HCE mess, posting to hopefully help others!

[wesr_gordon]

I have been pursuing polishing my PA app for about three years now.

 

I have applied through CASPA once (invited to two interviews that were subsequently canceled) and all the 'no' responses were due to lack of HCE. 

 

I had not decided on PA until the near end of my undergrad so it has been hard to get the HCE hours as I have been trying to catch up on prerequisites… I was hoping to give insight to people who are applying as far as where I wish I would of changed things.

 

What I did right:

- Shadowed PA's during undergrad: this is very manageable with a class schedule and social life.

- Got close with a PA: if you shadow a PA get close with them, ask them lots of questions, invite them to coffee, etc. They will be more than happy to help you along later with letters of rec.

- Researched the pre-reqs I needed early and aimed above to broaden the schools that are applicable.

 

What I have been struggling with:

- HCE in general.

 

I got my EMT last spring knowing that they are employed in many different environments. What I did not know is that the market is really saturated with EMT's and it is hypercompetitive to get a job just about anywhere. Because of this many EMT jobs require additional certs (IV, EKG, ALS, etc.) which can add months and months (maybe years) - not to mention dollars on dollars to achieving a position. Had I looked into this more I would of forgone the EMT certification as it is costly and employment opportunities are sparse. 

 

At the end of my EMT certification I was offered as job as a medical scribe which has taught me a lot, don't get me wrong, but it feels very limited and I would say 50-60% of schools will accept it - but many won't and many will count the time, but weight it less against other forms of HCE. 

 

This brings me to where I am now, which is entering a CNA program. There seems to be many jobs for CNA that require less experience and no additional certs. CNA is also cheaper and can be done more quickly. Further the types of facilities that employ CNAs are much more broad. Also, all PA schools accept CNA hours making it universally appealing - I wish I had pursued this much earlier than I did. 

 

These are just my thoughts, I hope others weigh in on this… 

[rcreek]

As a recently accepted student with almost 5 years of experience utilizing my EMT certifications, I just want to say that it can be done. In my state the EMT job market is also hypersaturated. I have pretty much always worked in a clinical setting, rather than out in the field. There are many things EMT's can do besides working with an ambulance service. The ace in the hole for me has been my experience as an ER Tech.

 

CNA is a good route too, and it is true that it is probably easier to find work. At one time I considered getting a CNA cert for the same reason, to allow me to apply to more jobs. In the end, CNA just wasn't for me.

 

I think this is a very helpful post. Gaining quality HCE can be tricky, especially while juggling college courses.

[D.C.]

Try to network. It's hard, but it will pay off if you put some effort into it. Ask friends, family, classmates, co-workers, former co-workers, the guy you're stuck in line with at the post office if they know anyone who works in health care. Talk to that person about your career goals. Don't ask for a job outright, but ask them to let you know if they hear of any open positions. WIth EMT and CNA you should be able to land a decent job eventually. After I passed the CNA exam it took me 4 and a half months to get a job.    

[EMEDPA]

shoot for HCE that EVERY program will accept. if you get your hce in something accepted by very few programs you really limit yourself when it comes time to apply.

even places that say they accept certain forms of low level experience will still rank it below more accepted forms. one of my local programs has 3 tiers for hce with points for each tier.

top tier is paramedic/rn/rt/lpn/military medic

second tier is cna/emt/medical assistant/xray tech

third tier is clinical research/scribe/lab tech/phleb/etc

if you apply to that program with 3rd tier experience in a year that everyone else has 1st and 2nd tier you will likely not get an interview.

[NathanLe]

CNA jobs are like phone jobs - there is so much turnover and there are always job openings. For me, CNA was a great way to get my foot in the medical door. Even though the position did not add a lot to my technical/clinical knowledge base, I learned a lot about patience, empathy, communication, and the reality of death in healthcare.

 

After being a CNA for 6 months, I was lucky enough to find a position in an imaging center helping to prep patients for MRI and CT scans. I take patient histories, do IVs, draw blood, run EKGs, etc. Training was all on-the-job. These kinds of jobs are less common, but they are out there if you keep your eyes open. 

