PA-S

Using Picmonic to Study in PA School 

There’s always some excitement and jitters around back-to-school season, but it’s a bit different when going into a graduate-level program like physician assistant school. The pace is much quicker and the expectations are higher in PA school. Traditional study methods may not be as effective for digesting the amount of information presented. 

I personally experienced this during the first week of PA school when we started with anatomy. Hours of notetaking and rewriting information weren’t feasible. There just weren’t enough hours in the day! Instead of seeking other resources, asking for help, or changing how I studied, I blindly kept going and ended up with a C on my first exam. 

That was a serious wake-up call and shook my confidence. I knew something had to change quickly if I wanted to complete PA school successfully and I took a good look at my study methods. I needed something faster that targeted what I was learning in PA school specifically with the information I needed to know to care for patients one day. There are tons of resources out there, but one that I continually hear about from PA students and wish I had during PA school is Picmonic. Lucky for me, I can use it during my PANRE recertification! Let me tell you more about Picmonic so you can determine if it would be a good fit for your PA studies. 

Picmonic is a visual study aid. You know how you can recall that one episode of your favorite childhood cartoon, but trying to remember what your professor said yesterday is impossible? Picmonic makes what your PA school professor said into an animated graphic with mnemonic devices to make the information more interesting and memorable on test day. 

I found it very difficult to remember all of the necessary information strictly from text on a PowerPoint. Once I was on rotations, seeing patients in person, everything came together so much easier and I could recall the information much quicker. Picmonic is a happy medium by providing bite-sized videos that show and put all of the information together in a way that makes sense. 

So how should you use Picmonic? If I were in PA school, I would use Picmonic after I reviewed material from the lecture and books and felt I had at least some familiarity with the basics. I would view the associated Picmonic animation to help me connect the facts and concepts in a way I could understand and apply it to a test question. I would watch the Picmonic, review the facts, and then take the associated quiz. If there were any topics I struggled with, I would go back to my lecture material for review and then revisit the Picmonic. 

During PA school, I also liked to do last-minute quick overviews right before tests. Picmonic is perfect for that because you can make a playlist of the subjects you would like to review and the videos are short so it’s very efficient. You can even just watch on your phone to make it even more convenient whenever you have a few minutes of downtime. 

Here’s a sample study plan for how you could use Picmonic during a 2-week module in PA school. Start by looking over the blueprint for the section and find the accompanying topics in Picmonic. Create a playlist with the Picmonics you want to review. Set aside a dedicated time each day to Picmonic. If you have a commute or want to take a break, but still feel productive, these are great times to watch a few videos. As test day approaches, increase your dedicated time to allow for reviewing and taking the accompanying quizzes. Mark any videos you want to rewatch as refreshers right before the exam. 

To try Picmonic, use the code THEPAPLATFORM for 20% off. Picmonic also offers a great free trial where you can play and quiz on the 15 most popular topics for 5 days and then browse after that. This is a great opportunity to see how Picmonic fits into your schedule and if it’s a good solution for you. If you’ve used Picmonic, let me know your study plan and how it’s helped you in PA school! 

My Picmonic PANRE/PANCE Study Plan

Brought to you by Picmonic. Affiliate links are provided. 

Fun fact - to become a physician assistant (PA), you not only have to successfully complete both the didactic and clinical portions of the program, but you also have to pass an exam at the end called the PANCE - Physician Assistant National Certifying Exam. And yes, we pronounce it “pants.”

To continue to be a PA, every 10 years you must take a recertification exam called the PANRE, and although many PAs specialize, this is a general test. For PAs like myself who have only ever worked in a specialty, this is a bit daunting. Since I am in my 8th year as a PA, it’s time to start studying and brushing up on the other 96% of medicine I’ll be tested on outside of dermatology! That’s where Picmonic comes in to save the day.

When I was in PA school, I adopted a mindset early on during the didactic portion that I was studying for not only the end of subject test, but also boards, the entire time. Once I figured out the resources that worked best for me, I stuck to those throughout the program. I’m a note-taker by nature and need a way to put together the information I’m seeing and hearing to apply it to real-life situations. This happens on rotations, but how can you learn that same way before being thrown into the real world?

Visual tools that combine memory devices with application, like Picmonic, are great resources that weren’t available when I was in school. Now that I have to start over, I’m so grateful I can use Picmonic in my studying for the PANRE and I’ve seen how it would have been such a great supplement to the death by PowerPoints we sat through for 8 hours a day. Here’s my approach for studying using Picmonic.

The PANCE/PANRE is made up of 14 subject areas in the PANCE Blueprint that are each assigned a percentage. Dermatology is a whopping 5% compared to the cardiovascular system at 13%. 

Luckily, Picmonic is organized into the same categories with the main subjects broken down into digestible bite-size videos. From a broad perspective, Picmonic is an audiovisual learning system with unforgettable stories and characters to help you remember everything you need to know for school. The quick little anecdotes stick with you throughout clinical rotations and tests as a long-term memory retention tool. If you’re anything like me, finding little connections and different word similarities to remember quick facts helps so much with recall on test day.

Click here to sign up and be sure to use code THEPAPLATFORM!  

Planning Finances as a PA with PA the FI Way

Are ya'll enjoying our recent focus on finances? Do you know what "financial independence" is? Kat from @pathefiway is on The Pre-PA Club podcast today to tell us about her journey to establishing a financial education and helping other PAs meet their financial goals through her podcast - PA the FI Way. It was a really fun conversation, and I'm actually on her podcast as well talking about my student loans and creative outlet through The PA Platform.

Kat: So my name is Katarina, but I often go by Kat. I am a PA that lives in the upper Midwest. And I went to a PA school at Des Moines University. 

Savanna: Awesome and you're practicing now? 

Kat: Correct! Yep, I started in family medicine for about six and a half years. And I recently switched over to outpatient psychiatry back in January. I still do have a casual position with my previous employer as a walk-in/Urgent Care PA role too, so I like to keep that generalized medicine still going on too.

Savanna: Nice! Are you doing in-person psychiatry or mainly telemedicine? 

Kat: When I first started, because of the COVID pandemic, it was mainly telemedicine, but just recently we switched back over to seeing people in person again too. 

Savanna: Okay, interesting. Yeah, that's what a lot of my PA friends who work in Psych have been doing - a lot of telemedicine. It's a specialty that definitely translates well to that. I'm in dermatology, and it's a little hard to see things over Zoom, when trying to look at skin lesions. We've made it work, but it was a little difficult. So, let's take it back a little bit and what made you interested in becoming a PA?

Kat: So back when I was in high school, I felt as though I needed to figure out what to do with my life, as I'm sure many people felt the need to do back then. And I really enjoyed science, and I hadn't really thought about different types of careers in medicine. So back then in high school, a lot of people only think of doctors or nurses, although there are so many other types of careers out there in medicine as well. I highly encourage anybody interested in medicine to research about and consider other careers as well. But when I was in eighth grade, I tore my ACL my first and last time skiing, because I was not a good skier haha. And in the ER, the provider who saw me was a PA, and I didn't necessarily register it at the time as a teenager. But a few years later when I was thinking about what to do for school, my mom reminded me that that provider was a PA, and so we researched the profession together. I just really liked the fact that you get to have less student loan debt, and a little bit less time in school as well. I also really enjoyed the lateral mobility of the profession, obviously as I've utilized, so those were the factors that prompted me to pursue the PA profession.

Savanna: Nice! Yeah I feel like everyone comes to it in a different way but those personal medical experiences tend to be a common theme where you figure out, oh there are people who can take care of me who aren't necessarily doctors, which is nice and a good path to take. So I've actually never had a PA who works in psychiatry on the podcast surprisingly because I feel like there aren't that many of y'all. There's definitely a need and I know in the area I'm in in Georgia, we definitely need more psychiatry providers. What does a typical day at your job look like? What is your schedule like in that specialty?

 Kat: Definitely, you're correct that there are definitely few PAs in psychiatry. When I was looking into switching into a specialty, the research I found at the time was that probably less than 1% of PAs work in psychiatry, so I thought that was very interesting. During a typical day right now, I will see either intake patients, or follow up patients. Intakes are new visits, and they are either self-referred, like some people just want to see a psychiatry provider for some reason, or family medicine may refer them, or a lot of times, they are follow-up from a recent inpatient hospitalization for psychiatric purposes, and we are seeing them once they've been stabilized in the hospital. As I mentioned too, it’s both currently a little bit of Telehealth visits, a little bit of in-person visits, so it's a little bit of both going on. We also manage their mental health medications, and we have to monitor labs with that. It's very weird, I'm sure you can relate as a derm PA, but it's very weird not to use the stethoscope anymore day-to-day. But that was something to get used to, but I still feel as though I'm helping people, and it's definitely a very interesting specialty for sure. You see a lot of different things, lots of different mental health illnesses, but it's very rewarding to try to help others feel better and try to help stabilize their mental health symptoms, so that they can improve. 

Savanna: So are there any limitations in your specialty? Because I don't know about where you're at, but as far as with medications you're able to prescribe, just being in a specialty where you may be prescribing drugs that are on different schedules? 

Kat: Sure, so that's a great question! At my company, they are very much trained on the job. So, the medical director is the supervising physician that we work with. In my state, we don't technically need the true supervising physician role anymore because of legislation changes. But every company keeps that role differently, right? So he's a psychiatrist, and he works with the PAs and is very hands on. So we have a weekly meeting with him where we ask all of our questions; we can send him messages all the time; we can go down the hall if he's in clinic. He oversees the PAs at other clinics as well which is really cool. So he's very hands on. We prescribe and manage all mental health meds. There's even one of the big gun antipsychotics called Clozaril (clozapine), you have to take some online training and then we manage that and prescribe that as well. A lot of injectable medications and controlled substances too, but I do appreciate that our company has a pretty strict controlled substance agreement policy. So we don't mix any controlled substances. Or if patients are using drugs like medical marijuana, depending on the situation, we often don't use controlled substances as well. So I do appreciate that support too. 

Savanna: That's awesome. That sounds like a really great work environment and set up, which should be a goal for anyone who wants to be a PA. I want to pivot a little bit. So the reason we connected was through Instagram, and I started seeing your posts pop up on your account PA the FI Way, which we'll explain a little bit about. but so can you just explain what got you interested in financial topics and what inspired you to kind of create your account and podcast?

Kat: Yeah that's a great question. So, I guess for financial topics… I really wasn't that into finances. My husband used to manage all the bills, so I just thought that he manages the bills and I didn’t really have to learn much about finances. As a PA, I was just learning so much that I didn’t necessarily mind. I was definitely trying to pay off my student loans, but now aggressively. Unfortunately, I started off working with a financial advisor, who was not the best fit, because some things that he suggested aren't necessarily sound wisdom, so we got burned a little bit right out of PA school. How I got into the topic of financial independence was through travel rewards or travel hacking. We were on our way to a friend’s wedding, and one of my friend’s husbands asked, “hey do you like traveling? have you heard of travel hacking?” And he introduced me to the Choose FI Podcast. That is the podcast I started listening to, and that's how I got hooked on financial independence. I became kind of frustrated with our training - about how much we get into debt. We do earn a fair income out of PA school, but how do you balance that? So, it made me want to try to educate other current and future PAs out there about the concept of financial independence. 

Savanna: I'd say in the last couple of years, that is something I learned about because they don't really teach us in school about debt or loans or investing or any of that. So it's a lot of self learning. But this concept of financial independence was new to me. Can you explain what that means on kind of a basic level for somebody who's never heard of it?

Kat: Sure, so financial independence is a very broad topic, but I will definitely do my best to try to explain it simply to those who are just kind of getting started. So financial independence, the abbreviation is FI (that's where PA the FI Way came from). And that's the first part of the acronym FIRE, or Financial Independence, Retire Early. Retire Early is actually optional, so once someone reaches the point of financial independence, they don't have to retire early. They certainly can continue working as a PA for many, many years to come if they would like to, but reaching that point provides many doors throughout your life, like you could consider cutting back on work or things like that. So, FI is the point at which a person (or a couple) reaches where they have invested savings equal to 25 times their expected annual expenses. So a lot of financial calculators look at your current income, but it's not really what you make that matters for retirement, it's what you expect to spend in retirement. For example, if a couple expects to spend $80,000 per year once they stop working, then they will need to have invested $2 million, or investments plus savings money. Otherwise, if they are able to live very frugally on only $40,000 a year, they would only need $1 million. Some people are really frugal and live on less than that as well. So financial independence is based on something called the Trinity Study, and what that study shows is that if you reach financial independence, you have a very high probability that you'll be able to last for 30 years with your finances. So if you are thinking about retiring really young, you probably should have more than 25 times your expected annual expenses saved up. 

Savanna: Okay, that's what I was just thinking. So you're saying if I had $2 million in the bank, I could just retire - that doesn't seem like that would work hahaha. I mean investing is so complicated with compounding and all that. I'm sure there are lots of calculators online where people can plug stuff in and all of that. So when we talk about investing and saving and paying off debt and all of these things - when there are so many different techniques and terms, what stood out about this concept of financial independence? Do you plan on retiring early? When you found out about this, what steps did you decide, like okay I'm gonna do these things to make this a reality for myself. 

Kat: So the two very condensed ways of achieving financial independence is trying to cut back on costs and save a lot, but then also try to invest throughout your career too. So you're trying to invest as much as possible for your future. In regards to whether I'll retire earlier or not, probably. I really don't want to work until I'm in my mid 60s or potentially even 70s. I'm not exactly sure when we will for sure retire, but again as I had previously mentioned, reaching financial independence or being close to it allows you the ability to really cut back on your work if you really want to. My husband and I don't have kiddos yet, but once we do, then that can help with a balance in our life at that point. Both my and my husband’s fathers passed away at relatively young ages. My dad was in his early 60s. and his dad was in his 50s. You hear all the time about how somebody reaches retirement age, and they’re so excited to retire and unfortunately something awful happens where a spouse passes away, or they get an illness, and they can’t do the things they planned for their retirement, whether that's traveling or other hobbies or activities. So that's why we're trying to pursue financial independence. 

