Transition from PA-S to PA to PA-C with ease: Part One

The Long Space between leaving PA school and practicing as a PA-C

If I could get a dollar for every time I’ve been asked β€œdo you have a job?” or β€œhave you started working yet?”, I’m positive it’d help pay off some of the interest accruing on my loans. While these questions are asked out of interest, it is frustrating to explain the long process it takes. This post is the first of two part that will include how to prepare if you’re finishing up PA School and what to expect after you become a PA-C.

Within 60 days of your last day of PA School:

  1. Register for your PANCE as soon as you can. You can take your PANCE 7 days after your official last day of school, but you can register for it from when your program gives you the okay (my school was at least 60days before we finished). https://www.nccpa.net/pance-registration
  2. Create a resume and cover letter.
  3. Start applying for jobs.
  4. Make a schedule for how you want to tackle your PANCE.
  5. Take your BLS/ACLS/PALS course training if you don’t have them or will be needing them in the specialty of your choice.

Officially a PA.

  1. Study hard and PASS your PANCE as soon as you possibly can. Check outΒ How to PASS the PANCE
  2. Continue to apply for jobs.

Officially a PA-C.

  1. Apply for jobs if you are still searching.
  2. Send in your state registration application. There are usually multiple steps for state registration, read the instructions carefully and pay the required fees. You can start this process while studying for your PANCE. In New York, it cost $115 and you can begin the application prior taking your exam and release your scores after you’ve passed. http://www.op.nysed.gov/prof/med/rpaforms.htm
  3. Sign up for your NPI. The easiest of all things you’d have to do. https://nppes.cms.hhs.gov/#/
  4. Apply for your DEA – (optional). If your job requires (as most do), your practice may pay for this or waived if working for a state institution. It cost $731 and most people reluctantly pay for this out of pocket. It can take up to 6weeks (Although it has taken less from what I hear) https://apps.deadiversion.usdoj.gov/webforms/
  5. If you’ve secured a job prior to finishing school or while studying for your PANCE, then you continue to start the credential process with your job. Private practices take less time to complete as opposed to hospital settings where average time is 3-4 months.

The delay is mainly due to credentialing. I’m speaking specifically for NYC here, make sure to keep in contact with the credentialing specialist assigned to you. There is a medical board that must review your credentials and to my knowledge, they meet once or twice a month and if your documents are not in order, you will not be presented and must wait for the next round. After accepting a job offer, you’ll have to complete a series of request. You must be proactive to email, ask for updates and complete all required tasks on time, otherwise, it will delay how soon you can start working.

Each company requirement for credential varies but you can expect the following plus more:

  1. Complete job application
  2. Medical clearance
  3. Recommendation from program director and clinical supervisors
  4. Background check
  5. HIPPA training and other training related to your job
  6. BLS/ACLS/ATLS/PALS etc as needed.

If you have not secured a job, continue to search, apply and interview.

Completing these steps are dependent on the individual, position and company. This is my experience and will be sharing the part two, which will include details on finding a job, deciding and more.

 

 

Wellness Check Up : why you need one

Have you completed your annual physical exam?

An annual physical is an examination of your health history, physical exam and routine lab work including your blood sugar and cholesterol level. It is data that provides basic foundation for your health. It can tell you if you’re anemic, which can contribute to the fatigue you complain about or point out elevated blood pressure readings that can be controlled early or it can simply be unremarkable.

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Unfortunately, not many people find it necessary to complete. A common misconception is if they’re doing “okay”, they don’t need a physical. With time spent working in the health care system, I have seen many issues that a regular physical exam can prevent and try to encourage those around me to complete one.

Annual physical can help to :

  1. Identify issues that you may be at risk and provide guidance to implement changes.
  2. Decreases ED/Urgent care visits. There are many visits daily in the ED that are primary care issues.
  3. Decreases total cost of care in the long run. If your health is recorded with a PCP, you’re more likely to track your history and know before hand.
  4. Improves management of long term medical issues such as diabetes, hypertension, CAD, HIV etc.
  5. Patient and provider relations is maintained for a long time. I’ve been with my PCP for over 8 years and do not plan on changing that. We have an understanding that I wouldn’t want to break.

