Informational Interview with Stephanie Howard OB/GYN PA

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Stephanie (S): My name is Stephanie Howard and I am a physician assistant. I live in Knoxville, Tennessee and I’ve been practicing obstetrics and gynecology since I graduated in 2010.

Savanna | The PA Platform (TPP): Has that been your only job?

S: Yes, I actually did a rotation with this physician, my supervising physician now, and I always knew I wanted to do women’s health. In undergrad I followed around an OB/GYN and so I kind of knew that’s what I wanted to do. I did my elective in women’s health also and I went back and did my elective with her and she offered me a job. So I’ve been with her, I guess, really since 2009 because I did 12 weeks of rotations with her.

TPP: Okay, cool. So I actually did something similar where I actually got hired before I did my electives. I was hired and then got to do 8 weeks of basically training before I jumped in my job so we kind of did the same thing there. 

S: Well I think that that’s awesome and I felt like I’ve recently picked up a lot of clinical year students. I try to tell all of them, “treat every rotation like a job” because you don’t know if people are going to have openings where you’re at, you don’t know who they know, and if you do a really good job like you could be offered a job. I think I was offered like five, I was offered 5 jobs during clinicals. Of course now you know in Knoxville where I’m at, its kind of a saturated area for PAs, but at the time when I did it wasn’t and so I always try to tell everybody like if there’s something that you like or want to do women’s health, like see if you can set up your own rotation or your own elective somewhere you may want to be and like prove to them and show them why they should hire you and how they could benefit from having a PA. 

TPP: That’s really good advice and something I wish someone had told me. (Let’s backtrack in a minute. I went into rotations with the mindset that I should tell everywhere I was working that that’s what I wanted to do. For example, let’s say I’m on family medicine, they would say “well what do you see yourself doing? What do you want to do?”, I would respond by saying “ oh, family medicine”. Even though, in reality, I knew I liked derm.  I knew I liked procedures, and when it came to rotations I actually really liked everything except for psych. It wasn’t until I actually about halfway through the year I started telling people when they asked. It was actually my surgery preceptor I first told, “You know I really think I’m interested in either surgery or maybe dermatology.” 

Once I started being honest about it and told him and my emergency medicine preceptor, that’s when people actually started seeking me out and saying like “I heard about this job, send your resume” and getting calls so it’s interesting that you give out that advice of “go into it thinking of it like a job interview because you don’t know who those people know”. It was my surgery preceptor that got me my job because he had that connection and he was able to make a phone call and say “you need to interview her and I think it would be a good fit” and so I was very appreciative of that.

S: They are more likely to take advice from a colleague who they respect and has been with somebody than like something that comes across on Indeed or an ad in the newspaper.

TPP: Exactly, I agree and that’s what I tell people with shadowing. Use all of your connections and when it comes to clinical I had a couple of preceptors who would tell me like “you seem like you want to be here and you are really participating” which I found to be a very strange comment. I felt as though all students should be like that, but apparently not.

S: I experience that also. If you ask the majority of people about their women’s health rotation there are so many mixed feelings -- you either want to do women’s health or have absolutely nothing to do with women’s health. It’s one of those things that I tell everybody, even if you don’t enjoy the rotation be interested and participate. We are trained as generalists, this is our only time in pre-PA to make the most out of our education and be the best most well-rounded PA that we can be. We really need to be all hands in and try. A lot of people have been on my rotation and they say “ooo I don’t really want to do this” and I think to myself, “well you’re here so you’re going to do pap smears until you’re comfortable with it”. A lot of people don’t and your preceptor can pick up if you don’t want to be there or not and it all goes back to how likely am I to refer somebody for a job or write a recommendation. It’s important to try and be present because they’re taking the time out of their day to teach you and obviously they enjoy their job or they wouldn’t have students and they wouldn’t be doing their job. 

TPP: That’s so true. I’ve seen the same thing shadowing. If somebody’s letting you shadow you need to act like you want to be there and pay attention. On clinicals that may very well be your only exposure to that area. You need to soak up as much as possible -- especially if you know you want to do something else because like I’ve found in derm, there are certain things that affect women in areas that would crossover with OB/GYN. I definitely see things and treat things that you guys see and treat. I get referrals from OBGYN offices so it’s important to have as much knowledge as you can even of other areas if possible.

S: Patients never understand, you know obviously there are different specialists but, they think that you know what their derm knows or what their internal medicine doctor knows so they’re going to talk to you about it so at least being familiar, and saying “well I don’t do that every day, but I do remember this from my rotation and this sounds familiar” because they’re going to ask you about stuff.

TPP: Let’s backtrack a little bit -- why did you decide to become a PA?

S: I think that I was kind of fortunate because my aunt and uncle are both PAs. I grew up knowing what a PA was. I was in high school and I was exposed to what PAs were and at that time it wasn’t as popular.  I’m not super old I graduated high school in 2003. When I went into undergrad I knew that I wanted to do something in the medical field and being a PA was always an option for me. I did that whole biology in undergrad and basically had to do the premed route because I would say “I want to be a PA” and people would say what’s a PA? Now they have pre-PA tracks that you can go through in school, but at that time, I graduated undergrad in 2007, nobody I knew, knew what a PA was. I got to shadow PAs, went around and I realized that that was something that I wanted to do as a female. I wanted to do something in medicine but I also wanted to be able to have a family and to be able to have a life. The balance of what the PA profession gives you, to have a life and a family and to be able to be a practitioner, it was just something that worked out really well for me. 

TPP: What did that look like? I graduated high school in 2008 and college in 2012 and I feel like there wasn’t much information out there and the same thing, I would go to my advisor and “you want to do what? What’s a PA?” so I can imagine you ran into that even more. What was your application process like? Did you get in your first time? How many schools did you apply to?

S: I don’t know when CASPA started or not but I had to apply through that. I applied to 4 schools. I’m from Alabama and I applied to two of them in Alabama and I applied to one in Arkansas, and then the one in Knoxville. I was a student in undergrad and knew what I wanted to do that right when I got out of school. My biggest challenge was really my patient care hours and trying to find something that I could get in without having tons of patient care hours was challenging.  I applied to those and got interviews at three places, was waitlisted at one, and then accepted into South here in Knoxville. The program was nice because it started in the fall and a lot of the other programs were starting in winter and so those things that just really lined up for me. 

TPP: Once you got to PA school was it what you were expecting? What was the most difficult part for you?

S: I remember our first day they told us the amount of information you’re going to get is like drinking water through a fire hose. I’m sure everybody tells you that analogy and so I knew that there would be a lot of studying going on and a lot of information. Honestly the hardest part really has to do with kind of like the fear of missing out. Not that you’re missing out on things, but people don’t understand how much time you spend studying and how your priorities have to change when you’re in school. I remember having friends and  I missed their weddings. It’s not so much in clinical but in didactic you were studying all the time. I remember I had some friends who came to Knoxville for the weekend because we had a wedding and I had like a peds test, an OSCE and like a pharm test on Monday and on Saturday they were inviting me to the pool and to have cocktails together and I had to tell them I had to go to the library. They just didn’t understand. I had to explain that I was basiclaly studying my life away and to go have fun without me.. 

TPP: I felt the same way. You have to make those decisions. I was living at home and my parents, I always felt so bad until I learned how to study. They would ask me to go to dinner and I would have to say “I can’t, I need that 30 minutes or that hour to study” which was a little bit dramatic, but you have to eat. 

S: You have to learn how to study and learn what’s important and what’s not important. Of course you’re not going to know everything but you have to get those basic concepts. At South, we had quarters so probably the first 2 quarters to try to like get in the groove and figure out studying.  It can be done, I got married the second quarter of PA school so it can definitely be done. More so time management and knowing that you’re not going to get to go out every night and there are some things that you’re going to have to miss, but it’s a small, small amount of time.

TPP: Plus, it goes by so quickly.  I felt as though it flew by -- small sacrifices. Once you got to the end of PA school you knew you wanted to do OB/GYN and you got lined up and did your electives. Did you interview for any other job or was that your only “this is the job I want”? 

S: Once she offered me that job, I knew that was what I wanted to do. During my rotations I had been offered other jobs and they were one of those things that they were getting in touch with me and it was more so if this falls through I’ll get in touch with you, but I knew that’s what I wanted to do and I really clicked with my supervising physician. She has taught me everything that I know about women’s health and has really trained me to do things the way that she wants them done. We have a great relationship and she values PAs in their role in medicine. She’s a very big supporter -- that’s so important as the PA to know that, who you’re working for really understands what you can do you and uses you to your full potential. 

TPP: What does a day at your job look like?

S: It differs from day to day. I do a lot of annual exams, birth control consulting, irregular periods, etc... I see everybody from adolescents to teenagers, pregnant women and menopausal women. I work up a lot of things such as dysfunctional uterine bleeding and pelvic pain. I deal with ovarian cysts, fibroids -- all of those things. We even do weight-loss counseling in our office, so there’s a lot of stuff. I am procedure-oriented, I love to do procedures so I do biopsies, such as endometrial biopsies. I manage abnormal pap smears, and do follow-ups with colposcopies. I do lots of ultrasound procedures like sonohistograms and hysterosalpingograms to look at the lining of the uterus and to make sure the tubes are open. We do a lot of bladder installations in our office for interstitial cystitis, and put birth control in and take birth control out. There’s a lot you can do in women’s health besides just pap smears all day long.

TPP: One question that I get a lot about specifically PAs working in OB/GYN is what can you do as far as pregnancy and delivering babies? Which I don’t know, I feel as though some of this varies by state maybe. What are your thoughts or role in that way? 

S: Yes -- I work with pregnant patients all day from conception -- trying to conceive and helping people conceive with Clomid and different medications -- to managing them throughout their pregnancy. Our hospital, or the hospital that I work at, currently doesn’t have any PAs, midwives or nurse practitioners that deliver. So I think really that it’s hospital-oriented and what the hospital wants you to do. I have delivered babies before with my supervising physician. You know it all kind of came down to what did I want to do? What lifestyle? And delivering babies is awesome, but babies do not wait on anybody and so if you get into the delivering thing you’re going to be on call on the weekends, you’re going to have to be getting up at 3 in the morning and go deliver a baby and that can be a rough lifestyle. For me, I don’t personally want to do that. I love managing my pregnant patients, I love managing gestational diabetes and hypertension and helping them throughout their pregnancies. When it’s time for babies to be delivered generally, my supervising physician, leaves the clinic and when she leaves the clinic it’s mine to run. I see her patients and I make sure that they are being taken care of so she can go do that. When she comes back she doesn’t have 15 patients still waiting on her before she can leave. I think it’s really a personal preference. I know that there are two residency programs now for post graduate OB/GYN and they do a lot of vaginal deliveries. I think more than anything it depends on hospitals systems because if the hospital is not going to let you deliver, it doesn’t matter where you’ve trained or what you can do. 

TPP: I remember in school we had a dermatology PA come in to do a talk and she had done one of those OB/GYN residencies I think in California. She said when she was out there she delivered about 300 babies and when she moved back to Georgia she could not get approved by the medical board to deliver babies. They just said no and even with the support of her supervising physician and proof that she had done all of these deliveries, in Georgia it’s just not considered part of a PA’s scope of practice. We do have a lot of midwives who deliver so I think that’s something for somebody who wants to deliver babies you have to look at that if you’re thinking about becoming a PA look at your state and figure out if that something you can do or not. 

S: Exactly because there’s definitely not a reason that we can’t deliver babies. We are trained adequately and obviously if you do post-residency it shouldn’t be an issue. A lot of states, unfortunately, have that rule and a lot of it could be that that’s a midwife thing in midwifery. A lot of times you have different organizations that maybe you don’t want PAs to get in there because that takes away job security as well.

TPP: Yeah I think that’s definitely part of it of why that kind of separation is there. How many patients do you typically seen in a day?

S: I see about 25 patients a day. Sometimes I can see more depending on if my supervising physician has to go do a delivery or what’s going on in the office. I have  slots in there too to work in but generally it’s about 25. 

TPP: Okay, and do you work full time?

S: I do. Full-time for us is four days a week. I have Tuesdays off which is nice so I can I spend time with my kids at home or kind of have a me-day. I always tell everybody working in medicine I love it and I would not trade it for anything, but especially woman’s health. We see a lot of psych stuff so there’s a lot of anxiety, there’s a lot of depression. I think because it’s such an intimate job, people are more likely to talk to me about things and tell me things that they should tell their primary care. Emotionally, it can be really exhausting some of the things that I hear so it’s nice to just have a me day to kind of decompress.

TPP: It is important to not take too much work home with you. Let’s talk a little bit about your Instagram account and now podcast. We first connected on Instagram in the little PA community that is there. What made you start now what was Teenage Female Health and is now the thegyn_pa? 

