Tag Archives: Future PA

Second time applicants, this one’s for you!

I get a TON of e-mails contacting me about what to do differently as a second time PA school applicant.

My not so great answer is: It depends on where you were and what you showed the admissions committee last year. 

But, for those of you looking for some more specifics (probably everyone) I’ll do my best here. 

Also first, let me ease some anxiety.  I can tell you that I was fortunate enough to be accepted on my first try (looking back I’m not sure how!) But I would say approximately 1/2 of my class were second time applicants and two people in particular who I thought were two of the smartest (and still do) in my class were both second time applicants. 

DO NOT allow a detour to inhibit you from finding a path ❤

OK.  Now down to the good stuff! 

The Quick and Dirty Version….

  1. Increase shadowing hours
  2. Shadow in new specialties
  3. Re-take courses
  4. Re-take the GRE (this is low on my priority list)
  5. Get a new certification 
  6. Volunteer
  7. Some people pursue additional Master’s degrees (THIS IS EXPENSIVE).  But a lot of people are doing it to set them apart
  8. Medical mission trip
  9. Demonstrate continuity by keeping your present job(s)/shadowing experiences/PCE/HCE
  10. Do something that makes you a stand out!  I had a lot of fitness certifications on my application.  PA schools aren’t looking for the same cookie cutter anything.  I’m partially convinced that my number of different experiences made me “different” and was a big contributor to me getting an interview. Dare to be YOU and different! 🙂

A Little More Detail + Questions to Ask Yourself

How did you improve? 

So, a year has passed. What changed?  How have you improved your application?  Did you re-take course work, get more exposure to the PA profession by additional shadowing, get any certificates (CNA, plebotomy, etc).  If you did–highlight that in your application and personal statement and/or interview!

“Nothing changes if you don’t change anything”

If you haven’t actively taken steps to demonstrate your continued dedication to the PA profession and strengthening yourself as an applicant– GO NOW and do it! 🙂

Who wrote your letters of recommendation (LOR)?

If you were lucky enough to read your LOR and weren’t blown away by them– ditch them.  Ask someone else.  This is another frequent question I get.  WHO SHOULD WRITE MY LOR?  This is based on what programs you are applying to and what they are requesting.  Make that a priority.  A good rule of thumb is as follows:

Professor: To attest to your past academic success and likely success in a arduous graduate studies program

Supervisor: Attesting to you being a quality employee, work ethic, team work– you know all that good stuff!

PA: Where this may seem obvious I did NOT even think of it!  But, a lot of schools want to see that you formed a good relationship with a PA who will attest to them wanting you to join the profession.

If you cannot get one of the above other great sources are RN, NP, MD/DO who can attest to your ability to work within the healthcare system as a team member and who will thrive specifically as a PA based on their observation of you and knowledge of a PA’s role and responsibilities

What did you learn from your unsuccessful CASPA cycle?

There is some new and emerging documentation stating that competitive graduate programs are actually seeking out applicants who have either experienced hardship or “failure” (I don’t actually believe in real failure– we either win or we learn) to see how they have responded to circumstances.  Show them you knew that not being accepted was not a final destination– but a detour and a learning experience. 

Either in your statement or interview talk about how you grew from the experience. 

How strong is your personal statement?

I get this question A LOT “should I re-write my personal statement?”

While there is no hard and fast yes or no to this my GUT responds to people with “Are you the same person you were a year ago?  Hopefully the answer is “no”.  Hopefully you’ve added to your application and grown as a person and professional in ways that will contribute to your experience as a PA-S, your classmates development as well as when you become a practicing professional. 

Top 5 Personal Statement Mistakes

I’ve been helping pre-pa students for the past 2 years with their personal statements.  During that time I’ve noticed some patterns that almost every statement I look at for the first time encompasses.  

  1. Lengthy personal stories

    Personal stories can be really great to use in your statement. As long as they contribute to why you want to be a PA, will be a good student or professional. Also, keep them concise.  I have read statements where their entire 5,0000 characters are simply a story.  And I find myself thinking “ok that is nice but why do they want to be a PA?  What will make them a successful student? If there is no purpose behind the story, it is simply only a story. 

  2. Abrasive/Abrupt transitions 

    Sometimes when I am reading a statement I’m reading about a patient care interaction and then its like BAM something totally different and I have no idea why the direction changed so quickly . Even between paragraphs– your statement should have an organization and flow to it.  It is different for everyone, but the order should make sense!

