CRAFTING WELLNESS STORY

Life as a PA Student:
The Good, The Bad, and Everything in Between

Randall, a PA Student, sat down with MDF Instruments Crafting Wellness Podcast to talk about what a Physician Associate does, how to become one, and why he loves it!

TRANSCRIPT

Randall 00:00
And I think why am I doing this in the first place, the only real reason you can go is because you care. It's a lot of hard nights, it's going to be sad moments in a hospital, maybe someone doesn't make it or you have to get bad news. But I think about all the good moments that are going to be there too, when I help somebody, or I can say you get to go home, or the results came back, nothing to worry about. It's benign. And so I don't know, I think that that kind of defines the reason why it's important to be in healthcare for me.

Brooke Smith 00:38
Hi, everyone, welcome to our crafting wellness podcast. Today, I have the pleasure of introducing you to Randall, can you give us a little rundown of yourself and kind of introduce yourself? For everyone who doesn't know who you are?

Randall 00:50
Yeah, of course, um, I'm actually a current PA student at Boston University, School of cine, their pa program, and I'm located in Boston, and I'm training to become a physician assistant. So I can give back and work in healthcare in the future.

Brooke Smith 01:04
Can you tell us a little bit about a PA? And what exactly a physician assistant one what that is? And to how you kind of fell into this career path? Because I'm really interested to know how you kind of found this passion?

Randall 01:16
That's actually a great question, because I feel like the terminology can be kind of confusing for physician assistant. And where does that role fall in, like in a healthcare team. So physician assistants are kind of similar to nurse practitioners, we're in the same, I guess, I scope acuity. And our role is to work with a collaborating physicians to assist and giving back in places like primary care, mental health, but we also exist in basically every field, from dermatology to surgery. And we can treat, diagnose, prescribe. So a lot of the things that you would normally assume a position, you might actually be seeing a PA, and your primary care. And I think the terminology can be a little confusing because you hear physician assistant. But in this case, you're just thinking a medical provider that has the ability to write a prescription, treat, and diagnose

Brooke Smith 02:09
that sounds like you do a lot of similar things that a physician does. What is the difference? What is it that a physician does that a PA won't do.

Randall 02:19
So in this case, we have a lot of the same abilities over time, it's taking time on the PA profession is a little over 50 years old, was actually created by a physician started at Duke University School of Medicine, actually, to be the first program. Some differences and really key differences is we're not independent practitioners. We work under a physician and sometimes you call collaborating in some states and, and supervising terminology is changing to go more along with collaborating, but the difference in our case might be that sometimes, we're always gonna see this like similar cases, but we might see less severe cases and in this case, we're always gonna have somebody check back with which in a lot of times can be can be good because we have another person to run things by for unsure. So in this case, when we think of like the big overall difference between a physician in this case being an MD or do there's a difference in medical education, they have four years plus residency, our programs are 24 months to three years. But we have a lot of the general skills that they deal with allow us to make big strides and important places like primary care and mental health and so that would kind of summarize those differences between levels.

Brooke Smith 03:32
Thank you for clarifying that. So okay, so that that my that was my gonna be my next question about schooling. So tell us a little bit about the the school journey the educational aspect of becoming a PA, do you go to get your ba first and then go to PA school? Or do you go straight to PA school tell us a little bit about what that journey is like.

