Tag Archives: pa school

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. 

Lack of nutritional education in PA curriculum

Why aren’t we taught about nutrition?

I was talking to my boyfriend last night who told his doctor about what his diet consists of based on macronutrient (proteins, fats, carbs) amount per day.  His healthcare provider had nothing to say or add.  They were clearly not well versed on the topic.  And I can’t blame them.  It isn’t something we are taught (at least in PA school– I cannot speak for medical school)
BUT WHY are we not taught about the one singular thing that sustains us to live? (well that and hydration) on a very basic level.  Yet, we are teaching medical providers absolutely nothing about it (that I know of at least–someone correct me if I am wrong :).  
What do we learn as first line treatment for EVERYTHING? “diet and lifestyle changes”.  Right?!
Yet, America overall is so very sick. What is causing this and how do we on a small individual level begin taking steps to mitigate this issue? 

1. Set a positive example

I think that a portion of lack of nutritional and lifestyle counseling comes from either lack of personal knowledge or providers who do not follow the advice they would like to provide their patients. 
I’m not suggesting this is always the case or that the majority of health care providers are overweight and know nothing about nutrition. I’m simply suggesting there is a gap. Between what most providers need to know and what knowledge they have.
 
We need to set an example of responsibility for health and wellness in our own lifestyles so that we are comfortable discussing nutrition and exercise with patients. The best boss I have ever had led by example, and it made me want to work harder and be more of a team player.  I know it isn’t exactly the same, but hopefully the concept is appreciated. 

2. Put the patient in control

When anyone is approaching change, they determine where they are ready to begin.  Meet your patient wherever they are in the change process.  Frequently as helpers we seek to “fix” and tell patients how they need to be “fixed”. 
 
I am SO guilty of this!  “do this not that” “avoid this and do this”. 
 
Recently, I have taken on some different language.  
 
“What changes are you willing to make to achieve a healthier lifestyle/weight/etc?”
 
“What are your reasons that are meaningful for you to seek out these changes?
 
“What goals do you have for your health?” 
 
WHAT IS YOUR “WHY”?
 
Talking to a patient about exercising 5 days per week when they do none or maybe they don’t WANT to do that is going to only lead to frustration. 
 
Baby steps.  I love the quote “slow is smooth and smooth is fast”.  Once they are able to make 1 or 2 things they want to make habit and a lifestyle, start suggesting additional small changes.  Small things ADD UP!

3. Seek out knowledge

There is an ABUNDANCE of educational materials and courses on nutrition available out there.  As providers, maybe we have a responsibility to learn some basics (I know don’t we go through enough school).  I am not suggesting we attempt to take on the roll of a clinical dietician or nutritionist. 
 

What is the purpose/function of each macronutrient (protein, fat, carb)? How does each one serve our body and needs in a different way.  We need protein, fats AND CARBS (yes you need those) on a CELLULAR LEVEL. Our cell walls are comprised of all three. Our cells make up our tissues, tissues make up our organs and our organ systems make up our WHOLE BODY.  NOTE: There are variations of needs for each individual based on coexisting disease, goals, desires and basically how you FEEL.  Some people do great eating vegan: good for you.  Some people count macronutrients: good for you.  Not every way of feeding and honoring our bodies works for each person.
 

Learn the basics of some of the major types of nutrition programs (macros, paleo, keto, vegan, vegetarian).  I am definitely victim to pigeon holing myself into IIFYM (if it fits your macros)– because it is what works for me (disclaimer: this does not mean one eats only donuts because “it fits my macros”).  Admittedly, I’ve had a judgemental approach in the past towards other nutritional approaches.  Until I realized we are all not the same round peg going into the same round hole. And as long as your nutrition supports your body and wellness, I’m taking the approach of “good for you!” 
 
Personally, the nutritional approach I follow is IIFYM (if it fits your macros).  Precision nutrition is the certification that my nutrition coach attained and most of the coaches who work for the company.
Excuse my fine dinnerware 😉 
 
PLUG/RECOMMENDATION: if you are interested in learning more about the IIFYM approach visit http://www.workingagainstgravity.com or feel free to message me!  (I love to talk nutrition).  As an active mover– weight lifter, orange theory, crossfit, hiker, runner, etc etc and health care professional I FULLY endorse their approach and coaching.  Their blog also has so much information available for FREE!  Definitely check them out (I get nothing for recommending them!)
DISCLAIMER: I am definitely biased towards this approach because it has worked for me. 🙂
There is also a great deal of information available on podcasts which I have branched out to, and they are FREE!  I encourage you to listen to  nutrition based podcasts and also listen to the ones you may not necessarily agree with. This not only helps gain perspective of a patient or future patient, but also simply because you don’t agree with the entire basis of the program doesn’t mean you can’t take bits and pieces and make them useful 🙂
 
A simple quote that we can ALL live by no matter what nutritional approach you follow is the following:
 
“Eat real food, mostly plants, not too much” -Ben Bergeron
 
I am not advocating veganism or vegetarianism with this concept.
 
Eat real food. 
 
