PCE or HCE: Which one do PA schools require? A deep dive into my experience with both.

Patient & Healthcare Experience: My 13+ Years in Medicine

It’s November already, where did the time go!?! Before you know it we’ll be ringing in the new year and saying “Sayonara 2021!” and “Helllooo 2022!”. As another CASPA cycle is nearing its end (you’re waiting to hear back too???), and Pre-PAs all over are preparing to apply this coming cycle, one of the most asked questions is “how do I obtain my healthcare hours?”. If you haven’t experienced the PCE/HCE struggle, count yourself lucky because the pandemic has brought on a lot of added stress for many who are searching for this magical unicorn. But guess what? That magical unicorn is easier to capture than what you think. Allow me to dive into my experience in healthcare as I went from a patient access representative to a phlebotomist and finally a surgery coordinator.

Picture this, it’s summer 2009 and I am browsing the “Job” section on Craigslist in search of a new j-o-b that will somehow bring very much needed excitement in the “career” section of my life. Then wham! I am now applying for a job that I have zero experience in: patient access representative at a OB/Gyn clinic. The guts I had! What was I expecting you ask? Well, I was expecting this job to just that, a job. Something different that would keep my mind occupied for a hot second. Boy was I wrong; little did I know that this would be the beginning of my healthcare journey.

Fast forward two years after working the front office area at a OB/Gyn clinic then a pediatrics clinic, I wanted more. By this point I felt so comfortable in a healthcare setting, I wanted to see what else was out there for me. At that time my sister was a college advisor at a community college and I went to her for advice. I wanted to obtain a continuing education (CE) certificate in order to be able to work at a hospital. I wanted the fast life; zoom zoom! I pictured myself like Dr. Ross saving patients on that show ER (ugh I just aged myself). Anyways, when my sister asked me which healthcare CE program I was interested in, my response was “I don’t care, whichever is the shortest one”. It turned out to be phlebotomy. Y’all, I had to google what a phlebotomist was, oh the shame! But I didn’t let that slow me down, I signed up and began the Phlebotomy program at El Centro College in the fall of 2010.

PCE vs HCE

When it comes to applying to PA programs, many require some amount of experience in a medical setting. You may see requirements range from 50-1,000+ hours of experience. Each program varies when it comes to PCE/HCE hours. Here’s a more important question: “What is PCE/HCE and why do I need it?”.

The Centralized Application Service for Physician Assistants (CASPA) defines PCE & HCE as the following:

• Patient Care Experience (PCE): “Experiences in which you are directly responsible for a patient’s care. For example, prescribing medication, performing procedures, directing a course of treatment, designing a treatment regimen, actively working on patients as a nurse, paramedic, EMT, CNA, phlebotomist, physical therapist, dental hygienist, etc.”
• Health Care Experience (HCE): “Both paid and unpaid work in a health or health-related field where you are not directly responsible for a patient’s care, but may still have patient interaction; for example, filling prescriptions, performing clerical work, delivering patient food, cleaning patients and/or their rooms, administering food or medication, taking vitals or other record keeping information, working as a scribe, CNA (depending on job description), medical assistant, etc.”

PCE hours are obtained when you are directly a part of a patients care. HCE hours are obtained when you are in-directly a part of a patients care. So what this breaks down to is what level of responsibility does you position hold? Clear as mud right? This is where students can find a lot of conflicting information online and in the form of advice. The best way to know what programs will count as PCE or HCE is to directly contact those programs and ask them if they have a list of what they consider PCE/HCE and/or if they can confirm that the position you’re looking into (phlebotomist, medical assistant, etc.) will count as either PCE or HCE. You can never go wrong when asking the PA programs directly.

I know this can still be confusing because what may count as PCE at one program doesn’t count as PCE at another. And there lies one of the main frustrations of Pre-PAs. But no worries friend, keep on reading as I guide you through what my PCE and HCE experience was like as I go into detail of each all from my point of view and stay tuned towards the ends as I share some very helpful tips.

“Was I nervous? Heck yeah! Who wouldn’t be? I definitely went through imposter syndrome…”

Becky Popiel, Pre-PA Student

Phlebotomy (PCE)

Phlebotomy programs are commonly found at community colleges, career training centers and even online. Every program can vary slightly on how they are structured so its important to research them carefully before choosing any program. My Phlebotomy Technician program was structured as follows:

• Two courses equivalent to 216 hours
• 1st course consisted of 96 hours on-campus lectures and lab
• 2nd course consisted of 120 hours in a clinical setting
• Two certificates of completion
• Sat for my national boards through ASCP