 

It sounds like you know what to do, wesr_gordon. Good luck!

[PM2PA]

Paramedic school? But it seems you're just looking for a job that gets you quick HCE. I would also forget taking the actual 2 week course for CNA and just test out if you're able to. I had a EMT friend who did this and just bought the book and read through it.

 

 

 

[EMEDPA]

"quick hce" is not the goal. quality hce is.

it's a process that should take several years, not several months.

[Timon]

I did my EMT + Phlebotomy (ASCP) + EKG Tech (NCCT) + ACLS/PALS/NRP within 4 months (took 2 months off after phlebotomy to study & spend time with fam etc). I networked my way into 4 job interviews and was offered my ER Tech job on the spot at 3 of the hospitals. You gotta do the whole thing and do it right / smart. If you have an "in" at someone's cardiology clinic then find what you need to get to work there (EKG tech?). Have someone you knew that's in surgery (surgical tech?). I knew a lot of physicians in varying specialties so all I did was ask them "how does someone get hired as an ER Tech?" And that basically segwayed into them introducing me to the director of the ER. Put on a little charm and show them you're driven, will be a hard worker, humbled, and have just the right amount of intelligence (not too smart but not dumb) to do the job and you're golden.

 

Moral of the story is make yourself a desirable candidate and utilize your resources. In EVERY industry (not just healthcare) this is how it works. No ones got time to look through 5000 resumes. Get that warm introduction and a foot in the door and make them want to have you around. Sales 101.

 

Keep your head up and keep trying!

 

Best of luck!

[EMEDPA]

also try not to deal with HR if at all possible. try to deal with the folks directly responsible for the area you want to work in(director of ER, chief of surgery, etc).

HR is focused on filling jobs that are already posted. other folks are focused on getting the coverage they need, even if it means creating a new position just for you. you need to make them know that they need you and then let them create a spot for you...this has worked for me at MANY places over the years. My first job was a direct result of talking to someone about PA staffing at a place that didn't have much. several later jobs were the result of persistence and cold calling folks in charge. my most recent job I applied for every year for 10 years. they finally hired me even though they didn't have a position posted.

[rev ronin]

"quick hce" is not the goal. quality hce is.

it's a process that should take several years, not several months.

... because HCE is not just something one needs to get INTO a PA program, it's the framework upon which clinical understanding is hung. THAT is why it's required for any real PA program.

 

I was taking an RMAP class (http://www.remotemedical.com/Integrated-Medical-Services/Remote-Medicine-for-the-Advanced-Provider-RMAP) (which I HIGHLY recommend) a few weeks ago, and taught an experienced ICU RN how to do a prehospital BLS evaluation in an hour or so.  She had all the prerequisite medical knowledge, but had not put it together in that way before--she noted that she was much better at taking and giving report.

[EMEDPA]

... because HCE is not just something one needs to get INTO a PA program, it's the framework upon which clinical understanding is hung. THAT is why it's required for any real PA program.

 

yup, what he said.....

also, I hope to take the RMAP class in a few years when done with my DHSc. not a whole lot of free time until then...

[wesr_gordon]

A lot of good comments, let me rephrase 'quick.' For those of us who need to work and can't afford months and months of training to get a job I meant CNA was a fast way to get working and get HCE - I don't mean it as a quick way to cheat yourself into HCE. 

 

Obviously more training is better and will make you more well rounded in the long run.

[Epangerl]

For those that got their HCE through EMT-B, which additional certs did you have or would you recommend and how did you get them?

 

I've got my heart set on EMT because I'm a lapsed first responder / EMR and enjoyed the intro to training, no interest in CNA even if it would be easier to get the HCE hours that way. I actually want to be an EMT and learn as an EMT for my HCE hours. I plan to take EMT-B and EMS certificate (EMT-B plus 7 cr of "advanced interventions" with ride alongs and a 3 cr communication course) at the local cc, but a local healthcare org also offers EMT-B plus other courses (ACLS, PALS, rhythm recognition). (I also wanted to take a wilderness first aid course through a local store, but that's partly because hiking is our family pastime.)

