Physician Assistants (PA) are medical providers who practice in many different specialties and settings. Responsibilities often include physical examinations, diagnosing and treating illnesses, ordering and interpreting medical tests, and assisting in surgery. They operate in a team setting, often working alongside other physicians, surgeons, and healthcare workers. Read what Emily Goodwill, PA-C, has to say about how her journey to PA licensure unfolded.
Students typically go one of two routes to secure their degree.
1. Enroll in an accelerated program by going into PA School right out of high school, which generally takes five years start-to-finish
2. Opt for the more typical route, which involves a traditional bachelor’s degree followed by acquiring your Master’s in Physician Assistant Science.
I started my education with the accelerated program, but due to an error of my college over accepting PA students, I was offered the option to instead go the more traditional route. Taking this path meant an additional year but also provided an opportunity to travel abroad for a semester.
There always seems to be a rush to get through PA school, which is why some students opt for the accelerated program, however, being able to extend my education and study abroad allowed me to slow down and gain a greater perspective than I would have otherwise. My experience abroad was set in Ambialet, France, at a monastery-turned-campus owned by my college and staffed with American professors.
In France, I took narrative medicine and compassionate caregiving classes that changed my perspective on healthcare. The lifestyle of living in a small French village also encouraged me to take steps back from social media and do more introspection — remembering to slow down every day and enjoy the little moments in life – like the memories made touring Europe, which included riding Vespas around the Tuscany countryside and wine tastings at Italian vineyards!
Becoming a PA isn’t easy, and it’s not for everyone. PA School is intense. Not everyone makes it out alive. It’s challenging, fast-paced, but also very rewarding. I chose a quaint school in a small town without many distractions, which was an intentional decision. Didactic year in particular, which is designed to develop clinical reasoning skills in the classroom, was mostly spent in lectures and studying for exams. Our program had strict grade requirements, as PA programs often do. We could not get less than 80% in any class throughout didactic year, which added to the pressure to succeed.
After surviving the Didactic year, I went on to complete my clinical rotations, which involve 5-week rotations in various practices. This is where you start to see the true day-to-day as a PA and allows more time to enjoy life outside of your education since you’re gathering so much hands-on experience on-site at a facility.
While these rotations vary by university, the most common specialties are Family Medicine, Internal/hospital Medicine, Women’s Health, Surgery, and Emergency Med. My college also allowed an elective, and I chose a Children’s Hospital ER.
While on my final rotation, COVID-19 struck and changed everything. Luckily, I was working in a small-town family practice that stayed open and allowed the rotation to continue. However, many classmates’ rotations were forced to end, and they either had to find a new office or do online patient experience assignments, which is unfortunate because these assignments aren’t as engaging or valuable as actual patient encounters.
After graduating from PA School and with COVID-19 still rampant, finding a location to take my BOARDs was no easy task. Fortunately, I was able to schedule the first available date after the 30-day wait required after graduation in one of the few locations available in the US.
Leading up to the exam date, I studied rigorously – limiting myself from distractions by taking advantage of a beautiful lake house owned by a friend who was also studying for her BOARDs. All that studying paid off because I (as well as everyone in my PA class) passed the first try!
This is not typical, and if you fail, you have six attempts to retake the BOARDs over a six-year period. My schools program prioritizes the goal of their students getting a perfect pass rate and takes measures to improve the odds of that happening, such as grade requirements stated above. However, in the class below me, only about 90% of students passed, which is more typical of the national pass rate for the exam.
Now with my license to practice medicine as a PA, I set off in search of a job in March of 2020. At first, I was promised many interviews, but then the second COVID-19 wave struck the US, resulting in many facilities pausing hiring due to specialty layoffs and focusing their resources to combat the pandemic.
Even looking and actively applying every day, months passed with fewer and fewer jobs being posted. It wasn’t until December 2020 when I was offered a position at a family practice that a friend had been working in prior to the pandemic. Although I was accepted to the practice and they desperately needed my help due to short staffing, it wasn’t until March of 2021 I was able to start.
The delay in my start date was largely due to poor onboarding practices — employer background checks were done via a third party, who was slow to take action and involved a lot of back-and-forths. Credentialing also took forever — finding the information needed, scanning documents, sending them to different stakeholders via email, fax, and other prehistoric and sometimes insecure forms of communication, getting all documentation approved, and getting feedback about what else you need. This process was often repeated several times and was incredibly inefficient.
On top of typical healthcare credentialing challenges, COVID-19 threw more wrenches in onboarding, as it was difficult to get a Physician letter of agreement, and was finally given a temporary approval due to the circumstances of the pandemic.
