PA Prep Q's Answered
convo ideas-
1-drug test mom upset at kid waiting- co-worker felt bad positive 2-group of 6 men/women who meet at starbucks every morning -fred, 89 years old one day asked if anyone was hearing a high pitched bell sound -everyone conversed & I was talking with them at the time while taking a break from work --came across possibility of auditory hallucinations- lack of oxygen to brain --asked if he has a pulse oximeter or if he has checked his blood oxygen --daughter picked him up, took him to get one & next day he wasnt at starbucks --was told he was in the hospital (blood oxygen was & now has oxygen tank --hypoxemia
biggest strength?
-empathetic listener -dr. naderi morning team meeting "somehow in less than 5 minutes Emily knows pts whole life story, understands what they are in the office for & is set up for the procedure/ has the patient prepped -truly listening not just to words but non-verbal cues/ mannerisms - -volunteering OB- girl w CP -struggled social situations -noticed animation/ love of dance -allowed me to connect deeper & make sure they feel comfortable & valued - as PA help to understand multifaceted needs of pts & serve them in greater capacity
Tell me about a time you have had with a difficult patient.
--sad: rhino sx, necrosis on tip, leaving for freshman year college for rush 2 weeks, set up hyperbaric & contacted revision dr in az --shadowing:
What are your thoughts on the PA name change from physician assistant to physician associate?
-Now as an MA at UC- pts get confused calling me nurse/ PA/ sometimes doc -confusion around what a PA does + errors with calling "physician's assistant" = grey area on the scope of PA/ extensive training PA's have (seems like dr's assistant) -leads to pts having less --HOWEVER- to change name as the profession becoming increasingly popular w more awareness of PA role = more confusion
In order to keep your PA-C certification, you need to perform 100 hours of continued education every 24 months. What is your continued education plan?
-PainWeek (every Sept) -largest US pain conference for frontline practitioners -CME category 1
have you applied to other programs?
-Yes -love to attend this program -ultimate goal to be a PA -i applied to this program specifically because XXXXXX (reputation, faculty rep, dedication to rural/ underserved, commitment to interprofessional education..etc)
Time you were asked to do something unethical.
-came in on tuesday after labor day -went to bring blood work from tuesday to outside lockbox for QUEST to pickup -reaized MA from yesterday put bloodwork out even though Quest doesnt come by on holidays -mentioned to practice manager TB gold test that was on ice was all melted -practice manager said it will be fine for 1 day just change lab req time but results will take longer -
What do you think will be one of the most difficult things to deal with as a PA? / Medical field?
-death of pt directly under my care -having relationship with pt & having to tell family -no real time to process- have to go see other pts right after
favorite area of medicine so far? least favorite area of medicine so far?
-difficult b/c shadowing & working in UC, ortho, gastro, plastics & derm things I am drawn to with each -shadowing learned so much role of PA/ scope- seeing role of ortho PA as first assist in OR -loved the mix of office days seeing pts at consult (in pain), pre-op (excited nerves/ ready to be better) & post op with relief -OR being meticulous/ high level of responsibility as first assist -clinic days being able to f/u & build relationships w pts & watch progression/ healing -gastro love b/c so much to learn, gut being 2nd brain, seeing how everything in body is interconnected LEAST- -UC loved b/c like when i served- fast-paced, quick thinking, see many different pt cases- learning opportunity -would like to build relationships w pts over a period of time & have time to get to know pt -sporadic nature of UC typically does not allow
why PA? when did you decide to pursue PA school? /how did you discover the PA profession?
-first job in healthcare was how I learned of the PA profession -working as waitress family i was serving ended up being the owner of the plastic surgery & derm office that I ended up working at for over 2 years -shutdown during covid my office shut down for 3 months/ wanted essential role where I could help during these times - convo with the dr- he asked if I had considered PA -led to research, discussions with different NPs, PAs -way to merge my passion advocating for equality, build off shadowing with marginalized populations with my love for medicine - would fulfill my desire for continuous learning- from CME hours (every 2 years) to learning from my patients experiences how I had learned from the people I volunteered with to learning from my SUPERVISING/COLLABRATING physician -w/o science background knew I wanted to accelerate process/ post-bacc- also proving could handle rigors of accelerated PA program -shadow UC PA Paula CONFIRMED-ELABORATE
What are some of the greatest challenges you believe facing PAs today?
