Is an Online Ivy League PA Program Too Good to Be True?

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Interview with James van Rhee, Director of Yale PA Online [Show Summary]

Have you always wanted to be a PA, but did circumstances in your life just not allow for it? Yale might have just the right program for you – a PA program delivered primarily online, with clinical experience in or near your hometown. Learn more from Jim van Rhee, Director of Yale PA Online.

An Inside Look at Yale’s Online PA Program [Show Notes]

It gives me great pleasure to welcome back to AST Jim van Rhee, Director of Yale PA Online. Jim became a PA in 1989 and after several years of working in patient care returned to academia. Since 2006 he has been Physician Assistant Program Director at first Wake Forest, then Northwestern, and now Yale, which he joined in 2013 as Director of the Yale Physician Associate Program. In 2016 he became Director of the Yale PA Online Program.

Can you give us an overview of Yale’s Online Physician Assistant Program? [2:01]

It is a blended program with a lot of different teaching methodologies. We have synchronous and asynchronous coursework, so students learn via video lectures, problem-based learning in small groups, immersions on campus for a week at a time where students learn the hands on skills that need to be taught face-to-face, and clinical rotations just like any other program. We do lectures online, small groups online, and use technology to the fullest extent.

The lecture portion of our curriculum is recorded. When we are online, students are doing application work in small groups – doing a case history, a physical exam applying what they learned in the lectures. It is really important to show and teach students how to utilize information, and we use all of our face-to-face time in application, not delivering content.

For our in-person immersions, the first one is 10 weeks, which is anatomy and physical exam skills. Right before rotation (12 months in) we have a procedural immersion – how to draw blood, how to give a shot, start an IV, etc. The last immersion is right before graduation to give a final assessment to make sure students are ready for clinical practice and boards.

A lot of programs frontload basic science, but we divide the curriculum by organ system. For example, students learn about congestive heart failure having just studied the physiology of the heart. They learn basic science and within days apply it to clinical medicine in cases with small groups

How many students are in each class of the Yale Online PA program? [6:00]

Our first cohort was 41 students, the second was 59. We plan to grow but are more interested in keeping at 60 for now to see the outcomes of our students. Our first cohort was January of 2018 and they just started clinical rotations and our second year students just started January 7th. Our first class graduates in May of 2020.

What does it take to get into the program? [7:40]

Just like every PA program, you have to have the academic skills to be in PA school. Our students tend to be a little older, so we are looking for people who have really thought this through. It really can take time to decide if you want to be a PA. When I went to PA school I had been a medical technologist for years. More and more we are seeing individuals coming to this as their second career. Part of our interview process is for applicants to explain how they can meet our mission, and since we are online, how they think they are going to be able to handle an online curriculum. You have to be self-disciplined to be successful in our program.

We strongly encourage (but don’t require) applicants to have at least 500 hours of clinical exposure, but in our first cohort we had applicants with zero and one with 69,000 hours. Our average is about 8,000 hours, but we try to look holistically at an application rather than at the total number of hours.

We spoke roughly five years ago when the program was just getting going. How has it evolved since then? [10:40]

It’s been an interesting process. Today is the five-year anniversary of the first meeting we had discussing this program. Over those five years we have gone through a lot – accreditation, development of curriculum, sites, faculty, and overall it’s been really rewarding. We’ve started dabbling with virtual reality and there is so much more to go. We are also working with our students on standardized patients online. We had students practice how to share bad news using the computer. The comments related by the standardized patients were excellent – they felt they were able to connect with the students, and students felt engaged in the process as well. We are really thinking about changing the way to deliver medical education.

How does the program handle labs and clinical exposure? [12:43]

We have the immersions using the Yale Simulation Center and Yale Anatomy Lab and we have developed CEED, which stands for Clinical Experience and Early Didactic. After students have been in the program for 10 weeks and figured the basics out, we find clinical sites in their communities where they go ½ day per week to utilize skills they are learning – they are mentored by a PA or Nurse Practitioner, for example, practice physical exam skills, and work with other members of a healthcare team. We didn’t want to wait until the clinical year to develop that.