Savanna: Yeah, those are great, great reasons. And that's so true. I mean, there is so much variation in the PA profession between our specialties, jobs, locations, life, and debt and all that. Is this a concept that you feel like most PAs would be able to achieve and pursue, or do you think you need to be in a certain place already before you consider making actions towards setting yourself up for financial independence?

Kat: Sure, that's a great question. I think that every PA and their family can reach financial independence, and there's a few reasons why. One is that PAs do make a pretty decent and good salary. There are many school teachers that reach financial independence on a salary that's way less than us as PAs. Again, it’s about those expenses, so you don't have to cut back everything and live super frugally. But you need to find the balance of finding those things that you value in life. You don't have to be married to a high income earner as well. You can be the primary breadwinner, but if you have a PA salary, then you can certainly reach financial independence. 

Savanna: Are there any resources that you use? I know there is Physician on FIRE, who talks about this who is a physician. There is also White Coat Investor; I feel like everybody knows about. What resources have you found to be the most helpful in just learning about finances?

Kat: Yeah! I absolutely love the White Coat Investor and Physician on FIRE; they're both excellent resources for those of us who practice in healthcare. As I mentioned before, Choose FI Podcast is great as well. And there's another PA on Instagram, Kristin Burton (@strivewithkristin). I recently interviewed her for my podcast as well. So she has tons of good resources too. There's so many good books too! The Simple Path to Wealth is an excellent book to start with, or Quit Like a Millionaire. It really depends upon what type of modality you want to learn from. There are podcasts, YouTube channels, books. I do have my podcast as well, PA the FI Way. I tried to really teach about these financial independence concepts, break it down in understandable pieces for peers and make it applicable to them as well. 

Savanna: Nice, and I love that it’s specific to PAs! As a PA, you can understand the education and everything that goes into it, the job, and all those factors as well. Let’s talk about the different stages. We have pre-PA students, PA school students, new grad PAs, and other PAs. What are some things that people can start doing at these stages to kind of set themselves up for financial success later on?

Kat: Sure, yeah so this is a really deep question that you can go into many different branches, but I'm going to do my best to be concise here and try to give some actionable tips along each step here. In high school, try to keep your college costs low when planning for college. You can do that by taking AP or dual enrollment courses. I went to community college for my first two years of college too, so you can plan to apply to community college, and then start applying to tons of scholarships in high school. Then in college, you can also consider living at home that can keep your costs low, or you can become a resident assistant as well. You can use used textbooks and apply to more scholarships, and then try to obtain healthcare experience. You don't have to spend tons of money on your education to be able to start getting some of those healthcare experience hours. And then when you do apply to PA school, make sure that you are applying only to those programs that you have met all of those prereqs. Because as you know the cost of CASPA is pretty high. And if you aren't meeting all those prereq requirements, then it's probably not worth even applying to because you have to pay for every single PA program that you apply to. And then, in addition to applying for more scholarships, consider joining the military because you can get your debt paid back as a provider. The PA profession was founded in the military, so it's very fitting. In PA school, live below your means. So you're going to have your student loans that you're going to get, but it's really important to start budgeting. You need to start tracking, probably three to six months of every single dollar that you're spending. Keep your housing costs low, you don't need to spend money to buy fancy medical equipment. Just the simple medical equipment can do. Try to get rotations near your friends or family. 

As a new grad, try to live like a PA student for two to five years. So don't let your fancy new income as a PA cause you to have lifestyle creep, meaning that the more money you make, the more money you're spending. Then really try to plan out how you're going to pay back those student loans, you can consider programs like Public Service Loan Forgiveness (PSLF). You can consider refinancing loans, certainly after the current COVID federal student loan pause is over though, and then try to start investing ASAP. Many jobs will have a match for their 401k or retirement plan. So try to start investing even if you are paying off your debt because time is your friend when it comes to compound interest. Also try to track your net worth. It’s hard to know where you're going to be going, which number is your financial independence number, and then how far along you are in reaching that number if you don't know what your current net worth is. There's a tool called Personal Capital (https://www.personalcapital.com) that I really like to use, and that allows you to put in different types of accounts to see where you are at that moment in time.

Savanna: Yeah I use that too. That’s a really helpful way to visualize everything and see where you are at. Those are great tips! As you were saying those, it’s funny and it sounds bad, but I was thinking about people who stand out at every level, either myself or someone I know. Like there was someone in my class who ate out every single meal, and someone else who bought a new car when they graduated. I clearly did not do everything perfectly either!

Kat: Exactly, exactly. I definitely did not do things right out of PA school either. I only learned about financial independence five years out of PA school, and I've been practicing for seven years now, so I definitely made all of those mistakes as well. You bring up a good point with food and transportation. Food, transportation and housing combined comprise 61% of American budgets. So if you can really focus on cutting back in those three areas, then you'll be able to save more money and invest for your future.

Savanna: What advice would you give to somebody who wants to learn about this but is overwhelmed? Do you have a good episode that would be a good place to start? 

Kat: That's a great question Savanna! With my podcast, in those first couple of episodes, I talked about what the PA profession is if people aren't familiar with it, and then I do also talk about financial independence, and the different steps that I mentioned along the way there too. I also did recently create a free resource called PA the FI Way Beginners workbook that you can find on my website, http://pathefiway.com/, so you can you can sign up to get that resource to start. Otherwise, you can shoot me an email at Kat@pathefiway.com, and I'd be happy to send you a copy of that too. 

Savanna: Perfect, yes, that's awesome, and you're on social media as well. I've definitely seen your posts popping up. I see yours and Kristin’s posts a lot because it comes up on my Instagram all the time, which is great. I need the reminders! Oh, and I’ll put all that information in the description, so everybody can find everything. I definitely appreciate all of your insights and information, and hopefully this will be encouraging to some people to at least take a look at their finances and kind of see what changes they can make. 

Kat: Yeah, definitely. And I wanted to thank you so much Savanna for having me on. I’ve been following you for several years now. I think we graduated PA school right around the same time, so I think it's awesome what you've built over time since you've graduated from PA school! So thanks for all you do for current and future PAs too! 


How to Create a Study Plan for PA School with Sketchy PA

Sponsored by Sketchy PA

The first thing people ask after receiving an acceptance to physician assistant school is - “What can I do to prepare myself?” With each program’s curriculum being so different, it’s difficult to get ahead, but one way to steady yourself for the difficulties of PA school is to develop a study plan. If you’re already in the thick of it and now understand what we mean by “drinking out of a fire hydrant,” you may be feeling overwhelmed by the amount of information being thrown at you every single day. It’s a lot! This blog post will help you determine your learning style, develop a study plan, and identify the most effective and efficient resources for the limited study time allotted during PA school.

What is Your Learning Style?

Many students float through high school and undergrad by adapting to each professor or class and depending on memorization. (Raising my own hand as I write this!) There isn’t a ton of focus on self reflection to determine your learning style, although doing so can make studying much easier, while also making the most of your time. I never took one of these tests until after PA school, but found I typically rank highest for Kinesthetic and Read/Write, but what does that mean?

There are tons of free quizzes online, like this one, that can quickly give you insights into how you learn best. The main identified learning methods in the VARK questionnaire are Visual, Audio, Read/Write, and Kinesthetic. In referring to the descriptions of these styles, Visual learners enjoy seeing information arranged in charts and graphs that show the information in a graphic manner versus writing, video, or photo. I love a good chart and definitely took advantage of the large whiteboards in the library during PA school. Auditory learning refers to students who best consume information through listening - podcasts, lectures, discussion, etc. Group studiers tend to fall in this category. Read/Write is somewhat self explanatory, but if you enjoy just reading the information in a textbook or on lecture notes, this may be your learning style. The last style is Kinesthetic, which is for students who like to see examples while learning to connect the subjects with experiences.

You may find yourself relating to multiple areas, and upon figuring out this information, it’s essential to recognize and adapt if a study method isn’t working for you or switch between styles when needed. PA school will be a rotating experience of different professors and testing styles, and you may need to adjust your study style along with them.

Once you have an idea of how you learn best, determine what type of other learners you study most effectively with. Group study isn’t necessarily just quizzing each other, but having a cohort of similarly minded students will help keep you on track and make studying a little bit more fun. While I personally don’t do well with “talking it out” or “teaching each other,” many students in my class preferred that method in their study groups. Being a more visual learner, I collaborated with 2-3 other students in the library, and while we mostly studied independently, we encouraged each other to keep going and asked questions when needed. We were also able to share helpful resources when the lecture notes weren’t sufficient. Moral of the story - Figure out what works for you, and stick with it unless it isn’t working anymore.

Developing a Study Plan

The majority of PA programs schedule lectures Monday through Friday from 8-5. So when are you supposed to study?? How can you take care of yourself in the process?? You’ll likely have an adjustment period while figuring this out, which is normal, but the sooner you set a schedule, the better. Most resources you use, like Sketchy PA, will give options for different lengths of use possibly ranging from 6-24 months to get you through PA school and help you plan your learning.

Take a look at your class schedule and determine if there are any pockets of time that you can use for studying. Are you a morning person or a night owl? I found studying early in the morning was much more effective for me when my mind was fresh before lecture. Look at your curriculum to see which topics and lectures are coming up and compare to the NCCPA Blueprint. Throughout all of your PA school education, remember that you are preparing for the PANCE! This brings us to the next point, which is finding the tools that will make your life easier. 

Identifying and Using Study Resources

Once you have a learning style and know what time you have available for studying, identifying the appropriate resources that will be most efficient for that allotted period. Realize early on that you will not be able to use every resource out there and what works for a classmate may not work for you. To illustrate the importance of finding a resource that will satisfy multiple learning styles, let’s take Sketchy PA as an example.

Unfortunately, these visual study aids were not prevalent when I was in PA school, but it seems to be a gold standard now. Why is that? Sketchy develops interactive learning with videos that help students remember material by connecting an image of a visual scene with the essential information, while showing the application of the material. We’re covering Kinesthetic, Visual and Audio learning, and if you take notes, you’ve got Read/Write done too! 

The videos created by Sketchy are specifically designed for PA students to highlight the information that is emphasized in the NCCPA Blueprint. To hear more about how this resource was developed, listen to this podcast episode with the PA Director at Sketchy, Prof. Moini. The image above shows a video with different symbols that are highlighted and explained in this story to help students retain information better and apply it. The videos are developed to supplement and support what you learn in the classroom, and kept to shorter lengths so you have digestible bite-size info for your small pockets of time. After solidifying the knowledge, use the review cards to make sure you understand the main points thoroughly. 

Most resources, like Sketchy, have a free trial so you can try it out and see if it will work for your learning style and study plan. Take some time to give it a shot, and I would love to hear your experience in the comments.

Take advantage of the Black Friday 2021 deal and use code PA20BF for 20% off all plans! If you miss out on that deal, SKETCHYSP will get you 10% off anytime.

Staying Health in PA School

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Today’s interview is with Ashley Turner. After graduating from UAB’s PA program, Ashley works as a full-time surgery PA with a background in nutrition. Ashley also does nutrition coaching through Faster Way to Fat Loss (which I did, and loved). We talk about our experiences in PA school, how to make good choices, and how to get back on track.

This episode also has a podcast which you can listen to here.

Ashley:  Hi everyone! I'm Ashley Turner. I'm a certified PA, and I work in Campbellsville, Kentucky, which is a small rural community where I grew up. I’ve been working in general surgery since graduating PA school. I live with my husband and 14 month old son, and all my family is here. I also do virtual health coaching with The FASTer Way to Fat Loss as well. So that's kind of me in a nutshell! 

 Savanna: How long have you been a PA? 

Ashley: I graduated in December of 2014.

 Savanna: We’re about the same because I graduated August of 2014! What was your background before PA school?

Ashley: I graduated from University of Kentucky with a Bachelor's of Science in Nutrition and Food Science. I wanted to go to PA school right after school, and I had my heart set on UAB. I always wanted to do surgery. So I applied only there following undergrad, and I did not get in. That was a huge blow to the ego! But that’s okay. I ended up taking a year off and I worked a lot of odd jobs. I worked as a nurse tech, doing triage at different clinics around Birmingham, Alabama. I actually moved there. I also cheered in college, so I became a cheerleading coach at UAB. And I also was a cheerleading coach in an all-star group down there as well. So I was working like three to four jobs during the entire year. Then I reapplied to UAB as well as another program in Nashville, Trevecca Nazarene University. I secured an interview at Trevecca, but did not get in. But at UAB, I got an interview and got accepted that second time, which I was really excited about! And it all worked out because I'm from Kentucky, and moving down there for a year and taking that leap of faith to reapply actually got me in-state tuition, which was helpful in the long run. 

 Savanna: That is a really big move! And I think a lot of people wouldn’t necessarily be willing to do that even if they really want to go to a particular school, and UAB is on the top of a lot of people’s list. 

Ashley: I really sing the praises of UAB; I had a really good experience. I think you can find faults in every PA program. You can really nit-pick any program. But you know, I really can't find many. The staff was just really great. All the educators were just really wonderful. Setting up our rotations were huge. And they had just a lot of great resources and a lot of great preceptors. So I have no qualms about UAB. It definitely does speak volumes when applying to jobs because people will interview me and ask me about my training at UAB. And I've had people specifically asked for “UAB-trained PAs”. It was just really great. So I love my program, and I'm glad I did take the leap of faith to move down there and work my tail off for a year. 

 Savanna: I also love surgery! I think if I did not do derm, then I would do surgery. Are you actually in the OR? What does your job look like on a daily basis? 

