Transition from PA-S to PA to PA-C with ease: First JOB (Part Two)

As one of the top 5 medical careers, a Physician Assistant job is not hard to find. Picking the best one for yourself as a new graduate can be a process. Check out the previous post on proper steps to get your license and average time for credentialing. Plenty of people begin their career with either a job they truly love and stay there for a long time, while some just take the first job they can due to several reasons not limited to paying back loans. My advice is also to be realistic with what you consider a dream job out of PA school. A job where you’ll learn, have support as well be able to grow are necessary requirement. Remember, you’ll have to show up to work, don’t take a job for frivolous reasons have to spend the next year miserable.

When I began to look for a job, I asked myself these questions:

  1. What specialty did I want? Emergency medicine (#1 choice) Surgery, Family Medicine, Dermatology?
  2. What hours was I willing to do? 9-5? 12 hour shifts (#1 choice)?
  3. Days or Nights shifts?
  4. Where did I want to work? Hospital (#1 choice), clinic, private practice?
  5. How far was I willing to travel for a job?
  6. How much was the salary?

Throughout the process, I found myself compromising on either the travel time or salary, but not on the hours. I knew I did not want a 9-5, five days a week job, which eliminated a lot of specialties that required that (i.e family medicine, certain surgical position, dermatology) but allowed me to explore potential internal medicine positions. I even thought ofย  orthopedic, ENT or neurology as those specialties looked to train new graduates more often than other specialties in my area.

There are different paths to finding a job. Positions recommended by people you know are always great because knowing someone within the organization has proven to help get you closer to an interview than simply sending a resume to the recruiting team. Tell you professors what specialty you’re interested in, or your clinical site supervisor to let you know if there are open positions. These are ways to get information early and apply. I also used Indeed, LinkedIn, recruiters, hospital careers websites and google search engine. There so many jobs opening and many of it will require experience. This could be disappointing, but a few of the time, I still sent in my resume and cover letter. I figured, I had nothing to lose.

Once I started getting positive response from the hiring team, I made sure to prepare my telephone pitch. It included who I was as person, what I was looking for and why I wanted that position. Phone interviews are very common with the recruiters of the hospitals you wish to work for, and it also helps you ask and learn more about a job before going in for a physical interview.

Physical interviews can be nerve wrecking. I remember my first one and my interviewer later told me how she thought I was a shy person (Ha! Anyone who knows me, can attest Iโ€™m the furthest from shy!). Since then, I have tried to allow my true self shine through and while Iโ€™m still learning, I got better. Practice makes perfect!

Some of the questions I asked during interviews included:

  1. What was their training timeline for new graduates?
  2. What is the turnover rate for employees working in the department?
  3. Is there opportunity for overtime hours?
  4. Are they aware of what a PA does and how do they utilize PAs?
  5. Are you mandated to take calls?
  6. Is there OR time allowed for surgical positions?

Most companies will reach out within 10-14 days if they do not offer the position right there to you. This has happened to me! Some may take a while if they’re still interviewing other applicants. Accepting a position is a commitment and most will ask you to sign an offer letter so they can begin credentialing. There are times where you may juggle a few offers and deciding which to accept will depend on what you really want out of the job. Remember, you ultimately decide if a job fits you, so ask questions and be active in the process.

Be aware of what youโ€™re willing to accept and step forward into the next phase of your career. This can be another long and frustrating process, but staying on track will make a difference in how you handle it.

Share and comment below if you found this helpful!

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.ย  Remember,

Health is weath!

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 fromย 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.

Dear NICU….

A change. I may or may not have prepared for it, but it wasn’t waiting for me to get it together. My body has become the vessel for a new being and I was elated, scared, anxious and whatever other feelings I could feel. I imagined who you’re going to be, how the delivery would go and what type of mother I’d be. The whole months that passed by, I heard congratulations, advice, appointments and the whole village was awaiting your presence.

But oh no…….

A declaration was made. My deceleration were wild, my membrane ruptured too early, the amniotic fluid was very little, the cord was wrapped around you, who knows what, it all sounded like jargon and they must bring you out immediately. Wait, I didn’t finish your crib, I wanted a home birth, I don’t want a csection, the baby shower is still weeks away, I didnt even get to push!