We have students watch a lot of things ahead of time so when they come to an actual session they can get a much bigger bang for their time because they are coming prepared and know the nuances already and are just practicing the skill.

We have just started our clinical year, and we have found a large number of sites around the country, but obviously we never know where the students are going to live who come to the program. I have a placement team whose sole job is to find clinical placement sites. With our first cohort, 2/3 of students are within 25 miles of their home, 10% are between 25-50, another 10% are 50-75, and just a few have to travel further. We have been lucky to find sites relatively close, but if a student lives in a rural location and wants to do a cardiothoracic rotation there might not be one for hundreds of miles so applicants need to think about that.

Are online PA students typically a little older (and more settled) than the off-line program? Did you consider your own experience when developing this program? [16:47]

Our students are older (about 32-33) and typically have more clinical experience. I think it was just natural to get the older student. We have an offering that can work for someone who might not be able to move for a program due to family concerns, for example, so we are offering an opportunity that might not otherwise exist. Our group naturally migrated that way due to the format.

Yale Online does not use the CASPA. Why and what is the application process like at Yale Online? [18:18]

We wanted to make it simpler. We are a different program, our cycle is open year round, and we wanted to make it easier and cheaper. It is a $50 fee, we have an online application that asks for demographic info, work experience, and where you went to school, but more importantly we interview online everyone we want to. We just were trying to make it easier. If you are doing a brick and mortar program you want to see the program in action. Since we don’t have that, we want to show the students our technology, which saves them a lot of money.

Can you discuss the 3 required essays that are part of the Yale online app? [19:40]

The essays help us identify fit with the program, but also for the student to gauge whether we are a match for them. One question relates to their experience with online education, as we want them to make sure they have thought about the self-motivation necessary to succeed in the program. Another question is about how they are going to meet the mission, which is related to high quality, patient-centered care, working in teams, and so we want to make sure they’ve thought that through as well. Our final question has to do with diversity and their experience with it. We want them to think through all of these areas. Yes, we are using it for scoring for fit but it really has a twofold outcome.

Yale PA Online is now accepting applicants for the cohort starting in Jan. 2020. The early decision deadline for that cohort is approaching rapidly and will happen on April 15. The priority deadline is July 1 and the final Deadline is Sept 1. What are differences between these deadlines and what advice would you have for someone starting the Yale PA application? [21:32]

We have the three deadlines because we want people to apply early. April 15 is our early decision, and we will decide quickly so the student will know really early in the process and not have to wait 8-9 months while we go through other students. The priority deadline is the same thing – the earlier the application gets in, the quicker the response. We try to get back within 4-8 weeks with everyone. It’s also helpful for us so we don’t get overwhelmed with applications at any one time.

My main advice is to be yourself. There are so many times when applicants are trying to tell me what they think we want to hear. Don’t try to answer questions or interview with what you think I want to hear as the answer. Give us YOUR answer. Be you. That tells us a lot more. Also, don’t be afraid to ask questions. You are making a big decision, and you need to make sure you have all the information you need. Make sure you check out the program you are applying to, not just the program website but accreditation website as well. Make sure the program is a good fit.

How can students or potential PA applicants prepare themselves and make themselves into more attractive PA applicants if they are eyeing a 2021 or later application? [26:13]

Reach out to us. I have an admissions team that will gladly speak to you. You don’t have to be applying for this next cycle to talk to them. You can enter info online and have them call you. Get in the system early. We do webinars all year and are more than happy to work with you. The team can help you develop a plan so you can put forward the best application possible when the time is right for you.

What would you have liked me to ask that I didn’t ask? [27:39]

“Why did you do this online program?” The reason I did this is because not everyone can move to go to PA school, and not everyone gets accepted to the program close by. If you really want to be a PA, we are providing that opportunity. We need primary care providers so badly. PA school is hard enough – we like keeping students where their support system is.