Randall 03:52
The pa journey is kind of unique actually, when you think about medicine, a lot of people go into nursing, go straight into a you know, as your bachelor's degree. For you know, becoming a physician, you're going to get your undergraduate and then go straight usually into medical school. And so interesting love pa are our students are actually a little bit older than medical students. Because there's a there's a difference in expectations. When you go in. Pa, there's an expectation of patient care experience. So you're going to get your four years of undergraduate, then you might work as you know, a scribe, a medical assistant and dermatology assistant place where you can actually interact, grow bonds, and make sure the PA role is really right for you because it's a unique role. And then after that, you're going to transition into a master's level program where you're going to be trained to become a general practitioner. And a lot of different fields you're going to see emergency surgery, primary pediatrics, ob gyn, so all the same core rotations that physician see. Just once again, the level of education is going to be like one year to doctor and one year clinical rotations. And afterwards, we certify. And I guess in this case, relevancies, which are required for physicians are optional. Sometimes you may want to specialize in a field and make yourself more competitive. And that's a way PhDs can do that. I think that a lot of times when we're thinking about health professionals, it's so easy to compare ourselves to, you know, the perfect person, the perfect 4.0. And you got to realize everyone has a journey, sometimes we don't we trip first and fall on them to get back up. And when I think about my journey, I went to community college. First, I come from a really small town about 3000 people I grew up to 84,000, I came from an even smaller town before then, and rural Missouri. And I went to community college for my first two years, got my associates degree. And then it went on to a state school, University of Missouri, St. Louis, to get my bachelor's. And I think having that difference in education, kinda let me see the difference, a lot of different gaps that exist in medicine. So for me to kind of help. And not only that, I like to share my story, in this case, to see that you don't have to be perfect. I think there was a stigma where I come from where people said, you may not get into PA school, you come from community college. And that's why we reach out to other students or potential pa to say, look, you can do it, I'm a community college guy, and I ended up here, and you can't as well. So I think the ways that we can get into PA school now are so unique. Some people go, you know, directly and some people take a couple years. And so when I think about my journey, specifically, I got a Bachelor's in biology from the University of Missouri, St. Louis. But I'm thankful for the other experience, they got to see rural environments, and how volunteering in an area of 3000 looks like were different to financial resources is so different from an urban city where you might have greater disparities in minority populations,

Brooke Smith 06:54
I think that's really important for everyone listening and watching to understand is that things aren't always linear success doesn't always just go one direction, success very often is, you know, it's just, it's all over the place. Because you go up, you go down, you go sideways, sometimes you feel like you're not moving at all. And then when do you realize, well, I come so far. So I think it's really an inspiring sentiment that you're that you're talking about, because I think it It should motivate everyone listening that we learn from our failures, those those failures are the things that make us strong, they're the things that make us resilient, they're the things that actually help us learn and grow into the direction into the people that we need to be. And every every experience is going to be different. Every everyone's going to have their own unique journey and how they fell into medicine and how they pursue it. And I think it's really important to remember that there's no one path and there's no just like, right way to do it. I think, you know, if you go to community college, you're living proof that you can go to community college, you can even start that way. And actually, it's a really smart way to go. Because you know, you're not paying for four years of a major university when you can go to community college, save a little money, go finish at a state school, and then go on to PA school. I love to hear how long of a break Did you take after getting your bachelor's? And did you scribe? or What did you do in between? Now where you are in your pa journey as back at Boston?

Randall 08:25
First off, Icouldn't have said better. Like, that's not linear. But when I think about the break, I took I graduated in 2019. I knew at that point, I kind of wanted to be in healthcare, my mother's a nurse. But it's one of those cases where there's so many different pathways you could take. And I think the job I took max really cemented that I wanted to be a PA specifically, there's difference in things you would do. I have friends who got into PA school from scribing. Me personally, I worked as a patient care tech and dialysis. And what is so unique about that is rather than being an ER and seeing patients every day, you kind of fall in love with your patients, because kidney disease is a lifelong illness. And in this case, you're going to see these people three times a week for the rest of their lives. Or they'll see someone like me. And so what I found so unique about this is that they kind of become like your family. When I when I used to volunteer in a hospital. I saw people for a day, maybe two days and you know, suddenly you learn their birthdays, their kids birthdays, you learn what they like to do for fine, what they still aspire to do. And when I thought about what I want to do, you know I worked in dialysis. I saw a bunch of different roles. You know, we have nurses. We had physician assistants and nurse practitioners that were around. We had nephrologist and that would be like if you're the attending physician. But most of the time actually, the nurse practitioners and physician assistants were actually coming to see your patients more because it was just easier for them to see a lot of the different patients. And so I thought about what did I want my, my future like role as health provider look like? Did I want to be more in hospital? Or did I wanted to hear people's stories about what they did on the weekend? And I also saw a difference. And I guess the level of honesty, if you see a provider, so often you start to be a little more honest. And the reality is, are you going to follow it from the plan? And so you can almost tell it the joking that's, you know, one of the petitioners or peers might have saying, did you okay, how much did you drink? You know, did you drink too much? Are we a little fluid overloaded today. And I think being able to know that and have like a one on one connection with something I said, I know, being a physician assistant is right for me. And I don't know if I would have gotten it some other way. So that's why I say you think like, I think about it, being patient attack not only allowed me to their occupations, but I got to calculate patients for dialysis. So I'm putting, you know, needles, and there's a level of trust there. I don't know when people listening this, what their fear of needles but like 1000 needles or 15 gauge needles, so that's a lot bigger than a normal IV, and someone trust you and say, Oh, it's going to be fine. If it doesn't work, like you. You try again, I think just shows how quickly bonds can be built. And so I'm so glad they took that it didn't have trans girls two years off, because I graduated 2019 started PA school in 2021. to really find my life niche, and so,

