Category Archives: Pre-PA

Breaking Down PA School Interview Questions XII

This week also features two questions.  Thanks to Abigail for e-mailing me!!  I love when you guys send me writing topics and questions you are asked at interviews, so keep it up!

Q:What patient population do you least like working with gathering your patient care hours?

What are they looking for

  • That you aren’t going to bash anyone.
  • Bias 
  • Compassion (that you have it, duh!)

What to avoid saying

  • Anything negative.
  • A statement that is going to cluster or segregate a group of people.  (Disclaimer: the statements below are not things that I would say and in no way represent how I feel.  They are simply a way to give examples.)
  • For Example:
    • “Working with pain patients was the worst, constantly ringing the bell to ask for more pain medications and complaining”
    • “Diabetics who are non-compliant.”
    • “Psych patients, it’s not even like they have a REAL problem.  Just suck it up”

What to say

  • You really enjoyed the diversity (of whatever population(s) you worked with)
  • Mention that the diversity of medicine you were exposed to really makes you look forward to clinical rotations and learning more about all areas of medicine. 
  • Every patient is a person first and that their disease does not define them.
  •  Certain qualites can present challenges such as non-compliance, but it is all part of working in medicine and that you look forward to growing as a person and future provider.

Q: What specialty would you least like to work with as a PA?

What are they looking for

  • To see if you’ve made up your mind about what area you think you want to work in
  • If you are open-minded about learning
  • If they are a program focused on underserved populations/family care if you have interest in that area

What to avoid saying

  • You are “certain” you want to work in a specific area.
  • Saying anything negative about a particular area of medicine.

What to say

  • Mention what you liked while shadowing, but DO NOT commit 
    • For example: ” I really liked the role and responsibilities of Emergency Department and Cardio Thoracic Surgery PA’s; however, I know there is a lot for me to learn and many areas of medicine to gain knowledge and exposure. 
  • You cannot be certain because you worked in a small subset of medicine (wherever it might have been) and that you look forward to figuring out what specialty you want to begin your journey in medicine. 

Breaking Down PA School Interview Questions XI

Focus on social media and internet self diagnosis!

Q: Would you accept a Facebook friend request from a patient?

What are they looking for?

  • Understanding of ethics and patient interaction
  • HIPPA
  • Professionalism.  My program was HUGE on this, it was a percentage of every class grade. 

What to avoid saying

  • “Sure, I have drinks every friday with patients from the clinic I volunteer at”
  • “Yes” without any thought consideration.
  • In my opinion saying “yes” at all.

What to say

  • The best and most effective patient-provider relationships are those that do not encompass dual relationships
  • Even with clear cut “simple issues” such as a UTI, you can never predict what issues may develop with a patient or a family. 

How you might be pressed 

  • What about in a small town where everyone knows everyone?
    • The good thing about being a PA is that there is likely a collaborating MD/DO who shares time in the clinic.  
    • State that you understand that you may know a number of your patients from other community groups (gym, church, etc) and that as frequently as humanly possible you would have patients with whom you have close personal relationships see your supervising physician to provide the best, most unbiased care. 

Q: How do you feel the internet and sites such as WebMD are contributing to healthcare?

What are they looking for?

  • Respect and consideration for your patient.  Simply that you can show you will listen to them. 

What to avoid saying

  • “Its destroying healthcare and making providers jobs more difficult”
  • “Your google search does not trump my medical degree” (even if you think it sometimes!)

What to say

  • There is a lot of information available on the internet.  If patients are able to find reliable information (CDC, Medscape) I think it can be helpful for patient education and awareness.
  • I don’t see much harm in it, at least it shows patients taking an investment in their health or illness and can provoke insightful questions and/or helpful information

How you might be pressed

  • What do you do when patients try and undermine your medical opinion? For example telling you they KNOW they need antibiotics.
    • Re-state their symptoms and tell them what was re-assuring about their exam.  A lot of the time when I get that “feeling” interviewing a patient that they won’t be happy unless they get an antibiotic as I go through their exam I make statements like “your ears look perfect, nice and clear” “lungs sound great to signs of infection” yada yada. 
    • If that isn’t effective I say “I understand your concern and if you would like I’d be happy to get one of my colleagues or collaborating physician for a second opinion” (this usually works)

 

Breaking Down PA School Interview Questions X

The PA career is incredibly competitive to enter.  Despite the number of programs out there and more popping up every year, your chances of acceptance are 1-2%.  For example the year I applied to Pitt there were well over 1,000 applicants and 40 seats.  THAT IS CRAZY TO ME! It makes me so thankful that I was able to earn acceptance, participate in such an amazing career and now help and interact with some really great Pre-PA students!

Q: Why should we choose you over other applicants?

What are they looking for?

