Join us on Shadow Me Next as we welcome our guest, Jim Allen, a lead physician assistant who shares his inspiring journey from aspiring military service member to a dedicated healthcare professional in urgent care. Diagnosed with type 1 diabetes at a young age, Jim's dream of joining the military was rerouted, leading him to discover a new path driven by resilience and an enduring passion for medicine. His story is a heartfelt exploration of how life's unexpected turns and personal challenges can forge a rewarding career path in healthcare.
Jim details the fast-paced world of urgent care, where each day brings new challenges and opportunities to make a significant impact on patients' lives. From managing high-acuity cases to mastering the art of differential diagnosis, Jim shares the nuances of urgent care practice. He emphasizes teamwork, autonomy, and the satisfaction of accurately diagnosing serious conditions, all within the vibrant environment of a PA-owned facility. His insights are not only informative for aspiring medical professionals but also a testament to the gratifying nature of urgent care work.
For those looking to enter the medical field, Jim provides invaluable advice on succeeding in PA school interviews and the importance of building a strong community and support network. His passion for mentoring the next generation shines through as he offers tips on crafting memorable interview experiences and navigating the competitive nature of medical education. Whether you're a pre-health student or simply curious about the intricacies of clinical practice, this episode is full of wisdom and inspiration. Follow and engage with us as we explore the rewarding journey of being a clinician and the joy of sharing that passion with others.
➡️ Check out Jim's YouTube channel: Urgent Care Stories, where he reviews interesting cases and walks you through forming a differential diagnosis for each one.
https://youtube.com/@urgentcarestories?si=KfEw2ZjNT5LtZRaL
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:43):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
(01:04):
Today on Shadow Me Next, I amexcited to introduce you to Jim
Allen, a lead physicianassistant in urgent care, who
brings a unique perspective tomedicine, from his early
aspirations of joining themilitary to finding his true
calling in healthcare.
Jim's journey is filled withresilience, self-discovery and a
passion for patient care.
(01:24):
Filled with resilience,self-discovery and a passion for
patient care.
In this episode, jim shareswhat it's like managing high
acuity cases in an urgent caresetting and the benefits of
practicing with full autonomy.
We dive into the topic ofmentorship Do you really need it
to succeed in medicine, or arethere other tools that can help
you navigate your career?
Medicine, or are there othertools that can help you navigate
(01:47):
your career?
Jim reveals the powerful lessonshe's learned from his patients
and the one unexpected interviewquestion that left a lasting
impact on him.
You are not going to want tomiss that quality question.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
(02:10):
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
Hi Jim, thank you so much forjoining me on Shadow Me Next.
Thank you for taking the timeto be with us today.
Absolutely, it's my pleasure howyou bring students into your
(02:46):
workday.
I'd like to start at thebeginning and talk to you about
what initially inspired yourcareer in healthcare and how you
chose to be a physicianassistant.
Jim (02:54):
Yeah, so growing up, I was diagnosed with type 1 diabetes
when I was five years old.
So you really have to grow upquickly when you have to
constantly be aware of howyou're feeling, what your blood
sugar is, making sure you'retaking control of your health,
like that, and so that kind ofmade me grow up a lot faster
than most people at that age.
(03:14):
So I was always around somedegree of the medical world.
When I was growing up, my dreamwas honestly always to be in
the military, and as a young kidI didn't realize that if you
have diabetes you're noteligible for the military.
And so when I called arecruiter when I was like 16 or
17, and they're asking me mymedical history and I say, oh
(03:35):
yeah, I have type 1 diabetes,they're like, oh well, if you
need to take medication on adaily basis to survive, you're
not eligible.
And so I said, oh okay, wellthere goes that dream.
So when I was in high school, Ihad recently gotten into
exercising and lifting weightsand stuff.
So that was definitely apassion of mine.
I was fascinated by the humanbody, but I was also really
(03:56):
interested in mechanical things,cars and just how things work.
That's always been kind of aninterest of mine is how things
work, and so when I was acceptedinto college, I initially went
to the University of Colorado inColorado Springs and they're
really well known for theirmechanical engineering program,
and so that's what I joinedcollege to do is mechanical
(04:18):
engineering Exercise was justkind of an interest of mine, but
wasn't really a career path.
Just kind of an interest ofmine, but wasn't really a career
path.
Prior to college I had nevereven thought about medicine.
No one in my family is medical.
My dad was actually a pastorfor a Presbyterian church and
then he formed his ownleadership consulting company.
After he left that field.
(04:40):
My oldest sister is an attorney.
The sister above me in line wasan arts degree and then she got
into sales.
My brother's a musician.
So we have a large variety ofexpertise and interest in the
family, but nobody was medical.
The undergrad work and what Ifound was I really wasn't doing
(05:04):
well at the math.
There was components thatplayed into that.
My dad died of a sudden heartattack when I was 18, right
before I graduated high school,so I was still grieving that
loss and there were someteachers with very heavy accents
that were part of my troublelearning calculus, and so I
found that if I wanted to reallybe serious about mechanical
(05:25):
engineering, I really felt thatI needed to understand the math
a lot stronger than I did, andso after my first year in
college, I decided to talk tothe college advisor and switch
degrees.
So one of the questions thecollege advisor asks is what are
you interested in?
And at that time I got reallyinto weightlifting.
(05:46):
So I was a competitivebodybuilder, later became a
competitive powerlifter, so Iwas really just into
weightlifting and that sort offield.
The problem that I found withthe college advisors is they ask
what you're interested in butthere's not a lot of thought of
what are you going to do withthis degree path for a job, how
much money can you make at thisjob and that sort of stuff.
So they pushed me into a healthsciences degree path, with
(06:08):
strength and conditioning waskind of my emphasis.
I had initially thought, oh, Imight be a sports team athletic
trainer or strength coach orsomething like that, maybe open
my own gym someday, somethingwithin the fitness world.
So I went through that degreepath.
I fell in love with anatomy andphysiology, biomechanics.
I just loved learning about themechanical side of how the body
(06:31):
works.
That kind of felt like a reallygood mix for me.
As I started to get into juniorand senior year, you're starting
to think about what jobs you'regoing to do out of college and
I quickly learned the type ofmoney that I wanted to make.
You just don't make as aundergrad level.
You know strength andconditioning coach, it's just
(06:51):
not really something that you'regoing to do.
It's not a lot of stabilitywith that, it's a lot of risk.
And so I started looking intowell, within the health world,
what are some kind of additionaltraining or kind of higher
level education that I can gointo.
So physical therapy obviouslywas a very obvious next step.
So I started working as aphysical therapy technician with
(07:11):
the goal of going to PT school.
So I did that for about threeyears out of undergrad and what
I found was I enjoyed it, but itwas a lot of the same.
It was just kind of the samething over and over.
You're not really the onemaking decisions, you're just
kind of following the standardprotocol.
Somebody did a knee replacement, let's do the range of motion,
(07:32):
let's get them stronger, andthen we kind of rinse and repeat
50 times a day.
So at that point my mom wasactually the one who said well,
have you ever heard of aphysician assistant?
And at that point I had no cluewhat they were.
So I started doing someresearch into PAs and started to
realize it actually could be areally good fit for me, because
(07:53):
you're higher level in terms ofmaking medical decisions,
diagnosing patients, prescribingmedications, interpreting, lab
work and imaging, but you don'thave to go through the extensive
training that a doctor has togo to, but you still allow some
big decisions to be made.
And then, on top of that, forsomebody like me who doesn't
like the same thing over andover, you could switch career
(08:15):
paths at any time, and so thatwas very appealing to me at that
point as well.
So the funny part was, as I waskind of learning about this, I
actually had a patient who was aPA.
I asked to shadow her.
She was primary care at thatpoint, so got a little
experience there.
Had another colleague who knewa PA in orthopedics, got to
(08:37):
shadow them in surgery and inthe clinic and really felt, you
know what?
I think this is a much betterfit for me.
So as I started to get ready forthe application for PA school,
took the GRE, ended up having totake it twice.
I just wasn't happy with myfirst score.
So I took the GRE twice, didall the prereqs that I still
needed for PA school, and then Iapplied my application process.
I applied twice to PA school.
(09:00):
So if you're out there and youdidn't get in first try, don't
feel bad about that.
It doesn't mean you're stupid,it's just that's part of the
process for some people.
I mean, the last time I checked, there's about a 5% chance
nationwide of getting into PAschool, and so it's very
competitive.
What I learned was one I appliedlate in the cycle the first
(09:20):
time.
So I applied in August becauseI saw the deadlines were October
, november, december, stuff likethat.
So I thought, oh well, I'mstill ahead of the deadline.
I didn't have a letter of recfrom a PA, which I think is
really critical and I justdidn't have anybody mentoring me
through the application process.
So I didn't know anything aboutthe process, I didn't know how
to make myself competitive, Ididn't know the things that you
(09:43):
need, and so I was just kind offiguring this out on my own.
So I had applied to five schoolsthe first cycle, one of which
being Duke, which was kind of ajoke that's the number one PA
school for those who don't know.
And then I applied late and Ididn't have a letter of rec from
a PA.
So of course the first cycle Ididn't have any interview
opportunities, didn't getaccepted anywhere.
(10:04):
So it was pretty hard for me atthat point because I was
thinking what am I going to dowith my life.
I don't want to be a PT techmaking, you know, very little
money.
I had engaged to my wife atthat time, so we were soon to
get married and so you know Iwas very concerned.
So I went back to the drawingboard, bought some different
books about how to becompetitive to apply to PA
(10:26):
schools, learned some things inthe process, got a letter of rec
from a PA, got more experience,shadowing and volunteering and
stuff like that.
My GPA, I think, wascompetitive.
So the second time around myprocess was if there's a 5%
chance of getting in, I'm goingto apply to 20 schools and
theoretically I should getaccepted to at least one.
(10:48):
It was expensive for me but itwas worth the effort.
So I applied early.
The second time I had the rightletters of rec, had the right
experience and I applied to alot more schools.
