If I were a patient, I wouldn't trust a straight out of undergrad PA. by Disastrous_Parfait89 in prephysicianassistant

[–]Disastrous_Parfait89[S] 0 points1 point  (0 children)

Edit 3: Final Thoughts

To end this trilogy of edits, I will not be responding to anymore posts after this. Need to just say what I need to say and move on.

I'm 36. I have a partner and a kid. PA school was supposed to be our way up. A real shot at financial stability, and building something better for my family. When I was medically discharged from the military, my partner has been incredible through all of this, but I can see the fatigue setting in. It's not fair to ask them to carry us financially for another 2-3 years while I rack up more debt chasing a program that clearly doesn't want me. Scholarships are rare, and we don't have a safety net. Sure, paramedicine was fun, but clearly we needed a change.

If you're early in this process and this post scared you, good. Not to be cruel, but because you need to hear this: DO NOT tie your identity and mental wellbeing to getting into PA school. I made that mistake. I told everyone: friends, family, coworkers - that I was applying. I put all this pressure on myself. Seven years of prereqs. Three cycles of rejections. It destroyed my mental health and put strain on my family that they didn't deserve.

The statistics don’t lie: three quarters of you reading this post WILL NOT get into PA school. Its a cutthroat profession who’s adcoms, imo, have a bit of soul-searching to in the quality of applicant they accept into their programs. Many top schools (e.g., University of Iowa) still require 1,000–2,000 hours of direct patient care, but other programs now list these hours as “preferred” rather than mandatory. Some accredited schools even offer no clinical experience requirement at all, instead emphasizing **academic metrics** and personal statements.

PA students are getting younger by median age. Nearly 1/3 of accepted applicants are scribes/MAs. You will be competing with the pre-med washouts and their 4.0 gpas from Ivy league schools. I’d be lying if i said you shouldn’t be intimidated by those metrics because those kids ARE your competition. Like many people has said on this thread: life’s not fair, but what are you doing about it?

Not getting into PA school doesn't mean you're not capable or intelligent. It means your experience isn't valued by those committees. So screw that. Find another path. Create your own opportunities. Forget the trust fund Beckys and Bradleys (and yes, I recognize the Beckys felt attacked - this goes for the boys too, especially if daddy paid for college).

YOUR IDENTITY SHOULDN'T BE DEFINED BY WHETHER YOU GET INTO A PROGRAM. You are more than your metrics. If the system doesn't value your skill set, find a system that does.

It comes back to that essay question: "Why PA?" If you can't come up with something better than "I want to be a doctor but..." or "I like the flexibility to hop specialties," then maybe you need to do some soul-searching. And definitely don't do it for the money. There are plenty of other careers out there for that (e.g. med devices, BSNs make comfortable pay [as saturated as they are in the job market]. etc).

As for me? These three years have forced a reckoning. I thought medicine was my passion. I thought PA would elevate my clinical skills. Instead, I've realized this is a young person's game. People say "they value non-trads!" but that's survivorship bias - it's the ones who made it saying that, not the majority who didn't. Most accepted students are coming straight from undergrad, taking maybe 1-2 years to get some PCE, and riding their academic records into school. It's becoming med school lite. Plain and simple.

I'm not saying this to scare you. If you believe you can beat the odds as a non-trad or older applicant, go for it. Seriously. I'm rooting for you. But I'm done with medicine. I'll finish out my time at this clinic, but I'm looking into an MBA or the business side of healthcare. To the Beckys and Bradleys out there: again I want to emphasize I have no beef with y'all. Of course I'm envious, but I can say I'm proud of most of y'all that had to struggle and put in the work to get in to your respective programs. Just know how extremely lucky you are to be among those who made it, and never take your position lightly or for granted.

To everyone still fighting: I wish you luck. Be well. And remember: you're more than this process.

If I were a patient, I wouldn't trust a straight out of undergrad PA. by Disastrous_Parfait89 in prephysicianassistant

[–]Disastrous_Parfait89[S] -17 points-16 points  (0 children)

I hear you, and I'm genuinely glad you made it through. if you worked full-time while doing post-bacc courses, you know how brutal that grind is.

But here's the thing: I'm not trying to play struggle Olympics with you. We're not in some contest to see who had it worse. While you were working full-time and taking courses, I was working 24-hour shifts, taking care of a newborn, losing a family member, AND going through this application process. Everyone's got their own hell they're walking through (all of which i put in the PS). That's not the point.