If you have access to care, please schedule a visit to your primary care provider. Begin and invest in your health, just as you are eating and exercising.Β  Remember,

Health is weath!

How to Survive Finals Week

FirstΒ  time inΒ  forever (probably since I started grade school) that I’m not preparing for an exam in December. Here are a few last minute tips to survive finals week. These have worked for me in the past and while I’m not a straight A student, I think I did okay.

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so studious πŸ˜‰

πŸ“ Limit or stay completely away from social media!! I used to either put my phone on DND or turn it off while studying so I’m not tempted to constantly start complaining about how much work I have 😩. We’re all guilty of this.

πŸ“Eat & Drink! So easy to want to get through a material and forget to take care of yourself. Your health is so important. & I have to eat, otherwise I get cranky πŸ₯΄πŸ€£

πŸ“Double check your topics list that will be covered on the exam. If you’re aware of what’s coming on the exam, you can plan how to review your notes, what your weak areas are and how to improve them.

πŸ“If it’s a cumulative exam, review old exam questions if you have them.

πŸ“Triple check the time & location of your exam. Don’t want to be late or go to the wrong exam hall.

πŸ“Ask for help. If you can arrange an effective study group, or call up a friend to explain a few things, don’t hesitate.

πŸ“Exercise. Even if its just taking a short walk, do something to help relax your mind.

πŸ“ Sleep! I always got atleast 5hours of sleep for every exam I ever took. I may tussle in my bed from nerves, but you won’t find me doing an all nighter. Never worked for me. (p.s the one time I got maybe 3hrs of sleep for an exam, I fell asleep while taking the exam πŸ€¦πŸΎβ€β™€οΈ, so it’s def not worth it)

πŸ“Do your best. Sometimes the effort put into a coursework doesn’t always translate into an A+.

Best of luck to everyone finishing up the semester!!!

Have a tip to help someone? Share!

How to PASS the PANCE

I started this blog post several weeks ago, where I added things, removed some and debated if it was worth sharing with the world. This topic is universal and very subjective because I’m only a recent graduate who is sharing her one-time experience with the PANCE. The rest of the post will be very informal, so judge very lightly.

These are my views on the topic and everything I wrote about is not going to apply to every student.

Was the test hard? Yes, it was. Β Probably one of the most challenging exams I’ll ever take.

What study tools did I use? I used Pance Prep Pearls and Rosh Rapid Review e-text as my text resource. Hippo education, PPP question book, Smarty Pance and Rosh Review were my resources for questions. In hindsight, I probably could’ve benefited from an additional study guide, but I am a person who doesn’t like too many sources. Once something works, rarely do I ever want to change it.

  • Rosh: I did all the body system questions, the family, internal, surgery and emergency medicine EORs. I also completed the Mock PANCE to replicate the PANCE in a 5 hour sit down. This was done 7 days before my exam.
  • Hippo: I completed at least 4x 200+ random question per practice exam. I reviewed mostly the questions I got wrong and allowed HIPPO to pick my questions based on my weak areas.
  • Smarty Pance: I did 3 of the comprehensive 225 questions exam during the first 2 weeks of my studying. I didn’t return to use Smarty Pance because it wasn’t as tough as the remaining resources.
  • PPP question book: I only did 160 question out of the whole 600 question book. I was short on time and simply preferred computerized practice question. Although if I had more time, I’d have done more of these questions because they helped.

Tutor or Exam mode while doing questions? I believe that tutor mode makes me lazy as it helps answer future questions. Simply put, I didn’t do any tutor mode. I timed myself for every exam to build up my stamina. You’re going to be taking an exam, so start stimulating that and you’ll be ready. Sidebar, I had about 8-10 min in each section of my PANCE to review my exam and news from fellow classmates was how they were running out of time.