What does this mean? If it is on a shelf or has an expiration date > 2 weeks– its not real food. 
 
Mostly Plants.
 
Micronutrients are SO important and vital to maintaining health and wellness.  There are micro’s that you can only get from a diet that is rich in veggies! Magnesium, zinc, vitamins, etc etc.  Don’t get me wrong I love my steak once in a while, dairy and ALL sources of protein (if you don’t, that is ok, too!)
 
Not too much.
 
This means something different for everyone.  For most of our patients this can be simplified to prevent being overwhelmed:
 
1/2 your plate is veggies
1/4 lean protein
1/4 starch/carbohydrate
1-2 thumb size of healthy fat (nut butter, avocado, egg yolk, etc). 
 
I think if we can all follow those 3 principles and relay them to our patients we might instill some wellness! 
Example of what I bring to work to eat during a day 🙂

4. Encourage wellness instead of treating illness 

I listen to a podcast called “Pursuing Health” By crossfit games athlete and now medical doctor, Julie Foucher.  On one episode, she discussed where medicine is heading and I LOVE that she said that we are gearing more towards KEEPING PATIENTS WELL instead of treating illness. Instead of incentives for how many patients we see it will be based on quality and wellness. 
 
The problem with this: you can give patients all the information and tools, but if they don’t do the work– will we be getting “dinged” for their illness?  
 
I see both sides. I want to promote wellness, but we cannot FORCE people. I’m interested to see where this is going.  Also, definitely check out Julie’s podcast!  She was the first CF athlete I cheered for and love seeing what she is doing!

5. Advocate change

This is more of a MACRO (as in large) concept.  I would love to hear if people actually THINK nutrition needs to be incorporated and on what level into PA (and/or medical) school curriculum.  Are there people out there who encountered nutrition as part of their pre-req’s or in PA/Med school?  I’d love to hear experience and/or opinions about this!  (Especially because I know I tend to be really biased about wellness/nutrition/exercise 🙂

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.  
     

What Specialty is Right For You?

Wow.  I feel like this is a huge one for me– and also will display a lot of how I have grown and developed as a person, student and now medical provider.  I am no where near the person I was in 2013– I am such a better version of myself and I grow, develop and learn everyday.

Before I went into PA school I was “strictly surgery…actual medicine is so boring and for weaklings”.  I also thought medicine was black and white (ha!) When asked at the beginning of PA school I was specifically strictly ortho or trauma surgery.  I actually did my elective rotation in trauma surgery. We were surveyed and when “orthopedics” was prompted I quickly raised my hand.  For anyone who knows me– you know I am enthusiastic and passionate about anything I do.

During didactic year we went through our system based modules and I was in for the surprise of my life. I slowly but surely became more interested in the art of medicine. When our module for women’s health came along, I never expected to love it.  I did.  Our teacher for this module is also the shit. Rosa is one of those people who has a gift to teach.  Everything clicked pretty well for me. I was hooked– like immediately.  I e-mailed our clinical coordinator that day and asked if I could please be placed with her on my OB/GYN rotation.  It was my 3rd rotation and hands down without a doubt my best rotation.  I struggled clinically A LOT on my rotations– my medical background was not strong and taking histories and putting the puzzle together simply took me a bit longer to grasp than others.  And that is OK– because I progressed. Anyways, I fell in love with women’s health here is how and why and how I have decided to pursue this career.

  1. Independent Practice

    Going through PA school and rotations helped me realize I wanted more collaboration as needed as opposed to supervision.  I also realized that the operating room just wasn’t for me (shout out to Dr. Opacic who called that shit first year of PA school– I get it now). I can’t describe it– I just simply don’t like the environment.  Plus I need frequent feeding and a sterile environment does NOT allow for that 🙂
    I wanted my own patient load.  I wanted to be responsible for treating and seeing my own patients– basically I desire to practice to the fullest extent of my license.

  2. Procedures

    I want to be able to do my own procedures, too.  IUD’s, Nexplanon, colopo’s, LEEPs– whatever I can get trained in and be competent in to do on my own.

  3. Some GYN’s also provide primary care

    I don’t want to lose my roots and ability to practice general medicine. PA’s are trained generally and I always want to try and keep a little bit of that flexibility whether it is in my every day practice or in a per diem job or volunteering at a clinic.

  4. The patient population

    Sometimes we need to figure out what we don’t want, in order to be certain of the things we do want.  I’ve decided this is true of everything in life from relationships to medical specialties.  I have spent almost 3 years practicing general medicine of varying acuity levels.  Medical consults, Hospitalist, Urgent Care and Family Practice.  Here’s what I know I DO NOT want to see everyday: really sick people, patients who have not “tried anything at home”, narcotics– I do NOT want to deal with pain management, children– especially babies (I swear I’m not that evil), people who have a runny nose who think it is an emergency (it’s not the person with the GSW to the head is), etc etc.
    Which leads me to well ok well why women’s health then? No one (ok 99% of people) do not show up for an invasive vaginal exam if there really isn’t something wrong. Most patients are able to provide you some semblance of a decent HPI because when something is wrong with your vagina you pay attention to it. They are typically somewhat on the healthier side.  The reason I say this is that if you have an awareness of “needing your annual exam” chances are you pay even just a little bit of attention to your health/wellness.

