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18. The end of it all
107 Plays2 years ago
We are done, we made it through PA school! I chat with one of my good buddies as we reminisce about PA school from didactic year all the way to the end. The episode was recorded a week before graduation.
But don't worry I am not going anywhere stay tuned for more hard-hitting interviews!
--- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Transcript
00:00:13
Speaker
Welcome
Introduction to the PA School Experience Podcast
00:00:13
Speaker
to the PA School Experience Podcast. I'm your host, Sebring Sands, and I take you through the behind the scenes look of PA School and explore what it takes to become a PA.
00:00:33
Speaker
If
Tools for Podcast Creation with Anchor
00:00:34
Speaker
you have been wondering how I could do this podcast in PA School, I'll tell you, I use an anchor. This is the easiest way to make a podcast. Let me explain. First, it is a free hosting platform which allows anyone to start a podcast with no upfront cost. It has built-in tools which allow you to edit and record a podcast. You can even record it from your phone.
00:00:56
Speaker
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Guest Introduction: Ragnar Clark and PA School Journey
00:01:26
Speaker
Welcome everyone to another episode of the podcast. It's a pleasure doing these and especially now that I'm ending, we're all our cohorts ending our peace school experience. It's fun to get together with some more people talking about it so we're gonna have a new guest on today.
00:01:47
Speaker
I think you'll really enjoy this conversation and talking about, you know, peace school in general, looking back on it now that we've had almost two, 27 months of experience and the highs, the lows are prospects for the future and all those good things.
00:02:07
Speaker
Do
Approaching Graduation: Reflections and Feelings
00:02:07
Speaker
you want to introduce yourself? I'd love to. I'm Ragnar Clark. I'm a PA student, S3 technically, right? We're in our third-ish cutty. However, they defied that. I don't know. Thanks for having me on the pod. Oh, thanks for coming.
00:02:22
Speaker
It's actually surprisingly hard to get people on the podcast. I don't know if it's just our cohort. I think they're just very humble and modest, and they don't want to be self-promoting. I don't know. I feel like approaching the secret like, hey, do you want to go on the podcast? I've only had one rejection, but most of the people. It's good that you wanted to come on. See, I had none of those reservations. Happy to showboat all day.
00:02:50
Speaker
You and Sawyer yes on the box. Let's do that So I kind of wanted to talk first about Peace school now that we're pretty much almost done. We graduate in a few weeks and like like a couple weeks and
Cautious Optimism and Exam Preparation
00:03:08
Speaker
I still don't, like it still doesn't feel real, you know? Yeah. I've had, I don't know, I was a little nervous just because we have some summative exams. And now that we're past our Oskies, I'm like, yes, like it's, it's more certain that's going to happen for me at least. I still don't like.
00:03:27
Speaker
I don't want to be cautiously optimistic about. My entire career in PA school, I have gone into things being so cautious with everything to the point where I have had some classmates tell me that it is obnoxious because they're like, you're going to do fine. But in my head,
00:03:48
Speaker
Very legitimately, I don't believe that, you know? So I understand the sentiment. I think, like, Oscars were the thing that I was very nervous for. That
Clinical Year Insights and Medical Challenges
00:03:58
Speaker
was, I mean, they're always a bit of a, at least in our program, you know, it can be a bit of a wildcard type deal. So I was very much like, okay, focus on this. And now that that's done, I'm like, maybe there is a light at the end of the tunnel, you know, like I'm starting to just kind of see it.
00:04:14
Speaker
Yeah, very much. Same feelings about it. So how was Peace School for you? Overall, how was it? It was, wow, I very like, it's very complicated to explain. I would say overall, I really have loved it. I'm not gonna say I've loved every single aspect of it, but like it was, you know, a bit of a trial by fire for sure, but I
00:04:42
Speaker
I would say that clinical year especially was so helpful in figuring out what I love and what I hate about certain aspects of medicine and just kind of feeling, especially a lot of rotations, I felt like I'd be able to kind of
00:05:00
Speaker
flex my muscles a little bit and like really feel like putting, being put in the shoes of an actual provider, right? And learning just how to navigate all those things they don't teach you. You know what I mean? Like Pants Prep Pearls is not going to tell you like how to navigate the actual healthcare system. And
Reality vs. Glamour in Medical Training
00:05:17
Speaker
so like actually going out and like being dropped in these, you know, different five week scenarios has been, I think like really, really fascinating to me.
00:05:25
Speaker
So I would say overall, I'd say positive. I would say didactic year was like that was like me in survival mode, for sure. I think a lot of other people would agree that it's like you keep trucking as much as you can and and hope for the best, you know. Yeah, very much so. I think I was telling someone about this is we, especially on clinical year or maybe even before PA school, we are interacting with PAs
00:05:55
Speaker
You have this survivor bias of like people that went through it and they're looking back on it and you don't realize how like intense and rigorous and like of a struggle it is until you're actually in it.
Study Demands and Survival Mode in PA School
00:06:09
Speaker
I feel like also YouTube they really
00:06:15
Speaker
Shh glamorize either medical school or peace school. There's not a lot of peace school ones, but they definitely glamorize Medical school, but it's it's drudgery a lot of the time. It's like getting up in the morning 12 13 14 hour days. It's in France and
00:06:34
Speaker
I think people don't realize that not to discourage anyone but it is difficult and I feel like that's one of the reasons why I did this podcast to help people realize it's just not me having a hard time everyone's having a hard time oh my oh my gosh I like I remember
00:06:53
Speaker
I would go to class. I would try to go to the gym in the morning, maybe, depending on the day. And then I would take notes in class, obviously. I would go home, and then I would make an anky or anky deck of all of the lectures and maybe try to go over them once. But it was like constant studying. I remember that was just how I digested the material best.
