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 "Bombs away!" I yelled to the captain as Navigator of our F-15 on a nuclear bombing run. "We did it. We just destroyed Saint Louis." I was so excited to be selected for a special science study program at the U.S. Air Force Academy.  Nothing is better than the feeling of a highly motivated team sold on individual excellence pulling for a single goal, and yet on that day running the flight simulation at the Academy, deep within my heart, I knew that medicine was my real calling. Becoming a Physician Assistant (PA) is the way I truly desire to use my love of medicine to serve others.

   The character qualities and academic excellence that caught the Air Force Academy's attention were honed and hammered by my 17 years of playing softball and other athletics, plus dedication in scholastic and extra-curricular activities. The most outstanding game I remember was against a strong conference rival on a day that easily surpassed 90 degrees.  I was the only pitcher on the team and pitched almost every pitch during my high school career.  The double header games were hard, the play was tough, and at the end of regulation play in game one, the score was tied and we went into extra innings. My perspiration was evaporating faster than I could force fluids, but the team was counting on me and there was to be no quitting and no surrender. I pitched a total of 18 innings that day. No, we didn't win, but I learned perseverance, mental and emotional toughness, and teamwork.  Our team stuck together and didn't quit! We encouraged each other, backed each other up, overcame each other's weaknesses, and together, we became stronger. I love leading by example and encouraging others to their best. Building team unity and coordinating our strengths is something at which I  excel.

   In College, I went from rising star to disabled "could have been."  After two shoulder operations, I was angry my body was broken. As an injured player I turned adversity into strength becoming a student coach, a spiritual leader as team chaplain,  chief encourager, and team captain. Four years of persevering, training, physical therapy, and medical answers that brought pain and disappointment made my resolve to be a PA that much stronger. I believe the lessons and character gained in high school and college are important to my studies and work as a PA.

   Athletics helped me  learn much about medicine through personal experience. I have undergone three surgeries, all because of my athletic career. I was exposed to the operating room and surgery, extensive and painful physical therapy, X-Rays, MRI's, and cortisone injections. I also dealt with the fears every patient has before surgery and the emotional and physical exhaustion of long-term pain. This has given me valuable experiences and insights into the medical field. My doctor, Marc Asselmeier, M.D.,  showed me how to care for patients and practice good medicine. In him I saw compassion, personal caring, and medical excellence.  That's the kind of medicine I want to practice. After seeing him for my first surgery during high school, I spent six weeks shadowing him in the office, rounds and in the operating room. I watched him interact with patients and with the medical staff and was exposed to the medical practitioner's side of medicine. Those six weeks were the best weeks of my high school career and solidified my desire to work in medicine.

   In addition, I have enjoyed working in different medical settings and volunteering in a rural medical clinic. I have worked along side doctors, nurses, pharmacists, phlebotomists, a dietitian, a PA in general practice, orthopaedics, pediatrics, and emergency room settings. As a patient in physical therapy, I've seen how therapists' work ties into patient care. All were experiences that helped me to confirm my desire to pursue PA studies. The most important truth I have gained from these experiences is how vital each member is to patient care. My work and volunteer experience help me see patient needs and  how each professional plays a significant part in good health care.

   I desire to become a PA taking an active role in patient care by accurately diagnosing, prescribing treatment, and monitoring follow up care. I love the problem solving aspect of diagnosing a patient and working with others to find solutions to the problems that patients will bring. I naturally see needs of others and jump into a situation to help get a job done. I believe that I will be able to read a situation and be an effective problem solver in a medical setting just as I have done in many diverse areas of life.  Also, I want to be a PA because I have a hands-on, person-oriented personality that is coupled with a love of medicine and awe of the human body. The body is amazing to me and I am constantly in awe of how marvelously it is made and works! I enjoy learning science and medicine and want to continue to grow in knowledge of medicine throughout my life.  I am also anxious to put that knowledge into practice by serving people in the medical field. I enjoy people and want to be a part of other's lives. I want to know patients as individuals, genuinely caring about people while providing them with competent medical care.

   I am amazed by the human body and how perfectly it is formed and works. Being able to devote my life to its study would be an exciting honor and opportunity. Being person oriented and a hard worker, I desire to pour my abilities into the service of people through medical practice. I want on that team! My experiences help me focus my desire to accurately diagnose, prescribe treatment, and monitor follow up care.  I want to become a PA so that I can take the love I have of medicine and the human body and use those to satisfy my deepest desire: serving others with my abilities.