Brooke Smith 11:32
So beautiful. I never really thought about that. But it's so true. Because when you're seeing someone on a more regular basis, and maybe you're able to be a little more honest with a PA, because you're like, well, the doctor is a little scary. And, you know, if you're young, and I feel like, you know, it would be a easier way to be like, okay, yeah, I did have a little bit extra to drink last night, and I shouldn't have done that, or whatever that is. And I feel like that kind of relationship that you can build over time. With just having that level of trust, it's a different type of experience. And I think it's just a tiny little light, like you said, pays do a lot of what physicians do, I think it's just this tiny little mental thing that patients just kind of have a different feeling. And so they're they, they would be maybe more open or more honest with you about the care, leaving you to be able to care for them more properly, then if they weren't going to be so honest, because you know, you can't help someone if they're not going to tell you the truth of what's actually what their what their life is actually like and what they're experiencing. in health care. I think it takes a really big hearted, selfless, empathetic person to do what you do. And I can tell from talking to you how much it means to you, and how much you care about other people and their health. And I just want to say thank you. And I think it's really beautiful. And I have no doubt that you found exactly where you should be. Because I know that if I needed help, I would love for you to care for me. Because I can tell that you really, it really matters to you. I would love to hear a little bit about how you found that position in dialysis. Did you know somebody? Because I know you said your mom was a nurse? or How did you kind of fall into that position in between getting your degree and going to PA school?

Randall 13:28
I want to say thank you. I do appreciate I'd love to take care of you. But I need a couple more years to do that

Brooke Smith 13:34
I passed you

Randall 13:35
by but how do they find that position? That's actually a great question. Because I like how I found myself now on social media. People ask me like what how do I get the first job you need the job to get into case? So how do you get that job? Well, for me, I actually had a friend who told me on this case, they were applying for medical school, but they still thought they may do dialysis. Just to get some better experience. I said, you know, that's actually kind of interesting and unique, a little bit different than normal scribing. But I actually just went online, on their website, and they had a bunch of different openings. And it wouldn't be enough. It's, they have dialysis centers everywhere, because so many people need dialysis. I also apply to other patient care jobs. But I think the biggest thing is just really putting yourself out there. I personally am always somebody who's like, you know, resume, and I'm going to shake your hand and meet you a little more difficult with COVID and everything. But I think showing interest in being president really distinguishes you from other candidates. And if you really want that for shot, you really want to become a PA or whatever healthcare role. You want yourself to sometimes push a little harder and step outside those comfort zones to get to the end goal. You got to think why am I doing what? How do I want my life to look like 5,10, 15 years from now?

Brooke Smith 14:59
Yeah, you don't know what You don't know. And I think it's very wise to talk to other peers, people who are pursuing other medical professions, even if it's not the same as what you're looking at, it can give you ideas and you can be inspired by something. Wow, I didn't, I didn't think of that. That actually sounds great for me, like, could that work for what I'm trying to do? Because I think, you know, sometimes we can get very focused and think, oh, there's only one way to do something, but kind of how we talked about earlier, there's a million ways in, and they're all different. And I think it's really great advice to think outside the box, talk to your peers, talk to other people who are doing what you want to be doing. The internet is such a great way social media, it's such a great way to reach out. And I'm sure if you guys have questions about becoming a PA or anything else, I'm sure that Randall would love to talk to you guys and give you advice. But it's really, really, I think, a wise thing and advice to give to others, is just even opening up the conversation with your peers about how they're going about it. Because you might be surprised at what you find.