  • You can demonstrate that you are confident and have earned the right to be in their program.  
  • Confidence
  • Assertiveness
  • You can clearly and concisely state why you are an excellent candidate
  • You’ve prepared  

What to avoid

  • Not having an answer.  
  • Being tentative. If you hesitate this demonstrates that you haven’t thought about this question or even worse that you don’t know how to answer it.  
    • A candidate who sits that and hims-and-haughs like “well….”, “ummmm”, or “I think….maybe…” Cut the crap say why you’ve earned this! Someone who hesitates or looks like they can’t give an answer isn’t someone an admissions committee correlates with a successful PA student.

What to say

  • I was not asked this questions; but, I did prepare for it.  My answers would have been as follows:
    • My tenacity.  By and far my first quality that sets me apart.  I risked a lot to take this course.  I also worked at times 4 different jobs to make ends meet and build experience and boost my application.  I did whatever possible to be successful in meeting this goal and I will demonstrate the same traits as a PA student and practicing professional.
    • My energy. I bring a great amount of energy into every situation I’m in and will put that energy towards becoming the best provider possible.  
  • Other great answers may include:
    • Perseverance
    • Diverse background
    • Maturity
    • Focus on wellness
    • Lots of time spent with underserved population
    • Substantial amount of clinical experience
    • Master’s Degree

Breaking Down PA School Interview Questions: Bonus Article

In addition to being asked to simulate an HPI with a standardized patient (If you don’t know what I am referencing see my last blog post here) a great number of programs are employing the MMI (multiple mini interviews) and also asking you to complete tasks. Sometimes odd tasks.  

So, why are they doing this and what are they looking for in their candidates?

1. Stress

PA school is stressful.  Interviews are stressful (no matter how you cut it). What better to do than to see how prospective students can react to a stressful situation.  Sound familiar? Sure does, admissions committees are taking the concept of behavioral interviewing and making it a reality.  The idea here is that if you can handle stress well during the interview, that behavior trait will transfer to PA school. 

2. Common Courtesy 

When you are stressed or someone corrects you, how do you react?  During my time as a student ambassador, I saw prospective students literally freak out when they didn’t understand a task or someone wasn’t following their directives. Be kind and polite.  DO NOT, I repeat DO NOT freak out.  This is a huge red flag to anyone (students, faculty, adjunct professors) evaluating you. 

3. Innovative Thinking and Effort

So, you don’t remember all the cranial nerves or parts of the kidney or understand how to tell someone to suture.  Don’t panic.  Stay calm and try and dig deep for anything you can remember about the task they are presenting.  If they give you 5 minutes to complete the task use that five minutes.  If you’ve never explained to someone to suture think about basic principles that might be important.  Its ok to say, “You know I’ve never done this before, but I’m going to do my best”.  This says that you can take on challenge in a positive way.  You might go on to say something like “I would think someone would need to wash their hands and create a clean environment to complete the procedure”.  So, maybe you don’t know what “sterile field” or “breaking sterile field” means.  Or the different types of sutures.  But, maybe you can say ” Well, the type of wound might matter as to how someone sutures”.  Keep it basic and simply TRY. I cannot stress enough, remain calm. 

4. Following Directions

A large part of PA school is being able to follow directions, complete tasks on time and multitask.  Programs want to know that you can complete a task they tell you to complete, in a specific manner. 

5. Action Speaks Louder Than Words

You are what you do. History repeats itself. However you want to say it, y’all get what I mean. You are what you do (just like you are what you eat haha 🙂 Show them you can handle stress, be kind and follow directions.  Don’t sweat it if you don’t know exactly what they are talking about, respond appropriately to the task and you will be just fine! 

 

Breaking Down PA School Interview Questions: Special Edition

I came across a post recently in a Facebook pre-pa group that some interviews are asking students basically to complete a HPI (History of Present Illness).  Now, if you did your patient care experience in mental health (because thats where you had a degree) you might find yourself fumbling.  So, if you run in to a situation that asks you to “talk to a patient about what is going on with them and give a diagnosis” I’ve got your basics covered!

What is an HPI?

  • History of Present Illness
    • Why is the patient coming in to see you and the story that goes along with it! 
  • Start with a “chief complaint”
    • This is usually something obvious such as abdominal pain, chest pain, fever, rash, red eye, sore throat, cough, etc
  • There are 7 vital aspects of the “HPI”
    • Onset
      • When did it start
    • Duration
      • How long has this been going on?
    • Location/Radiation
      • Where is the location of the symptom
      • For complaints like abdominal or chest pain ask the patient (especially if child) to point with one finger where it is the worst
      • Does the pain/symptom travel somewhere else besdies where it starts?
    • Quality
      • Describe what is going on
      • Is the pain sharp, dull, throbbing
      • When they have difficulty swallowing is it solids, liquids, etc
    • Quantity
      • The good old “on a scale of 1 to 10…10 being the worst and 1 being very little”
    • Aggravating/Alleviating
      • What makes symptoms worse
      • What makes symptoms better
    • Associated Manifestations
      • Depends on the chief complaint
      • Abdominal pain: diarrhea, constipation, fever, chills
      • Chest pain: diaphoresis, lightheadedness, palpitations, shortness of breath
      • Fever: Rash, cough, urinary symptoms (dysuria, frequency), recent travel, UTD on immunizaitons
      • Cough: is it productive or dry, short of breath, fever, chest pain