Did I take the NCCPA Pretest? Β Yes, I did and totally worth the $50 investment. Honestly, this is the only test that is very similar to the actual test and helps to show where you stand among your peers who’ve taken it. Do not take the pretest until you’ve reviewed all the topics and at least 10-14 before your exam date. It has a way of unnerving even the calmest students, so prepare for it because you don’t want to waste your money or time taking it when you’re not ready.

What were my weak areas? Pulm, Msk, OBGYN & GU were my weak points. I did terrible on reproductive system because I did not review those topics before taking the pretest. Therefore, it is important to finish reviewing all materials before taking it. TRUST ME.

How long did I study? PANCE is an individual race. You must know where you’re as a student and know what works best for you. I took my exam exactly 6 weeks after my first board review. I put in about 10 hours x 4 days a week consistently in the library and a about 6 hours here and there on days I wasn’t in the library. Β I needed the structure of the library and no distraction to complete what I needed to do. While this worked for me, it can be different for you. I know a lot of people say you’re studying for PANCE while in clinical rotation, but that time is not the same because you’re still focused on passing an EOR & graduating. There must be time set apart to focus on solely studying for the PANCE and that time varies. Average recommended time is 4-8 weeks depending on who you’re. Some students will take it within 2 weeks, while some will take 10 weeks or more. Its all up to where you stand.

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How much time is too much time? Just as you don’t want to take the exam unprepared, don’t take forever either. You can be ready objectively but subjectively you may feel not ready and willing to keep pushing off the test. If your practice scores show that you’re doing well, your pretest places you in the green and you know your stuff, don’t take forever waiting. Because life will be happening around you, which can affect how well you study if you are weeks to far into it.

What topics needs extra attention? The main heavy hitters to know are cardio, pulm and GI. BUT, reproductive health, GU, and professional practice are content areas not usually given much thoughts to and I’d recommend paying closer attention to them. Personally, I treated reproductive health as a topic that β€œI should know already” but it turns out that I needed to read and put in more effort. Β Do not sleep on professional practice content areas.

Was I anxious? I had a lot of anxiety leading up to my exam and even until the morning I got my result. I was blessed to receive so many great news that morning- my niece was born that morning as well. I believe that being mentally prepared for the exam was just as important as studying for the actual blueprint. We know the material but learning to be a test taker and not doubting yourself is vital. After my exam, I felt like such a weight was lifted and that I could have passed. While thinking about that, I tried to quell my eagerness because you just never know. That was the hardest part and the waiting was bad. Thank God for great friends who will adjust their plans to keep you company after taking that exam!

Does your score matter? I simply have no idea. To me it doesn’t matter if you pass at 350 or 750, because you’re both a PA-C. Your test score doesn’t determine what type of practitioner you’ll be. While studying, ask your faculty what numbers are ideal to be scoring. If you reach out to me personally, I will share what numbers I think can tell you where you stand. I have only my knowledge and other classmates to use as my source for it, which is why I do not feel comfortable sharing it here.

Test taking tips… Do not change the question asked. Answer what you’re given, as it is given. Do not think like a clinician, think exactly like the textbook. Read the last line first and then start from the beginning to help focus. Review questions you answered wrong then find out why you answered it the way you did and learn from it.

Group study or no? I did one group study session with my friends and it was only on cardiology. While it was helpful, we found that we were all at different points and wasn’t going to be productive to keep meeting up. We stayed in touch via video chat, group text and phone call whenever someone had a question, which was very often!

My support system was… My three closest friends in the program were the people I spoke with the most. I shared everything from my anxiety, study techniques, stress and tips with them and vice versa. I limited the amount of people who had access to me during my study time because I didn’t want to interrupt the energy I had cultivated. My state of mind during those 6 weeks were fragile and life was happening all around me and I had to block a lot of it out. You must do what you have to do sis!