Randall 16:01
Yeah, I think bouncing ideas off everyone again, like often feel overwhelming. I think by even talking to other fields, you can see, like you said different ways to solve things. And I welcome questions. You know, I wish I'd had somebody that I guess there were people out there, but you never want to be the person to I guess reach out. And I think get over that fear. You know, ask the right questions, reach out, whatever it takes to put yourself in a position where you feel comfortable going into whatever field interests you, whether it be in medicine, or anything, because I think that one of the regrets I have is that I don't know if I was confident enough. Like I said, you always compare yourself to that perfect person. And I feel like it's a difficult thing. But an unnecessary thing to take a step back from that and just say, I need help. I'm not I'm a little lost. Because there's plenty of people like me, myself included, you can reach out, and we'll have to help anyone who has any questions about getting in or understanding when I go from high school at any step of the way. Isn't it interesting

Brooke Smith 17:01
that, you know, nobody thinks about you as much as you think about you know what I mean, people aren't actually that concerned with, you know, a lot of times we have this fear and ourselves of like, Oh, I don't want to do this because I don't want to come across this way. Or I'm kind of embarrassed or I'm unsure. But really, it people aren't. People just aren't. They're so busy worrying about themselves and worrying about their own insecurities that they're not even going to notice yours. Do you know what I mean? And so I think, as someone who's been around a little bit, I say like, you must get over that fear. Because no one is gonna, everyone is always gonna think. Thank you for asking, because guess what, if you don't ask for help, or guidance or advice, then you have nothing right? You have no answers well, so you're just stuck exactly where you are, as opposed to putting putting yourself out there and saying, hey, the least, the worst thing that can happen is someone can just say, you know what, no, I don't have time to help you right now. That's it. But where are you differently, you're not anywhere different, because you already had the note to begin with. So I think it's important to remember that the whole quote, like no risk, no reward. I think it comes across as great advice for anything that you're doing in life. Because, you know, you don't want to hold yourself back out of fear. You always want to like take the shot, ask the question. If you don't know something, ask someone who might, because you got to advocate for yourself and have that passion and that fire to get where you are trying to get to.

Randall 18:30
I think adding to that, too. We were the I think fear that result. But in my own experience, if it does happen, it's such a small minority. I know when people reach out to me, and they say thank you, you really helped me understand it just makes me smile, because I'm like, I'm glad I was able to help you. And so even if that does happen, there'll be 10 other people who are happy to help. And so I think sometimes asking someone else, it because you've used them to have expertise not only helps you but it makes them feel better as well. So it's like you're everyone went

Brooke Smith 19:00
what something that you know, now, as three months in to being in Boston and being at PA school, that you you know, now that you wish you kind of would have known a little sooner to tell yourself like any kind of encouraging words or any kind of advice you have.

Randall 19:16
Yeah, that's actually a great question. Because it's so easy to get caught in the moment. I think the biggest advice I give people now when they say it is just enjoy the moment. When I think about what all I've learned through months, it is so much I don't want to say to scare anyone because people will rise to the occasion. Like I've had some of the longest study days I could ever imagine. But I've also had some of the happiest memories with friends, you know, and these are people in that program that you know, it's camaraderie. But I think leading up to this, it's so easy to get caught in should I be doing something should I be preparing? Is there something and I think also, in addition, you worry Am I too old in the program? You worry about like oh These insecurities and I think just enjoying the free time. And being happy with where you are is so good. Because once you get to PA school, or whatever health professional school you go to, that's going to be your life for a little bit. And that's okay. You know, I think things that are worth having, you have to fight for in their journey. But I'd say just finding happiness in the journey before school and entering school is so important. So if I give one piece of advice, it would be go on a road trip. Have fun, don't worry so much am I going to get in? Should I pre prepare and read textbooks, I think that would be like, the one piece of advice I could give is just be happy that you can maybe watch Netflix and go to the gym, you know, for a night that is just that's a treat. I think that's something that, like I said, you don't realize until the situation changes a little.

