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Shadow Me Next!
Shadow Me Next! is a podcast where we take you behind the scenes of the medical world. I'm Ashley Love, a Physician Assistant, and I will be sharing my journey in medicine and exploring the lives of various healthcare professionals. Each episode, I'll interview doctors, NPs, PAs, nurses, and allied health workers, uncovering their unique stories, the joys and challenges they face, and what drives them in their careers. Whether you're a pre-med student or simply curious about the healthcare field, we invite you to join us as we take a conversational and personal look into the lives and minds of leaders in Medicine. Access you want, stories you need. You're always invited to Shadow Me Next!
Shadow Me Next!
13 - Finding Strength in Self-Sufficiency and Purpose in Patient Care as a Physician Assistant | Jim Allen, PA-C
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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Hello and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face and what drives them in their careers. It's access you want and stories you need, whether you're a pre-health student or simply curious about the healthcare field. I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations, so make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped, and follow us on Instagram and Facebook at Shadow Me Next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests.
Ashley :Today on Shadow Me Next, I am excited to introduce you to Jim Allen, a lead physician assistant in urgent care, who brings a unique perspective to medicine, from his early aspirations of joining the military to finding his true calling in healthcare. Jim's journey is filled with resilience, self-discovery and a passion for patient care. Filled with resilience, self-discovery and a passion for patient care. In this episode, jim shares what it's like managing high acuity cases in an urgent care setting and the benefits of practicing with full autonomy. We dive into the topic of mentorship Do you really need it to succeed in medicine, or are there other tools that can help you navigate your career? Medicine, or are there other tools that can help you navigate your career?
Ashley :Jim reveals the powerful lessons he's learned from his patients and the one unexpected interview question that left a lasting impact on him. You are not going to want to miss that quality question. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Hi Jim, thank you so much for joining me on Shadow Me Next. Thank you for taking the time to be with us today.
Ashley :Absolutely, it's my pleasure how you bring students into your workday. I'd like to start at the beginning and talk to you about what initially inspired your career in healthcare and how you chose to be a physician assistant.
Jim:Yeah, so growing up, I was diagnosed with type 1 diabetes when I was five years old. So you really have to grow up quickly when you have to constantly be aware of how you're feeling, what your blood sugar is, making sure you're taking control of your health, like that, and so that kind of made me grow up a lot faster than most people at that age. So I was always around some degree of the medical world. When I was growing up, my dream was honestly always to be in the military, and as a young kid I didn't realize that if you have diabetes you're not eligible for the military. And so when I called a recruiter when I was like 16 or 17, and they're asking me my medical history and I say, oh yeah, I have type 1 diabetes, they're like, oh well, if you need to take medication on a daily basis to survive, you're not eligible. And so I said, oh okay, well there goes that dream.
Jim:So when I was in high school, I had recently gotten into exercising and lifting weights and stuff. So that was definitely a passion of mine. I was fascinated by the human body, but I was also really interested in mechanical things, cars and just how things work. That's always been kind of an interest of mine is how things work, and so when I was accepted into college, I initially went to the University of Colorado in Colorado Springs and they're really well known for their mechanical engineering program, and so that's what I joined college to do is mechanical engineering Exercise was just kind of an interest of mine, but wasn't really a career path. Just kind of an interest of mine, but wasn't really a career path. Prior to college I had never even thought about medicine.
Jim:No one in my family is medical. My dad was actually a pastor for a Presbyterian church and then he formed his own leadership consulting company. After he left that field. My oldest sister is an attorney. The sister above me in line was an arts degree and then she got into sales. My brother's a musician. So we have a large variety of expertise and interest in the family, but nobody was medical.
Jim:The undergrad work and what I found was I really wasn't doing well at the math. There was components that played into that. My dad died of a sudden heart attack when I was 18, right before I graduated high school, so I was still grieving that loss and there were some teachers with very heavy accents that were part of my trouble learning calculus, and so I found that if I wanted to really be serious about mechanical engineering, I really felt that I needed to understand the math a lot stronger than I did, and so after my first year in college, I decided to talk to the college advisor and switch degrees. So one of the questions the college advisor asks is what are you interested in?