-full practice authority; allowing for more affordable and accessible healthcare -include ability to prescribe -physician shortages have led to expanded roles **lack of understanding of the role of a PA- shadowing ortho PA during pre-ops and post-ops pts were hesitant/ confused why the dr. performing the sx was not who they were seeing for the appt
biggest accomplishment
-getting into post-bacc -moving to new state & not knowing anyone -leaving dog and family/friends very close with -going back to school after 4 years out -taking accelerated new science classes -not only excelling, making friends, lifelong mentors, and cementing passion for PA
What would you do if your collaborating physician told you to administer mediation to patient that you as a PA feel it may harm the patient?
-immediately discuss with physician- potentially wrong patient, wrong medication, as a PA i did not understand fully -if collaborating physician is NA- consult nurse, other PA, NP/ medical professional -do f/u research on rx fine print, go through pts chart thoroughly again -ULTIMATLEY= trust my training as PA & act in what i believe best interest of pt (my license on the line) -document EVERYTHING in chart & f/u with collaborating physician to understand decision/ f/u w pt to monitor treatment
You are a PA, a patient on your schedule insists on seeing an MD. How do you handle?
-introduce yourself -explain my title as a PA, educate on the role of the PA is -explain how I work very closely with the dr & the dr has trust in me -ultimately pts decision who they want to see, respect decision -explain may not be able to see them right away -EXAMPLE SHADOWING CHRISTINE --pt upset @ pre-op to be w PA not dr- once Christine explained she assists with the dr in the OR he opened up --asked specifics about the BUNIONECTOMY and PA answered all with thorough detail
how do you study?
-learned after going back to school for post-bacc -4 years out from undergrad into an accelerated yearlong program -change from memorizing "learning and purging" -work best with reading material, making flashcards for A&P did a lot of diagrams to then teaching others -most effective, helping my classmates while also ensuring I understand
how do you feel being older application? strengths/ challenges?
-more diverse clinical experience -older than those straight out of undergrad but age group/ friends who stay current with new technology -teach my parents- amazed able to scan docs from notes on iphone- not use bulky copier -recent post-bacc learned how to modify study techniques/ approaches to be more effective in accelerated program
Describe the history of the PA profession.
-national shortage primary care physicians -charles hudson (president of AMA) acknowledged ability to solve 2 problems 1. provide jobs for men returning from war (highly skilled/ trained providing medical care on frontlines 2. addressing the physician shortage -1965 eugene stead jr. brought to life- 1st PA class at Duke -4 men serving in Navy as medical corpsmen -framed around the fast-tracked medical training during WW2 -expanding on skills military corpsman gained from working on frontlines ---Eugene stead quoted in article titled "More than a nurse, Less than a doctor"- if i can't multiply the number of physicians, then maybe we can stretch their effectiveness by giving them extra arms and legs" -physician shortage due to: men returning from war needing medical attention and pressure on physicians to specialize to be trained on changing technology -first class graduated on October 6, 1967 (now designated as start of PA Week) ALSO eugene steads birthday -Dennis Franklin- part of first 5 graduating PA classes from Duke who are considered the "pioneers of the PA program" & deserve the credit for the success of the profession -graduated in 1971 -took classes with eugene stead
time you broke the rules (2)?
-new policy practice manager at UC says pts who test pos. at home for COVID & want to come get our rapid PCR test- they have to come in to office & be seen by dr -not going out to car to test -short staffed and dr. who has been there for 15+ yrs, works 5/6 out of 7 days/ week- does not want to increase odds of sick -i designate 1 room for pts who test pos. at home for me to do vitals/swab them then tell to go wait out in car 10 min -if pos. dr will call & advise them on CDC protocol OR if neg. pt has option to come in and see dr
What is your biggest regret?