S: I see so many teenagers in my clinic and you know it’s just so crazy because half of the stuff that I hear from them is they’re not very well educated when it comes to the female body and I think a lot of that has to do with the fact that we grew up and we are told “girls have vaginas boys have penises those are very private things we don’t talk about them”. Then in fifth grade someone takes us in a room and they’re like you’re going to have a period. We watch a video and you’re like “what in the world is happening?” and so then parents are like  “well, she learned about it in school and we rely on the school system”, but living in the Bible Belt especially living where we are is an abstinence only education system, there’s a lot of misinformation out there and there’s a lot of information that these girls aren’t getting. I wanted to create a program where they could get information that’s correct because you can look up anything on the internet and you can make it say exactly what you want it to say. I wanted to like be a source of information that was correct for these young women and I actually have an online sex-ed and comprehensive health program for girls from seventh to twelfth grade. It’s online so I started my Instagram because I quickly found out that Facebook isn’t cool anymore.

TPP: Facebook is confusing.

S: Everybody has Instagram so I quickly noticed that my audience becoming a lot of PAs, so pre-PAs, adolescent girls, young women in their 20-somethings and then also nurse practitioners and different healthcare providers. I felt as though naming it teenage female health isn’t very inclusive so I think a lot of people felt like “this page isn’t for me because I’m not a teenager” so that’s why I changed it to thegyn_pa. 

TPP: Okay cool. You started your podcast which I love the name by the way, you want to tell us about that?

S: Yeah, so the podcast is called Britt and Steph At Your Cervix! Britt was one of my students and we went and got pedicures a few months ago before she moved to Texas to start her job in OB/GYN and she mentioned that we need to do a podcast. I thought. “I have no idea how we would even do that!”  We talked about it and she is a huge podcaster she was like “there’s just not like anything out there for women’s health to listen to. I think there maybe something but it’s kind of like dry”. Our personalities are very like laid-back and we both value education and think knowledge is power so we wanted to get material and present it to future healthcare providers and current practitioners in a way that just kind of seemed like having a glass of wine with your friend and make it easy to understand.

TPP: Well I listen to the first episode and I can say that you guys nailed it. I listen to it while I was taking my baby for a walk and it was a great refresher and as you said, it’s really easy to listen to. The concepts are really simple to understand, nothing crazy or conceptual. It was great. I’m excited to see where you guys take it. I’m sure there are plenty of topics to cover. I’m sure you will get lots of  questions. 

S: Oh yes, so we already have 42 topics planned.

TPP: That’s almost a whole year! I think we covered everything. Any other advice or tips that you’d like to throw out there? 

S: I think that you know definitely one thing is that if you were interested in women’s health don’t be scared. For some reason people have this misconception that women’s health you know isn’t for PAs. My question is why? We are trained as generalists, we have just as much training in women’s health as we do in general surgery and pediatrics. Most people are like “PAs are just not in women’s health” and that’s true. There’s less than 1% of us, but it doesn’t have to be that way and we shouldn’t have to be discouraged. I would just have to say that if women’s health is something that you want to do, it’s definitely an attainable goal. It’s a great career -- go at it and find your rotation and let people know that that’s what you want to do. Don’t be scared to do women’s health. Just like we mentioned earlier, if you want to do vaginal deliveries then look at the states and know where you can do that or hospitals that will allow you to do that. 

TPP: Just before you jump in, get all the details. Stephanie will help you answer any of the questions that she can about her job and it’s kind of nice to have the social media to get kind of more awareness about our role in different areas. I think you’re doing a great, great job.

My Everyday Essentials as a Dermatology PA, Mom, and Blogger

This post has been sponsored by Zebra Pen. All thoughts and opinions are my own.

Working as a dermatology physician assistant for the past five years, I know what works and how to make my day more efficient. As a busy PA, blogger, wife and mom, people constantly ask, “How do you do it all?” It’s time for me to share what my days look like and what makes my life easier.


I’m a pen and paper kind of girl, but I’m very picky about my pens. Luckily, I recently found a favorite with the Sarasa® Grand Gel Retractable Pen from Zebra Pen. It’s got a good weight to it with a metal barrel, dries quickly, and even looks stylish. As an added bonus, no one in the office can steal my pen since they know it’s my trademark. I need a to-do list to keep my life organized. I’ve experimented with apps, but if I physically write something down, I’m much more likely to remember it. If you’re a pen junkie like me and on the lookout for a new go-to pen, check out more information here to see how you can Choose Different!


My planner goes everywhere with me so I can stay on top of deadlines and tasks. Each week, I take some time to review everything I need to get done for the week, as well as the things I would like to start working on. Goal planning is important, and breaking down bigger goals into small steps makes them seem more achievable.


For making a new podcast episode or video, I have to plan out a topic, title, talking points, images, and links. It seems like a lot until I take it one step at a time. I also like to look at my list daily and write down anything I need to do or put on my shopping list as soon as I think of it.


Once I get to work, there are a few tasks I do everyday. The first thing is my pathology reports. Since I do a lot of biopsies in dermatology, once the results are faxed over, I decide on a treatment and mark it on the report. I also have to check the schedule from the previous day and send letters to patients who missed their appointments.


Once I start clinic, it’s really busy and I see on average 30 patients each day. They range from acne and eczema to skin checks and biopsies. If you are ever involved in doing biopsies, make sure to get consent from the patient, and mark a skin map so we can find the lesion again in the future.


I think it’s funny when I have patients sign consent and they ask to keep my Sarasa® Grand Gel Retractable Pen. Having nice pens like this one from Zebra Pen is actually something my patients notice, and I view it as an accessory. They like the way it writes, but also that it dries fast without smudging. 


After I’m done seeing patients in clinic, I finally head home to see my baby girl, but I always keep my planner and pens in hand. You have to find systems and tools that work for you and stick to them!


Should the Title “Physician Assistant” Be Changed? Research Points to Maybe.

While at the 2019 AAPA conference in Denver, CO this week, I sat in a session titled “Title Change Investigation Update.” The hour-long presentation came from WPP, the research firm behind the exploration of whether the name of the PA profession should be changed. AAPA has released an article with an update as well, but I want to help you understand the information that was shared during the session and how it was received. This presentation was not made available after the session (so far), but my seven pages of notes will suffice. If you want the summarized version and don’t care about the logistics, scroll to the end.

For a little background, the title change investigation comes from a resolution that was passed in the 2018 House of Delegates that resulted in a vote of starting a further investigation on whether the physician assistant title should be changed, whether it was feasible, and what were potential alternatives. Over the past year, this has been a topic of much discussion of PAs, but in the spring a 45-minute survey was sent out to begin this investigation. This survey received some backlash for length and lack of seemingly relevant questions, which was (somewhat) addressed in the presentation.

Upon arrival, we were urged to shift to the center of rows to make room for more attendees as it was expected to be packed, but as the presentation started I found myself one of only 3 PAs sitting in my row. I’m not sure if the unexpectedly lower attendance was due to the session timing at the end of the day or a reflection of PAs having other priorities, such as learning about information they can apply to their daily jobs with patients.

The presentation started with Pandora, the project lead from WPP. She was joined by Rich Durante, the research and analytics lead, and Jasmine Tansy, the title lead.I have to admit, at this point I almost felt as if I was sitting in an Apple keynote between the very well-rehearsed talk and fancy PowerPoint. The goal of the talk was shared - review and give clarification of project to date, share and inform on the research, and share conclusions and next steps moving forward. This would be followed by addressing questions from the PA community.

They also addressed what would not be covered - full quantitative findings report (meaning we only saw two solid data points from the study), presentation of brand strategy and title options (there were no mentions of contending alternative titles), and financial outcomes. There is a legal team that is also on board, but was not in attendance, responsible for researching the legal and financial ramifications of a potential title change. They will review laws and regulation to avoid confusion in the marketplace and advise on legal and legislative steps with a goal of bringing outcomes to fruition and avoid changes in billing, scope, and responsibility. 

As the presentation began, it was noted that the PA profession would be referred to only as “physician assistant” throughout the talk, with no use of acronyms. Pandora made a point to address that the use of this title “may be difficult to hear” for some of the audience members. Personally, I found this bizarre as I attended physician assistant school and I am fine with being referred to as such. I will be using the PA acronym for the remainder of this article.

WPP made a point to recognize that PAs play a role, and will continue to play a role, in delivering high quality health care. Their stated goal with this project is to “position PAs to compete in an ever-changing healthcare marketplace, and increase relevance with state groups and patients now, and in the future.” There was no discussion of how WPP was chosen for this task, but the resources allotted to the project (thus far) were a million dollars to put the vast cost of this type of project into perspective. WPP stated the challenges they found for determining an appropriate title include the variety of PAs in scope and specialty, competition for space in patient’s minds from other providers, and a lack of a good understanding of what PA stands for. Pandora presented two key questions to address:

  • Is there a need to evolve the PA brand based on objective well-informed data and analysis driven view?

  • If so, how do we redefine how the PA profession is positioned in healthcare today and in the future?

The set up of the research process was discussed as a 5 phase process including discover and design, research and analytics, insights and strategy, title development, and validation. At this point, phase 1 and 2 have been completed, and we are in phase 3 with an estimated timeline of May to December 2019. 

Phase 1 - Discover and Design

The purpose of this phase was to set the foundation for learning by reviewing research for relevant industry trends, publications, and regulations to see how PAs operate today. To begin this process, WPP met with a council of 12 volunteers that all represent PAs, including members from influencing organizations like NCCPA and ARC-PA. It was decided at this point that there was not enough “data” available to indicate that a name change should be investigated further, leading to phase 2 and the survey portion.

Phase 2 - Research and Analytics

This “world class research” has a stated purpose to “inform understanding of how PAs are perceived as part of healthcare and understand what drives perceptions,” as well as how PAs are linked to broader perceptions of healthcare value. This survey will serve as the “backbone of strategy and title recommendation.” In addressing why this particular survey design in the quantitative portion, specifically length and format, Rich stated there had to be “trade-offs” for comprehensiveness and length of survey. Based on WPP’s experience, they have a good sense of number and types of questions that can be asked before causing people to drop out or compromise data quality. Rich informed the audience that the survey questions were pre-tested with PAs to get feedback from individuals, which influenced adjustments to “flow and length.”

This process began with qualitative research of discussions with 55 individuals, including PAs, PA students, NPs, physicians, patients, employers, “think tanks,” professional societies, medical boards, government agencies, and legislators across 20 states. One of the main findings across all constituents in the qualitative portion is that overall, PAs are well regarded. According to patients, PAs are trusted with good communication skills, but sometimes they don’t know what the PA roles and responsibilities are. With other healthcare providers, PAs are “capable allies” who help manage patient care, are trusted, and sought for counsel. Employers appreciate the financial access and patient care benefits of PAs. All of this indicates a “clear value in today’s healthcare system with access and improved economics.” Some of the stated benefits of PAs include:

  • Increased access with extending quality care to more patients by allowing quicker appointment scheduling, as well as less appointments with more time than physician colleagues leading to greater patient communication

  • From an economic standpoint, PAs are hired at “significant discount” to help healthcare facilities see more patients, offering more revenue at a lower cost expenditure

  • Value will grow in the future, due to an aging population leading to more demand for healthcare

Based on these benefits, WPP would like to highlight the opportunity for PAs to add value to the healthcare system by further extending access to care, particularly in rural areas in an economical way. 

Despite these benefits, it was found that there is a significant difference in the “perceived role” of PAs. Patients feel that PAs have more capabilities than NPs, stemming from the word “physician” in the title, which provides a “halo,” while NPs are viewed as “nurses with a lower order” from a patient perceived hierarchy. In contrast, other healthcare providers see PAs and NPs as the same in responsibilities and capabilities, with differences in how they are trained, while employers feel that PAs are more focused on procedures and surgical support, but NPs are more focused on preventative care and patient education.

From these results, it appears that perceptions are driven by the amount of direct contact PAs have with their constituencies. If a health care provider or employer has worked with PAs, they knew exactly what they did, but without that contact, they did not have a strong understanding of the capabilities. Patient understanding varies based on factors, such as exposure and age. Overall, PAs have a high degree of satisfaction and enjoy the role and its benefits, including direct patient contact, less debt, earlier start than medical school, flexibility, fewer “non-patient care” headaches, and are overall collaborative, not competitive, with physicians. 

The tension surrounding the profession stems from a lack of autonomy being an issue with many PAs, and while they feel physicians are mentors, many PAs feel micro-managed and that they spend too much time in non-patient care duties. The research then looked at the AAPA’s definition of PAs to determine how this description is perceived. 

“PAs are medical providers who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. With thousands of hours of medical training, PAs are versatile and collaborative. PAs practice in every state and in every medical setting and specialty, improving healthcare access and quality.”

