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					D’YOUVILLE PHYSICIAN ASSISTANT DEPARTMENT
APPLICATION FOR ADMISSION
Application for Fall 2010

♦
D’YOUVILLE COLLEGE 320 PORTER AVENUE BUFFALO, NEW YORK

D’YOUVILLE COLLEGE
GENERAL INFORMATION

PHYSICIAN ASSISTANT DEPARTMENT APPLICATION INFORMATION & PROGRAM POLICY

Admission to D’Youville College’s Physician Assistant Department* is based on several factors: ability to master the rigorous academic content of the program as demonstrated by previous academic course work and/or standardized test scores, motivation to become a physician assistant with a strong understanding of their professional duties, personal evaluations, verbal and written communicational skills, and level of personal development, maturity and character. Each year a large number of applications are received from candidates throughout the country. Due to the limited number of available seats, the selection process for admission to the PA department is extremely competitive. Not all applicants who meet the minimum application requirements will be invited to campus for an interview. Rather, a pool of the most well qualified applicants will be selected. At that time, the selection committee will screen candidates for their maturity, knowledge of the profession, ability to communicate effectively, and motivation to become a physician assistant. It is highly recommended that candidates shadow a PA in preparation for the interview phase of the admissions process. Each candidate will be notified by mail of the committee’s decision shortly after the interview. Neither the Office of Admissions nor the PA selection committee will discriminate against an “otherwise qualified” applicant because of a disability. However, candidates are required to meet certain minimum academic and technical standards, which are included within this application.

DIRECTIONS FOR FRESHMEN APPLICANTS: High school students applying for admission to the freshman class must have a combined (math and critical reading) SAT score of at least 1100 or an ACT score of 24, rank in the upper fourth of their graduating class and have a student average of at least 85% (comparable letter grade = B). Students must have passed, with a minimum grade of at least 83% (B-), all mathematics and science subjects including three years of math, and one year each of biology and chemistry. Applicants must show evidence of a minimum of 80 hours of direct patient care to be considered. Freshman candidates are encouraged to apply early in their senior year of high school. Qualified applicants will be invited for on-campus interviews between November and March. Students who are considering D’Youville College are strongly advised to apply for financial aid by the earliest possible date. Candidates need only complete the FAFSA (Free Application for Federal Student Aid) by the preferred filing date of March 1st to be evaluated. D’Youville College’s Federal School Code number is 002712.

DIRECTIONS FOR TRANSFER APPLICANTS: Candidates who hold previous college or university credits are categorized as transfer students. Transfer students are admitted to the first or second year of the program, depending upon their credit standing and seating availability. Applicants who have earned a bachelor’s degree from an accredited institution are not required to meet the core curriculum requirements of D’Youville College. However, they must take any prerequisite courses the PA major requires and fulfill all other policies and requirements pertaining to the degree. No transfer credit is given for any courses with a PA prefix. Applicants who have earned twelve or more college credits must have a GPA of at least 3.0 on a 4.0 scale (3.0 science GPA preferred) , and must have earned a grade of at least B- in all college science courses required by the PA program. Students will be required to repeat science courses taken six or more years prior to acceptance. Courses such as Biochemistry, Human Gross Anatomy, and Pathophysiology must be successfully completed at D’Youville College. If a transfer student has satisfactorily completed these courses with an earned grade of B- or better at another institution within 18 months prior to program entry, the course content will be reviewed by the math and natural sciences faculty to determine transferability. Applicants must show evidence of a minimum of 80 hours of direct patient care to be considered.