     

  3. Not writing to your audience

    I ask all of my clients the same question: who is reading your statement?  The answer: An admissions committee. When you write your statement, if the words do not serve a purpose to the admissions committee they need to go— its just “fluff”.  Do not lose direction or purpose at any point in your statement.

  4. Not focusing on THE purpose 

    If you take nothing else from this article the most important point I attempt to get across to my clients is: the purpose of the personal statement.  They are as follows:

    1. Why do you want to be a PA.
      I mean SPECIFICALLY a PA.  To be blunt no one cares that you are interested in medicine, want to help people or any other blanket/generic statementWhy do you want to be a PA as opposed to ANY OTHER MEDICAL PROFESSION?  
    2. Why will you be a successful PA student?
      Most schools receive approximately 1,000-1,500 applicants per CASPA cycle. Some more some less.  However, statistics demonstrate that attaining acceptance to PA school is more difficult by the numbers than medical school at an estimated 1-2%. What makes you unique? What previous behaviors have you demonstrated that positively predict your ability to succeed in an arduous post-secondary program!? 
    3. What will make you a successful professional?
      Demonstrate examples of your past that you will carry forward to your career that will make you successful.  Was there a situation in the past that you went above and beyond for a patient? How do you show empathy? Did you encounter challenges that required you to persevere and overcome obstacles? Draw connections to your previous experience and how it will apply to your success as a PA-C.

  5. Lack of assertiveness

    Listen, I am on board with bragging about yourself is difficult–unless you are a narcissist of course. I promise you other applicants are putting it out there.  DO NOT use passive language such as “I think I will….” Instead say “When I am a physician assistant student….” “When I reach this goal….” etc etc.  If you show the admissions committee that YOU are confident YOU will attain this goal– they are more likely to believe it too! Get rid of  the words: if, when, just, maybe, think and replace them with: can, will, know, certainty, etc etc.  
     

If you want to see a physician, I want you to see a physician.

“When will I see the doctor?”

For those of us who are practicing PA’s, there is no shortage of this statement. Up and coming PA’s: get used to it.

I know for me, I expected to hear it.  I have ZERO ego about someone who makes this statement to me.  If you do, consider a different career.

I had a patient today who was fairly rude about the fact that I was not an MD/DO.
“Well when are you finishing school?”, “Did you go to Stanford?” (so random), etc etc.

I told this couple that there wasn’t a physician on site.  We never have a physician on site.  I further told them that I am licensed to do everything in a family practice setting that a MD/DO can do.

They still weren’t satisfied.

At which time I said “If you prefer to see a physician I suggest you contact your health insurance company for a provider in your network”.

Why did I let this go so easily?

Establishing a relationship and actually getting a patient like this to value your words is worse than slim to nil. They’re wasting their time, I’m wasting mine and honestly I probably open myself to a law suit HEAVEN FORBID the slightest thing goes wrong.

Dear patients, if you want to see the physician–I want you to as well.

But not before I educate you about how capable PA’s are 🙂

Life as a Traveling PA

Recently I have had A LOT of questions about becoming a traveling or “locums” PA.  I decided to address everyone’s questions and tell everyone a little about my experiences to help out! Please leave additional question in the comments section and I will do my best to address them 🙂

FAQ:

1. Can I do this as a new grad?

You can.  However I imagine there would be pros and cons to this.  As a traveler/locum you are pretty much expected to go in somewhere, adjust to the EHR (electronic health record) if you have never used it before and roll like you’ve been there before.  So– there isn’t a lot of room for you to learn how to treat patients.
I tell most people that if you feel like you had great patient care experience, clinical experience and/or clinical rotations and if you can treat patients without feeling like you need to ask a lot of questions go for it.  I was a mental health therapist before being a PA and didn’t feel like I had strong rotations so it wouldn’t have been a great choice for me.
Second, expect to work in the “less desirable” areas or specialties.  I’m not trying to be rude or anything, but there aren’t a lot of people who wanna work in the middle of no where in North Dakota in psychiatry. BUT– if you take that job and get something on your resume it makes finding your next position a lot easier.  You have bargaining room.  Also, don’t expect the high-end of the pay spectrum (you would likely– most likely still be making more than anyone you graduated with).

2. What is the pay like?

It’s good.
I am unable to talk specifics, but it is definitely more than I was making as a new grad anywhere else.
You are paid hourly and always– ALWAYS high ball people.  The money is there.