Respondents familiar with PAs found this to be very accurate, and in general felt positively motivated to work with PAs after sharing this description. PAs find this definition aspirational, while other healthcare providers view it as accurate and reflective of reality, and employers view the versatility and collaboration as true benefits. Individuals with less familiarity were surprised by the description “in a positive way” because they were unaware PAs could prescribe or serve as a principal health care provider.

From a patient perspective, there were two barriers that seem to lessen patient interest in “seeking out a PA.” The first is the title, which is not seen as a good fit with PA role and responsibilities, and most find it demeaning to the capabilities to see the word “assistant” in the title. Patients, other healthcare professionals, and employers all agreed and felt that it was confusing and sent the wrong signals. From an emotional perspective, PAs don’t want to be looked at as “assistants,” but respected as peers.

The second barrier is a general lack of education and awareness about what a PA does as it is a relatively young profession and many non-healthcare providers have limited exposure and understanding of a PA’s capabilities. According to WPP’s presentation, a patient in the qualitative portion stated that the name “does a disservice to the knowledge of a PA, while providing a boost to the physician’s ego.” Personally, I can’t think of a patient in my practice who would be familiar enough to share these eloquent sentiments. 

For employers, the barriers have a different focus. Institutions find that PAs have a “lack of experience when new” compared to “NPs with several years of clinical experience as a nurse,” and feel that PAs require more time and supervision when new. Employers do recognize there are some driving factors that are beneficial in hiring PAs including extending access, great bedside manner, helping to improve efficiency, as well as being economically viable.

To summarize the qualitative portion of the survey, the results indicate that PAs are valued in the healthcare system and offer true benefits to health care providers, patients, and employers. We all knew this right? The study finds these benefits to include extended access, particularly to rural areas, increased system efficiency, lower cost to employers, and a growing contribution to the increase in an aging population with fewer physicians and a growing cost of healthcare.

So what issues limit this PA potential? A lack of a universal understanding of the PA role, a title that creates confusing with limited awareness and connotes less responsibility than PAs believe leading to tension within the profession, and employers perceiving that PAs need significant training out of school and laws requiring extra administrative time for supervision of PAs.

Moving on the the survey. For the quantitative portion, the survey was sent out to a list provided by the AAPA, and completed by 6,845 PAs and 1,357 PA students. This is a response rate of 6%, which sounds low, but AAPA states is in line with most research studies and provides a “good sample size and is robust for analysis.” The purpose of this part was stated as developing a deeper understanding of PA roles in clinical practice and determining the impact of PAs and other providers in delivery of healthcare. Basically, the goal was to figure out what are the perceptions of PAs and what drives value.

In order to do this, WPP explored the following themes:

  • How important is education awareness in increasing understanding of PAs roles and capacities

  • Demographic facts influencing knowledge of the PA role

  • Misalignment of fit between the PA title and role 

  • Tension between PA autonomy and connection to physicians

  • How employer perceptions impact hiring

  • Gauge differences in perceptions of what PAs are capable of and legally able to do

Only two data points were shared during the presentation. The first one was regarding the AAPA definition stated previously. Most PAs found that the definition fits with the roles and responsibilities, but the title “physician assistant” does not. This is the main point addressed in the AAPA’s article. Basically, we’re okay with the definition of what we do. If you ask if the name “physician assistant” describes that definition, it’s not a match.

Main conclusion - “Based on research and analysis findings, it is strongly suggested that an exploration of an alternative title should be pursued, and quantitative findings from physician assistants alone warrant this exploration.”

What’s Next?

Phase 3 - Insights and Strategy - This portion will begin in the August-September timeframe to leverage research to develop a strategic foundation to position and PA brand and inform title development.

Phase 4 - Title Development - WPP will try to leverage insights and strategy to explore new title opportunities. For title strategy, it’s essential to define intent to figure out what title should communicate and then figure out what’s available by looking into validating information and seeking legal counsel. (More on this at the end.)

Phase 5 - Variation and Implications - WPP will use field quantitative survey results to validate a new title option, and assess legal and financial ramifications.

The timeline for delivery is early 2020 with a brand position and title recommendation to be presented for HOD consideration with full quantitative findings beyond the data points that were presented at this year’s conference, as well as an evaluation of related business and legislative cost estimates. And with that, it was time for questions.

PA Concerns

So why didn’t the survey ask about what titles we recommend? While the survey was active, one of the main complaints among PAs was the 45 minutes it took to complete, as well as the lack of questions directly addressing a new title. At this point, WPP clarified that not only are they looking at the title issues, but the PA profession as a brand, and how these perceptions align with the ideal role of a PA to determine what it will take to move the profession in that direction. After those determinations, they will try to pick a potential title. If you were wondering during the survey why you had to rank various professions, the goal was to understand how PAs, physicians, and NPs are perceived along the same dimensions. Not to assert that one provider is more valuable than another, but to determine what makes PAs unique. This 360 degree perspective is meant to highlight PA strengths and the aspects of the role considered most important in providing care, pinpoint what differentiates PAs, and attempt to transcend the title for a “holistic brand strategy.” 

A researcher from Duke was first at the microphone, and questioned why the available peer-reviewed literature regarding the title change wasn’t used to come to the same conclusions without using significant resources, and WPP responded that their literature review didn’t provide the spectrum of what they needed to investigate since it did not link the perceptions of value to healthcare. She offered to point them in the right direction to resources.

Evelyn, a Pacific University PA student, asked about the brand positioning strategy and if that was something WPP would be assisting with, which they responded they would be happy to do, but had not been asked to stay on at this point to develop any advertising strategy beyond the foundation of strategy. This will be up to the HOD, which is why it’s important to make sure your delegates have your best interests in mind.

Someone asked if they included PAs outside of the United States, and they did not.

Betty, a PA from Arizona, questioned why they were waiting to look at legal ramifications until after making these decisions. As something that is in thousands of policies and regulations at many different levels, what is going to happen? WPP deferred to the Foley law firm that was not present, and Donna from AAPA stepped in to state that the first step was coming to the conclusion that there needed to be an investigation to look into titles first, and now the necessary steps are being outlined if a name change were to move forward. The name must be identified before looking at trademarks, and the path is starting so those discussions will unfold at what would happen at a state and federal level.

Another PA asked if the WPP firm had experienced a similar title change in another profession that was launched successfully. The response - “We have done extensive work in the healthcare field and title change is uncommon and not frequent because the decision has already been made so an outside group isn’t needed. We have hundreds of credentials across the globe with naming credentials and experts in titles and how people perceive language to gain clarity and get preference.” Short answer - No. 

The last PA to speak stated she wasn’t worried about the sample size or response rate, but the length of the study. In her opinion, a 45-minute study in the PA world will get a response bias because the only people who will answer are the ones who are biased. (This gained an applause from the audience.) She admits that people know it is a “lousy title,” but questions if the cost is worth it to change it at this point. She also stated that she feels the survey lost some credibility with the types of questions because PAs didn’t understand why they were being asked about things that didn’t seem related. WPP stated that not all data was shared and that the purpose of the survey wasn’t just to see if a title change was needed, and Rich felt that individuals who take the longer study will be more motivated, but won’t just be PAs in favor of the change.

The summary given by WPP is obviously going to be politically correct and not give too much direction, but the main takeaway is that according to PAs, other healthcare professionals, and patients, the “physician assistant” title doesn’t particularly fit with the definition, while most PAs do agree that the description in appropriate. Whether or not that should lead to an official title change is the next step.

I agreed with Betty’s concerns of why the legal and financial ramifications are not being looked at until resources are being poured into this study. A name change will not bring in more revenue, for AAPA, employers, or PAs, and may be detrimental as the study showed one of the desirable qualities of a PA includes the economic benefit. Will this cause our AAPA dues to increase? How much of the budget will this consume, while we continue to lag behind legislative financial support in comparison to other professions, including NPs? At the end of the day, this is a business decision, not an ego issue, and the questions of how this will have a financial benefit should be considered. Personally, I don’t believe a different title will result in a higher salary for myself, and will likely cost my practice money (that I hope they don’t take from me). While it may change patient perceptions over a long period of time, PAs may be inflicted with the burden of the cost. This should not be an emotional response or decision, similar to giving results to a patient, it should be based on well-thought out research and what makes sense from a legal and economical standpoint.

So if it is determined to be a feasible option, what should the “physician assistant” title be changed to? This research indicates that the term “physician” should remain as part of the name, which would rule out suggestions such as “medical practitioner.” I guess we’ll all wait on the edge of our seats until the next survey to see what our options are, but I would love to hear your suggestions in the comments.

#healthyinmedicine - Staying Healthy as a Physician Assistant

With the rigorous process of becoming a PA, it can be way too easy to lose sight of our own health when caring for others. This is something I’ve definitely struggled with, but continue to work on. We should be encouraging each other to be #healthyinmedicine instead of just focusing on our patient’s health. Here are some of the practices I’ve found to be helpful. I would love to hear about your habits and tricks for self-care in the comments or on social media. Make your own #healthyinmedicine post, tag @thePAplatform, and I’ll be sure to check it out!

Find ways to stay active. As a full-time physician assistant, wife to a busy medical resident, mom to a 10 month old, and blogger, sometimes I get a little tired or overwhelmed. (Understatement of the year.) I’ve had to get creative to find ways to keep myself moving and still be able to spend time with my family. Back in undergrad at the University of Georgia, I walked everywhere. Buses were available, but the campus was beautiful, so I only took advantage of hopping a ride maybe 10 times total. I took that built in exercise for granted, and realized how great it was once I was sitting in the same classroom for 8 hours a day in PA school. That changed things. I would never have made it to the gym if it wasn’t for two of my classmates. We were close friends, and they didn’t really give me a choice. I wasn’t always the best sport, but they encouraged me to at least put forth some effort in making my health a priority. Now, as a family, we love to go on walks and get outside. My baby certainly keeps me moving and chasing her, so that helps too. My medical assistant is great at walking during lunch, even if it’s only for 10 or 15 minutes. Find your small pockets of time and try to dedicate at least some of that to moving your body. I know some of these fancy Fitbits and Apple watches will even tell you when you’ve been sitting for too long.


Make the best food decisions you can with the resources available. With fast food (that is delicious) on every street corner, I find myself jumping to the easy option most times. This is something I’ve really been working on this year. I’ve even found that some salads and wraps are just as good, if not better, than the burger or fried chicken I would have previously ordered. Does this mean I always “eat clean?” Definitely not! I love the good stuff too much. I am trying to live in moderation though instead of indulgence. Less sugar, watching portions, and trying to actually understand what’s in my food and what it does for my body. We get so busy with school and work and life, and our food choices tend to be the last thing on our minds. In Emily Freeman’s new book about decision making, The Next Right Thing, she states that we make over 200 decisions a day just in relation to food! Planning out meals, even just for the next day, can make a huge difference.

Schedule dedicated workout time. With some trial and error, I’ve figured out that if I want to get an actual work out in, it’s more likely to happen in the morning. I’m not a night owl. Definitely more of a grandma/early bird. If I put it off and wait until the end of the day, there are too many distractions. I’m too exhausted from seeing tons of patients at work and all I want to do when I get home is love on my baby. Not my body. From making this shift to morning workouts, it helps me start the day on a good note. I feel energized and productive and ready to take on the day. That encouragement keeps me going and helps me continue my streak. You may find that night time or even at lunch works better for you, but make a commitment. Write it in your planner or put it in your phone so you make sure to prioritize dedicated workout time.


Invest in tools that hold you accountable. Another thing I’ve found that I pretty much have to do is put some skin in the game, aka pay for things. I’ve tried the On Demand and YouTube workouts and read tons of blogs on staying healthy, but because I’m really good at convincing myself out of things, I usually give up. I recently bought a spin bike for my house and invested in nutritional coaching with a fellow PA. Guess what? It’s the first time I’ve actually stuck to something for longer than a week or two! Having the accountability of a coach checking in to see how I’m doing and encourage me, and my husband saying I better get my money’s worth out of that bike have both made me actually take steps in the right direction. I hope you have better self control and more determination than I do, but it’s okay if you need a little motivation. There are a lot of great facebook groups centered around accountability that you could join or find a friend who is trying to live a healthier lifestyle as well and partner on helping each other out. Taking these steps has also removed some of the frustration of trying to figure everything out myself.


Take time off mentally and physically. I’m a proponent of vacations and “treat yoself.” We carry so much responsibility and mental load in our daily lives, that you have to give yourself a break. I’ll take days off where I don’t touch social media or even a computer. While those things are great for connecting, it can also be discouraging to see an illusion of someone else’s life if you’re not where you want to be. I also tend to always have a vacation planned. While I would love to go on elaborate trips all the time, usually it’s just a weekend at the beach or visiting with family. Taking these opportunities to invest in your mental health is so important for preventing burnout. Working in medicine is tough and very taxing. We have a lot on our plates and it’s okay to take some time off.