APPLICATION DEADLINE: In order to be considered for early decision, all materials must be received by the Office of Admissions no later than October 1st. Placements are made for all applicants on a competitive, space available basis. The admissions process will cease once the class(es) are full. Therefore, applicants are strongly encouraged to apply early. Incomplete applications will not be reviewed. PATIENT CARE ExPERIENCE To be considered for an interview, candidates must accrue and provide original (on company letterhead) documentation of at least 80 hours of direct patient contact, either through volunteer or employment experience. Examples of acceptable hours are nursing, nursing assistant, hospital/nursing home volunteer, EMT, paramedic, etc. The applicant must have direct contact with patients in a role that is not administrative (i.e. pharmacy technician, shadowing would not be acceptable). Hours should have been accrued within the last five years. Applicants without documentation will not be considered for an interview. REFERENCES Within this departmental application packet are Reference Forms (yellow), which are a required prerequisite for consideration as either a freshman or transfer candidate. These forms** must be forwarded by the applicant to three credible individuals who can evaluate the candidate based on the questions provided. Applicants should print their name and Social Security Number on each reference form (Applicant Name) prior to being distributed. One of the three references should come from a health care provider or professional (i.e., a physician, RN, PA, etc.) who has observed the candidate in a health care setting (either volunteer or employed). The remaining references may come from other sources such as teachers, employers, supervisors, etc. It is the candidate’s responsibility to see that these reference forms are completed and forwarded in a timely manner. To expedite their return, applicants may wish to include a postage-paid forwarding envelope (addressed to D’Youville College-Office of Admissions) with each reference they hand out. Once received and placed in the candidate’s file, these references become the property of D’Youville College and are treated with the highest degree of confidentiality. The contents of references are never discussed or revealed to the candidate at any time before or after a decision has been rendered.
** Three references are required. A fourth Reference Form is provided as an extra copy.

*Accredited by the Accreditation Review Commission on Education for the Physician Assistant

06.09

D’YOUVILLE COLLEGE

PHYSICIAN ASSISTANT DEPARTMENT DEPARTMENTAL APPLICATION
APPLICANT NAME SOCIAL SECuRITY NuMBER

____________________________________________________________ ____________________________________

___________________________________________________________ HOME ADDRESS

________________________________________ EMAIL

(____)_____________________ PHONE NuMBER

1. If employed, please record your present occupation: ______________________________________________________________

____________________________________________________________
EMPLOYER

________________________________
DATES OF EMPLOYMENT

_________________________________________________________________________ SuPERvISOR

(_____)______________________ TELEPHONE

( ) FULL-TIME ( ) PART-TIME*

*Number of Hours per Week ____________________

2.

Give the following information for all health related positions you have held, either paid or volunteer, beginning with the most recent. Attach additional sheets, if necessary. A. _______________________________________________________________________________________________________
INSTITuTION OR AGENCY INCLuSIvE DATES

__________________________________________________________________________________________________ ( ) FULL-TIME ( ) PART-TIME* POSITION OR TITLE *NuMBER OF HOuRS PER WEEk: ____________________

B. _______________________________________________________________________________________________________
INSTITuTION OR AGENCY INCLuSIvE DATES

__________________________________________________________________________________________________ ( ) FULL-TIME ( ) PART-TIME* POSITION OR TITLE *NuMBER OF HOuRS PER WEEk: ____________________

3. List the names and addresses of the individuals who will be providing references for you. At least one reference should be from a physician, physician assistant or other health care provider. A. _______________________________________________________________________________________________________
NAME & ADDRESS

B. _______________________________________________________________________________________________________
NAME & ADDRESS

C. _______________________________________________________________________________________________________
NAME & ADDRESS

4. Were you ever previously enrolled in a physician assistant program?

( ) YES*

( ) NO

*If Yes, what school? ________________________________________________________________ Dates: ___________________ Reason(s) for not continuing: __________________________________________________________________________________
(CoNTiNue oN BACk, iF Needed)

5. If accepted, I would like to begin taking courses toward my P.A. degree in the:

( ) SPRING 2010 SEMESTER

( ) FALL 2010 SEMESTER

D’YOUVILLE COLLEGE

PHYSICIAN ASSISTANT DEPARTMENT POSITION PAPER

_____________________________________________________
APPLICANT NAME

Please answer EACH of the following questions separately. Each essay should be approximately 500 words in length. You will need to attach additional pages. Your responses will be used by the PA Department Admissions Committee to assess your writing skills, which includes your ability to organize your thoughts, develop a topic, and exhibit clarity of expression. Only typed responses will be considered. 1. What was the most significant challenge you have faced in your life, and how did you handle it? 2. What is it about the physician assistant profession that inspired you to choose it as a career?

