Choosing the Right Physician Assistant School
By December of 2012, there were 168 PA programs nationwide. At the update of this article, there are currently 196 ARC-PA accredited accredited programs listed in the PAEA program directory, 8 of which are on probation, and 22 currently in development.
It’s up to you to decide which program you will graduate from, but there are several characteristics you might use to help you decide between programs, especially when programs have so much similarity in what they offer.
I suggest you use the PAEA program directory as a guide to help you search for schools in your area or state. Some students have found that the most reliable way to search for programs was to go through the CASPA website directly, but not all programs participate in CASPA. They have a page of all participating programs, here. It includes the direct links to the individual program websites, each program's application deadline, and whether or not each program requires a supplemental application and the respective costs. Other students have used PAed.com because you can search by area and see a list of prerequisites before even going to the school website.
-Narrow your schools down by where you wouldn’t mind living during and after PA school
-See what schools in those states/areas you meet admission criteria for
-Check out each program based on criteria below
-Visit programs, information sessions, talk with faculty and current or past students; see if they match with your expectations and standards
-Do your own homework (i.e. read more on their website) and narrow your result down further, consulting friends and family for advice where needed
Choosing your PA program fit isn’t meant to be a last minute ordeal. You should have done plenty of research to ensure you are applying to appropriate programs, otherwise you will just be wasting your money applying to schools you aren’t really interested in or don’t have a shot at admission to. Emphasis placed on saving money here! Please note that the information in the following categories is from the 29th Annual PAEA Report, which surveyed 171 PA programs during the 2012-2013 academic year.
Community Programs vs. University Associated Programs
The majority of PA programs are universities, whereas 4% are associate level colleges. 36.5% of programs surveyed by PAEA claim their sponsoring institution is an academic health center (AHC). 16.7% of programs claim to be associated with a medical center or medical school, while 4.8% are centered around a health professional school. If you attend a community PA program not associated with a medical school, chances are you will still get a fantastic education, but you probably won’t interact with medical/pharmacy/physical/occupational therapy students at all until clinical rotations. At major medical schools, where allied health programs exist, interaction among allied health students will probably be more prominent in classes like anatomy, physiology, or neuroscience and again in rotations. At other programs, namely the University of Iowa, integration of allied health students and PA students is provided in most courses. Students learn, study, and test together and are scored evenly against one another. It can be to your advantage to interact with these people because you’ll be working with people just like them in an everyday setting.
Degree Requirements and Preprofessional Degree Programs:
According to the 29th PAEA annual report, 1.2% of PA programs offer associate level degrees, 2.9% (5 programs) offer certificates, 3.5% offer baccalaureate degrees, 92.4% offer master’s level degrees.
Since the year 2000, there has been a rapid shift toward master’s level degrees (from 43% to about 92%). As far as admission goes, 86.9% of master’s degree programs require at least a baccalaureate degree. 60% of associate’s degree programs do not require any degree for admission, while 78.3% of baccalaureate degree programs do not require a degree for admission. Only 10.9% of master’s degree programs do not require a degree for admission. A few examples of master’s programs that do not require bachelor’s degrees are Touro College’s Manhattan and Bay Shore PA programs, where they require 90 hours of credit in lieu of a degree. Drexel University, Texas Tech University, Pacific University Oregon, and the University of Oklahoma - Tulsa are other programs with similar requirements.
According to the report, 6 (2.8%) PA programs award both a bachelor’s and a master’s degree upon completion and are called preprofessional degree programs because they prepare you for a master’s level PA program. As of 08/08/2015, there are currently 43 PA programs like this, but I will only list a few. DeSales University has a 5 year bachelor’s to master’s degree option, but you must enter directly from high school. Seton Hill University offers a BS/MSPA with a bachelor of science in biology and a Master of Science in PA in 6 years. Rochester Institute of Technology offers a 5 year BS degree transitioning into a MS degree. Le Moyne College and University of Detroit Mercy (Michigan) offer students a 3+2 accelerated track leading to BS/MS. It is very common for current and past PA students to be confused about the purpose of these “5- or 6-year” PA programs. Many “traditional” PA students criticize these programs before they understand their role, so just be aware of that when asking students about them. It would be best to get advice or opinions from the program directors, faculty, or students of the program you are interested in. This is a huge decision to make early on (as early as high school), so I recommend trying to shadow a PA/physician/NP before deciding what route is best for you, or check out this article.