00:07:20
Speaker
And that was like so like, you know after what a 10 12-hour day I would go home and still do at least two to three hours if not more sometimes sometimes a lot more of Studying like I know some people like oh I took every Saturday off. I was like, no that was not Physically how I could do that, you know, I wish probably looking back that I had kind of like cut myself a little bit more slack But I was so
00:07:44
Speaker
like I think the whole like scared straight method you know of like you know this is your cutoff for exams like I was so like it felt like it was so high you know that I was like I just don't even want to be near that point it was which was kind so like like when I say like survival mode it was just like I didn't even like I was like I have to like hit the ground running all the time and that was that was hard
00:08:07
Speaker
First trimester, I feel like I did it pretty successfully. Second trimester was, I talked to my mentees about this, I took them to a coffee shop, and I was like, listen. I was like, first trimester, you're gonna be like, you're figuring stuff out, that's okay. You're gonna have moments where you're like, oh, I shouldn't have done that, that's fine. You kind of adapt your study skills. I said, for me, second trimester, no matter what I did, I felt like I was always treading water.
Differences Between PA and Medical School
00:08:32
Speaker
I and like you know I came out of it I survived obviously we both did but I do remember being like wow that was like a lot there was just like the stupid fire hose you know drinking from a fire hose analogy that everyone throws I was like oh my god this is it this is it
00:08:48
Speaker
I just said to for a little bit of context, my mother is a family practice doc. You know, she went to med school in the early 90s. And and I would come home for like Christmas and I did she ask me like what I was studying. And I was like, well, in the last month, and I'd talk about all the body systems, everything. And she was like, we spent weeks and weeks and weeks on like one of these small subjects. And I was like, Yeah,
00:09:12
Speaker
I know. This is all of med school in a year, is what it is. Obviously, we have to kind of go high level over some things. We're not getting deep into the guts of the pathophys that maybe a physician would, but that's the point of the program, right? So it was very interesting seeing the difference between the two and how even she was like, I don't know if I could do that.
00:09:39
Speaker
I feel like medical school, well I haven't gone to medical school, so disclaimer. But the thing about physicians is they have a lot of more specialized knowledge based specialties than we do. They have pathology, like being a pathologist you need to know histo
00:10:01
Speaker
histology, but we didn't even cover that at all. Really. It's barely like mixed in a little bit here and there, mostly for our boards and exams. And we don't have to know biochemistry because none of us are going to be, you know, PIs in a research lab that some might be able to do that track.
Clinical Rotations: Bridging Theory and Practice
00:10:17
Speaker
So I think those little, not so much fluff, but
00:10:21
Speaker
We really take the core out of like medical school for PA school. And I think that's what leads to our high level of education. Obviously, like we're not as trained per se as a chief resident because we haven't been working. We've just been in the classroom, but we still have a really high quality, at least for our program, high quality education.
00:10:47
Speaker
that would helps us be good practitioners in the clinical space. I 100% agree, I think that like, especially being on rotations, clinical rotations with like first and second year med students, a lot of them
00:11:02
Speaker
Immediately throw these like like if we're being you know pimped by a preceptor they immediately like in my experience will throw Like pathophys stuff at a question because that's what they've been you know Really taught a lot of and like and we're like and I was like, oh, this is attention demo because the trachea is deviated You got a needle decompress it
00:11:19
Speaker
And they were like, yes, that's the answer I was looking for. It's kind of like, so we're kind of taught this more like, I'm not gonna say more practical, because that's not exactly true, but like you said, because we're not learning in this step necessarily, this step-wise, we learn all the pathophys of this, and then we'll talk about manifestations, and then all clinical stuff. I feel like we kind of get a bit of a jumpstart in that regard.
Gaining Confidence Through PA Training
00:11:44
Speaker
Obviously, once these med students
00:11:47
Speaker
finished you know their four years of med school however many of residency like obviously they're gonna have more knowledge than us because they have what four times as much education like of course they are you know I've that's the thing is I remember going into clinical year and I was like I I'm not gonna know
00:12:06
Speaker
I feel like almost anything you know and that's okay right like my point is I'm supposed to learn I kind of try to go into any rotation like a sponge just sucking up anything I can get who can never you can give it to me right because like the PA school is so short compared to you know like what a physician goes through and with the experience
00:12:28
Speaker
Like when you're on residency, like you are doing that job, right? You know, like you're, you're living it. That's the whole point. Um, whereas we get these little five week segments to just like, you know, try to absorb as much as possible. And then we move on to another one. So I think like, uh, it's, it's just a completely, it's different. That's the only thing I can say it's just different, but eventually we, it all rounds out, I think in the end, you know, after we worked clinically for a bit and stuff.
00:12:52
Speaker
Yeah. I mean, definitely at the beginning of didactic here, I was like, how am I supposed to be doing medicine after two and a half years? But at the end, really the process really helps you feel confident enough to, you know, start at a job, obviously going to be.