That cycle I had about 13offers to interview.
So that cycle I had about 13offers to interview.
(11:19):
I interviewed at seven or eightuniversities and then I was
accepted to two.
The two universities was theUniversity of Florida, which is
where I was just so gratefulthat I now had a career path and
a career moving forward that Icould participate in and so
ended up going to US and youknow we can talk about that, but
that was kind of my process forgetting into PA school and how
I shifted into medicine as Icontinued to go.
Ashley (11:39):
What a great story, Jim , Thank you so much for being so
detailed with that, because Ithink that you know it is a
journey, and it's one that isnot always a pleasant journey,
you know.
I think there's a lot of hurdlesthat we jumped through, the
challenges that you faced, theposition that you want to be in,
such as yourself, how theyovercome those challenges is
huge for us, is huge for us tosee, and you know, something
(12:09):
that we can kind of apply to ourown lives.
A common theme that I heard youspeak about just then is how
important mentorship is and howimportant it is to have somebody
who can help provide a littlebit of direction.
You know, starting it when themilitary had to decline your
application because of the factthat you have type one diabetes.
(12:30):
You know, at that point it'slike, well, where do I turn from
here?
You know, and all the waythrough, when you mentioned when
you were in college and theygave you a major but they didn't
perhaps give you an idea ofwhat to do with that.
Mentorship is hugely importantand finding it, I think, can be
really challenging.
Do you have mentors in yourlife right now, jim?
Jim (12:52):
When I was new to my current job years ago, the owner
of the company.
He definitely poured in andmentored me as a provider and a
PA, and we'll talk about thatlater.
I think he really had a keyinfluence on how I became the
provider that I am today.
I think that I have role modelsin terms of Christianity,
people who are pushing me to bea better Christian, a better
(13:14):
husband, a better father andstuff like that.
If you ask me currently, today,do I have any mentors?
I would probably say no.
I have friends and we help,push each other, but I don't
think I have a lot of people inmy life right now who I would
say this is a mentor, who ispushing me to be better.
I think I'm prettyself-motivated in terms of the
goals that I have for my lifeand for my family, and I'm kind
(13:37):
of taking it upon myself toresearch things that I want to
learn, either through books orYouTube or talking to people
with experience.
I think that's kind of thephase of life that I'm in now is
I'm just self-motivated andtrying to figure this stuff out
for myself, but I'm not afraidto ask people for help if I feel
like somebody has someknowledge that I want to obtain.
Ashley (13:57):
Which I think is probably a result of the
experience that you had growingup.
You are a self-made person andyou have done the research and
you have jumped through theloops and you have built a
really, really strong foundation.
I think oftentimes we do talkabout mentorship and it can feel
very stressful if you don'thave a consistent mentor in one
field of your life.
(14:17):
A lot of people do need that tosharpen themselves and to build
themselves up.
But, like you said, if you area self-motivated person who does
all the heavy lifting which isironic for you with your hobbies
I think maybe we'll talk aboutthat too.
But as a self-made person, thementorship factor might not be
as pivotal for you.
(14:38):
And I also think again,something we're going to speak
on I think this is what makesyou such a great mentor to some
of the students and some of thePAs that rotate through your
office.
So let's talk about when you'reworking, jim.
Tell us a little bit about aday in the life as a urgent care
lead PA.
Jim (14:57):
Yeah, so my company is actually a little bit different.
So I do have a supervisingphysician.
He merely exists on paper to me.
I have spoken to him once inthe last five years and I don't
talk to him about cases at all.
The owner of my company isactually a PA himself.
He was a flight paramedic for15, 20 years.
(15:19):
Then he went to PA school, thenhe worked in emergency medicine
for about another 15 yearsbefore opening his own urgent
care clinics.
So the owner of the company,who is a PA, he's a resource for
me.
So when I see a patient and I'mnot too sure about what to do
with them, he's the person Icall.
And a lot of times the phonecall will be hey, I've got this
(15:42):
person.
Blah, blah, blah.
Medical history chief complaint, blah, blah, blah.
This is the testing I've done.
This is what I'm concernedabout.
Do you feel this needs thisworkup or do you feel this needs
admission, or is this somethingwe can treat outpatient and
we'll kind of talk through thatcase and kind of decide what's
medically best for the patient,what documentation we need to
(16:03):
include, stuff like that.
So when you go through, this issomething that I really try to
when I have PA students rotatewith me.
This is something I really tryto teach them is when you're in
school.
Pa school is very heavy on theseare the symptoms and
presentations of this condition.
(16:23):
This is how you diagnose this.
This is how you diagnose this.
This is how you diagnose it andthis is how you treat it.
And so you're very focused onwhat is the diagnosis and the
appropriate treatment for that.
In the real world of emergencymedicine and urgent care acute
kind of patients the mindset hasto switch.
So you'll have somebody come inwith chest pain, let's say, and
(16:45):
instead of saying I need to getto the perfect diagnosis,
exactly what they have, themindset is I need to rule out
the things that arelife-threatening or critical.
That needs to be admitted forthis complaint.
So it's a lot more heavilyemphasized on the differential
diagnosis which you havetraining in at PA school, but
(17:06):
it's pretty minimal compared towhat the real world looks like.
So, for an example, if you comein and I have a 20-year-old
with chest pain who's healthy,versus a 76-year-old diabetic
with hypertension and coronaryartery disease, that person with
chest pain is going to get adifferent workup.
That person with chest pain isgoing to get a different workup.
(17:26):
So my focus is based on thesymptoms they're presenting to
me, the vital signs I see, theexam that I do and the
laboratory testing that Iinterpret.
I'm trying to rule out heartattacks, pulmonary embolism,
myocarditis, pneumothorax,pleural effusions, all these
different conditions that couldcause chest pain.
And if I find something thateither confirms something
critical or I can't rule outdefinitively something critical,
(17:49):
then they need more advancedworkup than I'm able to give at
that moment.
But if I can do my entireworkup and my urgent care
luckily is set up with a lot ofcapabilities that other urgent
cares don't have I think we're alot more like a freestanding ER
in the sense that I can docardiac enzyme panels, I can do
B-dimer blood clot rule-outs, Ican order same-day CT scans, I
(18:12):
can do x-rays on-siteimmediately.
So I have a lot of reallyimportant capabilities.
That allows me to rule out alot of critical things.
But that mindset of kind ofmaking sure I'm not missing
critical things is somethingthat it took a while to learn
and that's something that he dida really good job of teaching
(18:32):
me, and so that's something Itry to work with my PA students
on.
So a typical day we're in fluseason right now in the urgent
care.
So my clinic is open Mondaythrough Saturday, 9 am to 9 pm.
So each provider there's two ofus.
We each do three 12-hour shiftsper week.
So I work three days, she worksthree days and we each have
(18:54):
four days off.
So it's a nice.
You know it's hard days whenyou're there, but the nice thing
is you do have days off duringthe week to do other things and
enjoy your life.
So typically I'll get up in themorning and I'll go to the gym
and work out.
That's how I wake up and dealwith stress is work out and then
I'll go to the gym afterwards.
Yesterday I saw 35 and I saw 20of them within the first three
(19:17):
hours of the day.
Oh my gosh, the volume can bepretty insane.
So the volume can be prettyinsane.
So that'll range from a lot offlu symptoms, sinus infections,
coughs, pneumonia, ucis, thatsort of stuff.
You'll get belly pain, chestpains.
You'll get orthopedic injuries,fractures, stuff like that.
(19:38):
You'll have three lacerationsyesterday, one abscess drainage
yesterday, medication refillsfor different things, people
with high blood pressure.
That's hard to manage.
An urgent care can see all theabove.
So I've had people with heartattacks come through.
I've had people with strokescome through.
I've had big hip fractures,dislocated shoulders, you name
(19:59):
it.
The concern is just a lot ofpeople they'll come into an
urgent care maybe thinkingsomething isn't a big deal, and
then you have to figure out, oh,actually this isn't a big deal,
this needs surgery or thisneeds admission and management
or whatever the case may be.
So my visits have a wide varietyof what we see, and so the nice
thing is that every patientexperience is new and there's
(20:20):
definitely some exciting things,like the first time you
diagnose appendicitis based offyour physical exam.
Like that feels really good.
Stroke that you catch oh mygosh.
Like somebody comes in withfever right lower carter belly
pain.
They have a positive robson'spositive obturator.
You can literally make thediagnosis just off of your
physical exam.
You don't have to do blood workor anything.
You just say, hey, we need toget you, to get you to the ER,
(20:42):
you need to CAT scan and youneed your appendix out.
You know you call them the nextday.
You're like no, you're 100%right, it was my appendix, they
took it out, I'm feeling great.
You know, those feel reallyexciting.
The first time you see that Ihad a 13-year-old girl.
Her family brought her inbecause and so a lot of people
(21:07):
say, okay, what's thedifferential for that?
Well, at her age it was septicarthritis, so her hip joint was
infected and it's a blood spread, hematogenous spread, and so,
just based off of a physicalexam and history, I said this is
, you know, infected joint.
You need to go to the hospital,they need to wash it out.
So called them a couple dayslater, confirmed yep, that's
exactly what it was.
They washed it out, everythingwas.
I called them a couple of dayslater, confirmed yep, that's
exactly what it was.
They washed it out andeverything was great.
So, again, your medicalknowledge can take you a long
(21:28):
way, and those are things thatwe're all trained in in PA
school.
A lot of times people don't puta lot of effort into the
training process in PA school,so they forget a lot of this
stuff.
So part of my effort when I wasin PA school is I really worked
hard at the school work and Ireally spent a lot of hours
learning, and so because of thatI've been able to retain a lot
(21:49):
of the knowledge that I learnedthere and it's helped me every
day of my career.
So yeah, that's kind of a fullday.
You know, you see between 25 to40 patients per day.
Sometimes you'll have waves ofthem come in at once, sometimes
you'll have a little gap inbetween them, but yeah, it's
just 12 hours straight.
