type of person who printed out the notes and listened as the professor went along. If I heard something important that wasn’t on the notes, I would jot it down on the side. After class, I spent a lot of time on each individual disease state until I felt like I had mastered it.

I built what I called “concept maps” in my head for each disease. I attempted to connect the pathophysiology of the disease to the signs and symptoms and then to potential treatments. This strategy worked very well for me and I believed it helped me get a better understanding of each disease.

Q: By all accounts, becoming a PA can be pretty stressful. Was that your experience, and if so, how did you cope with stress?

Rebecca Buckley: Yes. I was so stressed that I started having hives the night before each exam, and after the exam, they would disappear. I mostly coped by “compartmentalizing.” I had to have time booked into my schedule on the weekends that had nothing to do with school.

Matthew Kohls: For myself, PA school was definitely a very challenging but do-able experience. It’s arguable which year is more stressful, the first or the second. I found the first year to be more stressful because of the avalanche of information being presented to you to learn. I spent the majority of time outside of class studying to stay as on top of the material as possible. On the weekends, it wasn’t super uncommon to study from the morning to bedtime to try and become as proficient as I could. My second year, while stressful, got better as time went as I started to feel more and more confident in myself as a provider.

I coped with the stress in a variety of ways. My biggest stress reliever was being able to lift weights or going for a run. Physical activity helps clear my brain and also makes it fresher for when I would start working again. Another big stress reliever was leaning on my roommates who were also in the same program as me. It was always nice to be able to talk about what was going on with someone who understood what you were going through. I highly recommend anyone entering a PA program to make a couple of friends because I think it incredibly important for success.

Q: What’s something that’s different about your field now compared to when you first started?

Rebecca Buckley: I work in a sub-specialty (psychiatry), while early on most PA’s worked in primary care. Now it is much more weighted in specialties, primarily surgical subspecialties, especially in urban and suburban communities.

In addition, we are making a lot more money. Again mostly in the surgical subspecialties.
Our profession, much like other providers, is driven by insurance reimbursement. Early on, we were hired to help treat some of the more common medical complaints so our physician partners could concentrate on some of the more complex cases. Now, it is all about money, how many patients we can see and how much we will be reimbursed. We still have physician back-up if we need it, but we are much more autonomous now.

Matthew Kohls: COVID-19 is something that is most certainly different about my field now than when I first started PA school. The pandemic has put many hospital systems into hiring freezes and in some cases the furloughing of employees. This is mainly due to the huge loss of revenue many hospitals suffered during the pandemic. This has made finding employment more challenging than under normal circumstances.

Q: What do you enjoy most about being a physician assistant?

Rebecca Buckley: It is all about taking care of people as best as I can and treating them with respect and compassion, no matter who they are or where they come from. The human connection.

I know you did not ask, however, what I do not like about being a PA is the lack of respect we sometimes suffer from other medical providers.

It is always providers who have never actually worked with a PA… “I know somebody who knows somebody who was treated by an incompetent PA…” It feels at times that it is more of a turf war than about actually taking care of people and providing quality healthcare. They generally have no idea the training we have or the ongoing medical education to keep our licenses. Fortunately, the nurses, NP’s, physicians etc. I have worked with in the past have been respectful, supportive, and great team players.

Matthew Kohls: While it may sound cliché, my interactions with patients are what I enjoy most about being a PA. Having the opportunity to meet people in need and being able to help them is incredibly satisfying for me. I love knowing that what I’m doing can have a positive impact on someone living a longer, healthier life.

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