Posted 1 day ago
I've tried PAJobSites, PA World, and PA Crossmatch. I've looked directly at (at least) 5 hospitals in the area and either sent in a resume to their employment email, or I've called their recruiters. No bites, and it's been almost a month. My class was/is very competitive and no one wants to share their job-finding techniques. Is there anything you can add?
adventures-in-medicine-land asked

Cluck cluck. It makes me sad that your class is “competitive” and won’t share their job finding techniques. Bunch of douchebags IMHO… Check out this post for some more broad-type job sites for PAs and other tips. Post your resume on Doc Cafe or one of those sites and you will have recruiters hounding you forever (I am still getting emails a year later). Of course, if you are very set to a particular city you will be more limited. The old adage goes location, salary, hours… you only get your choice of two. Apply even if they are “requiring” prior experience as a PA. The job I currently have now didn’t even want to interview me due to my lack of experience. I kind of sort of accidentally got the interview because I called the HR lady back a few times to inquire about things and she felt sorry for me I think.

You could also look at your state PA organization’s website for postings, although usually you will have to be a member in order to have access.

Make sure each application has a cover letter tailored to the position. Mention why the position in particular is appealing to you and why the organization resonates with you, and why you are special and better suited to fill this position than anyone else out there (total BS I know but it works). And get someone knowledgeable to take a look at your resume and make sure there’s nothing in there that could be turning off recruiters and HR for some reason. You never know.

Most likely there is nothing you’re doing wrong. Just broaden your search a bit, make those paid recruiters (not HR but those 3rd party sharks that get paid on commission) work for you, and polish your cover letter and resume. Be persistent but patient. It took me 4-6 weeks of searching, writing, applying, and phone calling before finally landing those interviews.

Posted 1 day ago
hey i'm currently a first year medical student but considering PA school. i really just want to work in the third world/overseas but i didn't know how limited PAs are in that aspect. any thoughts or resources you could point me to?
breakingspooky asked

I would check out PAs for Global Health to get more information. Honestly I don’t know too much about opportunities in developing countries. I think there are certainly a lot of areas that take shorter-term volunteer providers to staff clinics but it may be more difficult to find paid longer-term placement. I wouldn’t think PAs would be more limited in terms of practice than any other trained medical provider in a developing country, where medicolegal statues usually don’t exist. You may not even need to have a physician to practice with, although it would make it harder to not have someone who is further trained around to discuss patients with. There probably wouldn’t be resources to do the kinds of procedures that physicians would be better trained in (intubation, chest tube, central line, etc). Certainly you would be able to cast, suture, and I&D, procedures that would require more basic resources. Same idea goes for prescription of medication, not really limited just because you are a PA but probably not much available to begin with.

I did work with a resident as a student whose life goal was to relocate to a hospital he had done a few rotations at in Kenya. He was going to do a nephrology fellowship, then move him and his wife (a teacher) there so that he could provide specialty services for the hospital as a permanent physician. So this is definitely feasible and some providers choose to make it their life career choice, but it may be good to work at it early on as a student in order to find your niche in global health once you are finished training.

Posted 1 day ago
Hi, I keep reading all your post, and so interesting and fun for me to read. I've been researching for quite awhile. I'm about to own a nursing home business and still study to get a bachelor in school. I was wondering will this count as experience for PA school because I've looked at the requirements saying a EMT, CNA, nurse, etc but not a nursing home. Or will a home care aide count too?
susu-honey asked

Do you mean just owning the business and doing the administrative end of things, or actually working directly in a health care role with the patients? If just admin, then no that probably wouldn’t count. If you’re working as a home care aide but don’t necessarily have a CNA certification, that generally would count in my book. Of course it depends on the program. They will usually tell you if they have specific roles in mind that “count” for their health care experience.