Ashley (22:07):
Right, you know you mentioned about how, when you're
exploring physical therapy as apotential career, that you
needed a little bit more varietyin your life and, lord knows,
it sounds like you found thatvariety, jim.
Wow, you know, when you are inPA school, as you know, you do
learn about all of theseconditions and it is so exciting
to learn the number of waysthat our body serves us every
(22:30):
day and, unfortunately, thenumber of ways it can go wrong.
It feels really good to be ableto help somebody with all of
that knowledge that you took inwhile you were in school.
That's a huge patient load, jim.
Do you have, do you have,support at your clinic?
I know you mentioned it was youand another clinician and you
guys rotate, so it doesn't soundlike you're always there
(22:51):
together.
Are there other members of thehealthcare team that are there
providing support to you whileyou're trying to see 40 patients
a day?
Jim (22:58):
So our staff is a receptionist, a medical
assistant and an x-ray tech whokind of also helps in a medical
assistant kind of role.
All medical decision-making,all patient visits are your
responsibility as the provider.
It's a lot, it's completeautonomy.
Your job is identical to aphysician in an urgent care.
(23:22):
You have to really be on top ofyour game.
You really need to know what tolook out for.
You really need to know yourmedical conditions and your
treatments.
And then obviously our, theowner of the company.
You know he does a great job ofyou know he answers his phone
when you call.
So you know, when I was brandnew I'd call him 30 times a day,
you know, and it was more justthe medical, you know, the
(23:43):
understanding of the conditionswas there.
It was more the hey does thisneed to go to the ER, or can I
treat this?
Does this need a CT, or can Ijust assume?
it's this and a lot of timeswhat urgent care does is we'll
try to narrow it down as much aswe can and then we'll treat for
the two most likely things thatwe think you have.
So you know, an example wouldbe hey, you know, if you come in
(24:05):
and you're having vaginalcomplaints, vaginal discharge,
itching, something like that, wesend out a swab.
Your history doesn't reallymake us too concerned for STDs,
but hey, this could be bacterialvaginosis, this could be a
yeast infection.
So why not treat for both, sendout the appropriate testing,
and then we'll cover worst casescenarios.
So that's kind of what we'redoing.
(24:26):
Is not always are we going toget to the exact diagnosis that
you have, but we're going to tryto rule out as many things as
we can, and then we're going totry to do the best we can in the
meantime to make sure you don'tget worse.
Ashley (24:37):
I think that's great and, you know, with autonomy as
a physician assistant, I think,comes a lot of access to care,
and it sounds like that's what alot of these patients need,
right Is somebody to justevaluate them, to let them know
if this is something incrediblysevere or if this is something
that perhaps we can treat with aprescription, or if it's a
dislocated shoulder, maybe wecan just reduce it.
(24:58):
Jim, talk to me more aboutphysician assistant autonomy,
because of all of the peoplethat I've spoken with right now
that are physician assistants,it sounds like you practice the
most autonomously.
You are working by yourself andyou have very little oversight
and you might not need that.
So tell me a little bit aboutautonomy for you and what it
means to you as a PA.
Jim (25:20):
Yeah, yeah, so before I switched over to urgent care, I
did orthopedic surgery for twoyears and then I did a little
stint in primary care when mywife and I moved back to
Colorado.
Briefly, when I was inorthopedic surgery you're
basically glued at the hip toyour surgeon, so you guys
operate together, you seepatients, you talk to him about
(25:42):
consults in the hospital, so itis a one-on-one relationship.
There is a tremendous amount ofsupervising that's being done
because this is an orthopedicsurgeon who went through a
tremendous amount of trainingand has so much knowledge that I
don't have or would take mefive to 10 years to obtain.
And so when you're fresh out ofschool you need that constant
(26:02):
reinforcement, constanteducation, constant explaining
of how to do things when you'rein urgent care.
I needed a lot of that upfront,but it could come from a phone
call.
It didn't always have to be hey, look at the same patient that
I'm looking at.
And so I think my orthopedicexperience helped me
dramatically with urgent care,because there's a lot of
(26:23):
orthopedic complaints that comein that I have a little more
experience and knowledge dealingwith than some of our other
providers.
So they come in with a fracture.
Well, I know how to manage thatfracture.
I know most likely this isgoing to need surgery or most
likely it's not, and so I canhelp kind of guide the patient
along their expectations of whatto expect, moving forward, what
(26:44):
this likely is, how we likelytreat what they have and stuff
like that.
So the autonomy in an urgentcare for me, I really enjoy it.
I like to make my own medicaldecisions, I like to call the
shots and I think this is kindof a perfect field for that.
But that's not everybody mywife loves she's a dermatology
PA.
She loves to have a supervisingphysician that if a patient is
(27:07):
too complicated, she can justsay, hey, I'm going to send you
over to my supervising physician, because she says well, and so
to have that ability to offloadchallenging things that are
maybe above a scope of practiceis really appealing to her and
for me.
I think I like the idea ofalways having the emergency
department as my backup.
So if I really have no idea, Ithink I like the idea of always
having the emergency departmentas my backup.
So if I really have no idea,but I think you look critical, I
(27:30):
can always send you foradditional testing and more
expertise.
A lot of things I think I candeal with and I can manage for
people and I like to do that.
Ashley (27:38):
I enjoy the challenges that that presents, but I also
like the freedom of being ableto make decisions myself
presents, but I also like thefreedom of being able to make
decisions myself, and thank youso much for comparing your
position to your wife's position, because you know, and I align
more with your wife on thisObviously I'm also a Derm PA and
I think our oversight is verysimilar.
(27:59):
But imagine being in an urgentcare by myself with a patient
come in with a heart attack,with a STEMI, and having to read
an EKG with no other eyes on itexcept a man, by phone, like it
makes my feet sweat, my heart'sbeating too.
I might be having a STEMIthinking about it, you know, and
that's the beautiful thingabout being a PA is that there
is variety in not just what youdo but how you do it too.
(28:22):
And I think sometimes evenwithin the profession there are
certain people who work in,maybe, urgent cares and they
might want more oversight, somaybe they ask to be scheduled
when there's another physicianassistant, and it's not that
they're overseeing each other,it's more of just a
collaborative environment.
So I'm so glad you brought thatup.
Thank you for mentioning that.
But before we shift gears, Iwant to ask you know about our
(28:43):
quality questions segment on theshow.
Do you have a quality questionthat you'd like to share with us
?
Before we hear what Jim'squality question is, keep in
mind that there's more interviewprep, such as mock interviews
and personal statement reviewover on shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Jim (29:07):
Sure, so this is not a question I was asked or asked
anyone.
This was actually from aphysical therapist that I had
worked with years ago and it wasa question that he was asked
when he was applying to PTschool and I thought it was such
a cool question.
So these are one-on-oneinterviews, very similar to PA
school or med school.
So you're sitting in front ofan interviewer, they're asking
you questions why do you want tobe a PA?
(29:28):
Why don't you want to be adoctor?
Why do you want to go to thisschool?
You know things that can bevery intense questions.
So this guy asked the physicaltherapist.
He said who was AdmiralHirohito and what role did he
have in the US involvementduring World War II?
Ashley (29:45):
Oh my gosh.
Jim (29:48):
So when you hear that question, you go what, I'm not a
history major.
Why are you asking this randomquestion?
He said well, I don't know whoAdmiral Hiroshito was, but if I
had to guess, I would say thathe was involved in planning the
Pearl Harbor attack thatlaunched the US into World War
II against the Japanese.
(30:09):
And the guy says wrong.
I'll tell you.
I like that you didn't give up.
Ashley (30:14):
And in that instance I said oh my gosh, what a crazy.
Jim (30:17):
because if you would have asked that question to a hundred
people, most of them would havejust said I don't know who was
Admiral Hirohito, and they justsaid well, spoon, feed me the
answer.
But this guy was looking forsomebody who had some resilience
, who would take their best stabat it, who would at least try.
And I think that such a randomquestion can tell you such
(30:38):
important, key factors aboutsomebody's personality.
Are they going to quit when itgets tough?
Are they just going to ask foryou to do the work for them, or
are they going to give it theirbest effort and try?
But that question has alwaysstuck with me.
It's just such a random way toask something so deep about
somebody's personality, so Ireally enjoyed that question.
Ashley (30:59):
Jim, that is a fantastic question and I think a
lot of questions that wereasked on interview like that are
meant to make us think and theyare meant to show our tenacity
and our ability not to letanything go until we've at least
given it our best shot.
You know, we have a verysimilar situation at our
practice when we host PAstudents, which I'm excited to
talk to you about.
Next, when we have a PA studentcome in and, as a PA student,
(31:22):
you are seeing patients and thenyou're bringing the information
back to the PAs, which is youand me, and you're presenting
the patient and presenting theirdiagnosis and what their
diagnosis is.
And we have a saying around ourclinic that is don't guess what
their diagnosis is.
Tell me what their diagnosis is.
Don't say I don't know.
Don't just give me a randomanswer.
I want you to tell me what itis.
(31:43):
Don't say I think.
Tell me what their diagnosis is.
Don't say I don't know.
Don't just give me a randomanswer.
I want you to tell me what itis, don't say I think.
Tell me what it is.
Because, I can teach off of that.
If you tell me a patient iscoming in with a dislocated
shoulder based on your physicalexam findings, and I go in and
it turns out they have a blackwidow spider bite on their arm
(32:06):
and that's what's causing theirpain, this is a teachable moment
.
If you just come in and say,well, I don't know, their
shoulder hurts and there can bea million reasons for that, well
, that's not teachable.
So I think that question thatyou brought up that is great.
Okay.
So, jim, we spoke a little bitabout students and I think you
and I we have this sharedpassion for teaching and you
(32:26):
have a YouTube channel that iscalled Urgent Care Stories and I
watched all of them thismorning and I expected to only
watch one and I just couldn'tstop watching because the
stories that you tell aboutthese patients that you've
encountered, they're captivating.
