HOW DO I BECOME A
          PHYSICIAN ASSISTANT?
             (Information Sheet)

The following websites provide informat...
PLEASE REFERENCE AR 601-20 AND FY 2006 UPDATE BEFORE SENDING PACKET.
             INTERSERVICE PHYSICIAN ASSISTANT PROGRAM...
Puerto Rico or whom English is not their primary
  language)
  # Enlisted applications only                  __X_ TIS Work...
DSN 536-0386, Commercial 502-626-0386, fax: 1431, toll free: 1-800-223-3735, ext 60386,
HQ, USAREC, RCHS-SVD-PA, 1307 Thir...
All Science Courses in Biology, Chemistry, Physics, etc
Mathematics Courses
Physical Education Courses
Business Courses
EM...
3                         2.0                                  8                   5.3
                   4               ...
SUBJECT GPA: _______




                            Other Science Courses
                (Physics, Botany, Nutrition, Ge...
Humanities and Social Sciences
  (Government, Art, Education, Philosophy, History, Languages, Anthropology, Civilization, ...
SUBJECT GPA: _______




                               Graduate Courses
Course Title   Sem Hrs Grade         College     ...
DEPARTMENT OF THE ARMY
                               A DETACHMENT, 18TH PERSONNEL SERVICES
                              ...
14. Application Memorandum
15. MILPO/PSB/PSC Statement
16. Waiver request (s)
17. Security Clearance Memo
18. DA Form 3575...
DEPARTMENT OF THE ARMY
                           HEADQUARTERS, UNITED STATES ARMY RECRUITING COMMAND
                    ...
APPLICATION SUMMARY SHEET
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APPLICATION SUMMARY SHEET

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APPLICATION SUMMARY SHEET

  1. 1. HOW DO I BECOME A PHYSICIAN ASSISTANT? (Information Sheet) The following websites provide information required to apply for the Interservice Physician Assistant Program (IPAP): • The Interservice Physician Assistant Training Program Regulation: AR-601-20, 17 October 2000 www.usapa.army.mil • AMEDD Center and School IPAP Website http://www.cs.amedd.army.mil/ipap/ • Application Deadline:01 March 2006 • Official SAT & Transcripts Due:01 June 2006 Allows applicants to attend Spring semester Point of Contact: CPT James Jones 502-626-0386, DSN 536-0386, or call 1-800-223-3735 ext 60386 email ipap@usarec.army.mil, Fax -1431 PLEASE COMPLETE THE TOP PORTION AND SEND WITH YOUR APPLICATION.
  2. 2. PLEASE REFERENCE AR 601-20 AND FY 2006 UPDATE BEFORE SENDING PACKET. INTERSERVICE PHYSICIAN ASSISTANT PROGRAM (IPAP) APPLICATION SUMMARY SHEET (Keep In Sequence) Name: _________________ SSN: ____________________ Date Rec: ______________________________ Rank:_____MOS: _____/______________________ Prior Svc: Yes No Years in Svc:____________ Compo: AD/USAR- IMA TPU AGR NAAD IRR Waiver(s) Required: No Yes _________________________________________________________________________________________ Left side of Packet Right side of Packet Form/Document Form/Document On top of Tab 1: On top of Tab 5: _____ Summary Sheet *_____ Current Officer Record Brief (ORB) or #_____ Current Enlisted Record Brief (ERB) TAB 1: TAB 5: _____ DA Photo _____ DA 705 (APFT Scorecard) _____ DA 61 (Appointment Application) _____ Profile _____ DA 160 (Active Duty Application) TAB 2: TAB 6: Official Military Personnel File (OMPF) Documents _____ Handwritten Letter of Intent _____ Evaluation Report (OERs and/or NCOERs) _____ Typed Letter of Intent _____ DA 1059 (Academic Evaluation Reports) _____ CV _____ Awards/ Certifications/ Licenses TAB 3: _____ Certificates of Training Letters of Recommendation _____ Immediate Supervisor TAB 7: _____ Commander _____ DD 214 (Release or discharge if you had break _____ Physician Assistant in service or prior service) TAB 4: TAB 8: _____ RCC, Delay Plan Letter _____ Academic Worksheet _____ Waiver Requests (Time in Service, Age, Conviction) _____ SAT Scores _____ Conditional Release (print out of email approval) _____ Transcripts/Diplomas _____ Application Memorandum __X__ UNMC Academic Letter _____ MILPO Statement __X__ GPA Worksheet _____ Security Clearance _____ Physical (DD2807/2808)/ Labs/ Medical Waivers * _____ Appointment Letter * _____ DA 71(Oaths) _____ DA 330 (Language Proficiency) (natives of Guam