Posted 1 week ago
I have a less than stellar GPA for my first 60 units (due to not having a clear direction). Do you think that if I raise the GPA and get a 3.5< for my last 60 or so units that I would have a chance in PA school? (Considering of course, hours of HCE, LOR, community service, etc.) Also, what is the average in a typical PA program?
Anonymous asked

I think you are asking if you get 3.5 or less? The average by PA program varies. Some have absolute cut-offs and some don’t. I would say on average the mean GPA of the entering class is around 3.5. I’ve said it before, and I’ll say it again, grades aren’t everything. I think your experience is at least as important, if not more. But admissions committees will vary in their preferences. I’m sure there’s PA students with 3.0 GPA as well as perfect 4.0s that get admitted every year to programs. It just depends on their whole picture (experience, letters of recommendation, service, etc, like you mentioned).

Posted 1 week ago
Helllooo!!! For staters great blog:)!! Just had a question. Im currently a junior in college working on my bachelors in public health science. My main goal is to go to PA school buttttt i wanted to know how u felt on taking a break in b/w. Like right after undergrad school? Would that be something recommended or is it better to jst go straight into a program?. Thankkkssss
lucylouforyou asked

I talk about this topic in this post and this one. In sum, yes, I recommend a break between undergrad and PA school. It was a very formative experience for me and I grew a lot professionally in that in-between stage.

Posted 1 week ago

Last few weeks of training before my half marathon at the end of the month. Definitely still slow and nagged by old injuries but steady! Coincidentally I start a new work schedule next week (12 hour shifts) so my final 2 weeks of runs may be completed via head lamp…

Posted 1 week ago
I love this! I'm currently in PA school I have a semester left until I get thrown into rotations. I just feel like everythig I've learned I either have down really well or is now a blur. I'm going back to some of my older notes and I find myself saying "WTH we learned this?" I love what I'm learning and I cannot wait to be doing this daily. I just want to know during didactic and rotations did you find yourself sort of remembering information or were you a lot more confident?
Anonymous asked

OMIGAWD YOU ARE TOTALLY NORMAL. For real… Everyone feels this way. Even after they are done with the school part. I just went to a conference and they talked about giving clopidogrel for ACS and I was like what, did we learn that?? Maybe it’s because I only see the mildly-elevated-troponin-in-CKD-patients-is-this-real-or-is-this-fake rather than the obvious STEMIs that go straight to cardiology.

But my point is… real life will be just like your rotations. You will realize how much you know and how much you don’t know. You will have to review and relearn constantly. (Hence why I keep my PA school notes on my iPad mini and update from time to time. I find it easier to update and review in the context of what information I did learn and how I learned it.) I do regret how much I stared blankly or replied “I don’t know” to attendings pimping me on rotation when I wasn’t 100% sure of my response… only to have someone else pipe up with the right response, which was what I had been thinking of… So be confident, you really do know a lot at this point.

It can be difficult, however, because you have just been schooled on all topics in (hopefully) the most up-to-date, evidence-based, and/or USPSTF recommended methods and it’s very likely that your preceptors and various providers standing around have not been and they will try to tell you to do things the way they learned. Again, figure out a way to politely stand up for what you learned (Oh really? That’s not what I remember… do you mind if I look it up?) or double check it by yourself if you’re afraid of a douchey response from someone who can’t handle being wrong in front of a student.

Posted 1 week ago
I'm researching PA programs to apply to next year. What is the best way of reducing the many programs there are to a small list of 7-10. My main priority in a program are the passing rates, Curriculum/Faculty, and Tuition.
Anonymous asked

Check out this post. The pass rates are an easy no-brainer to help you narrow. Most programs make them public. The curriculum should also be public. Quality of faculty may be hard to judge. I’ve had decorated veterans of medical education give terrible lectures and complete newbies still in residency give me the best lectures. Similarly, experience sometimes means burnout in terms of mentoring, etc. Unless you know someone in the program who can give you advice (or have a totally different metric for judging faculty than I’m thinking of) I might make that a lower priority. Tuition of course is huge. I have $120k in debt and thank goodness for loan forgiveness programs cause I’d be drowning.