Jim:And at that time I got really into weightlifting. So I was a competitive bodybuilder, later became a competitive powerlifter, so I was really just into weightlifting and that sort of field. The problem that I found with the college advisors is they ask what you're interested in but there's not a lot of thought of what are you going to do with this degree path for a job, how much money can you make at this job and that sort of stuff. So they pushed me into a health sciences degree path, with strength and conditioning was kind of my emphasis. I had initially thought, oh, I might be a sports team athletic trainer or strength coach or something like that, maybe open my own gym someday, something within the fitness world. So I went through that degree path. I fell in love with anatomy and physiology, biomechanics. I just loved learning about the mechanical side of how the body works. That kind of felt like a really good mix for me.
Jim:As I started to get into junior and senior year, you're starting to think about what jobs you're going to do out of college and I quickly learned the type of money that I wanted to make. You just don't make as a undergrad level. You know strength and conditioning coach, it's just not really something that you're going to do. It's not a lot of stability with that, it's a lot of risk. And so I started looking into well, within the health world, what are some kind of additional training or kind of higher level education that I can go into. So physical therapy obviously was a very obvious next step. So I started working as a physical therapy technician with the goal of going to PT school. So I did that for about three years out of undergrad and what I found was I enjoyed it, but it was a lot of the same. It was just kind of the same thing over and over. You're not really the one making decisions, you're just kind of following the standard protocol. Somebody did a knee replacement, let's do the range of motion, let's get them stronger, and then we kind of rinse and repeat 50 times a day. So at that point my mom was actually the one who said well, have you ever heard of a physician assistant? And at that point I had no clue what they were. So I started doing some research into PAs and started to realize it actually could be a really good fit for me, because you're higher level in terms of making medical decisions, diagnosing patients, prescribing medications, interpreting, lab work and imaging, but you don't have to go through the extensive training that a doctor has to go to, but you still allow some big decisions to be made. And then, on top of that, for somebody like me who doesn't like the same thing over and over, you could switch career paths at any time, and so that was very appealing to me at that point as well. So the funny part was, as I was kind of learning about this, I actually had a patient who was a PA. I asked to shadow her. She was primary care at that point, so got a little experience there. Had another colleague who knew a PA in orthopedics, got to shadow them in surgery and in the clinic and really felt, you know what? I think this is a much better fit for me.
Jim:So as I started to get ready for the application for PA school, took the GRE, ended up having to take it twice. I just wasn't happy with my first score. So I took the GRE twice, did all the prereqs that I still needed for PA school, and then I applied my application process. I applied twice to PA school. So if you're out there and you didn'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 PA school, and so it's very competitive.
Jim:What I learned was one I applied late in the cycle the first time. So I applied in August because I saw the deadlines were October, november, december, stuff like that. So I thought, oh well, I'm still ahead of the deadline. I didn't have a letter of rec from a PA, which I think is really critical and I just didn't have anybody mentoring me through the application process. So I didn't know anything about the process, I didn't know how to make myself competitive, I didn't know the things that you need, and so I was just kind of figuring this out on my own.
Jim:So I had applied to five schools the first cycle, one of which being Duke, which was kind of a joke that's the number one PA school for those who don't know. And then I applied late and I didn't have a letter of rec from a PA. So of course the first cycle I didn't have any interview opportunities, didn't get accepted anywhere. So it was pretty hard for me at that point because I was thinking what am I going to do with my life. I don't want to be a PT tech making, you know, very little money. I had engaged to my wife at that time, so we were soon to get married and so you know I was very concerned. So I went back to the drawing board, bought some different books about how to be competitive to apply to PA schools, learned some things in the process, got a letter of rec from a PA, got more experience, shadowing and volunteering and stuff like that. My GPA, I think, was competitive.
