SAN FRANCISCO — About 80% of physician assistant programs encounter a shortage of clinical rotation sites, with more than a third indicating that they “often” or “always” struggle to place students in clinical rotations, according to research presented at the American Academy of Physician Assistants 2015 meeting.

“As the number of PA programs expands, the relative shortage of preceptors and training sites, as well as competition for these sites, will intensify,” reported Amber Herrick, MS, PA-C, Physician Assistant Program, College of Health Sciences, Midwestern University, Glendale, Arizona, and colleagues. “Additional steps at the program, university, and accreditation level may need to be developed to address this growing problem.”

The findings are based on data collected from an online survey that was sent to 191 PA program directors in December 2014. Surveys from the 65 responding PA programs were analyzed, and two programs were excluded because they did not have at least one year of students in matriculation (34% response rate).

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A majority (57.8%) of respondents ranked Women’s Health as the most difficult area to find placement for students, according to Herrick’s group. Pediatrics was the second most difficult (53.3%), followed by Psych/Behavioral Health (32.6%). 

Competition (95.7%) and a shortage of preceptors due to a perceived reduction of productivity and/or revenue while training students (89.1%) were the two most common barriers that were cited.

“Not surprisingly, programs reported that medical and PA schools are their biggest competitors for rotations,” stated Herrick.

About 24% of respondents stated that their program currently pays for supervised clinical rotations, which average $500 to $2,000 per student per rotation. A majority of programs (78.6%) reported that the primary source of funds was reallocated from other parts of the budget to finance the expense of rotation payment.

The most frequently reported reason for not paying rotations was that it was against the program’s philosophy (77.3%). However, 70.7% of programs reported that they have lost clinical sites by not paying the site/institution and/or preceptor.

When payment was not made, programs awarded certificates of appreciation (89.7%), adjunct or clinical faculty status (87.9%), and library privileges and/or access to online medical references/databases and eResources (79.3%).


  1. Herrick A et al. “Rotation Shortages in Physician Assistant Education.” Presented at: AAPA 2015. May 23-27, 2015. San Francisco, California.