Questions to Ask When Shadowing a PA
Questions for someone spending a day with a physician assistant, covering how supervision works in practice, what the PA handles alone, how pay and call are structured, and what the training route cost.
The questions
Each question, and why to ask it
What kind of practice is this, and how did you end up here?
Why ask it
PAs work in almost every setting, and the route into a given one is often opportunistic rather than planned. Hearing the sequence shows how flexible the career is and how much of it depends on who was hiring.
What does today look like, and how many patients will you see?
Why ask it
Patient volume and time per visit vary widely between primary care, a specialty clinic and a hospital service. The number is the fastest way to understand which of those you are actually watching.
Which visits do you handle on your own, and which involve the physician?
Why ask it
This is the central question of the role, and the boundary is set by state law, employer policy and the individual relationship. A vague answer usually means the boundary is informal, which cuts both ways.
How does supervision actually work here day to day?
Why ask it
In some settings the physician is in the next room, in others they are reachable by phone and review charts later. The practical arrangement matters more than the legal term for it, and it varies between employers in the same state.
What can you prescribe here, and what needs a co-signature?
Why ask it
Prescribing authority differs by state and by drug schedule, and chart co-signature requirements add real workflow friction. This is one of the areas students most often assume is uniform.
What procedures do you do yourself?
Why ask it
The procedural side of the job is learned mostly on site rather than in school, so the answer reflects this employer's trust as much as the PA's training. It also shows how hands-on this particular role is.
How did you learn this specialty, when PA school trains generalists?
Why ask it
Generalist training followed by on-the-job specialization is the defining feature of the profession. Ask how long it took to feel competent, because that period is longer than most applicants expect.
How hard is it to move to another specialty later?
Why ask it
Lateral movement is often cited as an advantage of the role, and PAs who have done it can say what it actually involved: a pay step back, a slower start, a willing employer. That is more useful than the general claim.
What is your charting load, and does it follow you home?
Why ask it
Documentation, inbox messages and prior authorization work take real hours, and whether they fit inside the working day is a major factor in job satisfaction. Ask when today's notes will be finished.
How do you handle a patient who says they want to see a doctor instead?
Why ask it
It happens regularly and the response is a practiced piece of communication rather than a defensive one. How they describe it says something about how the role is supported by the practice.
How is your pay structured: salary, productivity, call, bonus?
Why ask it
Compensation models differ substantially and productivity-based pay changes how a schedule feels. A PA who explains the structure gives you something concrete to ask about in a future interview.
How much call and weekend work is in this job?
Why ask it
Call burden varies from none to frequent depending on setting, and it is the part of a job offer that most affects the rest of your life. Ask how often it is actually busy, not just how often they carry the phone.
How do you work with the nurses, medical assistants and front desk?
Why ask it
PAs depend on the team to run a clinic, and the relationships determine how smooth a day is. It is also a part of the job invisible in any written description of the role.
What do you do when you disagree with the supervising physician?
Why ask it
The answer tells you how much clinical independence exists here in practice and how disagreement is handled culturally. Listen for whether it is discussed openly or quietly conceded.
What did PA school cost you, and how long did the debt take?
Why ask it
Program costs are substantial and the training is short, so the debt arrives quickly against an earlier income. Most PAs will answer plainly, and the figure should inform where and when you apply.
What did you do before PA school, and did it help?
Why ask it
Most programs expect prior clinical hours, and the type of experience shapes how ready someone feels in the first year. It also tells you which entry routes are realistic from where you are now.
What do you wish you had asked when you interviewed here?
Why ask it
This surfaces the terms that turned out to matter: call, charting time, ramp-up expectations, how new PAs are trained. It is the most directly useful question on the list if you plan to apply for jobs later.
Where do PAs hit a ceiling in this organization?
Why ask it
Some systems have PAs in leadership, teaching and specialty roles, others treat the position as fixed. Knowing which kind you are looking at matters more the longer you plan to stay in a job.
What made you choose PA over medical school or nursing?
Why ask it
The reasons are usually concrete: training length, cost, family timing, the amount of responsibility wanted. Comparing their reasoning to your own is the point of asking.
What kind of person struggles in this role?
Why ask it
Answers often point to discomfort with working under supervision, or with the ambiguity of a scope that shifts by employer. That is a more honest self-test than a list of the traits good PAs have.
Where should I stand, and when should I stay outside the room?
Why ask it
Ask this in the first five minutes, before anything else. It settles the practical question, shows you understand that patients come first, and makes the PA relax about having you there. Shadowers who never ask tend to spend the day being quietly managed.
Is there anything I should not ask about in front of patients?
Why ask it
Signals that you understand the difference between a corridor and an exam room. It also gets you the local rules, which vary: some PAs are happy to be asked anything once the door closes, others prefer questions saved entirely for breaks.