Why was that important to youto start that YouTube channel?
Jim (32:47):
Yeah.
So what I was finding was whenthe I had a few PA students work
it with me, and what I wasfinding was that the ability to
create a differential diagnosiswas really something that was
lacking, and I think it's justpart of the training process
that just a lot of people theydon't prioritize.
And so my goal was I was tryingto create, you know, cause
(33:08):
there's so many patientexperiences that I've
encountered that have taught meso much of like really important
lessons of like, if you feelthe need to do a workup, it's
always worth it because you'regoing to find something or you
know, listen to the patient,they're going to tell you their
diagnosis, or never assume youknow something about the patient
.
You know always kind of trustyour gut and listen to what
(33:31):
they're telling you.
And so there were some reallyimportant lessons that I've just
learned, that I've just foundhave been very valuable for me
through my career in terms ofmaking the right decisions, and
(33:51):
so I decided I wanted to createsome YouTube stories to just
kind of share my experiencesthrough memorable patients, of
things that are really important.
And so my goal was thisknowledge is trying to be
directed towards pre-med, pre-paor even freshly graduated med
and PA and nurse practitionerswho are new to the field and
they're eager to learn.
But there are some things thatonly experience can teach you,
and so my goal was to try topresent cases in a really clear
(34:13):
manner of hey, this is what thepresentation was, this is kind
of what my thought process was,this is how we worked this up
and why I chose to work it upthis way, and this is what the
outcome was and this is what weoutcome was and this is what we
do with that.
And so my goal is is each of thevideos I'm trying to take you
through a patient encounter,give you the history, give you
(34:34):
the presentation and kind ofteach you through that process.
And so my thought was that, youknow, videos were the easiest
way for me to do this.
Spent a lot of time on YouTubeanyway.
So that was kind of my avenue.
I'm not trying to make money,I'm not trying to be
Insta-famous or anything likethat.
My goal is just I like teachingand I like helping people.
That's part of why we go intomedicine is we care about people
and we want to help people, andso this was one avenue for me
(34:56):
to try to help people out therein the world of medicine.
Learn from my experiences.
Ashley (35:02):
I think it's a great idea and, of course, the ones
you mentioned from a shadowingperspective, which, of course,
is how I view the world rightnow.
It's stories for students whoare trying to figure out,
perhaps, where they want to endup in this medical career.
That is so wide entertainmentlevel.
Or are these storiesinteresting you?
(35:24):
Because you are just desperateto get your hands into this
situation yourself and to doexactly what you're doing and
running the tests on thesepatients and doing the physical
exams and making the diagnosesand seeing the results.
So I think it's great for astudent shadow, but I also think
it is fantastic for anybodyprepping for their boards too,
(35:44):
because the way that youapproach these patients is very
methodical and the historiesthat you give, like I said, the
physical exam findings.
Oftentimes you talk about testresults and then you present a
differential which is, inessence, a, b, c, d, e.
Pick the right, pick the rightdiagnosis right and say, before
(36:04):
they get to the end of yourstory, they can determine for
themselves.
You know what could this be?
And then you get to give themthe answer and you go.
You know, you get to explain tothem, you know what specific
findings led for that.
So it was just it wasincredible.
It's a great idea I'm soexcited to share and I'm excited
for other people to hear aboutthis.
Urgent care stories on YouTubeas well.
(36:25):
I'll make sure to link it inthe podcast description for
anyone who's interested inchecking it out.
But, jim, pa students, pre-pastudents, pa shadows you have
hosted many of these people.
What are some common themesthat you find yourself
(36:45):
discussing with these peoplethat come?
Jim (36:47):
and are looking to you as a mentor figure.
So vast majority are yourpre-PA students.
So these are usually undergrador recently graduated from
undergrad students who are inthe process of applying or
getting everything ready toapply.
So I've done a lot of that workand really I just felt like
when I was trying to find PA asa shadow, there's a lot of
people who say no, and I'm sureyou're in the same boat of
(37:10):
you're booked up for, I think, ayear on your shadows, but
there's just such a demand andthere's so few people who are
willing to do it, and so I thinkbeing at an urgent care as an
autonomous PA is a really uniqueexperience already.
So it's something that maybe alot of people are not aware is
out there in the world ofmedicine as a PA.
And then I think what I do iscool.
(37:30):
I think I see a lot of coolstuff, I get to make cool
decisions, I get to help a lotof people, and so I wanted to be
able to share that with peoplewho are thinking about getting
into this career path.
So some of the common thingslike the pre-PA students a lot
of them are going to ask aboutyou know, what was your GPA?
What was your experienceapplying?
How many schools did you applyto?
(37:51):
How did you get into PA school?
How were you competitive?
And then a lot of them aregoing to ask about the interview
process and what that lookslike.
And so you know, I ended upcreating a couple of videos on
my YouTube channel about, like,how to be competitive for PA
school, how to get into how todo the interviews kind of tips
and tricks and stuff like that.
There were just three videosthat people can watch because I
(38:13):
had a lot of people just askingme the same questions over and
over.
So one of the common things thatyou'll do in a PA school
interview or med school isyou'll do a group interview and
so the group interview for thosewho don't know you're going to,
once you're invited for aninterview, you've already made
it to like the top 10% ofapplicants already.
So that's a really big thing.
But once you get to theinterviews, you'll have a few
(38:33):
one-on-one interviews and thenyou'll have a group interview.
So the group interview is yousitting in a room and there's
going to be somebody who'sgrading you maybe one or two
people and so you'll have aquestion prompt and then there's
going to be a timer for 10minutes and then you're just
going to discuss that topicamong yourselves.
These are typically politicaltopics or just kind of things
(38:56):
that are going to have a oneside says this.
One side says that, shouldmedical providers have the
ability to remove your firearmsfrom your house, know that
you're a threat to yourself orothers.
Obviously there's one side whosays, no, nobody should take
your guns away.
That's your right.
Second Amendment Other side'sgoing to say, well, absolutely,
if it's for the greater good orif you're a threat to yourself,
(39:17):
we should be able to take thataway from you.
And then we're going to gradeyou on it.
And so a lot of people they'retrying to find a way to be
competitive in that process.
So one thing that's a commonpitfall is there's going to be
some aggression to try to belike oh, I'm going to read the
question prompt for everybody.
I'm going to show leadership,and so a lot of times I tell
people don't really try to fight, for that.
(39:38):
It doesn't mean a whole lot tous, it's just cool.
You were the first one to talk,you're a bit of a bully or
whatever.
So I don't really stress thatto students.
Really, the hard part is likewhen you're watching these
interviews as the grader.
One of the crazy things is likesome people will just not talk,
and it's amazing, becauseyou're sitting there and you're
like, hey, man, like why aren'tyou getting involved in this,
(40:03):
why aren't you talking?
You're just sitting there beingquiet the whole time.
I have nothing to grade you on.
So what I would recommend topeople is I would sit back and
let people discuss it for alittle bit, maybe throw
something in there, but I'd bewatching the other people in the
group, looking for who is nottalking, who's being a little
shy, and then what I would sayis I'd jump into the talk, I
would put my opinion out there,and then I would turn to that
(40:31):
person and say, hey, jason, whatdo you think about this?
And what that's going to do isit's going to show that you have
compassion for other people,and so at least I really
respected people who would tryto involve other people in the
process, and so it's a reallyclassy move.
It doesn't come across over thetop or anything.
It just shows that you care forsomebody else, and that's
really important in medicine isto find providers and PAs that
are compassionate, and so thatwas a really easy way to just
(40:51):
make yourself look good in thegroup interview is just ask
somebody else from the groupwho's been a little quiet or shy
, you know a question.
So that's kind of a quick, easything for people to do.
And then on the one-on-oneinterviews, some of my advice
for people would be a lot oftimes the interviewer is going
(41:12):
to ask you a lot of questionswhy do you want to be a PA?
Why this school?
What are your strengths, whatare your weaknesses?
You know what happens if youdon't get into PA school this
year.
What are you going to do?
Those sort of questions youshould have really
well-rehearsed, well-practiced,professional answers to, because
you're going to expect those.
They're obviously going tothrow some oddballs at you.
What kind of a superhero wouldyou be?
What's your favorite color andwhy?
(41:37):
Just kind of random stuff thatthey're going to ask.
But one of the best things isthey're going to ask you do you
have any questions for me?
Instead, phrase it as what areyou most proud of about this
university?
Ashley (41:46):
Like what makes you want to?
Jim (41:47):
work here Because that is going to really make them feel
oh well, I'm really proud ofthis, or I chose to work here
because of that.
So just the way that you'rephrasing questions to the
interviewer can really affecthow you're perceived.
And then the other advice Ihave for people is ask them
questions about themselves.
Everybody has a really easytime talking about themselves
(42:08):
and everybody gets nervous aboutinterviews, even the person
doing the interview.
They're still nervous.
You can ask them what do youlike to do for fun?
What fields of medicine haveyou done that you really enjoyed
?
Why did you decide to go intoeducation?
Then you can talk about thatstuff for a while.
And then the goal is whenthey're looking back at the
pictures of all of the peoplethey interviewed that day, they
(42:31):
might not remember what youanswered as to why you want to
be a PA.
Everybody says the same thing.
What they're going to rememberis they're going to look at your
picture and they're going to go.
Oh my gosh, we had thiswonderful conversation about
dogs and about the dog park andwhy I love this field of
medicine.
I really enjoyed thatconversation I had that's.
All you're looking for is justpositive points, and so it's
(42:52):
really easy to kind of just gamethe system and just kind of
make the experience positive foryou.
Ashley (43:00):
Jim, those are all such great recommendations and
really really very tangible tipsfor students and it's people
are going to think I set you up.
I didn't.
You mentioned two things whenyou were talking about those
interview questions.
You mentioned access invitepeople into the conversation who
might feel like they don'tbelong there, or perhaps they're
(43:21):
just a little shy, or perhapsthey just need an invitation.