D’YOUVILLE COLLEGE

PHYSICIAN ASSISTANT DEPARTMENT REFERENCE FORM

You have been asked to provide a reference for the following individual. This person is applying to the D’Youville College Physician Assistant Department. Please be conscientious and objective in your responses. When complete, forward this form as soon as possible to the address listed below.

____________________________________________________________
APPLICANT NAME

A. PLEAsE RATE ThE APPLICAnT In REGARD TO ThE fOLLOWInG ChARACTERIsTICs:
ABOvE AvERAGE AvERAGE BELOW AvERAGE uNOBSERvED

Intellectual Ability Motivation Perseverance and thoroughness Emotional Maturity Ability to relate to others Patient rapport Oral communication Flexibility Ability to accept constructive feedback

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

OVERALL RECOMMENDATION OF APPLICANT TO THE PHYSICIAN ASSISTANT DEPARTMENT: [ ] Highly recommended [ ] Recommend [ ] Recommend w/reservations

[ ] Not recommended

B. HOW LONG HAVE YOU KNOWN THE APPLICANT: ________________________________________________________________________ In what capacity?:

_________________________________________________________________________________________________________
C. Please comment on the applicant’s performance, potential or personal qualities that you feel would be helpful to the Admissions Committee. Consider the following information: applicant’s ability to interact constructively and diplomatically with other people; applicant’s chief motivation for applying to our Physician Assistant Department; applicant’s greatest strengths and weaknesses relative to a career as a physician assistant; and any other comments that you feel are not otherwise apparent in the candidate’s record.

____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
(CoNTiNue oN BACk, iF Needed)

_________________________________________________________________________________________________
SIGNATuRE TITLE DATE

______________________________________________________________________________(_____)_____________
PRINT NAME WORk ADDRESS TELEPHONE NuMBER

fORWARD TO: OffICE Of ADmIssIOns, D’YOuvILLE COLLEGE, 320 PORTER AvEnuE, BuffALO, nY 14201.

Thank You.

D’YOUVILLE COLLEGE

PHYSICIAN ASSISTANT DEPARTMENT REFERENCE FORM

You have been asked to provide a reference for the following individual. This person is applying to the D’Youville College Physician Assistant Department. Please be conscientious and objective in your responses. When complete, forward this form as soon as possible to the address listed below.

____________________________________________________________
APPLICANT NAME

A. PLEAsE RATE ThE APPLICAnT In REGARD TO ThE fOLLOWInG ChARACTERIsTICs:
ABOvE AvERAGE AvERAGE BELOW AvERAGE uNOBSERvED

Intellectual Ability Motivation Perseverance and thoroughness Emotional Maturity Ability to relate to others Patient rapport Oral communication Flexibility Ability to accept constructive feedback

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

OVERALL RECOMMENDATION OF APPLICANT TO THE PHYSICIAN ASSISTANT DEPARTMENT: [ ] Highly recommended [ ] Recommend [ ] Recommend w/reservations

[ ] Not recommended

B. HOW LONG HAVE YOU KNOWN THE APPLICANT: ________________________________________________________________________ In what capacity?:

_________________________________________________________________________________________________________
C. Please comment on the applicant’s performance, potential or personal qualities that you feel would be helpful to the Admissions Committee. Consider the following information: applicant’s ability to interact constructively and diplomatically with other people; applicant’s chief motivation for applying to our Physician Assistant Department; applicant’s greatest strengths and weaknesses relative to a career as a physician assistant; and any other comments that you feel are not otherwise apparent in the candidate’s record.

