On Being a PA

Paul Kubin, MS, MFT, PA-C, writing for Inside PA Training, 5 Reasons a Physician Assistant Career is Wrong for You:

Your interest in medicine is more about the science than about caring for patients. Don’t get me wrong – as a PA, you’ll need to know and work with plenty of science.  And PAs aren’t the only medical providers who care about their patients.  But as a PA, your patients are a larger focus.  Your communication with them and your ability to educate and counsel them about their health and treatment are your “magic bullets,” not your specialized knowledge of biochemical pathways or fluid dynamics.

This speaks to me. To be honest, I’m not the biggest fan of science. I wasn’t a science geek in grade school. I didn’t participate in the science fair. Don’t get me wrong: I respect science and can enjoy it. I actually look forward to learning biology and chemistry after having worked in healthcare for nearly ten years. I can finally see the application of it all. My end result though is exactly what Paul is talking about above. I’m all about people. And I’ve always enjoyed teaching; I’m just not knowledgeable enough on many subjects to get the ability to teach often. I’ve always enjoyed translating ideas into layman’s terms. I’ve always felt I’ve done a good job at not assuming any knowledge of an end user. Back when first learned Adobe Photoshop, I created a tutorial aptly titled So Easy a Caveman Can Do It. I had many comments on how easy it was to follow. You can still view it on my Deviant Art page 12 years later.

Stephen Pasquini, PA-C, writing for The Physician Assistant Life:

I honestly believe you can be better at compassion when you are more grounded. Having a life outside of work justifies life, it makes for a happy person which translates to better patient care.

I realized after quite a bit of soul-searching that I never really needed to be a Doctor, but I wanted to feel like one.

If you are on this journey to being a health care provider, just know that life exists beyond MD. It is a beautiful life, and it has fulfilled every single one of my dreams of being an excellent health care provider.

PA is the sweet spot! Where life and medicine meet in the middle.
— Stephen Pasquini, PA-C

Why PA School?

I’ve found myself in two situations in life where a career I’d never thought once about was introduced to me. Around 2010, I joined the Philadelphia Police Explorers, a youth program run by the Philadelphia Police Department, with assistance of the US Army, that taught discipline and hands on training. It was one of the most rewarding and enjoyable years of my life. Unfortunately, I aged out of the program because I joined when I was 20; I often wonder if my career path would have changed had I been allowed to continue. Through the program, we were trained by US Army drill sergeants, Philly police, and PA state police, to name a few. We learned how to conduct traffic stops, investigate and deescalate domestic disputes, handle firearms, how to march and drill, and much more. I had never seen the allure of a career in the military or law enforcement, but that mindset was quickly changed. I found all of it fascinating: marching as a unit, learning how to detain a suspect, entering into a building to find a criminal (actor) who was hiding inside. It was thrilling. The camaraderie, brotherhood, and sisterhood that I had with my fellow cadets was outstanding. I decided not to pursue such a career, but it’s always been in the back of mind even ten years later.

The second was in 2014 when I found myself in charge of the Undergraduate Medical Education (UGME) Program at Abington - Jefferson Health. I managed orientations for hundreds of medical and physician assistant students. Never once in my life had I considered a career in any aspect of medicine but now I was starting to see the appeal. I also worked alongside the Graduate Medical Education (GME) office. We had tons of foreign medical graduates coming to the US for the first time to complete their residencies. It was pretty inspiring to see. There were so many types of people coming through our doors. From the new batch of 50 residents per year to the 40 or so students per month that I was orienting, everyone had a story. They were all different ages. Many were married and had families. Many were older, non-traditional students who were non-science majors in undergrad. To add to this, I also assisted with Abington’s pre-med program. So from a college junior to a fifth year surgery resident, I was seeing the entire medical school journey unfold in front of me. There are medical students I’ve oriented who are now chief residents at the hospital, and others are practicing physicians.