You're giving access and thentelling stories, right?
That's ultimately what aninterview is.
Let me tell you a story aboutmyself, and I would love it, too
, if you could tell me a littlebit about yourself.
So I think access and storiesit is what brings humanity into
(43:42):
these things that we do, which,for you and I, happen to be
medicine.
So thank you so much forsharing that.
Thank you for dedicating somuch of your time to hosting
shadows.
Something that you said thatjust really resonates with me
because I always say it too isI'm proud of what I do as a
clinician.
You're proud of what you do.
What we do is cool, and sharingit with people is one of the
(44:03):
highlights of my day, as it iswith yours.
Thank you so much for takingthe time to join us here on
shadow me next.
I appreciate it.
Oh my pleasure.
Thank you so very much forlistening to this episode of
shadow me next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
(44:25):
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:43):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
(01:04):
Today on Shadow Me Next, I amexcited to introduce you to Jim
Allen, a lead physicianassistant in urgent care, who
brings a unique perspective tomedicine, from his early
aspirations of joining themilitary to finding his true
calling in healthcare.
Jim's journey is filled withresilience, self-discovery and a
passion for patient care.
(01:24):
Filled with resilience,self-discovery and a passion for
patient care.
In this episode, jim shareswhat it's like managing high
acuity cases in an urgent caresetting and the benefits of
practicing with full autonomy.
We dive into the topic ofmentorship Do you really need it
to succeed in medicine, or arethere other tools that can help
you navigate your career?
Medicine, or are there othertools that can help you navigate
(01:47):
your career?
Jim reveals the powerful lessonshe's learned from his patients
and the one unexpected interviewquestion that left a lasting
impact on him.
You are not going to want tomiss that quality question.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
(02:10):
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
Hi Jim, thank you so much forjoining me on Shadow Me Next.
Thank you for taking the timeto be with us today.
Absolutely, it's my pleasure howyou bring students into your
(02:46):
workday.
I'd like to start at thebeginning and talk to you about
what initially inspired yourcareer in healthcare and how you
chose to be a physicianassistant.
Jim (02:54):
Yeah, so growing up, I was diagnosed with type 1 diabetes
when I was five years old.
So you really have to grow upquickly when you have to
constantly be aware of howyou're feeling, what your blood
sugar is, making sure you'retaking control of your health,
like that, and so that kind ofmade me grow up a lot faster
than most people at that age.
(03:14):
So I was always around somedegree of the medical world.
When I was growing up, my dreamwas honestly always to be in
the military, and as a young kidI didn't realize that if you
have diabetes you're noteligible for the military.
And so when I called arecruiter when I was like 16 or
17, and they're asking me mymedical history and I say, oh
(03:35):
yeah, I have type 1 diabetes,they're like, oh well, if you
need to take medication on adaily basis to survive, you're
not eligible.
And so I said, oh okay, wellthere goes that dream.
So when I was in high school, Ihad recently gotten into
exercising and lifting weightsand stuff.
So that was definitely apassion of mine.
I was fascinated by the humanbody, but I was also really
(03:56):
interested in mechanical things,cars and just how things work.
That's always been kind of aninterest of mine is how things
work, and so when I was acceptedinto college, I initially went
to the University of Colorado inColorado Springs and they're
really well known for theirmechanical engineering program,
and so that's what I joinedcollege to do is mechanical
(04:18):
engineering Exercise was justkind of an interest of mine, but
wasn't really a career path.
Just kind of an interest ofmine, but wasn't really a career
path.
Prior to college I had nevereven thought about medicine.
No one in my family is medical.
My dad was actually a pastorfor a Presbyterian church and
then he formed his ownleadership consulting company.
After he left that field.
(04:40):
My oldest sister is an attorney.
The sister above me in line wasan arts degree and then she got
into sales.
My brother's a musician.
So we have a large variety ofexpertise and interest in the
family, but nobody was medical.
The undergrad work and what Ifound was I really wasn't doing
(05:04):
well at the math.
There was components thatplayed into that.
My dad died of a sudden heartattack when I was 18, right
before I graduated high school,so I was still grieving that
loss and there were someteachers with very heavy accents
that were part of my troublelearning calculus, and so I
found that if I wanted to reallybe serious about mechanical
(05:25):
engineering, I really felt thatI needed to understand the math
a lot stronger than I did, andso after my first year in
college, I decided to talk tothe college advisor and switch
degrees.
So one of the questions thecollege advisor asks is what are
you interested in?
And at that time I got reallyinto weightlifting.
(05:46):
So I was a competitivebodybuilder, later became a
competitive powerlifter, so Iwas really just into
weightlifting and that sort offield.
The problem that I found withthe college advisors is they ask
what you're interested in butthere's not a lot of thought of
what are you going to do withthis degree path for a job, how
much money can you make at thisjob and that sort of stuff.
So they pushed me into a healthsciences degree path, with
(06:08):
strength and conditioning waskind of my emphasis.
I had initially thought, oh, Imight be a sports team athletic
trainer or strength coach orsomething like that, maybe open
my own gym someday, somethingwithin the fitness world.
So I went through that degreepath.
I fell in love with anatomy andphysiology, biomechanics.
I just loved learning about themechanical side of how the body
(06:31):
works.
That kind of felt like a reallygood mix for me.
As I started to get into juniorand senior year, you're starting
to think about what jobs you'regoing to do out of college and
I quickly learned the type ofmoney that I wanted to make.
You just don't make as aundergrad level.
You know strength andconditioning coach, it's just
(06:51):
not really something that you'regoing to do.
It's not a lot of stabilitywith that, it's a lot of risk.
And so I started looking intowell, within the health world,
what are some kind of additionaltraining or kind of higher
level education that I can gointo.
So physical therapy obviouslywas a very obvious next step.
So I started working as aphysical therapy technician with
(07:11):
the goal of going to PT school.
So I did that for about threeyears out of undergrad and what
I found was I enjoyed it, but itwas a lot of the same.
It was just kind of the samething over and over.
You're not really the onemaking decisions, you're just
kind of following the standardprotocol.
Somebody did a knee replacement, let's do the range of motion,
(07:32):
let's get them stronger, andthen we kind of rinse and repeat
50 times a day.
So at that point my mom wasactually the one who said well,
have you ever heard of aphysician assistant?
And at that point I had no cluewhat they were.
So I started doing someresearch into PAs and started to
realize it actually could be areally good fit for me, because
(07:53):
you're higher level in terms ofmaking medical decisions,
diagnosing patients, prescribingmedications, interpreting, lab
work and imaging, but you don'thave to go through the extensive
training that a doctor has togo to, but you still allow some
big decisions to be made.
And then, on top of that, forsomebody like me who doesn't
like the same thing over andover, you could switch career
(08:15):
paths at any time, and so thatwas very appealing to me at that
point as well.
So the funny part was, as I waskind of learning about this, I
actually had a patient who was aPA.
I asked to shadow her.
She was primary care at thatpoint, so got a little
experience there.
Had another colleague who knewa PA in orthopedics, got to
(08:37):
shadow them in surgery and inthe clinic and really felt, you
know what?
I think this is a much betterfit for me.
So as I started to get ready forthe application for PA school,
took the GRE, ended up having totake it twice.
I just wasn't happy with myfirst score.
So I took the GRE twice, didall the prereqs that I still
needed for PA school, and then Iapplied my application process.
I applied twice to PA school.
(09:00):
So if you're out there and youdidn't get in first try, don't
feel bad about that.
It doesn't mean you're stupid,it's just that's part of the
process for some people.
I mean, the last time I checked, there's about a 5% chance
nationwide of getting into PAschool, and so it's very
competitive.
What I learned was one I appliedlate in the cycle the first
(09:20):
time.
So I applied in August becauseI saw the deadlines were October
, november, december, stuff likethat.
So I thought, oh well, I'mstill ahead of the deadline.
I didn't have a letter of recfrom a PA, which I think is
really critical and I justdidn't have anybody mentoring me
through the application process.
So I didn't know anything aboutthe process, I didn't know how
to make myself competitive, Ididn't know the things that you
(09:43):
need, and so I was just kind offiguring this out on my own.
So I had applied to five schoolsthe first cycle, one of which
being Duke, which was kind of ajoke that's the number one PA
school for those who don't know.
And then I applied late and Ididn't have a letter of rec from
a PA.
So of course the first cycle Ididn't have any interview
opportunities, didn't getaccepted anywhere.
(10:04):
So it was pretty hard for me atthat point because I was
thinking what am I going to dowith my life.
I don't want to be a PT techmaking, you know, very little
money.
I had engaged to my wife atthat time, so we were soon to
get married and so you know Iwas very concerned.
So I went back to the drawingboard, bought some different
books about how to becompetitive to apply to PA
(10:26):
schools, learned some things inthe process, got a letter of rec
from a PA, got more experience,shadowing and volunteering and
stuff like that.
My GPA, I think, wascompetitive.
So the second time around myprocess was if there's a 5%
chance of getting in, I'm goingto apply to 20 schools and
theoretically I should getaccepted to at least one.
(10:48):
It was expensive for me but itwas worth the effort.
So I applied early.
The second time I had the rightletters of rec, had the right
experience and I applied to alot more schools.
That cycle I had about 13offers to interview.
So that cycle I had about 13offers to interview.
(11:19):
I interviewed at seven or eightuniversities and then I was
accepted to two.
The two universities was theUniversity of Florida, which is
where I was just so gratefulthat I now had a career path and
a career moving forward that Icould participate in and so
ended up going to US and youknow we can talk about that, but
that was kind of my process forgetting into PA school and how
I shifted into medicine as Icontinued to go.
Ashley (11:39):
What a great story, Jim , Thank you so much for being so
detailed with that, because Ithink that you know it is a
journey, and it's one that isnot always a pleasant journey,
you know.
I think there's a lot of hurdlesthat we jumped through, the
challenges that you faced, theposition that you want to be in,
such as yourself, how theyovercome those challenges is
huge for us, is huge for us tosee, and you know, something
(12:09):
that we can kind of apply to ourown lives.
