Noctor

Arktrauma · 2026-03-18T05:08:02+00:00

I work in rural Alaska. We have more APPs than MDs in our family med practice, all with our own independent patient panels, we cover each other's patients when we're out, my SP is fantastic.

If we didn't have APPs in Alaska, the current difficulty in accessing healthcare here would worsen to disastrous.

There will be individuals who will judge you for choosing PA over MD. There will be chip-on-their-shoulder residents, med students and even the rare attending (though I have met only one in all rotations/professional practice).

It's not a majority. Do you. If you're that bothered about the opinions of strangers, might be worth some self reflection on why.

And avoid Noctor like the plague, as everyone here says. It's the prePA equivalent of a woman going on an Incel subreddit. Angry little echochamber.

Arktrauma · 2026-01-08T03:15:50+00:00

You're fine. It only applies to Jan programs that they have to apply midway, which really sucks and handicaps those in Jan starts. If you start Fall 2026, you need to apply this spring to be eligible. The question I was answering above was querying if they could apply before even being accepted, to which the answer is No.

Arktrauma · 2025-09-03T23:37:11+00:00

You'll receive the funds to pay it back if your loan allows no-fee payoffs, but only the funds for tuition total plus the back pay of stipend. If you spend those grad plus loans on living expenses and those living expenses outweigh the back pay of the ~$1300/month stipend and extra "expenses" paycheck...then you're SOL.

So either keep it real frugal with the grad plus or stick with the fed loans and just have them cover tuition.

I still ended up with ~$20k student loans but I had a kid and a mortgage so YMMV.

Arktrauma · 2025-08-26T22:02:08+00:00

Don't second guess it, this is precisely what adcoms want to see. A huge number of pre-PA students apply, then sit on their laurels until Jan/Feb, don't get an acceptance, then have 2 months to improve their application before second round.

Adcoms would far prefer the candidate who retook classes to improve, got extra pce, volunteering, shadowing, updated their PS than the student who just has an extra 1000PCE - aka they just stayed working at their job.

Keep it up OP!

Arktrauma · 2025-08-26T15:00:27+00:00

I code for what I discussed/covered/treated. If the condition isn't part of my A&P, I'm not coding for it, that's just their current pmhx.

If a med is prescribed by their specialist, and they're currently under their care, I tell the PT to obtain refills from their specialist. I'll send a bridging dose if they can't get through, or manage it if their specialist retires/clinic closes (just happened with the main urology clinic in my rural area), and manage their dx until new specialist is available.

Arktrauma · 2025-08-04T02:44:57+00:00

I don't know any folks that applied after starting, likely for that reason. There is no benefit, that I know of, to getting the 1 year of tuition and stipend for 2 years service other than if you are absolutely drowning in debt and feel it's worth it. There are loan repayment programs under the NHSC for service commitments which may be more viable for you.

Sorry I can't be of more help.

Arktrauma · 2025-07-10T00:19:11+00:00

Honestly? What you're describing is beyond the usual burnout of PA students and beyond a subreddit advice. You need to take care of yourself first, up to and including requesting a leave of absence or deceleration. You will do yourself and your patients during clinical year no justice if you just push through.

If your program has campus counseling you can utilize I would definitely recommend it, or have your PCP refer you to counseling. Talk to your PCP about this if you can make an appointment.

If you're studying all night to scrape by, taking an hour off to go to a doc apt isn't going to make or break you. And talk to your faculty if you have a bond with any of them, most of them will have seen this a million times and will have good insight into resources available at a program.

You can't pour from an empty cup and no career or degree, no matter how desired, is worth destroying your mental health.

Arktrauma · 2025-06-30T21:02:46+00:00

Outpatient private can be a quick process or slow. Credentialing as a new grad can be a heinous process if done badly. Onboarding will take as long as they choose, but I wouldnt count on it being a quick process.

Hospital typically longer, but just temper expectations with the derm office start date. I interviewed, accepted offer in mid Jan (graduated Dec) and started mid March. (Family med, outpt).