If you have tips for how you stay #healthyinmedicine, please share in the comments or on social media! Let’s encourage each other to take time for ourselves this week.

Read how other PAs stay healthy:

Erin - Stethoscope and Sparkle

Interview with Ngan - ENT Physician Assistant, PA Advocate, and Interview Coach

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Ngan is one of our rockstar coaches, and I’m excited to share some of the insights she provided on her job and role with AAPA. She has an interesting educational background and some insights into how legislation works in advocating for the PA profession.

Tell us a little bit about yourself.

My name is Ngan, and I am a fairly new PA working in ENT. I was part of the inaugural PA class from Florida International University in Miami, and graduated December 2017. Prior to PA school, I received my Masters in Public Health, and worked with a local health department as an epidemiologist investigating infectious diseases. I have also worked as a medical assistant at an HIV clinic.

Do you feel like having a background in public health helped you with getting into PA school or has helped you as a PA?

I would say that my Masters in Public Health did not necessarily get me any more interviews, but it definitely was a conversation starter while I was in the interviews. As a PA, I really do believe that it has changed my thought process to looking more to socio-economic status or factors that affect patient care. So because of that, I do believe that it does make me a better healthcare provider.

I definitely recommend that if you can, or anyone really, should take a few courses in public health. But as far as obtaining a second masters degree, I would say do it only if you are truly interested in working with the underserved population or contributing to greater health in public health.

You went to Florida International University and you were in the inaugural class – did you apply when it was provisional? Did you have any reservations about going to a provisional program? Or did you see any benefits of being in a provisional program?

Correct! I did apply when it was provisional and I am the first graduating class.

I think I was a little reserved applying without knowing much about it, but having been through the whole process, actually sitting in and being interviewed by the ARC-PA (accrediting committee for PA schools), I was confident. It takes a lot for a PA school to become accredited. And to new PA students out there, I definitely encourage you to look into it. One of the great things, I would say, about being in a brand new program, you have the opportunity to provide feedback and kind of mold the program and really make an impact for future PA students. If that is something you are interested in, to make an impact and leave a legacy, then I do encourage students to also look at provisionally accredited programs.

When it came time to apply to PA school, what did that process look like for you and how did you come to the decision of wanting to be a PA?

I will be honest, I did not do my research well. My journey to PA school was challenging, and I would even say that one of the hardest things to me was the whole application. At that time, I didn’t really know anyone going through this process so I had to do this process on my own. What really got me interested was working as an epidemiologist, and I was just frustrated. At that time, I was working on this specific project interviewing young adults that recently tested positive for hepatitis C. During these interviews, I would call the patients and notify them of their test results – here they are crying thinking this is like a life sentence, it was awful, and I was frustrated that these providers were the first ones to get into contact with these patients to notify them. I felt like I wanted to be the voice for these patients, do more and be there for them. And so that’s what trickled into wanting to be a PA.

When it came time to apply, how many schools did you apply to and what did that look like?

I applied in total to 10 schools, and like I said, I didn’t do my research - this is not something that I recommend to other students, so learn from my mistakes – I just pretty much applied to schools based on locations I thought I would want to live in. Majority of them, I wanted to stay locally, so I did apply to mostly Florida schools. Really, it was just that I compared my GPA to see what the schools requirements were and if I met them, typically that is where I would apply. Moving forward, I think for students that are out there, it‘s really important to do your research and also look into the program’s missions and values, I feel that it’s just as important. You are spending two or more years in these programs, you’re investing yourself into your career as well. I think with that you have to do your research and make sure the school is a good fit for you and not just go because it’s in easy reach.

Because of my lack of preparation and failing to really do the research, I was only offered the one interview at FIU, and fortunately, that was the only one school that I needed.

What advice do you have for somebody going into an interview?

I would say the most important thing, or the easiest thing really, is just to be yourself. Be genuine, don’t make up answers that you think the the interviewers would want to know. Speak from the heart and that will translate so much better. What I do notice with a lot of these applicants’ interviews, don’t discredit yourself. Every little thing you do, I think, brings a lot to the table and your weaknesses or strengths, play that up. Like for me, I will be honest, I didn’t have a strong GPA and that is probably what limited me in most my interviews. Yes, like I said, I have my Masters, but the schools really didn’t care. They looked at my undergrad GPA and they were like, yeah we don’t know. For me, I played up my public health strength a lot and I think that’s what ultimately what got me through the interview. So if there is any particular thing that you have that you think is unique, play that to your advantage and I think that will take you far. Speak from the heart and smile!

What was most difficult during PA school?

Early on, I struggled a lot with mental, like personal blocks. What I mean is early on, you are comparing yourself to others. I think that is something easier said than done, but you really just have to work on it. The only competition is yourself, to be a better version of yourself from the person you were yesterday. That was challenging. Of course, I think the volume overload with information that is provided - you hear often that PA school is like drinking water from a water hydrant. It is just challenging. Just trust yourself and trust the process. Whatever it is at the end of the day, everyone is in the same boat. Be your own cheerleader and motivate yourself to continue to study and not be so hard on yourself.

How did you end up in ENT (ear, nose and throat/otolaryngology)?

During PA school, when we had our ENT block, we had a great professor, Jose Mercado, and he was just really amazing. He was someone that was so passionate about ENT. I think I just fed off of that. He introduced us to the ENT conferences that I attended as a student. So that is ultimately how I got my interview and landed my job where I am at now. I just recalled going, as a student, and one of the doctors jokingly told me if you’re someone who likes to play with toys, ENT field is the way to go. That was another reason that caused me to pursue ENT.

Did you have trouble finding a job, or was that pretty easy?

I applied for jobs about 3 months prior to the end of PA school. I would say it was challenging at the time because a lot of the places wanted to see that you were certified. I think it all depends on when you apply, but still would encourage the students out there that are near the end of school to consider looking early. I ended up with two interviews prior to graduation and both of these opportunities came from networking, whether through a conference or just being involved with the state academy.

How has that adjustment been as a new grad? Did you feel prepared coming out of school? At this point, do you feel like you have a handle on things?

Not at all! I feel like there are good days and bad days. It is rough. The feeling walking across the stage knowing that you are now a PA graduate is amazing, but unfortunately, that does not translate well to you getting a job. It is going to be very similar to starting a new clinical rotation. You’re going to feel lost. It has definitely been a challenge. I think I’ve gone through one hurdle, but there is still so much to learn. Kind of what I said earlier about not comparing yourself to others, I have to remind myself frequently, it is not fair for compare my knowledge to my attendings -  someone who’s had seven years of residency training on top of medical school, plus years of experience. Again, that’s something that I will have to continue reminding myself and just continue to push myself to learn and grow each day. But I am hanging in there!

What does a typical day at your job look like?

My current position is interesting. We are affiliated with an academic center and I work closely with our residents and our attendings. Also, I would say, my ENT practice is different from others in the fact that we are very subspecialized – we have a specialist that works in otology, who is only dealing with the ears, rhinology, such as dealing with the nose, pediatric clinic and also, plastics/reconstruction provider. I feel like we are so spread out, whereas if you talk to most ENT providers, they are like, “Oh I am only an otologist and I only deal with ear issues.” Each day is different. I work Monday to Friday, 8- 5. Depending on my assignment, I may work with our ear doctor in the morning and then switch to a different clinic in the afternoon. As far as autonomy, I am still in the process of learning how to do the nasal endoscopies. At this time, as part of our training, the goal or what is expected, is for me to see every new or extended return patient, get a full history, perform the physical exam, maybe perform ear debridement if necessary, come up and discuss with my attending, come up with a plan, and then together we’ll go back to the patients room and discuss. The goal once the training phase is over, I’m expected to see patients on my own, then discharge them out, and ultimately have my own set of patients.

How did you first get involved with AAPA, and why was that something you wanted to do?

I was pretty involved as a student leader at FIU. I was diversity chair for my class. That also led me to work with our state academy. Really, just trying to get involved more as a leader. I got my start in lobbying years ago in college when I lobbied with Planned Parenthood for women’s reproductive rights. After getting my Masters in Public Health, I kind of needed a goal to use my PA title as a platform to advocate for patients health. Sure enough, I was browsing around on Facebook one day and I saw that the AAPA was looking for students to apply to become a delegate for the student academy. Typically, if selected, you will serve for a whole year – that begins in August/September and those duties will end at the conference.

If you are a delegate, what does that mean? What do you do?

As part of a delegate, you have the authority on behalf of the AAPA, to enact policies and principles for the PA profession. To kind of give you some background, there are 57 chapters representing 50 states, 26 recognized specialty organizations, such as dermatology and otolaryngology, and 8 organizations that share a common goal or interest in healthcare delivery. For us as the student academy, we have the largest voting body and have 16 seats, or in other words, 16 voting privileges. Every year, we meet at the AAPA conference for about 3 days – for the first 2 days we are discussing the different policies that are presented, ways that these policies may affect healthcare delivery, whether there is Medicare coverage, PA privileges, health promoting, and disease prevention. The final day is when we vote on these issues.

What are some current hot topics for physician assistants?

I would say one of the hottest topics right now, still is changing the professional title of physician assistants. I will agree where most people feel that the name change isn’t necessary and that it is silly that the AAPA is spending so much money investigating this issue. But in a way, do feel like the title or word the assistant does hinder our practice and confuses the general population. What this policy says is that it’s not necessary to vote whether or not we’ll go with the name change, but to kind of further investigate it and see what the general consensus is on whether a title change would be appropriate.

We voted to not necessarily change the name at this time, just to see what everyone thinks about changing the name and offer suggestions. Whether Physician Associate would be appropriate, or whatever it is. They are just investigating this at the moment. But I feel, at the end of the day, you just have to educate, not just your patients, but everyone - even if it is someone you meet on the street or on the elevator – just educate on who and what it is. Whether a name change will truly change that, I don’t know. We just have to do more work to get the general public to know who we are.

Another hot debate in the house this year was the standards requiring in person instruction. The original policy pretty much stated AAPA supports standards to requiring that PA training programs provide at least 80% of didactic instruction as in person or live lectures. I think it was a great topic started and may have been targeting Yale’s online program, as they are the only online program currently. At the end of the day, what it really boils down to is whether or not there will be a flood market available with online programs popping everywhere. Maybe the title or the way the policy was written didn’t clearly state that, but that is really what the underlying issue is. Unfortunately, that policy did get rejected in the house and down the line this is something we will need to talk about. Yes, I do believe that with technology advances that online components can be great for students, but I think we’d have to kind of light fires for the accrediting bodies, the PAEA, those that are in charge of PA education to really make sure there is a policy in place that not every university can create their own online PA program.

As far as any other major recommendations, there are two that will affect students in a way. One of them got passed this year, and this was an initiative started by the student academy, increasing PA diversity. That did get passed and what that policy states is that there needs to be an initiative for increased funding for development and operation for PA programs at historically black colleges and universities, predominantly black institutions, Hispanic serving institutions, and rural serving institutions. The last one here, support for PA federal loan limits. I see now that with the increasing challenges or competitiveness to get into PA school, there will be more students that come in with a Masters beforehand, and sometimes these loan limitations can affect these students. That is something I think will benefit future PA students.

Ultimate Physician Assistant Gift Guide - 2018

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Wondering what to get for all of the PAs in your life? Whether Pre-PA, current students, or practicing PAs, we’ve got you covered with this 2018 Holiday Gift Guide. We’ve broken it down by category and you’ll find more practical options to go with some of the more fun choices. Feel free to pass this guide along to your family and friends to give them some hints about what’s on your shopping list. Some of the links in this post are affiliate links, which means we get a small percentage if you make a purchase as no extra cost to you. This list is just in time for Black Friday so make sure to keep your eyes peeled for deals!

To Wear


Looking professional is a staple as a physician assistant! Medelita is my go-to brand for medical wear in clinic. A gift card will provide a choice between the various scrubs, white coats, or scrub jackets, but I’ll share some of my favorites.

Medelita offers free shipping, the option of embroidery, a 1-year warranty, and at-home try-on. What more could you ask for? I recommend any of the scrubs, and my favorite white coats are the Ellody or the Rebecca. If you’ve never bought anything from Medelita, you can set up a new account and get $20 off your first purchase over $70. Use the code PAPLATFORM4 for a 20% discount.


If you’re looking for something more casual, check out Medthusiast for the cutest and comfiest T-shirts and sweatshirts. Both Medelita and Medthusiast are companies that were created by PAs, which makes them even cooler!


To Read


For the Pre-PA Student - To help future PA students reach their goals, there are some must have resources out there to make the process much easier. The Applicant’s Manual of Physician Assistant Programs provides information about all of the current PA programs. This is a huge time saver because it can be difficult to track down that info. After applying, the interview is the next step, so the Physician Assistant School Interview Guide is a great present for anyone in the application process.