Certificate programs are also available as an option, as you are not required to obtain a master’s degree to become a certified physician assistant (PA-C) until 2020. The only current requirement is that you pass the PANCE. According to the report, 2.9% (5 programs) offer a certificate of completion. St. John’s University is one example of a PA program that offers a certificate program for people possessing a bachelor’s degree - this is a 2-year certificate program. Anne Arundel Community College is another program offering a 25 month certificate program. Unfortunately, certificate programs are being weeded out by the move to improve educational standards and more PAs and PA programs are choosing to deal away with them.
Online/Distance PA Programs:
Online (better named Distance) PA programs, are among the few and extremely competitive, requiring you to have lots of intense hands on experience prior to admission. Please read more about online, distance, and post-graduate online PA programs in this article, which may help clarify some of the newest information.
Research Based Program:
The current PAEA report did not include the percentage of programs offering research, but the last known percentage was around 30%, which is surprisingly less than I would imagine. While most master’s programs require some form of research as part of your master’s project, it may or may not be the research you might have done in undergraduate studies. Some PAs continue research after school with their supervising physician(s) and if this is something you’re interested in, you should seek opportunities to rotate with physicians who do research.
Gender, State, Veteran Bias:
If you’re suddenly feeling a bit overwhelmed by all of the female PA applicants out there, you’re not alone. On average, 71.9% of PA programs surveyed in 29th annual report were female, while 28.1% were male. Men are definitely outnumbered in this profession. These percentages don’t necessarily mean that programs are accepting more women than men, but rather, they reflect the population of people that are applying. This just simply means that more women apply to PA school than men. In my opinion, many programs embrace diversity and are looking to increase the percentage of male students in their programs.
Only 1 PA program is military based (IPAP) out of 171 programs surveyed, according to PAEA’s 29th annual survey. Rumor is that the University of North Carolina in Chapel Hill will begin a PA program in 2015 for veteran medics.
A few programs have state bias, meaning they prefer students from their home state before accepting students from out of state. This has a lot to do with funding. States give schools funding in return for graduates that will return on their investment, i.e. add to the state workforce in primary care, etc. One such program I personally interviewed at that maintains state bias is the University of Texas Medical Branch.
Reputation and ARC-PA Accreditation:
So your program is old, or new? The advantages of newer programs are that they’re usually cheaper when they first open. Disadvantages are that you are a guinea pig and you have no idea what to expect from the program. Newer programs have no PANCE records and you will have to wait until testing time to figure out whether the odds were truly in your favor or not. Newer programs can also have new professors and faculty, new curriculum with constantly changing structure, problems finding good rotation sites, and have no alumni support. One important fact to be aware of is that as long as the new program has provisional accreditation status when you matriculate, you will still be able to take the PANCE at the end of your program, regardless of whether they are granted full accreditation or put on probation. From Figure 3b we notice that there have been 2 peaks of new program enrollment between 1970-73 and 1995-2000. Since 2009, it shows that we might be in the middle of yet another peak in new PA programs.
Reputation can sometimes be more than just about being new, though. Sometimes accreditation can be lost for a number of reasons and it’s up to you to decide whether it is worth applying to programs that have lost accreditation and for what reasons they lost it. Currently, there are 8 out of 196 programs that are on accreditation-probation. “Probation is an active accreditation status and those entering a program that is on probation are entering a program that is ‘accredited.’ If the program remains on probation or is removed from probation and granted full accreditation by the time of your graduation, you would be graduating from an accredited program...in order to be eligible to take the PANCE, students must successfully complete a program that was accredited at the time the student matriculated.” (ARC-PA FAQ). This means that even while attending programs on probation, you can still sit for the PANCE. They can even lose their accreditation while you are in your program, just not before you matriculate. It can hurt your chances of gaining licensure and practice in some states. Many residency programs also require graduation from an accredited program.
If you want to know about when programs were first accredited, or when their next ARC-PA review is, check the ARC-PA website here. Otherwise, information about provisional, probationary, and accreditation status can be found on PAEA’s program directory.
