Interview with an Othropedic surgery PA

Here's an interview with a PA-C who happened to be married to one of my classmates. 

1)  Why did you choose to be a PA? 

I chose to become a PA based on the lifestyle. I wanted to practice medicine and becoming a PA provided me that option without going through medical school. I was constantly searching for a field in medicine that would fulfill my career aspirations and never felt right about other fields. Once I found out about PA, I never looked back. 

2) How did you pick UTMB? What was your interview process like? 

I chose UTMB based on the academics and the student run clinic. There is a clinic in Galveston where care is provided to the underserved community. The patients there are so appreciative of the care that they otherwise, would not have received. The pass rates are outstanding. My class had a 100% first time pass rate on the PANCE. I did get into 2 other programs, which were good as well, but I felt that UTMB was the best fit for me. 

3) What was your biggest surprise once you started working as a PA-C? 

What has surprised me is how much I still have to learn. I have been at my position for 5 months now, and I still see something new frequently. PA school is good at providing a background for primary care, but going into a sub-specialty requires its own education. There is so much information in medicine, that it is hard to know it all. 

4) What area of practice are you in now? What does a week look like for you? 

I work in orthopedic surgery with a foot and ankle surgeon. I split my time between the clinic, OR, and the hospital making rounds on patients. Every week is different so it is hard to even come out with a typical schedule. I would say that I work around 50 hours per week with call once during the work week and every couple of months for weekend call. 

5) What is it like with your husband in PA school now? Do you give him study tips? 

I love that he is in PA school now to be honest. We are able to spend more time together now than we did while he was working full time and going to school part time. I actually let him do his own thing during school. I have tried giving him study tips, but we study so differently that what worked for me does not work for him. 

6) Any advice for aspiring PAs? 

My advice for aspiring PAs is to shadow a PA. This is when I truly decided that becoming a PA was what I wanted to do with my life. Then I would focus on getting some sort of hands on experience. I didn't have that much hands on experience and I wish I had. Get involved in your community and organizations in school. Once you do get into PA school, take a break and relax. You will never have time like that again! I definitely miss my days of just being lazy around the house, so when I get those days, I cherish them. Last piece of advice is to have fun!

Interview with a PA-C in Neuro

Here's an interview witha PA who works in Neurosurgery. 

1) Why did you become a PA?

I became a PA in a roundabout way.  I suppose the same way a lot of people do.  I already had a Master's degree in Anthropology and was burnt out on academics.  I knew I wanted to do something practical with my training and experience.  Initially, I was taking pre-med prerequisites thinking I'd become a physician, but I met someone who was applying to PA school who was taking a class with me.  I did some investigating and realized that becoming a PA would be a better fit for me over all.  I wasn't wrong.

2) How did you pick BCM? What was your application and interview process like? 

I lived in Louisiana at the time I applied to Baylor College of Medicine in Houston.  Louisiana only had one PA school available and it was a Bachelor's program.  Baylor was relatively close to home and I didn't have to meet any residency requirements to go to Baylor.  I loved it there.  Great school and amazing experiences at the Medical Center there.  The application process was easy.  This was 1998-99 so I think it was an individual application process, not a centralized process.  The application process was enjoyable actually.  We all toured the campus and part of the Med Center.  We were assigned to interview with PAs and MDs.  It was pretty relaxed overall even though we were all stressed out.

3) What was your strategy for succeeding in the didactic phase? How did that change in clinicals?

I learn visually and I just remember reading and re-reading and re-reading and talking things through with classmates.  For me, re-writing my notes was really helpful.  Clinical phase was markedly different.  You learn on your feet, helping take care of patients and then reinforcing what you saw and learned by reading more whenever possible.

4)  What do you do as a neuro PA? What does a normal day/week look like for you?

As a neurosurgery PA I see patient's in my own clinic, assist my physician in his clinics, order and interpret tests, assist in surgeries in hospitals and in our surgery center.  I also take call after hours and round on the weekends as needed.  I also field phone calls from patient's and deal with disability paperwork and refill requests.  I also see patients in pre-op clinic and discuss their upcoming surgery and answer their questions.  A normal day starts at its earliest around 7 am and ends around 4:30-5.  I work Monday through Friday and, if on call, round on Saturdays and Sundays.  Occasionally, we do have emergency surgeries that happen after hours.  Occasionally we have to see patients in the hospital in consultation after hours too.

5) How did you get connected to your current practice? Have you worked in other areas of practice?

I actually interviewed with my current employer 9 years ago but accepted another job offer.  I was looking for a new position several months ago and answered an advertisement for a Neurosurgical PA on the TAPA website.  I have also worked in general orthopedics, neurology, orthopaedic spine and orthopaedic trauma surgery.

6) I've heard that the critical component of any PA position is the relationship with your supervising physician. What do you look for in that relationship?

