Shadowing a PA (Physician Assistant)
Today, we will focus on one of the most important pre-pa topics, the ins and outs of shadowing a PA! At Medgeeks, we often receive many questions in regards to PA shadowing because many times, students can feel frustrated about where to start, how to shadow a PA, and even how many shadowing hours they should have prior to submission of their CASPA application.
Luckily, this article will cover the whole process, from start to finish!
The importance of shadowing can not be understated for a variety of reasons. First of all, would you enter a profession without having any idea what the daily ins and outs were? What if you were exposed to a profession but then realized that you did not enjoy that job’s role?
Additionally, the PA profession is unique in that physician assistants work in a vast variety of specialties and roles vary greatly.
For example, if a student shadowed me in family practice versus my occasional urgent care shift, their experience would be entirely different!
Who Should I Shadow?
Our profession is particularly unique because not only do prospective students need to explore the role of the physician assistant, we also need to make sure that we are acquainted with the roles of other professions as well, particularly the physician and the nurse practitioner.
Students should be well versed with these professions and be sure that through the shadowing process, they are able to identify why they have made the decision to pursue a career as a PA.
Not only is it important to shadow a PA, we also recommend shadowing nurse practitioners and physicians to assure that the candidate understands all three roles and can discuss the differences and how they have come up with PA as the best possible option for them.
The more shadowing and experience with a wide expanse of providers, the better prepared the candidate!
How Do I Go About Shadowing?
I will be the first to make the comment that shadowing can be particularly difficult. The number one question we receive from students is how do I get my foot in the door? If you do not know a PA or have immediate resources available, the first step of even finding a practitioner to shadow can be very difficult.
In discussing this upcoming article with my colleagues, I heard the same thought continually: the first rule of setting up shadowing is be persistent!
We recognize the challenge, but staying motivated, persisting is the key. If you get 9 Nos from PAs but a single yes, you’ve succeeded! You have your foot in a door.
Next, we will look at some different ways to try to set up a shadowing experience. The oldest way would be “cold calling” or asking directly. In my practice, it is not a rare event for a patient or family member to ask me if their relative can shadow me. Sometimes I can accommodate this, other times I can not.
Cold calling means that the student calls an office, sends an e-mail, or even travels to the hospital or office to see if any PAs are capable of taking a student shadow. This approach can yield some success, but students can become frustrated and discouraged if the answer is no.
Our tip: each e-mail, phone call, or visit can provide an opportunity for a yes, which could change your entire life, so be persistent and do not give up!
Another common option that some students will look at would be shadowing their general practitioner or pediatrician. This is certainly an option and as I discussed above, it is a common question that I receive as a family medicine physician assistant. Be prepared to understand however, that clinicians are busy and taking on a student requires a lot of extra work, time for the clinician, so a no answer has nothing to do with you, it may just not be the right time for the clinician.
Another option is for pre-pa students to join their respective states’ physician assistant association. A membership in a state association may cost a few dollars, but may provide significant opportunity for shadowing, as this is an excellent way to meet PA students in addition to meeting physician assistants. Meeting someone in person can allow for easier communication and the PA may feel more comfortable allowing a shadow in the future if they have already met the student.
Local hospitals, particularly academic medical centers are also full of opportunity. Students can research local hospital system pages to see if any “internships” or shadowing experiences are offered. Applying for these can be competitive, but the benefit is that a shadowing opportunity is literally set up for you. As someone who completed one of these, I can honestly say that it significantly impacted my education, as shadowing multiple specialties in the hospital setting allowed me to identify the ins and outs of the profession and also what I enjoyed and did not enjoy.
For many applicants, membership in a pre-pa club through their college or university does provide additional resources for the student. In my experience, one of the most valuable resources that I had going for me was the work of others and my own motivation.
During my undergraduate education, I was involved in our “pre-medical club” which allowed me to explore numerous resources available from the work of past students, build connections with current PA students, and meet physician assistants.
This proved particularly helpful because it helped educate me on the profession and get my foot in the door with many clinicians. If you are not involved in your local pre-pa club, I highly suggest joining and reaping the benefits.
Although the traditional routes of asking, such as in person and cold calling are available, we are lucky to live in a modern age where technology is on our side. There are also numerous online resources that are ready to help, if students know how to find them.
- PA Shadow Online (http://pashadowonline.com/paso/)is a resource that allows students and clinicians to create profiles and students are then able to contact PAs directly to try to set up a shadowing session.
- The Physician Assistant Forum ( www.physicianassistantforum.com ) also has a section entitled “shadowing opportunities” where students can post their location and need in the hopes that a PA might respond.
- COPE Health Scholars (https://copehealthscholars.org/programs/health-scholar/overview/) program which is another great option where students can apply and then shadow at particular hospitals or health systems.
As you can see, there are numerous opportunities for shadowing, but they all require some work on the candidates’ end in order to be proactive to set the shadowing up, persistence to assure a shadowing opportunity is created.
Next, we will move on to discuss etiquette, how to record hours, and what to look for out of the experience.