Brooke Smith 20:55
It's so true to just like, make making sure that you're living your life in between all the moments, you know, because I imagine that like you said, your study days are long and and it's not like you're not living your life, but you're dedicating a portion of your time in your life to studying so that you can have the future that you want to have and help all those people you want to help. But I think it's it's easy to get caught up in like, Oh, I just I can't I can't go to my, my, you know, my brother's graduation or I can't do this this weekend. Because I I have so much studying to do, I'm so behind, I can't go. And then by doing that, you're kind of you're you're not living your life, you're missing out on moments. And I mean, really, you have to make those sacrifices sometimes to like live your life. Because otherwise you're gonna have burnout, you're not gonna, you're gonna feel like what am I doing all of this for it. So I think it's really great advice. Even if it's small moments, you know, maybe you can't take a whole day, but maybe you can take you know, 20 minutes to call friend or get some exercise or whatever that is to make sure that you're giving back to yourself, and you're living your life in between all the moments, because otherwise it goes by so fast. And you're just like what happened to my life? You know, I also wonder, you talked about how you have long, steady days. And I would love if you have any advice on how you get through those? How do you get through your long study days without getting burned out? Do you have any tricks or tips or any kind of advice that helps memorize or any kind of color coordinator? What is that? What does that look like for you?

Randall 22:25
Yeah, that's a great question. I think coming from PA school, no matter where you go to undergraduate or watching for, I'll tell you it is a big culture shock, you know, the level of material and the level you're learning at is very, very high. And there's a high expectation. And I think it requires adoption, and every front. But what I find so useful, and like you said, avoiding burnout, that's it's a long journey, you don't want to over exert yourself, and you don't get to the finish line. I think it's finding actual fun things to do. Like I say, when I say enjoy the moment, life is not only the highest, you shouldn't be you know, your best years are not in front of you there, you know, every day. And I still try to incorporate that during PA school. And that may mean you know, I may study 12 hours, which sounds like a lot, I'll tell you, it's a lot for me, there may be a day before an exam, I'm just looking at material, I break it down, you know, maybe you know, we have different study techniques, 25 minutes study, five minute break, I tried to take an hour go to the gym. And so I give myself these little, I guess pieces of enjoyment or satisfaction, things that bring me joy, to push me. And then every single time I have an exam, I think software is planning some social events, something with friends, and it reminds you Okay, only one more day, two more days. Because I think they can really help you get to that next hurdle. And then when you get to another exam, you do the same. because like you said, that's the amount of work that's required. It's a lot, but it's not unmanageable, because if it was unmanageable, it wouldn't be asked of you. Things I do specifically, I use spaced repetition, I can tell you and I didn't even know what that word meant. Before I got into the school, I was used to you know, reading slides. And that's how electrical learn. But there's degreasers, like on key that will basically put information in front of you sporadically, like in a variable ratio, which will create memorization, there's constant mapping, which might mean that you keep a bunch of similar terms and you try to connect them all. And when you can do that you think on the test. Okay, me not 100% know what this does, but I understand what it connects to. And you kind of cross choice though. Um, and I think a lot of these things overall, you guys, there are a lot of little things but overall, they make the amount that required of you doable and manageable. And I think it's crazy that people messaged me now, Randall, I don't think I can do it. And I'm like, trust me. You'll do it. I'm gonna see you in three years, you're going to be a PA whatever other field you want to be in, and I think that I've even had people that just started the program now and they like, take the first quiz, like, I can't believe I was able to do that much. Instead, I'm like, I'm like, see, you surprise yourself. And I think it's like you said, finding things to look forward to, you know,