00:13:10
Speaker
There's going to be some growing pains of learning things clinically, but you have a lot of the basics that you could build off of. And I don't know. I feel like I don't quite agree with this notion that physicians.
00:13:25
Speaker
will always know more than PAs. Sure after training they will, but I feel like that the level of knowledge is only dependent on your willingness to learn over your career. I feel like the sky's the limit and it was interesting to hear of PAs going back to medical school
00:13:51
Speaker
And their most cited reason was they wanted to have as much clinical knowledge or whatever knowledge as physicians. But I feel like that's totally doable if you make that a priority in your career. Yeah, let me be clear. I think that it's more just like if
Transitioning from PA School to Practice
00:14:08
Speaker
you are taking the experience of a fresh PA grad or a fresh, you're set at different places, right? But after five years practicing clinically,
00:14:19
Speaker
like this all levels out i really i firmly believe this like i've met several pa's who like i was like i especially in an outpatient setting you know and you know beyond i was like you're doing the same exact things that this physicians do like to a t um and you know i agree with you too though like you know if you want your education to stop wherever you feel comfortable and feel complacent that's fine
00:14:44
Speaker
I know, I mean, for me, that's not at all the way that's also just not the way medicine works, right? Like, that's how you become the practitioner who, you know, doesn't prescribe the right antibiotics, because that's what they've always done. That's the practitioner who, you know, doesn't like to stay up to date on things. And I feel like that's a
00:15:00
Speaker
kind of it's a bit of a silly mindset to have. I do think that and what's interesting about our profession is because we're able to kind of move between different specialties as much as we really as much as we please, right? You know, I think it's like there's a lot of opportunity to learn so much and to expand our knowledge base beyond, you know, what some other professions can do.
The Journey Through PA School vs. Med Alternatives
00:15:21
Speaker
Yeah, obviously like in surgery, we will never be the love of a surgeon because that takes bajillions of hours of training, especially training, but I won't even want to do that anyway. It's that stressful because it comes with all of that comes the baggage of.
00:15:37
Speaker
like being on call, having to be there because you are the one that knows it all and has to be there, the top dog. The buck stops with you at that moment. That's nice being a PA in that role where you have coverage and you're not, you know, so anyways, that's a really good aspect of becoming a PA. But no one tells you this.
00:16:02
Speaker
You don't really know this until you go through PA school and you've seen residents or interacting with attendings because you really don't get a good idea. You just have to stick to the cliche things in pre-PA and just hopefully every PA student gets the confirmation that they have chosen the right medical path because
00:16:26
Speaker
it has for me and it has for many other people I know and it's a great feeling when like yes I've avoided many things that could be bad so
00:16:36
Speaker
Yeah, that's really awesome. I entirely agree. Yeah, I think I don't regret anything about going to PA school. I will say, obviously, now being on the other side of 95% of the trudgery. It's like, oh, yeah, it's so great. But looking back, I was like, no, this was definitely a struggle. I won't say that it's not.
00:17:04
Speaker
You know one thing that I really wish that people would understand is they it's like there is this sentiment kind of For people who haven't gone through PA school. Are they like like oh, well med school is too hard. I'll go to PA school It's like ooh, I let's let's calm that down a little bit because I you know, like this is Yes, they're different like I'm sure there are there are definitely aspects of med school I'm sure that are much harder than PA school, but I can also say like the
00:17:28
Speaker
the volume and the pace. Like, this doesn't slow down, you know what I mean? I remember talking to some of the younger class and they're like, oh, I just wish that they would slow down with lectures. And I was like, they're just not going to. They physically, like, if you want to get out our program, which is longer than some programs, right? I was like, they physically can't stop. And that's what's difficult about it is there is no like, hey, let's pump the brakes. It's like, nope, you have to just, you have to keep going. And that's a big challenge.
00:17:57
Speaker
I remember in a few months ago, I was like, why couldn't I have learned this? Or someone was mentioning this, like, oh, we learned it all in didactic here. And I was like, I forgot most of didactic here. And then I came back to some lectures, like, this is why.
Learning Through Patient Interactions
00:18:13
Speaker
Because it's literally you have no time to study, especially me having a wife and a daughter, having my left's time. Because I have to spend time with them, and I have to sleep, and I have to eat, and all this other stuff.
00:18:25
Speaker
And I just felt like I was cramming all the time. Every exam I was cramming for it, dumping it, and then moving on to the next one. And you do retain some things. And I thought, you know, I did pretty good retention on the PACRAT. I was like, 50%, that's amazing. I was like, I guess I wasn't up to the standard of some people, but by the end of clinical year, I feel like, yes, you really kind of,
00:18:57
Speaker
kind of have a confidence and it grows with each clinical orientation. I think it also like, the confidence grows. I also think one, seeing a condition that you're not that familiar with, you know, like a lot of us like worked, you know, took a couple couple or more right, you know, years off between undergrad and PA school. I know I took three, I worked, I was described for a bit and then I was a medical assistant in outpatient Peds office and like I,
00:19:24
Speaker
that like so i saw like a lot of the like you know the classic peds complaints right but like i did not see heart failure and so i remember thinking like like i was like oh it's like really hard for me to like see this because we talk about it and all these like abstract things and then like you do like internal medicine or you do emergency medicine you see someone in an acute decomp state of heart failure and you're like you you know the classic findings you hear the crackles and like you see the edema and you're like oh this is it so like seeing
00:19:53
Speaker
These like like these really sick people and being like, okay That's what that looks like like clinical you're really kind of like pulls it together because you're like, okay I can see a person with this I can see the spectrum of disease like I remember like like and and I was talking to some other PAs my most recent rotation was the emergency room and
00:20:12
Speaker
And I remember she was a PA who does mostly pediatrics but would do some adult stuff too because that's what they needed at the time. And she was like, you learn by doing, especially after clinical year when you're done. She was like, you will see something and you haven't seen it before because you've only had two years to figure this out. And she was like, and you will never forget it. And I was like, that's super true.