Sincerely,
KEFields, M.S.P.A.S., PA-C

   With my Master of Science in Physician Assistant Studies, I have proven to be a responsible medical practitioner with a deep love of medicine, patient care and continued learning. My precepting physicians judged me as knowledgeable with a unique ability to empathize with patients leading to exceptional patient care. Some notable skills include an ability to intuit when patients and families need further explanation as well as finding a way to help them understand the diagnosis and treatment plan. In addition, my preceptors recognized my proficiency in technical skills and procedures and an ability to quickly learn and incorporate that learning into my clinical practice. I have been blessed and I want to share that blessing with others.

I work with Robert R. Carroll, MD., PA., a medical oncology practice that focuses on breast cancer treatment and prevention.  I am a 1992 graduate of the University of Florida Physician Assistant Program.  I chose to become a PA after working in research and clinical laboratories doing experimental and clinical hematology, basic science research into the elements of the bone marrow microenvironment, veterinary clinical pathology, and finally medical pathology focusing on abnormal blood clotting mechanisms and tests to identify patients with clotting disorders.  I had spent ten years working on patients' blood without the opportunity to learn about the patient themselves. Becoming a PA was the best way that I could see
to meet the patients and be more of a participant in the management of their health concerns. 

   It's hard for me to identify my most memorable moment as a PA -sometimes the most memorable is also the scariest.  In my former position in a large academic oncology practice, I was the "procedures person".  The first time I performed a bone marrow biopsy on my own was pretty scary, as was the first thoracentesis, the first lumbar puncture to instill chemotherapy into the spinal fluid, the first paracentesis.

Some of the most memorable times have been the times that I have spent with patients and their families talking with them about "what will the end be like?"  Singing at the memorial service for a patient/friend who I had cared for through 2+ years of battle with HIV associated lymphoma with central nervous system involvement will probably stand out as the most memorable event, at least until something more memorable happens.  Some of the happiest times that I can recall are when a patient who has just undergone a painful and frightening procedure tells me "that wasn't so bad after all", especially when they sing along with me during the procedure. 

  One of the most positive comments I have heard from my supervising physician was when he told a patient, in my presence that "Kate is not just an assistant.  She is a colleague, someone I can talk to."  Robert R. Carroll, MD

Current employer-Gerald A. Acker, MD, Plastic surgeon

Why did I choose to become a PA?  I was a Combat Medic in the Vietnam War and had the opportunity to function in many roles beyond my Military Occupational Specialty.  I left the Army overtrained and looking to find a career in medicine.  The PA concept was starting at the very same time and I thought that I could be utilized to the fullest as a PA.

My most memorable moment as a PA?  I've been doing this for so long that my memory fails me.  I believe that I am fortunate to be involved in the health care of so many patients and that I have the opportunity to make a difference in peoples lives.  I love being a PA as it affords me the opportunity to reach out to patients with hope and skill and to change their situation.  My most memorable moments are looking into the eyes of patents who are scared and feel hopeless and just holding their hands and smiling at them and offering them hope.  Their response is usually tear brimmed eyes as they feel that someone cares for them.  PA's fulfill the role of both a compassionate caregiver and highly competent specialists in their chosen fields.

Most Scary Moment?  Being assigned to the Surgical Intensive Care Unit.  As I looked at all of the monitors, IV tubes, digital devices, etc., I wondered how I was going to be able to care for the patient who seems to be a lost entity to many amidst the sophisticated equipment.  It was scary to think that perhaps I could not make a difference in this environment.  My fears were groundless as I saw demonstrations of kindness and concern as I observed the professional Nurses that worked the unit.  I too found that I could make a difference in the patients lives as I remember that beneath all of the equipment was a scared human being who just needed to be touched.