  3. 3. Puerto Rico or whom English is not their primary language) # Enlisted applications only __X_ TIS Worksheet * Officer applications only +_____ DA 1058 (USAR) + Reserve applicants only + _____ DA 4651R (USAR) X Completed by USAREC The Interservice Physician Assistant Program is a 2-year program with a year of didactics at Fort Sam Houston, and then a year of clinical rotations at a MEDDAC sized hospital somewhere in the continental United States (CONUS). The program is available to enlisted, warrant officers and officers of all military occupational specialties (MOS) and area of concentrations (AOC). At the completion of the 2-year program the graduate is awarded a Master’s Degree from the University of Nebraska Medical Center. Enlisted and warrant officer graduates are commissioned as 2LT in the Army Medical Specialist Corps, and awarded the AOC 65D. Officers are appointed based on constructive credit calculated in accordance with (IAW) Department of Defense Instruction (DODI) 6000.13 and other appropriate regulations. To be eligible, an applicant must be an active Army component enlisted, officer, or warrant officer, with a minimum of 3 years active service by the date they would report to IPAP. The last class starts in August of each year. A 2006 applicant could apply and have 3 years by the August 2007report date. Commissioned and warrant officers have been approved to apply indefinitely. Applicants with more than eight years active service are required and encouraged to request a waiver for time in service. Those who will be 33 years or older at date of commissioning (enlisted are commissioned on their graduation date) are required and encouraged to submit an age waiver. Enlisted applicants must have a GT of 110. All applicants, regardless of academic level, must have taken the Scholastic Aptitude Test (SAT) within five years of the FY of application and have a minimum score of 1000 on the older version and 1500 on the newer version with a minimum of 450 in each section. All applicants must have 60 semester hours of college credit. 30 "core" semester hours must have been earned at a college or university, or an accredited distance learning course via the internet. MOS, CLEP, DANTES, examination for credit, transfer credit without a letter grade, etc. will not fulfill the 30 "core" semester hours. The 30 “core” courses are: 6 SH from Humanities and/or Social Sciences (see next page for Humanities description) 6 SH Chemistry The 6SH must be “General Chemistry”, “College Chemistry” or higher level (Not intro Chemistries, Environmental Chem., nor Chemistry for Non-Health Science Majors) 6 SH English (3 SH must focus on composition) 6 SH Human Anatomy and Physiology (3 anatomy, 3 physiology or 3 A+P I, 3 A+P II) 3 SH College Algebra or higher (not prep algebra), Statistics is accepted 3 SH Psychology (any) The application deadline is 1 March 2006. Official transcripts and official SAT results will be accepted until 1 June 2006. No other documents will be accepted after 1 March 2006. This permits additional time for applicants to complete courses. The board reviews eligible applications in mid-July. Results are published on the Army Human Resource Command (AHRC) MILPER message site in late September. All information required to apply is found in the FY 2006 message update to AR 601-20 at this site http://www.cs.amedd.army.mil/ipap/ or AR 601-20 available at www.usapa.army.mil. POC for Active Army or Army Reserve is: Captain James J. Jones, PA-C Email ipap@usarec.army.mil