Jim:So the second time around my process was if there's a 5% chance of getting in, I'm going to apply to 20 schools and theoretically I should get accepted to at least one. It was expensive for me but it was worth the effort. So I applied early. The second time I had the right letters of rec, had the right experience and I applied to a lot more schools. That cycle I had about 13 offers to interview. So that cycle I had about 13 offers to interview. I interviewed at seven or eight universities and then I was accepted to two. The two universities was the University of Florida, which is where I was just so grateful that I now had a career path and a career moving forward that I could participate in and so ended up going to US and you know we can talk about that, but that was kind of my process for getting into PA school and how I shifted into medicine as I continued to go.
Ashley :What a great story, Jim, Thank you so much for being so detailed with that, because I think that you know it is a journey, and it's one that is not always a pleasant journey, you know.
Ashley :I think there's a lot of hurdles that we jumped through, the challenges that you faced, the position that you want to be in, such as yourself, how they overcome those challenges is huge for us, is huge for us to see, and you know, something that we can kind of apply to our own lives. A common theme that I heard you speak about just then is how important mentorship is and how important it is to have somebody who can help provide a little bit of direction. You know, starting it when the military had to decline your application because of the fact that you have type one diabetes. You know, at that point it's like, well, where do I turn from here? You know, and all the way through, when you mentioned when you were in college and they gave you a major but they didn't perhaps give you an idea of what to do with that. Mentorship is hugely important and finding it, I think, can be really challenging. Do you have mentors in your life right now, jim?
Jim:When I was new to my current job years ago, the owner of the company. He definitely poured in and mentored me as a provider and a PA, and we'll talk about that later. I think he really had a key influence on how I became the provider that I am today. I think that I have role models in terms of Christianity, people who are pushing me to be a better Christian, a better husband, a better father and stuff like that.
Jim: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 in my life right now who I would say this is a mentor, who is pushing me to be better. I think I'm pretty self-motivated in terms of the goals that I have for my life and for my family, and I'm kind of taking it upon myself to research things that I want to learn, either through books or YouTube or talking to people with experience. I think that's kind of the phase of life that I'm in now is I'm just self-motivated and trying to figure this stuff out for myself, but I'm not afraid to ask people for help if I feel like somebody has some knowledge that I want to obtain.
Ashley :Which I think is probably a result of the experience that you had growing up. You are a self-made person and you have done the research and you have jumped through the loops and you have built a really, really strong foundation. I think oftentimes we do talk about mentorship and it can feel very stressful if you don't have a consistent mentor in one field of your life. A lot of people do need that to sharpen themselves and to build themselves up. But, like you said, if you are a self-motivated person who does all the heavy lifting which is ironic for you with your hobbies I think maybe we'll talk about that too. But as a self-made person, the mentorship factor might not be as pivotal for you. And I also think again, something we're going to speak on I think this is what makes you such a great mentor to some of the students and some of the PAs that rotate through your office. So let's talk about when you're working, jim. Tell us a little bit about a day in the life as a urgent care lead PA.
Jim:Yeah, so my company is actually a little bit different. So I do have a supervising physician. He merely exists on paper to me. I have spoken to him once in the last five years and I don't talk to him about cases at all. The owner of my company is actually a PA himself. He was a flight paramedic for 15, 20 years. Then he went to PA school, then he worked in emergency medicine for about another 15 years before 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'm not too sure about what to do with them, he's the person I call. And a lot of times the phone call will be hey, I've got this person. Blah, blah, blah. Medical history chief complaint, blah, blah, blah. This is the testing I've done. This is what I'm concerned about. Do you feel this needs this workup or do you feel this needs admission, or is this something we can treat outpatient and we'll kind of talk through that case and kind of decide what's medically best for the patient, what documentation we need to include, stuff like that. So when you go through, this is something that I really try to when I have PA students rotate with me. This is something I really try to teach them is when you're in school.
