My Journey To PA-C

Happy PA week, everyone! In honor of PA week, I thought I would share my own personal story of my journey to become a PA.

For those of you who are a PA-C or even a PA student, I know you understand the time, stress, and dedication that goes into this process. Getting accepted in a PA Program is by no means an easy task. This process may be more linear for some, but for me it was definitely a little more chaotic. Looking back, I am happy my trajectory had some failures, twists, and turns in it. I truly believe that made me a more prepared PA student, and a better PA today.

To start, my sister and I are the first people in my family to go to college. I am also the first person in my family to go into medicine. With this being said, I truly had no idea what I was doing when it came to the PA application process. I also didn't even truly realize what a PA was until I was a sophomore in college. You heard me, a S O P H M O R E. Already almost halfway through my college degree. Looking back, I know I interacted with PAs throughout my medical care growing up, but since I was fortunate enough to have good health, I really was not at the doctor's office much unless it was for a routine visit. I always assumed all providers seeing me were physicians or Nurse Practitioners. For the longest time I thought the only people who worked in healthcare were doctors and nurses. (It blows my mind to think I once thought that).

I always knew I wanted to go into medicine, even as a child. Initially I wanted to be a vet, but I am allergic to essentially all animals so I knew that wouldn't be in the cards for me, so I switched to wanting to work in human medicine. So, I applied to my undergraduate institution to be a biology major because I thought that was what you did. At that time, my eyes were set on medical school. My first year I was a biology major and hated it. Frankly, I was sick of learning about ecosystems and plants. I had friends in college who were pre-med but also health science majors. They had to take the basic science classes like me, but instead of their additional classes in their schedule being more science classes about plants, molecules, etc., they were taking classes learning about the healthcare system, medical diseases, and even hospice and palliative care. That's what I wanted to be doing. So, after getting pushback from my biology advisor about switching to a Health Science major instead (telling me I will never get into medical school with any degree other than biology or chemistry), I went against their advice and switched anyway, because I knew that was the better choice for me. And I am so happy I did because you can get into medical school, heck, even PA school, with ANY degree!! All you need are the appropriate prerequisites and a good GPA.

My roommate in college was also pre-med, also wanting to go to medical school. One day we were walking through the student center when I saw a flyer for The Physician Assistant Club. On the flyer was a basic blerb about what PAs do, and when the next meeting was. I took a picture of the flyer and out of support, my roommate went to the first club meeting with me that following Wednesday. I remember feeling nervous, but everyone was friendly. Hofstra had a 3+2 program, meaning that you could apply to become a PA out of high school, get accepted into the program and do 3 years of undergrad with 2 years of PA school learning. A lot of the club members were part of this program, but there were other students like me who weren't. After attending a few of these meetings and doing my own education about what a PA does, I realized that this profession resonated with me. Of course, this is what I'm meant to do, become a PA!

So, that's what I started to work toward. I accrued patient care hours through an internship I had to do my senior year of college. I volunteered with Alzheimer patients where I would go into their houses to spend time with the patients so their family members and full-time caretakers could have a break. I would perform brain stimulating activities with them, help feed them, and help them around the house. I also did shadowing and basic office work at a pediatrician's office. In the summers throughout undergrad, I would shadow in the medial field. I did a lot of shadowing in the OBGYN field.

I graduated undergrad in 2016. I did not apply to PA school in the 2015-2016 cycle, because I knew I needed more patient care hours than what I had to be a competitive candidate. My first job out of college was as a Clinical Information Manager (CIM), similar to a scribe position, which I started June 2016. I was working full time, 3 12-hour shifts per week with the ability to pick up overtime. I remember starting this job and thinking it was so stressful. I had to learn a crash course of medical terminology during my training the first month. I also had to learn how to write a chart, the billing/coding requirements, and the flow of the emergency department. Scribes are responsible for transcribing the medical visit in the ED for the provider, which is a legal document. This part I think is the part that stressed me out the most. I was afraid that I would document something wrong or make a mistake in my charting that could down the road be detrimental to the provider I was scribing for.

In time, I got over this and learned I worked very well in this high stress, fast-paced environment. If I do say so myself, I was good at it, too. I would work 1-on-1 with a physician every shift. I was learning the workups for common ED complaints like chest pain, abdominal pain, and altered mental status. I was watching them perform exams, order medications, and in the process, learning their medical decision making. I wasn't allowed to legally touch the patient, but I was getting the best kind of learning experience there was, first-hand experience working 1-on-1 with the physician.

Concurrently, I was filling out my PA school applications on CASPA for the first time fall of 2016. Little did I know this was way too late to be starting my applications. I had a recommendation letter from a OBGYN who specialized in minimally invasive surgery, in addition to a contact I had made with a physician I was scribing for. I had no one proofread my application. I did not utilize any outside resources to tell me what to do. In my defense, it was 2016. I filled out the application, read it over a few times myself, and submitted it. At this time, there were no social media influencers connecting me with the tools I should use to prepare myself better. I simply did not know what I didn't know.