According to the 29th annual report, the average length of PA programs is currently 26.4 months. The range was between 21-36 months in the 2012-2013 academic year. The average didactic phase length was 58.8 weeks and the average clinical phase length was 54.1 weeks. The mean total program length was 124.5 weeks (or 28.8 months), including holidays. There is no right or wrong answer to choosing an “appropriate” program length for yourself. There are several reasons you might choose a longer program over a shorter one: lack of clinical experience (maybe your program offers longer clinical rotations), you want to spread out your didactic education, you want more time off (holidays). Other folks might choose shorter programs simply to finish sooner or because they want to start a surgical residency, etc.
Full-time vs. Part Time:
Whether you’re looking for part time or full time PA programs, its helpful to know what your options are. There are currently still only 3 programs offering part time according to the PAEA program directory: Drexel University, Rutgers University, and the University of Detroit Mercy.
Program Start and End Months:
Most programs begin between the months of May and September, with 32% having start dates in August. The most common end months are May (24.8%), August (29.3%), and December (24.2%), which hasn’t changed much from the last report. The importance of these dates can have harboring effects on your family and moving situations if you are out of state applicants. For example, when I was accepted to a school in Boston that began in January, it would have been extremely difficult for me to travel there during late December/early January and move all of my stuff in the worst possible weather. This is something to consider before applying.
PA Program Budgets:
PA program expenses can be difficult to come by, especially at information sessions and interviews, but they are especially helpful in discerning what type of program you will be attending. For example, you might want to know what percent of the budget provides support for student travel for clinical training, if any. You might also want to know what percentage of the budget goes into your education (i.e. instructional equipment and technology).
Overall Program Cost:
The average resident tuition (in state) in 2013 was $61,489, while the average non-resident (out of state) tuition was $71,184. Incidental costs are total costs incurred by students during their PA programs and includes anything but tuition. This could be transportation, living, food, textbooks, diagnostic equipment, computers, etc. The average total incidental cost per student was $5,106.
Public vs. Private Programs:
Today, 62.5% of PA programs are private, while only 35.6% are public. The average resident tuition (in state) for public institutions was $38,794 and was $74,426 for private institutions. Non-resident (out of state) costs between public and private institutions do not vary greatly, with the average non resident tuition at $68,311 and resident tuition at $74,523. Incidental costs between public ($5,937) and private ($4,672) were about the same.
Student to Faculty Ratio and Class Size:
On average, in 2013, the student to faculty ratio was 17.8 for the 2010-2011 academic year. This is an important factor to consider in your decision for a PA program, as more 1-on-1 time will be available to you at your exposure if you have a lower SFR. This number was calculated by dividing the total number of enrollees by the total number of core faculty FTE.
In 2013, the average enrollment for first-year class size was 47 students. Make sure you choose an appropriately sized program. If a small class size is important to you, then don’t pick a school like the University of Texas Medical Branch that accepts around 90 applicants annually or the University of North Texas that accepts around 73 candidates per year. Programs like the University of Wisconsin La Crosse accepts around 19 candidates per year.
Faculty and Student Opinion:
In 2001, a survey of 95 PA faculty was conducted by Dr. Blessing and colleagues to assess factors important to school rankings. The 95 directors strongly agreed that faculty to student ratio was important. Other important factors included faculty educational level, faculty in clinical practice, length of faculty clinical experience, and teaching or publishing awards by faculty. One item opposed by faculty was the number of faculty in tenure tracks. Currently, approximately 20.9% of faculty are on a tenure track, while another 12.7% are already tenured. More than 71.1% of faculty members have a Master’s degree, whereas 22.1% have a doctoral degree (including MDs). A whopping 77.1% of faculty members are PAs.
49% of faculty performed clinical work in the 2012-2013 academic year at an average of 9.3 hours per week. Student opinion can mean a great deal to you, for newer and older programs alike. You may inquire about quality or availability of rotation sites, traffic, living costs, weather, faculty accessibility, program reputation, mentorship programs, study groups, student run clinics, cadaver labs, PANCE preparation, available scholarship funding, and the quality of assessment skills.
Health Care Experience (HCE) and Prerequisite Requirements:
In 2011, PA programs surveyed were asked select prerequisites from a list of common science courses. Physiology (91%), general chemistry (90%), anatomy (87%), microbiology (80%), and biology (70%), statistics (63%), organic chemistry (55%), biochemistry (39%), algebra/calculus (37%), and genetics (19%) were the most important. If you’re wondering at all what they are looking for, these courses might give you a hint. Additionally, some programs want all prerequisites completed by December 31st of the year you apply, others want them completed by the time you submit your CASPA, and even others allow you to have a few courses in progress. A few schools will interview you and accept you with contingency status - meaning you have conditional acceptance based on the grades you will submit for courses you have not yet finished.