Finding the right "fit" with your supervising physician is very important.  You have to mesh well intellectually and emotionally.  Working with surgeons means that you have to respect and appreciate that your employer may do things differently from other surgeons, but your employer's way is THE right way when you work for him/her.  You are second fiddle to your boss.  If you can't accept that, don't become a PA!  For me, I need to work with someone who is respectful of me, my life and my opinions, and is honest about the expectations.  Some employers will try to win you over with money and benefits but then have no respect for your time outside of work.  I can take working long hours as long as I know that's what is expected of me.  I've been led down primrose paths before thinking that I would work "normal" hours (ie, 9-5) only to be in clinic until 8pm routinely and in the operating room until 11pm all too often.  With no extra compensation for all that time mind you.  If your employer works as hard as you do that's the exception to the rule.  That's how things are for me now.  Not always.  I used to work with ones who took their dedicated time off during the week but expected you to work your 40 hours and more.  

7) You've been practicing for 10 years now [ed: I think I remember that from our conversation, feel free to correct me] How has the role of a PA evolved in that time? 

I have been a PA in practice since 2002.  Medicine has changed drastically.  I think that US medicine is evolving towards a more centralized system.  Not necessarily toward government centralized but more towards hospital centralized care.  I see more and more private practices having real difficulties because they're competing with other providers who are employed by hospitals.  Imagine that you work for yourself and have employees.  All the income you generate is because of your great reputation and hard work.  Then, right next to your name in the insurance directory is a provider who provides, by appearances at least, all the service you offer but their salary is paid for by a hospital system and that provider is expected to keep all their referrals and testing within that system.  That's what we're going to see more and more of.  Your boss may be a surgeon who is competing with other surgeons who provide the same services, but your boss gets paid based on the work that your practice performs.  A hospital employed surgeon gets paid no matter how much work he/she does because they get a salary from their employers - a hospital.  Your boss may need to do 40 surgeries a month to keep the business going, but that hospital employed surgeon....I'm not sure how hard that surgeon would work since they would get a salary no matter what.  I feel that this trend will affect PAs and NPs and more hospitals will employ mid levels directly.  Might not be a bad direction to consider.

8) Any advice for aspiring PAs?

Study hard.  Ask lots of questions.  Listen to the nurses.  They can teach you a LOT.  Don't take things personally if people look at you like you're "just a PA" and "not a doctor."  I'm amazed daily how few people know what PAs are and what we do.  Don't stop learning.  Most patients just want someone who actually listens to them.  Try to really listen to people rather than just waiting for your time to talk.  Do what you enjoy and enjoy what you do.

Interview with a Surgical PA-C

1)  Why did you choose to be a PA?

I graduated with  BS in biology from Wagner College in Staten Island New York.  For three years after graduation I taught Biology and Chemistry and at a local catholic high school.   As much as I enjoyed it, I wasn’t going to stay there forever.  Since Wagner had a PA program I had a handful of friends who were already practicing PAs.  The more I continued to talk with them the more I decided that becoming a PA would be a great fit for me.

2) How did you pick UMDNJ? What was your interview process like?

My undergraduate GPA was not good.  I want to say it was around a 2.5.  I went back at night to retake some prerequisites and I made sure I had a 4.0 in all of those classes.  With such a low GPA I applied to almost every school I could drive to.  Living between NYC and Philadelphia that was almost 10 schools.
I was surprised to be granted interview at the first two schools I heard from.

The UMDNJ interview was the first one.  I went early and dressed in a suit.  I remember waiting in the outlying room as other candidates went in for their interviews.  I went into the room and sitting behind a small table were probably two faculty members and one or two students.  They asked a lot of questions, but I only remember one.  They asked me what I would do if I were not accepted.  I remember the question because I told the truth and at the time I wasn’t sure that it was a good idea.  I told them that I didn’t know what I would do.  My wife and I were planning on starting a family and we may not want to wait another year.

I heard back from them a week later and I canceled all the rest of my interviews.

3) What strategies worked for you during your program? Did they change when you entered the clinical phase?

I changed study strategies hundreds of times throughout PA school.  I used piles and piles and piles of index cards for anatomy my first year. I wrote test questions and little study guides my second year.  Some classes i focused and took tons of notes.  Others I did crossword puzzles while only half listening.  It depends alot on the class and how much your brain can take.  It is a ton mental work.  It is exhausting and it is a marathon.  I studies in groups and I spent hours alone in a cubicle.  I found I don’t do well for focusing for long periods of time. I prefer the 25 minutes on 5 minutes off technique.  I find my brain works better that way.  In Stephen Covey’s The Seven Habits of Highly Effective People the seventh habit is called sharpen the saw.  The premise is that if you are going to be cutting down trees for a 8 hours you can get a lot more done if you stop and sharpen your saw for at a 4 hours.  If you just keep cutting you will work harder and accomplish less.  I noticed this strongly in PA school and I have brought it into every area of my life.

4) What was your biggest surprise once you started working as a PA-C?

The biggest surprise I had was that people started to trust me immediately.  Nurses would ask me questions as if I knew something.  Scrub techs stopped watching me like a hawk.  Nothing had changed since graduation, but somehow a lot had changed.  Don’t worry when you get there you will be ready for it.

5) What area of practice are you in now? What does a week look like for you?