00:20:37
Speaker
Because there's always several cases for all my rotations that I've been like, that's what that is. And it's so helpful to be able to then kind of go back and look at your notes from didactic gear and be like, this is what they're talking about. And
Overcoming Health Challenges in PA School
00:20:51
Speaker
also for real life medicine to be like, what they teach you in didactic gear and what happens in the real world are sometimes two vastly different things. And you'll spout that textbook answer to your preceptor and your preceptor will be like, no.
00:21:05
Speaker
will flat out tell you that that's not real so it's just which I actually like it's just very interesting to kind of see how the dichotomy right and how different it is. Yeah that's very true. So what do you think your high and low didactic here was? Your non nuanced answer. I will say
00:21:29
Speaker
my low was definitely having like a stress-induced seizure at the start of yeah the start of um i remember something happening to you but oh yeah i wasn't in the know so it was uh january it was it was a martin luther king day weekend i
00:21:48
Speaker
I was, it was like, that was like just the start of a second trimester. And I was like, you know, we hadn't even really like gotten into like the meat of potatoes of anything. And I was like, feeling good. I split a bottle of wine with my girlfriend that night. Like, and that was it. I went to bed. I woke up at two in the morning and I was like, my arms sore. And my girlfriend was sobbing over me.
00:22:11
Speaker
And she had called 911 because I had a full on tonic colonic seizure. I dislocated my left posterior left shoulder and popped it back into place. That's crazy. And I had an avulsion fracture. I had to go to the absolutely.
00:22:26
Speaker
I was like admitted to Stanford Hospital. And I had to do the like the male GU practicum like the next day. And so I was like penning this email with one hand to be like, hello, I'm like actually conceited from my window. I won't be able to make it. They were like, oh my God. They're like, don't worry about it. They were like very good because obviously like I can't do that.
00:22:53
Speaker
It
High Points During Clinical Rotations
00:22:53
Speaker
was it turns out it was like an idiopathic like it was I was on a medication that just happened to Just lower it enough. I don't have a history of seizures and they just took me off the med and they were like You know, they did some testing everything was fine So I don't have epilepsy
00:23:10
Speaker
it was they think it was just i like i've talked to several faculty about it because i was like this is weird my neurologist was like i don't know um and they were like yeah they think it was like just like like even though i didn't feel actively stressed in the moment they think it's just like in the background it was just enough to like set me off
00:23:29
Speaker
I have not had a seizure since. My arm recovered perfectly without surgery, but I did have to walk around in a sling for several weeks, which was fun, yeah. So that was definitely my low. And what's funny is I just woke up, I took a nap, I woke up and my arm was sore. That was it.
00:23:48
Speaker
My girlfriend was the one who had to watch this happen. I felt so bad for her. She definitely has like PTSD, like some PTSD from it. If I twitch in my sleep, she freaks out. It's like a whole thing. I feel bad. Anyway, so that was definitely my low, because I was like, okay, I'm going into PA school for broken shoulder and all this second trimester.
00:24:12
Speaker
So that definitely put me a little further into survival mode for sure. So that was definitely my low. My high of PA school. The end? Oh my gosh, right.
00:24:34
Speaker
I almost want to be like, yeah, be like when I can just finally write this off and never walk into the tent again. No. One of my highs I think was it was like my first clinical rotation and I just always come back to this. Like I probably had other moments like academically where I felt like I did better, but I felt I was very proud of this. It was my first rotation, it was family medicine and I was talking to a patient
00:24:59
Speaker
And I loved my preceptor. She was really good. She was a PA too. And she was like, yeah, just go talk to this lady. She had shingles. I saw her a couple weeks ago, had a shingles flare, and she was coming in for headaches. And she was like, yeah, I have this pulsating, sharp tapping headache right here. And I was like, on your temple.
00:25:16
Speaker
And she was like, yeah, it like wakes me from sleep. I was like, wakes you. And I was like, and I did, you know, she was just like, oh, and she was like confused because she, she was like, I think it's an ear infection.
Academic Humility and Peer Support
00:25:27
Speaker
She had this history of this like awful like MRSA ear infection that she had to have like degraded like years ago. And I was like, okay, I took a look. Everything was fine. And, and so I was like, you know, I was able to like tap and she was like, yes, this hurts. And I was like, I think you have GCA.