You could maybe think about a geographic region or other criterion to help narrow as well. If cost is an issue then keeping it within driving distance so you don’t have to get a moving truck/pod or airline ticket for apartment hunting would be helpful.

Posted 1 week ago
Hello, I am applying to PA schools this year and I am having trouble writing my narrative. Could you please give me some advice. Thank you so much
Anonymous asked

Check out this post. And here is my own personal statement that I submitted if would like an example.

Posted 1 week ago
Hello! I am 24 and have been out of school for 2 years after graduating with a BA in Psychology. I had no clue what I wanted to do, so I got a sales job through a family friend. I'm interested in perusing a medical career as a PA or NP but have zero sciences done and no patient care experience. Is it crazy of me to take this on? Where do I even start and how long would it take me to be prepared to apply?
Anonymous asked

Nope, definitely not crazy to think about a career change! Especially with a psychology BA, unfortunately like my undergrad degree (microbiology & immunology) that doesn’t get you much unless you go on to Master’s and/or PhD. I’ll answer your question in terms of PA school. NP would be a little longer likely, as it would be 2 years of nursing school, working as an RN for a few years, then 2-3 years of NP classes (and maybe more as many programs are going to DNP).

You may have some of the prereqs done already. As far as how long it would take you to get the rest of the classes done, it would depend on whether you want to do full or part time. If money is not an issue or you can get the student loans, I’d do full time and just get it over with. And while you’re in your last couple of semesters, think about how you’d like to get your patient care experience, because it will probably involve taking a quick community college class or two on top of your current credits to guarantee you a paid job somewhere (EMT, CNA, phlebotomy, ED tech, medical assistant, etc). This would probably be 1-2 full time years of classes. Go to summer school, too. Taking ochem lab by itself during the summer was one of the best choices I made due to its time-consuming nature. Hell to take while you have other tough classes on the docket!

Then put in your patient care hours. Get your taste of medicine and think about what kind of setting you enjoy working in the most (hospital, clinic, both?). You can find PAs or MDs to shadow in different environments if work doesn’t give you this exposure. Learn how to talk to patients. Think about which providers and interactions you admire and how you would want to be treated when you’re the one who is sick. Learn your staff and supports: RNs, CNAs, phlebotomy/lab, clinic manager, PT, OT, speech, respiratory therapy, radiology tech, medical assistant, housekeeping, spiritual care, etc. And think about what you can do to help them once you are in the provider role. Think about ways that communication fails in healthcare and what you could do to make it better.

And lastly, once you have put in your hours, think about why you aren’t satisfied just keeping on doing what you have been doing in medicine. Why go on for more? And detail that as well as your experiences in your application statements. At this point it would probably be ~3 years of going back to classes and working until you’re ready to start submitting those applications. It seems like a long time, but in the grand scheme of things it’s really not. It will go more quickly than you think, and you’ll need that time to solidify your career goals for yourself.

Posted 2 weeks ago
Posted 3 weeks ago
I recently graduated with an undergraduate degree in art history. I have no desire to pursue that career track and wish to go back to school to study more science. I took an EMT class in college and it was overall my favorite class. I am thinking of taking the long journey back to school (I have no prerequisites except chem) and then possibly pa school. I guess my question is do you have any advice for someone just about to start the medicine track?
Anonymous asked

I would say to just always keep your eyes on the prize. Taking all that science at once is going to be rough but the bonus is that it will all be fresh in your mind for PA school! It may help in your case to work part-time in medicine to keep you interested and reminded in what you’re going back and doing all that work for. I can’t say that the extra bio and chem are going to seem very career-relevant in the moment, but once you get to anatomy and physiology then you can really relate it to your work in medicine. Also, aspiring doctors is a good Tumblr about a fellow arts major now going to medical school that you may like to follow.