Brooke Smith 25:15
It's it's that mentality of like, one foot in front of the other and like, focus on the next step. And the next step, in the next episode, you don't get like, so overwhelmed by looking at like, all the things you have to do. But also, I think gas mining little normalcy in your day, little moments of taking breath of taking time for yourself to try to get that memorization and and I think something I would say to you is, tell yourself, you can do it. You know, the mind is such a powerful thing. And sometimes when I have to do something really difficult that I'm like, I don't know how I'm going to do this. I tell myself, Oh, no problem, I got this, this is going to be easy. I'm going to do it. Who will be like, how are you going to do that? I'm like, Oh, it's no problem. I'm going to do it. And I just told myself that I can do it. And you wouldn't believe how what a difference it makes it sounds so silly, but but just turning your mind and saying like, this is easy, I can do this, even when it's not you just tell yourself it is. And you'll find instead of being discouraged, when you can't remember is something you're like, no, I got this, I'm going to I can do this, I know I can do this. And your your brain will remember also, I think, I don't know if you ever do this when you memorize. But sometimes when I'm trying to memorize something, I'll take little tiny power naps. And I mean, like maybe two minutes, I just close my eyes after I'm trying to memorize something for a while. And I think about it for the first maybe 30 seconds in my mind. And then I close my eyes and I don't think about it at all. And when in two minutes time when I come back, I'm like, Oh, actually I can remember I'm remember this a lot better. Because you're giving your brain like a moment to kind of just like absorb it all. Does that ever happen to you where you're like trying to memorize something and you're like, I can't I can't remember this. And then the next morning, you just know it.

Randall 26:50
But it's one of those ideas where you might have hit that point that's, it's why they actually encouraged it takes like 25 minutes on five minutes off, maybe go for a walk. I also do Now you mentioned that I do like sometimes midday naps. And I'm not sure exactly the science of it. But there's some scientists like under 20 minutes or under some sunset period where you reset your brain. And that can be so useful. Because if you sit there looking at it forever, sometimes it just like it's not going to click but then like you said, You wake up the next day, and you're like, have it all exactly as it was. And I also want to say about that, that self belief. It's almost like a self fulfilling prophecy. So I love that you mentioned that. Because when you believe in yourself, it's easy. Whenever you get stuck, you say I'm going to find another way. But if you don't, if you if you're doubting yourself, you're just going to give up. And so I think that that might be like, I'm going to see like take that point. Because that is social so important.

Brooke Smith 27:44
Yeah, I think you just encourage yourself, like you would encourage your friend or your family member, you know, like you got this you can do it. You know, I think just encourage that that little self talk like you can get through this. It does really make a huge difference when it when it comes to. And then you surprise yourself like what you were talking about, you're like, Oh my gosh, I can't believe I did that. Like I memorize that whole thing. And like, three hours, I thought it was gonna take me nine or whatever it is. And you're you surprised yourself. But that's good. Because we're capable of so much more than we even realize we don't give ourselves enough credit for how much we're capable for. So these things when you surprise yourself, it's such a good reminder to be like, Oh my gosh, I grew a little bit and like what else can I do that I didn't think I could do before. And it goes back to what you were talking about stepping outside of your comfort zone and kind of stretching yourself a little bit. And then realizing like how how far you can go just by tiny little tiny little stretches or tiny little outside the box choices.

Randall 28:39
Yeah, I love this, that whatever on this idea, because I think that is such a crucial part that's like often skipped over I think social media often focus on the highs and there are really big highs. But it's important to realize that there will be double back bad days, but how you deal with those kind of defines who you are as a person and how you will face and overcome adversity in the future. Rolling healthcare is so taxing that will be the the greatest days, I actually had one of the most humbling and you know, kind of difficult moments recently, we were in a cadaver lab and I got to hold a human heart. Someone sacrificed their you know, their body for science. And it was such a moment that was it emotions almost came over me it was like a very emotional moment. Because to be in a position like that. It wasn't a high it wasn't low somewhere in between. And I think it's being appreciative of those moments and just realizing that we have to get through tough times. And things like that even for you on to want to be the best you can because I don't want this person to sacrifice their body in vain. I want to help 1000 people from what I learned from from this one person inside the moment that we're in our that can be highs and lows, but it's just important that we always find the good and what we're doing

Brooke Smith 29:59
Now I mean, you're you're such an incredible person, I think, just the fact that you, you're literally holding human heart in your hands. And you're having gratitude for that. You're saying thank you for donating your body to science so that I can learn so that I can go help 1000s of people because I learned from you. And it's just such a beautiful journey that we're on together on this planet. You know, it can be so easy to think about all the things you don't have, or all of the sailing or I didn't, I failed this test, or whatever it is, it's like it doesn't doesn't matter that you fall, it matters, how you recover from the fall. You know, it matters, what you learned from the fall, it matters how grateful you are for the fall for teaching you the lesson that you needed to learn. And you might have to learn the same lesson more than once. I mean, it'll come in as many times as you need to learn it. But I think having gratitude, which obviously, you have so much of makes you an incredible, soon to be PA, I would love to hear. So I know you're three months into your journey. So does that mean because you said a journey could be 24 to 36 months? How long is your journey? And why is there a discrepancy between 24 and 36? Or is that just if you go slow?