In 2011, 46% of programs required applicants to have prior health care experience, while 14% did not require any. 40% “prefer,” but do not require applicants to have prior health care experience. Schools range from preferences of 0 to over 2000 hours of HCE. If you don’t have a ton to offer, you might seek programs that accept students with less direct HCE than others. In 2013, 94% of responding programs reported their students accrued patient contact experience and only 21.2% said they had accrued research experience.
If your GPA is less than a 3.0, have no fear! There are PA programs that accept students with GPAs less than 3.0. A helpful student named Matt recently put together a list of those schools, here. Some schools weigh heavily the last 45-60 credit hours, but it is useful to check with the programs you are applying to to see what their requirements are.
There are currently 129 PA programs requiring the GRE for admission. 153 out of 196 PA programs accept international applicants. Scores for the GRE and TOEFL are used as indicators for success in PA school, although most programs do not weigh them too heavily and they are a small fraction of the admissions process. Generally, GRE scores above the 50 percentile are considered competitive for PA school. The fact is, if you struggle with this standardized test, what does that say to schools about your performance on the PANCE?
There really is not an advantage to programs that require these tests versus programs that do not. There are plenty of good and bad programs that require them and do not require them, so GRE and TOEFL requirements are not good indicators of good schools per se.
Interviews may not be your thing. If not, have no fear. In 2011, only 95.2% of PA programs surveyed required interviews, which means there are 4.8% of programs that don’t require them.
Background Check and Mandatory Drug Testing
82.8% of programs require students to have a background check upon matriculation, while 78.7% require drug testing.
Graduation and Attrition Rate:
The average graduating class in 2013 had 41.5 (93.5%) graduates with 1.5 (3.4%) students withdrawn. 71% of 95 PA faculty surveyed in 2001 agreed that student attrition rate for the past 5 years should be accounted for in PA program rankings. While this data is available individually on a per annual basis, it has not been compiled as a composite value.
More male students withdraw (4.6%) than female students (2.9%). The most common reason for withdrawal in 2011 was academics (61%), followed by other personal reasons (27%), career change (9%), financial reasons (3%), and medical school (0%). Instead, it is at the will of individual programs to post their attrition rates on their websites or in information sessions. Some students have claimed that attrition rate is one of the highest components you should consider in what schools you apply to. A high attrition rate could be indicative of poor admissions standards or poor curriculum/faculty. In this article on PA Student Essentials, I write about transparency from PA programs about attrition.
Program Rigor, Curriculum, and Failure Policy:
Program rigor can be determined by a variety of factors, so there isn’t a direct answer to this component. Exam difficulty, study time, comprehensive testing, PANCE preparation, PANCE pass rates are all components you might consider part of program rigor. You could start by asking students in the program about their experiences with each of these and draw your own comparisons. You want a program that isn’t terribly difficult to get through, so that you’re not miserable, but you want it to be challenging enough to ensure you’ll pass your PANCE. Everyone will have a unique experience in PA school because it all depends on your background in your prerequisites.
Curriculum is an entirely other ballpark. Although it can contribute to program rigor, this is where you might variation between programs. For example, some programs lack pathophysiology, however, this can sometimes be integrated into other coursework like clinical medicine. In essence, you’ll want to focus less on what subject matter is taught and instead on how it is taught. Names might be interchanged between programs, but accredited programs will teach the same subjects to get you to pass your PANCE. According to ARC-PA’s accreditation standards (page 13), programs are directed to teach specific topics, but are free to structure them how they see fit.
Some programs emphasize “self directed learning.” If you don’t know what this is, it is essentially student directed learning. Traditional students learn using PowerPoints and lectures. Other programs teach using “organ” based learning or “system” based learning, collaborative or “team” based learning, traditional or “case” based learning, “asynchronous” learning, or “problem” based learning. For example, in system based learning, you learn everything you need to know about each system and then move on (e.g. cardio, ob/gyn, etc.) There are many methodologies for teaching available, even some I have not listed, but finding the right learning style for you matters significantly.