Posted 3 weeks ago
Hi I'm only a senior in high school but I'm really interested in shock trauma/ emergency I was just wondering what you get to do before the MD steps in or takes over?
Anonymous asked

It seems a lot of us practicing in medicine have our interests initially piqued by something adrenaline-junkie-ish such as trauma surgery, emergency medicine, etc. Until we really experience it. Just keep in mind that the ideas you have in your mind about trauma and shock situations are probably the TV glam versions. In real life, you have no idea what’s going on and what to do. You have to make rash, quick decisions and assessments that may or may not be right and the lifeless body you are doing things to in front of you is a real person, someone’s family, a dad, someone’s child, etc. It is a really awful experience until you desensitize yourself to it, which you must do in order to do this kind of work regularly, because people die frequently. People who shouldn’t, who really should get second chances in your judgment. It makes you kind of crass sometimes and seem really unempathetic to the rest of the world that judges you in your less than finer moments. A lot of people that work in these areas develop a kind of PTSD after time.

But I digress into crustiness (I can feel my hairs graying)… To answer your question, it depends. If you’re a seasoned PA and you’ve been around the ACLS block a lot, you’re more than likely working right alongside the physicians and nurses in a collaborative effort to revive someone. Lines are being placed, blood drawn, EKG leads stuck on, chest compressions done in turn, respiratory is intubating, and you and the physician are doing your quick physical exam and shouting which meds to draw up. There is no “takeover” in a resuscitation effort because there are more jobs to be done than one person can handle. If you are a new PA and don’t know WTF you are doing (or in my case a PA-S who didn’t know WTF they were doing), then you’re hooking up the vitals monitors and taking your turn with chest compressions while stealing glances at your ACLS pocket cards…

Posted 3 weeks ago
I'm only a freshman in college majoring in biology. It's my life goal to be a PA. I don't see myself doing anything other than that. What scares me is the plethora of topics student PAs have to learn in such a short time. I tend to retain information pretty easily especially when it comes to anything relating to science but the whole rigorous PA program makes me doubt that I won't be able to do it. Do you have any advice?
Anonymous asked

Meh, you learn a plethora of stuff in biology, too. Once you get your study habits for that down pat and figure out what works for you, likely the same will do in PA school as well. I also found it difficult in PA school to reign in my expectations that I would/should be able to retain 100% of what was spouted in lecture. In undergrad I felt generally prepared for my exams and like I knew all the material. In PA school, you won’t, so be easy on yourself. It helped that our exams were pass/fail rather than grades. What matters is the big picture. In real life, the little stuff you can look up to refresh your knowledge as needed.

Posted 3 weeks ago
What is the difference between a PA and a RN? They sound very similar to me am I right or wrong?
Anonymous asked

kimmarysleepy:

rnratched:

proveitmakemefightme:

populationpensive:

pa-in-progress:

digiti-minimi:

therunningpa:

Oh naw you didn’t! …

Sorry, you probably are asking this question very innocently but PAs get very disheartened by sentiments like this. No, we are not the same. PAs are educated and trained to diagnose and treat diseases. We are trained to take complete medical histories, do physical exams, order and interpret lab tests and imaging, write prescriptions, and know how and when to ask for further help from specialists, therapists, etc.

Could a good, proactive, experienced RN eventually figure out how to do many of these things? Probably, but it would be based mostly on protocol-type knowledge gained and algorithms vs well-rounded, organized medical training. This is why some RNs choose to become NPs, they want to expand on their on-the-job knowledge and fill it out more formally to fit the provider role.

Don’t get me wrong, RNs have an extremely important job. They are the ones who take care of all of the patient care orders I’ve requested, call me when I screw something up or when they know something is just not right with our patient, and deal with the real life poop, vomit, and tears situations in health care. In the inpatient world, they spend far more time with my patients than I do. I would want them to be the ones to insert your Foley catheter, start your IV and check for compatibilities, and know just how to give you your meds, because those are skills that RNs are much better trained on than I have been.

But the bottom line is that our roles and training are completely different.