For the current or soon-to-be PA Student - There were 2 books that were extremely helpful to me while I was in PA school - the “green” book and Lange Q&A. I used these the entire time and particularly when studying for boards. I’ve also heard great things about PANCE Prep Pearls.

For anyone and everyone - Dr. Atul Gawande is my favorite non-fiction/medical author. His books should be mandatory reading for anyone in medicine. Better and Complications would be welcome stocking stuffers for any PA!

For School


While PA school is thankfully a somewhat distant memory for me, there are a few things I couldn’t have survived without.

A great computer. If you really love your PA student (or soon-to-be student), make sure they have a functioning laptop. I’ve heard great things about the iPad Pro and Notability for taking notes, so that’s a good option too. I started school with a MacBook Pro and ended with a Microsoft Surface. I wish I had my Surface at the beginning of my program so I could have taken notes directly on our never ending PowerPoints. I’m back to a MacBook now, but the Surface was great for studying for boards.

A functioning printer. Even though everything is online these days, I’m still a pen and paper type of person at times. I like to write things out and take notes by hand, particularly for last minute studying before a test. I have the HP Envy, and it’s wireless, and does the job.

A water bottle. I’m the first to admit I’m the worst at staying hydrated. At work I use one of the large Tervis tumblers to keep my drinks cold or a good Yeti cup. I love this water bottle that helps to remind you to drink frequently by glowing to help increase water intake.

Amazon Prime. Having 2-day shipping was a lifesaver during PA school and clinical year. When my feet and back were so sore during my surgery rotation, I was able to get some compression socks and better shoes on the way ASAP because by the time I got off work nothing was open and I just wanted to sleep.

For Clinic


If you’re in the market for a new stethoscope, and want one that functions excellently and looks sharp, check out the ERKA stethoscopes from Medelita. I don’t use a stethoscope frequently in dermatology, but my husband has claimed by ERKA as his own and uses it daily at the hospital. There are plenty of color options, and the tubing holds up nicely even with frequent use.

For a coffee drinker, Medthusiast has amazing ceramic coffee mugs with gorgeous artwork on them. These mugs will be the envy of everyone else in the office!


While I wouldn’t recommend booking a full CME trip for someone else, travel essentials are always a great gift. After going to a few conferences this year, I’ve realized I don’t have great luggage or carry-ons, so those are at the top of my list this Christmas.

Lecture halls at conferences are always freezing for some reason. While I dress business casual and professional when I go to CME events, I’ve been carrying my Medelita Ionic scrub jacket with me to keep me warm. It’s a great weight and still looks professional, so I’ll just leave it at my seat in between sessions. Mine is embroidered so I don’t worry about it going missing. These are available for men and women, and they fit true to size. This is also my husband’s favorite jacket to wear at the hospital, even more than his white coat. (And don’t tell, but even all of the non-medical people in my family are getting these jackets this year!)


At conference, I always take a good size purse or bookbag to lectures, and I have my trusty Lilly Pulitzer notebook and a ton of pens. You could create a little conference survival kit and that would be an awesome present. Don’t forget the candy and snacks!

For Fun


Makeup and skincare are always a nice present because who doesn’t love a little pampering. Put together a basket with some bath bombs, sunscreen, and skincare kit for someone who needs to relax a little bit. I’m the first to admit that I’m a product junkie, but most recently, I’ve been using the FRÉ Skincare line. Being a dermatology PA, I’m very picky about products, but these are easy to use, gentle, and leave my skin feeling fresh. The choices aren’t overwhelming and I love that I only have to leave the Detox mask on for a few minutes. You can use the code SAVANNA1 for 15% off, and make sure you’re following me on social media for extra deals (and there’s a really good one coming for Black Friday!)

For more of my recommendations and favorites, check out my Amazon list.

Guest Post from PA Cents: Should You Do a PA Residency?

Guest Post from PA Cents.png

You’re in the final stretch of Physician Assistant school: graduation, PANCE, new job, it’s in your sights. You’ve been looking online at job openings and are not sure if you’re ready to join the workforce and be a full-fledged certified PA, practicing real medicine on real patients; so you think maybe a residency might be a good choice.

Possibly you’ve been looking for a job in a competitive area and can’t find a job in the specialty that you want so you want to gain more experience. There is a lot to consider if you’re thinking about applying to a residency.

I went to PA school in Southern California where there are a number of PA schools and a large pool of PA graduates to choose from to fill positions. The hospital where my orthopedics rotation was at had a lot of medical students, residents, PA students and PA residents. I asked one of them why they chose to do the residency and she said she was not able to find a job in that location in orthopedics.

If you’re tied to a certain area and really want to be in a specific specialty then more training in that area could be helpful and might help you find a job in that specialty. You will get a lot more training and might feel more competent after a residency.

A residency is by no means a necessity to get a job in any specialty. After I graduated from PA school I had multiple job offers that were all in different specialties. I interviewed for jobs in orthopedics, neurosurgery, and endocrinology. I ended up accepting a job in general surgery.

Surgeons all use different techniques and they all think the way they do it is the best way. My first job was with a surgeon who was getting older, there were four surgeons in the practice and only one used a PA at the time.

The surgeon I worked with saw the value of having a PA in the OR, as well as in the office, and with hospital rounds and wanted to hire one too. By the time I left the practice the PA that was working there before me had already left and one of the other surgeons also hired a PA. All of the PAs they hired, including the one that replaced me, were new graduates.

An advantage of hiring a new PA rather than one that has been doing it for a while is that they could train them to do things how they wanted it done. They did not have to teach old dogs new tricks. If someone else has trained you then you might have “bad habits” or just do things differently than they are used to.

More education is never a bad thing and doing a residency does let you learn more. If you know you never want to do another specialty than taking a year to learn more in that specific specialty can help you learn a lot and possibly be a better clinician.

The first year out of PA school is like PA school part II - PA school prepares you to take the board exam and the first year of being a PA teaches you how to be a PA. When you’re looking at a first job you should look for something that is still going to help you along in your education and where there is a good learning environment.

This does not need to be a residency. There are plenty of jobs that provide a good learning environment without having to do a residency. The job that I currently work at allows new Primary Care PAs to rotate through different clinics and with different specialties before they start seeing their own patients.

Learning is also somewhat dependent on your supervising physician. The surgeon I worked with for my first job didn’t mind teaching/explaining things, but I had to ask questions a lot of the time to get him going.

There was another surgeon in our practice who was recently out of fellowship and did a better job of naturally explaining things. I think a part of this was he was just in the habit of doing it as he was used to working with residents and students at a teaching hospital, whereas the further out from training you get the less you’re in that thought process.

As a PA we have been trained as generalist and one of the beauties of being a PA is that you can change specialties without having to do more training. My first job was in general surgery and when I was ready to move on I had offers from other places in all different specialties. I was not stuck working in general surgery forever. If some people are doing residencies that may soon become the norm and with residency training for PAs if that becomes the standard we will no longer be generalist and the benefit of being able to switch specialties without more training will go away.

If you feel like residency is your only option as you’re not able to find a regular position as a PA, it’s good to know that you’ll probably have to take less money as residencies usually pay less than a regular position.

At the 2017 AAPA conference I did talk to a residency for general surgery and they were offering $75,000 which is better than the $40,000 I’ve seen in the past but it is much less than what you could get in a regular position.

Whenever you’re looking at a job you always have to weigh the pros and cons. There are some benefits, such as more training and ability to network while you’re in the residency. If you can afford to take less and invest the time to do the extra training it may help you with your skills before taking a regular position. If you’re looking at a first job and have decided to take a regular position be sure that it is a place that supports learning and is going to help you as grow as a new PA.

This article was written by the author of PA-Cents a personal finance blog for PAs; to contact the author or for information on PA personal finance visit

How I Paid Off my PA School Debt


So have you heard that PA school is expensive?  Well, that might be an understatement.  Any graduate program is going to be a little pricey, but medical programs tend to be on the higher end of things.  If you look at estimated costs for PA school, you'll see a broad range from 5-digits all the way to hundreds of thousands of dollars.  That's a lot of zeros.  And you have to look at tuition + fees + books and other resources + tools + traveling for clinicals + housing + food + everything else!

Thankfully, I went to a public program so that initially cut my costs.  My second choice school would have cost 4x as much as my program cost.  Unfortunately, that's the norm.  I had a few other advantages that helped me to cut back on the amount of loans I had.  Which brings me to Tip #1 - Take the minimum amount of loans possible!  I was able to live with my parents for the first year, and although they couldn't cover all of my expenses, they covered my fees.  I only had to take out loans to cover my tuition.  I also went to a public program, and that decreased costs significantly.  Tip #2 - Don't take out extra money to put into savings.   The amount of return you get in savings is so much less than the amount you're being charged in interest, so it's just not a smart financial move.  

I took out federal loans though Sallie Mae, which is now Navient.  I made an interesting, somewhat subconscious, decision to not ever look at how much I owed until the end of PA school when they make you do financial literacy training.  I guess I figured that it wouldn't make any difference since I wasn't able to start paying them off yet anyways.  And although I was not able to do this, here's Tip #3 - If there's any way that you can make payments during PA school, do it.  (Even if it's a small amount.)  If you get any extra income, have a spouse who works, or have savings you're sitting on, think about putting some of it towards your loans.  Those small payments make a big difference in the long run, especially with high interest rates.  

So anyways, when I pulled up my loan summary, I owed around $75,000, and that was shocking to me.  Now I know that PA school costs a lot more for a lot of people, but you can't deny that 75K is a big chunk of money.  I mean, that's the average starting salary for a new grad PA.  About 55K was principal (meaning that I had actually borrowed that much), and the other 20K was interest (the fee for the money I borrowed).  My interest rates were varied, but averaged at about 6%.  

After you graduate, there's a grace period where you are not required to make payments on your loans.  Tip #4 - If possible, start making payments during your grace period.  While you don't have to make payments, your interest is compounding and growing.  From day 1 of getting a paycheck, it helps if you start making payments right away.  You won't miss the money if you already have it dedicated to your loans.  I committed to this at first, but then I got a little lazy.  My original goal was to put at least 1/2 of my salary each month towards my loans.  But then I got the great idea that I would just put whatever was left over at the end of the month towards them.  Just kidding.  Not a great idea.  That only lasted about 2 months before I got myself back in check.  After working so hard for 2 years in school with no compensation, it can be easy to go a little crazy.  I would love to tell you to make a budget and stick with it, but I'm personally terrible at budgets, so I can't give you much advice in that area.  

So I went back to committing at least half of my salary to go straight towards my debt.  Tip #5 - Decide how much you want to put towards loans each month, and do it.  As you see the amount you owe decrease, it's so reassuring.  There are differing views on what loans to pay off first.  Dave Ramsey has the "Snowball" plan, meaning you pay the one you owe the least on, without regard to the interest percentage, and go from there to gain momentum.  I paid off the one with the highest interest rate first, and then worked my way down.  If you do automatic payments, you may get a decrease in the interest amount.  

After you've put your committed amount towards loans, if you have any extra money coming in, consider putting it towards your loans.  Tip #6 - Try to put extra funds towards your loans.   Every little bit makes a big difference.  It may not seem like it at the time, but I don't think I would have paid off my loans as quickly as I did if I hadn't done that.  And I can think of specific purchases that I made that delayed my final payment, and they probably could have waited.  

So back to my loans.  After I found out how much I owed, I committed to paying half of my salary each month to my loans, and any bonuses I got.  There were a few hiccups along the way, but I got better at it with time.  I tried to put any extra funds to my loans.  I started working in August 2014, and this past January 2016 I made my last loan payment!  It felt awesome.  Took my entire bonus/commission, and drained our bank account, but it was worth it.  I feel like a weight has been lifted off my shoulders, and I have a lot more freedom at this point.  Instead of going to the beach a few hours away, I can afford the trip to the DR without feeling guilty for not paying towards my loans.  Tip #7 - Make frugal choices while paying your loans, not extravagant ones.  

Everyone is different, and I'm sure not everyone will agree with how I did things.  But that's ok, and I'm extremely happy with where I'm at.  Debt-free, and able to start saving more and making good financial decisions.  Tip #8 - Do what works for you.  I'm a generally frugal person anyways, but I can splurge on something like a vacation or good meal.  Making big purchases, like furniture, are a lot more fun now too.  

At the end of the day, whether you're still in undergrad or worried about affording PA school, your loans will be paid off at some point.  It may not be as soon as you would like, and you'll probably make some mistakes, but it will happen!  If you have any other tips for others about paying off loans, please comment!  Or if you've paid off you're loans, I would love to share your story and help others to have confidence that it is possible!  


PANCE/PANRE Review Course - The Resource You Need to Pass Boards!


