HCE Advice

[usk92]

Hi everyone -

 

I'm new to the forum, so I apologize if this topic has already been covered. I filtered through the search and didn't find what I was looking for, so hopefully I can get some advice here :)

 

I am deciding what the best route for healthcare experience is. At this time, I am choosing between EKG Technician and Phlebotomist. Does anyone have any input one way or the other? Any pros/cons/suggestions are appreciated!! 

[Arthropathy]

Phlebotomy. More varied pathophysiology to see.

[EMEDPA]

a more broad based skills set like medical asst. or emt would be better. both ekg tech and phleb. are skills done by other folks as a small part of their jobs and by themselves are fairly low quality experience.

ER techs for example do ekgs, splints, phleb, Im injections, neb tx, dressings, assist with minor surgery, cpr in codes, etc.

[Patho]

The office where I did my phlebotomy rotation had phlebotomists draw blood and perform EKGs. 

 

Just curious, why do I often see medical assistants as being high quality experience for PA school? Is it the fact that they have face to face interaction with patients that counts so much?

[LESH]

The office where I did my phlebotomy rotation had phlebotomists draw blood and perform EKGs. 

 

Just curious, why do I often see medical assistants as being high quality experience for PA school? Is it the fact that they have face to face interaction with patients that counts so much?

Disclaimer: This is only the experience of an AARP PA, so take it for what its worth. I'm not saying one HCE is better than another. Just providing observations to answer the OP's question.

 

It depends upon what the MA is allowed to do. Practices seem to vary on how they utilize MAs IMHO. I have always advocated for MA HCE for a few reasons. They usually had a primary care background and tended to go back to primary care to practice as a PA. (I know, my bias, but I'm old and set in my ways).

 

The level of clinical and patient care responsibility tended to be high especially those coming from rural and urban clinics. Most have worked closely with PAs or NPs and were usually encouraged and recommended by those providers to become PAs. Like the ER techs that EMED mentioned, I have worked with MAs in FP and UC clinics that had a broad skill set. I have also seen that skill set be helpful as a PA student. Especially during the clinical rotations.

[Joelseff]

Phlebotomy. More varied pathophysiology to see.

Really???

[Joelseff]

The office where I did my phlebotomy rotation had phlebotomists draw blood and perform EKGs.

 

Just curious, why do I often see medical assistants as being high quality experience for PA school? Is it the fact that they have face to face interaction with patients that counts so much?

I was an MA for 7 years before I became a PA (before that I was a corpsman and a phlebotomist/lab tech before that) I'm sure my previous experience contributed as well but as an MA not only did I interact with patients I was able to see how my Doc and PAs were thinking clinically. I also got to perform and/or assist a myriad of procedures and got to know IM/PC meds really well. In fact pharmacology was my easiest class in PA school.

[usk92]

so is phlebotomy not quality enough experience?

[EMEDPA]

so is phlebotomy not quality enough experience?

that is a matter of opinion. my opinion would be no, it is not.Neither is EKG tech. you want a broad based skills set like emt, ma, resp. therapy, etc. That means some time attending a cert. course. EMT is 120 hrs. M.A. is 6-9 months. RT, RN, and paramedic are 2 years. The foundation of the PA profession is strong HCE built upon in PA school. A 1 week course is not a foundation, it's a single skill. I learned phlebotomy, ekg, IM injections, and neb tx as part of my basic 1 week orientation to be an er tech after a 3 month EMT course.

Medical assistants(as mentioned above) essentially function as nurses minus IV skills in many settings. At one of my jobs I could not function without the help of my MAs. They also take XRays (some states allow this after a limited xray course of 3 months for MAs). My MAs do everything ER techs do and are used interchangeably with them. I agree with Lesh that they make excellent candidates for PA school and tend to pursue primary care after graduation. One of my former MAs just graduated from Medex this summer and took a full time job at a local family medicine clinic. We also hired her to work per diem in the ER.

[LESH]

so is phlebotomy not quality enough experience?