 Ashley: I'm currently not in the OR in this current job, as much as my previous jobs. So I don't know if this is a good or bad thing, but this is my fourth job right now. So in my first job, that was level II trauma center and acute care, my vascular and general surgery job, my priority is pretty much the OR. I did a lot of critical care. We really acted as first year residents. We had the pagers. We were first-call for any issues on the floor. We also rotated doing floor call, critical care call, and trauma call. So we responded to the trauma codes, and we would also be first assisting in the OR. That was really exciting. I got to do a lot of procedures - A-lines, central lines, chest tubes, thoracentesis, and I was learning therapeutic bronchoscopies towards the end. So it was really awesome! In my vascular and general surgery group, my first priority was the OR as well. We first assisted the majority of the time and rounded on patients. At my current job, I do a little bit of it all. I rotate in the hospital. I do a clinic for two weeks. And I do a little bit of OR. I round on patients and do consults in the hospital. 

 Savanna: Okay, cool. So what are your hours like?

Ashley: So there are 3 PAs in our service. We rotate two weeks stints in either the clinic with more hospital, or we have a float two weeks where you have a little bit of an easier schedule with some mornings off during the week if the load is light in the hospital. Coming off the hospital two weeks is a little gruesome because we are pretty much there 7am - 5pm Monday through Friday. Sometimes you can go home early, it just really depends on the workload, the patient load. You kind of have to be there in case consults come in because you are the first one to respond to consults. But in clinic, it's pretty much 8 am - 5 pm, and we have a half-day on Fridays. So it kind of rotates. It's been pretty nice. It's been nice for work life balance for me having a new child.

 Savanna: What is your level of autonomy and your relationship with your supervising physicians?

 Ashley: It has changed a bit. It’s gotten a little less autonomous as I’ve gone through my jobs. In my trauma job, they pretty much let you go. For chest tubes, I saw one, did one, and then went to the floor and did one by myself. The trauma surgeon looked at me and said, “You can do this, right?” And I was like, “Hmmm yep!” So I marched to the floor by myself with a student, and that was really the second time I put a chest tube in. That was quite terrifying, because my patient was awake on the floor in stable condition. So it was terrifying because they were very alert! So in my practice, if I ever needed them, they were a call away. They trained us very well. The other PA who trained us trained us very well, and they were there every step of the way. I saw a lot of chest tubes before I did that. They were just very good at feeling the situation and knowing when they needed to be there, and knowing when they felt confident in my ability with all the PAs. They did a wonderful job at maintaining the relationship between the supervising physician in the PA. 

Being in a small practice in a small town, it just makes it a little bit complicated, because everybody knows everyone. So you're pretty much seeing your patients at Church or at the Mexican restaurant in town and you don’t have that luxury because patients want to see the surgeon. They want to see your physician because that's who they're seeing out in the community. Midlevels are still a little bit new in a smaller, more rural community. So it's just a little bit different, but they still do a really good job of incorporating us into the practice.

 Savanna: Interesting! So what made you interested in nutrition? Like, why did you choose that as a major? And was it helpful for PA school?

 Ashley: Yes, I would say yes, to PA school, and also my career now. First of all, I was a biology major, but I hated coming out of the class and not really being able to apply it to my everyday life. And that really frustrated me that I spent all this hours learning things. And I was just like, “I want to just do something with this now. I want to learn something that I feel like I can apply to my life now.” And all through four years of college, I was a collegiate cheerleader. So being in shape, being at an appropriate size for our sport was very important. My sister was a nutrition major, and I would be kind of in the mix with her seeing what she was learning. I thought it was really awesome, what you’ve learned in class could apply to your life. You can build upon it and just continue on for the rest of your life! So I switched my degree to nutrition, and I ended up loving it. It helped me through my fitness level in college and where I needed to be and wanting to be. 

And as far as being a PA right now in our General Surgery Clinic, again, bring in a rural community, we do a lot of primary care through our clinic. So I think in a lot of larger communities, when patients come to your general surgery clinic, they pretty much already come with the diagnosis, and they come with a plan of action, what you're going to do. They have the appropriate studies ordered, and you pretty much know their problem and know your plan of action really before you see the patient, a lot of the times. But here, they come in a lot with vague symptoms and get shuttled to us to kind of figure out and decipher between their symptoms. And a lot of times, it's nutritional things. It’s IBS. It’s constipation. It’s diarrhea that is diet-related. It’s lactose intolerance. It’s gluten sensitivities. We coach people through that. We have a surgeon I work with Dr. Bahr, and he’s very sweet. People will come in with these complaints, and he’s like “She's the expert, please talk to her. Just listen to what she says.” So I’ll come in and counsel people through these things, even with people with diabetes who are so lost and clueless. So it's been really great. It's been really helpful in this environment! 

 Savanna: That’s an interesting way to think about it, because yeah, my biology degree was useless haha. Okay, so we’ve never really talked about this on the podcast at all -- staying healthy in PA school! I don't necessarily think I did a great job of this. It’s really hard in the thick of it, and you’re just trying to survive. You're not necessarily thinking about what you're eating, or if you're eating or if you're working out because school is such a big priority. So do you think you did a good job of taking care of yourself and your health during PA school?

 Ashley: I think I stayed active. I don't know if my diet was quite as tight as I would want it to be. But I think I've stayed fairly active, which was huge. My first year PA school, I was still coaching cheerleading, so I was able to work out with the cheerleaders and I even went to games with them and stayed active with them during my didactic year. So that was really easy, staying active and having an active stress relief from PA school, something to get my mind off PA school, my mind out of studying. So that was very therapeutic for me. And as far as overall health, I think that did wonders for me in my first year. 

I don’t think my diet did too well. You’re up at like 3 am trying to study for that test, and you’re just trying to stay awake. You’re going to Einstein Bagels, that was by our class. And sitting in class for six hours is mind-numbing, so at least you can enjoy that delicious cinnamon bagel. So I don’t know if I did my best with staying active. But I think staying active and finding that downtime and finding that stress relief when you think everything is kind of coming down on you -- I think I did fairly well. 

 Savanna: Yeah the only reason I worked out was that two of my friends in PA school would go to the gym and basically make me go. And they would run and I was like “I'm not running, I will walk with you guys around the track, but I'm not running.” They would always try to get me into mud runs and 5K races. And I would refuse! Haha I'm glad they were my friends and still my friends. I'm very thankful that they encouraged me to do that, because it was a good stress relief. 

Ashley: Yeah, and I think really managing your expectations on what healthy means to you at this point in time is important. Like having a raging six pack and a bikini body is probably not the best thing to think about in PA school. Maybe you don’t have the time to manage your diet and hit the gym like you are trying to compete in a bodybuilding competition or something. But really managing those expectations! Healthy means thriving in PA school, having the energy to study and having the energy to still maintain my relationships during this very stressful time in my life. So really digging deep, getting into your feelings, managing those expectations, what healthy means to you at the moment. I think that’s my number 1 tip is finding that stress relief and not allowing PA school to become all-consuming. Go out and have fun and find that stress relief. I think that could be the single most best thing you could do PA school.

 Savanna: Yeah! And make time for yourself. Even in the sense of checking in with yourself and doing things that take care of you like eating. I have said it before, but I love reading and I didn’t read a single book for fun during PA school. And when my parents would invite me to get dinner with them I would say no and ask them to bring me something back. And by the time they came home, I would usually be asleep because I just didn’t eat dinner. And that's not healthy. That's not making good choices for yourself. And again, looking back, I can see that. I don't know about your class, but my class had a snack closet. That was our fundraiser. So they would go to Costco and buy all the snacks for the closet. And then we could get a candy bar for like 25 cents. I mean, it was great! 

 Ashley: That’s definitely the number 1 question you should ask when you interview at PA schools. Do you have a snack closet? 

Savanna: I also remember that there were people in our class that would eat out every single meal. Like literally, they would bring Starbucks for breakfast. It was so expensive. They would go get something for lunch at the little cafe. And then they would all go out for dinner. And I was like how are you doing that? So expensive! 

So, how'd you get into nutrition coaching? One of the things I love is when PAs have interests outside of being a PA. 

 Ashley: Well, I never would have guessed in a million years that I would do something like this. Obviously I'll obviously always have been interested in nutrition. I have a degree in nutrition, I was a college athlete, where health and nutrition and fitness was really important. So it's always been an interest and always just finding ways to incorporate healthy things into your life. Because I knew from the very beginning, even as a nutrition major, that good health and preventative health starts with what you eat, period, We even learned that a PA school about being healthy for preventating disease -- 90% diet 10% exercise. I’ve always kind of had a passion for that, especially because people in my family have chronic illness. 

So during my post-partum period, I was lacking motivation. I was three months postpartum. I had a friend of mine, Lauren, who was a FASTer Way to Fat Loss. I had seen her posting, and kind of made fun of her. But I finally gave in because I was pretty much at a low point. I wasn’t making the best choices. Diet Coke was my best friend again. And basically every meal was refined sugar. I was like, “I’ve got to stop this. I felt miserable.” So I was overwhelmed at first, but after learning the strategies, it interested me even more. So I got onto PubMed and looked up articles on intermittent fasting. I was like, I think there is something to this. It was incredible. I was like, “whew, I think this is legit and this is real.” I mean, I wasn’t deprived. There wasn't a mean macro. There wasn't a macro that was eliminated or the “bad guy.” I felt like it was what I learned in nutrition. Everything in moderation. We have treats, we have carbs, we have fats. It was just a wonderful way to envelop everything people tell you into one system and one structure. So I loved it and eventually become a coach. And I’m a born teacher, a born coach. I love to do it; it’s my passion. So having nutrition, coaching, and preventative health all in one is a dream come true, honestly.

Savanna: We had an intermittent fasting lecture in PA school! I tried Whole 30, and that was awful. I tried it twice. The first time, I made it 15 days. The second time was when I was post-partum. I don’t know what was going on with my body, but it made me so sick. It was awful. I was waking up sick in the middle of the night. My husband was like “are you pregnant?” I wasn’t pregnant, like I didn’t know what was happening to me! I was doing it with my medical assistant at work. He's also one of my best friends. And I was like, “We're not doing this again. Not happening.” But I was like you, I was so desperate to not be squishy anymore, so I'm with you there because mine is 12 and a half months old.” 

So overall, what is FASTer Way to Fat Loss about? Give us the breakdown about that. 

Ashley: FASTer Way to Fat Loss is an online program that guides you through 6 pillars of the “FASTer Way”. The main one is intermittent fasting. Then you add in the others which makes it an awesome program altogether. But intermittent fasting, you have whole food nutrition, you have macros and macro tracking, carb cycling, strength training combined with HIIT, and then also accountability and community. You join an accountability group with me where I teach you and coach you through all the aspects. I teach you the metabolism of each macronutrient, why it is important to have them. I teach you why carb cycling is effective and what's happening metabolically in our bodies to show the results and the fat loss that we're having. We go over intermittent fasting, and what is happening inside our bodies and how intermittent fasting works with playing on our insulin levels and depleting our glycogen stores out of our liver, increasing apoptosis and cellular regeneration in our body. So I go through all of these things in the group, and I teach you how to put it together in cohesive flexible plan. It’s all online for 7 weeks and we have an accountability group. You have access to me daily with weekly trainings. 

Savanna: Okay, so I’ll say what I liked about it. I like that you as a coach - you have a degree in nutrition and you’re a PA. You’re not a random person who decided to coach people on nutrition, which I feel like I see sometimes. And I'm like, wait, why are you qualified to do this? So, that was great! Also, I tried intermittent fasting for a little bit. And I always thought it would be really hard. But once I got in the groove, it really only took a few days for me to adjust. Also through the teaching, I felt like I understood my body better and what it needed and why, which was very helpful. Also, I told you this, but I did not stick to the rules very well, like I pretty much ate what fit my macros, even if it was like dairy or whatever. But I didn't feel deprived of anything. I felt like I was eating a lot.

 Ashley: Yes, everyone says that! 

Savanna: I think one of my problems was that I didn’t feel like I could eat enough. But I was still seeing change and losing weight. So it was really cool. Really interesting how all that works. And if someone decides to do this, planning ahead was key for me. I learned that if I don't plan ahead, I'm going to choose the easiest option, which is usually the closest option - which for me is either McDonalds or Zaxby's. I learned a lot doing it! 

 Ashley: Yeah, I think it's such a great mindset shift for people, especially people who come from the 90s and are scared of fats. And then people who come from keto land, and are scared of carbs. And I preach all the time, I don't think there's a bad macro! I think you just have to find what fits for you, what makes you feel good. So you go through this program and you’re telling me how you feel through the whole thing. If I don't know the answer, I'll go find it for you. I'll research it for you. I'll find somebody else that knows the answer. And we really just brainstorm to find something that works and feels good for you. Because at the end of the day, if I just tell you rules to follow and they are not flexible and not personalized to you, you're not going to thrive and you're not going to survive in a lifestyle like that. And then it's going to be pointless. So that’s what I really like about it as well. I'm a huge proponent of understanding how and why we do something, so you just feel so much more empowered to do it. It’s a lot easier to kind of stay on track that way. It’s nice also depending on where you are in your journey. If you're at maintenance, if you want to change this, change more composition here, it just all depends on where you are in your journey. It can be flexible to meet that need! 

 Savanna: So tell us more about where we can find you and ask you all the questions!

Ashley: Sure! Here is a link that goes to my page as well FASTer Way to Fat Loss page, and you will see me as a coach. And we'll talk more about our pillars, what to expect, what rounds look like, and a lot more information. Also, I share a lot of tips and information on my Instagram. That's probably the main place that you want to follow me and see what's going on: https://www.instagram.com/ashleyphillipsturner or @ashleyphillipsturner. I keep you up to date on when my rounds start and when you can register. I like to drive into the science and why with my posts and stories. I try to keep you up to date on the latest research too! I kind of go over some stuff like that. 

