ELON P.A. App final... · 2011. 9. 12. · Admission Schedule Elon’s Master of Science in Physician Assistant Studies (P.A.) program will start accepting applications on a rolling

Admission ScheduleElon’s Master of Science in Physician Assistant Studies (P.A.) program will start accepting applications on a rolling basis beginning September 2011 for the charter class enrolling January 2013. Please submit your application as soon as possible for consideration.

It is anticipated that qualified candidates will begin interviewing January 2012 with the opening of the Gerald L. Francis Center.

Admission RequirementsCompleted applications must include:

Evidence of an earned bachelor’s degree from a regionally accredited college or university, or date when degree is expected

Official transcripts of all undergraduate and any graduate studies completed or taken

Official Graduate Record Examinations (GRE) scores taken within the last five years

Personal statement (instructions are enclosed with application)

Three letters of recommendation

International students must submit the following:

Photocopy of your passport(s) (required for all applicants from outside the U.S.)

Completed Certificate of Financial Responsibility (CFR) form

Original bank statement or letter from the bank issued within the last six months

P.A. Admission StandardsA minimum GPA of 3.0 for undergraduate work (3.2 or higher recommended) and minimum overall science GPA of 2.8 (3.0 or higher recommended) are required. Although there is no minimum GRE score requirement, preference will be given to candidates who score above 1000 (combined Verbal and Quantitative Sections). Finally, a minimum of 250 hours volunteer or work experience in a health care setting with at least 20 of these hours spent working with or observing a physician assistant is required (may be in progress). Preference will be given to candidates who have direct patient care experiences.

Application InstructionsPlease print or type.

Complete every item on all forms. (Note: Your Social Security number is optional on your application for admission. However, you cannot receive federal financial aid without a valid Social Security number.)

Include nonrefundable application fee of $50 payable to Elon University.

Include a complete set of official transcripts from all colleges/universities attended. If your transcripts reflect coursework in progress, include a listing of any courses that you plan to complete before beginning the program. In addition, we must be able to determine that you will be able to complete a bachelor’s degree by time of registration in the Physician Assistant program.

Have your official GRE test scores sent to the Office of Graduate Admissions. Elon University’s GRE code is R5183.

Secure three letters of recommendation on provided forms as directed on page A4. Each reference must be submitted in a sealed envelope that is signed over the seal by the recommender. The recommender must mail the completed reference to Elon University, Office of Graduate Admissions, 2750 Campus Box, Elon, North Carolina 27244.

everything you need to know about applying

ELON P.A.physician assistant

master of sciencephysician assistant studies

www.elon.edu/pa [email protected]

Course PrerequisitesAnatomy with Laboratory—four semester hours

Physiology with Laboratory—four semester hours

General Chemistry with Laboratory—four semester hours

Additional Chemistry course with Laboratory—four semester hours

Additional Upper Level Science Courses: two semesters (a minimum of six semester hours) of upper level courses focused on deepening an understanding of human anatomy, physiology and pathophysiology. Examples include, but are not limited to, biochemistry, cell and molecular biology, exercise physiology, genetics, immunology, microbiology and organic chemistry.

Additional Upper Level Courses: two semesters (a minimum of six semester hours) of upper level courses focused on deepening an understanding of the human condition. Examples include, but are not limited to, courses taken within the disciplines of anthropology, ethics, psychology, public health, sociology or religion.

Notes on prerequisite courses

Five of the six required science courses must be complete at the time of application evaluation.

Grades of ‘C’ or better are required in each prerequisite course.

No prerequisite course may be taken on a “pass/no pass” or “credit/no credit” basis.

Each science prerequisite course must have been successfully completed within 10 years prior to January enrollment.

Health Care ExperienceA minimum of 250 hours volunteer or work experience in a health care setting with at least 20 of these hours spent working with or observing a physician assistant is required (may be in progress). Preference will be given to candidates who have direct patient care experiences. Applicants may select from the following categories:

Patient Care Experience: defined as experience in which the applicant is directly responsible for a patient’s care; for example, dispensing medication, performing procedures, directing a course of treatment, working on patients as an active EMT, etc.

Other Health Care Experience: defined as experience in which the applicant is working in the health or a health-related field but is not directly responsible for a patient’s care; for example, filling prescriptions, performing clerical work, delivering patient food, cleaning patient rooms, working as “candy-striper,” etc.

P.A. Shadowing: hours spent shadowing (observing) a physician assistant.

Elon University is developing its physician assistant studies curriculum and scheduled for review for provisional accreditation by the ARC-PA during their September 2012 meeting. Students will not be enrolled until ARC-PA provisional accreditation is secured.

everything you need to know about applying




A1

I am applying for admission to Elon University’s P.A. program beginning January .