But you’re here now……

Way earlier than we planned and whisked from my stretched & tattered flesh into the arms of strangers. I didn’t hear your cries, someone said you’re all blue, no movement as I lay not feeling my lower body. Everyone in the room springs into action. I wasn’t your first hug or your first touch. You’re suctioned, probed, masked, pricked, infused with various drugs/fluids and placed in an incubator, secluded from my warmth, my touch, my heart beat.

Away from me….

Seeing the world but without my touch or my voice along side you. The team is now with you all day. Some stranger who earned a MD NP, PA, RN, RT behind their name spend more time with you than I can. The updates are sporadic, late phone calls to bring breastmilk, to keep pumping, lines all hooked up to you, the stares, audience when I’m forced to bond with you in front of people who doesn’t know me. Some will see me, smile, try to accommodate while hoping I don’t ask too much questions. They’re waiting for me to abide by their requests and not flinch when asked for permissions to continue probing you. The slightest frown or repeated question got a raised brow from them. All just wondering why I just don’t get it and be okay with everything.

How can I be okay….

Do they not know that I can see them? Hear their whispers about me and my baby? Can’t they see how I feel? The anxiety, the shame, the energy it takes to walk out and not leave with you in my arms? Have they placed their feet in my shoes? Didn’t they dream of the perfect baby like I did? Don’t they hurt when days turn to weeks then into months in the hospital and only allowed to visit my own child during visiting hours?

They must know….

They consoled when there was no progress, when you lost weight and nothing could stop the cries, my defeated walk out of the door, my frustration trying to get you latched onto my breast… or at least some of them knew. They smiled and laughed during discharged . They joked about my lack of sleep from here on out, couldn’t wait til I visit & show them how beautiful he/she would look. Or atleast that’s what we was all hoping for. Some didn’t get the luxury of going home with the baby. Prayer was a constant factor with hope that we got to take you home to help you grow some more into a beautiful member of the society.

And you do grow...

You grew before my eyes because of their help. I praised the strangers who became family during the stay. They brought you to a state a I couldn’t. I smiled, thanked them for their efforts and appreciated each one because I knew with certainty I was walking out with you in my arms. I accepted that I may have overreacted when they called one or few times, I took out my frustration on them when I shouldn’t and we both weren’t perfect. They were doing their job. One they must love and care. So I apologized to the team about their difficult jobs but to understand where I was coming from.

This experience was new, unlike what I planned for and each day was not guaranteed. I was only human. With that, I smiled then waved goodbye knowing that the true journey has just begun.

—————————————————————–

p.s: I am not a mother, I’m simply an observer. This piece is not to insult families who have had to go through NICU, not to disrespect the staff that works tirelessly to help or to ridicule the fragile state everyone is in during their stay. I just wanted to write again, to dig into the other part of myself I often neglect. And I appreciate you for reading this far.

B.

My First Rotation : General Surgery

When I found out I had Surgery as my first rotation, I was nervous. I heard horror stories about surgery, how tough and terrible some of the team members were. But, I was also excited because I have an interest in it. In my mind, it was either going to solidify if I can be a surgical PA or scrap that idea entirely.

Thankfully, I loved my time in General Surgery. I loved the types of surgeries we did, the patient care and how the team worked together. I got to work autonomously for majority of the time by taking H&P, writing my notes, presenting to the Residents or the Attending. I also was 2nd assist in all the surgeries I scrubbed in on ( the lovely job of retracting, suctioning, guiding the scope at times, and closing) because the Interns were the 1st.

I got feedback from various people such as how well I did with my h&p, patient/provider interaction, overall professionalism as well as things to work on (i.e- how to work on my notes, suturing, knot tying, and other placed I can improve upon).

Take away points :