 

Would you go through the cc (established program where I took fr, convenient location and time, gpa boost) or the local healthcare org (presume contacts within org, slightly less tuition)? Which certs to take from which entity?

[Guest JMPA]

I have been pursuing polishing my PA app for about three years now.

 

I have applied through CASPA once (invited to two interviews that were subsequently canceled) and all the 'no' responses were due to lack of HCE. 

 

I had not decided on PA until the near end of my undergrad so it has been hard to get the HCE hours as I have been trying to catch up on prerequisites… I was hoping to give insight to people who are applying as far as where I wish I would of changed things.

 

What I did right:

- Shadowed PA's during undergrad: this is very manageable with a class schedule and social life.

- Got close with a PA: if you shadow a PA get close with them, ask them lots of questions, invite them to coffee, etc. They will be more than happy to help you along later with letters of rec.

- Researched the pre-reqs I needed early and aimed above to broaden the schools that are applicable.

 

What I have been struggling with:

- HCE in general.

 

I got my EMT last spring knowing that they are employed in many different environments. What I did not know is that the market is really saturated with EMT's and it is hypercompetitive to get a job just about anywhere. Because of this many EMT jobs require additional certs (IV, EKG, ALS, etc.) which can add months and months (maybe years) - not to mention dollars on dollars to achieving a position. Had I looked into this more I would of forgone the EMT certification as it is costly and employment opportunities are sparse. 

 

At the end of my EMT certification I was offered as job as a medical scribe which has taught me a lot, don't get me wrong, but it feels very limited and I would say 50-60% of schools will accept it - but many won't and many will count the time, but weight it less against other forms of HCE. 

 

This brings me to where I am now, which is entering a CNA program. There seems to be many jobs for CNA that require less experience and no additional certs. CNA is also cheaper and can be done more quickly. Further the types of facilities that employ CNAs are much more broad. Also, all PA schools accept CNA hours making it universally appealing - I wish I had pursued this much earlier than I did. 

 

These are just my thoughts, I hope others weigh in on this… 

yes the job market for emt may be saturated but you always have the option of joining a volunteer squad

[EMEDPA]

EMTs also can work as er techs, work at urgent care ctrs, work for the forstery service, etc.

I worked as an er tech for years before medic school. great experience.

[taotaox1]

Volunteer squad is nice, but most places require paid HCE.

[jtmathew]

As someone who is serious about the PA career, I have made the decision to get my associates in nursing and become a licensed RN. I have re/taken most of the courses that are required to obtain an ASN in order to get into PA school but have struggled with the HCE issue. It will take me 1.5-2yrs to complete the ASN but, after consulting my PA mentor, I have decided it is a worthwhile decision. I currently work as a tech at a hospital but am not receiving any attention from ADCOMs for several reasons, lack of quality HCE being one of them. I have also found that I am EXTREMELY limited in the tasks I am able to perform as a tech in the hospital for which I work. After consulting several PA's, I have decided to get the ASN and become part of the diagnostic process. I want experience that will allow me to become part of the treatment process instead of a bystander who stocks carts and wipes butts (important, dont get me wrong). As an aspiring diagnostician, I dont know why anyone would want to shortcut this aspect of their resume.

[rev ronin]

For those that got their HCE through EMT-B, which additional certs did you have or would you recommend and how did you get them?

Before I went to PA school I took ACLS prep, which was a 4 hour class with intro to ECG, ACLS, and Basic IV therapy.  I did all of those classes through one AHA training center who also did a bunch of other classes.

 

Since then, I've taken a lot of other classes that are available at the BLS level, and that I recommend:

* AMLS--really good about medical problems.  Of all of them, I think it's the most generically beneficial for pre-PAs.  It's a newer course

* PHTLS--Good course, trauma focused

* PALS--ACLS for babies, probably not that useful unless you're going to do peds all the time.

* NRP--PALS for infants and preemies, probably not that useful unless you're doing L&D.

* ABLS--very niche, in depth class, but a great one-day class.