3. What specialties can I work in?

It depends on what you are looking for.  As a new grad– see above. It also depends on what you have experience in.  You will always get more money in fields you have experience.  However, if you want to try something new and are ok with taking a little less money you might be able to try something new.

4. My friend/significant other and I want to travel together can we get an assignment in the same location?

Sometimes, yes.  Or it could be relatively close– or in between so you could share housing. But I would think with some positions this would be possible.

5. How do I find a company to work with?

NALTO is the National Association of Locum Tenens Organizations. This is basically the BBB for travelers/locum providers.  It is to protect you and the organization who is placing you from anyone getting treated like crap (for lack of better words)

6. Who finds your housing?

Your company has an entire department that is responsible for finding and paying for your housing.  And YES you can bring your dog =)  My nugget comes everywhere with me! I know some travel nurses who get a stipend and then find their housing– I haven’t heard or encountered this as a provider.

7. What about malpractice/licensing/credentialing?

Again, your company should have an entire department for this– if they don’t you’re with the wrong people.  I don’t lift a finger for any of this.  Make sure they cover “tail” insurance.

8. Can you pick your sites?

Yep.  I don’t go anywhere or do anything I don’t want to.  I’m an “independent contractor” which means I DO WHAT I WANT.  =) It also means I file taxes as an independent contractor— get a good CPA.

9. How long is each assignment?

It’s totally up to you.  I like to take assignments about 3-6 months long.  Then it is worth it for me to move all my stuff and be kind of settled, explore the area and peace if I want to!  If you’re good you’ll be offered extensions or permanent positions.  PRO TIP: a lot of companies have clauses about taking permanent positions out of a locum position.  As in how long you have to be gone from the position or there are also “locum to permanent” positions out there too.

10. What about benefits (medical, dental, vision, 401k)?

The only company I have come across that offers this is COMP HEALTH.  I didn’t take an assignment with them yet, but all of the recruiters I talked to were really nice and I would consider taking a job with them.  Their hourly pay is a little less compared to other companies, but you do get benefits.  PRO TIP: they have a 6% 401k match which is pretty good.
To give you an idea of benefits cost per year here is what I have been in for:
Health insurance: 260/month with a 4,500 deductible
Vision: eye exam was like 180$ and my contacts $120 for about a year
Dental: x rays and cleaning cost me $240.
I recommend a health savings account. I’m also increasing my disability insurance to better reflect my current earnings which will cost me about $150 per month.

11. Are you re-reimbursed for transportation and travel?

YES.  You should not drop a DIME.

12. What are the PROS and CONS?

PROS: 
The pay, no rent or utilities.
You get to travel and see the country on someone else’s dime. You aren’t subject to all the “office politics” because you are an independent contractor.
If you don’t like something about the job— it has an expiration date.
CONS: 
You move a lot.
You don’t have control over “the little things”– see below —

13. Are there positions outside the USA?

No idea.  Not that I have found yet.

14. How does retirement work?

I have my own retirement funds as of right now.  Comp Health (which is a locum company) does offer benefits to their employees.  6% 401k match.
I recommend a good financial adviser.  I love mine if anyone needs a rec.

15. Can you get hired on permanently?

This depends on the company you are currently contracting through and their rules.  Some have clauses in your contract that state “cannot work for x,y,z for one year after end of contract” others don’t care and some positions are also noted as “locum with opportunity to transition to permanent”

16. Are there any PA schools that incorporate study abroad?

Yes, my friend is applying to one but I cannot remember which.

17. How does state licensing work?

Literally your company should do EVERYTHING for you.  You should not lift a finger. Or pay a dime.  And don’t let anyone ever tell you that you cannot work for another company because “they paid for your license” that is complete bullshit and a rep just trying to bully you into staying with them.  I highly recommend not working for someone who tells you this as they definitely don’t have your best interest at heart.

18. Do you get a living stipend?

No.  My costs are literally all covered.  I don’t pay rent or utilities.

19. What is the best way to prepare for this type of position before/during/after PA school?

Before: Get experience as a CNA, in a hospital, work as a nurse– some type of position that prepares you to be immersed in health care and you don’t feel like a fish out of water as you graduate.
During: Really really really focus on the plan of care.  Know what you would do for the patient.  Also know what you would do if something went wrong.
After: Apply? And be willing to take a job somewhere not ideally located or not in the perfect specialty

20. How competitive is being a locum?

There is a HUGE need.  This also is variable based on specialty.  I have done all hospital, family or urgent care med.

