Balance in PA Life

It’s no secret- journeying into medicine is hard. It takes over your life and leaves you wondering if you’ll ever have any energy for your family and friends, much less your hobbies and passions. So how do you balance drinking from the fire hose and exuding compassion for your patients, while keeping food on the table, your sanity in check, and your relationships healthy?

Schedule time for you and yours- and don’t cancel!

Caveat: I’m not an expert. I wasn’t perfect at any of that. I’m still not perfect. But I do have some pointers that I think really helped!

Schedule time. I’ve touched on this before, but scheduling a bedtime, dates with friends/significant others, religious services, and exercise is key. Just as you wouldn’t call out of work because you’re busy, don’t cancel important life activities to study. You will NEVER feel like you know everything. You will always feel like you could fail a test. That is ok! You’ll never know all of medicine, but you will always need sleep, your friends/family, your faith, your health, etc. Prioritize it.

Meal prep Sunday!

Meal prep. I started this in PA school and continue to do so now. Planning your meals helps you budget time and money, and makes you less likely to make last minute unhealthy choices. Spend an hour or two on Sunday planning your meals for the week–this goes a long way and will easily give you back an hour each night. Daily burn has a great article on meal hacks to save you time during the week- check it out!


I can’t believe this girl hasn’t run away from me yet!

Humor. It’s the little things in life that make you laugh, make memories, and remind you that the world still spins outside of PA school. Don’t forget the value of silliness. Find a comedian you like and follow them on social media. Keep an album of medical memes that describe your frame of mind in perfect satirical fashion. Put the sunglasses on the dog. Whatever it takes to keep your smile muscles working!

Perspective. PA school is a mind game. Nearly everyone fails a test at some point. I failed two exams in my didactic year. Guess what? I still graduated with honors, I still had a job by graduation, and I completed a post graduate fellowship at one of the most prestigious hospitals in the world (Cleveland Clinic Foundation!). Failing a test or two means next to nothing in my book, and says nothing about your potential to be an outstanding PA. Change up your study habits, ask a classmate for help, find video lectures (I love Dr Najeeb!). You’ll pass it the second time and life will go on as if nothing happened. I’ve got a blog post coming of all the ways I “failed” in PA school, including the time a professor told me I was “unteachable” in didactic year. Spoiler alert- none of it mattered.

Keep up the great work and don’t give up. If you feel like you’re getting pummeled by an avalanche with nothing but a fork to dig yourself out… you’re doing this PA school thing right. Keep tackling the challenge with whatever tool you’ve got handy and you WILL make it. You’re a warrior for making it this far, so don’t give up! How do you balance your life in medicine with all the other aspects of you?

Plastic Surgery- Breast Reconstruction

Breast reconstruction is probably the most common set of procedures people think of when you say reconstructive surgery. With 1 in 8 women being diagnosed with breast cancer, it’s no wonder why! Breast reconstruction specialists reconstruct the breast after breast cancer. Most people know about implant based reconstruction, but there are so many more ways to reconstruct a breast! Let’s go through a few.

The first option- do absolutely nothing. Patients can, for a variety of reasons opt to do absolutely nothing. She may have a lumpectomy or mastectomy and opt for no reconstruction. That’s ok! It should always be an option as reconstruction has the potential to increase surgical time, risk of infection, and recovery time. There are whole groups of women who choose this option, like the women of Flat and Fabulous. It is always important that this option is given to patients, as breast reconstruction is not a requirement.

Oncoplastic reductions- If a patient only needs a lumpectomy/partial mastectomy, she may be a candidate for a breast reduction at the same time. This allows the remaining breast tissue to be rearranged and lifted, hopefully concealing the defect left behind by the lumpectomy. This is one of my favorite procedures- breast conserving surgery has great benefits including the potential for preserving nipple sensation while avoiding the risks of implants or flap surgery.

Tissue Expanders/Implants– Also known as alloplastic reconstruction, this form of reconstruction uses an artificial implant to reconstruct the breast after a mastectomy. It can be done all in one surgery at the time of a mastectomy (direct to implant), in a two stage procedure (tissue expander first, then implant), or in even more stages if needed.