Healthcare credentialing was not only a pain point of my personal onboarding process, but one of many PA students in my class, subsequent employees at my office, and healthcare professionals nationwide.
Be sure to create a free Kamana profile for all your credential management.
Fast forward to today — I’ve been a Physician Assistant for over a year at my practice, and have evolved in many ways as a healthcare professional.
In PA school, you were never ultimately the one making decisions, but rather bringing your suggestions or thoughts to the provider who was treating the patient. You weren’t the final decision-maker. You always had someone looking over your shoulder and analyzing every detail of your patient care.
It’s hard for many, myself included, to transition from that environment to putting your education into practice — having the confidence to be assertive in your medical recommendations and believe in yourself in order to provide the best care for your patients. Being able to do so is a skill you need to develop and something that you will improve upon over time.
This feeling of doubt is often coined “Imposter Syndrome”. To combat it, I recommend making sure that where you work, particularly out of college, surrounds you with other providers (and especially your supervising doctor) that you can trust and will support you in your medical recommendations, while also being a soundboard for complex patients that you need guidance on.
Each week, I work four 10-hour days. Three days in-office, and one at-home serving patients via telemedicine. In the office, I see a patient every 30 minutes, and sometimes more due to misscheduling or an influx of patients. Clinical Assistants room my patients, chart-prep, and then they’re ready for my visit. Outside of seeing patients, I answer a lot of workloads (patients calling in with questions or concerns) and reviewing lab work.
During my telemedicine day, I still see patients every half-hour and my nurses prepare for the visit similar to if it were in-person. Once they’re ready, the person logs on to our facility portal and we connect on a video call.
Pros of Telemedicine
There are pros and cons to virtual visits. Telemedicine is great because it’s often more convenient than showing up in person, as elements like anxiety and transportation can be a barrier to care. Productive conversations are often related to acute illness, mental health concerns, lab reviews, and annual wellness checks.
Cons of Telemedicine
Telemedicine also has its limitations. I often get complaints of rashes, blood pressure follow-ups, UTIs, and other health issues that simply can not be diagnosed over a video call. You’re also relying on the patient compliance to get their blood work or other recommended test done, which can often be a challenge.
Becoming a Physician Assistant is a difficult, yet rewarding career. I chose to become a PA for several reasons.
1. I knew I wanted to help people and practice medicine.
2. I wanted to do meaningful work and garner the respect of being a healthcare provider.
3. I also see it as very beneficial to help educate the general public about their health. But, that’s not always easy.
Healthcare is challenging, and people don’t always want to take your advice.
For example, you could have an uncontrolled diabetic and give them all the right suggestions to live a healthier life, but they simply won’t do it. You might recommend life-saving screenings that never get done. It’s challenging to convey my recommendations in a way that educates patients on why they’re important and motivates them to take action. Ultimately, it’s their choice, and some patients even dismiss you because you’re “not a doctor.”
Many PA’s complain that other physicians at their facility don’t show them the same respect as they would a doctor, but I am thankful at my practice that I am surrounded by phenomenal physicians that are supportive and respectful, so my issues are often only limited to patients being uneducated about my role in medicine.
I considered other routes in healthcare but didn’t necessarily want to take on the even more extensive education to become a doctor. A nurse practitioner is another career similar to a PA that many take on, but I knew less about the programs available, as my sister was a PA and had gathered a lot of information due to her expertise.
I love the healthcare career I chose because you can switch gears and do something very different with the same degree. For example, I work in a family practice now but could change my career and work in OBGYN, Surgery, Emergency, or whatever may interest me in the future with few barriers to entry.
My career as a physician’s assistant thus far has provided me with a great salary out of college that has allowed me to buy a house with my fiancé and start saving for our wedding! Career-wise, I’d love to eventually work in a pediatric position, as caring and interacting with children is something that comes naturally to me.
For those interested in becoming a Physician Assistant (or trying to hone in on your first job opportunity) here are a few takeaways to help:
I hope my perspective of becoming a PA and everything I’ve learned in my career thus far helps inform whether a career in this field is right for you!
Emily Goodwill, PA-C, is a Physician Assistant practicing family medicine in northwestern Pennsylvania. She earned her Masters in Physician Assistant Science from Saint Francis University and is currently a staff Physician Assistant at Seneca Medical Center. Outside of her career, Emily loves tasting craft beer and wine, and exploring the outdoors with her fiancé (…and Kamana employee!) Jason as well as their dog Ekko.