Thank you so much for reading! I hope you found Ashley as endearing as I did. 


When to Have Kids as a Physician Assistant

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Even though you want to become a PA, you probably have other goals such as getting married and having kids. So we are diving into that topic today! This question comes from Jocelyn. Thanks for your question Jocelyn!

Jocelyn: My question is specific to females desiring to have kids. When is the right time to have kids as a PA, still fresh in the industry? To be specific, I'm 23 years old thinking that I will be done with PA school around 26 or so. My goal is to have maybe one kid by age 30. And I kind of feel this pressure where I would like to get in this upcoming cycle, if not the next. I just don't know if this is something that should be even thought about or just kind of pursue my dreams and see what happens. Thanks! 

This is a tough question. But I have some more recent experience with this since I have a three year old. So let's talk about what you should be thinking about if you're concerned about whether or not you can become a PA and still have the life you're envisioning as far as having kids. Now, I don't feel like this is a topic that is solely for females. If you are a guy, your wife may be thinking about kids more than you are or maybe you are too. It's okay to want to plan out your future. I tend to plan and really think about things in advance. So I'm with you if this is something that you are concerned about. Now, there's a few things to consider.

First of all, I think I learned this from personal experience; there's no good time to start a family and have kids. You can plan it and think about it, but things may not go the way you planned. Something’s always going to come up; it's going to be the next thing. For example, starting school, moving cities, getting a new job, getting a different job, someone’s wedding, vacation. There is always going to be an excuse, and there is always going to be something preventing you from starting a family. Eventually, you kind of just have to make the decision that now's the time. It's now or never. Just go for it!

Now, for a little background on me. If you've watched some of my videos or listened to some other podcasts, you've heard that I got married while I was in PA school. And that's not something that's typically recommended. But to me, it was important. My husband and I met in high school, went to the University of Georgia together, both biology majors. We got engaged right at the end of senior year. Then we both went to school. I went straight to PA school, and he went to medical school. For us, we didn’t want to wait so many years to get married until all of our training was done. We just had to make a decision, and that was to get married during school with a shorter honeymoon. It meant that it was a little bit stressful, and I wasn't quite as involved in the planning as I wanted to be (Thanks, Mom!). But for us, it made sense. 

When we had been married for five years, we started thinking about kids. I'm steady in my job. My husband had finished med school and was in residency. When's the best time? Do we wait until he's done with residency? But then is he going to do a fellowship? He's going to be starting a new job, is that a good time? I'm in my job, is that okay? I feel like I'm finally established - is okay for me to take a step back and take time off to be with a new baby? Essentially, we just decided that it probably was the right time, and it wouldn't be perfect. But that would be okay. So last year around this time, I had a baby. And I've learned a lot about the process. Pregnancy teaches you that you are not in control of anything. I mean, you can't predict if you're going to have an easy pregnancy or a difficult pregnancy. Thankfully, I had a pretty easy one, if anything, I was just a little bit tired. No real morning sickness or complications. But a lot of things can happen, and you kind of have to be willing to just let it go and trust that everything's going to be okay. I think for Type A personalities that tend to be PAs, that can be a little bit difficult. And I definitely struggled with that and had some anxiety about that throughout my pregnancy.

There is this pressure to get everything done right at once, and do it all. Sometimes, this isn’t always realistic, and that’s okay! You have to take things step by step and really decide to you what's important. 

Let’s break down your options:

  1. Pre-PA: This is a great option. Like I said, pregnancy is unpredictable, so that may give you some more freedom with that unpredictability to adjust if necessary. Now that may push your timeline for becoming a PA, and this is where you have to weigh pros and cons with your priorities and what is important to you. You may be able to spend more time with them while they are so young because you aren’t in PA school yet.

  2. PA School: PA school is hard, busy, and rigorous. If you talk to any new PA students, usually they they are completely overwhelmed. Personally, I can't imagine having kids while I was in PA School. I would’ve done it because then that would’ve been my new normal. But I don't know if it's something I would have actually chosen because it would definitely have been tough. During PA school, you would need a ton of support. This also depends on school set-up because some programs have very strict policies. For my school, you could not miss class unless you had a doctor's note. And even then, it was very, very looked down upon. That being said, I never missed a day of PA school. So with pregnancy, there are many appointments, and you may not feel good at times. With that unpredictability, that may cause you to miss some classes. Your school may ask you to take a leave of absence or extend your time in the program due to this.

Side note: If you go to the PA forums, there are some stories there. The PA Cafe is a blog specifically for PA moms and PA student moms. And we have an interview with the creator of that from a while back. But that's a good place to check to just to hear other stories from other people and see if you find something that you relate to. So in my class, nobody got pregnant and gave birth during school. A girl in the class above me got pregnant while on rotations. She was actually due the week after she took her PANCE. So she graduated, took the PANCE a week later, and then had her baby a week after that. I remember asking her about rotations, and she said the expectations for her were the same as any other student, despite being very pregnant. So for example, in surgery, you may be expected to stand for hours and hours, but that’s may be very difficult while you are pregnant. But that's something that you've got to just take into account and be ready for it. That's what happens. There are some Instagram accounts of PA students who have had babies, and it’s possible. You don't necessarily have to put that on hold! 

  1. After PA school: This is what I did, and that's what most of my friends have done too. Right after PA school, we had just a bunch of weddings. And then a few years later, a bunch of PA babies were born! I wouldn't change anything about how I did things. Maybe if anything, I would have had her sooner because it seems like my baby has just been a part of our lives. And I can't imagine her not being here. So I love it! Actually, I was that person who's always like, “I'm going to be ready to go straight back to work. And I'm going to want to have such a short maternity leave.” That’s definitely not true now. I want to spend every single second with her, and even now when I get home, the first thing I want to do is give her a hug. You have to think also about finances and being financially stable. I don't think babies are quite as expensive as everyone makes it seem. There are definitely ways to save money! I have a true baby clothes addiction, so I'm probably not the best person to speak on that haha.

Keep in mind that the other thing about having a baby, either in PA school or as a working PA, is that you’ve got to have a plan in place for childcare and support. What are you going to do if your baby is sick, or if your sitter cancels? I work as a dermatology PA, and I have 35 patients on my schedule! That would be tough to move everyone. I would absolutely do it if I had to, but thankfully I have parent-in-laws who are willing to help out if something comes up. 

Whatever decision you make, it'll be the right one, and it'll be fine! And you'll have a sweet little baby who you love. And that's all that really matters. So you gotta decide what works best for you. I would love to hear your thoughts in the comments! And just shoot me a message on Instagram. Let me know your thoughts and what you did. If you have a story about how you became a parent before, during, or after PA school, please share it. I hope this was helpful and answered the question! Thank you for reading. 


Your Next Steps After Graduation

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Once you graduate, all you have to do is pass the PANCE right? Everything else is self-explanatory, isn’t it? Unfortunately, it is not. The focus of your program has likely been on the PANCE and understandably so. Schools are ranked on their pass rates, so they are very invested in your success on this test. However, that is merely the start of your career. There are many more steps to come, much of which are not straight forward. By being aware of the next steps you can minimize the time it takes before you start your new career and get your first paycheck (here is an article on what to actually do with that paycheck). So, what are these next steps?

First off, make sure you have plenty of money saved.  The process from graduation to practice will add up, costing up to $2,000. I don’t have to tell you that nothing about becoming a PA is cheap. Be sure you save all your receipts so you can submit them for a potential refund from your new employer (this should be brought up in the negotiation process of your contract). Any money you saved that is not needed can be thrown at your student loans! Let the payback begin!

After you pass the PANCE (congratulations by the way!) you need to apply for your PA license in the state in which you will be practicing.  Each state has their own website and process for this, so be sure to look into your own state ahead of time. Do not wait until you have your PANCE results to prepare. Have a game plan so you can get you application in as quickly as possible. The timeline and cost for this will also vary state by state. My experience (the state of Colorado) was a cost of under $300 and a 3-week wait. Other states can be more expensive and have longer waits. Because of this, you want to ideally have your application submitted the same day you received your passing PANCE results. Save the celebrations for the evening (but then go HARD in the paint. You deserve it!)

Once you have your PA license you can apply for your DEA license (so you can prescribe controlled substances) and your NPI (National Provider Identifier). You can apply for these at the same time. The NPI application is free and has a very quick turnaround of a week or less. This is not the case with a DEA license.  This will cost you a whopping $731. This is one that is definitely worth getting your employer to refund you for. The process typically takes 1-2 weeks to get your approval and DEA number. Some employers may not initially require this, but I recommend everyone obtain a DEA as prescribing controlled substances is well within the scope of PA practice. Plus, not having this may be a negative for a potential new employer in the future. 

If you are in an office-based private practice, this may be the end of your licensing journey and you can finally start practicing as a full-fledged PA! If you have any involvement with a hospital, whether in the ER, specialist consultant, or as a surgical PA, you will need to get credentialed with any hospital you are going to work at. If you thought the previous steps were slow, you’re in for a surprise. The credentialing process with a hospital will often take around 3 months! This will entail copious amounts of paperwork and a lot of back and forth with the credentialing department. To help speed up the process there are a number of documents that you should have ready ahead of time.  These include:

  • Your new PA license

  • Resume or Curriculum Vitae

  • Vaccinations included updated PPD

  • Passport or Birth Certificate

  • Undergrad and PA degrees

  • Reference list- they may need to fill out a reference the hospital will send to them

Have these on hand to quickly provide if a hospital requests them. 

These various processes can be overwhelming, especially when all you want to do is start your new job. Stay organized and think ahead. The first few steps are all up to you, but once you get to credentialing, you will have additional guidance. You may be able to shadow in an office setting, but you will not be able to step foot in the hospital or OR until your credentialling is completed! 

We all just want a minute to relax after school is over, but don’t worry, you will have plenty of time for that. Stay on top of your game for another couple months and save yourself the hardship of delayed employment or running out of money as you wait to start your new job. Congratulations on all your achievements and welcome to the world of PA-C!

Thank you so much to Savanna and The PA Platform for this opportunity. If this article was helpful to you and you would like more guidance on things like job hunting, contracts, retirement accounts, or choosing a specialty, head over to www.panextsteps.com to get my guide on what to do after physician assistant school.  


Non-traditional Applicant using the GI Bill to Class President  

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This post is a transcription from an episode of The Pre-PA Club Podcast. Listen to the episode here: https://www.thepaplatform.com/podcast/gi-bill-for-pa-school

Travis: Hi everyone. My name is Travis Laverne. I’m a second year PA student at  Drexel University. I'm currently in clinical rotations; my 5th clinical rotation is in OB/GYN.  I'm also currently the class president for our class as well.  

Savanna: We'll definitely get to that because I have my personal thoughts on being an  officer in your class. But first what kind of brought you to the PA profession? Give us a  little bit about your background.  

Travis: Yeah, so it was pretty non-traditional. I was in the U.S. Air Force active duty for  13 years before I started PA school. I had always kind of had an interest in medicine. I  thought was really cool. I’ve always been attracted to the high-tempo type of careers, a  lot of responsibility. I do really well under pressure. That side of medicine always  interested me, but I just was kind of a knucklehead in high school and didn't have the  patience to kind of get through school. So I went the military route and I loved it. It was  really high speed; I traveled the world. I was exposed to a lot of PAs in the military,  because those are pretty much the main providers that we see in our clinics. So I was  kind of familiar with the career field, but I really didn't started investigating it until  probably about 10 years into the Air Force. My wife and I would sit down at night, and I  would watch those Untold Stories in the ER. I would just get so hooked, and I've  watched them religiously every night if I could have. I would always just try to figure out  what was going on with the patients. And she just kind of questioned me and was like,  “Why don't you ever get into medicine?” And that's kind of what kicked it off. Then I just  started doing more research, and the more research I did, the more the fire got lit. I  started reaching out to some PAs and some friends that I knew. I started doing some  shadowing, and the rest is history.  

Savanna: That's awesome! Okay, yeah so I would call that non-traditional.  

Travis: Before I had nothing to do with medicine. I operated the jet engine testing  facilities, so I was just straight maintenance type stuff. No medical background prior to  that. So it was a big jump.  

Savanna: So when you made the decision that this something you want to pursue,  practically what did that transition look like?  

Travis: I started doing a lot of research and trying to figure it out. I was carving  out a path as to what it would take. I had my bachelor's degree, and I was just about to 

finish my master's degree in management when I started. I had no prerequisites, core  science classes, or anything like that. So once I carved out that road map over the  course of probably 6-8 months in addition to shadowing and talking to PAs, I had a good  idea of what I needed to get done. School was my main focus, just getting the  prerequisites done. And then once I got closer, probably halfway through, I started  getting my shadowing hours. The more courses I took, I just started getting more and  more interested. I loved anatomy. I loved biology. I was like, “This is definitely my path.”  And then I started volunteering in the emergency room. And then I got a job scribing in  the evenings. That was kind of hard. I was active duty Air Force, so I had to work 8-5  morning job, and then I would come home and head to the emergency room for like a  10pm-2 or 3 am shift three days a week to try to get those hours and experience. All  while I was married with a baby.  

Savanna: Wow, that’s a lot!!  

Travis: Yeah, I did that for about three and a half years. I build up a decent amount of  hours to where I had to like make that decision, like was I going to apply to PA school  and separate from the Air Force? Another interesting component of it was I had to time  it right because when you're active in the military, you have a contract that you're  bounded by. With the Air Force, it was 4-6 years, so I had to time it right when my  contract was going to expire, and I could hit the application cycle. And I was short a  couple months, so I actually had to make the decision to leave the Air Force before  even applying to PA school. I was at 13 years in the military, and at 20 years, you can  retire. I would have been 37 years old with a pension, so that was a tough decision.  