Randall 31:05
That's a great question. There's a lot of factors on I guess, a little bit different. It's very similar with nurse practitioners. To become a physician, most medical schools are almost all the same exact same, like there's a couple three years that are accelerated. Pa programs are a little different. Because some of them have different core focuses. Boston University School of Medicine Physician Assistant Program, which is what I go is a little unique because it's one of two, where we take 70 to 80% of our class with medical students, second year medical students. And some people may say why you're going to be officially sustained. Why would you want to learn the same? And that's a great question. Our university believes that incorporate early. And so that means the product a little bit longer, it's 28 months, leads to a higher level of medical knowledge. And not only that, you've got to realize that you're gonna be working with the healthcare team. These physicians, in this case are sometimes you're collaborating and supervising you, they understand you have the same knowledge when that same class with me took the same task. And that can also increase the provider to provider trust, which is important. Some other reasons do because a 24 month it's the founder of physician assistant education. A lot of them in California, like Stanford's USC is our 30 to 32 months. And that's because they have such a they spend a lot of time on some employer rotations, and comes more on deductive education. So you can kind of be up to university decide, what do we want? Do we want more electives to kind of let people see? Or do we really want a lot of time with active education. But like you said, some do have longer breaks, I have a friend who goes to a program, and her program gives her three months off. So her program is longer as a result of that. So it kind of just depends, I know there are some only choices as well in part time if you want to exaggerate the journey, but most of the time, the difference is really up to the university say what do we want you to learn whenever you graduate? Like how are we going to distinguish you a little bit from another physician assistant. And I think I kind of like that, that there's sometimes it's good to think if we're working in a team, everyone might have a skill that's a little bit better. You know, because if we all have the same skills, we're all good at doing the same job. But it's kind of nice to think that we might have a little bit of a specialty, right? When we start

Brooke Smith 33:27
what you want to do what you want your specialty to be when you become a PA,

Randall 33:32
It's actually two things. I think what I love about a PA and that distinguishes us, I guess I should have mentioned earlier, over a physician or nurse practitioner, which are both well considered in the field of practitioners, the physician being independent in all capacities, and nurse practitioner being independent, depending on the state is that we're taught as generalists. So unlike a physician who may do a residency in emergency medicine and be stuck there forever, I can assist in emergency medicine, and then I can work in psychiatry, and then I can work and family medicine. And then I can work in dermatology. And you think about that there's no other medical condition that can treat, diagnose and prescribe that can do that. It's kind of like an anomaly. And I think for me to avoid burnout, I know I want to work in a lot of different areas. I think going back to my roots, I know mental health, and I think family medicine will always kind of play a role in what I want to get back. Because I know what it's like to not have a specialist or specialist be two hours away. I know what it's like not to have a primary care physician for most of my life. And I don't want other people to experience that same reality. I also know that you know, being in Boston, dermatology, a big interest when I think about kind of what I want to do. It's kind of a mix. I know i'd love the remote idea, especially with COVID has shown that you can like do psychiatry and state and mental health especially during a pandemic. It's something that's so necessary. You know, sometimes you really do need to speak to somebody, I love that I can do that, and I can help and work in, well, maybe I'm in Boston, and then I could do dermatology. I love the idea of general dermatology, because you see all these skin conditions. And for me, that's, I think, something that I find the most interesting now. But who knows, it could change, you know, I think you'd be on rotations and you get to, you know, assist in a surgery or you get to biopsy something, and maybe it changes everything. And I kind of love that you go in with an idea. And maybe you do the complete opposite when you leave.

