The Ultimate Preparatory Vocation Towards Becoming A Physician Assistant: Medical Scribe

As a new Physician Assistant student this year, I continually am thankful for the incomparable experiences medical scribing that have brought me here. I graduated from UCLA in 2010 with a Bachelors of Science in Anthropology.  When I discovered the Physician Assistant career shortly thereafter, I fell in love with and quickly began working to build my application. During this time I focused on the main aspects of the CASPA application: (1) completing prerequisite courses with strong grades; (2) completing the GRE; (3) obtaining patient care experience; (4) obtaining letters of recommendation; (5) completing my personal statement.

The two of these I found myself immediately struggling with were obtaining patient care experience and letters of recommendation. How was I supposed to obtain experience when I had none to start with? And how will I find three people who know me well enough to write me strong letters?

Through networking I was fortunate enough discover the exact type of experience I needed: Emergency Room Scribing. The position was fast paced, exciting and an unbelievable learning experience. In a matter of just a few weeks I found medical terminology, aspects of medical decision making, and nuances of patient interaction were already becoming second nature to me. When you start school, professors will tell you how learning medicine is like learning a new language. Think of this as a study abroad program.

Like I said, I did a lot of research on schools when I went about this application process. With almost 200 physician assistant schools across the US, you have a lot of options and a lot of information in front of you. Some easy ways I found that helped me effectively narrow these down were to input key information (required hours, GPA requirements, course requirements, etc.) into an excel sheet and fill in the blanks using information from individual school websites as well as the PAEA website which has this information summarized for you if you subscribe to them.

In general, hours of experience are key in applying to most Physician Assistant programs across the United States. Based on my research last year, these requirements varied from none (but strongly preferred) to up to 4,000 hours. On average most programs want approximately 2,000 hours of direct patient care experience by the time of application. The term “direct patient care experience” can in fact include medical scribing experience especially now as the scope of our experience is becoming more widely known. However, for those programs still unfamiliar with what a scribe does (which was a concern for me applying last cycle but not so much for you now), it is important to indicate on your CASPA application exactly what the position entails. Some key descriptors that I used in the “duties” section included : accompany attending from beginning to end of physical exam, diagnoses, treatment and discharge; accompany practitioner to patient’s bedside to assist through direct verbal contact and track patient histories / health complaints ; prompt clinicians to follow up on patient cases that meet certain conditions ; completed over 120 hours of training prior to assisting in the ED ; monitor progress of imaging studies, lab results, exams, and procedures  to evaluate patient visit records and help create treatment plans.

Unique to other means of gaining experience, scribing alone will allow you to make a wage without first requiring some sort of certificate or outside training. The other common means of direct experience such as emergency medical technician, licensed vocational nurse, medical assistant ,medical technologist, military medical corpsman, nursing assistant, paramedic, psychiatric technician, radiologic technician, or respiratory therapist all require outside training and certification.  Also, the fact that scribing experience is paid is valuable for more than just the obvious reasons. Most programs will look at the fact that your experience is paid and do prefer such experience. With adequate explanation in my CASPA application and illustration of the wide scope of the scribe experience during the interviews, the validity of my scribing was not questioned in my case.

Also, note that volunteer experience falls under a different category entirely on the CASPA application. Anything you do that is not a paid position will be looked at as volunteer or shadow experience. This is not to say that your volunteer hours are not important because many schools do want these hours in addition to your patient care experience. But these hours do not contribute to the patient care hours most programs are looking for.

I cannot stress this enough. I cannot believe how invaluable this experience has been. I liken the experience of medical scribing to a residency. During my interviews, my illustration of my experiences spoke for themselves.   Even those programs unfamiliar with what a scribe is were impressed at my medical fluency and the scope of my experience.  Just like on the CASPA, it is important to illustrate this during your interviews. For some programs, by the end of the interview I was even asked for advice on how to incorporate scribes into their practices (a great thing to indicate in your thank you letters that you would be happy to assist with upon acceptance).

Now that I am in a program, on a daily basis, my fluency in medical language has created a foundation helping me during exams, seeing practice patients, and understanding new material. Of the 40 students in my program, about a quarter of the students are previous scribes. I am continually noticing that even a few months removed from scribing, I have an advantage because of the foundation of knowledge my experience has given me. I grasp material quickly because terminology and even general intuition regarding patient care is already there. While many of my classmates have one specific expertise based on their past positions, scribing has given me a background in many aspects of the patient care process. This was a benefit my professors now tell me factored into my admission in the first place.

I chose the Physician Assistant field because of my desire to be part of a collaborative team. I knew this was one of my strengths and my experiences as a Medical Scribe helped me fine tune the personal skills needed to do this. After a year and a half of Medical Scribing, I had gained nearly 2,500 hours of direct verbal patient contact, been given not only three but six glowing letters of recommendation from providers that had spent many hours working directly with me,  and gained a network of colleagues that I look forward to working with again once I graduate. Moreover, now that I have begun my PA program I am grateful for what this opportunity has done for me and look forward to soon becoming part of the healthcare team.

Deanna Shah
Physician Assistant Student

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