____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
(CoNTiNue oN BACk, iF Needed)

_________________________________________________________________________________________________
SIGNATuRE PRINT NAME TITLE WORk ADDRESS DATE TELEPHONE NuMBER

______________________________________________________________________________(_____)_____________
fORWARD TO: OffICE Of ADmIssIOns, D’YOuvILLE COLLEGE, 320 PORTER AvEnuE, BuffALO, nY 14201.

Thank You.

D’YOUVILLE COLLEGE

PHYSICIAN ASSISTANT DEPARTMENT REFERENCE FORM

You have been asked to provide a reference for the following individual. This person is applying to the D’Youville College Physician Assistant Department. Please be conscientious and objective in your responses. When complete, forward this form as soon as possible to the address listed below.

____________________________________________________________
APPLICANT NAME

A. PLEAsE RATE ThE APPLICAnT In REGARD TO ThE fOLLOWInG ChARACTERIsTICs:
ABOvE AvERAGE AvERAGE BELOW AvERAGE uNOBSERvED

Intellectual Ability Motivation Perseverance and thoroughness Emotional Maturity Ability to relate to others Patient rapport Oral communication Flexibility Ability to accept constructive feedback

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

[ [ [ [ [ [ [ [ [

] ] ] ] ] ] ] ] ]

OVERALL RECOMMENDATION OF APPLICANT TO THE PHYSICIAN ASSISTANT DEPARTMENT: [ ] Highly recommended [ ] Recommend [ ] Recommend w/reservations

[ ] Not recommended

B. HOW LONG HAVE YOU KNOWN THE APPLICANT: ________________________________________________________________________ In what capacity?:

_________________________________________________________________________________________________________
C. Please comment on the applicant’s performance, potential or personal qualities that you feel would be helpful to the Admissions Committee. Consider the following information: applicant’s ability to interact constructively and diplomatically with other people; applicant’s chief motivation for applying to our Physician Assistant Department; applicant’s greatest strengths and weaknesses relative to a career as a physician assistant; and any other comments that you feel are not otherwise apparent in the candidate’s record.

____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
(CoNTiNue oN BACk, iF Needed)

_________________________________________________________________________________________________
SIGNATuRE PRINT NAME TITLE WORk ADDRESS DATE TELEPHONE NuMBER

______________________________________________________________________________(_____)_____________
fORWARD TO: OffICE Of ADmIssIOns, D’YOuvILLE COLLEGE, 320 PORTER AvEnuE, BuffALO, nY 14201.

Thank You.

D’YOUVILLE COLLEGE
INTRODUCTION

PHYSICIAN ASSISTANT DEPARTMENT MINIMuM TECHNICAL STANDARDS FOR ADMISSION & MATRICuLATION

The Americans with Disabilities Act of 1990 (AdA) (Public Law 101-336) was established to empower qualified persons with disabilities to seek employment opportunities, transportation, and access to programs and services without fear of discrimination. The Physician Assistant Department at D’Youville College is prepared to make reasonable modifications to policies and practices in order to allow students with disabilities an equal opportunity to participate and succeed in the academic program. No otherwise qualified person shall be excluded from participation, admission, matriculation, or denied benefits solely by reason of his or her disability. The Physician Assistant Department will not discriminate against qualified individuals but will expect applicants and students to meet certain minimum academic and technical standards. In carrying out their functions, the department will be guided by the technical standards set forth in this proposal.