Savanna: Oh gosh, that is tough. That’s like a leap of faith there! So you decided you  were going to go for it and apply. What did applying look like for you? What were you  looking in programs, and how did the cycle go?  

Travis: With the way that I had my life structured, I was married and we have a baby.  We really had to look for something that was going to support us, not only financially  with the GI Bill, but my wife’s family was in New Jersey. She's a high school teacher, so  she has a pretty good job. But we also need to be around family for like support. I knew  that PA school was very demanding, and we weren’t going to be able to do it alone.  Fortunately, in the New Jersey and Philadelphia area, there are a good amount of  programs compared to the rest of the nation, so it served us well. I found out that a  couple of the programs not only accepted the GI Bill but they offered the Yellow Ribbon  Program, which kind of adds to that. Drexel was a 100% Yellow Ribbon Program, so  that was definitely a top school. 

Let me go back a bit because before I was even able to apply, I got a job fortunately  through resources and asking friends and family at the hospital at University of  Pennsylvania as a clinical research coordinator in cardiac surgery. I think that is what  really propelled me to be able to get at least a couple looks at my application from  having such a non-traditional background. It really exposed me to a lot of really cool  medicine, and my letters of recommendation came from there. So I did that for a couple  months, and then I was able to put everything together.  

Savanna: Okay, so you had a wide variety of experiences on your application, which is  always a good thing. So how many schools did you apply to total?  

Travis: I applied to 5 schools total. I got interviews at all of them, but I only attended  Drexel's because that was the first one I got. With the Yellow Ribbon Program and GI  Bill, Drexel’s program pays for 100% of my tuition. So that was definitely a no-brainer  once I got the acceptance there.  

Savanna: Nice. Yeah my program has had the Yellow Ribbon Program, so we had a  couple of Veterans. Can you talk a little bit about like what that means, and who  qualifies for the GI Bill?  

Travis: Sure! I can speak from the active duty side. I’m not really too familiar with  the reserve and guard side. If you serve at least 3.5 years of active duty, you can benefit  from the GI Bill. You have to pay into it for at least a year, I think. When I did it, it was  like $100 a month out of your paycheck for a year. And then once you had those 3.5  years of secured active duty time, you had access to those GI Bill benefits. The cool  thing about the GI Bill benefits is that the GI Bill pays 100% of your in-state tuition up to  38 months. Unfortunately, a lot of the PA programs are at private universities, so it  would only pay up to a certain percentage. At the time when I looked, it was like  $19,000 or something like that, annually. But if that university had a Yellow Ribbon  Program, which is like the university acknowledging that they are veteran friendly, they  would match the GI Bill contribution, which was pretty significant. And it’s really  stipulated by like the different universities. Some universities will accept 5% of the  student population that are veterans and give them an allocated amount that varies. I  think some of the programs that I applied to would give me like $2,500 for the year or  $10,000 for the year. Drexel would make sure that 100% was covered the matter what.  At Drexel, if you're a veteran, you get it no matter what. It’s not even an application  process. You contact the VA department for the school, and they kind of do all the  paperwork for you. It’s a really easy process. You have to really contact the departments 

to see; it's very specific for the university. But yes, it's a phenomenal benefit and in  addition to the tuition, they pay you a housing allowance for the zip code of the college. I  think for Philadelphia, it is $2,500 a month on top of them paying your tuition. Definitely  worth taking advantage of!  

You gotta really understand how it works for you. Some people that I knew took  advantage of the GI Bill and the Yellow Ribbon Program for like their associate's  degree. That’s great, but in comparison, if I were to use it all up during my associate's  degree, that would have cost me probably $20,000-30,000. Whereas later in my career  for a graduate professional degree, it’s going a lot further. A lot of those VA reps at  colleges are very well versed in that, so if anybody has that benefit available to them, I  would highly suggest that they reach out to that department.  

Savanna: Yeah and at one point I was working with a PA at Duke, who is trying to really  advocate for veterans going into PA school. If anyone has questions, I can get you his  contact info. because he was working one-on-one with veterans to try to help them. All  right, so then you went to PA school! How’s that been? Good, bad, what you expected?  

Travis: My interview was one of the first groups of interviews. I waited a little  over a year before I started school. I continued to work at Penn. I was just kind of sitting  here, like alright I got it, now I just wait a year. So it was an interesting year.  

Savanna: Yeah! So you decide to run for class president.  

Travis: The way our class did it, I guess you could nominate yourself. I have no  intentions to do it because I'll be honest with you, like that first quarter… That’s when it  really hits you. Your eyes get really open, and you’re getting blasted. Anatomy and  everything was just crazy. And you're just kind of adapting, and I was commuting from  New Jersey to Philadelphia on the train, and that was all new to me. So I was like,  “There's no way I'm taking anything else on. You know I have a family at home. Like my  wife will kill me if I do this.” But I'm always seeking out the next greatest thing. I ended  up getting nominated by a couple of the members in my class. And I kind of sat on it, I  really didn't say anything and I started thinking that if somebody had went out of their way, seen something in me,  and nominated me, the least I could do was stand up in front of the class and make a  five minute speech. Next thing you know, I got elected. I took it on from there. I'm really  glad I did! Because that first quarter, I wasn't fully bought in because I had my wife and  kid at home. I was commuting. I was struggling, and I was tired. But then when I took on  a little bit extra responsibility as kind of a representative for the class, I just shifted gears. I was really brought in. And then everything started getting better. So, I think it  really saved that first quarter for sure!  

Savanna: Definitely, it helped you connect a bit better. How big is your class?  

Travis: I think Drexel has a reputation for a pretty high attrition rate due to the first  quarter of anatomy and stuff. I think we had 6 or 7 students from the previous year go  through anatomy again with us. And I think we are 82 to 84 students.  

Savanna: Oh wow that’s big! Yeah we were at 44. And I think I have said this before,  but I actually regret not running for president. In our class, it was a pretty important role.  I thought about it but didn’t end up doing it. There were times throughout the program  when I wished I had. But yeah it can definitely be a tough job.  

Travis: Yeah definitely, you can really do a lot of good in that position, especially for a  lot of students. I mean one thing is communication between like faculty and students.  When the students have issues, you really have an opportunity to like bring the class  together and really make it unique. As each class goes through, they create their own footprint. There are so many smart people in the class! That is one thing that's so great  about the profession -- it attracts these great minds. Just being able to steer that ship a  little bit, engage people, get good ideas from the class is great. I mean it’s a self-running  machine and our class is great because of that, but you are able to empower people.  When you empower the right people, cool things happen! So those positions are fun.  

Savanna: And you seem like someone is very easy to come to with any class issues  and is perceptive to class issues.  

Travis: Yeah! It takes a lot to like really like shake me up, just because you  deployments and stuff like that. So I learned to weather the storm.  

Savanna: You’re a natural fit there! All right, so you said you struggled a little bit  beginning PA school, which is normal. Everyone does. How long did it take you to find  your groove and what works best for you?  

Travis: To be honest, I think that whole first quarter was pretty messy for me. And that  was 10 weeks. I would say at week 6, I kind of had figured out. We had all these  recommendations from people, like what not to do, don't wait too long before you  change something, change right away, don't get stuck in your ways, and always ask for  help. And that's not something I did either because my GPA was really good. I had aced anatomy prior to this, and I thought I would be fine. And I wasn’t. It’s a lot and very  different. I remember my first exam, I literally failed badly. I was like, “Whoa, wake up!” I  was really upset. I was doing everything I could. I just wasn't retaining it, and you get  competitive with other people. You wonder why is nobody else failing like this? But they  really are, just nobody is really opening up about it, which is something else I found out.  But I think it probably took me that first quarter to get my confidence back up and get  into it. It was a little bit hard for me too because I had a lot of things going on back  home. It probably took me at least six to eight weeks to feel like I had this. Once that  second exam came back, things started getting better and I was improving. I knew I was  doing the right thing. I just had to do a little bit better.  

Savanna: Do have any tips on balancing? This is a question I get a lot, that I can't  speak to because I wasn't in this position of having a family established. I don't believe  in balance; I don't think everything will ever be completely balanced. But how have you  made that work with your family?  

Travis: I think you nailed it - it’s once you figure out that there will not be a balance.  Especially in my situation, it took me 3.5 years to get to this point. So we know what  was kind of coming. I mean, we thought we knew, right? Once you're in it, you're like,  “oh we have no idea what this was going to be like.” But we thought we knew what we  were getting into. But the best thing for me is that once I figured out how difficult this  was going to be, I sat down with my wife. We really went over how hard this was going  to be, and I showed her everything. No one will really ever understand it until they're in it  as much as you try, but I showed her all the assignments that were due and things that  we were expected to learn. We had a family calendar. As long as I was very on top of  that calendar in terms of showing my study time or if I needed to come home and lock  myself in the office, and she could visually see that, it made things better. As opposed to  me saying “I'm going upstairs to study” but she wanted to watch a movie or something.  But as long as I was a week or two ahead of her, I could put what I needed to get done  that week. Now it was still hard, very hard. And I kept promising her that it would get  better with clinicals, and it has. So she believed me and she hung in there!  

Savanna: Okay! Yeah it goes does go by quickly.  

Travis: Don't expect a balance and communicate as best as you can. There's gonna be  days where you're frustrated and stressed out, and they're frustrated and stressed out.  To be honest with you, there were days that I had to close my computer, and just say to  myself that I’m going to do my best. And that's all I can do, you know? I might not get an  A on this exam and just be okay with that because you have other things going on. I have two children. We ended up having a second son later on. I was upstairs in the  office, and he was calling my name. My oldest son goes, “Daddy doesn't live here  anymore.” Because he hadn't seen me. And that was it. Like I had to close the  computer and go downstairs. That broke my heart. And I was like never again. Once I  started learning what the exams were like, what’s expected of you, and how far you can  push yourself, I set a limit. I was never studying past 10 o'clock. I’d also maximize my  weekends; I didn't really study for my weekends. So I had my weekends with the family.  Yeah it wasn’t perfect, but we got through it.  

Savanna: No, that is hard, and I was living at home with my parents. And they were  great, but they also didn't quite understand. My fiance was in med school, so we would  see each other once a week for study date. That’s all we had. I remember one day I  was sitting at the dining room table. And there was a lot going on, a lot of tests, during  the first semester, I just broke down in tears. And my dad walked in, he was like, “What  is wrong with you?” I was like, “I'm fine. I just am having a moment.” And he went and  got my mom, and she was like, “She's good, just let her be. She’s good.” Because she  understood. Yeah, those things happen.  

Travis: Yeah I remember being in the library and seeing things carved in the desks like,  “We will get through this quarter - PA student 2018.” Yeah you know, everyone goes  through it. And yes it’s madness.  

Savanna: It's very interesting. But kudos to you for handling all that! You do it; you just  make it happen but like I can't imagine that.  

Travis: The quarters go by pretty quick.  

Savanna: Yeah, it really does. Alright so with clinicals - how have those been?  

Travis: They've been awesome! It’s a totally new world, totally cool. And I thought I was  going to thrive better in the clinical realm versus the didactic year. I did pretty well during  didactic, but I'm a people-type person. I like interacting and getting my hands-on experience. It's been everything that I thought it would be, maybe even more! So it's  been pretty awesome.  

Savanna: That’s great! And do you have any idea of where you want to end up? 

Travis: Yeah, I love surgery. I really would like to get back into it. The hours are really  long. And that’s what I'm working on right now with my wife, so we'll see. Emergency  medicine or surgery is definitely what I enjoy.  

Savanna: Derm has some surgery in it, just throwing it out there!  

Travis: What’s actually interesting is that my preceptor for my pediatrics rotation owned  a medical spa, and his brother is a plastic surgeon. He works in the office below. So I do peds during the day, and then in the late afternoons and evenings, I've worked  downstairs doing lips, Botox, and all sorts of stuff. So I don't know! Maybe there’s a little like pediatrics/derm/plastic surgery thing.  

Savanna: Yeah it’s not the same as an OR. I love the OR too. Well, thank you so much.  Is there anywhere where people can find you?  

Travis: They can check me out on Instagram (@ tjlaverne )! I'm a rookie at Instagram  right now. It's mainly just been kids and stuff that I've been posting. Or they can shoot  me an email too!

Savanna: Yeah definitely. They can reach out to me if they have questions and we'll get  you in touch. Awesome, thanks so much! 

2020 Gift Guide

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It's that time of year again! When we get to celebrate our loved ones by getting them heartfelt gifts. We've compiled a list of our favorite choices for the pre-PA students, current PA students, and practicing physician assistants. It's been such a strange year with the pandemic and everything shutdown, so even if you can't see your loved ones in person, you can show them love this season through your "presents." (Feel free to forward this list to friends and family to give them some ideas. That is what I will be doing also.) This post does include some affiliate links, which doesn't increase the price for you, but gives us a small percentage of some purchases. Follow us on social media @thepaplatform on Instagram to be on the lookout for deals and sales.

Pre-PA Gift Ideas

For school: To make the pre-PA journey a little easier, here are some gifts to consider gifting to take some of the stress away.

Interview Package - Interview Guide and Course - When it's time to apply for PA school, the interview is one of the most important parts and it's never too soon to start preparing.

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  • Med Couture Scrubs - Getting patient care hours is required for almost every program, and many positions have a dress code of scrubs. These ones on the right are some of my favorite affordable one

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For self care: When focused on becoming a PA, it can be easy to forget about taking care of yourself. Help your pre-PA student focus on themselves during the process.

  • Big water bottle - One change I've made this year is increasing my water intake, and it's made me feel so much better. Highly recommend this half gallon water bottle.