If you’ve made it this far, I hope you learned something and will share my experience with the 2019 PANCE with others. It was an exam that put my 27 months in the program to test, to see if I had what it takes to practice. I am blessed to have family and friends who supported me because it was a tough 6 weeks. No one else will be able to understand what you’re feeling, except for your classmates, so it is okay to take however long you need to be ready. If I remember more helpful information, I’ll update this post as needed.

B.

p.s: be mentally prepared by learning how to control your anxiety.

p.s.s: If you are a borderline student or struggled while taking your EORs, PACKRAT etc, then I’d recommend taking your time to evaluate your weak areas and strengthen them. Those areas do not disappear just because you’re done with school. The PANCE is too important and expensive to just “go take it”. There are students who don’t pass or do well, that’s the sad reality of it. It doesn’t mean they’re not smart, they just must adjust to taking a test. Do yourself a great service and do what’s best for you. Check how you’re scoring on your practice test; find patterns in questions you get wrong and alter your studying appropriately.

p.s.s.s: the passing score of 350 from last year exam will not yield a 350 this year according to the information regarding the 2019 PANCE. That means the PANCE was harder this year, which has put alot of people on edge. It is neccessary to stress, because you want that “C” bad, but don’t let the stress stop you from effectively studying and learning to be a better tester.

The 2019 PANCE was a real one, from my experience and the passing rate nationwide.

 

7 Tips to Create a Competitive Transcript for PA School

PA school has evolved from the first class at Duke University 50 years ago. PAs today can now hold a masters degree in the profession and students as young as high school graduates begin their journey toward earning the most expensive “C” of their life. A lot has changed and will continue to. Prior to applying to programs, I did alot of research, like many people do. The initial part of my research focused on my transcript. I knew I wanted to be a PA from high school, so I tailored my classes toward meeting my prerequisites as well as taking classes that I had interest in, although not neccessary for PA school (i.e African American Lit, Drama & Women Fiction). As of 2016 when I sent in my applications, schools began to increase necessary classes to have, such as requiring and not recommending biochemistry on your transcript. This pattern of requiring more from applicants would only increase as schools tries to create a more competitive pool of applicants.

So how can you create a competitive transcript?
  1. Start early and be patient. Check out requirements for multiple PA schools. If you’re just starting college, that’s great. You have a blank canvas, so create and plan accordingly. Anatomy, Physiology, General and Organic Chemistry, Psychology, Statistics and/or Calculus, English Composition and Microbiology are the most common basic requirements for the program. Work with an advisor to anticipate when you will take these classes if you’re still an undergrad. If you’re a post grad student, check your transcripts and make sure you have the most basic requirements the school ask for. If you don’t, enroll and give yourself enough time to get those classes before applying. Most schools accept one or two prerequisite to be in process if you’re applying for the current cycle. If you’re going to be a PA, don’t put a time stamp on when you must achieve it.
  2. Advance science courses such as Biochemistry, Histology, Molecular Biology, General Physiology, Genetics, Embryology, Analytical Chemistry should be considered. Schools look for students who have more than the minimum requirements. Some of these classes are going to be part of your curriculum if you’re a Biology or Chemistry major anyways.
  3. Take classes outside of your major that can help to reflect a well rounded student. Take an additional psychology class that you find interesting, or an advance writing class. It helps to add character to your transcript.
  4. Check if your prospective PA schools have an advisement committee for incoming students or open houses. Some schools hold advisement during open houses for students to see if they do have the correct requirements and allow their staffs to give advice. Some schools will look through your transcript, so inquire if you need to.
  5. Seek help with your classes. If you’re struggling with a class, ask for the help of tutors. Putting in your best effort in each class will yield great results at the end of the semester. Most undergraduate school have learning centers and since you’re already paying tuition, might as well make use of your money.
  6. If you’re a post graduate student and you need to re-take a class because of a low grade, do so. Retaking the class & working hard to earn a better grade is important. It shows that you’re determined and learn from your mistakes. I don’t recommend withdrawing from a class if you’re in progress, but if you need to, do it. Life happens and you must always make a decision that will benefit you. Better to retake the class and give it your all, than to finish half baked.
  7. Look up your professors prior to taking their class. I used ratemyprofessor site while in undergrad and it saved me from alot of heartache. Ask your seniors about the professors, tips to help with the class. Remember a closed mouth doesn’t get fed.

