Preparing for the Physician Assistant School Interview
Compared to professions like physician and nurse, Physician Assistant (PA) is a relatively new category of medical service occupation. With the first PA class graduating from Duke University in 1967, a new kind of medical profession was established, with the goal of offsetting a shortage of primary care physicians and increasing patients' access to care. The American Academy of Physician Assistants (AAPA) was established the following year in 1968, and the field has continued to undergo continued growth, accreditation, and refinement in the years since. Still, knowledge around the role of a PA remains considerably less widespread than more traditional medical roles, so a key aspect of the PA interview is demonstrating your understanding of this particular role and vocation, and specifically articulating why this medical career is the best choice for you. As such, many PA school interview questions will probe your understanding of the role, scope of practice, and professional challenges associated with becoming a Physician Assistant.
The PA School Interview
In terms of interview format, note that some PA interviews will include a Multiple Mini Interview (with MMI questions), some will have traditional or panel type interviews or group interviews, and some programs may require CASPer, so be sure to check with each school to prepare effectively. Here is a link to help with your CASPer test prep, and here is a definitive guide to the Multiple Mini Interview with MMI practice questions.
As well, on top of PA-specific questions, you should prepare for more general interview questions, such as, “Tell me about yourself” and “What is your greatest weakness?” This post will focus on 10 PA school interview questions specific to this particular profession, but traditional interview questions are also fair game.
PA School Interview Question 1: What is a PA?
Hopefully, it goes without saying that you should have a firm understanding of the role and scope of practice of a PA long before getting to the interview stage. Briefly, in practical terms, a PA works in a supporting role, under the supervision and delegation of an MD, participating directly in patient care, treatment, and education. There are some limitations to what a PA can do – for example, PAs cannot perform surgery (though they can assist), and their ability to prescribe medications varies considerably depending on location (including what they are allowed to prescribe if prescription of medications is permitted - e.g., narcotics and other controlled substances).
More philosophically, and as noted briefly above, the purpose of a PA is to enhance patient care and access to primary care practitioners. PAs act under delegation from an MD, taking on a wide variety of illnesses and injuries that are more commonly treatable, allowing MDs to devote their time to complex and acute cases (though PAs may assist on these) and to research or other scholarly activities. As time constraints and workload continually increase the pressure on MDs, limiting the amount of time they have to devote to each patient, and geographical limitations result in gaps in patients’ access to care, PAs play a critical role in facilitating patient treatment, developing strong patient-practitioner relationships, ensuring thorough patient education, and working with the patient as part of a multifaceted healthcare team.
PA School Interview Question 2: Can you describe the history of the PA profession?
While you don’t need to memorize the entire timeline of events that led to the establishment of the PA profession, and every step from that initial class of PAs to today, you should have a sense of how and why the profession began, the context from which it emerged, the needs it sought to address, and some milestones in its development.
PAs in the United States
Along with a shortage in physicians and issues around geographical distribution of doctors (particularly in rural areas), the PA role evolved in the 1960s from military medics returning from the Vietnam War. These highly-trained medics, who were not fully-licensed MDs, did not have an equivalent role when they returned to civilian life, yet their skills and abilities had been proven during their service. The combination of these led to the development of a medical professional role that sought to maximize patient care and build a bridge for trained medical practitioners who had the knowledge necessary to provide such care, yet who had not attained an MD degree.
1961 saw the initial proposal for a type of medical assistant in between a technician and a medical doctor, able to take on many of the responsibilities and procedures often reserved for physicians. The first physician assistant program was established at Duke University, by Eugene A. Stead, Jr., MD, in 1965. The American Association of Physician Assistants (later the American Academy of Physician Assistants) was founded in 1968, and the Comprehensive Health Manpower Training Act of 1971 paved the way for the American Medical Association to officially recognize the PA profession. This led to the initial certification and codification of professional standards and scope of practice. A few years later, in 1975, the National Commission on Certification of Physician Assistants (NCCPA) was established to standardize PA certification. Today, there are 250 accredited PA programs in the U.S., and PAs have some prescribing authority in all 50 U.S. states.