00:25:44
Speaker
and I was like I know and like you know obviously they tell you like oh don't look for zebras on your rotations it's not gonna and so I went to my preceptor and I was like listen I know that this is so crazy like I was like and it's probably not this I was like but she's a horrible vascular path to begin with like she has all this other stuff going on I was like maybe we just do some screening tests and my preceptor was like
00:26:07
Speaker
yeah like you know what i wouldn't have thought of that but sure let's do some screening tests her esr and crp were through the roof oh man and we had to get a biopsy and she had gca oh so like i was like wow yeah i was i know i was like yes like i was like i'm not crazy um didn't have like a i feel like a breakthrough moment so it was all downhill from there for clinical actually but oh okay well you're skipping ahead so
00:26:35
Speaker
Low, no really highs in didactic gear it sounds like. I mean I would say like if I had to split up so like that was clinical year didactic year I would say like one of my highs I think was
00:26:50
Speaker
This is so stupid. I got like a 100 on a farm test. What? Oh man. And it was. But hold not on me. It was like the, the one that like a bunch of people like didn't, it was like, Oh, that's the one I feel. It was hot. So like, but I, when I, when I say to you, like I walked out of that test being like, I think I got a 2% on that. Like I was like, I do. So I think like one, he threw out all the questions I happened to guess wrong. Like,
00:27:16
Speaker
Because I was like, I don't feel comfortable. But still, that's a accomplishment. Because I saw my grade and I actually cackled because I was like, this isn't real, this is a mistake. I was like, is this new Blackboard ruining something? And then I was like, oh, wait, no, this is real. Because I don't like, you didn't know about this because I didn't really tell anyone, because I don't like to, I don't enjoy bragging about that kind of stuff. That's good, that's good.
00:27:42
Speaker
I know that there are people who have done much better than me on other things. And
Emergency Medicine and Personal Fit
00:27:45
Speaker
I, and like bragging about how good you do on tests. I think it's one, it just demoralizes other people. If someone asks me straight up, I might answer. And I generally try to do the like, I did fine or I did well, because like I, like, especially our program, like we don't calculate, we're not competing against each other. We're all just trying to cross the dang finish line. Right. So like, I want to help everyone do that. I don't want people to feel inferior or anything like that. Because if you, if you get
00:28:12
Speaker
like above the passing grade. You did it. Great. Who cares? So that's just my philosophy on it. That's why you're coming to the podcast, hard-hitting interviews of amazing feats of excellence. Looking back, that's amazing. It was luck. That's awesome. I really think it was luck. I really do.
00:28:32
Speaker
Well, that's all you need is a little luck. Well, luck is preparation meets opportunity and you have both. So true. That's true. So what was your low of clinical year? I should ask that.
00:28:47
Speaker
I definitely know where I'm comfortable, which is weird because a lot of people don't feel comfortable in this setting. I love my outpatient office where I have like, here are my finite resources, you know what I mean? Like, I don't have a CAT scan here. I love that because it helps me kind of stratify what I need to do.
00:29:07
Speaker
in an inpatient setting, I get overwhelmed. So I thought that surgery, because it was just a bit of a harsh rotation, was going to be the worst one. I would say although I learned a lot, and I did a lot of cool stuff, emergency medicine is absolutely not for me. I did so many cool things. You
Tailored Preceptorship and Learning Environment
00:29:27
Speaker
know, I put in central lines, I helped with codes, I learned I work actually very well under pressure, like with people who are
00:29:34
Speaker
Who died like I saw several deaths. It was like a lot but I remember like so I was like, oh cool like I actually can function under pressure what I didn't Like was that I've always just felt like so constantly uncomfortable
00:29:51
Speaker
And I don't know if that was just the site. If it was, you know, I was kind of, I was with a different preceptor all the time. My body is absolutely not meant for overnights. I like my sleep schedule of like never seeing the sun for three days. I did three overnights in a row, which is like, I know like nothing, but I was like, I can't like, like I was not firing on all cylinders, as they say. I don't think I wowed anyone that rotation, but that's fine. It was my last one too. So I was just like, get me out of here.
00:30:19
Speaker
um so that was it was it was my low like i i missed things that i should have done because i was exhausted or because i just was like i like like when because i was so uncomfortable i don't think i was able to kind of like properly
00:30:33
Speaker
think through some things or express what I wanted. It was also difficult when I was with a different preceptor almost every single day. So it was difficult to try and figure out what do they like? What do they don't like? How do they like me to present? Because some people give me five words and I'm fine. And other people want the full surgical, that whole thing. And so that was just kind of difficult. So that was my hardest one. I really like,
00:31:00
Speaker
like i remember i i had some like actually like like some palpitations a little bit towards and it was so funny because my girlfriend was like why are you freaking out about this and i was like i looked at her and i was like because i just don't want to go like i don't i was like i'm just sick of being uncomfortable that's the only way i can describe it like and that's and like this is nothing against that sight i learned so much there loved it
00:31:23
Speaker
Like I like I really I really did like I learned so much But I just like if you told me like you have to do this for another five weeks I would have been like I'm not I would have like begged, you know because I it's just not where I see myself It's not the type of medicine. I liked you know to do I'm the person where if someone comes into the ER. I want to talk about all their chronic conditions Maybe how are their feelings like like no one has time for that. Yeah
00:31:47
Speaker
which is zero because they're actively dying or not. But like, I'm like, wait, smoking? Do you want to talk about smoking cessation? And my priest was like, what are you doing? Like he has chest. That's the support. Yeah. Like he's like, he's like, he's like, get an EKG. What are you doing? I'm like, Oh yeah, I guess I'll do that later. Um, so that's, but that's just how I am. So, so yeah, that was my low.