Bonus : Make sure your classes are still within the time frame for your perspective program. Some schools have limited course life, some up to 5, 7, 10 years since you took the class. Check with the schools you’ll like to attend to make sure your courses are still in good standing. Applications are expensive and you don’t want waste your time and money.

PA school applications are much more than your transcript and grades. They’re looking at the overall student, but making sure you are solid on areas that may easily be fixed prior to applying is crucial. Double, triple check your transcript and plan ahead. If you’re not prepared for the long journey of PA school, you’ll be frustrated and discouraged very easily.

If there are other tips or ideas to help someone with creating a competitive transcript, share!!!

And don’t forget to share and comment if this post was helpful.

Why Diversity Matters

With every opportunity, I recommend my school to anyone who will listen long enough for me to boast. There are positive qualities and areas where the program can improve upon, but one factor that makes them different from most Physician Assistant (PA) program is how diverse each cohort is. Each class is an example of what the world looks like, with students from various ethnicities, beliefs and practices. Unfortunately when I talk or see students from other programs, there is a lack of diversity among the cohort.

It is important to have diversity. Numerous research has conclude that quality of care for racial/ethnic minority patients improve tremendously when they share a ethnic, language or even religious similarity with their provider. Also, it is known that health care experience and outcome for minorities are much more different than the results of their counterparts in both medical and surgical specialties.

In 2017, less than 20% of PAs were minorities and less than 4% were Black. Attending my school, I often forget that students from other programs do not look like my classmates. There is usually just one or two Black students among the cohort. There are many reasons why minorities make up such a small amount of the percentage and it is up to us -the current students and clinicians- to change those numbers.

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Diversity Matter T-shirt fromΒ The PAC

How do we start?


ADVOCATE. We must encourage others and create a future where we matter. We must also take up positions as administrators when opportunity presents. Use social media as a tool. Social media is much more than a pretty collection of our best looks, it is a place that can inspire the next generation to believe in themselves. It is important to note that you don’t have to be Black or a minority to advocate for diversity. We all share responsibility in creating what we hope to achieve.

So each day going forward, do your part to diversify the field of medicine.

B.

It Only Takes One ‘YES’

Exactly 2 years ago, I was graduating from undergrad and worrying about PA school. When I woke up that morning, I felt like sh!t because the last school who had me on a waiting list was hosting the incoming class orientation the same day I was getting my B.A. On my way to the ceremony, I got a call from the Administrator asking if I still wanted to be on the wait list. I was shocked cause I thought the class was completed. Ofcourse I accepted and she promised to get back to me later that day. I checked and rechecked my phone all day. This was worse than waiting for a reply after sending a guy a lengthy or risky message. By the end of the day no phone call came. That night, after beating myself up mentally, I opened up CASPA and started entering my data for another application cycle.

2 days later – spongebob voice

On June 1, I got another phone call. The person asked if I still wanted to join the class. I thought someone was playing a cruel joke on me. I was a few seconds from cussing someone out! After he explained that he was part of admissions committee, he asked the question again. My initial thought was to say “No”. I had chucked up the cycle as a lesson and that I’ll do better the next time around. I asked my cousin who was laying next to me, what she thought and she looked at me as if I was crazy!!

Maybe I was…

I mean who turns down what they had been praying for?? I almost did because I was scared. I was scared that just maybe, I wasn’t ready, or that if they took that long to get to me, it wasn’t meant for me yet. I know you’re probably like “girl are you mad?”. Obviously you know I ended up accepting because I’ve shared the journey over the last two years with everyone who will listen but I wanted to share that the road to your dream may not happen as you imagined it. I surely never imagined that I’d be starting PA school 2 days after the whole class started but it happened. Your journey will be different from mine, at your own allotted time stamp according to God. And when that time comes, don’t let fear or doubt win.