What PA Students Say Makes the Didactic Year Hard
Jennifer Forbes, DMSc, MHS, PA-C, DFAAPA; Leslie Woltenberg, PhD; Heidi Vonderheide, DMSc, PA-C; Andrew Draper, PharmD, MSA, NCTTP; Jill Cavalet, DHSc, PA-C
Students across six PA programs rated workload as their biggest challenge and reported an average of 15 factors affecting their academic performance.
When a PA student struggles on an exam, an advising conversation often starts with the material they missed. A study in the Journal of Physician Assistant Education gives faculty a reason to ask about the week leading up to the exam, too. How much material was the student trying to cover? What happened when they tried to follow their study plan?
What students reported
Jennifer Forbes, DMSc, MHS, PA-C, DFAAPA, and coauthors Leslie Woltenberg, PhD, Heidi Vonderheide, DMSc, PA-C, Andrew Draper, PharmD, MSA, NCTTP, and Jill Cavalet, DHSc, PA-C, invited 314 students from six U.S. PA programs to complete an anonymous survey midway through the didactic year. Of those invited, 159 responded, a 51% response rate. Students rated how much each factor affected their academic performance on a scale of 0 to 10.
Workload stood out. Ninety-five percent of respondents said it affected their performance, and it received the highest average rating at 6.19 out of 10. Students also frequently cited changes in their daily routine, difficulty managing time or staying focused, and trouble creating or following a study plan. Mental well-being and test anxiety were each reported by more than 85% of respondents. Workload ratings varied across programs, while the other top-rated concerns were broadly similar.
What this means for PA educators
The survey captured students’ perceptions at one point in training. It did not measure grades or test whether specific forms of support improved outcomes, and findings from six programs may not apply to every PA program.
The findings can still help faculty decide what to ask during early advising. An advisor might review an upcoming exam week with a student, help them make a realistic study plan, and ask whether anxiety or changes in routine are making the plan hard to follow. When a cohort consistently reports heavy workload, program leaders can look at where exams and assignments cluster. A conversation that starts with the student’s actual week gives faculty a clearer basis for deciding what support to offer.
Original study
Forbes J, Woltenberg L, Vonderheide H, Draper A, Cavalet J. Factors Impacting Academic Performance Among Didactic-Year Physician Assistant Students: A Multiprogram Study. Journal of Physician Assistant Education. 2026. 10.1097/JPA.0000000000000800
Comments