-not taking science courses during my undergrad -my major didn't require it -now knowing my interest & how i was successful during post-bacc -could have expedited my journey to PA -would likely today be working with pts
Time you were asked to do something unethical.
-pt came in on a thursday @8 AM for TB skin test -was told to come in sat. from 8:01- 7pm (when close) for reading-- 48-72 hours after reading -pt paid $65 for test -pt came in for reading on saturday but manager office closed last minute due to dr. having family emergency -when pt came in sunday it passed window & pt needed new test -manager said its pts fault & she needed to re-pay -i expressed how it was on us for closing & that we should not re-charge -finally agreed
time you broke the rules?
-pt having deviated septum SX on friday/ nervous office closed weekend what to do if she had bleeding issues -anxious the dr. would not be available or answer her call -i told her to email the sx email I was in charge of anytime over the weekend & id be promptly checking all weekend -not supposed to answer emails off the clock- could only clock in at the office -pt expressed her comfort w me/ would greatly appreciate having way to contact me -let the office manager know the situation and she cleared me to
plans if not accepted to PA school this cycle?
-reach out for any feedback from programs on ways to make more competitive -shadow different specialities- given best understanding of profession & has deepened my drive to become PA
why PA/ medical model
-reconstructive pt as MA -pts questions about her diagnosis set in w me cause was trying to understand my moms recent breast cancer diagnosis -tons of research on disease, treatment options chemo/ radiation/ mastectomy/ lumpectomy- benefits/risks of each -highlighted interest in medical model/ focus on disease & improving pts outcomes -further narrowed to PA not MD- drawn to ability to consult dr for more insight but also autonomy to make own decisions -EX volunteering OB
how do you handle blood & gore? have you seen someone die?
-shadowing urgent care PA & working at derm & plastic sx was surgical wounds, lacerations -shadowing ortho & being in OR- total ankle replacement- first time seeing process start to finish- OPENING/ cutting into FOOT -very intrigued- dr. schipper & christine explaining as much as could -learned quickly importance as observer to not get in sterile field
tell me one thing we wont find on your application.
-summer 2023 started helping my friend/ old hs fh teammate who is head coach of my old hs varsity team -used to do club in college/ adult league in my area ended during COVID -last year w her as coach team made it to STATE QUARTER FINALS
biggest challenge in PA school
-talking with current PA students/ past students w 2-3 tests a week concerned about getting sucked into putting all time on one class -getting very invested in material & losing track of time -balancing time needed based on how difficult the course/ subject is for me -during post-bacc i would set timers to remember to take 5 minute study breaks, timers to switch subjects, and made list/ planner of breaking down each task/test/assignment
tell me about your gpa
-undergrad i struggled w many classes wanted to take not being offered -post-bacc i excelled/ learned to study effective -also realized reflection of deep interest in science
time you have been judged unfairly? challenge you have had to overcome?
-volunteering at food for others -power pack program- 90% retired adults volunteering -assumed I was just there for academic credit/ requirement -didn't engage or approach me for help -saw some struggle to reach tall shelves/ lift stuff- approached them & offered to help -stay after session to help oorganize/ load up things -UC: pt discussed volunteering at food distribution place; -reiterated that most of the younger people are in/out just for school requirements & dont put in full effort
how is your time management?
-working at UC has fine-tuned -only one MA- being walk-in the rushes/needs of pts are unpredictable -ALSO post-bacc (38 science credit hours in a year) taught me time-management; highly recommended not to work but i shadowed and volunteered at FFO
In your opinion, what is the most concerning issue facing the medical industry today?
1. access to care? 2. opioid crisis -chronic pain: few situations where pt has say in successful treatment outcome is - pt comments on if pain has improved, quality of life improved, hopefully consider functional capacity --OPPOSED TO ex hypertension: provider measures blood pressure/ if its a good range/ bloodwork- modifications made on meds -non-pharmacological approaches are tried first for many conditions- hypertension= modify diet, limit salt & diabetic=modify diet, cut down sweets, etc. not with pain management
What have you done to prepare for PA school?