Jim:Pa school is very heavy on these are the symptoms and presentations of this condition. This is how you diagnose this. This is how you diagnose this. This is how you diagnose it and this is how you treat it. And so you're very focused on what is the diagnosis and the appropriate treatment for that.
Jim:In the real world of emergency medicine and urgent care acute kind of patients the mindset has to switch. So you'll have somebody come in with chest pain, let's say, and instead of saying I need to get to the perfect diagnosis, exactly what they have, the mindset is I need to rule out the things that are life-threatening or critical. That needs to be admitted for this complaint. So it's a lot more heavily emphasized on the differential diagnosis which you have training in at PA school, but it's pretty minimal compared to what the real world looks like. So, for an example, if you come in and I have a 20-year-old with chest pain who's healthy, versus a 76-year-old diabetic with hypertension and coronary artery disease, that person with chest pain is going to get a different workup. That person with chest pain is going to get a different workup. So my focus is based on the symptoms they're presenting to me, the vital signs I see, the exam that I do and the laboratory testing that I interpret. I'm trying to rule out heart attacks, pulmonary embolism, myocarditis, pneumothorax, pleural effusions, all these different conditions that could cause chest pain. And if I find something that either confirms something critical or I can't rule out definitively something critical, then they need more advanced workup than I'm able to give at that moment. But if I can do my entire workup and my urgent care luckily is set up with a lot of capabilities that other urgent cares don't have I think we're a lot more like a freestanding ER in the sense that I can do cardiac enzyme panels, I can do B-dimer blood clot rule-outs, I can order same-day CT scans, I can do x-rays on-site immediately. So I have a lot of really important capabilities. That allows me to rule out a lot of critical things. But that mindset of kind of making sure I'm not missing critical things is something that it took a while to learn and that's something that he did a really good job of teaching me, and so that's something I try to work with my PA students on.
Jim:So a typical day we're in flu season right now in the urgent care. So my clinic is open Monday through Saturday, 9 am to 9 pm. So each provider there's two of us. We each do three 12-hour shifts per week. So I work three days, she works three days and we each have four days off. So it's a nice. You know it's hard days when you're there, but the nice thing is you do have days off during the week to do other things and enjoy your life. So typically I'll get up in the morning and I'll go to the gym and work out. That's how I wake up and deal with stress is work out and then I'll go to the gym afterwards. Yesterday I saw 35 and I saw 20 of them within the first three hours of the day. Oh my gosh, the volume can be pretty insane. So the volume can be pretty insane.
Jim:So that'll range from a lot of flu symptoms, sinus infections, coughs, pneumonia, ucis, that sort of stuff. You'll get belly pain, chest pains. You'll get orthopedic injuries, fractures, stuff like that. You'll have three lacerations yesterday, one abscess drainage yesterday, medication refills for different things, people with high blood pressure. That's hard to manage.
Jim:An urgent care can see all the above. So I've had people with heart attacks come through. I've had people with strokes come through. I've had big hip fractures, dislocated shoulders, you name it. The concern is just a lot of people they'll come into an urgent care maybe thinking something isn't a big deal, and then you have to figure out, oh, actually this isn't a big deal, this needs surgery or this needs admission and management or whatever the case may be.
Jim:So my visits have a wide variety of what we see, and so the nice thing is that every patient experience is new and there's definitely some exciting things, like the first time you diagnose appendicitis based off your physical exam. Like that feels really good. Stroke that you catch oh my gosh. Like somebody comes in with fever right lower carter belly pain. They have a positive robson's positive obturator. You can literally make the diagnosis just off of your physical exam. You don't have to do blood work or anything. You just say, hey, we need to get you, to get you to the ER, you need to CAT scan and you need your appendix out. You know you call them the next day. You're like no, you're 100% right, it was my appendix, they took it out, I'm feeling great. You know, those feel really exciting.