21. Can you change specialties?

Sure. It helps if you have prior experience in these specialties.

22. TAX DEDUCTIONS

So– you can turn A LOT of things in to tax deductions.
Flights
Food
Coffee
Health Insurance
Dental work
Vision
Hotels
Cell phone
Electronic purchases
Amazon Prime
Kindle
iPad
Anything that “is a cost of operating business”

23. Are certain areas in higher demand.

Yes Rural areas.

24. How does salary/payment work?

You are an hourly employee
If you don’t work you don’t get paid– but you are paid well and honestly it doesn’t matter.
You are paid through your company.

25. Is salary competitive?

Yes.  More than competitive. And again– always, always HIGH BALL on your offer for what you want compensation wise.

26. If you live in a state that NCCPA exempts you from taking PANRE and you travel to a state that requires it, do you have to take the PANRE before you go?

So, as a traveler I would no recommend going without NCCPA cert. Most locations want or require it.

27. Are you given additional training?

I have not been.  You need to be ready to step in to someones shoes for the most part.  But– I do think there are jobs out there that are longer contracts that may be willing to train if you took less pay or something.

Tid-Bits:

  • Keep copies of everything.  Especially the malpractice insurance you have with each company/position.  You will need this with each new position you apply for
  • Make a folder for each company/position you work in your e-mail.  Keep everything.
  • As for copies of proof of wherever you are living.  I recently lost my housing (which wasn’t my company’s fault but a total pain in the ass) Ask for every damn thing in writing.
  • If people are interested in how I cook/eat/count macros while living in a hotel let me know.  I’ll write a post all about that
  • Yes, your dog can come.
  • Get a file folder for all of your “business related” receipts

Things you don’t have control over that you probably haven’t thought about:

  • Your shower pressure
  • closet space
  • washer/dryer
  • neighbors
  • dishwasher
  • how long does the hot water last?
  • sometimes contracts fall out.  I swear all of the “this never ever happens” have happened to me.
  • Fridge space
  • THE MATTRESS.  I swear if any performance mattress companies out there want to sponsor me I AM IN.  My last 2 places had shitty soft mattresses and I have honestly thought about having one sent to me.
  • Concealed carry license.  I’m not trying to be political at all but if you have a concealed carry license for a weapon it will be a pain in the ass to transfer it so you can actually use it.
  • If you like your position and they want to hire you depending on your contract they might not be able to
  • Auto insurance.  As long as you are only in a location for 6 months you can use whatever permanent location you want.

Stuff you wouldn’t think of but need to know:

License plates.

Yea totally didn’t think about this.  There are a couple routes you can go.  You can sell your car or park your car somewhere and have your company rent you one.  Or you can say “eff it” and figure it out as you go– which is what I did because I LOVE LOVE LOVE my Nissan Rogue!!!!  My plates actually expire this month.  I am using a co-workers address in a county in California that doesn’t require smog inspection. What is tricky is that in order to change your drivers license address you normally need a lease, mortgage or utility bills to “PROVE” you live there.
Well I have none of those. So, what do you do?
The DMV also accepts bank statements.  So, I changed my investments and my bank statements to that address and I explain my situation and bring those documents.  That has worked with me in the past and hopefully when I go for my license plates and address update they change it for me!

Driving Insurance

I left my insurance under the town I lived in for my first travel assignment in Danville, PA because the rate is dirt cheap. You are “LEGAL” as long as you are only staying somewhere for 6 months. You don’t necessarily have to change your location.

Health Insurance

So, I haven’t had to deal with cross states yet.  I’m also for national health insurance (bring on competition and drive down rates hahahaha).  However, my guess is that moving to a different state would be a “qualifying event”

Voting

See my debacle regarding license plates!

Banking

I recently switched all of my regular banking with USAA (my dad was in Vietnam so I automatically qualify to have accounts with them).  I HIGHLY HIGHLY recommend them.  They are so kind and always willing to help and EVERYTHING– EVERYTHING can be done on the internet or phone.

