Central Application Service for Physician Assistants 20-Year Data Report 2002 to 2021

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INTRODUCTION: This study provides a 20-year analysis (2002-2021) of the Central Application Service for Physician Assistants, extending earlier reports to assess long-term trends in PA admissions. Central Application Service for Physician Assistants participation rose from 51% of programs in 2002 to nearly universal adoption by 2021. Applicant numbers increased 5-fold, reaching 28,445 in 2021, while matriculants grew from 3715 in 2007 to 11,178 in 2021. Despite growth in available seats, matriculation rates declined, fluctuating between 31% and 41%. METHODS: Central Application Service for Physician Assistants data from 2002 to 2021 were used to examine trends in applicant behavior, academic metrics, demographics, and experience. Outcomes included program participation, applicant and matriculant counts, and matriculation rates. Explanatory factors included program designations, mean overall and science grade point averages (GPAs), age, gender, race/ethnicity, first-generation and economically disadvantaged status, and shadowing and patient care experience. RESULTS: Applicant behavior and academic metrics shifted. Average program designations increased and each additional designation up to 13 improved matriculation odds. Mean overall and science GPAs rose steadily. Asian and Hispanic/Latino(a) representation increased, while proportions of Black/African American, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander applicants and matriculants remained low; White applicants continued to matriculate at disproportionately higher rates. First-generation and economically disadvantaged applicants increased but were less likely to matriculate. Most applicants reported shadowing and patient care experience, associated with higher matriculation. DISCUSSION: Findings demonstrate sustained growth in PA education but slow advancement toward racial, ethnic, and economic diversity, underscoring the need for more equitable admissions strategies.