I admire therunningpa so much for explaining things so well without ever being a jerk about anything. Thank you!

(Also, totally laughed out loud at that gif usage because it’s exactly how I was feeling when I read the question.)

Yes yes and yes.

Well stated!

Further, the role of the provider is to treat the medical diagnosis, and the role of the RN is to treat the human response.

I know the response to this anon wasn’t meant to offend, but I get frustrated with the sentiment that people (MD’s, PA’s, DO’s, and even NP’s alike) get offended when they are compared to an RN.

 My background in my nursing education was solidly based on the hard sciences (loads of chemistry and biology), evidence-based practice (as in practice based on research), and sharp critical thinking skills. With that background, our role demands that we know how to anticipate a diagnosis- so while we don’t make a medical diagnosis, especially in the ER when they don’t have one, we are supposed to assess the condition of the patient and do so accurately. We take that information, formulate our own care plan, and make suggestions to inform the patient’s treatment. We anticipate what procedures, labs, tests, and diagnostics will be performed, and we are trained to interpret those results and understand them, as well as what those results mean for our patients. Most importantly, we are the patient’s advocate. Not that providers aren’t concerned for their patients, but we are the implementer and observer of the care plan, and when we see changes in a patient we need to be skilled enough to recognize that and address those changes accordingly. 

That means we don’t just give medications and understand compatibility- we know what those medications do, how they interact on a chemical level in the body, what adverse reactions are, what therapeutic results we should anticipate, and how to titrate those medications according to the patient’s condition.

We have to think critically about implementing provider orders. We don’t just do tasks, we weigh the pros and cons of those tasks with consideration of our observation of the patient condition, and if we feel that the patient is unfit for any particular order set we will say so and ask for either clarification or a change.

We are also expected to be top-notch educators, and are tasked with taking the medical diagnosis and making it understandable to the patient. We teach the patient how to manage their diagnosis, their medications, and what lifestyle they should expect in relation to. 

We hold hands, we clean up urine, and we wipe some ass. When I hold hands, I use myself therapeutically and I carefully consider the art of conversation and being with that patient-even empathy and emotional support have a significant amount of critical thinking involved. When I change the incontinent patient I assess the skin of breakdown, look for signs of irritation that could be potentially hazardous, take care to clean the skin, and work carefully to prevent skin tearing when I pull out the depends.

When I start IV’s, I weigh the considerations of what that patient needs- will they need a contrast CT? CT loves 20 gauge minimum in a big ass vein, but I have this little old woman with tiny veins and technically they should be able to do IV contrast on a 22 in the hand.

When I insert a foley, I first weigh the pros and cons - is it necessary to put in the foley? Why? Is this a critical patient that needs output monitoring? Is this for the sake of convenience? Are there better alternatives that have a lower chance of a urinary tract infections?

Even my simple tasks that I do regularly are done with great care and consideration, and I always, always look at my patient before I implement a single thing. In simple terms, as Florence Nightingale said, if you cannot assess you cannot be a nurse. Even the most experienced nurse can suck if he/she lacks the ability to critically analyze and assess his/hers patient’s care plan and response. What I listed above are skills and abilities required of even entry level nurses, and the demands for our critical thinking ability are like never before. Even though entry level can be obtained through an associates, we are seeing a shift in the curriculum nation wide where the standard in comparison between the requirements for the ADN and BSN degrees are virtually the same.

Nursing is a practice developed from unique theories that stands apart, but not separate from medicine. Bottom line is nurses could not survive without providers, nor providers without nurses (nor nurses and doctors without techs, CNAs, respiratory, imaging, lab, etc).

I am by no means suggesting the original post author is being condescending or discrediting towards nurses. I’m just merely making an observation of an attitude where people are offended by being compared to a nurse, and I felt some of the sentiment here. It feels to me just the same as when someone says “you throw like a girl!” 