I currently work for the department of surgery in a small community hospital.  I first assist on any case that a surgeon at our hospital needs help with.  I did a robotic prostate yesterday.  I have lumbar fusion case today.  I have a C-section scheduled for Monday.  I am lucky enough to have the job I went to PA school to get.  I am in the OR 5 days week with a huge variety of cases.  I don’t take call.  I don’t work nights, weekends or holidays.  It really is fantastic place to be

6) You have a great and thorough review website. How did that get started? What are your goals for PA Exam Review?

I got started producing content for Physician Assistant Exam Review because I couldn’t find what I was looking for.  I wasn’t in love with any of the review books out there.  I also really enjoy listening to podcasts and I couldn't find anything on medical review that I could use.  I decided to create what I couldn’t find.

I initially set out to write a review book, but I don’t think that's what I’m doing anymore.  I am building a place where PAs can go to feel like they are not alone when preparing for their exam.  The PANCE is one thing.  You are surrounded by a group of people in the same boat.  When you take the PANRE you are alone. Even if you work with other PAs you are still alone because their cycles likely don’t match up with yours.  So my biggest goal is to create a place for PAs preparing for their exams to feel welcome.

7) Any advice for aspiring PAs?

Get started now.  I put it off for three years debating what to do.  It’s a great job.  You may be worried about the three year commitment, but you will be three years older whether you go to school or not.

Neurosurgery PA-C Interview

Here's an interview with a Neurosurgery PA-C

1) Why did you choose PA as your career?

Initially, I was considering becoming a physician, and the more I looked into it, the PA field is much more portable.  I would not be tied down to a practice location, or specialty.  I also like the idea of having an attending physician available to me at all times to provide ongoing consultation, and education which continues to mold my clinical judgment.  


2) Where did you go to PA school? How did you choose?

I applied to probably 7 different schools in TX, NY, IL and FL.  The TX schools I chose because they were for the most part, "local".   The others, I chose because they offered entry within a few weeks of my completing my pre requisites.  So, I could start pretty much immediately.   The other thing I took into consideration was, was whether the program went year round with few breaks, versus on a traditional semester system.  For me it was important to start and finish and begin working as a PA in the shortest time possible.  And, for all those reasons, I chose Nova Southeastern University in Fort Lauderdale FL.  


3) What do you do as a neuro PA? What does a normal day/week look like for you?

Typically, I have 1/2 day clinic on Mondays, full day on Wednesdays.  OR cases are scheduled for Monday afternoon and Tues, Thurs and Friday.  We do 7-15 brain and spine cases per week, and I see 25-30 pt in clinic, then do rounds and consults at 5 different hospitals.  There is another PA who shares the patient burden with me, and he is a great asset.   I am "on call" every other weekend, which means all hospital rounds and cases, and I help 3 surgeons during those times.  Not all of them require assistance every weekend, though.  I always make myself available to the other physicians, nurses, and hospital staff at any time, and they all have my cell number.  In this specialty, it is critical that the communication be uninterrupted so problems can be taken care of quickly. There are no "normal" days in Neurosurgery!  Each one is full of new challenges, and I relish that.   The environment is fast paced and can be stressful, but I am part of a team and we trust and support each other tremendously and that makes all the difference in the world.


4) How did you get connected to your current practice? Have you worked in other areas of practice?

A "headhunter" contacted me about my current position.  In the past, I have used the healthEcareers webiste on the AAPA site.  I have worked in Neurology, Neuro Interventional Radiology and Physical Medicine and Rehab, as well as Neurosurgery. 


5) I've read some people in specialty practice would prefer a more specialty focused PANRE. Do you like reviewing the generalist helps you as a PA or would you prefer to focus further into your specialty?

My field is so specialized, that I like having to refresh myself with the generalist PANRE.  I refamiliarize myself with skills and treatments I do not get to use on a daily basis.  It makes me a more well rounded PA with skills and knowledge that cross over into to other areas.  If I can recognize a patient's acute cholecystitis, or UTI, it keeps me from ordering what may be an unnecessary MRI of the spine when I can treat and manage these other issues and get them the care they need. 


6) The PA profession is continuing to grow, with new legislation, more PAs in medical leadership, and practicing in new areas. What would you like to see happen next professionally?

I am pleased that the PA profession is growing and more recognized in communities, & branching into other practice areas in order to serve patients.  Going forward, I would like to see PAs more recognized as legitimate providers of high quality care by more of the medical community and lay people.  The more active we are with supervising physicians in promoting the field, the more receptive patients will be to our involvement.  Professionally, I would like to see more partnering and discussion with, and among mid-levels,  Independent practitioners NPs and PAs, regarding best practices and how to better serve patients and our supervising physicians to expedite the best and most cost effective care for patients.


7) In addition to shadowing and getting good grades, any advice for future applicants?

Remember PA school is a great experience but is just the beginning.  Being a PA is a commitment, and very fulfilling.  Getting good grades is important, but once out of school, thinking quickly about how to solve problems is extremely important, and the ability to do so under stress.