P E R S o n A l D At A

Name: Mr./Ms. L A S T F I R S T M I d d L E / M A I d E N P R E F E R R E d

do you have educational materials under another name? Yes No If yes, indicate name:

Mailing address: Permanent address: N U M b E R A N d S T R E E T I F d I F F E R E N T F R O M M A I L I N G A d d R E S S N U M b E R A N d S T R E E T

C I T Y S TAT E Z I P CO d E C I T Y S TAT E Z I P CO d E

Telephone numbers: ( ) ( ) ( ) C E L L W O R k H O M E

Email address: Social Security # (Optional):

birthdate: / / Place of birth: Country(ies) of citizenship:

If not a U.S. citizen: Are you a permanent resident? Yes No If yes, card number (required):

First language if other than English:

Colleges and universities are asked by many sources, including the federal government, to describe the racial/ethnic backgrounds of our students and employees. In order to respond to these requests, we ask that you answer the following four questions (your responses are optional):

do you consider yourself to be Hispanic/Latino? Yes No

In addition, select one or more of the following racial categories to describe yourself:

American Indian or Alaska Native Asian black or African American Native Hawaiian or Pacific Islander White

Other:

Elon University welcomes students from a wide variety of faith traditions. The Truitt Center for Religious and Spiritual Life uses the information to inform students about programs and services. Religious Affiliation:

I am from a family that lives in an area that is designated as a Health Professional Shortage Area or a Medically Underserved Area. Yes No

Have you had US military experience? Yes No If yes, please describe

List other P.A. programs to which you have applied:

How did you first learn about the program?

application for graduate admission




A2P.A.

P o S t S E C o n D A R y E D u C At I o n A l D At AList chronologically all colleges and universities attended (use attachment if necessary).

Name of Institution City/State

dates

Major degreedate Received

or Expected GPAFrom To

A C A D E m I C W o R k I n P R o g R E S SList all courses that you will have in progress for the fall, winter and/or spring semesters prior to enrollment. Please complete all information requested. Final grades earned for in progress courses completed during fall, winter and/or spring must be received by the Office of Graduate Admissions prior to enrollment. It is the applicant’s responsibility to submit verification of final grades by the required dates.

Fall Semester

Name of Institution Course Title and department Credit HoursExpected

Completion date

Winter Semester


Completion date

Spring Semester


Completion date

A3P.A.t E S t S C o R E S A n D D At E S

date Taken date(s) Scheduled

GRE SCORES

Verbal Quantitative Analytical Writing

Note: MCAT scores are not required. However, if you have taken the MCAT Exam, please list your most recent scores here.

date Taken date Scheduled

MCAT SCORES

Verbal Reasoning Physical Sciences biological Sciences Writing Sample

H E A lt H C A R E E x P E R I E n C EA minimum of 250 hours volunteer or work experience in a health care setting with at least 20 of these hours spent working with or observing a physician assistant is required (may be in progress). Preference will be given to candidates who have direct patient care experiences. Applicants may select from the following categories:

Patient Care Experience (experience in which the applicant is directly responsible for a patient’s care; for example, dispensing medication, performing procedures, directing a course of treatment, working on patients as an active EMT, etc.)

Other Health Care Experience (experience in which the applicant is working in the health or a health-related field but is not directly responsible for a patient’s care; for example, filling prescriptions, performing clerical work, delivering patient food, cleaning patient rooms, working as “candy-striper,” etc.)

P.A. Shadowing (hours spent shadowing (observing) a physician assistant.)

Given these definitions, we ask the applicant to consider the duties which they performed during their experience and use their best judgment to determine which category their experience falls into. You may NOT repeat hours between the sections. If the position duties encompass more than one section, enter the position in both sections and divide the hours accordingly.

Patient Care Experience

Setting Titledates Number of hours

per weekFrom To

Total Hours:

other Health Care Experience


per weekFrom To

Total Hours:

A4P.A.

Experience working with or observing a physician assistant (minimum 20 hours required)

Setting Titledirect care? dates Number of hours

per weekYes No From To

Total Hours:

o t H E R W o R k E x P E R I E n C E (outside of health professions)


per weekFrom To

Total Hours:

A C H I E v E m E n t S A n D R E C o g n I t I o n S

Please list any research, community service, awards, honors, or leadership experiences you have had.

Please list any health-related training you have had.

R E C o m m E n D At I o n SList the names and positions of three individuals who have written recommendations for you. One letter should be written by a science instructor or health profes-sion’s advisory committee qualified to evaluate the applicant’s academic achievement and potential for success as a graduate student. One letter should be written by a professional or supervisor qualified to evaluate the applicant’s interpersonal skills and ability to meet the future demands of providing patient care under the supervision of a physician.

Name and Title Institution/Organization

A5P.A.

P e r s o n a l s t at e m e n tPlease respond below and attach additional pages if necessary.

Please describe your motivation towards becoming a P.A.:

a d d i t i o n a l i n f o r m at i o n

Have you ever matriculated in or attended any P.A. educational program? Yes No If yes, give details:

Have you ever had any certification, registration, license or clinical privileges revoked, suspended or in any way restricted by an institution, state or locally?

