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Everything posted by amwillaert

  1. Hi George - I agree with you on most points. As our program is located within 30 miles of a state border we naturally have many students who comes from both states. So “out of state” for us is relative. I agree that if you choose to go to PA school (for example) on the east coast that to expect a program to set up all of your rotations in California is unrealistic. I also make them choose one geographic region- no traveling around the country :) This is one of those situations though that I think requires a frank conversation with the student upfront- both to set expectations and to ascertain their level of connectedness in their geographic area of choice. If it’s an area I’m interested in developing more sites (i.e rural location in a neighboring state) then I’m willingly to work a bit harder because this will benefit students in the future as well. If they want every rotation located in a metropolis where we aren’t located - hard stop! I typically run into this situation when the student applied to schools in their geographic region of choice but for whatever reason didn’t get accepted.
  2. You can likely find a program that will allow you this flexibility. However I can tell you (as a clinical coordinator with 2.5 years of experience) that unless you have very strong personal connections (ie you’ve worked in a single healthcare system for 5 years and have a wide range of contacts) and/or multiple family members within a healthcare system who are willing to go to bat for you, the chances of getting all your rotations outside of the program’s primary sites are slim. It also is very dependent on that states you are looking to go. Certain states make it almost impossible to place out of state students due to unrealistic regulations or HUGE fees. Also worth checking out if the sites you are interested in are even taking new affiliation agreements. This is a common issue at sites in larger cities that are saturated already.
  3. Hello all! I am in the process of writing a letter to the editor. This is in response to a scathing letter from a retired MD lamenting how the opiate epidemic was caused by excessive opiate prescriptions from non- physicians and specifically “physician’s assistants.” I am hoping to have some stats to include, but Google and PubMed searches are not yielding much helpful information. Anyone know of any recent literature I can cite in my response? Thank you!
  4. My personal rule on this as a clinical coordinator is 2 years before they can take an "observation only" student (first year didactic students). 3 years full time before taking a full time clinical phase rotation. You need to have your feet solidly under you as a PA before you can take on teaching responsibilities.
  5. I am glad to hear you have notified the program. It sounds like some remediation may be in order. Specific examples are very helpful so as educators we know exactly where the student is struggling. If you genuinely don't believe the student meets even baseline expectations (after discussions with the program and presuming some remediation occurs) then absolutely the student should be failed. Student who keep getting passed along despite consistently poor performance reviews are a real problem.
  6. @UGoLong - thanks for writing that detailed description above. Compared to other Allied Health accreditation bodies, ARC-PA has much more stringent standards and better oversight (at least this seems to be the case based on discussions with other allied health professionals in academics who have also been through accreditation). Having just been through accreditation, it is no joke. They look at EVERY aspect of your program top to bottom and it would be difficult (if not impossible) to pass an audit with consistently inadequate clinical experiences. I think part of the issue is what is the average practicing PA considers "adequate experience" is likely different than what is necessary to meet the ARC-PA standard. Some of the standards are quite general and do give programs a fair amount of leeway as to what "counts." If PAs as a whole think they should be stricter then yes this needs to be addressed prior to the next set of standards being released.
  7. Was trying to offer a much better alternative than "count your contraception appointments as OB hours" as was mentioned above. Our clinical team is responsible for scheduling over 400 rotations a year, and has to supplement hours maybe once or twice a cohort. The "few days" of OB is because the student has already gotten some OB experience but just needs a bit more to meet our standard. We really do our best :)
  8. I am sorry to hear this, but unfortunately it is an all too common response from interested (and former) preceptors. It's not as simple anymore as finding an interested preceptor and matching them with a student. There are usually at least 2-3 layers of other individuals above the preceptor who must approve a potential rotation (lead PA or physician in the group, clinic manager, clinical ed coordinator, etc). If any one of those individuals can find any reason why a student shouldn't be allowed in the clinical site (EMR transition, hiring too many new support staff in the next 6 months, the sky is blue) then the request will be declined even if the preceptor is willing. It usually all comes back to money, and the thought that having students will adversely affect productivity and revenue.
  9. It's more complicated than that. Cutting a rotation short (especially if the student is getting good GYN experience but just needs some additional OB experience) would be simple if OB preceptors grew on trees. Because they unfortunately don't, and because OB heavy sites are notoriously difficult to find (not many PAs working in OB), that would put the student at risk of not graduating on time if a new site couldn't be established prior to rotation end. And given that it takes weeks to months to onboard and that the majority of our rotations schedule 6 to 12 months out, the chances would be slim. Thus the compromise of taking a few days from a non-core rotation to supplement. As Clinical Coordinators, it's our job to constantly find and develop new sites and preceptors. How else can we make up for the established preceptors who retire, move out of state, change specialties etc? Someone always has to be the first student at a site. And we can set expectations until we are blue in the face, but at some point you have to see how it goes, understanding that it may not always be perfect on the first try. I always notify students if they are a first student at any site and am in frequent communication with them throughout.
  10. Not good and certainly should not be the norm. We (very occasionally) have a student receive what we consider to be inadequate OB experience on their OB/GYN rotation (often with new sites or new preceptors who just don't quite meet the mark despite education about requirements beforehand). An appropriate response to this would be to supplement the rotation (perhaps during an elective) using hours at a site where they are sure to obtain the appropriate experience. It makes all PA programs look bad when programs choose to skirt the rules like you mention above, but I don't think it is very common thankfully.