From the first day of PA school, you are fully aware that boards will be necessary at the end to practice as a Physician Assistant.  Although some people wait until after school to buckle down and study exclusively for the PANCE, I think it's best to start studying from day 1.  All of the tests during didactic year and clinical year are important, but that last test is the MOST important.  

I'm really excited to be able to share an awesome resource when it comes to studying for the PANCE - the PANCE/PANRE Study Guide and Review Course. There are so many aspects to this that will be helpful to every kind of learner.

The Study Guide - When studying for this all important test, you want to make the most of your time and focus on high yield material. The Study Guide is a 109 page PDF that focuses on everything you need to know. It's short and sweet, and to the point. It's essential that you are able to recognize buzzwords and match them with diagnosis, imaging, or treatment. For example sausage mass on palpation in a pediatric patient should automatically make you think of intussusception. This is the resource you need to focus your brain on what you NEED to know. If you just want the guide, you can download the study guide for 9.99.

Online Content - For the review program , you log in, and are able to access a ton of content. The course is organized based on the NCCPA Blueprint, so again, the focus is everything you actually need to know. In each section, you'll find an introductory video, the NCCPA Blueprint information for that section, the percentage it is on the PANCE, an audio review section, the PANCE Study Guide for that section, quizzes, flash cards, and more review material. Basically, there's a little bit of everything and the material is reviewed in multiple ways.

Quizzes - There are different options available when it comes to the quizzes.  There are basic ones that just ask pretty straightforward questions and some situational ones, and then there are buzzword matching ones.  Practicing actual questions is the best thing you can do because you are testing your understanding and knowledge.  Knowing buzzwords for the PANCE is also necessary.  Like other standardized tests, there is strategy involved, not just knowledge.   I was reminded just how much I don't remember from school after taking just 2 quizzes.  

So why should you invest in this review course?  Well, if you don't pass your boards, you get a full refund.  That's a pretty bold promise.  There's a free trial available that still has a ton of valuable knowledge, so you can try it and see if it would work for you.  For lifetime access, it's $199 (and there's a discount below!), and you get access to so much knowledge.  And that means you can start it the day you start school and use it throughout your program.  This is a resource that I will use to stay up to date on the material I need to know and I plan on using it when I have to recert.  The creators have worked really hard to make this an all-inclusive study guide, and I think they have succeeded.  

I think if I was using this today to study, I would do a practice quiz, then read through the study material, listen to the audio review, and then take more quizzes.  It's basically everything I did to prepare for PANCE 2 years ago, just in one source instead of multiple books.  

If you are interested in checking out the study guide or review course here is a coupon code that will get you 15% off of your purchase!! - thepaplatform15

I was provided access to the course and a copy of the study guide for free, but my thoughts are completely my own!  

My Favorite Books to get through PA School


If your program is anything like mine, they will give you recommended books or resources for each section.  While a few of these were helpful, there were other books that I used during the entire didactic and clinical years, and I don't think I would have made it without knowing where to find the information I needed.  The internet is a great resource, but I love being able to flip through a book and highlight and make notes too.  Here are some of my favorite books, and make sure to comment below with anything you think I left off! This post contains some Amazon affiliate links. 

A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants - This was my main PANCE study book, but I used it all year long.  It is based off of the NCCPA Blueprints for the PANCE exam and goes through every single section with the main ideas that are important for PA school.  I would always read through the related section the morning before a test just for a refresher.  My only complaint about this book is that the medications are not always specific in the treatment section, and I could use a little more info there.  

Step Up to Medicine - While this book is technically for medical school, it's great for studying all of the basics of PA school, especially all of the Internal Medicine topics.  It's split up really well and easy to read.  This book fills in what the PANCE review book leaves out, and I wish I had known about it for more of didactic year, but it's great for clinical year too.  

Pocket Medicine - This is a pocket reference for your white coat that I actually didn't have, but I wish I knew about it.  My husband currently uses this book on his medical school rotations, and it's really cool.  It has all of the current recommendations for Internal Medicine subjects, and also all of the articles that the recommendations are based on, so it's truly evidence-based.  If you're in an academic center, the attendings love it when you can reference an important study.  There's a Pediatric version as well.  

Maxwell Pocket Reference - This is another book you should have in your white coat.  It's really small, and for $5 it comes in handy.  This little book has outlines for different types of notes in the hospital, ACLS codes, physical exam and history, and all kinds of other important topics.  Unless they've stopped, if you join the AAPA as a student, they will send you a copy of this.  

Lange Smart Charts for Pharmacology - This was my go-to for pharmacology, aka the worst class of PA school.  It's just so hard until you're actually seeing these drugs on rotations or practicing .  This book is a flip chart of all the drugs separated by class with everything you want to know, including brand name, mechanism of action, side effects, and contraindications.  I love a good chart, and these made studying so much easier.  

Bate's Physical Examination - This is basically the go-to book for learning how to do a proper physical exam.  It was required by my program, and my husband used it as a reference in medical school too even though it was never recommended.  There's pictures and great explanations for any part of the physical exam that you can imagine.  And there's even a pocket version as well.  

Lange Q&A Book - This was my main book for practice questions.  Doing questions and attempting to apply the knowledge I'm trying to learn has always been the best way for me to evaluate where I'm at.  I used this book during the clinical year and studying for the PANCE, but I wish I had it for didactic year as well.  The questions cover all subjects, and have awesome in-depth explanations.  

Tarascon Pocket Pharmacopoeia 2015 - Shirt version and White coat version - This is another reference book you can use on rotations.  I know you have Epocrates on your smart phone, but I liked having this book as well.  It's really easy to find what you're looking for and they update it every year.  

Basic Concepts in Pharmacology - This is a small book, and it has really short and straightforward chapters about different drug classes.  I liked to read the relevant sections before Pharm tests as just a quick overview.  I probably just need to read this book every month to retain some of the knowledge from PA school.  Sometimes it feels like all I prescribe are topical steroids and acne medicine! 

First Aid for the USMLE Step 2 CS - If you have physical exam or practical examinations with standardized patients, then you need this book.  This is another one that I unfortunately did not have while in school, but it would have made my life so much easier.  I spent hours trying to come up with practice cases, and come to find out, here's a book with everything I was looking for.  There are checklists for each case, and you'll need a partner to get the most out of this book.

Pance Prep Pearls - This book had just come out when I was in study mode for PANCE, but a few of my classmates did use it, and they passed!  I've heard a lot of buzz about this book recently, and I definitely plan on using it when it comes time for me to 8 years! 

Here is a blog post from a fellow blogger with her recommended resources, some of which are the same as the ones you will see here.  

Conference Review: GDPA Dermatology PEARLS


The Georgia Dermatology Physician Assistants (GDPA) puts on an annual conference called Dermatology PEARLS (Physician Extenders Advanced Regional Learning Symposium).  It is held in Atlanta, GA or somewhere nearby.   It was in October this year, and the next one is scheduled for March in the Buckhead area of Atlanta.  There was a maximum amount of CME of 26.5 hours offered, with a possible maximum of 22.5 hours for each attendee.  8 of those hours could be self-assessment if you are in the new CME cycle.  3 workshops were offered - Intermediate Surgery, Hyperhidrosis, Neurotoxin & Fillers - but I didn't participate in any of these.  The price for this conference was really reasonable.  For early registration a non-GDPA member, it's $300, and if you were a member, it was $275.  These prices increased by $75 each for later registration, so plan early!

The location was at the Cobb Galleria Centre, and the hotel was adjacent to the convention center.  I didn't need to stay at the hotel since my sister lives in Atlanta, but it would have been nice to have just a 5 minute walk to the conference.  The conference was 3 days long, which I felt like was appropriate.  There was a ton of information presented, and I was exhausted at the end of each day.   Everything was extremely organized, and the schedule ran on time.  There were a few lectures I would have liked a little more time for questions, but it was nice to know what to expect throughout the day.  

There was a notebook given that had all of the information for the conference, wi-fi information, and a page for notes on each of the lectures (and I took tons of notes).  The speakers were all awesome.  There were some physicians and some PAs, and I would just love to spend a day with any of them.  I don't think there was a single lecture that I felt like I didn't learn something.  There were a few instances where I felt like the information went over my head (immunology!), but I still feel like I learned a lot.  I got so many pearls, and I'm really excited to try them out in practice.  It was also reassuring to hear from people who have been practicing dermatology for 10, 20, or 30 years that they struggle with treating some of the same skin diseases that I feel frustrated by.  

I had a great time at the conference, and I learned so much.  This is definitely a conference that I plan on attending again in the future!

Tips for a Medical Conference


This past week I attended my first ever Continuing Education conference.  The one I went to was put on by the Georgia Dermatology Physician Assistants (GDPA), and it was their bi-annual Dermatology PEARLS conference.  The next one will be in March in Atlanta, GA if you have any interest in dermatology or are looking for a conference.  I went there not really knowing what to expect, but it was an awesome conference!  (I guess I don't have anything to compare to, but I did enjoy it.  I'm going to do a separate post reviewing this particular conference, but here are some tips I would like to share if you are getting ready to go to a conference!

  • No matter what you wear, you probably won't be the most underdressed or overdressed.  There were people in anything from jeans to suits.  
  • Bring a sweater!  It might be cold, and you'll be sedentary for most of the day.  
  • Welcome back to PA school!  Be ready to sit and listen to lectures for about 8 hours, unless you go to a conference that only has lectures in the morning.  
  • There's lots of food and coffee.  We had a breakfast and lunch buffet, and lots of coffee breaks with little snacks and drinks.  
  • Goodies!  They gave me a bag, pens, a notebook, and a jump drive with lectures when I arrived.  And then in the Exhibit Hall, there are a bunch of booths with pharmaceutical reps, hospitals, and other medical products that have handouts and information.  
  • You can come and go as you need to.  You can only claim the CME for the parts that you are actually present for, but it's not a big deal if you need to leave early.  
  • The sessions can be very interactive.  We had clickers to answer questions, and the speakers were very engaging, and encouraged questions.  
  • You need to know generic names.  All of the speakers try to be non-biased so they will use the generic names instead of the brand names as much as possible.  
  • Learning is exhausting, especially when it's been a while since you've had such intense classroom time.  
  • Students welcome!  There were a good bit of students at the conference I went to, and I think I would have been overwhelmed as a student, but also I would have learned a lot.  It's a great place to make connections and meet people for finding rotations or a job after graduation.  
  • And lastly, if you go to a dermatology conference, then everyone will have perfect skin!  But seriously, they did.  

Comment with any of your tips for conferences, or any CME events that you've been to and would recommend!

The Hard Parts of Practicing


As much as I love what I do, I have days that are just really tough, or entire weeks, like this one.  When I first started working, there were more days and weeks like this just because I felt like I didn't have a great grasp on dermatology and felt like I should already know everything.  It's definitely gotten easier, but there are still some days that are just so hard.  

I feel like we mostly talk about the good stuff of practicing medicine while we're in school, but there's a lot more to it than that.  Occasionally, we'll learn about difficult or non-compliant patients, but that just barely scrapes the surface of what it's like in the real world.  You can role-play situations as much as you want, but you won't know how to react or what to say until you're actually encountering patients.  I work in dermatology, so I know there are others in specialties that deal with even more difficult situations than me.  

These are the things that I've found difficult during my first year of working, and during this incredibly long week:  

  • When patients are frustrated that the treatment regimen you gave them for their eczema or acne didn't work
    • I promise I gave you what I thought would work the best and be most cost effective.  But sometimes, I'm wrong.  I didn't do it on purpose, and I will keep working to find what works for you.  
  • When a patient wants you to inject an area that you know may cause blindness 
    • There isn't always a quick fix for everything, and I would never purposefully do something that would harm my patient.  Like injecting steroid into a stubborn acne bump in an area (the glabella, aka in between the eyebrows) that could potentially cause blindness.  Sometimes we have to wait it out and let our body heal itself, even if it takes longer than we would like.  
  • Having to make a phone call to a patient to tell them they have melanoma
    • I hate melanoma phone calls.  That's about the worst thing to do in dermatology, and it can be a really tough conversation.  Most of the public is not very knowledgeable about skin cancers, or don't consider them "real cancers."  I think once you have a 50-year old patient with a melanoma that gives him a 15% 5-year survival rate, that counts as real cancer.  
  • Having 3 patients in a row no-show, but also patients showing up 30 minutes late or with no appointment at all, which just throws the whole day off
    • This is something I still have trouble not getting frustrated about, but things happen and I try to give patients the benefit of the doubt.  
  • Having to tell a patient she might have MRSA and probably shouldn't hold her new grandbaby until the culture results come back, and then her calling saying I "didn't help at all"
    • It's not a good feeling to have a patient call with a complaint like that.  Especially when I treated her appropriately.  That's where emotions of the patient get involved, and things get complicated.  A phone call usually helps.  I was dreading calling this patient back, but when I did it actually made the situation better.  I was able to tell her she has normal Staph and not resistant Staph, and although I still want her to avoid the baby, it made it not quite as bad.  Patients will most always appreciate your time, and I think as providers we should take the time to make situations like this better if we can.  
  • Seeing a 7-year old with a skin disease that could potentially cause him to lose mobility of his leg
    • Kid stuff is hard.  This kid had something called lichen sclerosus et atrophicus, and areas had progressed to morphea.  This was something I had read about, but never actually seen.  Hopefully, we should be able to help him before things progress too far.  