"I could not practice medicine without my PA.  Gerald A Acker, MD, PC"

Robert M. Blumm, MA, PA-C 

First PA to respond:

1. I work in an outpatient family practice. So, I go to clinic about 8am  and see patients until about 12. I have an hour for lunch and end at 5. I diagnose, treat, order lab/xray, and manage lots of different disease processes. 
2. What do you find challenging about your job? I find the diversity of diseases that present challenging, however, this is part of the reason that I love family practice. You never know what’s coming in. 
3. Has technology changed your work in any way?  I’ve only been out 2 ½ years. So, I use technology pretty much the same as I did when I started. I use a PDA very frequently every day (usually >epocrates). I also use the internet to look up diseases, pathophys, etc. 
4. What are the major qualifications for success in this occupation? You have to know your limits and have a hunger for knowledge. 
5. What are helpful high school classes to take to prepare for  this occupation? Science courses would be helpful. 
6. What is a typical pay range for someone entering this occupation? To start, probably around $60,000 for someone working full-time. 
7. What attracted you to this type of work? >I love the patients and the constant need for learning. 
8. Is your job different from how you first thought it would be?  Were there any surprises? The only surprise was that you can truly love your job and, at the same time, hate your management group. (don’t quote me on that:^) 
9. If you were starting again, what, if anything, would you do differently?   I might go into the profession a little sooner than I did. I got a bachelors and masters in zoology before PA school. I would probably have skipped the masters. 
10. What other advice do you have for a person considering this career?  Make sure that you are dedicated to being a PA, before PA school (it’s pretty tough). If you find that you like it, stick with it; it is an amazing profession!

Second PA to respond:
1.. On a typical day what do you do?    I work at a very rural clinic out in the middle of nowhere in NM, on  the Mexican border. Nearest hospital is an hour away. We do have an  ambulance in town but the EMTs who work it are sorely undertrained  and are full volunteers. A typical day for me? There is no such  thing. Every day is different. Sometimes I get to work in the  morning and there's a patient having an emergency (i.e. heart attack  or amputated finger) when I show up. It can get scary out here. Some  days I see 15 patients; other days I see up to 27-30...just depends  on the day, the season, etc. I see everything and everybody...I do  family practice....tons of diabetics, lots of kids, gynecology  (womens health), derm (skin stuff), cardio (heart stuff), ortho  (bone and joint stuff), trauma, ...you name it. Lots of social  issues with these patients (many of them Spanish speakers  exclusively)...illegal aliens, poor, some homeless, overcrowded  living situations, no running water or electricity at home and  certainly most of my patients do not have a phone at home.    My typical day starts at 8am....lunch at 12-1...and most of the  time, I do leave the building. Off at 5pm...sometimes I get to leave  at 5pm, sometimes not. Just depends on the patient load. 

2.. What do you find challenging about your job?  Dealing with the social issues I mentioned above...patients unable  to afford treatments or meds, etc.    The remote nature of this job puts the onus ON ME to be able to  handle any emergency that walks or is carried in to the clinic.  ...my philosophy is to just do all I can to keep the patient going  until he can get to the hospital ALIVE...Then, it's up to them to  take over. Legally, I am responsible for the health and safety of  the patient until they arrive at the doorstep of the ER. This IS  quite daunting. 

3.. Has technology changed your work in any way?    NO, the lack of technology in this grassroots clinic has changed the  way I work.    Of note, I now do have a PDA (handheld calculator) and that has  greatly eased my work in that I have lots of tools/calculator/med  list at the tip of my fingers IN the room with the patient. 

4.. What are the major qualifications for success in this   occupation?    Empathy and caring for the patient...you need to care ABOUT the  person sitting in front of you in that examining room.    Willingness to be ALWAYS learning...stay up to date with changing  philosophies and treatments in medicine.    Be detail oriented...face it, if you screw up on a dosage for  somebody for a given medicine, you can do them harm....You have  peoples lives in your hands (literally and figuratively),--you can  kill someone with your mistakes!--so, be detail-oreinted and pay  attention to what you are doing.    Be a team player... be nice to your staff....dont be an idiot...dont  be rude--use the words "thank-you" alot...you will only get a  disgruntled staff if u dont treat them right. You need them and  cannot do a good job without them! I've seen too many a doctor who  was an (expletive deleted) to his staff and disallusioned them...and they made  his life hell in the end. 

5.. What are helpful high school classes to take to prepare for   this occupation?    Chemistry, Biology, Physics, Math. Take the humanities too:  Literature, history, and , of course, SPANISH!!!!! It ALWAYS helps  to be bilingual!!!! 
 

6.. What is a typical pay range for someone entering this   occupation?     depends on where you are geographically....in northeast and east  coast, starting pay seems to be higher...such as a starting salary  of $65,000; west coast/southwest, around $55 or $60,000/year. 