  11. As a current Clinical Coordinator who takes great pride in finding the best possible clinical placements we can (no UC for IM here) I can tell you that this happens for two reasons - 1. Lack of time and 2. Lack of willing preceptors (or willing sites) It takes an extraordinary amount of time to find rotations for each of our students, as we are a private institution not affiliated with a medical school. Day after day, dozens upon dozens of emails go out, in addition to the networking I do while working at my clinical job, cold calling, etc. There are so many barriers to obtaining adequate clinical experiences (far more than I can go into detail about in a short post). Anytime I meet with pre-PA students I tell them the same thing. Your didactic education will be pretty standardized. There's only so much programs can do to get creative with it. Plus you can do a lot of supplementing on your own if you have a lecture or subject area that is weaker. But your clinical experiences will be made or broken by the quality of your Clinical Coordinators/Clinical team. Make sure to ask questions about how your rotations will be scheduled during clinical year.
  12. I am coming into this discussion late when so much has already been covered. If I can offer a slightly different perspective (based on personal experience). While I agree that it's in everyone's best interest to disclose pregnancy in a timely way (both because of the "team player" piece and also to allow the employer adequate time to find additional staffing should they so choose) I think whether or not to disclose before the end of first trimester is a very personal decision. The fact is 20% of pregnancies end in miscarriage or loss (perhaps higher depending on your age and other medical comorbidities). Say I am a woman who has been trying for years to have a child. Multiple miscarriages. I find out (of course) as I am applying for new jobs. Would YOU want to disclose such personal information to an employer knowing there is a good chance you may have to go back and untell these strangers in several weeks/months? This is not as simple an issue as some posters would like to believe.
  13. Just got the certificate in the mail. Any idea how/if we can see our actual scores? Not that it really matters but just curious.
  14. I think it depends what they have you doing. I was in charge of obtaining all heights/weights, plotting those on a growth curve and interpreting results, reading results of hemoglobin and lead testing and making appropriate referrals based on results, and developing simple nutrition assessments and plans. It's not rocket science but it's certainly as much "patient care" as being a medical assistant. Still, since it is more nontraditional, it is probably worth contacting the programs you are most interested in and checking that they will count this for hours. I would be shocked if they didnt- I got lots of positive feedback for it on the interview trail.
  15. You don't need the internship to use your degree! Work as a nutritionist for WIC for a year. It will count as patient care hours, you get great exposure to public health, and it will give you some good background working with underserved populations. Plus it's a little more unique experience than the standard CNA, EMT, etc. I am biased because this is the route I took but it turned out well!
  16. Former staff PA, just transitioned to per diem over the last 6 months for a job in academia. For my group, the scheduler asks me for any weekends I want to work about 3 months in advance. These are pretty much guaranteed- they always need extra coverage on weekends. The rest of just a crapshoot. I look at the schedule the first day it comes out and pickup what I can. Otherwise it's pretty much picking up shifts day of for sick calls or pickups for vacation coverage, CME, etc. Not ideal but the flexibility is worth it to me right now!
  17. Congrats on your acceptance! I am a 2013 graduate of the program and still work there per diem. I'm sure I'll be seeing you around.
  18. As a member of the Regions Hospital Emergency Medicine Physician Assistant residency inaugural class, I wanted to take the time to post regarding my experience thus far with the residency. Having completed the first six months of the residency I can say without reservation that my decision to complete an ER PA residency was a great one! Regions Hospital is a level one trauma center in Saint Paul, Minnesota with a well-respected Emergency Medicine Physician residency. Brad Hernandez (Residency Medical Director) and Ann Verhoeven (Residency Program Director) worked closely with the leaders of the MD residency program to create a PA residency that gives physician assistants the skills they need to be great EM PAs. As a PA resident I work side by side with MD residents both in the ER and on off-service rotations. My hours and the expectations placed upon me are identical to those for MD residents. Just to give you a sampling of some of the skills I have learned in the first six months: Intubations (Anesthesia) FAST/cardiac exams (Ultrasound) Central line/arterial line placement, pressor management, ventilator management (SICU/MICU) Splinting/reduction techniques (Orthopedics) Management of toxicologic emergencies (Toxicology) This is a just a short list off the top of my head. We also had a 2 week EMS rotation where I rotated through various EMS services in the area, including a day out at Afton Alps with their ski patrol! As PA residents we are expected to attend a 5-hour didactic conference each week with MD residents. I have been consistently impressed with the quality of the education I receive during this conference, not to mention that my CME hours for the next 2 years are already completed. All residents are also given the opportunity to obtain all the major certifications needed for ER PAs - ACLS, ATLS, PALS, FCCS. The best part of the Regions Hospital Emergency Medicine PA residency is how closely it is aligned with the MD residency, resulting in an amazing educational experience you simply can't get on the job. I went back and forth about whether I should complete a residency, but once I saw the wide variety of experiences they had available I was completely sold. I couldn't be more pleased with the quality of the program. As you can see in Ann's post above, we are still accepting applications for the class of 2014. If you have any interest in completing an EM PA residency, I urge you to consider Regions Hospital. Please do not hesitate to PM me or to contact Christine.E.Eck@HealthPartners.com for my contact information.
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