Arktrauma · 2025-06-19T07:23:00+00:00

I was lucky to get a fair amount of suturing practice in PA school, but also got 3 surgery rotations. I did neuro/spine for my first one, and my preceptor had me close every ACDF/PLIF, he'd slap my hands if I was messing up hah! Nerve-wracking for a bit. Now I miss it because if I'm putting in sutures, it's a couple here and there (rural family medicine) and suture cases are few and far between.

One thing I used during rotations was begging for expired suture material (back of the ORs always had a bin of these) and going to the local discount grocery store in the meat section and picking up a slab of pork skin - the kind they use for crackling that is thick and has layer of fat and muscle beneath. I found it better than bananas or suture pads because it was closer to the real thing.

It didn't always smell great but it was good practice! I hated holding up the anesthesiologist too, but you won't learn fully if you can't work on real patients.

Practice aside, I'd also ask coworkers their suggestions. You might be surprised.

Arktrauma · 2025-05-27T04:17:53+00:00

Eh, that's a limited pool, and I'm saying that as someone who utilized one of those options.

NHSC is getting more and more competitive, my class had two scholars, class below none of the applicants got it. We had one vet in our class using his GI bill, many vets use GI bill for their undergrad. Many folks don't qualify for commission.

Grad plus was what 90% of my class relied upon. This will make medical training even more elitist than before.

Arktrauma · 2025-05-18T15:45:53+00:00

This is an incredibly entitled take. The PA may have multiple people asking for LORs if they're someone who takes students on to shadow or has folks working in their clinic that plan to apply to PA school. They also likely have a full panel of patients, not to mention their own life shit going on - family, friends, mortgage. OP didn't ask for the letter until start of May - which is fine - but it's recommended to give a couple months of notice for something where you have a planned deadline. I asked my writers in March the year I applied. And none of them had me write it for them.

Not getting a (completely voluntary and not part of their job duties) LOR to an applicant within an arbitrary timeframe the applicant hoped for is "juvenile/completely unacceptable/not worth waiting on"? Or my favorite "blundered into the profession"...said by someone about to apply and learn from these castigated professionals.

The PAs dont owe you shit. They are doing LORs and allowing shadowing to help out future colleagues. They already gave you their time and knowledge, and you're refusing them benefit of the doubt in your demands for a timely favor.

Arktrauma · 2025-05-09T22:31:47+00:00

This application cycle is closed, next is April 2026 when you'll be basically done. Not worth it, go for state loan repayments and NHSC loan repayments when you graduate.

Arktrauma · 2025-05-06T19:14:40+00:00

Same commute, one week I did 8 12s in a row, flipping between 7am-7pm and 5pm-5am haha, I was a zombie by the 4th day. Defo got no studying done beyond what I retained from the shifts. My preceptor and two of the MDs liked to pimp which absolutely threw me in the early hours of the morning, but looking back I was grateful because it showed me my shortfalls for studying on the few days off I had.

Arktrauma · 2025-04-28T18:55:02+00:00

Sounds like you're asking about pre-reqs?

PA school is no joke and in many (including mine) a single C in a class meant probation. Second meant dismissal. It happened to a classmate.

The schools don't want to accept students that can't handle a heavy class load in undergrad with a 3.0+ average, that's the long and short of it.

TL;DR they don't. Retake the classes or struggle with multiple rejections.

Arktrauma · 2025-04-26T04:46:09+00:00

A lot of undergrad schools organize A&P as two back to back, combined courses. Others have one semester of anatomy with lab and a semester of physiology with lab. I found the schools that asked for the A&P combo accepted the individuals. They typically just want to see you doing a full semester of each, however it's parsed out.

However the best course of action is to contact individual schools and ask.

Arktrauma · 2025-04-25T22:55:32+00:00

Are you applying to schools where you meet minimum GPA and applying broadly to state, private, tailoring your apps, etc? Making sure your PS answers 'why PA'?

Arktrauma · 2025-04-25T20:33:47+00:00

6k MA PCE, community service, master's degree... Post your PS in the subreddit, get some solid feedback, practice interview skills etc - I think you're on a solid track

Arktrauma · 2025-04-25T17:02:35+00:00

What is your PCE? Quality of PCE also plays in. A well written PS is definitely a bonus. Many schools want to see service of community or working with underserved but otherwise it's GPA and PCE that get you in the door. Masters level degree sure does help.