In 2015, a close mentor of mine, one of the internal medicine physicians had said to me, “You know, you would make a great physician.” For the past few years people have been complimenting me on my people and customer service skills. And not just anyone; the former CEO of the hospital told me this in 2018. I’m not trying to sound pompous here; but when people like that compliment you, it’s incredibly meaningful. It’s these skills that landed me a job as a patient advocate in an emergency room. And that’s where I’ve been the past year and a half. I’ve been in hospital rooms. I’ve watched surgeries. I’ve shadowed physicians in the areas of family medicine, OB/GYN & internal medicine, even witnessed an autopsy; never though did one of those experiences make me say “Hey, THIS is what I want to do.” That all changed once I started working in an emergency room.

The camaraderie I found in the ER reminded me of my time in the Police Explorers. There was this way everyone blended into one big team; everyone had each other’s backs. The “always on” atmosphere of the ER is electric. Ever since it opened over 100 years ago, there has been a constant flow of patients. First responders, ambulances, traumas, it was all really exciting. I enjoyed spending time there and getting to know the staff but quickly I realized I wanted more. I wanted to be on the clinical side of things. As a patient advocate, you can only do so much. I realized I wanted to learn how to heal patients directly. The ER employed around 25 physician assistants. I was able to watch closely at how they worked, how they interacted with physicians and nurses. It seemed perfect for what I was looking for. They had ownership for their patients, but they weren’t at the top of of the ladder. They sat at a nice place in the hierarchy which I could appreciate.

I had never even heard of a physician assistant until 2014. It seemed like a pretty sweet gig. Two years of schooling to then have the freedom to go into whichever specialty that would take you. PA just sounded cool. I like interesting jobs that fit into special roles, and that seemed to be exactly what a PA was. It was a little bit mysterious. What exactly do they do?

Then there is the question… why not a physician? People have asked me that. I’ve heard of tales of PA students switching to medical school. I just can’t see myself as a doctor. I think visualization is an important part of life. There’s a certain level of pomp, glamour and stature that comes with being a physician and nothing about that seems appealing to me. Don’t get me wrong, I revere and respect physicians immensely. I often see though how intermingled life and career can become and that’s not something I’m looking for. I want to work to live, not live to work.

I like the idea of being a healer, but something a bit more involved than a nurse. I like the mechanics of making diagnoses and figuring out what is causing a patient’s problems. Waiting for lab results or radiology results to come back to find out what to do next is very exciting. I also like the “generalist / jack of all trades, master of none” dynamic that comes with emergency medicine or primary care. I can’t see myself getting into a specialty. But who knows? Life is full of surprises.

The Pomodoro Technique

My biggest concerns with going back to school are study technique, time management, work ethic, and procrastination. I feel like it’s worth looking into the science of studying; what are the most effective methods? I never thought twice about the efficiency nor effectiveness of studying in undergrad. It’s not often that we stop and think about the tasks we do every day. On numerous occasions I’ve taught my coworkers and managers shortcuts for Microsoft Office applications that would save them hours of time in the long term. So with that said, I’ve been looking into the science of studying.

The first thing I came across is something called the Pomodoro Technique, a time management method developed in the 1980s by Francesco Cirillo. Basically you break your workday into 25-minute chunks with 5-minute breaks in between. Here’s Kat Boogaard, writing for The Muse:

The idea behind the technique is that the timer instills a sense of urgency. Rather than feeling like you have endless time in the workday to get things done and then ultimately squandering those precious work hours on distractions, you know you only have 25 minutes to make as much progress on a task as possible.

Additionally, the forced breaks help to cure that frazzled, burnt-out feeling most of us experience toward the end of the day. It’s impossible to spend hours in front of your computer without even realizing it, as that ticking timer reminds you to get up and take a breather.

At first, working in such small increments felt unnatural. There were quite a few times—especially in the beginning—when I was tempted to ignore the timer and continue working. But, I forced myself to stick to the format.