Healthcare Culture: Everything Hurts and I’m Dying

There are a lot of issues being discussed in healthcare today.  One point I don’t hear a lot about, but see everyday comes directly from our patients mouths.  They come in to clinic with the mindset of “everything hurts and I’m dying”.  What this means is that if they have a headache they think and know that they have a brain bleed and they need and MRI.  If their child has a cough they definitely need an antibiotic.  They woke up sick this morning or have an ache in their shoulder x1 day: everything hurts and I’m dying.  

The undertone of this statement that they don’t directly say: And you BETTER do something– better yet– what I think you need to do. 

Now, let me be clear it isn’t that I’m not empathic to patients who are feeling ill or in pain.  However, there is this culture out there that extreme measures, investigations and treatments need to be taken if you have a headache.  Are there the small percent of people who do need these measures? ABSOLUTELY.  That is why we do history and physical exams to weed these people out and send them for these tests.  

Why does this matter? What is this causing in medicine? Cost. Waiting room lines. The emergency department being used for non-emergencies (sorry people this was not created for you to get a pregnancy test free or score some morphine for back pain– it was meant for people with asthma exacerbation, CHF, PNA amongst so many others). 

How does this effect providers? We also have to act like someone who thinks they are dying are dying.  If we don’t they’re not satisfied. Re-assuring patients has become the most difficulty part of my job.  We all know when we have this person in front of us.  I always make sure to do a full physical exam.  I talk them through it saying “your ears are clear–no infections, airway is patent– tonsils are not enlarged, no lymph node enlargement, lungs sound great, your neurological exam is completely normal, vital signs completely within normal limits—– etc etc”.  But for some people they just aren’t satisfied.   

What else are we to do?  Patients who push for further intervention, I tell them I cannot treat an infection that is not there or worry about signs or symptoms that you do not have.  I tell them this is good news.  

My question is where are we going wrong? It seems like more and more people are lacking basic concepts about colds, headaches and belly aches.  I do my best to educate my patients.  Viral bronchitis is a BIG one.  I tell them 98% of bronchitis is caused by a virus. The cough can last 3-4 weeks even after you begin feeling better.  I state “Scary symptoms that you DO need to be concerned about are persistent fever or coughing up blood streaked sputum.” I ask them EVERY TIME “do you have any questions”.  I usually ask this twice. Yet somehow there are still people who come back a week later cause they have a dry lingering cough?  

Would love to hear thoughts from students on rotation and practicing providers with how you best handle these situations.  As well as suggestions.  May this serve as a reminder to always educate your patients as much as possible!

Breaking Down PA School Interview Questions XII

This week also features two questions.  Thanks to Abigail for e-mailing me!!  I love when you guys send me writing topics and questions you are asked at interviews, so keep it up!

Q:What patient population do you least like working with gathering your patient care hours?

What are they looking for

  • That you aren’t going to bash anyone.
  • Bias 
  • Compassion (that you have it, duh!)

What to avoid saying

  • Anything negative.
  • A statement that is going to cluster or segregate a group of people.  (Disclaimer: the statements below are not things that I would say and in no way represent how I feel.  They are simply a way to give examples.)
  • For Example:
    • “Working with pain patients was the worst, constantly ringing the bell to ask for more pain medications and complaining”
    • “Diabetics who are non-compliant.”
    • “Psych patients, it’s not even like they have a REAL problem.  Just suck it up”

What to say

  • You really enjoyed the diversity (of whatever population(s) you worked with)
  • Mention that the diversity of medicine you were exposed to really makes you look forward to clinical rotations and learning more about all areas of medicine. 
  • Every patient is a person first and that their disease does not define them.
  •  Certain qualites can present challenges such as non-compliance, but it is all part of working in medicine and that you look forward to growing as a person and future provider.

Q: What specialty would you least like to work with as a PA?

What are they looking for

  • To see if you’ve made up your mind about what area you think you want to work in
  • If you are open-minded about learning
  • If they are a program focused on underserved populations/family care if you have interest in that area

What to avoid saying

  • You are “certain” you want to work in a specific area.
  • Saying anything negative about a particular area of medicine.

What to say

  • Mention what you liked while shadowing, but DO NOT commit 
    • For example: ” I really liked the role and responsibilities of Emergency Department and Cardio Thoracic Surgery PA’s; however, I know there is a lot for me to learn and many areas of medicine to gain knowledge and exposure. 
  • You cannot be certain because you worked in a small subset of medicine (wherever it might have been) and that you look forward to figuring out what specialty you want to begin your journey in medicine. 

Breaking Down PA School Interview Questions XI

Focus on social media and internet self diagnosis!

