TAPA 2013 Video Interview #4

Here's an interview I did with a PA-C working in Hormone Replacement Therapy. 

TAPA 2013 Video Interview #3

Here's an interview with Jack Runyan PA-C, PhD. He is faculty at UT Pan America, a Physician Assistant since 1977, and founder of Mercy Trips non profit healthcare outreach organization.

TAPA 2013 Video Interview #2

Here's an interview with a PA-S from UTMB

TAPA 2013 Video Interview #1

Here's the first of several video interviews I did at this year's TAPA conference. Eric Martinez is working with TAPA and recently completed his EM residency at BCM.

End of Didactic Interview

Here are some quick thoughts from a PA student who is wrapping up the didactic portion of her program and moving into clinical rotations!

1) Tell me about your PA school experience thus far. (ups and downs, was it overwhelming, what surprised you, etc)

Overwhelming is an understatement, but there have definitely been more ups than downs. There's more work and studying in PA school than I would have ever imagined, but the entire experience of PA school is what you make of it. I've enjoyed my experience in school so much because despite having to work so hard, I've always allowed myself to have time set aside for fun, friends, and family - this is something that I highly suggest. If you are always studying and never give yourself a break, the stresses of school will really get to you. Also, no matter how hard it gets or how badly you wish you weren't studying at the moment, always be thankful that you're in the program because there's a lot of people who would rather be in your place!

2) What was your favorite unit/section/class?

My favorite section is clinical skills. Its the class where you learn all of the basic clinical procedures like sutures, IV placement, and foley catheters. This was my favorite because it's hands-on learning and is a sign that you're almost at the end of your didactic portion. Also, learning the procedures is just fun.

3) How did your study techniques evolve during your time in the didactic phase? What worked best and what didn't work?

Group studying helps out a lot, especially when you're teaching others. It's great because in order to teach someone, you really have to know the material well. However, everyone in the group must study individually before the group study session in order to be efficient. This has worked out well for me throughout the entire didactic phase, and worked for a lot of other people as well.

4) Which clinical are you looking forward to the most? What about that one excites you?

The rotation that I am most excited for is orthopedic surgery! The orthopedics block was really interesting and I really enjoyed surgery when I was shadowing, so naturally this would be the one I'm most excited about. Plus surgery is nothing like the other clinical rotations - the process of manually fixing the body is fascinating!

First Month of PA School

Here's an interview with a PA-S 

1) How did you prepare for the start of PA school?

Honestly, I didn't really prepare. I had 2-3 weeks between undergraduate graduation and the beginning of PA school so I milked out those 2-3 weeks. I crammed in as many movies as I could while I packed for New Mexico! I just tried relax and enjoy as much time as I could with friends and family.

2) What has been the most interesting thing you have learned so far? What has been the hardest?

We have a class called Clinical Assessment and right away we're learning how to take a history and do a physical exam. We also do case studies every week where we learn about different conditions write a full SOAP note and we have to figure out what to prescribe to them. I feel like we've been pushed into the deep end of the pool, but it's really interesting and useful information! 

The hardest thing so far for me is just accepting that I'm not going to know everything. We are taking 22 credit hours of graduate level work and between anatomy, physiology, clinical assessment, a research course, and a professionalism course, there is an overwhelming amount of information we are learning about. No matter how much you study, there is no possible way to retain all of that information without losing sleep (and I definitely need my sleep!). I've recently learned to focus my studies on the material that's emphasized during lecture, then if I have extra time go back and study the rest of the chapter. It's really easy to get behind in other classes if you devote too much time to another class, so it's also a huge juggling act. 

Also, my anatomy teacher "pimps" students during lab so it's kind of terrifying, especially when you don't know the answer. Getting used to this method of teaching was an adjustment, but I really appreciate the one-on-one attention we get. It makes sure you stay on top of the material.

3) What study strategy has worked? What hasn't?

I kind of mentioned it in the previous question. Accept the fact that you're not going to know and retain ALL of the information. Just really focus on what the instructor emphasizes in lecture (so make sure you're paying attention in all your classes!). If you have extra time, go back and look at the rest of the info. Also, don't be afraid to ask for help!! One thing I love about my program is that we have such a small class size so everyone has become really close. There is absolutely no "competitive" mindset so everybody helps each other out. Don't be afraid to ask classmates or your professors for help. 

 

4) What do you like about PA school vs. undergrad studies?

Most of my classes in undergrad had huge class sizes. We have such a small class size in my program so you get a lot more attention. Also, it's really nice learning anatomy on a human cadaver rather than just pictures from a book or various animal cadavers as we did in undergrad. 

PA school is a lot more work, but most of the material is stuff that I thoroughly enjoy studying so it makes it fun in a way. 

Interview with a Rural Medicine PA-C

Here's an interview with a PA who practices Rural Medicine in North Texas.

1) Why did you become a PA?

 I spent quite a bit of time in my undergraduate career trying to decide between medical school and physician assistant school.  I had the opportunity to work as a medical assistant at a Christian family practice office where I feel like I was introduced to excellent medicine and a great example of a physician/PA team. One of the physician assistants I met there had trained at Duke during the first few years of that start up PA program in the 1960's, so coming to know him and hear his stories of training was truly a dose of PA history! The other physician assistant at the practice was a new graduate and offered a fresh perspective on the process of applying to PA school, and the up and coming advances in the PA profession. It was through coming to know these excellent physician assistants that I realized the value of the profession and began to learn more and more about PA's and their patient centered focus.