  4. 4. DSN 536-0386, Commercial 502-626-0386, fax: 1431, toll free: 1-800-223-3735, ext 60386, HQ, USAREC, RCHS-SVD-PA, 1307 Third Ave, Fort Knox, KY 40121-2726 For information on the Interservice Physician Assistant Program (IPAP) to http://www.cs.amedd.army.mil/ipap or http://www.armypa.info USAR applicants must be enlisted. Officers in the Reserves are not eligible for the Reserves, but may apply for an Active duty slot. USAR applications must be in compliance with the FY 2006 USAR IPAP Message. For NG applications contact the program manager at 703-607-7306, DSN: 327-7306 FAX: xxx-7385 NEW 2006!—Requirements Completion Course. You could be given the opportunity to complete your needed coursework at Fort Sam Houston and ultimately attend IPAP. See the FY 06 message for details! ACADEMIC DELAY You want to apply but won’t have your course work completed by 1 June 2006. You may still be able to apply if you have 15 or less prerequisite semester hours to complete. Applicants who meet all academic and eligibility criteria, except for 15 or less semester hours, may still apply to the 2006 board. They must meet the 1 March 2006 application deadline except for official transcripts of courses in progress. Academic delay applicants will be boarded separate of fully qualified applicants and may be selected as alternates if the board determines the applicant shows potential. The delays will be placed on an order-of-merit-list (OML). Alternates from the primary board will have precedence over academic delays. However, academic delays will be utilized after primary alternates are exhausted. The top sequenced alternate, who has completed all prerequisites and maintained eligibility, will be activated when an alternate is needed. If the alternate in the top spot has not provided official transcripts verifying completion of prerequisite courses, with a letter grade of “C” or better, the next academic delay that has completed the course work will be activated. HUMANITIES REQUIREMENTS Total 6 Semester Hours to fulfill the Humanities/Social Sciences prerequisites. UNMC will accept: All History Courses All U.S. Government/Political Science Courses All Psychology/sociology/Anthropology Courses All English/Literature Courses(Above the required 6SH needed for English) Speech Art Courses Music Courses Language Courses Ethics Courses Philosophy Courses UNMC does not consider the following courses humanities/social sciences:
  5. 5. All Science Courses in Biology, Chemistry, Physics, etc Mathematics Courses Physical Education Courses Business Courses EMT or LPN Courses Any Sciences such as Medical Tech, Nursing, etc. Most courses taken in the military will not fall into the Humanities/Social Sciences umbrella with the exception of military history. US Army Recruiting Command Interservice Physician Assistant Program (IPAP) Academic Worksheet ____________________________________ ______________ ____________ Last Name, First Name, Middle Initial SSN MOS / AOC ___________________________ ________________________ Other names listed on transcripts Date completed Part I. List all colleges and universities attended and the dates of attendance (semester and year, e.g. Fall 1996) Must have an official transcript from each institution forwarded to USAREC prior to application deadline. College / University and Location Dates of Attendance Total Number of Credits Degree Granted Part II. List all course work currently in progress. College / University and Location Course in Progress Anticipated date of completion Part III. List all courses attempted, including those failed, under the appropriate heading. List the semester hours (Sem Hrs) of each course. Quarter (QTR) hours should be converted to semester hours according to the following scale: QTR Hours SEM Hours QTR Hours SEM Hours 1 .7 6 4.0 2 1.3 7 4.7
