Physician assistant (PA) students have reported witnessing and experiencing discrimination or abuse throughout PA programs in the United States, particularly in nonwhite students and students attending public institutions, according to a study published in the Journal of Physician Assistant Education.

Michelle DiBaise, DHSc, PA-C, from the A.T. Still University PA program in Mesa, Arizona, and colleagues, conducted an online survey of PA students to increase the understanding of discrimination, psychological abuse, and physical abuse in PA education programs and the impact it may have on attrition.

The survey consisted of 6 sections with 128 items. The first 4 sections queried individuals as to whether they had:

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  1. Witnessed discrimination
  2. Personally experienced discrimination
  3. Personally experienced psychological abuse
  4. Personally experienced physical abuse

The final 2 sections covered:

  1. Consideration of quitting school because of psychological abuse, physical abuse, discrimination, sexual harassment, or another reason, with an open-ended response.
  2. Demographic information.

Surveys were emailed to PA program directors to be distributed to their students. The first electronic mailing occurred on May 18, 2015, and was sent on 4 separate occasions. The survey concluded on March 3, 2016.

The survey received 1,159 responses, representing 6.1% of total PA student enrollment. Up to 30% of respondents had witnessed or experienced discrimination, and up to 2.3% had experienced psychological abuse while in PA school. A total of 11.6% of students reported that they had witnessed sexual harassment: 18.7% reported witnessing the use of racial slurs: 27.8% reported jokes or remarks centered on obese body habitus: and 18% reported homophobic jokes or remarks. The majority of witnessed or experienced discrimination during PA education was not reported (<2%). Reports were not made because students feared retribution or they simply did not know who to report to, particularly if the incident involved faculty.

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The researchers found that 2.9% of respondents had considered quitting PA school because of issues of discrimination; 5.7% because of psychological abuse; 0.3% because of physical abuse; 0.6% because of sexual harassment; and 7.7% for another reason. The most common reasons provided in the “other” option included mental health issues (eg, anxiety, depression, and stress) (37.5%), difficulty with faculty or staff (37.5%), academic difficulty (20.8%), financial issues (2.1%), and pursuing medical school (2.1%).

“Reducing the prevalence of discrimination in PA education requires recognition of this issue and thoughtful, targeted efforts to ensure that the infrastructure of a program is inclusive and demonstrates valuing diversity of all kinds,” the authors concluded. “The intentional development of welcoming spaces for all students is an important step in reducing feelings of marginalization and isolation. Institutional and program mission and value statements that explicitly state diversity and equity as a core value help improve the overall climate and culture of an institution.”


DiBaise M, Tshuma L, Ryujin D, LeLacheur S. Perceived discrimination, harassment, and abuse in physician assistant education: a pilot study. J Physician Assist Educ. 2018 Jun;29(2):77-85. doi: 10.1097/JPA.0000000000000192