Flaps- A flap refers to using the patient’s own tissue to reconstruct another part of the body. A pedicled flap means that tissue remains attached to its own blood supply and does not require microsurgery to connect blood vessels. Pedicled flaps include latissimus (from the back) and TRAM (from the abdomen) flaps.

Free flaps, on the other hand, take tissue from a remote part of the body such as the abdomen, thigh, or buttocks to reconstruct the breast. The tissue is taken with a named blood supply (artery and vein), and reattached under a microscope to blood vessels in the chest (usually the internal mammary). The most common approach is the deep inferior epigastric artery (DIEP) flap. Which has the added bonus of a free tummy tuck- but buyer beware… this isn’t a cosmetic tummy tuck and the priority is always making a new breast first!

Breast reconstruction is an ENORMOUS topic so this barely scratches the surface of what can be offered to a patient with breast cancer. Breast reconstruction makes up the majority of my practice and is near and dear to my heart- drop any questions in the comments!

An Open Letter to an Arizona Hospital, Ascend Medical and Zip Recruiter

Last night I came across this job ad online and simply could not believe what I was reading. This is a real ad on ziprecruiter.com, on behalf of Ascend Medical. While it does not state the hospital name, a quick google search verified that there is only one 139 bed hospital in Bullhead City, AZ. As they are not directly named in this ad, I will not list them here. However, they are fairly easy to identify in this small community. They are seeking to hire a Hospitalist for their team. While the link is no longer live (I suspect because they received complaints), I did see this posting on ziprecruiter.com before it was removed. I hope it is fake news, a fake ad, or someone’s idea of a joke gone bad. But even so, I was compelled to respond directly to leadership of the hospital, Ascend Medical, and Zip Recruiter. The letter below has been sent to each respective office, and I will be sharing it here as well. Discrimination has no place here in the 21st century. Please feel free to share if you agree.

Dear Sir/Ma’am,

I recently came across your job posting for a Hospitalist position in Bullhead City, AZ. It is clear that your hospital is motivated to hire a new Physician, as you cite that the hospital credentialing process will only take 30-60 days, and that you will only accept licensed providers to expedite the start date. What is not clear, is why in your time of need when seeking to attract quality physicians, would you be eager to willfully and publicly discriminate against 50% of the population based on gender alone? Why further would you open yourself to public scrutiny and legal proceedings by leaving nothing to the imagination, and openly stating “women don’t do well here”?

You state that this is “a tough facility and medical staff” as your reasoning for women not thriving in your hospital. What I suspect this really means is that your leaders, likely both medical and administrative, support a culture of overt sexism. It also suggests that you are unwilling to remove these toxic leaders from your organization in order to replace them with contemporary visionaries who seek to build effective medical teams to care compassionately and competently for your patients. What a shame for your community– that their local hospital is willing to compromise their care by supporting this discriminatory culture that is both illegal and detrimental to the community at large.

In all, this job posting proves failures at all levels. I call upon the hospital, Ascend Medical and Zip Recruiter to all reconsider their hiring practices going forward. Perhaps also, you may wish to more closely consider the non-discrimination laws of this country when seeking to hire new staff. And finally, as a first step to restore public trust in your organization, I urge you to issue a public apology and a comprehensive plan to change your organization’s culture moving forward. If these are not acceptable terms for you, I do welcome and urge your resignation so positive change may begin unimpeded.

Yours respectfully,

Kathryn Sidrow

PA Wednesday!

Check out our very first PA Wednesday contributor, Angie! She’s a pediatrics PA-C in Georgia who graduated last year and has a year of clinical practice under her belt. Read on for a look into her daily life and learn some Pre-PA and PA school tips from a new grad perspective!

Tell us a little about your life as a PA since graduation:

I have been in Pediatrics for about a year and typically see about 20 patients a day. I take call 1 to 3 days a week (3 if it’s my call weekend). I also round on the newborns in the hospital. I see kids from newborns to 18-19. We see well and sick visits, and manage long-term conditions. I’m also a PA in the Army national guard. I have loved working with the kiddos, but orthopedics was always my goal, and I’m very excited to be making the transition to Orthopedics/Sports Medicine in January!

 What led you to the PA profession?

