Shadowing for Physician Assistant School

It’s only normal for a student to be curious about who to shadow for admission into physician assistant school. You might have questions such as the following listed below. Well, I’m here to answer them to the best of my knowledge.While some may disagree with my answers, this is just my opinion and if you wish, you can check out PhysicianAssistantForum.com for more information.

Is it acceptable to shadow a MD/DO or Nurse Practitioner instead of a PA?

Yes. While you may shadow a physician or nurse practitioner, it is recommended by many programs that you shadow a physician assistant as well. Shadowing these other providers gives you knowledge and experience of their roles in healthcare, but you should know the differences between them and a physician assistant.You can really shadow anyone in healthcare. I've heard of people shadowing physicians, nurse practitioners, paramedics, etc.

Do programs prefer shadowing of a physician assistant?

By and large, yes! At all costs, shadow a PA, even if it is for only 3-5 days.

What types of clinical settings are appropriate for shadowing?

In my own experience, the physician assistant I shadowed gave me some good advice. She suggested shadowing her in clinic and hospital (surgery) settings. Ultimately, it gave me a very broader understanding of the role of a PA in various settings, as well as learning the differences between outpatient and inpatient services. This is important for your own understanding as well and shadowing in all settings will make it easier to talk about during your interviews.

How long should I shadow for?

This is ultimately your decision. Shadowing a provider for a few days (40 hours) is just as helpful as shadowing for 40 days or weeks. The length of time shadowing really doesn’t count for much in admissions, but the amount of knowledge you gained from shadowing is important. There are only a select few PA programs out there that actually require shadowing minimums. The admissions committee is more worried about your hands on patient experience in addition to your understanding of the roles of physicians, physician assistants, and nurse practitioners (through shadowing). Personally, I shadowed my PA for about 5 days total in clinic and 3 days total in surgery. You don’t want to overstay your welcome with a PA. Ask your PA if they know other PAs you could shadow as well. When I began shadowing in the hospital setting, I was introduced to 3 other PAs in different specialties that quickly offered shadowing to me whenever I pleased.

How should I record (document) my shadowing hours?

While there is no official way to record your shadowing hours, it’s always important to use an honor system. I think most students use pen and paper or an Excel file to record their hours. Make sure to record the date, name of the provider you shadowed, and number of hours spent shadowing. You might also consider jotting notes down about each day so that you can use them when entering in information about your shadowing into CASPA. Some of your supplemental applications might ask for provider information to confirm your shadowing, so make sure to keep phone numbers and e-mails. You can check out this shadowing form created by Wayne Highlands School District.

Is it okay to shadow my primary care provider (PCP)?

Yes! If you are fortunate enough to have a provider (physician, PA, or NP) offer shadowing to you, you should gladly accept their offer!

Should I shadow a PA in one specialty (longer) or many PAs in various specialties (shorter)?

While I think you could easily benefit from shadowing one PA or provider in one setting/specialty, I think you could benefit more by shadowing multiple providers in various settings/specialties for a shorter amount of time. If you have the option, shadow a PA in primary care or an underserved area. It will be great experience and knowledge for your application and interview.

How can I obtain a shadowing experience or position?

While most students find it easiest to simply network with prior contacts to obtain a shadowing position, this may not always be accessible.
Some hospitals have formal shadowing programs that you must apply for, such as St. Luke’s Hospital and Geisinger's Intership/Externship Program.
Physician Assistant Shadow Online is another helpful resource to find shadowing experiences. You can create an account and see if any PAs in your area are available for shadowing.
LinkedIn allows you to create essentially an online resume. You can use this account to connect with other professional individuals, such as PAs.
You could also consider joining a global medical brigade - these travel to third world countries and offer clinical services to the underserved.
Other students have reported having success by contacting their state PA chapter. You can do this by e-mailing the administrator or PAs from the directory a little bit about yourself (including you wanting to shadow), the area you live in, and possibly a resume. Additionally, I know a few people who have become AAPA members that have access to the nationwide member directory. Using the directory, you can narrow your search to AAPA members (PA-C) within your area. It includes their contact information and the school they went to. If you choose to contact them, let them know you found their information through the AAPA directory. There are also specialty organizations, caucuses, and special interest groups that you can use to your advantage.
Yourdoctor.com also has a list of PAs by state.
Having HCE can greatly increase your chances of obtaining a shadowing position. Some providers want to see that you are familiar with medicine or the PA profession before shadowing. If you have any certifications or certificates, it would be helpful to mention these in your correspondence. Examples include, but are not limited to: BLS for Healthcare Providers, HIPAA compliance, OSHA bloodborne pathogens, and any others.
You might also find your own workplace to be of great value as you can inquire from other healthcare professionals to see if they know a fellow PA you might be able to shadow.

What should I expect to do during shadowing?