2) How did you pick UNT HSC? What was your time like there? What strategies helped you?

I picked UNTHSC because of the warm welcome I received during my interview period.  I had taken a few days to talk candidly with students at several of the Texas PA schools, and the UNT students were honest about the difficulty of PA school but spoke highly of their program, and felt like they had the support of their faculty and student peers.  I also knew I wanted a longer PA program, so the length of UNT's program was very attractive to me.

I had an excellent time at UNTHSC.  Looking back, it was very challenging, but also a time of great personal and academic growth.  Our class of PA students operated like a family, we all worked together to take complete notes, and shared study materials; the fact that competition between classmates was not a hindrance was something that helped all of us navigate the three years of PA school.  Taking one day or part of a day off from studying, a "day of rest" if you will, was another vital part of maintaining a balance in school.  There is a "buddy system" in place where you will be assigned an upper class PA student to help you with tips and strategies during the first few weeks of school, and I would recommend taking full advantage of their experience and knowledge.  

3) How did you get into Rural Medicine? Did you do a rural rotation in school?

I did not complete a rural medicine rotation, and would not have initially seen myself practicing in a rural setting.  I knew I wanted to gain experience in primary care with my first job after graduation. To be quite honest, when I interviewed for my current position, I didn't fully realize how rural a setting it was until I arrived at the job interview!  Once I met my supervising physician, and saw the practice setting, I was intrigued  and impressed; I decided I was up for a challenge and an adventure in rural medicine, and I have not regretted that decision.

4) How has your perception changed about Rural medicine since you started practicing?

My perception has changed in several ways.  My perception of the PA/physician team started off as something fairly standardized, but now I realize that that relationship is unique to the individual physician and physician assistant, as well as variable by practice setting.  The scope of practice of rural family physicians and by extension, that of rural physician assistants, is still fairly extensive.  

My perception of work/life balance has changed quite a bit; in the rural setting, your job and involvement in the community doesn't end at 5:00 pm.  You become an integral part of the community, and people come to know you as a leader, and will ask you to commit to various voluntary or appointed positions.   I've had patients call me in the middle of the night, with a health emergency or question.  You see people at the local meat market or grocery store and they will ask you their medical questions with bold (and sometimes amusing) honesty; they will often introduce you to family and friends and say "This is my PA, they take care of me".  

Finally, my perception of the medical community overall has changed since I began working in a more rural area.  We do have limited specialist coverage, and all of the family physicians rotate call for any patients that are admitted to the hospital.  There is a spirit of teamwork between the family doctors, their physician assistants, and the specialists we have covering our local hospital which I have not witnessed anywhere else in my training, and this is something I will always remember about rural medicine.  The medical staff here truly do rely on each other for personal and professional support, and everyone collaborates very well to help patients receive the treatment they need, even if it means staying late or taking on an patient consult. For example, I frequently contact our orthopedic surgeon and cardiologist on call for our area hospital on their personal cell phones when I need advice on a patient I have in the office.  

5)  What kind of patients do you see?

I see a range of patients in the family clinic, infants to geriatrics, for anything from preventive exams to chronic disease management, to walk in visits for sick patients and minor injuries.  My supervising physician and I also see patients at the local nursing home, so I round on those patients at least one per month. I am the provider on call for the nursing home, so take 24 hour telephone call for any situation that may come up with our patients there.  After building my skills in the clinic and nursing home my first year in practice, I have had the opportunity to gain some experience with inpatient medicine; I essentially pre-round on any patients my physician or I admit to the local community hospital, and work closely with my supervising physician to coordinate hospital orders and discharge planning.

What does a typical week look like for you?

My days start at around 06:30 when I call up to the local hospital to check on any admitted patients.  If we have patients in the hospital (usually anywhere from 1-5) I head up to the hospital around 07:00 and start rounds and progress notes.  My supervising physician usually meets me on the inpatient side and we wrap up discharge planning or further hospital orders together.  Clinic starts at 8:00, so I head to the office after hospital rounds, and see patients from 8-5.  If anything comes up for our nursing home patients during the day, or if I received an overnight call for any problem, I will drive by the local nursing home during lunch of after office hours to make a nursing home visit for any sick patients. I don't typically take call at the hospital or round on patients over the weekend, although I am still on call by telephone for the nursing home;  If our nursing home patients get sick over the weekend and I am in town I usually will pay a weekend visit to them.  The providers at our office number seven (three physicians and four physician assistants) and we alternate shorter weekend clinic hours, so we each work one out of every seven weekends.

6) What is your favorite part of your practice?

My favorite part of my practice is the long term relationships I have had the opportunity to form with patients.  It is common to build relationships and take care of several generations of a family.  It is rewarding to see patients back for follow-up over an extended period of time and mark their progress.

7) Any advice for future PAs?

I think my advice would be to remain open to career changing opportunities, but don't be a afraid to take that first job in primary care, for those who are so inclined. I believe it has been a really valuable experience, and I think that physician assistant scope of practice can really be utilized to its full extend in that setting.  Second, I would say to make sure to try and maintain a work/life balance that will help you stay grounded and prevent burnout, especially during the first few years of practice.