There are programs that will accept phlebotomy and program's that won't. You just have to do your research. Good luck in your PA endeavors. LesH 

[dndandrea]

Working as nurse assistant would probably be better than an EKG tech or phlebotomist. As a nurse assistant, I was taught how to perform EKGs on the job after my initial training. However, if you have the time and money, I would definitely recommend EMT or medical assistant for quality health care experience. 

 

I work as a nurse assistant in a float pool as PRN. I cannot begin to tell you how much I love it. I practically work whenever I want and get to see everything in the hospital. I work in the ER, ICU, med-surg, post-surgery orthopedics, behavioral health, mood disorder, transport, telemetry, and geriatrics. Not to mention, the staff will treat you well because you're coming in to help their unit when they need you most! The only education required was a high school diploma.

[Chazilla]

I feel that as long as your GPA is good then your HCE could be any of that sort that is previously stated; however, if your GPA is average then maybe you should invest in a heavier HCE load, which would include RN, RT, etc.  You have to have something that out-weighs your GPA and that is obviously by your HCE.

[Joelseff]

^^^ideally you should have excellent HCE AND GPA. If your GPA were low, wouldn't you work hard on bringing it up? If your HCE is low or weak why not do the same?

[EMEDPA]

^^^ideally you should have excellent HCE AND GPA. If your GPA were low, wouldn't you work hard on bringing it up? If your HCE is low or weak why not do the same?

agree you need both and not mediocre both, but stellar both.

[Nonlegit]

I have been saying this for years now on these forums, and I always get my inbox blown to smithereens after I post this. So forgive my brevity.

 

This VAST umbrella of "assistant-type" jobs are really very specific to state, and even office/health system/hospital etc etc. What I mean by this is that I have done almost all of these jobs over the years (still slogging through undergrad), and you have to actively search out the best jobs. This forum won't help you much in that regard. Title means very little. Certifications may or may not be relevant. I couldn't deduce from your post if you had done any schooling or were just persuing a job opportunity, but basically you search for jobs where you get the best experience. I agree, EKG tech and phlebo by themselves are probably not good for depth of experience. I do those things in my job regularly, and they are at most, minor contributors to my job's "experience" value.

 

You need to find what the requirements are to work in a high value type position. This could be at the state level or hospital/office level. Not every doc's office will require an active MA cert to work as an assistant. Ditto nurses aide, ED tech = EMT, etc.

[brenasuarus]

I have been saying this for years now on these forums, and I always get my inbox blown to smithereens after I post this. So forgive my brevity.

 

This VAST umbrella of "assistant-type" jobs are really very specific to state, and even office/health system/hospital etc etc. What I mean by this is that I have done almost all of these jobs over the years (still slogging through undergrad), and you have to actively search out the best jobs. This forum won't help you much in that regard. Title means very little. Certifications may or may not be relevant. I couldn't deduce from your post if you had done any schooling or were just persuing a job opportunity, but basically you search for jobs where you get the best experience. I agree, EKG tech and phlebo by themselves are probably not good for depth of experience. I do those things in my job regularly, and they are at most, minor contributors to my job's "experience" value.

 

You need to find what the requirements are to work in a high value type position. This could be at the state level or hospital/office level. Not every doc's office will require an active MA cert to work as an assistant. Ditto nurses aide, ED tech = EMT, etc.

 

I'll chime in here and give some anecdotal evidence to support this post (which I highly agree with):

 

I worked at a local Family Practice office this summer where I was trained as an MA (no official certification, essentially no medical experience prior to this internship). At the office I got to do the basics: vitals, patient histories, injections, EKG's, EMRs, etc. However, I also assisted in surgery and was taught phlebotomy (which isn't the norm in my experience, but others are free to correct me who know better). After 3 months at the office, I applied to a job at an urgent care facility where I'm now working. They didn't care at all that I was uncertified, so long as I was proficient in the necessary skills. Now I draw blood, assist in minor surgeries, do EKGs, spirometry, drug testing, etc. all of which seems pretty ideal for the HCE that PA schools want. However, I've shadowed at offices where all MA's EVER get to do is take vitals, record health histories, and chart that data. Not all positions under the same name are equal. 

 

tl;dr: Your duties/experiences are not the same in all "(Insert Medical Title Here)" jobs. Further, you may not have to spend precious time getting a certification to get prime HCE. 