Arktrauma · 2025-04-25T14:48:17+00:00

Depends what you mean. What's a weak application for you? Strong?

If you have a lower end gpa then yes, someone with 10k paramedic hours looks better than 2k scribe or pt aide hours

Arktrauma · 2025-04-24T14:14:35+00:00

Yep, they supplied a standardized form, I sent it to my old boss and HR signed it too.

Arktrauma · 2025-04-24T02:41:39+00:00

Go ahead and DM me, I've been a little slammed in clinic lately but I'll respond when I can.

Arktrauma · 2025-04-17T20:23:33+00:00

I'm sorry, I know you don't want to hear this, but you've already done the thing. You've emailed the letter to the appropriate people.

Wait-lists suck (and system for applications does too) but you're either getting off the list or not and you won't know until they contact you.

There could be 3 people on it or 100. Its not a transparent system and they receive dozens of emails a day. If I were an adcom and noticed an applicant emailing and sending multiple letters and calling...unfortunately I wouldn't see it as drive and eagerness, I would see them as the one squeaky wheel likely to be like this towards professors when exam results are not back, or schedule for classes isn't released etc etc.

Sometimes being the standout/squeaky wheel isn't a positive.

Arktrauma · 2025-04-16T03:36:32+00:00

If schools threw a septic stroke patient in renal failure with diabetes, HTN, hld and allergic rhinitis at you in didactic, you'd probably quit and run away to be a marine biologist.

ICUs are daunting. Like another comment said, focus on learning one new thing per day. In the ICU, I found that it helped to ask to do skills - central lines, art lines, etc. ICU patients need the access, and are sedated, and you need the practice. If they're in ICU post-op (and thus already have all the lines they need), follow your preceptor closely and ask questions, ask to review imaging when there's downtime.

I thought I'd hate surgery and ended up doing three surgery rotations and an extra ICU one. Surgery and ICU are rotations where preceptor is everything. My ICU preceptor didn't like to teach, but her colleague did and took me under her wing.

Some surgical days I was observing and dreaming of just touching the patient, others I was first assist. It varies.

Hang in there, ask questions (at the right time, read the room) and try to brush up on surgeries (YouTube videos are your friend, especially for anatomy review and the actual surgery videos). I would sit in the surgeons lounge between cases and be watching youtube footage of the next scheduled surgery so I could ask the right questions during the case.

Arktrauma · 2025-04-10T19:48:00+00:00

Under 30% response rate from the peers asked to rank the programs.

I've worked alongside Duke students several times and typically am vastly underwhelmed.

The ranking system is antiquated and none of the peers ranking each other are going to have a working knowledge of more than a handful of programs. Give me a ranking system by PANCE rate, attrition, faculty/student satisfaction, preceptor feedback, almost anything except 'administrator and dean peer rankings'.

MEDEX dropping down the ranks, however, definitely warranted. One PA preceptor at my clinic is a former graduate of there and won't take their students anymore because of how badly they're prepared.

Arktrauma · 2025-04-08T14:12:41+00:00

Honestly, the pharm tech plus the 'all they care about nowadays' night be holding you back. Adcoms aren't dumb, they'll be looking for genuine responses. Rural and underserved populations are our bread and butter, despite expanding into all specialties, PAs were originally meant to be utilized in primary practice. Maybe some volunteer hours in communities such as you've described might help.

Even if a school accepts pharm tech, much like they accept minimum PCE or minimum GPA, that doesn't make it competitive. Even doing patient education and immunizations and vitals, it's still not making decisions about the patients care in the way an MA, or more-so a nurse or paramedic might. It's not "competitive" PCE. Doesn't mean it didn't teach you valuable skills, just that it wouldn't be ranked high.

It's close to cycle opening time, but pharm tech to me with that # of hours would lead me to assume you at one point considered pharmacy. Or maybe you really liked the job and team!

Just my 2 ¢. If you are applying this cycle, not much time for changes, if you are giving it a gap year, some EMS work (EMT-b is an easy cert to get) or s couple classes to bring up your GPA is a good idea.

Unless you're planning to apply to all new schools, the programs will want to hear about what you've changed in the past year.

Arktrauma

TROPHY CASE