Admissions Interviews: How History Can Pave the Way Toward a Holistic Future in Military PA Program Admissions and Hiring.

Abstract

Admissions processes for graduate health professions, including physician assistant (PA) and medical school, were built over time through trial and error. Admissions process research was not common until the early 1990s, and it seemingly began because the system of admitting applicants solely on the basis of the highest academic metrics resulted in unacceptable attrition rates. Recognizing interpersonal attributes were unique from academic metrics and critical to success in medical education, admissions interviews were added as a component of the admissions process and have since become nearly ubiquitous for medical and PA applicants. Understanding the history of admissions interviews informs ways to optimize admissions processes for the future. The PA profession was originally comprised entirely of military veterans with extensive medical training during their service; the number of service members and veterans matriculating has significantly decreased and is not reflective of the percentage of veterans in the US. Most PA programs receive applications in excess of available seats; yet, based on the 2019 PAEA Curriculum Report, the all-cause attrition rate is 7.4%. Given the large pool of applicants available to select from, it is valuable to identify students who will succeed and graduate. This is especially critical for the Interservice Physician Assistant Program, the US Military's PA program, to optimize force readiness by ensuring sufficient PAs are available. Utilizing a holistic admissions process, considered best practice in admissions, is an evidence-based way to decrease attrition and support increased diversity, including increasing the number of veterans becoming PAs, by considering the breadth of an applicant's life experiences, personal attributes, and academic metrics. The outcomes of admissions interviews are high-stakes for the program and applicants, as they are often the final step prior to admissions decisions. Additionally, there is considerable overlap between the principles of admissions interviews and job interviews, the latter of which may occur as a military PA's career unfolds and they are considered for special assignments. Though numerous different interview modalities exist, multiple mini-interviews (MMI) are highly-structured, effective, and are supportive of a holistic admissions approach. Through examining historical admissions trends, identifying a modern way to select applicants through holistic admissions can support decreased student deceleration and attrition and increased diversity, optimizing force readiness and supporting the success of the PA profession into the future.