Jim:The first time you see that I had a 13-year-old girl. Her family brought her in because and so a lot of people say, okay, what's the differential for that? Well, at her age it was septic arthritis, so her hip joint was infected and it's a blood spread, hematogenous spread, and so, just based off of a physical exam 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 days later, confirmed yep, that's exactly what it was. They washed it out, everything was. I called them a couple of days later, confirmed yep, that's exactly what it was. They washed it out and everything was great.
Jim:So, again, your medical knowledge can take you a long way, and those are things that we're all trained in in PA school. A lot of times people don't put a 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 was in PA school is I really worked hard at the school work and I really spent a lot of hours learning, and so because of that I've been able to retain a lot of the knowledge that I learned there and it's helped me every day of my career. So yeah, that's kind of a full day. You know, you see between 25 to 40 patients per day. Sometimes you'll have waves of them come in at once, sometimes you'll have a little gap in between them, but yeah, it's just 12 hours straight.
Ashley :Right, you know you mentioned about how, when you're exploring physical therapy as a potential career, that you needed a little bit more variety in your life and, lord knows, it sounds like you found that variety, jim. Wow, you know, when you are in PA school, as you know, you do learn about all of these conditions and it is so exciting to learn the number of ways that our body serves us every day and, unfortunately, the number of ways it can go wrong. It feels really good to be able to help somebody with all of that knowledge that you took in while 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 you and another clinician and you guys rotate, so it doesn't sound like you're always there together. Are there other members of the healthcare team that are there providing support to you while you're trying to see 40 patients a day?
Jim:So our staff is a receptionist, a medical assistant and an x-ray tech who kind 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 complete autonomy. Your job is identical to a physician in an urgent care. You have to really be on top of your game. You really need to know what to look out for. You really need to know your medical conditions and your treatments. And then obviously our, the owner of the company. You know he does a great job of you know he answers his phone when you call. So you know, when I was brand new I'd call him 30 times a day, you know, and it was more just the medical, you know, the understanding of the conditions was there.
Jim:It was more the hey does this need to go to the ER, or can I treat this? Does this need a CT, or can I just assume?
Jim:it's this and a lot of times what urgent care does is we'll try to narrow it down as much as we can and then we'll treat for the two most likely things that we think you have. So you know, an example would be hey, you know, if you come in and you're having vaginal complaints, vaginal discharge, itching, something like that, we send out a swab. Your history doesn't really make us too concerned for STDs, but hey, this could be bacterial vaginosis, this could be a yeast infection. So why not treat for both, send out the appropriate testing, and then we'll cover worst case scenarios. So that's kind of what we're doing. Is not always are we going to get to the exact diagnosis that you have, but we're going to try to rule out as many things as we can, and then we're going to try to do the best we can in the meantime to make sure you don't get worse.
Ashley :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 a lot of these patients need, right Is somebody to just evaluate them, to let them know if this is something incredibly severe or if this is something that perhaps we can treat with a prescription, or if it's a dislocated shoulder, maybe we can just reduce it. Jim, talk to me more about physician assistant autonomy, because of all of the people that I've spoken with right now that are physician assistants, it sounds like you practice the most autonomously. You are working by yourself and you have very little oversight and you might not need that. So tell me a little bit about autonomy for you and what it means to you as a PA.
Jim:Yeah, yeah, so before I switched over to urgent care, I did orthopedic surgery for two years and then I did a little stint in primary care when my wife and I moved back to Colorado. Briefly, when I was in orthopedic surgery you're basically glued at the hip to your surgeon, so you guys operate together, you see patients, you talk to him about consults in the hospital, so it is a one-on-one relationship. There is a tremendous amount of supervising that's being done because this is an orthopedic surgeon who went through a tremendous amount of training and has so much knowledge that I don't have or would take me five to 10 years to obtain.