TECHNICAL STANDARDS The holder of a Physician Assistant Certificate must have the knowledge and skills to function in a broad variety of clinical situations and to render a wide spectrum of patient care. In order to carry out the activities described below, candidates for the PA certificate must be able to consistently, quickly, and accurately learn, integrate, analyze, and synthesize data. They must have functional use of the senses of vision, and hearing. Their exteroceptive (touch, pain, temperature) and proprioceptive (position, pressure, movement, stereognosis, and vibratory) senses must be sufficiently intact in the upper extremities to enable them to carry out all activities required for a complete PA education. Candidates must have motor function capabilities to meet the demands of PA education and the demands of total patient care. A candidate for the PA certificate must have abilities, attributes, and skills in five major areas: 1) observation, 2) communication, 3) motor, 4) intellectual, including conceptual, integrative, and quantitative abilities, and 5) behavioral and social.

I.

Observation:

Candidates and students must have sufficient vision and somatic sensation to be able to observe demonstrations, experiments, and laboratory exercises in the basic sciences. They must be able to observe a patient accurately at close range and at a distance.

II.

Communication:

Candidates and students should be able to speak, to hear and to observe patients in order to elicit information, examine patients, describe changes in mood, activity and posture, and perceive nonverbal communications. They must be able to communicate effectively and sensitively with patients. Communication includes not only speech but also reading and writing. They must also be able to communicate effectively and efficiently in oral and written form with all members of the health care team.

III.

Motor:

Candidates and students should have sufficient motor function to elicit information from patients by palpation, auscultation and percussion, as well as carry out diagnostic maneuvers. A candidate should have motor function sufficient to execute movements reasonably required to provide general care and emergency treatment to patients. Such skills require coordination of gross and fine muscular movements, equilibrium, and sensation.

Iv.

Intellectual: conceptual, integrative, and quantitative abilities:

These abilities include measurement, calculation, reasoning, analysis and synthesis. Problem solving, the critical skill demanded of PA’s requires all of these intellectual abilities. In addition, candidates and students should be able to comprehend three dimensional relationships relationships and to understand the spatial relationships of structures.

v.

Behavioral and Candidates and students must possess the emotional health required Social Attributes: for full utilization of their intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive and effective relationships with patients. He/she must have a high level of compassion for others, motivation to serve, integrity, and consciousness of social values. Candidates must possess sufficient interpersonal skills to interact positively with people from all levels of society, all ethnic backgrounds, and all belief systems. Candidates and students must be able to tolerate physically taxing workloads and to adapt to changing environments, to display flexibility and to learn to function in the face of uncertainties inherent in the clinical problems of many patients.

CONCLUSION The D’Youville College Physician Assistant Department and its sponsoring institutions will attempt to develop creative ways of opening the Program to competitive, qualified individuals with disabilities. In doing so, however, the Department and sponsoring institutions must maintain the integrity of the curriculum and preserve those elements deemed essential to the education of a physician assistant. The Department and sponsoring institutions cannot compromise the health and safety of patients. It is inevitable that adherence to minimum requirements will disqualify some applicants and students, including some who have a disability. Exclusion of such an individual, however, does not constitute unlawful discrimination. An applicant or student who is unable to meet the minimum academic and technical standards is not qualified for the practice of the profession.

PLEASE KEEP THIS DOCUMENT WITH YOUR RECORDS

D’YOUVILLE COLLEGE

PHYSICIAN ASSISTANT DEPARTMENT DEPARTMENTAL APPLICATION

The following is a list of fees and expenses that are exclusive to the Physician Assistant Department as well as for students entering a specific class year in the fall semester. These are additional charges that do not include the standard college fees required of all DYC students. All fees are subject to change yearly. For a complete list of standard college fees and expenses, refer to this year’s edition of the D’Youville College catalog.
FRESHMAN YEAR: COLLEGE FEES

SPAA ................................................................................................................................................................................................................$10

SOPHOMORE YEAR:

