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

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

Tell us a little bit about yourself.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What was most difficult during PA school?

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

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

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

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

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

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

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

What does a typical day at your job look like?

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

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

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

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

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

What are some current hot topics for physician assistants?

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

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

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

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

Advice From Current PA Students - From White Coat Dreaming

I recently connected with Alex on Instagram (@whitecoatdreaming), and she introduced me to her awesome PA blog - White Coat Dreaming. Apart from sharing her own awesome advice, Alex has also interviewed her fellow classmates in PA school to get their advice as well.  In this post, I'm going to share some of the best points to help you succeed in PA school! If you want to see more, make sure you head over to her blog to see the interviews in their entirety. 

Interview Tips:

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I think that schools like to see that you have other interests besides medicine and that you make time for the things you care about.  - Megan

I would really recommend going on a mission trip before PA school starts because it gives you an opportunity to learn more about the medical field and prepares you for PA school. Not to mention, it shows the interview committee that you are well rounded and more than just your grades. -Norin

Career change?  Be totally honest with yourself about who you are deep down, what you like, what all of your motivations are, whether you could get what it is you think you’re looking for while staying in your current spot or with a less drastic change. -Craig

The number one tip I can give you is to just be yourself! And I know that probably sounds super cliché, but it’s so true. Don’t try to be someone you’re not. Don’t try to put on an act, or memorize all the right answers to ace an interview or personal statement.
— Giftson from White Coat Dreaming

I didn’t do anything to practice so I just showed up thinking I could charm some people. And then they were tough and I bawled in my car after 2 or 3 of them. - Megan

I would truly recommend helping out the community as much as you can. During interviews, they look at more than just your grades. They want to see that you are a caring individual that does more than just study.  -Norin

There is a lot of competition for spots in PA school for good reasons, you’ve got to show that you are the cream of the crop and are a good bet for the school in terms of being able to one day be a skillful, practicing PA. -Craig 

It is so easy to compare to others and feel like you fall short, but it is so not true. We are all worth so much more than how we perform or measure up to the world’s standards. Finding my worth in Christ and knowing that He loves me no matter how small I feel was the biggest game changer. -Michelle

Applying Tips: 

Don’t get discouraged if you are waitlisted! I know plenty of people who were waitlisted and got in as late as April. -Megan

I took a year off before starting PA school because there were still some pre-requisites that I needed to complete and volunteer hours that I needed to add into my application. This really helped me focus on my application and make it stronger. -Norin

While getting into school and becoming a PA might seem like the most important thing in your life right now, don’t fall into the belief that whether you become a PA or not determines your value. You are so much more than your career! Work hard, but rest in the idea that you are going to end up exactly where you are meant to be. You are no more valuable as a PA or less valuable as something else! -Jill

Find yourself a good group of friends who will provide you with love, tissues and wine nights. They will be your backbone throughout the ‘process.’ - Alexa

People are afraid to major in something non traditional (like English, Poli Sci or philosophy), but I think it’s best to follow your own passions and interests. That will show that you are true to yourself, and are not just trying to do what you think you are ‘supposed’ to do.
— Erica from White Coat Dreaming

For me the hardest thing about applying was the cost.  - Erica

I’ve tried to make the best out of every situation. I know right now school is kind of rough, and you have to give up a lot of things that you used to have, but in the end it’ll all be worth it. -Giftson

 It is good to always have a plan B after you apply and focus on areas that you need to work on before you know if you got in that cycle or not! -Norin

The hardest part of applying was sorting through all the various requirements and prerequisites for each program. -Jill

Also, I would recommend a strong personal statement. It summarizes who you are as a person and your purpose for wanting to pursue medicine. Every part of the application is important, however, the personal statements gives them insight into your life so make sure it is strong. -Norin

I feel like location was a big factor in my decision. I knew I wanted to be in an area where I could still be around family, and having a support group nearby definitely influenced that decision but I also was excited to be out of my comfort zone. -Giftson

When the competition is so steep, you want to have as good of chances as you can, and applying to multiple programs is one way to do that! - Jill

PA School Tips: 

Know what you are getting into before you come to PA school. I was not mentally prepared for the amount of dedication that it would take to be a PA student, and it took me about 2-3 months to truly grasp how much my life was going to revolve around studying. - Erica

If your heart is not in it and this is not something you truly want to do, then stop yourself before it gets too late. PA school is hard, and honestly the pressures of the program is going to take a huge toll on you…physically, mentally, emotionally, and spiritually. If you’re not doing it for yourself, then you’re going to crack under pressure. - Giftson

Once you get accepted, stop trying to ‘better yourself’ academically or otherwise– and just relax and enjoy yourself, as much as logistically and financially possible. If you can take a vacation beforehand or some time off, definitely do- you will be so glad later. - Erica

PA school ends up taking all of your time, so you don’t really get a chance to think about how much time you’re not spending with family and friends.  -Giftson

I faced some of my darkest moments in PA school, because, surprise…it’s hard.  And the thing that kept me going above all else was having compassion for where these long nights of studying would take me.
— Silas from White Coat Dreaming

It helped to have a running schedule that I would try my best to stick to. That forced me to workout most days after class even when I didn’t feel like it. -Michelle

Being professional and acting in a way that shows respect to others is honestly far more important than the number of years you have under your belt. I was always worried that patients or even other classmates wouldn’t take me seriously because I was so young, but over time I’ve learned not to worry about things I can’t change. -Giftson

Also, make efforts to stay balanced while in school. So many people seem to put everything aside for their grades- mental health, relationships, exercise, sleep– but those things are necessary to be successful. -Erica

We all are starting at different parts of our life, and just because you don’t have experience doesn’t mean you can’t do well. You have to understand your limitations, and strive to push those limits every day! You’re going to make mistakes. Learn from them, and keep pushing forward so you can be the best PA you can be! -Giftson

I realized when I ate healthy, it definitely helped my energy level and helped me focus better and not get so tired studying. -Michelle

Self-doubt was a huge problem for me. I would always see other people that knew so much, and wonder if I would ever get there (still haven’t got there by the way). -Giftson

Sometimes it can be challenging when you compare and think how far ahead your kiddo classmates are in terms of being about to start their career when you would have still been waking up at noon on a Wednesday to go do a half-shift of bagging liquor- but hey, whatever path you take, you are bound to have learned something that someone on another path hasn’t. - Craig

You learn quickly that your classmates are in the trenches there with you, and you depend on each other far more than for just explaining a concept you didn’t understand in lecture.  -Silas