Lets break this down further. The first course was all about obtaining the knowledge and skills to prepare me for my clinicals and passing my Phlebotomy Technician board exam offered by the American Society for Clinical Pathology (ASCP). What were the courses like? Well friend, let me tell ya. In the lecture portion we learned everything from the history of phlebotomy which used to be known as “bloodletting” to the anatomy of our bodies which contain the river of life. Here’s your first test question: “When and who first used the bloodletting method?”, any guesses? It was the Egyptians around 1000 BC and they believed it could cure diseases like the plague and cast out evil spirits. Wild I know! This was such an amazing part of the program because I had an amazing instructor and my eyes were opened to how amazing the human body is. While studying like a mad woman became part of my everyday norm, it was well worth it in the end. To this day, I know that the lecture portion prepared me for biology courses I would later take at university. We also had a lab portion which was spent practicing the techniques and skills that allow you to perform the best stick. We practiced on dummy arms that felt so real and yes, we even practiced on each other. This hands-on experience really prepared me for the clinical portion that was to follow. After completing the first course, I was set to move on to the second course: clinicals.

My program assigned us a clinical location based on where we lived and what site was available. We were either placed in a hospital or clinic setting. I was so excited when I found out I was assigned a Level 1 Trauma hospital in one of the busiest areas in Dallas. This hospital at the time was a 1,000+ bed hospital which if you can imagine consisted of a several buildings including a 17-story main building. When I say I got my steps in, y’all, I got my steps in. This was my favorite part of the program because I was able to put what I had learned in the 1st course to practice. Was I nervous? Heck yeah! Who wouldn’t be? I definitely went through imposter syndrome until I was able to overcome my doubts and conquer my fear of failure. I was assigned a mentor during my clinicals who showed me the ropes and trained me to be the best phlebotomist possible. Shout out to the best phleb mentor in the world (you know who you are). Running around in this massive hospital gave me so many opportunities to perfect my blood collecting skills as well as the opportunity to shine as a person. This ultimately led me to a job offer at the end of my clinical.

I was at the top of the world as a brand spanking new phlebotomist in a thriving hospital system that I explored to its finest. I would ultimately move up to become a phlebotomy trainer myself and help train other phlebotomist in our sister hospitals on our systems and overall phlebotomy skills. I was able to grow as a leader and teammate through phlebotomy. Although not every place requires one to have be certified or have completed a phlebotomy program, it is important to understand what being a phlebotomist is all about. You are a part of a patients care team and are integral in keeping the wheels of healthcare turning. It is vital that we our future patients care and safety as well as ours when it comes to deciding if phlebotomy is right for you and which program will set you up for success. One can say “well I can get certified in one weekend” or “I can do it solely online with not clinicals needed”, but to you I ask: “what type pf phlebotomist do you want drawing your blood?”. I would want someone very knowledgeable who had extensive in-class instruction and hands-on training. All I’m saying is choose wisely because its your time, money and future you are in vesting in. Just like you research PA schools, research programs when you’re looking to get certified in the medical field.

“I’ve spoken to some higher ups and told them all about you and how much I want you on my team so we added a position so you can join us…”

-Surgery Manager, my future boss

Surgery Coordinator (HCE)

A surgery coordinator can also be known as a surgery scheduler but in my experience, scheduling surgeries was a just a part of my overall duties. I became a surgery coordinator, well, funny enough after I applied for and was offered a sterile processing tech position in the surgical unit but that position was no longer available. Wait, hold up? A sterile processing tech position? Confused yet? Let me explain. After 5+ years as a fabulous and confident phlebotomist, I wanted something more. I was honestly burned out and needed a change of environment/career. I returned to community college while still working as a phlebotomist and obtained my certification and license as a “sterile processing and distribution technician” or SPDT. This was another continuing education program which spoke to me because U wanted to get my hands dirty in the surgery world. An SPDT is responsible for the cleaning, sterilization, storing and distribution of medical equipment utilized in the surgery unit. You can learn more about it here.

I applied to an SPDT opening at a sister hospital and received a call one hour after I interviewed offering me the position. I was so excited! I was getting my foot into the OR doing a pretty cool job. Here’s where it gets interesting. About 15 minutes after I received the call with the job offer that I immediately accepted, that same person called me back stating there was an error. “Oh no Becky, this can’t be it!”. It wasn’t, what happened was that somehow there was a mix-up between the surgery manager (my future boss) and human resources and the job I had just been offered had been given away to somebody else. Oh the travesty! But wait, it gets better, as I am on the phone with my the surgery manager and were laughing about the mix-up and I’m slowly dying inside, my ears perked up when she says: “I am sorry about the mix-up but I want you on my team. Give me a few minutes and I’ll call you back, I have to make some phone calls”. Ummm excuse me but what just happened? I of coarse said “yes, I’ll be here, take your time” when in reality my mind was racing faster than the roadrunner. After what seemed like a lifetime, she called me back and said: “I’ve spoken to some higher ups and told them all about you and how much I want you on my team so we added a position so you can join us as our new surgery coordinator.” I almost fell out of my chair. I accepted the position right away and honestly was not sure what it entailed but I just knew that if a manager went through all that trouble just having met me, then that was someone I wanted to work with.