After some time, the technique started to really gel with me. I was focused and insanely productive during my work time, as I was eager to get as much completed during that 25-minute interval as I could. I didn’t find myself mindlessly scrolling through Facebook or getting sucked in by those pesky clickbait articles. And, as a notorious multi-tasker, I noticed that I was totally zoned in on the one project at hand.

Because I was forced to get up and give myself a rest from staring at my laptop screen, I found that I actually did feel better at the end of each day. Not only did I feel like I had put in an honest day’s work, but I also felt less stressed, blurry-eyed, and cramped up.

It makes sense, right? It’s overwhelming cracking open your laptop with the entire day ahead of you, an amorphous blob of time. When do you start? When do you stop? I like how she was eager to get as much done as possible in that 25 minute stretch. It’s a manageable enough amount of time to not be overwhelming. It looks like a potential pitfall is continuing working when you’re in the zone. I’ve read that it takes a while to get back on track when you are interrupted, but if you are the one doing the interrupting, I suppose that makes a difference? This is definitely something I’m going to try.

Going Back to School in Your 30s is Easier -- and More Rewarding -- Than You Think

Tim Baker, writing for Thrillist (2016):

Unlike the first time around at college, staying home to read a book as an adult inspires neither guilt nor FOMO -- it's actually quite pleasant. This is one of the many advantages of being an older student. It’s actually been shown that more mature students do better in school. Researchers in Canada performed an extensive study of community college students, and their findings suggested that mature college students (those over 25) actually performed better on their final exams (on average six to seven points higher) than their younger counterparts.

This is promising. I remember the older and second career students when I was in undergraduate always being top performers. They were more focused and usually the leaders of any group projects.

One of the great things about heading back to college for a second degree or certificate is that the rewards are immediate and tangible. Your first time around, it’s not always clear what the long-term rewards of  struggling through statistics are. But when you know that the stats you learn may be the way to escape from a less-than-ideal work situation, it’s a lot easier to dedicate yourself to mastering the skills required.

This is something I’ve thought a lot about. When I was 20, I had no idea what I was working towards. I was taking random classes like economics, art history, management information systems, statistics, and microbiology with no clear end goal in mind. I was a business major. What did I need to ace microbiology for? Well, had I known that 10 years later that C in microbiology would affect my chances of getting into a post-bac and PA school, I would have tried a little harder.

The Journey to PA School and the Second Career

I came across a blog I had bookmarked years ago. It only has four posts from late 2010 into 2011, but includes a pretty detailed account of grinding through the pre-req courses toward PA school. The author was in real estate for 15 years and decided to make the jump. Plenty of insight here on the rigors and uncertainty of picking up the pre-reqs. They also touch upon the sacrifice an older student has to make because of their already established life and increased responsibility.

I have had some life changing experiences that have tugged me in a new direction and it is now time to create a new me. The future prospects are exciting and to tell you the truth, I was scared as hell. Many of my friends ask the question, "What are you doing man?" I am changing my life and creating my new future.

I realize that people really need a caring health care provider and advocate for themselves and their families when going to the hospital. This is my main reason for going into medicine, I want to be that professional that can explain in lay mans terms, the complexity of medical problems, treatment options and prevention.

I cannot believe that the semester is almost over and I am still having fun.

Right now, I am missing my wife and two boys, they are having a good time on vacation but they too deserve this time, the only downside is that they are without me and I miss them. I will be joining them tomorrow night once I have completed my self inflicted torture. I realize that when I get into PA school there will be many days without seeing them, since I will be living a few hours away. I know this will be difficult and I don't know how I will do it, but I know other people go through this and survive, so can I. I realize that they are one of the reasons for my commitment to this future in medicine.

That last excerpt is from the last entry in April of 2011. Nothing is posted after that. There are even some comments asking how the author is doing but no replies. I hope they made it to PA school and beyond!