A common theme that I heard youspeak about just then is how
important mentorship is and howimportant it is to have somebody
who can help provide a littlebit of direction.
You know, starting it when themilitary had to decline your
application because of the factthat you have type one diabetes.
(12:30):
You know, at that point it'slike, well, where do I turn from
here?
You know, and all the waythrough, when you mentioned when
you were in college and theygave you a major but they didn't
perhaps give you an idea ofwhat to do with that.
Mentorship is hugely importantand finding it, I think, can be
really challenging.
Do you have mentors in yourlife right now, jim?
Jim (12:52):
When I was new to my current job years ago, the owner
of the company.
He definitely poured in andmentored me as a provider and a
PA, and we'll talk about thatlater.
I think he really had a keyinfluence on how I became the
provider that I am today.
I think that I have role modelsin terms of Christianity,
people who are pushing me to bea better Christian, a better
(13:14):
husband, a better father andstuff like that.
If you ask me currently, today,do I have any mentors?
I would probably say no.
I have friends and we help,push each other, but I don't
think I have a lot of people inmy life right now who I would
say this is a mentor, who ispushing me to be better.
I think I'm prettyself-motivated in terms of the
goals that I have for my lifeand for my family, and I'm kind
(13:37):
of taking it upon myself toresearch things that I want to
learn, either through books orYouTube or talking to people
with experience.
I think that's kind of thephase of life that I'm in now is
I'm just self-motivated andtrying to figure this stuff out
for myself, but I'm not afraidto ask people for help if I feel
like somebody has someknowledge that I want to obtain.
Ashley (13:57):
Which I think is probably a result of the
experience that you had growingup.
You are a self-made person andyou have done the research and
you have jumped through theloops and you have built a
really, really strong foundation.
I think oftentimes we do talkabout mentorship and it can feel
very stressful if you don'thave a consistent mentor in one
field of your life.
(14:17):
A lot of people do need that tosharpen themselves and to build
themselves up.
But, like you said, if you area self-motivated person who does
all the heavy lifting which isironic for you with your hobbies
I think maybe we'll talk aboutthat too.
But as a self-made person, thementorship factor might not be
as pivotal for you.
(14:38):
And I also think again,something we're going to speak
on I think this is what makesyou such a great mentor to some
of the students and some of thePAs that rotate through your
office.
So let's talk about when you'reworking, jim.
Tell us a little bit about aday in the life as a urgent care
lead PA.
Jim (14:57):
Yeah, so my company is actually a little bit different.
So I do have a supervisingphysician.
He merely exists on paper to me.
I have spoken to him once inthe last five years and I don't
talk to him about cases at all.
The owner of my company isactually a PA himself.
He was a flight paramedic for15, 20 years.
(15:19):
Then he went to PA school, thenhe worked in emergency medicine
for about another 15 yearsbefore opening his own urgent
care clinics.
So the owner of the company,who is a PA, he's a resource for
me.
So when I see a patient and I'mnot too sure about what to do
with them, he's the person Icall.
And a lot of times the phonecall will be hey, I've got this
(15:42):
person.
Blah, blah, blah.
Medical history chief complaint, blah, blah, blah.
This is the testing I've done.
This is what I'm concernedabout.
Do you feel this needs thisworkup or do you feel this needs
admission, or is this somethingwe can treat outpatient and
we'll kind of talk through thatcase and kind of decide what's
medically best for the patient,what documentation we need to
(16:03):
include, stuff like that.
So when you go through, this issomething that I really try to
when I have PA students rotatewith me.
This is something I really tryto teach them is when you're in
school.
Pa school is very heavy on theseare the symptoms and
presentations of this condition.
(16:23):
This is how you diagnose this.
This is how you diagnose this.
This is how you diagnose it andthis is how you treat it.
And so you're very focused onwhat is the diagnosis and the
appropriate treatment for that.
In the real world of emergencymedicine and urgent care acute
kind of patients the mindset hasto switch.
So you'll have somebody come inwith chest pain, let's say, and
(16:45):
instead of saying I need to getto the perfect diagnosis,
exactly what they have, themindset is I need to rule out
the things that arelife-threatening or critical.
That needs to be admitted forthis complaint.
So it's a lot more heavilyemphasized on the differential
diagnosis which you havetraining in at PA school, but
(17:06):
it's pretty minimal compared towhat the real world looks like.
So, for an example, if you comein and I have a 20-year-old
with chest pain who's healthy,versus a 76-year-old diabetic
with hypertension and coronaryartery disease, that person with
chest pain is going to get adifferent workup.
That person with chest pain isgoing to get a different workup.
(17:26):
So my focus is based on thesymptoms they're presenting to
me, the vital signs I see, theexam that I do and the
laboratory testing that Iinterpret.
I'm trying to rule out heartattacks, pulmonary embolism,
myocarditis, pneumothorax,pleural effusions, all these
different conditions that couldcause chest pain.
And if I find something thateither confirms something
critical or I can't rule outdefinitively something critical,
(17:49):
then they need more advancedworkup than I'm able to give at
that moment.
But if I can do my entireworkup and my urgent care
luckily is set up with a lot ofcapabilities that other urgent
cares don't have I think we're alot more like a freestanding ER
in the sense that I can docardiac enzyme panels, I can do
B-dimer blood clot rule-outs, Ican order same-day CT scans, I
(18:12):
can do x-rays on-siteimmediately.
So I have a lot of reallyimportant capabilities.
That allows me to rule out alot of critical things.
But that mindset of kind ofmaking sure I'm not missing
critical things is somethingthat it took a while to learn
and that's something that he dida really good job of teaching
(18:32):
me, and so that's something Itry to work with my PA students
on.
So a typical day we're in fluseason right now in the urgent
care.
So my clinic is open Mondaythrough Saturday, 9 am to 9 pm.
So each provider there's two ofus.
We each do three 12-hour shiftsper week.
So I work three days, she worksthree days and we each have
(18:54):
four days off.
So it's a nice.
You know it's hard days whenyou're there, but the nice thing
is you do have days off duringthe week to do other things and
enjoy your life.
So typically I'll get up in themorning and I'll go to the gym
and work out.
That's how I wake up and dealwith stress is work out and then
I'll go to the gym afterwards.
Yesterday I saw 35 and I saw 20of them within the first three
(19:17):
hours of the day.
Oh my gosh, the volume can bepretty insane.
So the volume can be prettyinsane.
So that'll range from a lot offlu symptoms, sinus infections,
coughs, pneumonia, ucis, thatsort of stuff.
You'll get belly pain, chestpains.
You'll get orthopedic injuries,fractures, stuff like that.
(19:38):
You'll have three lacerationsyesterday, one abscess drainage
yesterday, medication refillsfor different things, people
with high blood pressure.
That's hard to manage.
An urgent care can see all theabove.
So I've had people with heartattacks come through.
I've had people with strokescome through.
I've had big hip fractures,dislocated shoulders, you name
(19:59):
it.
The concern is just a lot ofpeople they'll come into an
urgent care maybe thinkingsomething isn't a big deal, and
then you have to figure out, oh,actually this isn't a big deal,
this needs surgery or thisneeds admission and management
or whatever the case may be.
So my visits have a wide varietyof what we see, and so the nice
thing is that every patientexperience is new and there's
(20:20):
definitely some exciting things,like the first time you
diagnose appendicitis based offyour physical exam.
Like that feels really good.
Stroke that you catch oh mygosh.
Like somebody comes in withfever right lower carter belly
pain.
They have a positive robson'spositive obturator.
You can literally make thediagnosis just off of your
physical exam.
You don't have to do blood workor anything.
You just say, hey, we need toget you, to get you to the ER,
(20:42):
you need to CAT scan and youneed your appendix out.
You know you call them the nextday.
You're like no, you're 100%right, it was my appendix, they
took it out, I'm feeling great.
You know, those feel reallyexciting.
The first time you see that Ihad a 13-year-old girl.
Her family brought her inbecause and so a lot of people
(21:07):
say, okay, what's thedifferential for that?
Well, at her age it was septicarthritis, so her hip joint was
infected and it's a blood spread, hematogenous spread, and so,
just based off of a physicalexam and history, I said this is
, you know, infected joint.
You need to go to the hospital,they need to wash it out.
So called them a couple dayslater, confirmed yep, that's
exactly what it was.
They washed it out, everythingwas.
I called them a couple of dayslater, confirmed yep, that's
exactly what it was.
They washed it out andeverything was great.
So, again, your medicalknowledge can take you a long
(21:28):
way, and those are things thatwe're all trained in in PA
school.
A lot of times people don't puta lot of effort into the
training process in PA school,so they forget a lot of this
stuff.
So part of my effort when I wasin PA school is I really worked
hard at the school work and Ireally spent a lot of hours
learning, and so because of thatI've been able to retain a lot
(21:49):
of the knowledge that I learnedthere and it's helped me every
day of my career.
So yeah, that's kind of a fullday.
You know, you see between 25 to40 patients per day.
Sometimes you'll have waves ofthem come in at once, sometimes
you'll have a little gap inbetween them, but yeah, it's
just 12 hours straight.
Ashley (22:07):
Right, you know you mentioned about how, when you're
exploring physical therapy as apotential career, that you
needed a little bit more varietyin your life and, lord knows,
it sounds like you found thatvariety, jim.
Wow, you know, when you are inPA school, as you know, you do
learn about all of theseconditions and it is so exciting
to learn the number of waysthat our body serves us every
(22:30):
day and, unfortunately, thenumber of ways it can go wrong.
It feels really good to be ableto help somebody with all of
that knowledge that you took inwhile you were in school.
That's a huge patient load, jim.
Do you have, do you have,support at your clinic?
I know you mentioned it was youand another clinician and you
guys rotate, so it doesn't soundlike you're always there
(22:51):
together.
Are there other members of thehealthcare team that are there
providing support to you whileyou're trying to see 40 patients
a day?