[kb1988]

"Not all positions under the same name are equal."

 

Agree with this, and for what it's worth I'm an example of a phlebotomist who got into PA school. As previously stated, some schools will accept this type of HCE, others will not. You'll have to research each school individually. For my part, I worked for about 3 years drawing blood all over the hospital. It allowed me to experience areas like the ICU, surgical, pediatrics, geriatrics, maternity, behavioral health, etc., and the varied patients that came along with each. It also allowed for lots of interactions with both providers and support staff. My specific job taught me some great skills in my opinion.

 

I don't know a whole lot about EKG tech as experience, although at the hospital where I worked they seemed to have the same type of work flow as we did and we often overlapped in patients' rooms. In my personal experience, phlebotomy HCE worked well for me. I think how much money you have, time to spare, job outlook in your geographical location, and which schools you plan to apply to will all determine what decision is right for you. I do know that if it made sense in your situation, EMT is considered fantastic HCE pretty much everywhere. Good luck to you, and let me know if you have any other questions!

[GoHokies]

I didn't want to start an entirely new thread, but these kind of questions are ones I'm struggling with. I'm 28, went through undergrad with an engineering/business focus, but I'm realizing that I'm leaning towards the PA route more and more.

 

Starting with zero medical background, I realize I have several years before I'm able to apply anywhere (as well as using that time to decide if it's really right for me), but I'm at a loss on how to get HCE without taking a fairly hefty pay cut in the interim. I'm in central NC, and all the programs I'm seeing have specific exemptions of volunteer work, which I'd assume would mean those weekend shifts with the local rescue squad are out.

 

I'll likely go the volunteer route anyway to test the waters, see if I like it - but are there types of HCE that are more friendly to being a 2nd job?

[EMEDPA]

er tech, cna, etc part time

[Patho]

I'll chime in here and give some anecdotal evidence to support this post (which I highly agree with):

 

I worked at a local Family Practice office this summer where I was trained as an MA (no official certification, essentially no medical experience prior to this internship). At the office I got to do the basics: vitals, patient histories, injections, EKG's, EMRs, etc. However, I also assisted in surgery and was taught phlebotomy (which isn't the norm in my experience, but others are free to correct me who know better). After 3 months at the office, I applied to a job at an urgent care facility where I'm now working. They didn't care at all that I was uncertified, so long as I was proficient in the necessary skills. Now I draw blood, assist in minor surgeries, do EKGs, spirometry, drug testing, etc. all of which seems pretty ideal for the HCE that PA schools want. However, I've shadowed at offices where all MA's EVER get to do is take vitals, record health histories, and chart that data. Not all positions under the same name are equal. 

 

tl;dr: Your duties/experiences are not the same in all "(Insert Medical Title Here)" jobs. Further, you may not have to spend precious time getting a certification to get prime HCE. 

 

It amazing that you were able to do all of this w/o any formal certification, although I don't think I would want someone sticking a needle in my arm without formal training; not sure if it's even legal.

[PACdan]

It amazing that you were able to do all of this w/o any formal certification, although I don't think I would want someone sticking a needle in my arm without formal training; not sure if it's even legal.

 

Perfectly legal. Most states/hospitals/clinics/offices don't require a specific certification to perform venipuncture. And "formal" training/classes for it are rather useless.

 

1. Find the oldest, snarkiest, most attitudinal nurse you can <3 ...or the person the everyone goes to for the "hard stick".

2. Watch them do it.

3. Have them watch you do it.

4. Practice on the most unconscious pin-cushions...err, I mean patients, first.

5. Improve with every stick.

 

There's not a lot to it except practice.

[EMEDPA]

Perfectly legal. Most states/hospitals/clinics/offices don't require a specific certification to perform venipuncture. And "formal" training/classes for it are rather useless.

 

1. Find the oldest, snarkiest, most attitudinal nurse you can <3 ...or the person the everyone goes to for the "hard stick".

2. Watch them do it.

3. Have them watch you do it.

4. Practice on the most unconscious pin-cushions...err, I mean patients, first.

5. Improve with every stick.

 

There's not a lot to it except practice.

yup, this is how medicine is taught. see one, do one, teach one. repeat with next skill. I learned every clinical procedure this way.