As a surgery coordinator my main functions were to assure that the surgeries that were scheduled or needed scheduling were on the schedule properly and accordingly. Each procedure required certain medical equipment and staff. Each surgeon had they’re preferences when it came to surgeries. I worked alongside the charge nurse and OR staff to assure that our daily surgery schedule went as smooth as possible. If a patient needed to go to ICU after surgery, I would contact ICU and made it happen. If we had a trauma en route, I would notify the trauma team that it was go-time. Every single day consisted of communicating with multiple surgeons, OR staff and departments. Although I didn’t directly care for a patient, I was part of their care team. I would at times translate for patients in pre-op or assist with running in medication to an OR room. I wore many hats and learned a lot. I was entrusted with an important part of the surgery unit and that my friends was how I obtained my HCE.

I have gained so much in working in healthcare for as long as I have and although I left in 2019 to pursue my bachelors degree full-time, I have always missed being surrounded by medicine. So when the pandemic hit and skilled healthcare workers were needed, I jumped right back into things. However, this time it was in a different capacity. Wanting to help out in an area that desperately needed it, I began to volunteer as an interpreter and lab tech. I was back y’all! So mid 2020 I have been putting my skills to work at a free clinic who serves an under-served area in my city. There I am able to keep up my phlebotomy skills, take vitals and interpret for patients and providers. Its a very tight nit group and best of all, I continue to build up on my healthcare hours while helping during a global pandemic. I feel right at home.

Tips & Advice

When it comes to gaining patient and health care experience, its always a great idea to start out by researching which schools you want to apply to and what they consider PCE and/or HCE. As I mentioned before, not every program is going to accept the exact hours so be sure that you invest time in making a list and checking it twice. Here are some of my tips:

• Make a list of the PA schools you are interested in and all of their requirements like GPA, PCE/HCE hours, etc. You can download the template I created that helped me keep this information organized. Click here.
• If the PA program doesn’t have examples on their site as to what PCE/HCE will count, email them and ask. Let them know you are interested in their program and want to obtain your hours in a position that will count towards their program. This way you get it straight from them.
• Not sure what you want to do or what all the positions mean? That’s ok, make another list (I love lists can you tell?). List what different PCE/HCE positions there are and make notes. Choose one that not only fulfills the PCE/HCE requirement but one that you’ll enjoy. You will be working in this position after all so make sure its one that you can see yourself showing up to, enjoying and learning as much as you can.
• Once you have an idea of a few positions you’re interested, start searching for job openings and making note of what the requirements are to apply. If there’s something they require that you don’t have like a certification, then further research that certification if you’re still interested in that position. Its important to keep this information organized so you can make the best decision on which job to pursue.
• For example, if I was interested in becoming a phlebotomist I would research what the position entailed, what current openings were in my area and what the requirements were to apply. So, I’d google “Phlebotomy job description” to learn more about the position, then “phlebotomy jobs in (insert zip code here)” to see what openings were in my area, and then this way I have a better overall idea at what I’m looking at.
• When looking at a job posting, there are different sections to pay attention to: job description/duties, job requirements and job preferences. If a certification is under “job requirement” and you don’t have it, don’t apply just yet, because that will be an automatic rejection if you don’t have that certification. But if a certification is listed under “job preferences” and you don’t have said certification, then go ahead and apply if you meet the other requirements. The difference is one job requires it while another prefers it, either way, always make sure you understand the job posting.
• Another way to get to know what type of PCE/HCE jobs previous PA applicants had, reach out to them. There are many ways you can get to know PA students; one of them is on social media. Attending PA virtual shadowing sessions like here at Empowered PAs allows you to also hear about the experience our PA guest had when applying to PA programs.
• Creating a LinkedIn profile can also be a gateway to finding your next PCE/HCE job. Create a profile and start searching for jobs on there. You can browse postings that medical facilities list on there as well as read about said facility. You can check my LinkedIn profile here to get an idea of what can be added to your profile.
• Last but not final tid-bit (more to come), when in doubt, reach out and ask for help. PA programs can provide clarification as well as others like myself. You’re not alone!

If you have stuck this far, I appreciate you! I have much more I can say so feel free to reach out to me on Instagram or on here. We have all been there so don’t ever feel like you’re alone. Finding the right job to fulfill PCE/HCE hours can be all sorts of scary and stressful but you don’t have to go through it alone friend.

-Becky P.

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