That first application cycle I applied to 6-8 schools (I can't remember the exact number). I got rejection emails from them all. Not 1 single interview invite. The craziest thing about this experience is that I thought getting rejected from the next step to pursuing my dream job would absolutely crush me. BUT, it didn't. I won't say I was relieved, but I definitely was okay with being rejected. To me, this meant I simply was not ready for this next chapter like I thought I was. My last rejection came in March, just before the next application cycle was ready to open. I knew the best thing for me was to take a gap year, work on myself as an applicant, and apply next year. So, that's what I did.

I think the hardest thing about making this decision was dealing with the feeling that I was behind in my life to where I thought I was supposed to be. I had friends who were applying to PA school and going directly out of college, or already enrolled in a direct entry program from undergrad. Seeing others' success and comparing it to my own story I think was the worst thing I could have done for myself back then, but it was so easy to do. It took me a long time to understand that this chapter of my life and my own journey was meant to be different than others. It wasn't until I was in my first semester of PA school that I realized how much those 3 gap years between undergrad and graduate school benefitted me and was truly a blessing in disguise. There were tests my first quarter of PA school that I got questions right because of my prior scribing experience, not because I learned it in my classes. I already knew how to write a chart (I've written thousands) while my peers were just learning. I didn't have to learn the medical terminology, because I already knew it.

One of the many blessings I encountered during this gap year was meeting one of my very best friends, who was a new graduate PA. We met in the ED, as I would scribe for her. We truly "clicked" from the moment we met. She is my best friend to this day, and I was even maid of honor in her wedding. She mentored me through my gap year and offered to help me re-work my personal statement and look over my CASPA application from the previous cycle.

I will never forget how empathetic and kind she was when she looked at me fearfully that she would hurt my feelings when she told me my CASPA application was awful. That's right, it was quite bad. My personal statement was a reinteration of my resume (big no-no), and I only included medical related experience. I didn't add half the extracurricular activities I was involved in or jobs I worked through college because again, they weren't related to medicine. She helped me essentially gut my entire prior application and give it the full 360-degree makeover it needed. Don't get me wrong, I filled out the application and rewrote everything, but she was my personal reviewer. I tell her all the time I would not be a PA without her. She gave me something I did not have readily available to access, and something I could not have myself: the guidance and firsthand experience of someone who has done this before me.

I will never forget the relief that washed over me when she told me my application was awful. An essay is easy enough to re-write. An application can be redone. The issue wasn't with me, or even my experience but instead, how I was presenting myself on paper. I could fix that! ...and for that, I was elated.

I continued to scribe for 1 year before the company I was scribing for was removed by the ED I was at due to the healthcare system hiring a more affordable scribing company. This more affordable company shall not be named, but did not want to compensate for my experience, and ultimately, wanted to promote me to the team leader (in charge of attending meetings, training new employees and making the schedule) without additional compensation. Although I loved the ED I worked in and the people I worked with, I knew this wasn't the place for me to continue with. The company I was already working for was based in NJ and offered competitive pay, plus travel compensation, food vouchers, hotel compensation, and a financial incentive just for showing up to a shift if I agreed to travel to various EDs (mostly in NJ) to scribe to show other scribes how to document using the EPIC EMR. After traveling to various EDs in NJ doing this and even one ED in South Carolina, I was temporarily placed at an ED in NJ where I was tasked with starting a scribe program in their ED with this company. I would train new hires in addition to teach the ED physicians and other providers how to appropriately use a scribe.

This ED was amazing. I made great contacts here, and even traveled on a Mission Trip to Haiti with this team. The memories were truly unforgettable, and the experience was irreplaceable. A physician I grew close to was one of my references for my second application to PA school for the 2018-2019 cycle.

While I was re-doing my CASPA application, I did a full reflection on things that I could do to become a better applicant. Scribing was by far the best patient care experience I did before applying, and definitely prepared me the best for actually being a PA. However, I needed to look at myself and my application the way the programs would. Every PA program has different requirements. I looked at the prerequisites of the top schools I was interested in. I then decided to take courses at local colleges near me for the courses I needed that were not covered in my undergraduate degree that most of these schools wanted. Some of these courses were genetics and medical terminology. Taking these extra courses not only made me a more appealing applicant, but also helped boost my overall and science GPAs.

I also looked at what these schools considered as acceptable patient care experiences. My overall undergraduate GPA was a 3.5, and my science GPA was a 3.8. Although they aren't bad GPAs, they are definitely not the most competitive. I knew the more patient care experience hours I had would only make me more valuable. Most schools consider scribing, but not all do. This was the majority of my experience (thousands of hours), but if a school did not count them, I had barely 500, which was not competitive enough. So, I started a job as a pediatric nurse aid. I purposely applied to a nurse aid position that did not require a true certification and would take my prior healthcare experience. They trained me on the job and it was great. I would work my pediatric nurse aid job Tuesday through Friday. Then, Friday night after getting off work, I would drive to NJ, and work in the ED Saturday-Monday. When I would get off work Monday, I would drive home to PA and start this process all over again. During this time, since I was bieng paid a whopping $13/hr for my nurse aid job even though I had a college degree, I would pick up hours here and there waitressing for extra income, mostly to pay for my student loans that were back in repayment from undergrad. There was a period of time where I truly grinded. I didn't have a day off for over 6 months and was working 3 jobs at once. (I do not recommend)