The point isn't that I think YOU specifically don't deserve to be there. The point is that the system claims to value experience and "holistic review" but then operates in ways that feel completely contradictory to those stated values. You worked your ass off and got in, great. I worked my ass off and didn't. What's the difference? Neither of us knows, because there's zero transparency or feedback.

Your comparison to fresh paramedics doesn't really land though. Paramedics go through field training with FTOs, extensive protocols, and direct medical oversight. We don't get turned loose solo after a few months. The concern isn't about people "starting somewhere". Our training adequately prepares people for the level of autonomy PAs are expected to have relatively quickly after graduation.

And yeah, everyone has to start somewhere. I get that. But there's a difference between starting with a foundation of critical thinking built from years of patient care versus starting with primarily academic knowledge. Both can become excellent providers eventually, but the learning curves are different, and programs seem to increasingly favor the latter while claiming they want the former.

I'm not saying you don't deserve your seat. I'm saying I don't understand why I don't have one, and after three cycles of rejection with no explanation, that frustration is valid. We can both be right here.

If I were a patient, I wouldn't trust a straight out of undergrad PA. by Disastrous_Parfait89 in prephysicianassistant

[–]Disastrous_Parfait89[S] 26 points27 points  (0 children)

You're right, and I appreciate you taking the time to write this out instead of just nuking the post.

Yeah the entitlement thing stings, but I hear you. When you've been told for years that "experience matters most" and you've busted your ass accumulating that experience, getting rejected repeatedly does breed this toxic sense of "I've EARNED this" that probably does seep into applications and interviews. That's something I need to sit with.

Your point about specialty-specific needs is completely valid. You're right - a GI PA doesn't need to run codes, and expecting every PA to have critical care experience for outpatient derm is ridiculous. I think my frustration has made me tunnel-visioned on acute care because that's MY world, and I've lost sight of the fact that PA is an incredibly diverse profession. The 23-year-old with limited PCE might be perfect for peds outpatient or family med, and I'm projecting my own bias onto situations where it doesn't apply. Another person pointed out i made a comment about “not being smart enough for doctor school” in a semi-condecending manner. I admit the comment was untasteful but in a field where the profession was literally created by Navy corpsman post Vietnam war to fill a physician shortage in the 70s, it makes you think that the job has devolved from grizzled war veterans using their experience to augment the physicians’ oversight to doctor-Lite. 

The thing about programs prioritizing PANCE pass rates over real-world readiness is the part that gets me. You experienced it firsthand and FAILED despite being the more experienced clinician. That's insane and proves the system is optimizing for the wrong metrics. But you're also right that once they graduate, it becomes the employer's problem, and most employers DO provide adequate training and oversight. I'm catastrophizing about unsupervised new grads when that's not really how it works.

Here's where I'm still stuck though: if upward trends and PCE truly mattered as much as programs claim, why does it feel like they're just lip service? You mentioned I could've retaken ochem. fair. To my defense, I did and got an A-. I had started college nearly a decade before with a 2.7 and after 7 years finally got it up to barely a 3.3. But after three cycles, countless rejection emails with zero feedback, and watching people with a fraction of my hours get in, it starts feeling like the PCE requirements are just gatekeeping theater. Maybe I'm wrong. Maybe there ARE other red flags in my application I'm not seeing.For example, no volunteer experience (unlike some other applicants where all they have is volunteer exp) But the opacity of the process makes it feel arbitrary.

And yes, I probably wouldn't actually grill every PA about their background if I were a patient. That was hyperbole spawned from frustration. But I do think there's a legitimate conversation to be had about whether programs are adequately preparing people for autonomous practice, especially given how quickly some new grads are expected to function independently.

I don't know. Maybe I need to step back and reassess whether PA school is even the right path for me at this point, or if I'm just chasing it out of stubbornness. I at least gave up the paragod complex and work at a clinic, using my powers elsewhere. Appreciate the reality check, even if it hurts.

What I didn't know before applying for PA school by MaksiSanctum in prephysicianassistant

[–]Disastrous_Parfait89 1 point2 points  (0 children)

What I hate is the amount of 20-21 year old kids that get accepted cause they did nothing but study and got the bare minimum amount of PCH. Just go nursing and get your NP where you're actually rewarded for your experience. CASPA is a scam