You can find a more robust list of key historical milestones in the establishment of PAs in the U.S. here.
PAs in Canada
In Canada, the role of PA was likewise first established in connection with the military, in this case as a role for senior medics. This started in 1984, and in 1991, Canadian Senior Medical Technicians became Physician Assistants, and these were the first formally trained PAs in Canada. The Canadian Academy of Physician Assistants (later the Canadian Association of Physician Assistants, or CAPA) was established in 1999, and began advocating for PAs throughout Canada. From 2000-2010, provinces across Canada began recognizing and establishing curricula and standardization for PA training, work, and certification. Prescribing authority for PAs in Canada varies by province, though PAs are generally not able to prescribe narcotics or controlled substances.
Check out a timeline of historical milestones in the establishment of PAs in Canada here.
PA School Interview Question 3: What is the difference between a PA and an NP? Between a PA and an MD?
Understanding the distinct roles of various medical professionals is key, as the increasingly diversified medical workforce means a network of various experts with different scopes of practice and areas of expertise. You need to be able to demonstrate that you fully understand the path you’re pursuing, and that you have specific reasons for pursing this particular medical career. You should want to become a PA because of the role and ethos you will fulfill (as opposed to, say, pursuing this career as a “safety net”, if you don’t get into med school – that’s a “red flag”!).
Follow this link to learn more about the differences between PA vs. MD.
In terms of the differences between a PA and an NP, or Nurse Practitioner, some key differences have to do with healthcare philosophy, specialization, and autonomy.
PA vs. NP: Healthcare Philosophy
Simply put, NPs follow a nursing (patient-centered) model, and PAs follow a disease-centered model. As a whole, nurses – including NPs – prioritize patient education and disease prevention, while physicians and PAs focus on biology and pathology, and both participate in patient assessment, diagnosis, and treatment, in various ways.
PA vs. NP: Specialization
PAs tend to be trained as generalists first, with some ability to specialize later, if desired. For example, while PAs cannot perform surgery, they can assist in surgeries, and can specialize in general surgery or emergency medicine, among other possible specializations. Because they are trained as generalists first, with the option to specialize later, PAs tend to have more lateral mobility - meaning they can change specializations without having to go through extensive additional training later in their careers. NPs are generally required to choose a specialty area for their education and practice, often working with distinct populations or those with specific needs, in areas like women’s health, mental health, or geriatric health, among others.
PA vs. NP: Autonomy
Generally, both NPs and PAs work under the supervision of a physician. However, in some areas, NPs are able to establish independent practices. Currently, PAs cannot work independently, without physician oversight; however, a movement to make PAs more independent and autonomous does exist.
PA School Interview Question 4: What is your understanding of what PAs do?
This question has both a general and a specific component, each of which will depend at least in part on where you’re hoping to practice. Note that regulations around what PAs can do, and the steps needed to do those things, vary both nationally and at the state/provincial level, so you must be aware of the regulations around practicing as a PA in the place where you hope to practice.
General PA Roles: This speaks to the philosophical component noted earlier. In general, PAs act in a supporting role, under the supervision and delegation of physicians. They are intended to mitigate barriers to care for patients, often providing more cost-effective and geographically-diverse care than physicians. With increasing, and increasingly complex, patient populations, PAs provide primary care and patient education, allowing doctors to take on complex and acute cases, perform complicated procedures and surgeries, and devote time to research and scholarship.
Specific PA Roles: Specifically, PAs take on more common illnesses and injuries, provide diagnosis and treatment, sometimes prescribe medications (where permitted), and provide patient education. Again, what that means can vary from nation-to-nation and state-to-state or province-to-province, so you must look into the regulations in your region and be able to speak to the scope of practice relevant to your location.
PA School Interview Question 5: Why do you want to be a PA?