(Insert Americas next top model slow clap .gif here to that last statement)

The first real description I have ever seen about nursing

None of this touching your heart, changing your life forever, holding your hand and a million butterflies fill the room horseshit

That’s not what I do. Nurse is a KNOWLEDGE profession

Hoo guys… clearly I have touched a nerve here but I think it was a misunderstanding… I did NOT mean that nursing school prepares RNs to make decisions based on algorithms and protocols vs real knowledge. What I meant was that once one IS an RN, that their additional on the job training that furthers their knowledge towards that of a provider (IE being able to pass a comprehensive test a provider takes like MD/DO, med students, NPs, PAs, etc) is too patchwork to fill in all of those decision-making gaps. And thus even a senior RN with tons of experience would not be guaranteed to have learned what is covered in an organized medical curriculum (especially given that it’s patients of all ages and nurses tend to work with a specific age group). For example, an experienced adult hospital RN would know a lot about treating DKA. They learned about it in nursing school, know the pathogenesis of diabetes and the pharmacology of insulin, etc. They’ve had enough patients with this to know to expect unexplainable rip-roarin’ abdominal pain and that the patient isn’t just being whiny. They’ve managed the pumps enough to know that there is generally a bolus to cover that high high sugar, that fluids get started with potassium even if the K is normal on the labs, and after a certain point dextrose must be added. This is what I mean by knowledge based on algorithms… And I don’t mean the insulin titration flowsheet, I mean like algorithms you develop in your head around an idea that you understand very well but may not have learned the vagaries of. If this, then that is usually what happens… What even the experienced RN might not know is the rationale for the dextrose fluids (which might seem counter-intuitive, if the person has high sugar why are we giving them more?). And how it’s linked to the anion gap. And what a gap means. And why to care about whether its normal or increased. And how to calculate it. And what kinds of anions are unmeasured.

Do you get what I mean? This is why I said some RNs choose to go back to school to become providers themselves. They want to do more provider-y things and comprehensively learn more about medicine: history, physical exam, workup, and diagnosis or referral.

I understand that RNs learn a lot of chemistry, anatomy, physiology, psychology, nutrition, etc. I took a lot of my undergrad classes in these subjects with nursing students. And I know nursing school teaches you a whole lot of shit that I know not much about, hence why there are many things in patient care I would defer to a nurse’s skills or judgment. And I also know that RNs assess constantly and have a lot of knowledge and intuition, so that’s why I said that I appreciate it when they call me when they know I’ve screwed something up or give me a heads up that they feel the patient is not doing well. Yeah, you guys treat the person and all their problems. Believe me, I know. I worked as a CNA. Most days I think that you guys have a harder job than I do.

So why the chip on my shoulder when I am called an RN? It’s not because I’m offended because I’m too good for that or above that or something, it’s because I took all those classes alongside nursing students. I did a whole undergrad degree. And then I worked some more. And then I chose to go back to school and learn even more about all of those things. A&P PA school edition was wayy more in depth than undergrad. The amount of knowledge and PowerPoints thrown at me every day was mind-boggling. It was like finals week in undergrad every single week. Don’t get me wrong, nothing gets harder exam-material wise than an undergrad physiology or organic chemistry exam. PA school or med school is not HARD. RNs don’t avoid med school because they are less smart or can’t handle it. The material is not any harder than nursing school. It’s the amount. Tons and tons and tons. You have to build a giant encyclopedia of knowledge in your head that you must add to every day of your life. Babies, adults, old people, pregnant ladies… It’s that formal encyclopedia that graduates you to a provider role. And yes, I’m stinking proud of it! I worked incredibly hard for it. I passed my tests with flying colors. And when someone says wait, you’re basically a [insert non-provider role here] it is really disheartening for me because to me it dismisses all those abilities that I trained additionally for.

So I apologize if I offended anyone. I know all you RNs out there are rock stars and the world would stop without you. Please just know that, especially as a relatively new role in the medical field, for PAs and NPs it really smarts when our additional training as providers is not recognized.