 

Breaking Down PA School Interview Questions IX

Q: On clinical rotation your preceptor is treating patients disrespectfully and making hurtful comments to you about them after they leave.  How do you react and what do you do (if anything)?

What are they looking for?

  • Maturity and leadership.  That you can make a decision to talk to your clinical coordinator about this preceptor.
  • That you can keep your cool under a stressful situation
  • Despite your preceptor being “in charge” of you, you can stand up for what is right in an appropriate respectful manner

What to avoid?

  • Stating you would do nothing.  This is a red flag that you don’t have respect for patients or the maturity to do the right thing even if it is someone in a higher position than you doing wrong. 
  • Say that you would create any kind of immediate confrontation directly with your preceptor

What to say?

  • That you would remain calm while on site at rotation
  • Contact your clinical coordinator immediately at the end of the day
    • State that you were in a very uncomfortable position
    • Make it clear that you don’t support his/her actions
  • How should your clinical coordinator react?
    • They may or may not take a question like this in this direction.  They should definitely leave you with some sense that the situation is at least being looked in to. 
  • What if they ask you if you are comfortable going back to the site?
    • Be honest. If a preceptor is being disrespectful to patients you probably shouldn’t be at that site.  

 

 

Breaking Down PA School Interview Questions IIX

Q: What would you do if you disagree with your supervising physician in the treatment plan for a patient? 

What are they looking for?

  • How you react to stressful and confrontational situations
  • No one wants to work with someone or allow someone to represent their institution that’s going to be a jerk if you disagree with them 
  • That you can kindly and appropriately advocate for your patients 

What to avoid

  • Saying that you would do what you thought was right no matter what your SP says
  • In the same light, stating that you would do whatever your supervising physician said because they are in charge is also not the right answer
  • If you go to another colleague– never ever bad mouth the physician involved in the course of treatment.  

What to say

  • You would talk to you SP in a way that you were asking for education regarding the course of treatment.  In other words something along the lines of “This isn’t a course of treatment I am familiar with would you mind giving me some information so I can better understand?”
  • If after you’ve asked for clarification you still don’t agree to the extent that you think the patient may suffer–talk to your colleagues or another SP about what they think the best course of treatment would be.
  •  Always remember and make it a point that you would not seek another opinion until after talking to your initial SP.
  • Always promote collaboration and learning into your answer whenever someone asks you about a controversial situation.

Breaking Down PA School Interview Questions VII

Q: What questions do you have for us?

What are they looking for?

  • Ability to be insightful, that you’ve done you research on their program
  • To see that you are genuinely interested! A lot of applicants will just sit back and let the time pass. 
  • Pay attention to what other people ask! (If the Q&A is within a group)
  • When someone speaks turn and look at them when they address a question.  This shows respect and that you are interested in learning about what you might be able to learn from others.

What to avoid

  • #1:ASKING QUESTIONS YOU CAN FIND ON THEIR WEBSITE
    • HUGE, MASSIVE NO-NO.  Ok, but really know the information available on the website inside and out.  
  • Asking questions that have already been answered by staff or that someone else have already asked 
  • Not asking any questions at all

What to ask

  • One of the questions I asked was “What can you tell me about what your program has to offer that I can’t find online?”
  • The role of the PA is shifting, we work in more settings and sub specialties than ever before.  Think about asking how the program is adjusting to teach the students to meet the demands for jobs upon graduation. 
  • If you are one-on-one with faculty ask them about their job, what area of medicine do they practice, what do they enjoy about it?
  • What is the best advice you have for students to succeed and gain the most out of their education at <insert name of school>?
  • Ask questions that build on information already available on the website or that you’ve learned through your visit
    • ie: I saw on your website your PANCE pass rate is 98%, what steps does the program take in order to ensure students are well prepared”

Breaking Down PA School Interview Questions IV

Q: What do you feel is one of the biggest issues currently facing our health care system?

What are they looking for?