My original thought was to go to med school. But I also didn’t want to get stuck in one specialty. I’ve always jumped around from job to job, being stuck doing one thing was not appealing to me. I ended up getting a masters in biology and thought I was going to do research. When I realized I did not want to be stuck in a lab all day, I started looking into PA school. The PA profession called to me because it allowed me flexibility, while still allowing me to provide medical care to anyone and everyone. I applied on a whim to the only 3 schools that still had applications open. I got two interviews and got into one school. I was so shocked! But now, working as a PA, I’m so incredibly glad I made my choice. I love being a PA.

Where did you go to school and what kind of HCE did you do?

I went to PCOM- Georgia. They require a minimum 300 hrs PCE. I was an EMT, worked as an MA in Dermatology, interned in general and orthopedic surgery, and taught Emergency Medical Response and Anatomy and Physiology at dual enrollment programs and at a college.

What tips do you have for pre-PA students looking for HCE hours?

It’s all about who you know. I went to church with the dermatologist I worked for. I told him my goals and plan to go to PA school and not only did he hire me as an MA, but he also came in early to give me lectures and teach me skills like suturing. He actually ended up letting me close some of his surgeries for him too, which was awesome! But don’t be afraid to reach out to people you may know.

Also, don’t be afraid of taking a job that may seem “beneath you”. It doesn’t matter if you have a bachelor’s or not, take whatever opportunity you can. Or go get an extra certification like MA, CNA, etc. Don’t just think about it as hours to get, think about the experience you get with those hours. It will help a lot in PA school.

Do you precept PA students or allow pre-PA shadows?

I do accept both PA and pre-PA students at my current pediatrics job. I know my new job will also accept students, but my guess is that I’ll have to be there a little while before I can take on students myself.

What pearls can you share for pre-PA students?

Be yourself throughout the whole process. Write about authentic experiences for your essay. Talk about yourself and be honest with your strengths/weaknesses, etc for you interviews. Also, remember that you are choosing the school as much as they are choosing you. Don’t go to a place just because they accept you. Make sure your philosophy lines up with theirs, that you like the way they structure their classes, and that the professors are people you can count on.

Also make sure you take time for yourself away from the books and studying. Have a life outside of school. I know it feels like you have no time for it, but self-care is important!

 Thanks so much to Angie for contributing to PA Wednesday! If you have questions for Angie about her PA life, drop a comment below!

“Plastic Surgery? Like, boob jobs and stuff?”

That is a direct quote from a former coworker of mine when I told her I was leaving emergency medicine to pursue plastic surgery. What do you think of when you hear the words “plastic surgery”? Chances are “boob jobs and stuff” isn’t far off. I’ll be honest, if you asked me what plastic surgery was all about a few years ago, I’d have probably told you the same thing. And hey, it isn’t wrong … but it isn’t comprehensive either.

Plastic surgery covers a very wide range of procedures that cover virtually every inch of the body. Let’s break down some of the sub-specialties of plastic surgery to give you an idea of just how broad this field is. We’ll start with the one everyone knows- cosmetic surgery!

IMG_4283Plastic surgeons specializing in cosmetic surgery focus on aesthetic improvement of the face and body. For the breast, popular procedures include breast augmentation, breast lifts, and breast reductions. They do the ever popular “mommy make over”, liposuction, tummy tucks, and body lifts. And of course, surgery to enhance the face with face lifts, rhinoplasty (nose surgery), blepharoplasty (eyelid surgery) and neck lifts. For those not ready to jump into surgery, there’s always Botox, fillers, lasers, and nonsurgical fat reduction methods.

Cosmetic surgery used to be a taboo, hush hush affair reserved for the rich and famous. Thankfully now it is becoming more and more popular and accepted for the rest of us! While my practice is primarily focused on reconstruction, I love helping patients through the cosmetic surgery process because I have seen it truly transform lives, give back confidence, and lift a burden that previously weighed so heavily on my patients’ hearts and minds. Its an honor to share in that journey as a PA and if you’re thinking of cosmetic surgery– go for it! Drop a comment or contact me with your burning cosmetic surgery questions!

Up next- Breast reconstruction! Stay tuned 🙂

 

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