* WUMP--Lets you upgrade your EMT to a Wilderness EMT, and does a bunch of austere medicine; whole week of training, but quite a great investment.

 

Of course, there's no substitute for actually running calls, but if you're able to get training in, it's a lot better than doing nothing.

[NileCrok]

shoot for HCE that EVERY program will accept. if you get your hce in something accepted by very few programs you really limit yourself when it comes time to apply.

even places that say they accept certain forms of low level experience will still rank it below more accepted forms. one of my local programs has 3 tiers for hce with points for each tier.

top tier is paramedic/rn/rt/lpn/military medic

second tier is cna/emt/medical assistant/xray tech

third tier is clinical research/scribe/lab tech/phleb/etc

if you apply to that program with 3rd tier experience in a year that everyone else has 1st and 2nd tier you will likely not get an interview.

 

EMDPA, what is your opinion of getting HCE by working as a physical therapy aide (referred to as "rehab aide" in some facilities)?

[EMEDPA]

EMDPA, what is your opinion of getting HCE by working as a physical therapy aide (referred to as "rehab aide" in some facilities)?

it's good experience. we had several in my program and they all did well. it's not top tier experience but certainly every bit as good as cna or similar positions.

[NileCrok]

it's good experience. we had several in my program and they all did well. it's not top tier experience but certainly every bit as good as cna or similar positions.

 

Good to hear. If someone has the opportunity to work as a PT aide in an inpatient setting such as a hospital (mostly taking care of elderly patients and those who've recently had surgery) as opposed to an outpatient physical therapy facility (I.e., the kind of place patients go for their 45 minute weekly PT session for 6-8 weeks), which one would you advise a pre-PA to apply to work in? Everyone tells me to shoot for working in the outpatient setting because it's less "icky," but others tell me that outpatient PT aides do almost nothing involving direct patient care.

[dreatx]

I'll say this: in 2006 I started thinking about becoming a PA. Now I'm a 5 year paramedic in a busy 911 system. I've gotten to see all kinds of things, I know what it's like to be at fault in a bad patient outcome, I've gotten to run codes, delivery a baby or 2, learn some pharmacology plus I've treated sick people and trauma patients. I would have hated to have all that sprung on me in PA school, for the first time.

 

Now if I can just get in!!!!

[EMEDPA]

I'll say this: in 2006 I started thinking about becoming a PA. Now I'm a 5 year paramedic in a busy 911 system. I've gotten to see all kinds of things, I know what it's like to be at fault in a bad patient outcome, I've gotten to run codes, delivery a baby or 2, learn some pharmacology plus I've treated sick people and trauma patients. I would have hated to have all that sprung on me in PA school, for the first time.

 

Now if I can just get in!!!!

you made the right choice. you will get in.

[greenmood]

Good to hear. If someone has the opportunity to work as a PT aide in an inpatient setting such as a hospital (mostly taking care of elderly patients and those who've recently had surgery) as opposed to an outpatient physical therapy facility (I.e., the kind of place patients go for their 45 minute weekly PT session for 6-8 weeks), which one would you advise a pre-PA to apply to work in? Everyone tells me to shoot for working in the outpatient setting because it's less "icky," but others tell me that outpatient PT aides do almost nothing involving direct patient care.

Inpatient. One would hope you aren't going into medicine to avoid "icky." If so, boy do you have a wake-up coming. Outpatient aides do direct patient care, but you can't beat the acuity and variety of inpatient.

 

 

Sent from my iPad using Tapatalk

[NileCrok]

Inpatient. One would hope you aren't going into medicine to avoid "icky." If so, boy do you have a wake-up coming. Outpatient aides do direct patient care, but you can't beat the acuity and variety of inpatient.

 

 

Sent from my iPad using Tapatalk

 

Well, it's necessarily ickiness that I want to avoid in general, but I would just like to avoid wiping butts/giving baths as part of my HCE. I understand that CNA's spend much of their time taking care of those tasks, so that's one of the reasons I was interested in becoming a PT aide. Right now, the only part-time jobs posted in my area are for outpatient PT aides, so I might not have any choice in the matter.