  5. Setting and work/life balance

    Are you looking to work in a hospital, ED, operating room or clinic?  What type of hours do you want to work? Do you want a set schedule, shift work, do you hate working nights, etc etc.
    I am NOT a night person. I worked nights and it was not easy for me.  I love being up at 4:30am. I love my workout before work and I want a job that allows me to do these things 🙂
    As I said before I do not want to be in a OR– or at least to this point in my career I have not found a position that has made me go “owe I wanna do that!”  Never say never, but I know right now it isn’t in my cards.
    12 hour shifts are also not up my alley.  To me it was like– ok I’ll do EVERYTHING that needs done in my life 7 days from now when I have a day off.  Simply not for me.  Some people love it.

    All things to consider!

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.

Breaking Down PA School Interview Questions X

The PA career is incredibly competitive to enter.  Despite the number of programs out there and more popping up every year, your chances of acceptance are 1-2%.  For example the year I applied to Pitt there were well over 1,000 applicants and 40 seats.  THAT IS CRAZY TO ME! It makes me so thankful that I was able to earn acceptance, participate in such an amazing career and now help and interact with some really great Pre-PA students!

Q: Why should we choose you over other applicants?

What are they looking for?

  • You can demonstrate that you are confident and have earned the right to be in their program.  
  • Confidence
  • Assertiveness
  • You can clearly and concisely state why you are an excellent candidate
  • You’ve prepared  

What to avoid

  • Not having an answer.  
  • Being tentative. If you hesitate this demonstrates that you haven’t thought about this question or even worse that you don’t know how to answer it.  
    • A candidate who sits that and hims-and-haughs like “well….”, “ummmm”, or “I think….maybe…” Cut the crap say why you’ve earned this! Someone who hesitates or looks like they can’t give an answer isn’t someone an admissions committee correlates with a successful PA student.

What to say

  • I was not asked this questions; but, I did prepare for it.  My answers would have been as follows:
    • My tenacity.  By and far my first quality that sets me apart.  I risked a lot to take this course.  I also worked at times 4 different jobs to make ends meet and build experience and boost my application.  I did whatever possible to be successful in meeting this goal and I will demonstrate the same traits as a PA student and practicing professional.
    • My energy. I bring a great amount of energy into every situation I’m in and will put that energy towards becoming the best provider possible.  
  • Other great answers may include:
    • Perseverance
    • Diverse background
    • Maturity
    • Focus on wellness
    • Lots of time spent with underserved population
    • Substantial amount of clinical experience
    • Master’s Degree

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: 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

 

Breaking Down PA School Interview Questions IX

Q: On clinical rotation your preceptor is treating patients disrespectfully and making hurtful comments to you about them after they leave.  How do you react and what do you do (if anything)?

What are they looking for?

  • Maturity and leadership.  That you can make a decision to talk to your clinical coordinator about this preceptor.
  • That you can keep your cool under a stressful situation
  • Despite your preceptor being “in charge” of you, you can stand up for what is right in an appropriate respectful manner

What to avoid?

  • Stating you would do nothing.  This is a red flag that you don’t have respect for patients or the maturity to do the right thing even if it is someone in a higher position than you doing wrong. 
  • Say that you would create any kind of immediate confrontation directly with your preceptor

What to say?

  • That you would remain calm while on site at rotation
  • Contact your clinical coordinator immediately at the end of the day
    • State that you were in a very uncomfortable position
    • Make it clear that you don’t support his/her actions
  • How should your clinical coordinator react?
    • They may or may not take a question like this in this direction.  They should definitely leave you with some sense that the situation is at least being looked in to. 
  • What if they ask you if you are comfortable going back to the site?
    • Be honest. If a preceptor is being disrespectful to patients you probably shouldn’t be at that site.  

 

 

Breaking Down PA School Interview Questions IIX

Q: What would you do if you disagree with your supervising physician in the treatment plan for a patient? 

What are they looking for?

  • How you react to stressful and confrontational situations
  • No one wants to work with someone or allow someone to represent their institution that’s going to be a jerk if you disagree with them 
  • That you can kindly and appropriately advocate for your patients 

What to avoid

  • Saying that you would do what you thought was right no matter what your SP says
  • In the same light, stating that you would do whatever your supervising physician said because they are in charge is also not the right answer
  • If you go to another colleague– never ever bad mouth the physician involved in the course of treatment.  

What to say

  • You would talk to you SP in a way that you were asking for education regarding the course of treatment.  In other words something along the lines of “This isn’t a course of treatment I am familiar with would you mind giving me some information so I can better understand?”
  • If after you’ve asked for clarification you still don’t agree to the extent that you think the patient may suffer–talk to your colleagues or another SP about what they think the best course of treatment would be.
  •  Always remember and make it a point that you would not seek another opinion until after talking to your initial SP.
  • Always promote collaboration and learning into your answer whenever someone asks you about a controversial situation.