Q: Would you accept a Facebook friend request from a patient?

What are they looking for?

  • Understanding of ethics and patient interaction
  • HIPPA
  • Professionalism.  My program was HUGE on this, it was a percentage of every class grade. 

What to avoid saying

  • “Sure, I have drinks every friday with patients from the clinic I volunteer at”
  • “Yes” without any thought consideration.
  • In my opinion saying “yes” at all.

What to say

  • The best and most effective patient-provider relationships are those that do not encompass dual relationships
  • Even with clear cut “simple issues” such as a UTI, you can never predict what issues may develop with a patient or a family. 

How you might be pressed 

  • What about in a small town where everyone knows everyone?
    • The good thing about being a PA is that there is likely a collaborating MD/DO who shares time in the clinic.  
    • State that you understand that you may know a number of your patients from other community groups (gym, church, etc) and that as frequently as humanly possible you would have patients with whom you have close personal relationships see your supervising physician to provide the best, most unbiased care. 

Q: How do you feel the internet and sites such as WebMD are contributing to healthcare?

What are they looking for?

  • Respect and consideration for your patient.  Simply that you can show you will listen to them. 

What to avoid saying

  • “Its destroying healthcare and making providers jobs more difficult”
  • “Your google search does not trump my medical degree” (even if you think it sometimes!)

What to say

  • There is a lot of information available on the internet.  If patients are able to find reliable information (CDC, Medscape) I think it can be helpful for patient education and awareness.
  • I don’t see much harm in it, at least it shows patients taking an investment in their health or illness and can provoke insightful questions and/or helpful information

How you might be pressed

  • What do you do when patients try and undermine your medical opinion? For example telling you they KNOW they need antibiotics.
    • Re-state their symptoms and tell them what was re-assuring about their exam.  A lot of the time when I get that “feeling” interviewing a patient that they won’t be happy unless they get an antibiotic as I go through their exam I make statements like “your ears look perfect, nice and clear” “lungs sound great to signs of infection” yada yada. 
    • If that isn’t effective I say “I understand your concern and if you would like I’d be happy to get one of my colleagues or collaborating physician for a second opinion” (this usually works)

 

I Don’t Have Time VS. It’s Not a Priority.

I cannot emphasize how much “I don’t have time” correlates to “It’s not a priority.”  I challenge everyone to take the phrase “I don’t have time” and replace it with “It’s not a priority”.  I guarantee you that it will be eye-opening.    

Quite frequently I have individuals who talk to me about my workout regimen and my food prep and I’m amazed at their ability to find reasons as to why I am able to do the things I am able to do for my health and how those reasons correlate to why they absolutely cannot.  
The most recent incident occurred as someone proceeded to tell me that I have time to workout because “I’m not responsible for other people”. Translation: I don’t have a husband or children.  First, I believe this is an excuse.  Do individuals who have families have a time management and priority challenge: yes. Do individuals like me have a priority challenge?  YES. Everyone’s time management challenges are unique to them.  I feel as though others have attempted to make me feel that because I don’t have a family, my priorities and check lists of things to complete are somehow easier to accomplish or not as important as those with families/husbands/wives.  I proceeded to tell this person that I work full-time. I run a side business and a website.  I have a dog that is a priority and I make sure she has food prepared and gets a walk 6 days a week. I spend a lot of time on the website/blog and other projects I’m working on collaborating with other professionals.  I also spend a decent amount of time reading about medicine and investing into my career. 
Everyday I wake up at 4:45am. I go to the gym participate in group crossfit class 5-6 days per week and 3 days a week I do extra individualized programming.  I’m either out of the gym by 6:30 or 7:30am on days that I work depending on my programming.  I go home walk my pup and listen to my HIPPO education RAP, shower/get ready/pack lunch(already prepped for week)/eat breakfast. Any extra time is dedicated to editing statements or working on the website OR a special project I’m working on with National Physician Assistant Eduction (its secret for now 😉  I arrive at work at 9am.  9am.  By the time I get to work I’ve done more with my day than most people do with 12 hours.  Currently I work in an urgent care.  This morning in 3 hours and 15 minutes I have seen 11 patients and written most of this blog.  Any down time at work I spend editing, reading medicine or responding to emails. 
We all have priority challenges.  We filter massive amounts of information, people and tasks daily and we decide consciously and unconsciously what we prioritize.  You are what you do, not who you say you are or what you say you will do. 
We all have the same 24 hours in the day, it’s all about finding ways to maximize every minute and hour afforded to you. 
I challenge everyone who reads this article– for ONE WEEK: Replace “I don’t have time” with “It’s not a priority” and I guarantee you will learn a great deal about yourself.  