Honestly, those are just the few highlights, and there were plenty of other situations I could talk about.  Part of what makes my job so tough is that at times I get the feeling that patients are thinking I just gave them a medicine for the heck of it, or that I didn't make them better on purpose, or that I don't care that I'm 30 minutes behind and they had to wait a little longer.  Truthfully, these things actually bother me.  A lot.  And I know they bother most other providers as well.  I wish patients were able to see the behind the scenes sometimes, instead of thinking we just mosey around at our leisure.  

I've been on the patient side too.  At my annual GYN appointment last year, I waited for 3 hours to see my physician.  And she spent about 5 minutes with me.  But she had an emergency patient that had to be seen to, and when it comes down to it, I know that if I was the one having an emergency she would have made someone else wait.  People are very quick to make judgments these days and very impatient.  I see Facebook posts almost weekly about "Why would my appointment be at 3:00, but the doctor didn't see me until 3:30?" or continual updates about how long the person has been sitting in the doctor's office.

 As someone who has seen both sides, and is sometimes responsible for people sitting in the waiting room, I think we need a little more grace.  Both patients and providers.  It is not uncommon for my patients to be late.  And not just a few minutes.  I've had patients show up an hour late and most of the time they don't even mention it.  If I make a patient wait more than 5 minutes, I apologize because I hold myself to higher standards than that.  So I do get frustrated with those patients who are late.  At the end of the day, we're all just people.  Both patients and providers, and we all make mistakes, so I hope we can give each other a break.  

1 Year Out


I just recently realized that I've officially been a graduate for 1 full year, and it was about this time last year where I was nervously awaiting PANCE results.  It's been somewhat of a whirlwind year, and I wanted to reflect and share some advice to you guys as I look back.  It's amazing how time flies in PA school, and then it still goes as fast when you're busy working.  I went to a pharmaceutical dinner last night for PAs, and some of my past professors, and now colleagues, were there.  It was so funny because one of the teachers couldn't even remember when I graduated!  And she wanted me to call her by her first name, which just still seems weird to me.  It's amazing what a difference a year can make.  

This time last year, I had officially graduated, taken PANCE, and was training at my dermatology job.  I was almost as nervous to check my board results as I was to actually take the test.  I was at work that day and as soon as I got the e-mail that scores were posted, I went outside of the building to check them.  I had pretty much decided that if I failed, I would just leave and not go back.  Luckily, I didn't have to do that, but passing boards is what made it feel real, like I had finally made it.  I'm dreading retaking them in 10 years, but I just won't think about that for now.  

Some advice to Pre-PA students - Being a PA is a great job, and I definitely recommend it, but look at all of your options closely and decide why being a PA will be a good job for you personally.  Although in many fields, you do most of what the physician does, PAs are not physicians, and some people will never be happy in that role.  It takes hard work to become a PA and you have to decide that it's worth it you.  While you're doing all of the prerequisites for PA school, have some fun.  Looking back, I had a great college experience, but I was almost too goal focused and I do wish I was a little more laid back at times.  The stress and tears weren't really worth it.  

Advice to current PA students - Eventually, you will be done with classes and rotations and boards and you will be a PA too!  It does end, so just remember that during the weeks that you think you might just not make it.   There are still about 2 weeks that I remember as just being terrible, but we all made it through.  I would encourage you to still take care of yourself and your passions.  It can be easy to lose those things when you're so microfocused on school all the time.  I don't think I read a single book for fun while I was in PA school, instead I would read study material until I fell asleep.  Was that necessary?  Probably not.  Also take time to invest in your friendships and family.  The first 2 semesters of PA school, I wouldn't even go out to eat with my family because I "had to study."  Looking back, it would have taken probably 30 min- 1 hour, given my brain a rest, and given me nourishment and fellowship.  Maybe I got 1 point higher on the test by skipping dinner?  But I think I would have rather gone to dinner.  So don't be so uptight that you let things slip away.  Become friends with your classmates too, and hang out with them outside of school!  Some of my best friends are girls I met in PA school, and most of the things we did were unplanned and random, but just what we needed to survive.  Like buying last minute floor seats to see Taylor Swift 2 days before the show, with multiple tests the next week...maybe not the best plan, but exactly what we needed at the time.  (And it was so worth it.)  One last thing, you will find a job.  So no need to cry over that like I did either.  Your first job probably will not be your last job, but there are plenty to go around.  While job searching, I would recommend not discussing specifics of jobs with your friends or close classmates because it can get a little uncomfortable if you and your best friend are interviewing for the same job.  So just make a plan to hold off until you've signed the contract.  


Advice to new grads - Congrats, you made it!  Welcome to the real world!  Vacation is something different now, and if you're working in a clinic with a set schedule, be prepared to ask off months in advance because they really don't like having to move 20-30 patients when you decide you're ready to go to the beach. Be wise with your money.  I had a great plan right out of school that I would just buy whatever I want and then whatever was left would go to my student loans.  Yeah, that's  a terrible plan.  Look into paying off your loans early and investing as soon as possible.  (A great resource - White Coat Investor).  While being wise with your money, don't be afraid to have some fun too.  You've deserved it!  Like if you want to plan a random trip to Las Vegas with your spouse or buddies, do it!  And keep up with your classmates.  It takes a family to get through PA school, and now that you have a bunch of new colleagues, use those resources to make each other better PAs.  If you hate your current job, look for a new one.  I once heard that you should never stop looking for a job, and there are tons out there so don't stay somewhere that you are unhappy.  Don't forget to give back to your program either, and not necessarily financially.  If you are able to lecture or be a preceptor for students, that's a huge help to the program and even more to the students.  

Overall, I'm extremely happy with my decision to become a PA and I love my job.  There are still some days when I feel overly stressed and exhausted, but there are far less than when I first started working.  I'm excited to see where our profession is heading, and how it will change and evolve.  I'm still figuring everything out, but it's getting much easier.  And I'm just happy to not be studying for the PANCE right now.  

Providers as Patients


Obviously we are all patients at some point in time, and that is where we develop empathy for our patients and can really step into their shoes.  I wanted to share my most recent experience as a patient and how it's affected how I practice, and possibly can provide some clinical insight for your patients!  


I'm not a super "moley" (not a medical term, but commonly heard at my job) person, but I've always had 1 mole on each of my feet.  I've never worried about them, but over this past year I started to think they were maybe getting a little larger, and then one of them in particular began to darken.  Those are pretty typical signs of possible dysplasia (atypical changes) in pigmented lesions like moles.  I had shown them to my supervising physician when I first started about a year ago, and she thought they were fine at the time.  When I showed her this past week, her opinion had changed, which was what I was expecting.  If I saw these moles on a patient, I would want to take them off.  


You have to be really careful with moles on the feet because they can be forgotten and due to the volar skin that is a little different, the characteristics you look for are slightly different.  In dermatology, we use a tool called a dermatoscope, which is basically a magnifying glass with a light.  Dermoscopy is very helpful, but if you are suspicious of a mole with the naked eye, the dermatoscope should really only confirm your suspicions and decision to biopsy.  There pictures are of my moles (because I had to send them to all my friends from PA school of course).  

So here's the deal with moles and biopsies or removal.  There are 2 types of biopsies.  Both consist of numbing the area locally with a shot of lidocaine, usually with epinephrine.  A shave biopsy is basically a razor blade that you bend to shave underneath the lesion.  This is typically done for raised moles being removed or to biopsy possible skin cancers, among other various things.  A punch biopsy is like using a cookie cutter to remove a portion of skin all the way down to the subcutaneous fat, which requires stitches.  This gets the epidermis and the dermis, which provides a deeper sample.  There are different sizes of punches, ranging from 2mm-8mm.  These are done on any lesion suspected for melanoma or moles that are suspected to be atypical/skin cancers if you can remove the entire lesion.  Everyone has different standards and there are some practices that do more punches or more shaves and may not agree with those standards, but those are my (very rough) guidelines.  

So for the size of my moles and the dark pigment, punch biopsies were the best option.  I had about a week to think about how bad the shot was going to hurt, and honestly it was just as bad as I expected.  There are so many nerves in your hands and feet, that a shot there is killer.  And lidocaine burns like crazy.  Then it feels very strange when your feet are numb.  So we did the biopsies at lunch last Thursday, and luckily I didn't have to work on Friday.  Here is a picture of my feet post-biopsy (sorry for the ugly foot pic).  The white area around the stitches is the blanching from the numbing shot.   


I took a picture of the samples in the specimen bottles as well.  


Friday morning it felt like I had a chunk taken out of both of my feet, and they were extremely sore.  I basically hobbled around all weekend and sat as much as possible.  This process has made me very thankful for my feet, and I can't wait for them to feel like normal again.  

So here we are a week later, and only one of my biopsy sites is infected, even though I've been keeping them covered constantly, and both of my feet are still pretty sore.  But of course, I've been working all week and that probably doesn't help.  I feel like I have so much empathy for my patients now, and I know exactly what they are going through and how tender it is when I have to give them a numbing shot.  I understand that it's difficult to relax while someone is cutting on you.  I think it's helpful for patients to know that I've been through this as well and that I can relate.  I'm a huge proponent of being honest with patients and letting them know that we go through the same things they do.  I think there is sometimes a stigma with providers, but we're all just people too.   

My advice to patients who need a biopsy done is:

  • It's not as scary as it seems 
  • The shot does hurt pretty badly (especially on the foot), but it only lasts about 5 seconds.  
  • The feeling pressure and no pain is very strange, especially when the suture are being put in 
  • Even if you do everything you're supposed to do for aftercare, you can still get infected
  • Stitches are really itchy!  
  • The biopsy site may be sore afterwards, but it's nothing ibuprofen or acetaminophen can't take care of. 

My advice to providers doing a biopsy: 

  • Don't try to pretend the shot doesn't hurt because it does.  Just try to get it done as quickly as possible, and remind your patients to take deep breaths while you are injecting.  And if you are injecting in such a sensitive area, you may want to recruit some help for keeping the patient still and ask the patient to try to not jerk with the needle stick.  
  • If you think a spot needs biopsied, be confident in that decision and either take it off yourself, or if you are not working in dermatology refer the patient to a dermatologist.  If you really think it may be atypical or malignant, it's probably best for it to be biopsied in a dermatology office because it's really helpful to see a lesion before it's messed with.  

Respecting Patients


There has been a lot of press about a news story that came out recently.  Basically, during a routine colonoscopy, the patient accidentally had his phone recording, and happened to hear some very insulting remarks being made by the anesthesiologist during his procedure.  The things that were said were pretty outrageous, but unfortunately it is not too uncommon in many medical settings to hear negative comments about patients at times.  There were many things wrong with this case, including that the physician was making inappropriate comments, no one tried to protect the patient, and the physician made comments about billing for diagnoses that weren't present.

This case is a good reminder that it is our job as healthcare providers to protect our patients, and not just because you could lose money over it.  Working in the medical field day after day can be exhausting and sometimes it is easier to complain and rant then to just keep the frustrations in.  Whether it's the late patient, the difficult patient, or a drug seeker, it is not our job to judge the person who comes to us for help.  Even if you're not the initiator, you can help to be a positive influence in your workplace.

A story like this gives medical providers a bad wrap, and makes patients even more skeptical about whether we are really there to help them.  Especially if a patient is going under for a procedure, there's a good chance they are nervous about it, and the focus needs to be on "doing no harm" at all times, even when it's hard.  I hope you keep this in mind when you are out in clinic or hospitals and let's be more aware of how we are treating our patients.

Free Apps for Clinic Use


We're lucky to be practicing medicine in a time where technology is readily available.  As frustrating as working on an EMR can be at times, I'm thankful that my computer is there if I need to look anything up or get more information about anything.  Phones and tablets have also found a place in medicine, and can be great tools to look something up quickly.  Today I'll share some apps with you that I use frequently in practice and that would also be useful for rotations.  Make sure to comment with any other apps that you find helpful!

- Medscape - This is one of my favorite resources for an all-inclusive source of information.  When you look something up on Medscape, it includes physiology, presentation, work-up, differential diagnosis, treatment options, prognosis, and basically anything you would want to know.  Even when I google stuff on the computer, Medscape is typically my go-to source if I'm not using UpToDate (which requires a paid subscription).