00:32:07
Speaker
Okay, well that was quite vulnerable, that's amazing. Everyone knows my load, but it sprouted a, for me it sprouted a sequential improvement in my confidence with a culmination of like amazingly confident me, version of me,
00:32:31
Speaker
that even like our program director because I have he's my advisor but also I've been in contact with him for various other reasons and he's like Sebring I'm so impressed with your confidence I was like
00:32:44
Speaker
Is this what it is? Yeah. Like, yes, I'm certain I have good arguments and I can put forth my, you know, opinion and everything in a professional way. But like having, I think it really, like I kept getting more confident and more comfortable, um, being in a new situation. But when it hit with my orthopedic one, it just was, I was already familiar with the OR, so that was very helpful on two previous surgical rotations.
00:33:14
Speaker
So it was very comfortable in the OR and I started out in the OR and mostly did everything in the OR. So I was like, yes, I know what to do. I am familiar with this. This is great. And then I was with the PA team and seeing them work and working with them was way less stressful. Totally. And working with residents and everything. Yes. And I was like, yes, I definitely want to do this. And then I did an ER rotation. It was okay.
00:33:38
Speaker
Um, I impressed the right people with my, my suture skills and everything. Um, and then I did a capstone and then I did my, I actually changed my elective from internal medicine to a orthopedic. And luckily.
00:33:54
Speaker
I was able to get into the one I wanted to get into and then I came back and the first day on the wire I was like, yes, this is my home. I love being here. But it helps that I had really good surgical rotations where I didn't get pimped. I never had to do crazy hours or schedules. And pretty much like a PA would.
00:34:16
Speaker
that really helped but definitely understand the overnight er ones because i was a zombie yep i was like falling asleep in my chair trying to get some sleep the night the day before i'm like i feel so bad i had i had this when i did my three overnights i was with the same doctor this was like the one time i was with like a consistent preceptor and he's
00:34:38
Speaker
awesome, but he very much like and I think I needed this a little bit was to be taken down a peg a little bit like and Especially in the ER where I knew I was uncomfortable and I let him know that I was like this is where I like I said I don't You know like I was honest like where I was like a lot of my experience is outpatient right even a lot of my rotations have been outpatient say for like a handful and I was like I Like I don't know how these things work, right? So like you're gonna have to take like they bring it down to basics here first
00:35:08
Speaker
And I remember he would go on if it was like a slow day, which we had only like one of those He would he would lecture and the lecture was read my mind about Philosophical things which I was like, I don't like I was like it is 3 a.m.
00:35:26
Speaker
I was like, I don't know what you're talking about. And he would be like, okay, you can't function. I was like, no, I can't. He was like, well, we'll put up in this. He was very nice. I really appreciate him. But I just remember he was trying to get me to think these abstract, and I was like, no, I can't do this right now. And he was like, that's fair. I was like, okay, thank you for understanding. But I get the zombie thing.
00:35:48
Speaker
I think it's funny because my gen search rotation was not, like I was like, oop, nope, never stepped foot in an OR and then I did my ortho rotation and I was like, actually I might be able to do this because it was a PA run service and they were all so happy to teach, let me do things and they're like, let me show you this. And like, I almost like cried tears of happiness because one PA looked at me and said, I'm never going to yell at you.
00:36:18
Speaker
because that's not how you're going to learn. She's like, let me show you something and let me let me let you do things and then you'll learn. And I was like, oh my God, you get like, thank you. Like, actually, I was like, thank you so much. Like quietly, like sobbing, like under my big hood and everything.
00:36:38
Speaker
Like my philosophy for P8, cause I really want to be a preceptor. My philosophy is as long as you show up and you just try, you should pass. No problem.
00:36:51
Speaker
And basing it off of just useless knowledge or just knowledge that you don't really need to know clinically. But if you're at least trying and showing up and being there, I feel like that should be grounds. And then you'll learn. You will learn. Totally. You're not going to learn everything in that rotation. And if people are treating it like that,
00:37:14
Speaker
some preceptors feel like you they're treating it like that or they're treating you like a season 10 year ERPA. Oh my gosh. I know you're there to be there and to kind of absorb the environment and have a good experience because if you don't have a good experience you're never gonna want to do that but we need PAs everywhere
00:37:34
Speaker
and
PA School Motivations and Future Aspirations
00:37:34
Speaker
if everyone has a good experience then they really can really know what they like and get their wings a little bit and get their feet under them totally totally i mean i think also like i found the most frustrating is when i would have some preceptors act as though i should
00:37:52
Speaker
like like i have been like if i'm day one at the rotation i should know everything about the specialty at that moment it's like how how would i know that like where like even in pediatrics where i felt the most comfortable my preceptor was really good because he saw that i had a decent background and and that's where i was like it's really funny in peds where most people are like get me away from this i don't want to touch children i'm like oh
00:38:14
Speaker
Let me go see the kids. And he was like, day two, he was like, go see patients. He gave me a lot. He was like, go chart, you got this. But then he was like, let's talk about some harder topics. And that's what I enjoyed. He was just like, this is a really weird finding. Have you learned about this? And I was like, I've seen it maybe once. And he was like, and he was pimping me on those things. And that's where I was like, this is what I want. Like, he met me where I was at.