  • Understanding of what is happening in our health care system.  This shows the panel that you are interested in medicine and what is going on in the field you want to enter (in a lay persons answer: you know what’s up)
  • Perhaps you have a member ship to AAPA and read PA professional or JAAPA, mentioning these or others  as your source of information demonstrates a few things: dedication to the profession, extra effort to obtain information, self motivated behavior

What to avoid

  • This is tricky here, because you need to mention what is happening in health care without associating your personal opinion to the matter which can be difficult (to some degree you have to give an opinion because they are asking you what you think–just be careful!)

What to say

  • There are so many issues facing health care right now, below are a list of issues I feel are at the forefront of medicine and affecting providers:
    • Opiate abuse and dependence, both prescription and street heroin use
      • I would say 2/3 patients I admit or see have a prescription for a narcotic pain medication.  It’s a very intense issue in our country and is complex and multi-factorial.
        •  Patients who are given prescriptions after surgery and continue to have pain therefore continue to have a prescription for pain medication.
        • Lack of conservative measures or patients failing conservative measures such as physical therapy, weight loss.  I see a lot of patients on narcotic pain medication for arthritis, much of which joint destruction is caused by obesity (not ALL of the time but pressure on joints can really destroy them)
        • Pressure for patient satisfaction.  Docs, PA’s and NPs are being scored and reimbursed based on how patients feel they are treated.  As part of that crisis I don’t doubt that some providers view part of that satisfaction as controlling patients pain control.  I’m not stating all providers do this by any means, but I know I can say I saw it on rotations and I have treated patients in the hospital who have not seen their provider in 6 months and they continue to provide scripts for family members to pick up for them (by the way this is not ok and I’m fairly certain is some type of violation of a DEA license because patients need to be seen at regular intervals for a continued narcotic script to be valid)
        • Street use I hope is an obvious one that I’m not going to breakdown here
        • Serious implications for health, especially with heroin use–infections, overdose, etc.
    • Shortage of providers/Rural Medicine/Access to treatment
      • This issue is real.  As a traveling PA I can tell you that both of my assignments now will be in areas that desperately need providers.  
      • This is also a great way to talk about how PA’s help bridge the gap (Mind the GAP!— London anyone?) 
    • Cost of health care
      • This issue is also all too real.  Listen I pay 193$ a month and I’m a completely health individual.  I barely use my health care.  That is just the BEGINNING of this issue.  High monthly payments, high deductibles (my deductible is $2,700 and just for some perspective my financial advisor thought this plan was best for me), cost of medications, lab work, imaging.  I could go on.
      • IMO patients not being able to afford their medications creates a number of issues. 
        • First, they can’t get basic control of their chronic medical problems–say diabetes
        • Second, if patients can’t control their basic medical problems they end up with complications in the hospital and then they can’t afford their hospitalizations.  This is a problem not only on a personal level for the patient but also health care at large–driving up costs like crazy. 
        • The bottom line is that patients are more concerned with paying for healthcare than their own wellness which is is just bad all around
    • The specialization of medicine
      • We have become a society that continually self-refers to specialists.  Ankle pain? See ortho.  Diabetes? See endo. Both on an inpatient and outpatient basis–heres the issue:
        • PCP’s have less time with patients and more issues to cover–which creates more referrals and also patients to self refer because they can’t get appointments (which goes back to both cost and access)
        • Less continuity of care.  As best as we try for communication between offices it doesn’t always happen the best. 
        • Devaluing general medicine
          • Ok, this is my bias–but I believe that a medical home is really important.  Having a provider that knows you well and a “first line of defense” when you have a problem.  We are driving providers away from family practice and internal medicine for many reasons (less pay being one of them) and it seems to create the persona that this is not important and it is! 
          • Despite my bias/opinions make sure that if you discuss this you do so in a positive light.  Again, reinforcing the importance of family medicine and giving as many people as possible access to quality care.

Breaking Down PA School Interview Questions V

Q: What do you feel is one of the biggest issues currently facing the profession?

What are they looking for?

  • Ability to demonstrate a working knowledge of issues facing health care and PA’s
  • Ability to discuss issues in an appropriate manner (ie not being rude or insulting about certain issues or beliefs)
  • Understanding of what is going on in the world of the PA profession

What to avoid?

  • Showing a strong opinion on the issues you discuss–you never know who you might offend its honestly just being safe.  State the facts not your opinion.
  • Relaying information that isn’t accurate (check your facts)

What to say

  • Some of the current issues are as follows:
    • Changing the name of the profession from “Physician Assistant” to just “PA” (which I don’t agree with but that is an topic for another day)
    • Changes to the recertification process which you can find details about on nccpa.net
      • Baics include the option to have a specialty certification for the field you are presntly employed and also instead of one test every 10 years PA’s would participate in a series of take home tests every so often (again these are basic concepts see NCCPA.net for specifics as I won’t go into them here)
    • Legislation is always in the works to advance the profession.  The PA profession has been on that since the creation continues to strive for further independence of it’s practictioners.