Academic: Post-bacc- similar intense, accelerated, new coursework and in new state away from family & friends -being out of school for 4 years, learning more effective ways to study Work: different MA positions- derm, gastro, and now UC UC made me more adaptable -esp at a walk in office- each pt bring unique cases, short staffed days take on more responsibility, different rush times, software glitches -learned to adjust, find solutions quickly -mirrors medical field w different unexpected challenges & different pt needs
what is least favorite class?
Genetics -summer was online, did most work independently up till now - would try to figure out on own -moved to new state, content presented in way that my old memorization method & independent work habits not work -learned to develop resources & depend on my classmates - made google doc study guides/ afternoon study sessions with classmates/ help from tutoring center
Why do you want to be a PA?
I value the balance between autonomy and physician supervision. -more permanent & advanced role -after shadowing and working as a MA with all different healthcare professionals, the PA role on the healthcare team makes the most sense to me -through volunteering, shadowing, and my work as an MA - I realize value of having someone you can consult like an attending physician for extra input and have your own autonomy to make your own decisions or treatment plans appropriately -had chance to shadow urgent care PA- fast paced, 40+ pts daily -mentioned how her training as a hospitalist out of PA school was best training & has prepared her for working in fast paced UC - breadth of knowledge evident, impressed on ability to use her 10+ years in gastro to provide in-depth pt education on handling a pt w/ **GERD**
Tell me about yourself
My name is Emily Lemoine, I was born in northern VA, right outside of Washington, DC and went to JMU where I majored in Justice Studies which focused heavily on community engagement and service -i volunteered with different organizations like overcoming barriers, not just working to meet their unique needs but connecting with them and making sure they were comfortable with me -recently moved back to VA from NC after post-bacc -enjoy going on hikes with my dog & baking -i love to run/ few half marathons- currently trying to teach my dog to run with me & not after bikers - I played FH in HS/ club in college- I love being active and currently am assisting my old HS teammate who is head coach of our old HS FH team -most recently I began working as MA at UC and volunteering with hospice as i prepare for PA school
What is your opinion on socialized health care versus privatized health care?
Overall I am for socialized health care (the right to health care, universal health care). Socialized health care could lower the cost of health care in the US which would result in a healthier general population. Having worked in underserved communities I can see how socialized health care would save lives. If more people could afford health care then I feel that the poverty level would decline. People would live healthier lives and miss less work and hold onto jobs longer. I do however seen the downside to socialized health care. In countries with socialized health care, the wait times to see a doctor are longer. Socialized health care can also lead to rationing of medical services but this could be a good thing in some ways. I currently work in the hospital setting and see that certain diagnostic tests are performed unnecessarily, leading to increased patient hospital bills. One other con to socialized health care is that it might cause a further decrease in physicians. In some ways I feel that this may be a good thing as people will become physicians to help people rather than for the money. This could be combated by increasing mid-level providers to balance the decline in physicians.
most important person on healthcare team?
patient -purpose of healthcare team is provide care to pts -every effort of NP/PA/Dr/MA is to improve pts outcomes -pts preferences/ values/ beliefs considered to provide most appropriate care/ increase chances of adhering to treatment plans -HOWEVER improving pts health/outcomes wouldnt be possible without the collective work of every healthcare team member
What would you do if witness co-worker stealing medications?
understand: -could be pts rx that they need & harm the pt -could be drug issue of co-worker that could be affecting co-workers ability to care for pts -clear violation/ disregard of rules that could be happening in other areas of their job EX: night nurse: -feel out situation: if confronting co-worker may turn aggressive/potentially violent- go striaght to manager or supervisor on duty -if feel comfortable confront co-worker- ask why the took X? in a calm, non-accusing manner --> after 7 co-workers reported to DA in PA suspicions CHARLES CULLEN was using rx to kill pts & it was dismissed due to lack of evidence -1st choice to control co-worker to avoid potential harm to pts or themself (cullen killed more pts after evading being caught)