Of the patients we just saw, which was the hardest, and why?
Why ask it
Anchoring to something you both watched gets a far more concrete answer than asking about difficult patients in the abstract. It also shows you were paying attention rather than waiting for your turn to talk.
What was that patient's presentation telling you before you examined them?
Why ask it
Best asked immediately after leaving a room, while it is fresh. You are asking about reasoning rather than facts, which is what shadowing can teach and reading cannot. Even a one sentence answer shows you how a clinician sorts the likely from the serious.
How much of your job is working out what is not wrong with someone?
Why ask it
Ruling things out is most of primary care and urgent care, and it is invisible to an observer. The answer reframes the work: not spotting the rare diagnosis, but safely excluding it a dozen times a day.
What do you do when you are not sure?
Why ask it
The most important question here about clinical judgment. You want the specific move: calling a colleague, bringing the patient back in two days, writing the differential down. Certainty in the reply is the warning sign, not the reassurance.
How much of your day is decided by you, and how much by the schedule?
Why ask it
Autonomy over the schedule varies more between employers than between specialties. The answer tells you what to look for in a first job: appointment length, whether double-booking happens, and who controls the template.
What is the hardest conversation you have in a normal week?
Why ask it
Gets a specific scene rather than a category. Answers often involve telling someone they cannot have what they came in for, which is a skill nobody warns applicants they will need.
How do you keep going when a patient does not follow the plan?
Why ask it
Adherence is where clinical work becomes emotionally costly, and it is a common reason clinicians tire of outpatient medicine. Listen for whether they describe a practice for handling it or simply endurance.
What can you not do in this role that you wish you could?
Why ask it
More revealing than asking about scope of practice in the abstract. The answer names a specific limit that comes up weekly, which is exactly what you would want to know before committing to the profession.
What did PA school not prepare you for?
Why ask it
Almost every clinician has an answer and it is usually not clinical: billing, difficult families, the pace, or how much of the work is tolerating uncertainty. For someone deciding whether to apply, this is the most useful question here.
What is a misconception you would correct about PAs?
Why ask it
You will hear something specific about training length, autonomy, or being a step toward medical school. It is worth knowing before an interview, since repeating a common misconception is an easy way to lose ground with a PA on an admissions panel.
Would you choose the PA route again, knowing what the other paths involve?
Why ask it
Fair to ask directly, since most PAs weighed the alternatives before applying. The answers usually turn on training length, debt and how much independence they wanted, which is the comparison you are trying to make.
Do you see yourself doing this in ten years?
Why ask it
Ask what they would move toward: another specialty, teaching, administration, fewer hours. Because PAs can change specialty without retraining, the answer tells you about the flexibility of the profession as much as their own plans.
What would you look for in a first job that you did not know to look for?
Why ask it
Asks for hindsight rather than advice, which produces specifics: call schedules, how a supervising physician gets assigned, whether the practice fills its vacancies, and who ends up doing the charting.
What would you tell me to do in the next two years if I want to be a strong applicant?
Why ask it
Push for specifics: which patient care roles count, how many hours, whether their program cared about the GRE, what a good letter looks like. General encouragement to work hard is what you get if you ask this too vaguely.
Would you be willing to answer questions later, or to be a reference?
Why ask it
Ask before you leave rather than by email months on. Shadowing contacts fade quickly, and a specific request made in person is far more likely to get a yes than a message in the spring.
Getting the most from the day
Practical guidance for the conversation itself
Before you arrive
Sort permissions in advance
Clinics and hospitals usually need an observer form and immunization records, and some require a background check. Ask several weeks ahead so the day does not fall through.
Learn what this specialty sees
A rough grasp of the common conditions means your questions can be about judgment and scope rather than terminology, which is a better use of a busy clinic day.
Log the hours properly
If you intend to apply to PA programs, find out at the start how shadowing hours should be recorded and who signs them, rather than asking months later.
During the day
- 1Ask at the start where to stand and when to step out, and accept that some patients will decline.
- 2Watch which visits the PA closes alone and which involve the physician, then ask about the pattern afterward.
- 3Note how much time goes to charting and messages between patients.
- 4Pay attention to the team around the PA, since they determine how the day runs.
- 5Record nothing that identifies a patient.
- 6Ask your career questions at the end of the day rather than between rooms.
Common pitfalls
Assuming the scope is the same everywhere
What a PA may prescribe, sign or perform depends on the state and the employer. One day in one clinic tells you about that clinic.
Comparing the role to medicine only in the abstract
Ask about training length, debt, supervision and mobility specifically. The general comparison between PA and physician routes hides the tradeoffs that matter to your own situation.
Skipping the money and the call
Pay structure and call burden shape daily life more than any clinical detail, and both are easy to ask about politely.