"snarkiest nurse" is actually great advice. I would add crusty as well. generally > 50 yrs old and wanting to turf as much work to others as possible. teach me to do IVs and you can drink coffee when one needs to be started in the dept....:)

[gbrothers98]

Here is some unique advice.

Follow the footsteps of a distinct percentage of PAs.

Enlist in the Army, Navy or Air Force and become a medic or a corpsman.

Not only will you have the prerequisite HCE, you will likely have more varied and indepth experience than your classmates.

You will work alongside PAs whom could write reference letters for you, something I always pay attention to when I interview a candidate.

An added benefit is the ability to get the branch of service to pay for classes while you are active duty and take advantage of the post 9/11 GI bill to pay for that expensive PA education after you separate.

Plus you will get paid nearly as much as a civilian CMA when you take into consideration salary, housing and possibly COLA.

Then there is the life experience of basic training, medic school and then being sent to your first base, post or ship. 

Nothing better.

Good luck.

G Brothers PA-C

[Joelseff]

Here is some unique advice.

Follow the footsteps of a distinct percentage of PAs.

Enlist in the Army, Navy or Air Force and become a medic or a corpsman.

Not only will you have the prerequisite HCE, you will likely have more varied and indepth experience than your classmates.

You will work alongside PAs whom could write reference letters for you, something I always pay attention to when I interview a candidate.

An added benefit is the ability to get the branch of service to pay for classes while you are active duty and take advantage of the post 9/11 GI bill to pay for that expensive PA education after you separate.

Plus you will get paid nearly as much as a civilian CMA when you take into consideration salary, housing and possibly COLA.

Then there is the life experience of basic training, medic school and then being sent to your first base, post or ship.

Nothing better.

Good luck.

G Brothers PA-C

And as a medic or corpsman, you get to do Sick Call which is (outside of FMG) the BEST Pre-PA HCE IMO. I put it up against RN and even paramedic esp if you are going into primary care or UC. You treat all the "Navy Crud" (or army crud... Dunno what u guys call it), a lot of the acute injuries/illnesses, suture, do physicals, dispense meds, and do all the basics like venipuncture and vitals etc. Nothing like it in the civilian world.

[Nonlegit]

It amazing that you were able to do all of this w/o any formal certification, although I don't think I would want someone sticking a needle in my arm without formal training; not sure if it's even legal.

A monkey could stick a needle in someones arm if trained. Most medical procedures that I see that I used to put on a pedestal (to think many years ago I had to be "checked off" to use the glucometer at the nursing home...) can be taught to anyone without much difficulty. In medicine, it seems like the real skill is knowing when a certain procedure is indicated, as opposed to can one do it. I work with a lot of interns that have started a hell of a lot more central lines than me, yet I consistently will know when a patient needs one or DOESN'T need one before they do. It'll be sitting in the room set up along with the ultrasound machine before they ever ask. Thats the real skill they will learn over residency, and one I will eventually fully flesh out in my own schooling.

 

I have a standing offer with one of our trauma attendings that next open chest, I get first dibs on cardiac massage (bucket list). He promised to coach me on proper technique, and I have watched a couple youtube videos - haha. No formal training on that one for me!

 

I'm not minimizing the skill needed to perform the actual task, it's just that critical thinking combined with skills clearly makes a better provider than merely x number of tubes/lines, etc etc.

 

Re: legality, I have jumped through so many hoops with damn certifications, hospital check-offs and classes, and skills lists, it would make your head spin. The laws vary widely or simply don't exist, leaving it up to facilities. Last hospital I worked at allowed me to me start peripheral lines and perform certain tasks like foley placement, NG/OGs, central line dressing changes, among others. This current hospital doesn't let medics (or regular techs - me) do any of that (and I was NEVER a medic in the first place!). This goes on and on, I have a million of the same stories from state to state, and hospital to hospital. These last 10 years have been a trip. I went from not being able to use a glucometer when I first started to having the OMFS on call girl teach me how to pull a bum tooth a couple of months ago. What a journey it has been.