7.. What attracted you to this type of work?    I was a physical therapist for about 10 years before going into  this. As a therapist, I worked in a rehab hospital. I got to see the  patient after they were diagnosed and treated for a problem...and I  always wondered what it would be like to be involved in their  primary (early) care. I didnt wanna go to medical school cuz  basically it was too long of a schooling adventure for me AND I  liked the flexiblity of the PA profession. I currently am doing  family practice...but could work in any specialty if I wanted. Such  as if I wanted to be a ER PA or a dermatology PA or a PA who works  with nothing but cardiac patients. MDs cant do this...say an MD is a  cardiologist...he's board certified in cardiology...so, if he wanted  to switch to being a gyncecologist, he needs to go back and do all  this certification and school for that. Bleck! The PA profession is  much more flexible. Also, being an MD often means being MARRIED to  your job....I do NOT want to be married to my job....I dont wanna be  ON-CALL (sometimes 24 hours a day). That is not for me. I have a  life outside of the job...when I am home, I am NOT at work....I will  not do that. Being an MD, this is sometimes necessary. Now,  basically, I do about 90% of what a family practice physician  does....basically, the big difference is that I make about 1/2 of  what an MD makes. If I was in it for the money, I would have gone to  medical school, but I am not. I am doing what an MD does here....so  why would I drop everything now and go to medical school to do what  I am already doing? 

8.. Is your job different from how you first thought it would   be? Were there any surprises?     ...the biggest surprise I've had to deal with at this clinic is the  emergencies that come in. That freaks me out a bit...but I never ACT  freaked. I just do the best I can. 

9.. If you were starting again, what, if anything, would you do   differently?    My first job as a PA was horrible...I had an intuition that the  place was different and weird but I could not put my finger on  it....I took the job cuz I really needed to get employed and start  paying off bills, etc. I was in a hurry to get to work. I should  have listened to my innerself....it was a disaster. The doctor I  worked with turned about to be very unethical, dishonest (i,e  medicare fraud) and on top of that, I ended up finding out he was a  cocaine-head too....If I had done it differently, I woulda never  taken the job. 

10. What other advice do you have for a person considering this   career?    To finance your education, try applying with the National Health  Service Corps like I did (you can do a google search to get the  website). Basically, they'll pay for your PA education, if you agree  to work at selected sites across the nation that are medically  under-served after you graduate. You must be willing to be very  geographically mobile. If you have kids or a spouse or have ties to  family/friends in a given area, this option is not for you. But if  you are a free-wheel, like me, it may be worth it. It was worth  EVERY penny for me...I got a FREE 2.5 year medical education at the  BEST PA school in the nation: Duke University, in Durham, NC. It's  something like $60,000 a year to go there and all of my classmates  will be paying off that debt for years to come. Meanwhile, I am here  doing what I love and am debt free.... 

Third PA to respond: 
On a typical day what do you do? Having had several jobs during a 30+ year career, it could be anything you  wish, from 48 hrs straight and several days off (when you are less than 40 yo  and can withstand the physical and mental rigors of this work, or 7-9 hours  in a quiet derm office. There really is no typical day. What do you find  challenging about your job?  Integrating the science of medicine with the art of medicine.

Has  technology changed your work in any way?  Technology changes your work and work patterns every day. An obtuse answer  you say, not at all. The rule of thumb is that medical science (information)  doubles every five years. Your career can last 30-50 years. That would be  X to the sixth or tenth power. Are you ready for that? 

What are the major  qualifications for success in this occupation?  Trustworth, Loyal, Helpful, Friendly, Courteous, Kind, Obedient, Cheerfull,  Thrifty, Brave, Clean, and Reverent These are qualities of a good human  being. The rest is just how you wish to apply them to your chosen vocation. 

What are helpful high school classes to take to prepare for this occupation?    The four majors, English, Science, Math, History 

What is a typical pay range for someone entering this occupation?  It will change by the time you get here. I started at $12,000 a year. The guy in the clinic down the street is making $96,000 a year. 

What attracted you to this type of work?  It was new, challenging, and I had been working at the University Hospital  as a lab tech while in school. Life is full of choices that will seem fortuitous when viewed in retrospect Is your job different from how you first thought  it would be? 

Were there any surprises?  Yes, I wanted to change the world, instead I changed a small portion a  little bit. I hate surprises. I try to avoid them. I try to prevent them. I was successful as much as God and fate would let me. 

If you were starting again, what, if anything, would you do differently?  I would start a retirement fund earlier. 

What other advice do you have for a person considering this career?  Pinch your nose, and jump in.