Breaking Down PA School Interview Questions: Bonus Article

In addition to being asked to simulate an HPI with a standardized patient (If you don’t know what I am referencing see my last blog post here) a great number of programs are employing the MMI (multiple mini interviews) and also asking you to complete tasks. Sometimes odd tasks.  

So, why are they doing this and what are they looking for in their candidates?

1. Stress

PA school is stressful.  Interviews are stressful (no matter how you cut it). What better to do than to see how prospective students can react to a stressful situation.  Sound familiar? Sure does, admissions committees are taking the concept of behavioral interviewing and making it a reality.  The idea here is that if you can handle stress well during the interview, that behavior trait will transfer to PA school. 

2. Common Courtesy 

When you are stressed or someone corrects you, how do you react?  During my time as a student ambassador, I saw prospective students literally freak out when they didn’t understand a task or someone wasn’t following their directives. Be kind and polite.  DO NOT, I repeat DO NOT freak out.  This is a huge red flag to anyone (students, faculty, adjunct professors) evaluating you. 

3. Innovative Thinking and Effort

So, you don’t remember all the cranial nerves or parts of the kidney or understand how to tell someone to suture.  Don’t panic.  Stay calm and try and dig deep for anything you can remember about the task they are presenting.  If they give you 5 minutes to complete the task use that five minutes.  If you’ve never explained to someone to suture think about basic principles that might be important.  Its ok to say, “You know I’ve never done this before, but I’m going to do my best”.  This says that you can take on challenge in a positive way.  You might go on to say something like “I would think someone would need to wash their hands and create a clean environment to complete the procedure”.  So, maybe you don’t know what “sterile field” or “breaking sterile field” means.  Or the different types of sutures.  But, maybe you can say ” Well, the type of wound might matter as to how someone sutures”.  Keep it basic and simply TRY. I cannot stress enough, remain calm. 

4. Following Directions

A large part of PA school is being able to follow directions, complete tasks on time and multitask.  Programs want to know that you can complete a task they tell you to complete, in a specific manner. 

5. Action Speaks Louder Than Words

You are what you do. History repeats itself. However you want to say it, y’all get what I mean. You are what you do (just like you are what you eat haha 🙂 Show them you can handle stress, be kind and follow directions.  Don’t sweat it if you don’t know exactly what they are talking about, respond appropriately to the task and you will be just fine! 

 

Breaking Down PA School Interview Questions: Special Edition

I came across a post recently in a Facebook pre-pa group that some interviews are asking students basically to complete a HPI (History of Present Illness).  Now, if you did your patient care experience in mental health (because thats where you had a degree) you might find yourself fumbling.  So, if you run in to a situation that asks you to “talk to a patient about what is going on with them and give a diagnosis” I’ve got your basics covered!

What is an HPI?

  • History of Present Illness
    • Why is the patient coming in to see you and the story that goes along with it! 
  • Start with a “chief complaint”
    • This is usually something obvious such as abdominal pain, chest pain, fever, rash, red eye, sore throat, cough, etc
  • There are 7 vital aspects of the “HPI”
    • Onset
      • When did it start
    • Duration
      • How long has this been going on?
    • Location/Radiation
      • Where is the location of the symptom
      • For complaints like abdominal or chest pain ask the patient (especially if child) to point with one finger where it is the worst
      • Does the pain/symptom travel somewhere else besdies where it starts?
    • Quality
      • Describe what is going on
      • Is the pain sharp, dull, throbbing
      • When they have difficulty swallowing is it solids, liquids, etc
    • Quantity
      • The good old “on a scale of 1 to 10…10 being the worst and 1 being very little”
    • Aggravating/Alleviating
      • What makes symptoms worse
      • What makes symptoms better
    • Associated Manifestations
      • Depends on the chief complaint
      • Abdominal pain: diarrhea, constipation, fever, chills
      • Chest pain: diaphoresis, lightheadedness, palpitations, shortness of breath
      • Fever: Rash, cough, urinary symptoms (dysuria, frequency), recent travel, UTD on immunizaitons
      • Cough: is it productive or dry, short of breath, fever, chest pain