Yes No If yes, give details:

C h a r a C t e r i n f o r m at i o n Have you ever been disciplined for academic performance or conduct violations (e.g. academic probation, dismissal, suspension, disqualification, etc.) by any

college or school? Yes No If yes, give details:

Have you ever been arrested for or convicted of a crime other than a minor traffic violation? Yes No If yes, give details:

C e r t i f i C at i o n

I certify that all information given in this application is complete and accurate. If I am admitted to Elon University, I agree to abide by established rules and regu-lations of the university and to accept the obligations imposed upon me by the honor system. Elon University is authorized to release information to the news media concerning my achievements.

Signature Date

The University does not discriminate on the basis of age, race, color, creed, sex, national or ethnic origin, disability, sexual orientation, or veteran’s status in the recruitment and admission of students, the recruitment and employment of faculty and staff, or the operation of any of its programs. Students with documented disabilities may request in writing reasonable special services and accommodations. Questions should be directed to Ms. Susan Wise, disability services coordinator, Duke 108H, (336) 278-6500. The university’s Section 504 coordinator for students and Title IX coordinator is Ms. Jana Lynn Patterson, Moseley 206, (336) 278-7200. The university’s Section 504 coordinator for applicants and current employees is Mr. Ronald Klepcyk, 314 W. Haggard Ave., (336) 278-5560.

In accordance with the Student Right-to-Know and Campus Security Act, complete information regarding campus security policies and programs and campus crime statistics is available upon request from the Director of University Relations, 2030 Campus Box. Information regarding completion and graduation rates may be obtained from the Office of Admissions or at www.elon.edu/irweb.

http://www.elon.edu/irweb

B11

Applicant’s Name: ( P R I N T O R T Y P E ) L A S T F I R S T M I d d L E

TO THE APPliCANT: Complete the identifying information above before delivering this form to the individual you have selected as a reference. The recommender is to complete the form, place it in a sealed envelope, sign the envelope on the outside over the seal and mail to the Office of Graduate Admissions (address on next page).

TO THE APPliCANT ANd THE RECOmmENdER: This recommendation will be used for admission purposes only and will not be retained in any educational record should the above named applicant enroll at Elon University. Consequently, the recommendation is not subject to the stipulations of the Family Educational Rights and Privacy Act of 1974; under the law the applicant will not have access to recommendations.

TO THE RECOmmENdER: Please complete form and return directly to the Office of Graduate Admissions (address on back) in a sealed envelope with your signa-ture across the seal. Elon places a great deal of importance on comments from recommenders. We appreciate your assistance.

How long have you known the applicant? years months

in what capacity? Employer/Supervisor Colleague/Coworker

Instructor/Professor Advisor

Internship/Job Shadowing Other:

How would you rate the applicant for each of the following characteristics? Please select the rating that best describes the applicant in each category.

Superior Excellent Good Average below Average Not Observed

Intellectual Ability 5 4 3 2 1 N/O

Written Communication Skills 5 4 3 2 1 N/O

Oral Communication Skills 5 4 3 2 1 N/O

Emotional Maturity 5 4 3 2 1 N/O

Adaptability 5 4 3 2 1 N/O

Team Skills 5 4 3 2 1 N/O

dependability 5 4 3 2 1 N/O

Conflict Resolution 5 4 3 2 1 N/O

Interpersonal Skills 5 4 3 2 1 N/O

Awareness of Limitations 5 4 3 2 1 N/O

Reaction to Criticism 5 4 3 2 1 N/O

Patient Interaction 5 4 3 2 1 N/O

Overall Evaluation 5 4 3 2 1 N/O

Summary Evaluation: do not Recommend

Recommend with Reservation

Recommend

Recommend without Reservation

recommendation form




P.A. B2

Personal references are a valued and an integral part of the admissions process. Physician assistant programs seek individuals who have the potential for success in a rigorous educational program and possess the personal attributes required to become a competent and compassionate health care professional.

Please use this area for additional comments you wish to make about the applicant. Please cite specific instances or evidence to support your comments.

Comment on her/his motivation and suitability for a role as a health care provider.

Consider the qualities in the grid above as well as integrity, ability to work with others, commitment, and cultural sensitivity.

Your candid evaluation of the applicant will be of significant value and is appreciated.

Signature date

Name (print)

Title and department Telephone

Employer Telephone

Address

Email Address

Please mail directly to: Elon University Office of Graduate Admissions 2750 Campus Box Elon, North Carolina 27244

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recommendation form




P.A. B2






Signature date

Name (print)


Employer Telephone

Address

Email Address


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recommendation form




P.A. B2






Signature date

Name (print)


Employer Telephone

Address

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Documents

ELON P.A. App final... · 2011. 9. 12. · Admission Schedule Elon’s Master of Science in Physician Assistant Studies (P.A.) program will start accepting applications on a rolling