- Epocrates - This is a very important pharmacology app.  It can be especially tough to keep up with all of the changes in medications.  There are constantly new drugs coming out and changes being made in availability, and this app does a great job of staying up to date.  On the free version, you can look up specific medications and find out dosing, alternate names, how it is supplied, adverse affects, contraindications, and even pictures of what the medications look like.  There is also a feature that you can add all medications that a patient is on and see if there are any cross reactions.

- Figure 1 - This app is like Instagram for medicine, and it is amazing.  Since I work in dermatology, and a lot of my cases depend on what I see, it's especially interesting to me.  Basically, people can post pictures and descriptions of cases for discussion.  Sometimes people will be looking for input into a case, or they may post something that they have seen to let other people become familiar with it.  This may not be something that you look things up on in clinical, but it may be helpful if you have a question, and it can familiarize you with diagnoses you may not frequently see.

- GoodRx - This is another pharmacology app, but it is more to the benefit of your patients.  You are able to put in medications and your zip code and find out the cost of the medications based on dosage.  This helps to compare and see what the most cost effective option is for your patient if you are deciding between medications.  There is an app, but you can also just pull the site up on your phone.  You can also print out coupons for specific pharmacies that make the prescriptions cheaper.

These are the ones I use the most, but I would love to know what you use as well!  And definitely check with your school or hospital and see if there are any apps that they offer subscriptions to as well.

And here are some other sites with their lists of top apps!

The PA Job Search: Where to Find Jobs


Earlier this week, I did a post on what to look for when first starting a job search, so here's a follow-up post about where to actually look for the jobs.  I promise they're out there!  Some areas are more saturated with PAs than other areas so it can be a little more challenging, but the more flexible you are, the better luck you'll have finding a job.

The Internet:  This is pretty obvious, but it's a good idea to start with Google to get an idea of what may be open in your area.  When I was first starting, I would just search "physician assistant job augusta ga," and it usually took me to or some other job site.  Most of the results from these searches go through an agency or are hospital listings.  Looking at specific hospital websites that are in the area you are interested in can also be helpful.  The only issue with these is that they may not update the listings very frequently, but there are usually at least a few positions posted at each of the hospitals in my area.

Preceptors:  When you are on rotations make it well-known what areas you are interested in working in to your preceptors and staff at your rotation sites.  When I first started rotations, I thought I should act like I loved whatever area I was working in for the month, but once I started being honest and talking about my love for dermatology and surgery was when I started hearing about job opportunities.  I attribute to my job to my surgery preceptor for the most part.  He was a colleague of a doctor that I heard was hiring and gave her a call on my behalf.

It's sometimes said during rotation orientation that you should expect to get numerous job offers while on rotations, but that isn't always true.  If most of your sites are ones that have been used for a long time and always have students, it is not likely that they are looking to hire.  You're going to have a much better shot at a job offer if you are able to do rotations at sites that have not had students in the past.

Cold Calls:  One of my teachers recommended this and it was incredibly intimidating, but now I definitely recommend doing it.  The best way to do this is to call offices, ask to speak to the office manager, and then ask if they are looking to hire a PA.  The majority of offices I called said not currently, but asked me to send my resume anyway.  I felt like this was possibly a dead end, but I actually met 2 different PAs during the time I was looking that recognized my name from my resume, and then told me about jobs they had heard about.

Program Resources: Some programs are really great about helping their students to find jobs after graduation.  Ask your advisor and any faculty you feel comfortable with if they know of any open positions (if you want to stay where your program is).  Our program also has a job board and a Facebook page for alumni where jobs are posted frequently, so see if your program has this, and if not just start one yourself!

Staffing Agency: Some offices go through agencies to find PAs.  I've talked to a few of these, but I'm not sure how effective they are.  Two of my closer friends from my program applied to and interviewed for programs through an agent, but from what they said they had to follow up very frequently and ultimately didn't get anywhere.

I hope this gives you some direction if you're job searching, and please comment with your tips for finding a job!

The PA Job Search: What to Look For


About this time last year, I was nervously getting ready to start my final 2 rotations at the dermatology office that so graciously decided to take me on as a new grad.  Looking back, that job search was a bit exhausting and honestly there were some tears involved.  I love my job, and I feel very fortunate as this is my first position, but I thought it may be helpful to share some of the things I learned along the way.  As a new grad, you're excited and ready to get out into the working work, but getting there takes some effort.

So congratulations if you just graduated/are graduating soon, or if you are finding yourself looking for a new position and leave a comment below if you have any other tips!

What to Look For:

So when looking for a job, I've read multiple theories and recommendations about what you should focus on.  You have to decide what's important for you personally.  It seems to me the more essential aspects of a Physician Assistant job are - location, specialty, supervising physician, salary/benefits.

You need to rank these factors in order of importance to you.  A year on rotations should have helped to make it a little more clear what your priorities are.  I decided that having a great supervising physician and doing something I loved were more important to me than salary.  In my opinion, I would much rather wake up and want to go to work than dread my job or who I'm going to work with.

Location is important if you have an area you really love or family you want to be near. I was raised in Augusta and went to PA school in Augusta. My husband is still in medical school here, so that was an obvious choice for me. If location isn't as important to you, it may be a great opportunity to try out a new place and get some experience so later you can find your dream job in your dream location.

Rotations give you a good idea of what areas you do and don't want to work in. The main questions that came up for me were sick vs not sick and appointment vs walk-in and procedures vs no procedures and continuity of care. I'll explain that a little more because I didn't really get it until I was in the field.  When it comes down to specialty as well, I will mention that it seems any experience you have makes you very valuable for other fields, so I think it is much better to have an open mind when starting your job search.

Sick vs not sick - Some specialties you see "sick" patients, which I consider the ones that have things you could catch. This includes pediatrics, family medicine, internal medicine, urgent care, and ER. Other specialties like dermatology, pulmonology, cardiology, hem/onc, GYN, and lots of others have patients that may have diseases that make them very sick, but they aren't going to cough on you so you could catch it.  Personally, I didn't love seeing the flu and strep throat all winter long.  And when other students say you should plan on getting sick on your pediatrics rotation, it's absolutely true.  (And sidenote - go to the doctor or health clinic when you start feeling sick, and not the last day of your rotation, so maybe you can avoid being diagnosed with pneumonia like me.)  A lot of the patients I see in dermatology have very real, serious disease that affects their lives, so I definitely still feel like I'm helping patients even though I'm not seeing the acutely "sick" ones.

Appointment vs walk-in - If you're working in private practice, you will likely have a schedule of patient appointments that you are expected to stay pretty much on time with.  If you are good at time management and a fairly quick decision maker, this should be fine for you.  The frustrating thing about having a set schedule is that it can easily get thrown off by late or complicated patients.  It's personally very important to me to stay on time out of respect for my patient's time, but there are definitely days where it seems like everyone is complicated, so they need more time (and I'm becoming a little more okay with that.)  Areas like urgent care, emergency med, or being in the hospital will mean that your patients just show up or are already there.  This has it's advantages because you don't have to worry as much about the late patients or your own punctuality, and it's ok if you need to take longer with some patients.  The disadvantages to not knowing your schedule for the day mean it's a bit of a surprise, and you can't predict as well if your day will be slow or hectic.

Procedures vs no procedures - This is pretty straightforward, but if you loved surgery and getting to do things with your hands, then you probably want to do something where you can do procedures.  I would say in most specialties there's at least a possibility of being able to do some hands-on stuff.  Specialties that are more lab-based (ex - endocrinology) may not have as much going on there.  General or family practice is a bit of a toss-up because there are some that do their own injections and even biopsies, and then other practices that don't do any of this.  So that's just something to consider when looking for what field you want to be in.

Continuity of Care - It was really important to me that I know how my patients are doing after I treat them, and I wanted to be able to build relationships with my patients.  You may get a little bit of this in urgent care or emergency med, but usually when you recognize a name there it's not a good thing.

Now on to supervising physician(s).  It's much easier to work under one SP, but sometimes if you're looking at working for a large practice or hospital, that's not going to be the case. I cannot stress how much having a supportive SP who is willing to adequately train and teach you is important.  My SP will stop what she's doing, even if she's running behind, to come see a patient if I ask her to.  You also want a SP that will support your decisions, and although they may not agree and will tell you that in private, they should never throw you under the bus in front of a patient.  There's a saying that if a patient sees a bad doctor, they'll find another doctor, but if they see a bad PA, they'll never see another PA.  I think that's true because most patients still have a little bit of a difficult time understanding what a PA is and what we can do, so they are quick to lose faith if something happens.

Now for salary and benefits.  I have a much different opinion on this than other PAs from things I've read and discussions I've had.  I definitely believe in not being lowballed, but I also believe in being willing to accept a fair offer, especially as a new grad.  It is going to take both money and time, and probably mistakes, to train you to be a good PA.  And you have to weigh the worth of location, supervising physician, and experience you will gain.  So really look at everything involved, and not just the number.  Is there a bonus structure in place?  That can potentially make a huge difference.  There's a lot out there that says you should never take a job if it's less than the national average and that new grads should be making 90K+.  I think this is possible, but is not necessarily the norm, so you have to be realistic.  Also, consider vacation/sick time, CME days and money, insurance, retirement, and just quality of life.

What are some of the things you are looking for in a job?  What helped you make the decision to take a certain job?

Dermatology Resources


After I graduated, I went straight into working in dermatology.  During didactic year in school, we got about 2 weeks of derm, and it makes up a whopping 5% of the PANCE.  Those 2 weeks and some dermatology shadowing I did before were enough to spark my interest in the field, but not quite enough to make me feel confident enough to know what I really needed to.  I am extremely lucky to have a great supervising physician and I was able to do my 2 elective rotations in dermatology, so that was helpful, but even after being at my job for almost 3 years, I still find myself looking up information multiple times daily!  Today, I'm going to share with you some resources I found helpful while in school and what I currently use in practice!

In school:

  • AAD Basic Dermatology Curriculum - The American Academy of Dermatology has a specific curriculum for medical education, and it's awesome.  The lessons are thorough and a great overview of some basic dermatology topics that are likely to come up both on boards and rotations.  They don't take a ton of time, and I think are definitely worth taking a look at.
  • Dermatology Secrets Plus - This is a small, simple book that is filled with pictures, which are so helpful in dermatology.  I used this book during didactic year, and I still refer to it occasionally in practice as a quick reference.  Not the best book if you are looking for every detail on a subject, but more of a quick overview w/ pics.

In practice:

  • UpToDate -  I recommend UpToDate for any specialty really!  Like the title says, it has the most current information and is updated regularly.  One of my favorite features is print outs for patients!  These are so helpful, and the majority of the time there is one for what I'm looking for.  The drug information is also very specific and always provides exactly what I'm looking for, including dosage and how the medication is supplied.
  • VisualDx - This is a resource that I use on a daily basis.  I pull it up on the computer as soon as I get to work to have it ready to go!  You can look up multiple dermatologic subjects and there is a huge photo library with great examples, and it provides all the info you need to know, including pearls, diagnosis methods, differentials, and treatment.  There's a really nice accompanying app as well!
  • Habif's Clinical Dermatology - This is the first actual textbook I got for derm when I started working, and I have used it a bunch!  For a textbook, this one is very easy to read. My one complaint is that sometimes it does lack some of the details I'm looking for so I'll visit my supervising physician's library to borrow one of her books. 
  • Practical Dermatology- Practical Dermatology is my favorite journal for getting all of the up and coming derm news.  It's very easy to read and the topics tend to be more common things that I actually want to read and learn about.
  • Litt's Drug Eruption and Reaction Manual - Possibly my most helpful book.  This is my go to for any rashes that could be caused by drugs. It lists every medication and the possible side effects.  Great for my itching, photosensitive, and hairloss patients when medications are involved. 
  • Wolverton Comprehensive Dermatologic Drug Therapy - This is the most in depth book about dermatology medications. If I have any question about side effects, contraindications, dosing, etc, this is my go to.  UpToDate is great, but this is strictly derm, and sometimes I just sit and read it. (Nerd alert)
  • Andrews' Diseases of the Skin and Bolognia's Dermatology - These are my supervising physician's favorite books. She can actually just pick one of these up and turn to the page she wants because she used them so much during residency.  It's amazing! But they have so much detail and every obscure derm disorder ever. 
  • SDPA Diplomate Fellowship Program - I've just started these modules, but so far, they are very well done. This is training specifically for derm PAs, and it follows Bolognia's Dermatology Essentials

Some of these links are affiliates, which means if you use them, I get a small cut from Amazon, but you pay the same low prices and get your Prime shipping! I hope that some of these are helpful to you, and please comment with any other resources you love to use!