Brooke Smith 35:34
I love that I had no idea that I had so much like flexibility in the career, amazing that you can kind of just hop around and still be helpful in all of these different fields. That's really interesting. I thank you for sharing that. I have no idea about that

Randall 35:48
Fortunate for pa as lateral mobility. And I think it's so important for burnout, because I've met position too, maybe a mid 20th year of practice, maybe they're not as passionate. And I think they can they can also double certified and get another residency. But I love that the second I'm not, I'm not feeling something 100% I can just switch. And I think that that allows me always to give 100% and I think why am I going with this in the first place. It's not for the money. And I tell people like that is the number one reason that's going to healthcare, there's a lot of other things you could do that will make you more money. I think whenever I think about the journey, the only real reason you can go is because you care. It's a lot of hard nights, it's going to be sad moments in hospital, maybe someone doesn't make it or you have to get bad news. But I think about all the good moments that are going to be there too when I help somebody or I can say you get to go home, or the results came back in and nothing to worry about. It's benign. And so I don't know, I think that that kind of defines reason why it's important to be in healthcare for me.

Brooke Smith 36:54
I love talking to you, because it's just so clear how much you care. And what a great heart you have what I know that you took a little time off after you graduate in 2019. And you were working, and then COVID happened and now you're you're in PA school? Is COVID really affecting PA school right now in Boston, have they? Do they have different kinds of measures that were different? And how is COVID kind of affected you during this time?

Randall 37:23
While these have been some dark times, I think there's some real long term things that we've gained. And I think sometimes it's important to focus on the positives, you know, I think it increased access to care. Like I talked about growing up being two hours from a specialist. Well, I know when I grew up, that meant that you know, you weren't going to see that specialist often. Or maybe you didn't go at all. And now you can log on to your computer, you have a camera. And you can see I'm and I think increasing access to care has really been something that was difficult in the beginning, but might be the biggest overall thing that we've gained. And I think with seeing providers often comes in increased trust and health issues. Because when you see people more often, like in this direction or other, there's just a greater trust in the people you're talking to you. And a lot of our live hardships that we face in the last year, I think that that might be the biggest, the most positive, is allowing more people to see and receive help when they need it. Because I think that it's just so boring.

Brooke Smith 38:24
Absolutely. I think, you know, just talking about this, it reminds me, you know, sometimes before it's like you have to take off work, you have to drive depart, you have to get there. A lot of times people are just like, they don't want to do it. They're already like afraid something's wrong with them. They're like, I don't really get bad news today. Like, it's a lot of effort. And you have to overcome a lot of things to go in. And I think with doing it online, doing it from your phone, doing it from an app, being able to talk to a doctor or the denarian. It makes it so much easier to say, Hey, I'm having this problem. Should I worry or not? You know, do I need to come in or not. And I think it makes people more inclined to reach out and get that help and let less time go by. Because you know, a lot of times with with illness, the quicker you catch it, the better, the better it will be. So I think it does encourage people to say, Okay, well, you know, I can find five minutes to hotline real quick and tell the doctor what's going on with me. And then if they think I need to come in and they'll schedule me. So yeah, I think that's really great and positive. And that's something I really thought about,

Randall 39:24
Oh, I remember working actually had somebody like I saw that they stepped out of work for like 30 minutes because that's all you need. If you're doing on your phone, you can step outside during lunch break and answer a call and so you think about that person probably would have came in. And so it's so great to think that another person who helped just as reality of increase in access to care.

Brooke Smith 39:45
So great, so positive. Thanks for sharing that. Well, Randall, it's been such a pleasure having you on our crafting wellness podcast I absolutely adored and loved having you. For everyone listening and watching. I'm going to link all of his information in this video. You'll be able to find him on Instagram and is there anywhere else we can find you?

Randall 40:07
So it's at Randall, period the period up. Yeah. It's been great to getting to know you, Brooke and meeting you face to face offline as well,

Brooke Smith 40:17
Absoultely, and yeah, I'm sure Randall would love to talk with you guys. If you have any further questions or want to reach out. I know he's happy to do so. And thank you again, Randall for being on our podcast. It's been a pleasure.

Randall 40:28
Thank you Brooke.

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