00:38:36
Speaker
And sometimes where I'm at in these rotations is much lower than where I was in pediatrics, right? But that's how I feel like a good preceptor is. I have no shame in admitting that I have walked into some rotations of being like, I don't know anything. We need to go ground level. How does this even, even just basic things, where is the patient now? Where will the patient go? If I'm not told that, I won't know.
00:39:03
Speaker
Outpatient, I know that they're in room 12. They're gonna stay in room 12 until I tell them to leave. Inpatient, gosh, you know what I mean? These little things that they don't tell you. Yeah, reducing the pressure, I feel like. That's gonna change the PA education or health education as it is. For sure.
00:39:22
Speaker
like at the onset like this is very low pressure and then you'll have fun and you'll enjoy it but anyways we're running out of time I want to get to why you want to even go to PA school and to begin with
00:39:35
Speaker
I wanted to go to preschool. At first, my mother pushed me towards med school. She was a doctor, right? Son of a physician. And so I was like, I'll totally do this. And then after undergrad, I was so fried from that experience. My undergrad was OK. I would not say I have fond memories of the actual academics of that time. It's hilarious if you looked at my GPA from
00:39:59
Speaker
undergrad like my GPA and PA school was like millions better that which is like crazy like most people it's like the opposite but I was you know because I like this you know and and like this is where I was like oh I got this so anyway I applied for like a couple schools knowing I didn't I was gonna was not gonna get in because I didn't want to get in like I was like I don't want to spend like I just was like I don't want to and then I got my rejection letter and was like I am kind of sad but also not
00:40:24
Speaker
So I was like, I'm taking some time off. So you took the MCAT and everything. I took the MCAT and everything. I had competitive scores. They were fine. But I wasn't a competitive candidate for the other reasons. Unless I jacked my GPA up and took a bunch of extra courses and stuff like that, I was like, why do I really want this? I sat down with myself and I was like, I know I told myself I wanted this for years, but is this it? And so I was like, I'm going to take a step back.
00:40:52
Speaker
So I got a job as a scribe. They put me in an outpatient Peds office. And then I saw that there were a bunch of PAs working there, too. And it was a family medicine kind of conglomerate. And I was like, I shadowed the PAs and they're like, I was like, you're doing the same exact thing. And they're like, correct. They're prescribing narcotics. They're doing like literally everything in an outpatient setting that I've always wanted. And I was like,
00:41:14
Speaker
And how long is this program? And they're like, it's generally two years. If you were on the med school track, you have most all of this. It's the same things. And so I was like, OK. And so I shadowed a couple for a bit and was like, this is definitely what I want to do. So I got my stuff together. And I was talking with one of the nurse practitioners. And I was like, I don't think I'm going to apply. And she was like, Ragnar, if you don't hit Submit on this application, I'm going to hit you myself.
00:41:42
Speaker
because I was so nervous and I only applied to like six schools. And I got interviews at a couple and I got interviewed here and eventually I got in so and I was like wow so like and I know it's like very atypical from some other and let me tell you it was not my GPA that got me in here it was I think I must have wowed during the interview. Well this program
00:42:09
Speaker
Like, uh, mine's borderline, not borderline, but a little bit borderline passable. But I felt like this program really wanted not just, you know, with the right GPA, but they also looked at our personality and everything. And the, the interviews too, they were really, I liked them because they were very.
00:42:34
Speaker
non-confrontational, and they're very, a lot of them are group. There's only at the towards the end was by ourselves for a couple of them. But non-confrontational really set me at ease at least. But the program I feel like has really for me has was like the perfect program because I didn't feel like I needed to be the best student in order to succeed, which is getting here was
00:42:59
Speaker
was enough and that was great. I think what's interesting is that I agree, I remember like searching because I wanted a school that was like had more a bit more of a primary care focus you know like this like the school does but like obviously you can do anything with it and also like looked at me as like a whole person because a lot of places are just like we don't like if you don't have a GP at this point we don't even care like we won't even look at you which I think is so detrimental to a lot of
00:43:27
Speaker
Like like I feel like GP is not something that you can just base like the whole package on And I think like it's funny because in this program. I feel like people who might have had a lower GPA coming in have done Very well in this program, which is harder more rigorous, right, you know, so it's it's very interesting I think that and I'm glad that they took that, you know, I'm very happy. I chose Sacred Heart. Yeah. Yeah. Well, it's cool I was talking to Kendall and she's one of the
00:43:56
Speaker
like why did you come to Sacred Heart kind of a thing like she got she I think got accepted to some like amazing programs that we would think as amazing but she said they only cared about numbers yeah they wouldn't like but here in Sacred Heart they because it's a small program they want us to succeed like it looks good with on them and
00:44:17
Speaker
That's like, yes, yes. I would say that because this is a smaller program, I have a much better relationship with the professors. And I know for certain, I was like, oh yeah, there are ones that I could name that are like, you're in my corner and I know it. I was like, I know that I could come to you if I have a problem and we can, you know, that's great. So that's how I feel, yeah. Awesome.
00:44:39
Speaker
Um, so what do you want to do when you grow up? What do I want to do when I grow up? Um, so I'm looking at family medicine or pediatrics jobs right now. I was thinking maybe psych, but then I realized if I go into psych, I will never touch a person again. Are you going back to Maine?