Jim (22:58):
So our staff is a receptionist, a medical
assistant and an x-ray tech whokind of also helps in a medical
assistant kind of role.
All medical decision-making,all patient visits are your
responsibility as the provider.
It's a lot, it's completeautonomy.
Your job is identical to aphysician in an urgent care.
(23:22):
You have to really be on top ofyour game.
You really need to know what tolook out for.
You really need to know yourmedical conditions and your
treatments.
And then obviously our, theowner of the company.
You know he does a great job ofyou know he answers his phone
when you call.
So you know, when I was brandnew I'd call him 30 times a day,
you know, and it was more justthe medical, you know, the
(23:43):
understanding of the conditionswas there.
It was more the hey does thisneed to go to the ER, or can I
treat this?
Does this need a CT, or can Ijust assume?
it's this and a lot of timeswhat urgent care does is we'll
try to narrow it down as much aswe can and then we'll treat for
the two most likely things thatwe think you have.
So you know, an example wouldbe hey, you know, if you come in
(24:05):
and you're having vaginalcomplaints, vaginal discharge,
itching, something like that, wesend out a swab.
Your history doesn't reallymake us too concerned for STDs,
but hey, this could be bacterialvaginosis, this could be a
yeast infection.
So why not treat for both, sendout the appropriate testing,
and then we'll cover worst casescenarios.
So that's kind of what we'redoing.
(24:26):
Is not always are we going toget to the exact diagnosis that
you have, but we're going to tryto rule out as many things as
we can, and then we're going totry to do the best we can in the
meantime to make sure you don'tget worse.
Ashley (24:37):
I think that's great and, you know, with autonomy as
a physician assistant, I think,comes a lot of access to care,
and it sounds like that's what alot of these patients need,
right Is somebody to justevaluate them, to let them know
if this is something incrediblysevere or if this is something
that perhaps we can treat with aprescription, or if it's a
dislocated shoulder, maybe wecan just reduce it.
(24:58):
Jim, talk to me more aboutphysician assistant autonomy,
because of all of the peoplethat I've spoken with right now
that are physician assistants,it sounds like you practice the
most autonomously.
You are working by yourself andyou have very little oversight
and you might not need that.
So tell me a little bit aboutautonomy for you and what it
means to you as a PA.
Jim (25:20):
Yeah, yeah, so before I switched over to urgent care, I
did orthopedic surgery for twoyears and then I did a little
stint in primary care when mywife and I moved back to
Colorado.
Briefly, when I was inorthopedic surgery you're
basically glued at the hip toyour surgeon, so you guys
operate together, you seepatients, you talk to him about
(25:42):
consults in the hospital, so itis a one-on-one relationship.
There is a tremendous amount ofsupervising that's being done
because this is an orthopedicsurgeon who went through a
tremendous amount of trainingand has so much knowledge that I
don't have or would take mefive to 10 years to obtain.
And so when you're fresh out ofschool you need that constant
(26:02):
reinforcement, constanteducation, constant explaining
of how to do things when you'rein urgent care.
I needed a lot of that upfront,but it could come from a phone
call.
It didn't always have to be hey, look at the same patient that
I'm looking at.
And so I think my orthopedicexperience helped me
dramatically with urgent care,because there's a lot of
(26:23):
orthopedic complaints that comein that I have a little more
experience and knowledge dealingwith than some of our other
providers.
So they come in with a fracture.
Well, I know how to manage thatfracture.
I know most likely this isgoing to need surgery or most
likely it's not, and so I canhelp kind of guide the patient
along their expectations of whatto expect, moving forward, what
(26:44):
this likely is, how we likelytreat what they have and stuff
like that.
So the autonomy in an urgentcare for me, I really enjoy it.
I like to make my own medicaldecisions, I like to call the
shots and I think this is kindof a perfect field for that.
But that's not everybody mywife loves she's a dermatology
PA.
She loves to have a supervisingphysician that if a patient is
(27:07):
too complicated, she can justsay, hey, I'm going to send you
over to my supervising physician, because she says well, and so
to have that ability to offloadchallenging things that are
maybe above a scope of practiceis really appealing to her and
for me.
I think I like the idea ofalways having the emergency
department as my backup.
So if I really have no idea, Ithink I like the idea of always
having the emergency departmentas my backup.
So if I really have no idea,but I think you look critical, I
(27:30):
can always send you foradditional testing and more
expertise.
A lot of things I think I candeal with and I can manage for
people and I like to do that.
Ashley (27:38):
I enjoy the challenges that that presents, but I also
like the freedom of being ableto make decisions myself
presents, but I also like thefreedom of being able to make
decisions myself, and thank youso much for comparing your
position to your wife's position, because you know, and I align
more with your wife on thisObviously I'm also a Derm PA and
I think our oversight is verysimilar.
(27:59):
But imagine being in an urgentcare by myself with a patient
come in with a heart attack,with a STEMI, and having to read
an EKG with no other eyes on itexcept a man, by phone, like it
makes my feet sweat, my heart'sbeating too.
I might be having a STEMIthinking about it, you know, and
that's the beautiful thingabout being a PA is that there
is variety in not just what youdo but how you do it too.
(28:22):
And I think sometimes evenwithin the profession there are
certain people who work in,maybe, urgent cares and they
might want more oversight, somaybe they ask to be scheduled
when there's another physicianassistant, and it's not that
they're overseeing each other,it's more of just a
collaborative environment.
So I'm so glad you brought thatup.
Thank you for mentioning that.
But before we shift gears, Iwant to ask you know about our
(28:43):
quality questions segment on theshow.
Do you have a quality questionthat you'd like to share with us
?
Before we hear what Jim'squality question is, keep in
mind that there's more interviewprep, such as mock interviews
and personal statement reviewover on shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Jim (29:07):
Sure, so this is not a question I was asked or asked
anyone.
This was actually from aphysical therapist that I had
worked with years ago and it wasa question that he was asked
when he was applying to PTschool and I thought it was such
a cool question.
So these are one-on-oneinterviews, very similar to PA
school or med school.
So you're sitting in front ofan interviewer, they're asking
you questions why do you want tobe a PA?
(29:28):
Why don't you want to be adoctor?
Why do you want to go to thisschool?
You know things that can bevery intense questions.
So this guy asked the physicaltherapist.
He said who was AdmiralHirohito and what role did he
have in the US involvementduring World War II?
Ashley (29:45):
Oh my gosh.
Jim (29:48):
So when you hear that question, you go what, I'm not a
history major.
Why are you asking this randomquestion?
He said well, I don't know whoAdmiral Hiroshito was, but if I
had to guess, I would say thathe was involved in planning the
Pearl Harbor attack thatlaunched the US into World War
II against the Japanese.
(30:09):
And the guy says wrong.
I'll tell you.
I like that you didn't give up.
Ashley (30:14):
And in that instance I said oh my gosh, what a crazy.
Jim (30:17):
because if you would have asked that question to a hundred
people, most of them would havejust said I don't know who was
Admiral Hirohito, and they justsaid well, spoon, feed me the
answer.
But this guy was looking forsomebody who had some resilience
, who would take their best stabat it, who would at least try.
And I think that such a randomquestion can tell you such
(30:38):
important, key factors aboutsomebody's personality.
Are they going to quit when itgets tough?
Are they just going to ask foryou to do the work for them, or
are they going to give it theirbest effort and try?
But that question has alwaysstuck with me.
It's just such a random way toask something so deep about
somebody's personality, so Ireally enjoyed that question.
Ashley (30:59):
Jim, that is a fantastic question and I think a
lot of questions that wereasked on interview like that are
meant to make us think and theyare meant to show our tenacity
and our ability not to letanything go until we've at least
given it our best shot.
You know, we have a verysimilar situation at our
practice when we host PAstudents, which I'm excited to
talk to you about.
Next, when we have a PA studentcome in and, as a PA student,
(31:22):
you are seeing patients and thenyou're bringing the information
back to the PAs, which is youand me, and you're presenting
the patient and presenting theirdiagnosis and what their
diagnosis is.
And we have a saying around ourclinic that is don't guess what
their diagnosis is.
Tell me what their diagnosis is.
Don't say I don't know.
Don't just give me a randomanswer.
I want you to tell me what itis.
(31:43):
Don't say I think.
Tell me what their diagnosis is.
Don't say I don't know.
Don't just give me a randomanswer.
I want you to tell me what itis, don't say I think.
Tell me what it is.
Because, I can teach off of that.
If you tell me a patient iscoming in with a dislocated
shoulder based on your physicalexam findings, and I go in and
it turns out they have a blackwidow spider bite on their arm
(32:06):
and that's what's causing theirpain, this is a teachable moment
.
If you just come in and say,well, I don't know, their
shoulder hurts and there can bea million reasons for that, well
, that's not teachable.
So I think that question thatyou brought up that is great.
Okay.
So, jim, we spoke a little bitabout students and I think you
and I we have this sharedpassion for teaching and you
(32:26):
have a YouTube channel that iscalled Urgent Care Stories and I
watched all of them thismorning and I expected to only
watch one and I just couldn'tstop watching because the
stories that you tell aboutthese patients that you've
encountered, they're captivating.
Why was that important to youto start that YouTube channel?
Jim (32:47):
Yeah.
So what I was finding was whenthe I had a few PA students work
it with me, and what I wasfinding was that the ability to
create a differential diagnosiswas really something that was
lacking, and I think it's justpart of the training process
that just a lot of people theydon't prioritize.
And so my goal was I was tryingto create, you know, cause
(33:08):
there's so many patientexperiences that I've
encountered that have taught meso much of like really important
lessons of like, if you feelthe need to do a workup, it's
always worth it because you'regoing to find something or you
know, listen to the patient,they're going to tell you their
diagnosis, or never assume youknow something about the patient
.
You know always kind of trustyour gut and listen to what
(33:31):
they're telling you.