Failure policies can vary from program to program. It is best to check with your individual programs on what the policies are. Some are more strict than others. For example, some programs require you to make grades of 85 and above on every exam. If you do not, it is considered failing, and you might be allowed to fail one exam the entire program before you are put on probation or asked to withdraw from the program. Other programs curve grades based on class averages and some throw out bad questions when students perform poorly on them.
Program Emphasis and Values:
Whether you attend a primary care or a surgical focused PA program, you will never need further certification to practice in any specialty you wish. Say you attended a primary care program, but now you decide you want to become a surgical PA. You can either find a supervising physician willing to train you, or elect to attend a surgical residency (although not necessary) or fellowship. There are a few surgical focused PA programs out there including the University of Alabama in Birmingham and Cornell University in New York. The idea is that you still take the same board exam as every other PA (the PANCE), but you come out of PA school more equipped for surgery (by having more specialty training in surgical rotations). Some programs may place emphasis on integrative medicine, such as Duke University. In the Integrative Medicine Unit, practitioners at Duke share information about their specialty, types of patients to refer, services offered, etc. from specialties like accupressure, accupuncture, ayurveda, and massage. The University of North Texas in Fort Worth, Texas, is known for its osteopathic or alternative medicine emphasis. The University of Colorado - Denver has long been known for its focus in pediatrics. Other unique programs, like Marywood University allow you to specialize in your clinical year in either emergency medicine, orthopedics/sports medicine, pediatrics, hospitalist, or general surgery. While most programs will place emphasis in primary care or underserved areas, it will be up to you to decide what program emphasis is best for your needs. Keep in mind that primary care and underserved areas doesn’t necessarily mean practicing in rural areas. You can practice primary care for an underserved population in a metropolitan area. However, if primary care is what you are looking for, schools like the University of Nebraska with a 12 week primary care rotation might be what you want.
The values of each school may also vary and you’ll want to ensure that these align with your values and goals in life. If they aren’t a match, it could potentially be problematic later on down the road. Read over the program's website and get a feel for the school. Read their mission statement and decide if the program is a right “fit” for you. The only way to tell if a program is the right one is to put in the work yourself and do the research. When you go to information sessions, take notes. Jot down things admissions personnel say and take it home with you and look it over. If you have second thoughts about a school, then don’t submit your supplemental applications or withdraw your application completely.
Quality of Clinical Skills:
Clinical skills can vary from program to program. This is definitely something you’ll want to consider in each program. When you graduate, your supervising physician will teach you what you need to know specific to his or her specialty, but other skills you may be expected to know. Common clinical skills taught at programs (not all) are suturing, physical exam skills, intubation, chest tubes, IV insertion, ACLS, simple codes, PALS, splinting, wound care, joint injections, phlebotomy, casting, biopsies, lumbar punctures, and ultrasound imaging.
Prosection vs. Dissection Cadaver Labs
Prosection refers to cadavers that have previously been dissected by another individual. This is usually a professor, a medical student, an allied health student, or an upper class PA student. Full dissection cadaver labs are sometimes offered where you are the primary investigator and are allowed to dissect the cadaver yourself or in a team. Other programs won’t offer either. Instead, some programs offer technological resources, such as computerized cadavers that you view along a glass computer screen or anatomy courses online. Programs with full dissection have been scrutinized for “wasting valuable time” because of the time it takes PA students to perform such dissections. However, many students find full dissections very useful and often perform better on anatomy exams. Prosection may provide more time in PA school for other learning, but it might not give you the spatial relationships you need for anatomical organs. Most PA students say that this factor was definitely one of the “deal breaking” components when choosing a school.
Location, Resources, and Facilities:
Location can be difficult to decide between as there are lots of factors to consider. Do you want to live close to home? Do you like large metropolitan areas or small towns? Do you want to attend a program close to a medical school or lots of health centers? Would you need to commute to school? Do you have a strong family or support base nearby? Is the program in a state you would be willing to work in after graduation? After considering many of these questions, you might find that other characteristics of school weigh heavier than these. This is because the quality of a PA program should weigh much more than the location. Regardless of the location or any other excuse you can come up with, the quality of the program defines what type of graduate you will become afterward. Subsequently, what type of employer will hire you afterward depends on where you go to school. Choose a quality PA program over the location, please. Do yourself the favor. Several PAs have made this decision and have even moved their families over 2,000 miles across the country to do so.