In some ways, the question, “Why do you want to be a PA?” carries with it an implicit additional component -- that is, “Why do you want to be a PA, as opposed to an NP or MD?” While you don’t need to know every single difference between these various medical practices, what’s key is that you can speak to why you want to become a PA, specifically. As this is still a relatively new medical role, there are many misconceptions about what a PA is and why someone would choose this route. Consider your strengths, key qualities, values around collaborative healthcare, and goals as an aspiring medical professional, and speak to how these are achievable within the PA vocation. If you applied to med school and didn’t get in, and are pursuing a PA degree as a “back-up”, that is not a good reason (and would likely be the death knell for your interview!).
Why do you want to be a PA? Sample Answer
“First and foremost, I want to be on the front lines helping patients, particularly patients that experience social, geographical, and economic barriers to care. During my shadowing experience, I had the opportunity to work as part of a mobile clinic serving homeless populations in an urban area, with a team of PAs, nurses, and technicians, working under the supervision of an MD. While I have so much respect for every member of that medical team, the passion and connection I witnessed between PAs and their patients really impacted me. The PAs on that team managed to balance the insights of physicians with the patient-centered approach of nurses, working simultaneously to diagnose and treat, while also educating and fostering strong patient-practitioner relationships. Patients who had been suspicious of the medical establishment found the collaborative attitude and approach of PAs comforting, while also having confidence in their medical ability and know-how. The simple ability to take time to be with patients and hear them – which isn’t always possible for physicians – enables unique connections that foster positive patient outcomes.
As well, I am a very team-oriented person. I’m capable of being a leader, and have filled leadership roles [in X, Y, Z experiences], but I don’t need to be the leader, and I find that I’m most fulfilled when working collaboratively with others. I firmly believe in an ethic of sharing and support and find this both personally satisfying and in the best interest of patients. Coming together as part of a network of professionals, helping patients understand their diagnoses and treatments from multiple perspectives, not only facilitates wellness, it builds trust. That’s not to say that other kinds of healthcare professionals can’t or don’t do such things, but the specific role of the PA is to provide exactly that kind of collaborative care. So, both personally and professionally, it’s that approach that draws me to this profession.”
PA School Interview Question 6: Are you familiar with national or state/provincial regulations for PAs?
There’s no getting around it: You have to do your research for this question. It’s not acceptable to simply answer, “No,” or try to guess your way through. That said, you also don’t need to memorize the exact regulations in every state and province in North America, either. They know you’re not a PA yet, so they won’t expect you to know every detail and minutiae of these regulations – that’s something you’ll learn along the way. What matters is that you’ve at least looked into this enough to speak to it in a meaningful way that demonstrates your commitment to the profession.
Again, there are some unfortunate misconceptions about who pursues a PA and why – largely as a fall-back or safety-net after unsuccessful med school applications. This absolutely must be countered, as PAs are front-line medical professionals in their own right, with their own important role to fill. So, demonstrating that you have invested time and thought into this specific profession, and have explored some of the specifics of this role meaningfully and purposefully, will help demonstrate that you are a serious and committed applicant. So, look into the specific regulations in the state or province where you are interviewing, and be able to speak to these. You don't need to know every nuance, but a general working knowledge will go a long way to both demonstrating your commitment and helping you fully grasp the profession you're pursuing.
PA School Interview Question 7: How have you prepared yourself for the PA profession? How are you making yourself and your application more competitive?
In this response, it is crucial that you are able to speak specifically to the PA profession, not just to healthcare generally. This is an open-ended question that allows you to demonstrate your commitment to the profession, so your answer will be highly individualized. So, you can talk about your volunteering, shadowing, and/or clinical experiences, any additional courses you’ve taken, or any work experience you have that has helped you understand more about life and work as a PA, and that helped solidify your decision to pursue this particular path. You could also reflect on specific patient interactions you’ve had or witnessed that stand out for you as representative of your desire to become a PA. In short, this question is asking you why the PA is the best route for you, and what you’ve done to prepare yourself for this career.