COLLEGE FEES

SPAA ................................................................................................................................................................................................................$10 Gross Anatomy Lab fee:.....................................................................................................................................................................$250 Medical Equipment......................................................................................................................................................................$700-800 Medical equipment is typically purchased in the spring of the sophomore year so it can be delivered before the start of the junior year. Also, the total cost depends on the amount of equipment the individual student needs and the particular model chosen by the student. LIST OF MANDATORY EqUIPMENT: Stethoscope, diagnostic kit (otoscope/ophthalmoscope), blood pressure kit, tuning forks (2), reflex hammer, goniometer, tape measure, blazer style lab coat, and EkG calipers.

jUNIOR YEAR:

COLLEGE FEES

SPAA ................................................................................................................................................................................................................$10 Child Abuse Recognition Seminar ....................................................................................................................................$20 online CPR ...................................................................................................................................................................................................................$50 Infection Control Seminar.....................................................................................................................................................$30 online Name badge:................................................................................................................................................................................................$10 D’Youville PA Patch .................................................................................................................................................................................... $5 Liability Insurance:.....................................................................................................................................................$20 x 2 semesters Clinical Skills course: ................................................................................................................................................................................$71 Professional Organization membership fees: .................................................................................................$150 (estimate) Other expenses may include but are not necessarily limited to: an up-to-date physical examination, PPD, measles, rubella and varicella titers and/or the costs of any immunizations necessary such as Hepatitis B vaccine along with a titer to prove immunity.

SENIOR YEAR:

COLLEGE FEES

SPAA ................................................................................................................................................................................................................$10 PDA ...............................................................................................................................................................................................................$450 Liability insurance .....................................................................................................................................................$20 x 2 semesters Senior Professional Seminar I (includes ACLS/PACkRAT) .............................................................................................$230 Professional Organization membership fees: .................................................................................................$150 (estimate) updated physical examination and PPD ............................................................................................................................variable Clinical travel expenses**:...........................................................................................................................................................variable

GRADUATE YEAR:

COLLEGE FEES

SPAA ................................................................................................................................................................................................................$10 Liability Insurance ......................................................................................................................................................................................$20 DEA Number...........................................................................................................................................................................................$551 Lab fee included in financial aid packets for PANCE exam .........................................................................................$450 NYS State License Registration Fee ............................................................................................................................................$150 **Students are responsible for all clinical travel expenses, including transportation, meals and lodging. These expenses are variable and will be likely to increase if a student chooses to do out-of-state rotations. The program may also require a student to complete distant in-state rotations at the student’s expense, depending on site availability.
Revised: 5/08

D’YOUVILLE COLLEGE

PHYSICIAN ASSISTANT DEPARTMENT APPLICANT CHECkLIST

The following checklist is a record for your use. We highly recommend that you document your activity during the application phase. verify the completion of each item by dating the appropriate line. If you have any questions regarding any of the items listed below, contact the Office of Admissions at 716.829.7600 or 1.800.777.3921 or admissions@dyc.edu for assistance. 1. D’Youville College Application for Admission mailed: _____________________________________________________
DATE

2. PA Departmental Application mailed on: _______________________________________________________________
DATE

3. Position Paper (2 essays) mailed with application on: _____________________________________________________
DATE

4. Application fee of $25.00 included with application: ______________________________________________________
DATE

5. Transcripts requested from/on: ______________________________________________________________________
SCHOOL/COLLEGE DATE

______________________________________________________________________
SCHOOL/COLLEGE DATE

_______________________________________________________________________
SCHOOL/COLLEGE DATE

6. References requested from/on: #1. ___________________________________________________________________________________________
NAME DATE

#2. ___________________________________________________________________________________________
NAME DATE

#3. ___________________________________________________________________________________________
NAME DATE

7. Official volunteer or Direct Patient Care documentation: __________________________________________________
DATE

8. military Discharge (DD form 214): ___________________________________________________________________
(IF APPLICABLE) DATE

9. Invitation to Interview received: ______________________________________________________________________
DATE

Applications will not be reviewed until ALL information has been received and assessed by the office of admissions.

PLEASE KEEP THIS FORM WITH YOUR RECORDS


				
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