  6. 6. 3 2.0 8 5.3 4 2.7 9 6.0 5 3.3 Technical courses such as typing, welding and courses taken for certification (Emergency Medical Technician or Licensed Practical Nursing) are not accepted. Do not list these courses. List additional courses on a continuation sheet if the sections do not provide sufficient space. English and Literature Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY SUBJECT GPA: _______ Biological Sciences (Anatomy & Physiology, Biology, Microbiology, Genetics, Immunology, etc.) Course Title Sem Hrs / Grade College Date Completed USAREC (Semester & Yr) USE ONLY SUBJECT GPA: _______ Chemistry Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY
  7. 7. SUBJECT GPA: _______ Other Science Courses (Physics, Botany, Nutrition, Geology, Geography, Astronomy, etc) Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY SUBJECT GPA: _______ Mathematics Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY SUBJECT GPA: _______ Psychology Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY SUBJECT GPA: _______
  8. 8. Humanities and Social Sciences (Government, Art, Education, Philosophy, History, Languages, Anthropology, Civilization, Music, Speech, Ethics, etc.) Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY SUBJECT GPA: _______ Other Courses (Business, Economics, Law, Computer Sciences, CLEP, DANTES, etc.) Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY
  9. 9. SUBJECT GPA: _______ Graduate Courses Course Title Sem Hrs Grade College Date Completed USAREC (Semester & Yr) USE ONLY
  10. 10. DEPARTMENT OF THE ARMY A DETACHMENT, 18TH PERSONNEL SERVICES BATTALION FORT BRAGG, NORTH CAROLINA 28310 REPLY TO ATTENTION OF: A DETACHMENT, 18TH PERSONNEL SERVICES BATTALION FORT BRAGG, NORTH CAROLINA 28310 AFZA-SG-PDA 01 January 2005 MEMORANDUM FOR Commander, USAREC, RCHS-SVD, 1307 Third Avenue, Fort Knox, KY 40121-2726 SUBJECT: MILPER/PSB/PSC Verification of Applicant’s Eligibility for the Interservice Physician Assistant Program for SSG Smith, Jane Q., 123-45-6789. 1. A review of the applicant’s application packet and personnel records confirms eligibility in terms of course prerequisites outlined in AR 601-20, paragraph 6. 2. A local records check has been made and the applicant is administratively qualified for appointment as a Commissioned Officer in accordance with AR 135-100 and AR 135-101 and/or has prepared the necessary request(s) for waivers. 3. The applicant does not have any pending UCMJ action, bar to reenlistment and is not flagged. 4. There is evidence of a security clearance of secret based upon a National Agency Check, which includes the date the clearance was granted. 5. This action is not in contravention to AR 600-8-2. 6. POC is the undersigned at DSN 123-4567 20 Encls 1. Official DA Photo 2. DA Form 705 JOHN B DOE 3. Letter of Intent MAJ, AG 4. Curriculum Vitae Personnel Authority 5. Letters of Recommendation (3) 6. Academic Worksheet 7. DA Form 61 8. 2A 9. 2-1 10. ERB 11. DA Form 1059 12. Microfiche 13. DD Form 214
  11. 11. 14. Application Memorandum 15. MILPO/PSB/PSC Statement 16. Waiver request (s) 17. Security Clearance Memo 18. DA Form 3575 19. DD 2808/2807-1 Certified True Copy or Original Physical Exam 20. Conditional Release
  12. 12. DEPARTMENT OF THE ARMY HEADQUARTERS, UNITED STATES ARMY RECRUITING COMMAND FORT KNOX, KENTUCKY 40121-2726 REPLY TO ATTENTION OF: ABCD-EFG 15 January 2006 MEMORANDUM FOR COMMANDER, HQ USAREC ATTN: RCHS-SVD-PA 1307 Third Avenue, Fort Knox, KY 40121-2726 FOR Staff Sergeant Jane Q Doe, SSN 123-45-6789, U.S. Army Medical Department Activity, Fort Jackson, SC 29207 SUBJECT: Interservice Physician Assistant Program Application Time in Service Waiver Request 1. In accordance with AR 601-20, AR 135-100 and AR 135-101 I request a waiver for time in service. I will have 8 years of service effective (enter date). Please consider this waiver so that I may be considered to attend the Interservice Physician Assistant Program . My basic active service date (BASD) is 01 November 1998. I will have 8 years 2 months as of 1 January 2007.. 3. I can be reached at the following address: 1234 Main St, Hometown, US 12345; DSN 123-4567, commercial (123) 456-7890, or e-mail JaneQDoe@us.army.mil. JANE Q DOE SSG, USA Combat Medic

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