  1. If you dont know it, dont say that you do. If you’re not sure of a lab value, vitals, status or information, don’t make it up to look good for that moment. Just say, “idk, but I’ll check & get back to you”. It shows that you’re taking responsibility and not placing a patient’s health in jeopardy.
  2. Read about the usual Gen Surgeries.ย I only got pimped ( when MDs ask you questions about medication, anatomy, physiology, etc on the SPOT, mostly likely in the OR while retracting lol) a handful of times and only once was it embarrassing. I advise reading your basic blood vessels of the GI tract, anatomy of the GI, and any interesting case coming, read about it!
  3. Be attuned to your surroundings. Pay attention to the discussions happening around you because it looks bad if someone ask you for an update on a patient on your team and you don’t know what is going on. The team is constantly busy, moving at a fast speed that it can be overwhelming the first few days, but if you just ask what can be done to ease their workload, it will help you find your footing much better and faster.
  4. Follow up on your patients. You’re usually assigned one or two patients to follow. Round on them before your AM round, complete pertinent physical exam, ask the patient of they understand the plans and monitor them throughout the day. As students, we get more face time with the patients than the team does.
  5. Work with everyone on the floor. Get the nurses to teach you how to draw blood if you dont know how or not comfortable. Help out the nurses whenever you can. Anyone need a specimens sent to the lab? Volunteer. They’re are doing wound care rounds? Go ahead and offer to assist. You’ll learn from not only the immediate providers but from the axillary team as well.
  6. Feedbacks are important. To have someone who tells you how you’re doing & where you can improve will help you as you round out your time with the team. So, ask the Residents or anyone you’re working closely with about how you’re doing if no one has by your 4th week.
  7. Study while on rotation.ย You’ll have some down time where you can whip out your tablet, notes, or phone and get some questions or videos in before your next case. You can also work on your writeups so it doesn’t pile up for later. Use your time efficiently.
  8. Perfect your craft. Practice how to tie your knots and sutures. Perfect your history taking and your physicals. Volunteer a lot. You learn by doing.
  9. Take care of yourself. You’re going to be up before dawn (I was usually up by 4:30am because my site was very close. Imagine if it was further??). Sleep early, keep snacks on you for busy days. Plan accordingly. Set aside time to study, even if it’s just an hour a day and time to have fun.ย Go out with friends and decompress with loved ones, because it can get overwhelming very fast!

How did I PASS my EOR??

  1. I prayed ALOT to God.
  2. I printed out the topic list from PAEA (our school uses their EOR exams).
  3. Read Pance Prep Pearl’s according to the topics needed. PPP went everywhere with me, literally.
  4. OnlineMedEd videos for an “in lecture” recap & took notes.
  5. Rosh Review and Smarty Pance for questions.

I can honestly say I had a great time in Surgery, which was not what I expected. I complained about my early mornings, but I learned alot in such a short time, often looked forward to the procedures. I am looking forward to the remaining 9 rotations, so wish me luck and watch this space!!

Any questions, comment, e-mail and check out my Instagram for frequent updates.

Primary Care Study Tips : Dermatology Module

Hey everyone, this post is about how I’m passing my major course this semester.ย  This semester we’re taking a 8 credit course that focuses on Primary Medicine with various systems of the body getting tested every couple of weeks along with the rest of my classes.

If that sounded overwhelming, it feels like it!ย 

We started with GI and Infectious Disease in January, then Hematology and Pulmonary and we are finishing up Renal and Dermatology now so I’ll begin writing this journey with Derm.

How do you prepare for Derm?

  • Pictures! If you have time, begin by making your flashcards because if you cut the pictures and write it out, you’re learning as you do this. My friend did this and it was very effective. It allows you to be able to work on the go. If you don’t want to write it, do it via quizlett or an app on your phone.
  • Use your Google Drive: drop all the pictures into a file on the drive and make another documents with the answers. You will go through each of the pictures,ย  write down your answer and check your answers once you’re done. This technique work best after you’ve learned the material.
  • Look for written exams online to guide you with what type questions you may see on your exam.

How do you know what questions to ask yourself?

Derm is detailed oriented. Most disorder have a hallmarkย  sign that helps to differentiate the skin disorder. So you’ll ask yourself key factors like:

  • What type of workup will you order for a Pt presenting with small, grouped erythematous papules around the mouth and gentirals (Tzanck Prep). Take it a step further and ask what type of cells will you see if you order an Tzanck Prep?
  • What disorders will present with erythamous rash across the cheeks and nose? And how do you rule each one out?
  • What age group commonly has bullous pemphigoid, and how would you treat?
  • What are the different stages of decubitis ulcers?

Repetition is Major Key.ย 

You have to review the materials several times. Grab a classmate, a friend, your girl/boyfriend or mom and ask them to quiz you. Tell them to ask you the disorder hallmarks, dx, sx , tx and keep repeating it. Try it different ways.

I always learn by first reviewing things alone then in a group. When I talk about things outloud, I retain more and I’m able to explain why my amswer is right.ย  Thats when I know I’m comfortable with the material.

And most importantly, always trust your instinct.

Leave a comment if you’re trying these methods out or if you have any other method that are helpful .