  • Workout clothes - Getting active and moving your body is a great energy booster. Here are some of my favorite Amazon Lululemon dupes.

  • Sound machine and gentle alarm clock - Sleep is essential! This sound machine and gentle light/alarm clock duo is perfect for the anxious student.



PA Student Gift Ideas

For school:

To study - The study 24/7 lifestyle is just a part of PA school, but here are some things that can make it just a little bit easier.

  • Smarty Pance - Studying for the PANCE starts on day 1 of PA school. Smarty Pance is a great option to study throughout school. - thepaplatform 10% off

  • PANCE prep pearls - AKA the PA school Bible. I'm honored to call the author Dwayne a friend, and he is also a practicing PA, so he knows exactly what's needed to get through PA school.

  • PANCE review book - For a quick review, this was my go-to during PA school, and a book that every student needs.

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Tech - Since the majority of PA school consists of hours of lectures, pen and paper may not cut it anymore.

  • iPad - In the Pre-PA Club group on Facebook, it's overwhelmingly recommended to have an iPad for taking notes during PA school.

  • Apple pen. If your student already has the iPad covered, the apple pen is a great companion and you're saving trees!

  • iPad case with keyboard - Personally speaking, it's the worst when an accidental drop wipes out a device. This case provides protection and a keyboard.

For rotations: Clinical rotations can be stressful with long hours, so being ready to take them on is essential.

  • Medelita scrub jacket - My absolute favorite thing to wear at work 24/7.

  • Crocs for work - Crocs have become my go-to work shoe. They're light, supportive, and comfortable. Don't knock them 'til you try them!

  • Apple Watch - I got an apple watch last year from a family member, and I never thought I would love it as much as I do. Super convenient.

    • Having an extra band is always helpful, and I love this one. It's affordable and easy to clean.

For survival: Help your PA students in your life focus on some things outside of school and get through the tough weeks with some of these gifts.

  • Keurig mini - Coffee. Because PA school.

  • Kindle - My personal lifesaver. My kindle goes everywhere with me and is a great distraction. See below for favorite books.

  • Cashflow Cornerstones online course - One thing we didn't really learn about in PA school is finances. This course created by a PA is a lifesaver for getting the basics down.

Physician Assistant Gift Ideas

For work: While the PA in your life may not specifically request something for work, here are some things they may not have invested in themselves yet.

  • White coat - When it comes to white coats, Medelita has set the standard. The Rebecca is my absolute favorite and I recommend Sprite for thread color!

  • New Balance Nergize - Good-looking comfy shoes are a must for working in medicine. These are some of my favorites. I might have 4 colors.

  • Blue light glasses - Thanks to EMRs, we stare at computers and screens all day long and could use some eye relief.

  • Scrubs - If you have any guy PAs in your life, my husband's favorite scrubs are Figs. Use this link for $20 off your first purchase.

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For life: To separate from work life, here are some fun things that I've loved this year and think any PA (or person) would be happy to get.

Skin category: Being a dermatology PA, I have to give some skin recommendations of course.

  • Babe Lash - Using a lash serum and not having to use mascara everyday has been a game changer. Use code SAVANNA for 20% off.

  • Revision block - For an updated, but basic skincare routine, Revision skincare is my favorite cosmeceutical line. With these 3 products, you'll be set.

    • Brightening Wash - This vitamin C and glycolic acid based wash is a great first step.

    • Vitamin C - Dull skin? No problem! This topical vitamin C will brighten skin and lighten dark spots.

    • Retinol Complete - Retinols are the best for slowing down fine lines and wrinkles. This one is very tolerable.

  • Dyson Airwrap - Ok. The price tag is high, but the time saving is so worth it. Wet to styled hair in 10 minutes.

To read: Book club is the highlight of my month, and here are some of the favorites from the past year.

  • The Silent Patient - The biggest thriller and twist we read all year.

  • One True Loves - Taylor Jenkins Reid is my new favorite author of 2020, and this is a nice, lighter romantic read.

  • The Nightingale - A historical fiction set in WWII and one of our most favorites of all time.

Fun Category: Here are some fun stocking stuffers (kind of) that anyone should be thrilled to receive.

  • Starbucks gift card - No one will ever turn down coffee! And those chocolate croissants aren't too bad either.

  • Corksicle - Best cup ever. I got one of these for my birthday this year and now I"m obsessed.

  • Loungewear - A fun robe has been my quarantine dress code this year.

  • Peloton - Ok, I know. We hear about them all the time and there's a big price tag, but with the financing options, it's so worth it. Total fitness game changer. Use code UFSYCC for a free accessory package! If you get this for a significant other, brownie points forever.

For even more gift ideas (or to just see what I am eyeing and buying) check out our Amazon Storefront!


How do Students Afford PA School? with Juno

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Thanks to Juno for sponsoring this post!

One of the most common questions that comes up once you decide to pursue PA school is how do people pay for this? There are so many costs involved in attending a graduate program - tuition, fees, books, study resources, living expenses, etc. The majority of programs don’t allow students to work, and with the rigor of PA school, it would be extremely difficult to study and maintain a job. Most students end up needing to take out loans for all of these expenses, and then it gets confusing with all of the options available.

One of the most important things to look at when considering loans is the interest rate. The percentages you see may seem small, but when the money starts compounding on the first day of PA school classes, you will want it to be as low as possible! That’s where Juno comes in because they use group buying power to negotiate with lenders to get you the best interest rates available. It’s like buying in bulk to save money. Does it make more sense to buy one roll of toilet paper for $2 or 20 rolls for $10? You are basically getting a volume discount by combining your need for school funds with other students. I recently had the pleasure of speaking with Juno co-founder, Chris Abkarians, for my Youtube channel! I also encourage you to check out the Juno website yourself and see how up front they are with the process, but I’ll explain how it works. (And they have scholarships available that you should apply for right now!!) 

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According to the 2019 PAEA report, the average cost of tuition at a private program was $95,058, with public programs coming in at an average of $52,585 for in-state students. Out of state students at public programs were just under the average of the private programs at $93,313. When you add in an average of $7,978 for fees plus living expenses that will vary based on location, that’s a huge chunk of change. Becoming a PA is definitely worth it, but those numbers can come with a shock value and the money has to come from somewhere. 

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To see if Juno has a good option for you, the first step is joining the Juno student loan negotiation group for free and providing the typical information needed to obtain a loan. This allows Juno to put together a group of creditworthy students to present to lenders to compete for the best rate. The lenders will come back with options for flexible repayment terms and both fixed and variable rates or more limited terms. This is basically like sending your application out to multiple PA schools to see who is the best fit and has the best to offer you as a student. The story of how Juno began is really cool because the founders, Nikhil Agarwal and Chris Abkarians, actually did this process on a smaller scale while students at Harvard to save themselves and their classmates money just though negotiating directly with lenders. 

Juno looks at all of the offers and will evaluate what will be the best fit for the most members. Those factors include interest rate, fees, term and repayment options, customer service, eligibility criteria, and death and disability policy, as well as non-financial features. This holistic approach results in rates and terms that are better than anything available in the current market. 

After doing all of this work for you, Juno presents the negotiated deal for members to decide if the loan option is the best for them in comparison to other available loan offers. Juno will help you figure out the differences in what is being offered and also looks at the variation in the private and federal loan options. Both U.S. Citizens and U.S Permanent Residents can take advantage of this innovative approach to loan negotiations. 

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If you decide the loan offer makes sense, you’ll have the opportunity to apply directly, but there’s no obligation to take the negotiated deals. You can pick a difference lender or decide not to get the loan at all. Juno will follow up and make sure everything went smoothly and all of your expectations are met through the lender that was chosen. 

I appreciate Juno’s transparency that you can see for yourself on the website. Many of the lenders offer a referral fee for using their services, but Juno will give that amount back to you when you use one of their deals. You’ll get at least 0.05% back in the form of a check when you take a negotiated loan through Juno

They also clearly state that you should consider federal student loans before any private loans, which some other private loan companies may not mention in the interest of getting business. 

Make sure to check out all of your options when looking into borrowing money. Compare the rates, ask questions, and look at the big picture to choose what’s best for your own situation, and including Juno in the process is a great idea. Click here to visit the Juno website and find out more


2019 Ultimate PA Student Gift Guide

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The holiday season is just around the corner! We put together a gift guide of everything the PA Student in your life wants and needs for a successful year!

  • Please note some of these links are affiliate links meaning that The PA Platform may earn a small commission if you purchase an item from this list. All opinions are my own. Thank you for your support!

Let’s get started!

  1. Gift Cards

    Gifts cards are always much appreciated as a student! Visa gift cards are great because your student can get what they need from any store such as the bookstore, the grocery store and everywhere in between. Food gift cards such as Panera, Wendy’s, Panda Express, Dominos, Chipotle, and of course Starbucks not only fuel their brains (and bellies!) but also take “what do you want for dinner?” out of the question.

  2. Friends Themed Pop Socket

    If your student isn’t studying, chances are they are binging one of their favorite early 2000s shows, Friends. This Pop Socket is not only a fun accessory but also helps them hold on to or prop up their phone — a perfect stocking stuffer! Buy a PA Pop Socket here!

  3. Comfortable Tennis Shoes

    Between running from class to the lab to the library and clinicals, a PA-S will need a good pair of comfortable yet stylish shoes. I love these Nikes because they check all of the boxes and they are under $60! Pick up a pair here.

  4. An Audible Subscription

    Many students commute to school every day and crave something different than the radio on their way in. An Audible subscription allows for the to listen to their favorite books from a variety of genres. Sign up for a subscription of Audible here.

  5. AirPods

    AirPods are high quality, discreet headphones that are a hot gift this year! These compact headphones offer superb sound quality and make it easy for your student to listen to podcast, books and music while on the way to class PLUS they can chat on the phone, handsfree without compromising the sound. Grab a pair of AirPods here.

  6. PA- S Wine and Coffee Cup Set

    Funny yet practical, any PA student would love a Before Clinical coffee cup to get their brain running and an After Clinical wine glass to relax at the end of a long day. Pick up a set here!

  7. Apple iPad

    Lighter and more compact than a full size laptop, an Apple iPad is a powerful tool that will set a PA Student up for success! A big gift that will last for years — we especially like the detachable bluetooth keyboard to make typing up reports easy and comfortable. Pick up an iPad here.

  8. Keurig with Disposable Pods & Reusable Pods

    Just what every PA Student needs, a way to caffeinate! We love this Keurig because it is compact and doesn’t take up too much space on the countertop. These are my favorite disposable k-cups from Starbucks that have a variety of flavors and this is my favorite reusable k-cup that your PA student can load their own coffee into and reduce their carbon footprint.


How to Pay for PA School

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I am really excited about this post because it is highly requested -- learning more about the financial part of paying for PA school. I brought on one of our interview coaches, Hanna, to share her experience with you because we have different experiences as far as the type of PA schools we went to, the cost associated and how we each paid for it. My hope is that this episode will help you plan for the future and understand the process of how people pay for these HUGE price tags that come with PA school. 


Before we do a deep dive, I want to point out that this is a very extensive topic, there's a lot that goes into this. We are not experts, we are not financial advisors. We're not going to share logistics of how to apply for these things or what exactly a certain program covers. For that you need to go to your registrar's office program websites. A lot of times your school will have this information, they'll tell you how much a program cost, what's involved, the fees, tuition, etc… and how to apply for aide and whatnot. Just know that everyone’s situation is different and this is a very personalized topic. 

Savanna (S): Hanna's going to start us off with talking about just what does it cost to go to PA school? What are the fees involved?


Hanna (H): In regards to cost a PA school and just as you just said, this is super expensive, there's a lot of different aspects to take into consideration. With the 223 programs, and varying private versus public programs in state versus out of the state that in general, right there is going to really bring down or hike up the cost of your program. I'm at the median cost going back to 2015/16 school year was about $89,000, for a private PA program. That, in comparison to where I went to school, it was a private program -- I was at $102,000 and that was six years ago. Clearly, that's kind of under marketing some of the programs out there. We also looked at the public median cost, and that was about 52,000. Stepping back, really look what schools are you applying to and doing your research on their website. Most schools have a wonderful cost breakdown of their tuition, the cost expected for fees and lab coats, didactic versus clinical years, and really getting a true idea of what the basis is going to be for your specific program. 


S: Just to jump in, you're $102k was for your total tuition for the whole time your in PA school? 


H: Correct. 


S: That's what these numbers are referring to , i.e., $89,000 as a median cost is your entire tuition fee for the two/three years, you're in school. Because schools are different lengths, you're going to have different amounts you owe each semester. In comparison to Hanna's private program, I went to a public in state program as an in-state resident. My final tuition was around $45,000 for my 27 months program. That's a pretty big difference. But hey, we're both PA. 


H: That's another great point that you mentioned in regards to length of program, my program was a 26 month program. Definitely something else to consider is how long are you going to be in the program, because that will definitely change the cost. 


S: Yeah, and I think also, just for people who are maybe in the process right now of deciding what school to go to, I think cost should be a factor -- I don't think it should be the only factor because you should choose somewhere where you're going to be happy. Also think about when you start school, especially going into application season -- if you're able to start a program in January compared to September, and then you're going to potentially graduate earlier, and especially if it's a shorter program, that can essentially give you eight extra months of income. It might make it more financial sense to go with the program that starts sooner if you're just looking at the cost of everything.

I thought this was interesting, the PAEA did a survey in 2015 of students starting PA school and one question was, “What do you expect your total debt from PA school to be, not including personal debt just from school?” 21.9% said they expected $100k to $125k, 20.8% said $75k to $100k, 14.5% said $50k to $75k. That's a pretty good spread and a lot of money. I know it sounds like a lot of money and something to mention, coming out of school right now, the average salary for a new grad PA is around $75k to $80k. There are a lot of factors that go into that, such as where you live, cost of living and specialty and all that. This is just an average. 