Additionally, you can draw on related experiences and skills you’ve developed that will help you reach your goals as a future PA. For example, if you want to work specifically with underserved rural communities, and you’ve taken on volunteering opportunities that put you into contact with such communities, that is both preparation for your future and something that can make you a more competitive applicant. If you want to work among immigrant or refugee communities and took the time to learn their language (for example, learning Spanish to work in California or Texas immigrant communities), that shows immense initiative, forethought, and care for the patients you hope to serve in the future.
PA School Interview Question 8: Why our PA program?
Prior to the interview (and – ideally – prior to submitting your application), you must look into the mission, vision, and values of the school and program to which you are applying, as well as their specific PA curriculum. Because the rules around how PAs practice vary based on location, PA programs in different areas often have curricula specific to that area, and different priority populations on which they focus. Being able to demonstrate how your own values and priorities align with those of the institution is critical, because it demonstrates that you are a “good fit”. As with any medical profession, academics and other quantitative data are important, but alignment at the level of values and qualities is just as important. So, if a program has a specific mission and curriculum that prioritizes care for homeless populations, for example, and you demonstrate your own commitment to serving such communities, that shows that you won’t just thrive in terms of your grades, you’ll be an effective ambassador for their program after you graduate and enter into practice.
Here’s a great video on why it’s so important to look at an institution’s mission statement:
PA School Interview Question 9: What do you think is the number one problem facing PAs today?
This is a question that builds on a lot of what has been discussed already, so let’s jump in with another sample answer that brings some of this together:
“As a medical profession, the PA role is relatively new, compared to more traditional paths like physician or nurse. While PAs are well-respected members of medical teams within the medical community, the wider community of patients are often not entirely clear about what a PA is, what they do, what their role, authority, and scope of practice are. Because of this, and because of the term 'Assistant' in the title, there are a lot of misconceptions, with some patients assuming that PAs simply don’t have certain kinds of expertise or training. This, of course, isn’t the fault of the patients themselves; while there are organizations and individuals devoted to clarifying the role of PAs, that information just isn’t as widespread as it needs to be yet. So, a significant hurdle is helping patients understand that we are advocates for their health and that we are there to help bridge gaps in the existing healthcare establishment, because building that trust will allow us to foster stronger relationships with our patients, which in turn improves communication, treatment compliance, and patient outcomes.”
There are any number of other ways of responding to this question, and your answer should be an honest reflection on the profession. You could also discuss something like specific healthcare challenges faced by PAs, issues around workplace stress and burnout in PAs, or anything else you see as an issue to be dealt with, within the profession. Just ensure that your response is consistent with the values associated with this particular medical role: community, collaboration, increased access to care, prioritizing underserved populations, communication, service orientation, etc.
PA School Interview Question 10: What kind of stress do you see associated with the PA profession?
In any medical profession, burnout is a concern, so it’s important that you are knowledgeable and realistic about the stresses you will face. While MDs tend to face the highest risk of burnout, it’s a discipline-wide concern in the field of medicine. You’ll likely face long hours, interpersonal stressors, compromises on your time, and the demands of a challenging job where a lot is at stake. So, familiarize yourself with these concerns and be honest about them; demonstrating that you’ve looked into these shows that you’re a serious candidate who has done an earnest, mature evaluation of the demands of the profession you hope to enter and how you will thrive despite these pressures.
As well, you can use this as an opportunity to talk about the stress-relieving tactics you’ve already developed, which can also highlight your general well-roundedness. As someone who has already done a good deal of schooling, and possibly some considerable work experience, as well, you likely have some solid coping mechanisms to put work aside and mitigate stress. So, use this to demonstrate your resilience and show the interviewers some of your own uniqueness. If you play sports or engage in extra-curriculars to blow off steam, talk about this, and why you enjoy the particular things you do in that regard. If you love cooking, or art and music, writing or journaling, or have any other creative outlets, these are all great ways of dealing with stress that also contribute to the overall portrait of who you are as an applicant and as a person.
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