PA applicant U.S. citizenship status and likelihood of program matriculation

Area of Science:

• Health Professions Education
• Medical Education Research
• Physician Assistant Studies

Background:

• Barriers to Physician Assistant (PA) program matriculation disproportionately affect historically marginalized groups.
• This study investigates the association between U.S. citizenship status and PA program acceptance.
• Addressing these barriers is crucial for enhancing diversity within the PA profession.

Purpose of the Study:

• To evaluate if U.S. citizenship status is associated with the likelihood of matriculation in Physician Assistant (PA) programs.
• To identify potential disparities in PA program admissions based on citizenship.
• To inform strategies for improving diversity and accessibility in PA education.

Main Methods:

• Analysis of data from five Centralized Applicant Services for Physician Assistants (CASPA) admissions cycles (2012-2021).
• Cross-sectional evaluation using bivariate and multivariate logistic regression to assess matriculation likelihood.
• Models controlled for key confounders including age, gender, race/ethnicity, English proficiency, patient care experience, GPA, and number of applications.

Main Results:

• Non-U.S. citizen status was significantly associated with a lower likelihood of PA program matriculation.
• Odds of matriculation were 32% to 42% lower for non-U.S. citizens compared to U.S. citizens, even after adjusting for covariates.
• The disparity in matriculation likelihood was most pronounced in the 2012-2013 and 2016-2017 admissions cycles.

Conclusions:

• Non-U.S. citizenship status represents a potential barrier to entry into PA programs.
• PA programs must enhance diversity to better reflect patient populations and improve health outcomes.
• Recommendations include raising awareness and improving accessibility for non-U.S. citizens in PA admissions.