Let's talk in-state versus out-of-state program costs. I decided to go in-state and the cost was part of it. That price tag looked a lot better than another program I was considering that was four times as expensive when it came to tuition and cost of living and all that. 


H: I knew that I wanted to go out of state and there was a big push for me to stay in. I grew up in Georgia from Atlanta. I've always wanted to go out of state and I made that decision applying to graduate school programs, specifically out of state. One of my biggest regrets was not taking into account the finance, the process, and not really having a full grasp of how the various costs of the PA schools. And I didn't realize that much further into my application process. Ultimately I didn't end up taking that into consideration with my school choice. And I'm paying that off now. 


S: I think a lot of people are at this point are so eager to get in that they don’t look at that and it’s ok! Like I mentioned earlier, I don’t think it should be the biggest deciding factor, but it should play a role. One question we got on The Pre-PA Club Facebook group is, “Can you switch from out-of-state to  in-state, so if you apply to a school that has a cheaper option for in-state residents, can you technically become a resident?” You know, for Georgia, I think there were a few people who were able to do this, I think you have to live in Georgia for over a year and have a good amount of documentation in your name, you have a license and bills, to show that you're truly a Georgia resident. Now, if you're only gonna be there another year, is it worth it? I mean, you're probably saving $10-15,000 but then you're gonna have to move and do all that again, most likely. Each state's going to have their own rules. Hanna, your school didn't have an in state option?


H: Correct. A lot of the states are very happy to have lived in that state for one year client, Most states and again, a very, that you have to live there for one year prior to starting your program. With that being said, most of us are finding out that we're getting into a program until under that one year mark, and it's very specific in regards to one year, so not, a school year but rather one full year. In many schools, once you've come in as an out of state resident, you cannot switch to an end state further along in the years. Schools have become very strict on following this, looking at where you're paying your taxes with, where you're registered to vote. It's not so much “Oh, my grandmother, or my sister who lived in New York”, which is where I went to school. It is definitely something that you really have to take the time to look at what your state requirements are and to talking to the school because some of them are willing to help make it work, especially it's, you know, come close to qualify. 


S: Yeah, and I think that, again, is something to look at. Just from an application standpoint, if you're applying to schools, because that process is expensive, too. That's a whole other post. If you are applying to schools, I strongly discourage applying to in-state programs, if you are not a resident of that state or if you don't have an extremely competitive application, and you know, some of these schools, they set 90% in state residents. At my school, we had 44 people, and it was 90% in state residents, we had, I think four or five people who are out of state. That wasn't something that was negotiable, they had a certain number of spots, because they got public funding. You could apply there if you're out-of-state, but your chances compared to an in state resident were so, so much less. You don't really want to waste your time and money applying to a bunch of programs that you are really only competing for a few spots. 


H: One thing that I found really interesting that I didn't know existed when I applied to PA school. and now that I'm living on the West Coast I have been interested in because I've been helping do mock interviews, and watching these acceptances start to roll in, which is very exciting, is that a lot of states participate in regional programs. Although you may be from California, I know that there's a Western Regional graduate program that allows Western applicants to apply to other schools within the region and your aren’t stuck to just your home state and still get in-state tuition. There's a regional one for the southern region,  Western, New England that I was able to find. These do apply for graduate school. I would definitely recommend looking into these and seeing if you qualify for those qualifications.


S: My school kind of did that because we're right on the border of Georgia and South Carolina, I went to Augusta University -- if you were from a few certain counties in South Carolina, you were considered an in-state resident for tuition purposes which was awesome for them. 

This was something that I thought was worth talking about, switching to in-state, if that's an option for you, you're going to try to become an in-resident, if you are still being filed on your parents taxes, you may not be able to switch. My parents claimed me on their taxes until I got married and I was 23. They were helping out with my school. As a parent helping out with my school, they got a little bit of tax benefit from that. They wanted me on their taxes to be able to write that off and get that reimbursement or whatever they got, I don't really understand taxes. They would not have probably let me switch or wanting me to unless I wanted to start buying my own taxes and paying for the rest of my school, which I did not. 


H: Definitely communication is key with that one with your parents. I know my parents and I went back and forth on that for a little bit because they can save I think it's up to like $2,500 per tax season so that can definitely add up pretty quickly. You also don't want to get caught doing tax fraud by both trying to file for that. Definitely having good communication is key. 


S: Definitely. Okay, so how do people pay for PA school? 

H: The number one thing you need to do is you need to apply for FAFSA. For FAFSA, that's your federal aid for for students across the board. It's that kind of the best way to start and it's broken down into direct subsidized loans and unsubsidized They have a great website called FAFSA forecaster that predicts your expected contribution of your fees to graduate school. In graduate school, you don't actually qualify for direct subsidized loans, that's no longer available, they cut it out in 2012. Basically, in a lot of applicants, probably do have loans from undergraduate but during undergrad when you got these loans, all that meant was the government was helping pay for the interest on these loans, so that was not accruing. This is a really big deal and would be really nice to have for graduate school but now for graduate school, you can only apply for direct unsubsidized loans, also known as Stafford loans. What that means is that you can take up to $20,000- $20,500 for a year, I believe. As soon as you take out that money, you start to accrue interest on that money and you're responsible for paying that once you get out of that program. You get a six month leeway with that, but the interest is accruing the moment that you receive that loan. 

With that, let's talk a little bit in terms of what that money does. When you go through the FAFSA application, which I don’t know about you, Savanna, but I felt like it, it's very straightforward. Name, DOB, --  very straightforward application. Once you get approved, which is relatively easy, that money goes directly to your program. You don't ever touch the money that goes directly into your program. It gets immediately applied to tuition and fees. If there's money left over from that, it falls into your room and board if you are rooming with the school, then after that they reach out to you for permission to put it towards other charges that may come with the program. If there's still money left over from that point, then you get a check, or somehow receive that money back and use that towards your education costs. Savanna, I’ll let you take it over for a little talk about your experience with FAFSA and a scholarship. 


S: I applied for FAFSA, I didn't have any debt from undergrad, which was great. Georgia has something called the HOPE Scholarship where if you qualified, and it’s changed a little bit since I got it, but they essentially cover all of your tuition and fees. The only thing that I had to pay for, or my parents helped me pay for, in undergrad was living expenses, which was amazing. I had to obviously keep my grades up and all kinds of other qualifications but going into grad school, I did have to take out loans.  I took out these Stafford loans, I filled out FAFSA. I was actually the last or at the tail end of when you got subsidized loans. I had one semester where I got a little portion that was subsidized, which I'm thankful for but the rest of my loans were unsubsidized. I took out the $20,500 for the year. Now my tuition for the year was a little bit and fees was a little bit more than this. I ended up taking out total $45,000 in I guess I took $40,100 but my tuition was $45,000. My parents did help out with you few thousand here and there, which I appreciate and I was living with them which helped save on expenses. These loans did end up getting interest right away. Now, you put the current rate here, which is 6.6% -- that is a very high interest rate. Just FYI, I think mine was around that, too. My supervisor physician talks about her loans from medical school and her percentage was like 1% -- it's so so low, and it has changed so much since then. 

I'll talk a little bit about my experience FAFSA, because when I applied, I was awarded a scholarship randomly, and I didn't know that I was applying for scholarships, but some of them do pull your information from FAFSA. About a semester into PA school, I got a check in the mail for $1,500 dollars and a little letter saying I was part of this Lettie Pate Whitehead Scholarship, and a few other people in my class also got it. I received those checks, I think three times during school, which was crazy -- it was just out of nowhere. It was one of those things where you get the check in the mail and you kind of question it, is this real? Is this a scam? What is it? When I looked it up, it was a real thing. It's a special scholarship for women in the Southeast who are pursuing medical degrees -- that was awesome. That helped out a ton with my fees and extra expenses here in there -- you've got to pay for equipment, all kinds of things. Luckily for me, I didn't have to take out any additional loans. Just to clear things up, the way that most people pay for PA School is loans and that's okay. I mean, I would say there are a few extremely lucky people who maybe their parents can help them out completely, or they were able to save a ton of money, but for the most part, everyone's going to have loans. Would you agree, Hanna? 


H: Absolutely. I think one, you know, the bright light at the end of the tunnel is that we're going into a career where we should be making money to pay back those loans. That's incredibly rewarding and exciting, because a lot of people do not have, necessarily that guarantee when they get out of graduate school. I do think that it's you know, and most people have already made this decision that it is an investment that is worth making. You definitely have to make sure that you're ready for that because it is a lot of money. If you're not going to follow through on it, you don't even want that first $20,000 of debt sitting on you. 


S: I mentioned that at the beginning, before we started that, I was just getting my loan money went straight to my tuition and fees. I never saw a penny of that. I did not check my interest before or throughout school -- I just didn't want to know, I didn't want to look. I knew it was accruing interest. By the time I graduated that $40,000ish had turned into $75,000 that I owed and that was a little shocking to me. That is what it is what it is.

H:  It definitely stings and is motivation to get that job. 


S: Oh, yeah, I went to work right away. I was like no vacations here, put me to work! 

One question was, how do you know what to do? How do you know how to get these loans? How do you know how to pay for this stuff? Is this something that schools help with? 


H: I would head to the financial aid office, they're definitely going to point you in the direction of FASFA first. They may also be aware of certain scholarships, it really depends on how involved the financial aid section of your schools involved in the graduate program, I felt where I went to school, it was not as involved as it was in the undergrad program, because they had a massive undergrad program. You're really able to find some better systems online, and they can definitely at least point you in the right direction. I think it's a great place to start. How about you? How did you go with that? 


S: I felt like our school was very helpful. The first thing they tell you to do is fill out FAFSA. They kind of tell you that and then give you a little bit direction as far as loans after that. What would what would be the next step after you got your Stafford loans, they paid for your tuition fees, but now how are you going to pay for living expenses? 


H: Absolutely. So definitely, with the cost of my program, the $20,500 did not cover my tuition and fees so that's when I started to look at grad PLUS loans. Those loans are at a higher interest rate, they are at a higher fee, I believe the interest rate is about 7.12% don't quote me on that, but it is still high, but it's not 12-13%, which you may see some private loans at, and this is going to change year to year. With the with the grad PLUS loans, they will cover for the rest of your fees for your program, minus of course, they take a look at what other loans you've already received and subtract that from what they will finally get to you. That can be used towards living expenses. For example, I was living in New York, paying for a studio apartment in Manhattan is not cheap. My sister shared the studio apartment for a little while because of expenses, and really just did whatever we could to get the costs down. But you know, those loans went towards that and for food and those coffees that I probably should have cut out a little bit more, but they just surviving PA school. 


S: When people ask, how much should they took out loans. In my mind, you want to take out the most minimal amount possible. Everyone's going to be a little bit different in their kind of thoughts on this because I definitely had people in my class who ate out every single meal, and I knew that they were living on loans. Then after school, usually they were the first ones to go buy a brand new car. You have to make your own I think financial decisions but you want to make sure you have enough money to live on to.

H: I think you just kind of have to learn semester to semester, I know that some of my really close friends in PA school, we talked about this a lot. It was like how much are you taking out? Calculating our rent and our expenses? I think it should be an open conversation because it you know, it is the same cost to attend this program across the board. Are you kind of keeping in mind but like, are you paying $2,000 more per rent than your friend? Do you need a roommate? Should you save those expenses, but also just making sure, like the cost of your stethoscope and your books and other fees are kind of keeping in line and holding each other accountable for some sort of budget to figure out what you should be taking out and trying to live off.


S: I agree. Plus, you can always take out money and then give it back. You don't have to use it all or you don't have to let it sit there. If it's in your savings account that makes what like 0.05% interest rates, like those that nickel you make over six months is not going to counteract the interest that you paid on it. This is not money that you want to take out and try to invest. It's not fair investing, your return is not going to be higher than your interest rates. Again, I'm not a financial advisor, but I've read enough White Coat Investor to know that that is not a good idea. 

I don't know what your thoughts are or if you have any experience, but do you know if people are paying back loans for undergrad, if they go into deferment?  I feel like this is going to depend on where that came from? 

H: Exactly. So This is definitely dependent on where the loan came from.  We're talking about the terms of the subsidized loans earlier meaning government's paying your interest. If you are enrolled in school, at least half time, those direct loans will be placed into different banks. You don't have to make any payments on those until six months, just kind of like your other your first a new loans give you this grace period. If they're private loans, if you're not sure what type of loan they are, you kind of need to do the research. These things are changing constantly. In regards to something we didn't mention earlier, but there was a Federal Perkins loan for a while and that no longer exists. So laws come in and out based on the year. You really have to do your due diligence, following up on what's going to happen with your student loans. 


S: I love Google who doesn't. I mean, just kind of searching for things, you can find stuff on the PA forums, and there's a lot of information out there. But again, your school is going to be the best person to talk to, and talk to the class above you and see what advice they have as far as what they've done and maybe mistakes they made just so you can try to avoid that. 


H: We want to close off This episode in regards to talking about refinancing. After you've made it through PA school, and you've got multiple different types of loans, possibly public and private, really looking over those loans and more specifically, the interest that you've accrued on them and the interest rate at which they're accruing. So for myself, I think I had six or seven different loans come after the completion of PA school. The loans really varied year by year. I might have had one that was kind of had a 4%, 6%, 7%, I had a 12% and a 15%. Then I had another one that was relatively low, 4-5%. The first thing that I did was sat down and talked with my parents about them and again. This is an important aspect to remind you guys that we're not financial advisors, you really should consider speaking to someone about this, but knowing that you can refinance these loans and basically group them together as one specific, total sum of money and reduce the overall interest rate. That way, you're paying maybe 6% on all of your loans rather than possibly the high 12-15% loan. That's really going to change year to year. If you guys want to really follow this market, you've seen that this year, interest rates have gone up quite a bit, last year they were much lower. Watching to see what they do over the course of your PA school career. SOFI is one of the refinancing tools and there's Earnest and Common Bond, there are so many out there, but a lot of these specific businesses, they look at graduate students who are coming out of programs that they know are going to make a good salary.