00:44:54
Speaker
I'm staying in this area, actually. We like it. I like being close to New York City, but not being actively in New York City, if that makes sense. Quick train ride and being like, hi. Being able to visit it when I want, but not having to ever go there if I don't want to. Exactly. Not having to deal with driving in. It's very nice. And I think there's a lot of job opportunity. You can work anywhere in the tri-state area. Because there's just so much.
00:45:21
Speaker
coming from Maine where transportation is not a thing. It's like, oh, I can just take a train. It's like, that's so great. Look at me like the hillbilly over here. So I'm looking at those jobs right now. I think that there's always a shortage of primary care jobs. That's good to know because I'm a very limited outpatient primary care in PA school.
00:45:45
Speaker
I always felt like it was very limited, but I'm glad that it's not. Yeah, it's usually people, there's their help. It's because it's not as flashy as some of the other specialties. I do see a lot of job postings for surgical. They always want that, and that's obviously pretty in high demand too, but primary care is hard up. It's one of the ones that I feel like gets the least amount of respect
00:46:11
Speaker
For some of the most amount of work. Yeah, and I and I you know, I know what I'm signing up for Like I know this is gonna be it's gonna be long hours. It's hard. It's not exactly like sexy medicine You know what I mean? It's a lot of chronic conditions, but that's that's what I'm passionate about. So no, that's really cool so
00:46:28
Speaker
Let me tell you my idea of how primary care is going to save the American healthcare system. Please do. So have you heard of direct primary care? I've heard the phrase. I'm not sure. I feel like here, they always think it's concierge, which it's kind of similar, but it's not like the way I know it is direct primary care.
00:46:50
Speaker
is where you have a provider, you pay a fee monthly and it's pretty low. Like a really high fee is $200 for unlimited all your primary care needs. You don't ever have to go to ER based unless you're like dying. You don't have to go to urgent care. All your chronic conditions are being taken care of. And that's an expensive one. There's some cheaper ones, 100, 150 for a family.
00:47:17
Speaker
I feel like I've heard of some programs that are doing that now.
Challenges in Healthcare and Insurance Role
00:47:21
Speaker
There's a really awesome one that's a more of expensive one, but what they do is, it's a California, it's a Christian couple. And like the poorest, they like it in the poorest part of like California. And what they do is they, you pay $200 for unlimited healthcare and that pays for two people for free. Two people don't have to pay for that same service. Is this like,
00:47:45
Speaker
Ex like outside of health insurance to yeah, so unfortunately it's outside of health insurance But what you do is you I'm not sure how it works with specialties of the key if you need to have Yeah, but but the thing about it the way they
00:48:01
Speaker
market themselves that you don't need to go to specialists because we can take care of it as primary care which is exactly so like like just I know we are running out of time but my my mother being in like rural Maine like if you want to see a rheumatologist that's a two-year waiting list yeah so she's like I will just like I'm just gonna manage it and so like that's the thing is like it's true like like primary care like sure
00:48:23
Speaker
in some places you if you want to you can be a referral mill sure but like that's not the kind of medicine i want to practice like i want to handle it all yeah and then so you have this sustainable and then the very the the people that do that they can text their patients they have like this amazing communication with them
00:48:42
Speaker
Um, so you have this and then you get health insurance, like high deductible, only emergency. Cause that's all you probably ever need. Um, and then where I see it is you have a doctor at the court and then you hire PAs to grow. Cause that was one of the limitations is they're not as, they're not as big as insurance based practices, but they can be with an army of PAs or MPs to like.
00:49:09
Speaker
do maybe not in some states it's restricted maybe not see like a new patient but to help manage other patients and if they do need to see the doctor for something they can but I feel like that is but unfortunately right now like direct primary care it's the marketing is physicians only only get physicians because that's what people want PA's is sub
00:49:32
Speaker
Um, subpar in a lot of people's minds. So that's my version of that. I feel like that can really change American healthcare, make it affordable, also high quality. And to get rid of a lot of these insurance based stuff that just price gouges people. Anything that I could cut out insurance into, I would be like anything.
Encouragement for PA Students and Conclusion
00:49:51
Speaker
Cause it's, that is the biggest, like, I think roadblock to people receiving good quality care is insurance being like, um, we don't actually think that you.
00:50:01
Speaker
should give that medication that you prescribe. It's insane. It could be a whole other podcast episode about that. Last thing, what will you want everyone to know? P.A. students, pre-p.a. students? About P.A. Any last words of advice? I want people to know that although this is rigorous and it's hard,
00:50:23
Speaker
like know that coming in but know that like you can do it and that like seems cliche but like you know people are going to tell you that you can't and you can't yeah like is that persevere like jeez just like put your you know nose to the grindstone and keep going and that like it it will get much better you just have to like push through this is and that it's a super rewarding career i'm so happy i'm here
00:50:48
Speaker
on the other side right you know like oh so great yeah but i am you know and so i those are just my words of encouragement i think awesome well it's been such a pleasure ragnar i hope you get a job real quick same are you taking the pants uh 17th oh man so we graduate the second yes there's a lot of people in our program that are taking it i thought i thought two weeks was i talked to a pa and he was like you can learn anything in two weeks
00:51:12
Speaker
I'm personally, I'm probably going to do it in February because I have to do a little bit extra stuff afterwards, but I actually feel good about it. Like, yeah, I think I actually could do well, like pass at least. Oh, for sure. So, yeah. Okay. We'll talk to you later. Ragnar. Thank you so much for having me on the path on the pod.