First off, always be on time. Typically, before entering or immediately after entering the room, the provider will ask the patient if they mind you being present. Most often the provider will ask that you remain to the side and be quiet during the procedure or visit. Sometimes you’ll be able to help out with getting supplies, but most of the time you are listening and observing. You can expect to see physical exams, suturing, casting, injections, and everything else you’ve read about PAs doing. If you are shadowing in surgery, never touch the blue! Try to steer clear of it. Ask as many questions as you need to, but never during an exam or visit. You might research procedures or surgeries beforehand to be familiar with what you’ll be observing that day. Always make sure your phone is turned off during shadowing. As far as bringing study materials - just don’t. In my own experience, I had an hour or two of downtime where she was charting. After watching about the first few hours of charting, you understand how to write a note, but you don’t need to watch everything they type. Instead of studying or bringing leisure reading, talk with other staff in the office. Try to remain engaged and be involved, even when things get slow. You don’t want the provider to feel as though you are bored because they might ask you to leave.

What should I include in correspondence with a provider I am shadowing?

When you’re contacting a potential provider always include your full name, e-mail, and phone number in all correspondence. This serves as a preventative measure in case they ever need to contact you outside of e-mail. Providers I shadowed gave me their cell numbers because it became easier to contact them. Always thank the provider for the opportunity.

What if hospitals or clinics I am looking at don’t allow students to shadow?

Many hospitals and clinics are eliminating shadowing privileges due to HIPAA violations. If this is the case, you can always ask a PA to lunch and ask them questions/interview them. While you may not get the full scope of practice, you can at least get more information about the PA profession than what you read online.

What types of questions should I ask while shadowing?

It’s probably best to establish with your provider when a convenient time to ask questions would be. Some would rather you hold them until after a procedure, exam, charting, or dictation, while others may let you ask during a procedure or surgery.
Don’t ask questions that you can look up later yourself. It might be helpful to keep a journal where you log your questions and only ask the important ones during down time.
Ask them what they do in their practice on a day to day basis, such as:

How do you usually treat this type of injury/illness?
What signs/symptoms do you look for? How did they get it?
When would you refer a patient with these symptoms/signs to a surgeon or specialist?
Where did you go to school? Did you like the program there? Are you still involved with the school? Do you ever regret becoming a PA and not pursuing another profession?
What drew you to the profession?
How would you answer the question, ‘what is a PA?’
What is the most difficult part of your job? What do you wish you could change about the PA profession?
What is your favorite procedure? What is most rewarding about your job?
How did you think the PANCE/PANRE were? Did you use any preparatory courses?
What can I do to stand out to PA programs?
What is your relationship like with your supervising physician?
What are challenges currently being faced by the PA profession?

What should I wear to shadow?

Always coordinate with your provider what is appropriate wear for shadowing. In my own experience, wearing scrubs was never necessary, but some providers may ask that you do wear them. Check with the provider to see what color of scrubs you’re allowed to wear as well. I’ve always worn business casual wear when shadowing. Always wear comfortable shoes.

Should I ask my provider for a recommendation letter after shadowing?

The best advice I can give you on this is to think about how long you have shadowed and known your provider (PA, NP, MD/DO). If you only shadowed them for a few days, you probably should look elsewhere for a recommendation letter. Just because you get a recommendation letter from a PA doesn’t mean that it will be a good one. Admissions committees can read right through your letters and can tell when someone truly knows you. If you know someone through work from your hospital/clinic in which you work, it would be better to ask them for a letter of recommendation if you’ve known them longer. For example, I asked one of the charge nurses from the ICU unit where I previously worked for a recommendation letter, even though I was already shadowing. When I applied, I didn’t have a letter from a PA, but some schools contacted me asking me to submit information for a PA that would write one for me. They contacted the PA and she wrote my letter for me. It must’ve worked because I was interviewed at all of those schools and accepted 1 offer.

When is it appropriate to ask for a recommendation letter?

Personally, I wouldn’t ask for a recommendation letter until you are nearing the end of your shadowing experience, if at all. If the PA has learned about you (what type of person you are, your knowledge of the PA profession, and how you learn) then it may be suitable. However, if you have barely known them and they cannot remember your name, it’s best to either wait, or ask another individual you may know better. If your schools require a letter from a PA, you might want to plan ahead to shadow someone, rather than waiting until the last moment before your letter is due. You want to give them time to write your letter, although occasionally they’ll allow you to write it.

Is it appropriate to send a thank you card afterward?

Yes! Extremely appropriate! If you want, you can even send your PA a nice little treat for taking time out of their schedule to allow you to shadow them.

Sources:

http://www.differencebetween.com/difference-between-clinic-and-vs-hospital/

http://multibriefs.com/briefs/exclusive/innovative_approach_to_obtaining.html

http://www.hpplc.indiana.edu/ohp/clinicalobservation.shtml

https://www.aamc.org/download/356316/data/shadowingguidelines2013.pdf

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