How Do I make the PA Shadowing Experience Better?
When reaching out via e-mail, telephone, or in person to a clinician, care should be taken to be polite, cordial, and courteous. Thank the clinician for their time and even their consideration of letting you shadow them.
The grammar, word choice, and overall tone of an e-mail should be taken into account. A brief introduction explaining your educational status, goals of shadowing, is recommended. It is important for students to allow time for a response and not become discouraged if a response is not received, as clinicians are very busy people.
Once a clinician has agreed to allow you to shadow them, it is recommended to thank them, confirm the time and place of shadowing and determine the dress code. It may vary based on setting, such as hospital versus outpatient setting, but general recommendations include looking professional, no sandals, or shorts.
A general rule of thumb would be to dress as if you were going to a job interview…..hey, stranger things have happened! Doing a dry run the day before the first shadowing session might be helpful if the location is in question, or if it is part of a large hospital.
On the day of shadowing, I usually advise students to dress appropriately, allow some extra time for nervousness or transportation issues, and aim to arrive to the office about 15 minutes prior to the agreed upon time.
I would recommend walking in confidently and introducing yourself to the receptionist or secretary, saying “Hello, my name is Daniel Champigny and I am here today to shadow Andrew Reid.”
Keep in mind that offices can be big and the person may need a few moments to track down the PA or clinician. Being courteous, smiling, and polite to everyone you meet is essential and is well received.
It can be a nerve wracking first day for shadowing, but be excited for the experience. Clinicians are generally very busy people, so you may end up walking into the office and immediately going to see a patient. Many clinicians will have a discussion with you first, about expectations, procedure, and any requests they may have for the day. It is important to pay attention to these, to never be in the way of a procedure or visit, and to be respectful at all times.
I generally advise students that they are free to speak if they have something to add, or to respond to a patient’s question. Believe it or not, many patients get very excited about students. It is wise not to interrupt the clinician or the patient, be courteous and respectful.
It is a smart idea to take a small notebook to the shadowing session for notes and for patient experiences. Obviously no patient identifying information should be put in the notebook, but is helpful to write down the number of hours shadowed, who you shadowed, and some key experiences. Some of the most important shadowing experiences I had came from interesting or meaningful cases I encountered, some of which were considered in my personal statement, so take notes early and often!
What Should I ask the PA?
Getting some information about the PA, when time allows is important.
- Where did they go to school?
- Were they satisfied with their education?
- Why did they choose their particular field?
- What do they like about their job?
- What don’t they like about their job?
For the student, it is a great idea to look at multiple specialties, settings and ask yourself: could I see myself working in this specialty or practice after graduation?
Most clinicians generally are good about inviting students back for more shadowing, if applicable, but setting guidelines for the schedule is helpful. It is certainly okay to ask how many hours they are willing to let you shadow them for. A general rule of thumb is to have a few days in each specialty, because a day with me in family practice can be dramatically different based on the patient schedule.
At the close of a session, it is always important to thank the clinician for their time. In addition, a hand written thank you note a few days later mailed to the practice is always a nice thing as well and may be remembered later in life when you are a licensed PA looking for a job.
Physician Assistant (PA) Shadowing Hours
We do get a lot of questions about how many shadowing hours are “required” for admission into PA school. This is definitely very variable and a lot of times there is not a set amount of hours that is required, but rather the experience you make out of the shadowing is more important.
My motto is “quality, not quantity”.
It is very easy to show up, do the bare minimum and log many hours. It takes more effort to show up, be engaged, learn a ton about the profession, and gain valuable experience with seeing many patients with a PA.
That being said, if I had to choose a number, I would say between 50 to 100 hours across multiple specialties is a reasonable goal.
As mentioned above, it is wise to shadowing multiple physician assistants across a wide range of specialties. Emergency medicine, urgent care, and family practice are always common ones, but hospital based medicine and sub-specialty are just as important.
In addition, it is important to be sure to have interaction with physicians, nurse practitioners and other members of the health care team to assure good exposure.
A general rule of thumb would be, as long as you have shadowed multiple PAs and other professionals, have a good grasp of the physician assistant profession and the PA’s role as well as the other team members, you have probably done enough shadowing.
Schools do commonly post requirements or their accepted classes’ averages, including shadowing or “health care experience”.
Health care experience would be a job or career where you were directly involved with patient care. A review of numerous program admission data, many times did not reveal any specific requirements for the number of hours one should shadow. The student should be sure to perform research in relation to the programs that they apply to make sure that there are not minimum requirements, although many programs indicate that shadowing is preferred to acquaint the student with the physician assistant profession.
Today we have covered all things shadowing, one of the most important stepping stones to determine whether the physician assistant profession is right for you. It is important for students to consider the concept of shadowing early, as it can provide important exposure to the profession and the various settings that physician assistants practice in each day. Remember: be persistent even if it seems difficult to set shadowing up, show up with a mind ready to learn and as always, remain respectful and shadowing will be a very enjoyable experience for both the student and the clinician.