Resources and facilities should be taken on a case by case basis. You should make your own assessments of the quality and quantity of libraries, guest lecturers, study rooms, recording technology, dummies, cadaver labs, simulation labs, student run clinics, lecture halls, simulated encounters with actors, nearby food courts, gyms and any other resources you see conducive to learning. You should also consider your access to those resources and what times they offer (e.g. 7 AM - 11 PM).
Availability and Location of Clinicals and/or Preceptorships:
Personally, I think the quality of the rotations is a huge aspect of choosing your program, but admissions won’t come right out and say their rotation sites aren’t very good. You’ll have to dig deeper and ask students (lots of them) to get a good feel for how they really are. You might want to ask questions like, are lots of the clinical sites located far from campus? Are you required to relocate for clinical rotations? Are you required to set up any of your own rotations? Does the program offer short term housing options? Most clinical rotations last between 4-8 weeks each, and some programs offer elective rotations where you have the option to choose where you want to go. You might also want to know about the quality of these rotations and if your school has a database containing surveys from prior students about each one. These types of tips can be very helpful in choosing a program as many PAs say that the quality of rotation sites is key to jobs.
Some programs claim to end clinical rotations with a preceptorship. Preceptorships are essentially just extended rotations. For example, you might do 6 5-week rotations followed by 2 12-week rotations (preceptorship). Other programs might have you start with a four month family practice preceptorship, followed by one month rotations in other areas.
Dress Code & Attendance Requirements:
Some programs require a dress code while others do not. This can range from business casual, white coat, scrubs, “casual wear,” to no requirement at all. Some students at programs where there is no dress code requirement at all complain that some students wear clothing that is highly inappropriate for school, especially graduate education. Most programs advise against athletic wear, flip flops, and pajamas. If comfort at school is important to you, this is something you might consider looking into.
While most medical schools don’t make a fuss about attendance, almost all PA programs require attendance in lecture and laboratory. The majority of programs hold class Monday through Friday from 8:00 AM to 5:00 PM, but reports of class outside this time are not uncommon.
PANCE Pass Rates & Program National Ranking:
In a study conducted by Dr. Blessing on 95 PA faculty in the year 2001, 86% believed the overall PANCE pass rate was significant for program rankings, while 84% believed the 5-year average PANCE pass rate was important. While a score of 350 out of 800 on the PANCE exam is required to pass, most students won’t score above a 700. First time PANCE pass rates are probably more important than 5-year or overall averages, because anything could have happened in the last 5 years, 10, or 15 years, including change of directors or faculty, etc. Additionally, each year is dependent upon the quality of the students matriculating, so scores can vary. PANCE rates are ultimately what determine if you become a PA, so weigh these pretty heavily in your list.
Program national rankings by U.S. News & World Report can be found online, here, although they are conducted periodically and the last one available is from 2015. Their methodology is also highly debated and has been criticized by many PAs and programs as not being a good indicator for program success. Also, USN&WR only surveys master level programs and some of the best programs might offer certificate, associate, or bachelor level degrees. Other people, such as Rhee et al. have proposed new methods for ranking PA programs.
Overall, be careful in choosing a school and listen closely as you attend information sessions or interviews. Take time to get to know yourself before applying, visiting, and interviewing. The closest school, the cheapest, or the easiest route may not be the best fit for you. There is no number of PA schools you should shoot for, although cost will end up limiting you in the end.
My stats: Ultimately, I applied for about 15 by end of July and I received interviews for about 12 of them by December. Two of which I never finished my supplemental applications and didn’t submit transcripts to 1 because of program costs. Of the 12 I received interviews at, I only attended 4 interviews and I was accepted at 3 and waitlisted at 1.
Read this article to help determine whether you are a PA competitive applicant or not. Best of luck applying!
An Investigation of Potential Criteria for Ranking PA Programs (Blessing et al., 2001)
Predictive Modeling the Physician Assistant Supply: 2010-2025 (Hooker et al., 2011)
A Novel Approach to Ranking Physician Assistant Programs (Rhee et al., 2010)
27th PAEA Annual Report, 2010-2011 (Physician Assistant Education Association) http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/149930