The reason why that they aim their businesses towards us, because they know if you're making a good salary, you should be able to pay off your debt, that you shouldn't become bankrupt and go out on your loans. With that, they're really willing to work with you and set a low interest rate in comparison to what you've been sitting on for the past, let's say 26-27 months. So it's definitely something to look at multiple at these different options and companies to see what the lowest possible interest rate you can get. So that you can ultimately start paying off these loans and paying off as little interest as possible. 


S: I only have federal loans so I was not able to refinance, I have looked into it. With some of the kind of repayment or federal programs, if you do end up refinancing your loans, they kind of lose eligibility for some of that. So you really have to look at it and think about it, talk to someone who knows what they're talking about, like a financial advisor before you decide to do that. I have heard really good things about the SOFI. 

Anyway, another thing that people sometimes talk about is, and this is just a way to pay back your loans afterwards is, will jobs pay for your loans? Is there a way for your employer or your supervising position to pay back your loans or help you out with those? It's not out of the question, I've heard of that happening. In my mind, you never know until you ask and so when you're in your contract negotiations, why not throw it out there you know, see if there's options for some loan repayment. Usually the way I've heard it work use you know, through there for a year you get a certain amount or two years or three years that go straight towards your loans, or it's given as a bonus for your loans, essentially. That's something to think about. It doesn't happen that often, I don't think so. Didn't happen for me, you never know. 

Thank you so much, Hanna for taking the time to share your experience!

Make sure to check out my Youtube channel to learn about more ways to pay for PA school! Here are some videos you may be interested in: Student Loan Options for PA School, How to Afford to Pay for PA School, Learn How to pay for PA School with Stride Funding, and How to pay for PA School.

To listen to this interview as a podcast, click here!

Let us know other topics you would like for The PA Platform to cover in the comments below.



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.


What You Need To Know About The Interservice Physician Assistant Program (IPAP) - Guest Post from Chris Walerysiak

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What is the IPAP program?
The Interservice Physician Assistant Program is a program for members of the department of defense, all branches, to become a PA. It is accredited through the University of Nebraska's Medical Center and consists of a 16 month didactic period (phase 1) at Fort Sam Houston in San Antonio, TX. Upon graduation of Phase 1 students receive a bachelors degree. Phase 2 consists of a 12 month clinical rotation. The locations of clinical is dependent upon your service, but will most likely be at military treatment facilities. The Navy does their rotations in San Diego. Upon completion of phase 2, students graduate with a MPAS and are eligible to take the PANCE.

Who is eligible to apply?
The Navy and Marine Corps only accept active duty applicants. I believe the Army and Air Force allow reserves and national guard to apply. It is an Army run program, therefore the seats for Army and Air Force are greater in numbers. I think roughly the Navy and MC have 15-17 seats once a year and the Army and Air Force have ~30 seats three times a year.

What is the application process?
The first step is to apply on a LiasonCAS which is a system very similar to CASPA, where UNMC determines your eligibility to apply. The second half of the application is branch specific consisting of roughly the same things. They include a personal statement, letters of recommendation, a commanding officer's endorsement, review of military record, transcripts, possibly shadowing hours (Army/Air Force), and a few interviews with appraisal sheets.

What are the basic requirements?
Here are the basic requirements:

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Chris also granted us permission to share his academic review from UNMC that has a clean look to it. The italics are not required.

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What are the benefits of the IPAP program?
The benefits for IPAP are amazing. It has consistently been a top performing school (top 15 more or less) for the past 5 or so years. They have had if 100% very near it first time PANCE pass rate. If accepted into the program, not only is it free but you also get paid your current pay rate in the military during school along with all other benefits that come with being in the military (housing allowance, healthcare, ect). Once you graduate you become a commissioned officer which is another pay raise and your time in school also counts towards retirement from the military. Also, applicants to not need to posses a bachelors degree, nor take the GRE to apply. You just simply need the specific required prerequisites.

Are there any disadvantages?
The program, at least for the Navy, is very, very competitive. Even more competitive than civilian programs. I would highly discourage someone from joining the military just to get into this program. There are certain rank requirements to apply that may take a few years to get there as well as other things that would make you competitive like leadership/deployments/awards that will take years to accumulate. In the Navy there is only one time a year that you can apply so not getting accepted puts you on hold for a whole other year.

How long is the program?
16 month didactic phase in San Antonio (Phase 1) and a 12 month clinical rotation phase in various locations dependent on your branch of service, usually MTFs (Phase 2).

What made you stand out to gain acceptance?
The biggest things that board members look at are grades, SAT scores, personal statement (why you want to be a PA), and interview appraisals. So make sure those are all top notch to stand out. I stood out by having sustained superior performance on my annual evaluations for work as well as dedicating down time and off time to do some shadowing/OJT with family practice and the ED. I also work in the OR so that helps. Leadership helped me, being in charge of X amount of people or running different programs, like being a BLS program coordinator and instructor. My previous duty stations to include being deployed with the Marines. (Side note, PAs in the military are one of the most deployed medical assets to include deployments with the Army, Marines and on ships. Board members also want well rounded individuals so extra curricular activities helped. I coach/play soccer and rugby and volunteer a lot with the boy scouts.)

What advice would you give someone who is interested in the IPAP program?
Again, do not join the military to try to get into the program. It would be much easier to get into a civilian program. If you already in the military then step out and start shadowing PAs in family practice, try and get into an OR, or shadow some people in specialty clinics. The best resource a person can have trying to get into this program is to get in contact with someone that has gone through the program. There are facebook pages out there that have a ton of information on them about specific branch requirements, down to the tiniest details, and full with people that are willing and wanting to help. If anyone wants more information about the program or where to find more resources or specific questions I authorize you to give out my email to people and they can contact me.

Bonus note-this link will take you to the IPAP website operated by the Army where you can find things like the school's mission statement, goals, curriculum, past PANCE rates, and other helpful links.

4 Ways to Manage Your Anxiety in PA School - Guest Post from Elise Morgan

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Going to PA school is a challenging and time-consuming endeavor. There are deadlines to meet, exams to pass, and papers to write, not to mention any other important responsibilities in your life. All of the pressure can build up, and, before you know it, your stress and anxiety levels are through the roof. However, there are ways to prevent or reduce anxiety so that it doesn’t negatively affect your academic and professional goals. Here are four strategies to help with your anxiety while attending PA school.


Keep the Juices Flowing

A big portion of your time studying will be spent in a seated position. Sitting for long periods of time can cause stiffness, pain, and inflammation in your joints, lowering your flexibility and range of motion. In addition, focusing intensely on one topic for extended periods of time can make your mind sluggish. 

Regular exercise will keep your brain and body systems oxygenated and working to their maximum potential, as well as trigger endorphins that have both an invigorating and calming effect on the brain. In addition, being proactive about your health by exercising is a good example to portray and share with your future patients.


Prioritize Sleep

It’s when we sleep that our bodies perform essential restorative processes that prepare us to face another potentially productive day with plenty of energy.  Quality sleep and mental health are also intertwined, in that each affects the other. In addition, one study showed that sleep loss can cause a surge in cortisol, a stress hormone that is necessary for survival in the face of real danger, but elevated levels can increase your stress and anxiety levels.

You can prioritize sleep in many ways, like developing a 20 to 30-minute wind-down routine each evening that can include a warm bath, stretching, or meditation. It also helps to create a sleep sanctuary out of your bedroom space. Choose soothing colors for your bedding and walls and forego having a television in your bedroom. Technology screens are more draining than they are relaxing.


Take Plenty of Breaks

In addition to your scheduled workout sessions, it’s important to take several breaks during your study sessions to fit in a quick walk or climb some stairs to kickstart your next study round. You can also find a quiet spot to meditate for 10 or 15 minutes to bring yourself back into the moment and clear your mind of overwhelming thoughts or negative self-talk. 


Organize and Reduce Clutter

Nothing makes studying more daunting than a cluttered workspace. It not only makes it hard to find items you need, but research has shown that a physically cluttered space contributes to mental clutter than makes it hard to organize your thoughts effectively for studying. If you’re hitting brick walls in your studying efforts due to clutter, make it a priority to reorganize your workspace regularly.

There is no way to avoid the challenges that going to PA school presents. Like anything else worth achieving, it will take a lot of diligence and commitment to your mental health to complete the PA program successfully. However, these are some effective ways to set yourself up for less stress and productivity in PA school.



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.

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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!

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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.

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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.

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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.

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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.

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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. 

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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!

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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

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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.

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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.

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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.

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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

Tips for the Second Time Applicant – From a Second Time Applicant - Guest Post from Meghan in Medicine

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Meghan is a current 2nd year PA student at UTMB, and she blog at Meghan in Medicine. Since it’s becoming more common for applicants to have to reapply to PA school before gaining acceptance, this is a timely post to reshare because many people may be in a similar situation. Don’t take this advice lightly, but use it to make yourself more competitive for the next time. You can follow Megan on Instagram - @meghaninmedicine


As some of you may know, I applied to PA school straight from undergraduate school and DID NOT get in on my first try. Although I knew it was a big possibility after reading all the forums, blog posts, and hearing about different peoples experiences along the way, I was obviously disappointed. I remember consciously giving myself a couple of days off from the entire process, but then immediately diving back into grind by thinking of ways to elevate my application to the next level. So that brings me to my first tip:

1. Give yourself a break, then turn the motivation back on but up a notch

Being rejected in any format does not feel great. Being rejected in the one thing that you’ve been working hard for years for definitely does not feel great! I’m a big believer of giving yourself the smallest of pity parties. Whether that be treating yourself to something you normally wouldn’t do like getting your nails done, a full body massage, a night in with zero responsibilities, whatever it is just do it for your own sanity.

After you’ve spent some time on yourself, it’s time to kick it back into high gear because life waits for no one. Remind yourself that you are blessed to be where you are, wherever you are. Remind yourself that you are capable!

2. Find a way to even slightly improve EVERY aspect of your application

This has to be my biggest piece of advise to those applying a second time around, and it was the piece of advice given to me from a PA-C working in academia. The best way to improve your chances of getting into PA school after not getting in the first time around is to somehow improve every single aspect of your application. That means improving: personal statement, patient care hours, volunteering, GPA, supplemental applications, shadowing, and GRE. After I received this advice, it all really did click for me. These schools have to see that you’ve given extra effort to stand out during the year that you’ve been waiting for the next cycle, so go for it!

Possible ways to enhance every facet of your application:

  • Editing your personal statement to better encompass who you are and who you want to be as a PA

  • Increasing your amount of patient care hours

  • CHANGING the way you’re obtaining patient care hours (EMT, CNA, Scribe, MA)

  • Volunteer with a program/company that you’re GENUINELY interested in and stick with the same place to show your long-term commitment

  • Retake a few of your lowest scoring classes from undergraduate school. If you received two C’s, retake them and shoot for two B’s.

  • Use Kaplan, Magoosh, or other GRE preparatory books and programs to improve your GRE score

  • Shadow every single chance you get to show your curiosity and commitment to the PA profession and medicine in general

3. Reach out to those that have gone through this

I never would’ve known where to begin without the PA-C in academia giving me advice for what to do. The entire process of applying to any professional school can be extremely overwhelming at times. All of the comparison is especially stressful. Make it a point to reach out to some schools that you applied to and see if they offer any personalized application reviews. If they do not, I would then reach out to PA’s that you’ve previously shadowed or have connections with for them to review your application and offer up their advice for any improvements.

If you are a reapplicant make sure to check out my Youtube video PA School Reapplicant FAQ - What You Need to Know to Reapply to PA School where I answer helpful questions about reapplying to PA school!


PA School Spotlight: Ohio Dominican University PA Program

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PA Program: Ohio Dominican University (Columbus, OH) 

How long is your program and what quarter/semester are you in?: 27 months- my first rotation of clinical year is almost in the books. 

Class size: 50 seats 

Why did you apply to your program?: The program defines themselves as having a 'holistic approach' to instruction and clinical experience, which I was immediately drawn to. I also think that coming from an undergraduate program with 20k+ students, a small, walkable campus sounded heavenly. 

Why did you end up choosing to attend your program?: It all just resonated with me. The authenticity of our program director and genuine feel of the program as a whole ultimately influenced my decision to attend. 

Is there anything unique about your program?: Our program was the first university in Central Ohio to offer the M.S. PAS degree. I also feel that because we are a smaller, liberal arts college, our approach is more distinct in the sense we are drawing from all disciplines to graduate competent, well-rounded providers. 

What is your favorite study resource?: UpToDate and WikiEM are always there to help you brush up on specifics. I love PANCE Prep Pearls for a more condensed review of topics- my only regret is that I didn't buy it until the end of didactic year. If you're a chart/table person, you NEED it. (Affiliate link)

What is the most difficult or surprising part of PA school?: The most difficult part is probably realizing that every time you think "the most difficult part" is over, a new one seems to begin...the most surprising part is how much knowledge you'll truly have by the end of it all. 

What advice would you give to other PA students?: Keep the things that matter most in your life first. Don't take yourself too seriously or stress too hard over grade points. You're laying a solid foundation that will last you a lifetime- just try to enjoy the ride and remember why you chose this career in the first place. 

Where can we find you?: @theholistic_pa - feel free to DM me with questions about our program or just PA student life in general! 


If you're a current PA student and would like to share about your program in a PA School Spotlight post, send an email to savanna@thePAplatform.com or use this link to contact us at The PA Platform now.