And so there were some reallyimportant lessons that I've just
learned, that I've just foundhave been very valuable for me
through my career in terms ofmaking the right decisions, and
(33:51):
so I decided I wanted to createsome YouTube stories to just
kind of share my experiencesthrough memorable patients, of
things that are really important.
And so my goal was thisknowledge is trying to be
directed towards pre-med, pre-paor even freshly graduated med
and PA and nurse practitionerswho are new to the field and
they're eager to learn.
But there are some things thatonly experience can teach you,
and so my goal was to try topresent cases in a really clear
(34:13):
manner of hey, this is what thepresentation was, this is kind
of what my thought process was,this is how we worked this up
and why I chose to work it upthis way, and this is what the
outcome was and this is what weoutcome was and this is what we
do with that.
And so my goal is is each of thevideos I'm trying to take you
through a patient encounter,give you the history, give you
(34:34):
the presentation and kind ofteach you through that process.
And so my thought was that, youknow, videos were the easiest
way for me to do this.
Spent a lot of time on YouTubeanyway.
So that was kind of my avenue.
I'm not trying to make money,I'm not trying to be
Insta-famous or anything likethat.
My goal is just I like teachingand I like helping people.
That's part of why we go intomedicine is we care about people
and we want to help people, andso this was one avenue for me
(34:56):
to try to help people out therein the world of medicine.
Learn from my experiences.
Ashley (35:02):
I think it's a great idea and, of course, the ones
you mentioned from a shadowingperspective, which, of course,
is how I view the world rightnow.
It's stories for students whoare trying to figure out,
perhaps, where they want to endup in this medical career.
That is so wide entertainmentlevel.
Or are these storiesinteresting you?
(35:24):
Because you are just desperateto get your hands into this
situation yourself and to doexactly what you're doing and
running the tests on thesepatients and doing the physical
exams and making the diagnosesand seeing the results.
So I think it's great for astudent shadow, but I also think
it is fantastic for anybodyprepping for their boards too,
(35:44):
because the way that youapproach these patients is very
methodical and the historiesthat you give, like I said, the
physical exam findings.
Oftentimes you talk about testresults and then you present a
differential which is, inessence, a, b, c, d, e.
Pick the right, pick the rightdiagnosis right and say, before
(36:04):
they get to the end of yourstory, they can determine for
themselves.
You know what could this be?
And then you get to give themthe answer and you go.
You know, you get to explain tothem, you know what specific
findings led for that.
So it was just it wasincredible.
It's a great idea I'm soexcited to share and I'm excited
for other people to hear aboutthis.
Urgent care stories on YouTubeas well.
(36:25):
I'll make sure to link it inthe podcast description for
anyone who's interested inchecking it out.
But, jim, pa students, pre-pastudents, pa shadows you have
hosted many of these people.
What are some common themesthat you find yourself
(36:45):
discussing with these peoplethat come?
Jim (36:47):
and are looking to you as a mentor figure.
So vast majority are yourpre-PA students.
So these are usually undergrador recently graduated from
undergrad students who are inthe process of applying or
getting everything ready toapply.
So I've done a lot of that workand really I just felt like
when I was trying to find PA asa shadow, there's a lot of
people who say no, and I'm sureyou're in the same boat of
(37:10):
you're booked up for, I think, ayear on your shadows, but
there's just such a demand andthere's so few people who are
willing to do it, and so I thinkbeing at an urgent care as an
autonomous PA is a really uniqueexperience already.
So it's something that maybe alot of people are not aware is
out there in the world ofmedicine as a PA.
And then I think what I do iscool.
(37:30):
I think I see a lot of coolstuff, I get to make cool
decisions, I get to help a lotof people, and so I wanted to be
able to share that with peoplewho are thinking about getting
into this career path.
So some of the common thingslike the pre-PA students a lot
of them are going to ask aboutyou know, what was your GPA?
What was your experienceapplying?
How many schools did you applyto?
(37:51):
How did you get into PA school?
How were you competitive?
And then a lot of them aregoing to ask about the interview
process and what that lookslike.
And so you know, I ended upcreating a couple of videos on
my YouTube channel about, like,how to be competitive for PA
school, how to get into how todo the interviews kind of tips
and tricks and stuff like that.
There were just three videosthat people can watch because I
(38:13):
had a lot of people just askingme the same questions over and
over.
So one of the common things thatyou'll do in a PA school
interview or med school isyou'll do a group interview and
so the group interview for thosewho don't know you're going to,
once you're invited for aninterview, you've already made
it to like the top 10% ofapplicants already.
So that's a really big thing.
But once you get to theinterviews, you'll have a few
(38:33):
one-on-one interviews and thenyou'll have a group interview.
So the group interview is yousitting in a room and there's
going to be somebody who'sgrading you maybe one or two
people and so you'll have aquestion prompt and then there's
going to be a timer for 10minutes and then you're just
going to discuss that topicamong yourselves.
These are typically politicaltopics or just kind of things
(38:56):
that are going to have a oneside says this.
One side says that, shouldmedical providers have the
ability to remove your firearmsfrom your house, know that
you're a threat to yourself orothers.
Obviously there's one side whosays, no, nobody should take
your guns away.
That's your right.
Second Amendment Other side'sgoing to say, well, absolutely,
if it's for the greater good orif you're a threat to yourself,
(39:17):
we should be able to take thataway from you.
And then we're going to gradeyou on it.
And so a lot of people they'retrying to find a way to be
competitive in that process.
So one thing that's a commonpitfall is there's going to be
some aggression to try to belike oh, I'm going to read the
question prompt for everybody.
I'm going to show leadership,and so a lot of times I tell
people don't really try to fight, for that.
(39:38):
It doesn't mean a whole lot tous, it's just cool.
You were the first one to talk,you're a bit of a bully or
whatever.
So I don't really stress thatto students.
Really, the hard part is likewhen you're watching these
interviews as the grader.
One of the crazy things is likesome people will just not talk,
and it's amazing, becauseyou're sitting there and you're
like, hey, man, like why aren'tyou getting involved in this,
(40:03):
why aren't you talking?
You're just sitting there beingquiet the whole time.
I have nothing to grade you on.
So what I would recommend topeople is I would sit back and
let people discuss it for alittle bit, maybe throw
something in there, but I'd bewatching the other people in the
group, looking for who is nottalking, who's being a little
shy, and then what I would sayis I'd jump into the talk, I
would put my opinion out there,and then I would turn to that
(40:31):
person and say, hey, jason, whatdo you think about this?
And what that's going to do isit's going to show that you have
compassion for other people,and so at least I really
respected people who would tryto involve other people in the
process, and so it's a reallyclassy move.
It doesn't come across over thetop or anything.
It just shows that you care forsomebody else, and that's
really important in medicine isto find providers and PAs that
are compassionate, and so thatwas a really easy way to just
(40:51):
make yourself look good in thegroup interview is just ask
somebody else from the groupwho's been a little quiet or shy
, you know a question.
So that's kind of a quick, easything for people to do.
And then on the one-on-oneinterviews, some of my advice
for people would be a lot oftimes the interviewer is going
(41:12):
to ask you a lot of questionswhy do you want to be a PA?
Why this school?
What are your strengths, whatare your weaknesses?
You know what happens if youdon't get into PA school this
year.
What are you going to do?
Those sort of questions youshould have really
well-rehearsed, well-practiced,professional answers to, because
you're going to expect those.
They're obviously going tothrow some oddballs at you.
What kind of a superhero wouldyou be?
What's your favorite color andwhy?
(41:37):
Just kind of random stuff thatthey're going to ask.
But one of the best things isthey're going to ask you do you
have any questions for me?
Instead, phrase it as what areyou most proud of about this
university?
Ashley (41:46):
Like what makes you want to?
Jim (41:47):
work here Because that is going to really make them feel
oh well, I'm really proud ofthis, or I chose to work here
because of that.
So just the way that you'rephrasing questions to the
interviewer can really affecthow you're perceived.
And then the other advice Ihave for people is ask them
questions about themselves.
Everybody has a really easytime talking about themselves
(42:08):
and everybody gets nervous aboutinterviews, even the person
doing the interview.
They're still nervous.
You can ask them what do youlike to do for fun?
What fields of medicine haveyou done that you really enjoyed
?
Why did you decide to go intoeducation?
Then you can talk about thatstuff for a while.
And then the goal is whenthey're looking back at the
pictures of all of the peoplethey interviewed that day, they
(42:31):
might not remember what youanswered as to why you want to
be a PA.
Everybody says the same thing.
What they're going to rememberis they're going to look at your
picture and they're going to go.
Oh my gosh, we had thiswonderful conversation about
dogs and about the dog park andwhy I love this field of
medicine.
I really enjoyed thatconversation I had that's.
All you're looking for is justpositive points, and so it's
(42:52):
really easy to kind of just gamethe system and just kind of
make the experience positive foryou.
Ashley (43:00):
Jim, those are all such great recommendations and
really really very tangible tipsfor students and it's people
are going to think I set you up.
I didn't.
You mentioned two things whenyou were talking about those
interview questions.
You mentioned access invitepeople into the conversation who
might feel like they don'tbelong there, or perhaps they're
(43:21):
just a little shy, or perhapsthey just need an invitation.
You're giving access and thentelling stories, right?
That's ultimately what aninterview is.
Let me tell you a story aboutmyself, and I would love it, too
, if you could tell me a littlebit about yourself.
So I think access and storiesit is what brings humanity into
(43:42):
these things that we do, which,for you and I, happen to be
medicine.
So thank you so much forsharing that.
Thank you for dedicating somuch of your time to hosting
shadows.
Something that you said thatjust really resonates with me
because I always say it too isI'm proud of what I do as a
clinician.
You're proud of what you do.
What we do is cool, and sharingit with people is one of the
(44:03):
highlights of my day, as it iswith yours.
Thank you so much for takingthe time to join us here on
shadow me next.
I appreciate it.
Oh my pleasure.
Thank you so very much forlistening to this episode of
shadow me next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
(44:25):
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
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