Eventually, I knew I couldn't keep this continuous work streak going. I eventually dropped the scribing job because the travel was becoming too much. I transition to working as a pediatric nurse aid M-F and waitressing on the weekends. By this time, however, it was time to reapply for the CASPA cycle. I made sure to submit my application the first week it opened. At this point, I was torn thinking about my future. What if I didn't get in this application cycle either, despite all of my efforts? I knew I could not continue working below my degree, making a wage that could not support me. I decided I would transition into a position in medicine that had opportunity for growth. A job that would give me a decent salary, and a chance to work my way up in the job, allow promotions, and even standard wage raises over time. My cousin worked in research and told me about a job position opening with the neurosurgery/neuro-oncology team. I knew this would be the perfect opportunity.

I applied for the job, and after two interviews, was accepted into the position. Between my first and second interview, I received an invite for Hofstra's PA Program (my first one). My interview was the 2nd week of September. By the time they offered me the job, I found out I was accepted into the program. I did it! I was going to be a PA. I told my new research boss that I was accepted and would ultimately only be available to work for about 1 year before starting school in September. They were okay with this, and willing to hire me anyway.

My job in research was the most fun I've had at a job. The team I worked with was amazing. I loved working so closely with the patients and the research team. I would process specimens in the lab for the biorepository (brain tumors, CSF, and blood), obtain consent for studies, and push into the pediatric spina bifida clinic. It was a really fun time. It was my first time working an office job with my own desk, which was something I never did before. Everyone always complimented how productive I was, but the truth is, after working with kids and in the ED, the office life was just much slower paced than what I was used to. Working in research opened my eyes to what I could do as a PA in this field in the future. It made me want to help as a co-principal investigator on a research study or do something in the research field during my PA career.

Once I started as a research coordinator, I no longer worked as a pediatric nurse aid because both had day hours, Monday through Friday. I was still waitressing on the weekends. I was very happy with this balance. Since I already secured a non-refundable seat deposit to Hofstra's PA program, I decided that unless I was invited to a school that was closer to home, or made more sense to attend financially, that I would decline those interviews. I applied all over the country to 10-12 schools my second cycle. I received numerous interview invites but declined them. Until I received an invite to interview for Drexel's PA program in the middle of November. Not only was Drexel rated in the top 10 schools in the country, but they were a lot closer to home and more affordable than Hofstra's program. I decided to accept the interview. I interviewed the first week of January in 2019. I received a phone call from a Drexel faculty member while I was sitting at my cubicle at work a few weeks later, congratulating me that I was accepted into their matriculating class. I was boarding an airplane ready to go to Medellin, Colombia in February of 2019 when I accepted my seat to Drexel.

I did it, I was going to be a PA! The feeling didn't truly hit me until I moved to Philly and started class. All of those years of hard work, sacrifice, perseverance, and dedication have finally paid off. And now, I am working my dream job as an EM PA. I know there are many deserving applicants who apply to PA programs and never get in. I am grateful I had the privilege to be chosen, and the opportunity to be given the honor to practice medicine.

PA school was hard, but honestly, I performed my best academically in PA school. I loved what I was learning, and I had amazing roommates and friends in the program that made all the hard times worth it. As you can see, my journey had many twists, turns, ups, downs and everything in between. I may have gotten to where I am slower than others, but I am grateful for it.

Whether you are reading this as a practicing PA, PA student, PA school applicant, someone debating on the PA school profession, or someone who has nothing to do with the PA profession altogether and is just here out of curiosity, I appreciate you taking the time to read my personal story. Sharing this story is honestly empowering. Now that social media has evolved to the degree it has over the past several years, there are luckily a lot more resources, discussions, and tools to navigate this process. However, that does not mean this journey is any easier. Each year more and more applicants apply to these PA programs for the same number of seats. It also does not mean that the uncertainty, self-doubt, and self-criticism is not there. It is easier now than ever to compare ourselves to others.

I hope sharing my story will be relatable to some of you. Empowering to others. And a reminder to the rest of you that you can do it too. Not everything is "picture-perfect" like you see on Instagram. Embrace it. Embrace your journey and know that you too will reach your goal. That goal doesn't just have to be acceptance into PA school. Anything you choose to do in life can be possible with enough grit, dedication, and the right resources/opportunities.

With that being said, for all of my fellow PAs, PA-students, pre-PAs and pre-med students out there, I am offering to be your resource. Please reach out if you need advice, guidance, a listening ear, or a friend. More Than Medicine is here to support you and make this journey a little easier on you.

Please contact me via one of the platforms below:

Email: Mannysmorethanmedicine@gmail.com

Instagram: @Moveslikemanny

Happy PA Week, Everyone! If you're a fellow PA, I'm honored to have you as my colleague. If you're not a PA, but know one make sure to show them some love!!

XO,

Manny

❤️