Jim:And so when you're fresh out of school you need that constant reinforcement, constant education, constant explaining of how to do things when you're in 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 orthopedic experience helped me dramatically with urgent care, because there's a lot of orthopedic complaints that come in that I have a little more experience and knowledge dealing with than some of our other providers. So they come in with a fracture. Well, I know how to manage that fracture. I know most likely this is going to need surgery or most likely it's not, and so I can help kind of guide the patient along their expectations of what to expect, moving forward, what this likely is, how we likely treat what they have and stuff like that.
Jim:So the autonomy in an urgent care for me, I really enjoy it. I like to make my own medical decisions, I like to call the shots and I think this is kind of a perfect field for that. But that's not everybody my wife loves she's a dermatology PA. She loves to have a supervising physician that if a patient is too complicated, she can just say, hey, I'm going to send you over to my supervising physician, because she says well, and so to have that ability to offload challenging things that are maybe above a scope of practice is really appealing to her and for me. I think I like the idea of always having the emergency department as my backup. So if I really have no idea, I think I like the idea of always having the emergency department as my backup. So if I really have no idea, but I think you look critical, I can always send you for additional testing and more expertise. A lot of things I think I can deal with and I can manage for people and I like to do that.
Ashley :I enjoy the challenges that that presents, but I also like the freedom of being able to make decisions myself presents, but I also like the freedom of being able to make decisions myself, and thank you so much for comparing your position to your wife's position, because you know, and I align more with your wife on this Obviously I'm also a Derm PA and I think our oversight is very similar. But imagine being in an urgent care 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 it except a man, by phone, like it makes my feet sweat, my heart's beating too.
Ashley :I might be having a STEMI thinking about it, you know, and that's the beautiful thing about being a PA is that there is variety in not just what you do but how you do it too. And I think sometimes even within the profession there are certain people who work in, maybe, urgent cares and they might want more oversight, so maybe they ask to be scheduled when there's another physician assistant, 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 that up. Thank you for mentioning that. But before we shift gears, I want to ask you know about our quality questions segment on the show. Do you have a quality question that you'd like to share with us? Before we hear what Jim's quality question is, keep in mind that there's more interview prep, such as mock interviews and personal statement review over on shadowmenextcom. There you'll find amazing resources to help you as you prepare to answer your own quality questions.
Jim:Sure, so this is not a question I was asked or asked anyone. This was actually from a physical therapist that I had worked with years ago and it was a question that he was asked when he was applying to PT school and I thought it was such a cool question. So these are one-on-one interviews, very similar to PA school or med school. So you're sitting in front of an interviewer, they're asking you questions why do you want to be a PA? Why don't you want to be a doctor? Why do you want to go to this school? You know things that can be very intense questions. So this guy asked the physical therapist. He said who was Admiral Hirohito and what role did he have in the US involvement during World War II?
Ashley :Oh my gosh.
Jim:So when you hear that question, you go what, I'm not a history major. Why are you asking this random question? He said well, I don't know who Admiral Hiroshito was, but if I had to guess, I would say that he was involved in planning the Pearl Harbor attack that launched the US into World War II against the Japanese. And the guy says wrong. I'll tell you. I like that you didn't give up.
Ashley :And in that instance I said oh my gosh, what a crazy.
Jim:because if you would have asked that question to a hundred people, most of them would have just said I don't know who was Admiral Hirohito, and they just said well, spoon, feed me the answer. But this guy was looking for somebody who had some resilience, who would take their best stab at it, who would at least try. And I think that such a random question can tell you such important, key factors about somebody's personality. Are they going to quit when it gets tough? Are they just going to ask for you to do the work for them, or are they going to give it their best effort and try? But that question has always stuck with me. It's just such a random way to ask something so deep about somebody's personality, so I really enjoyed that question.
Ashley :Jim, that is a fantastic question and I think a lot of questions that were asked on interview like that are meant to make us think and they are meant to show our tenacity and our ability not to let anything go until we've at least given it our best shot. You know, we have a very similar situation at our practice when we host PA students, which I'm excited to talk to you about. Next, when we have a PA student come in and, as a PA student, you are seeing patients and then you're bringing the information back to the PAs, which is you and me, and you're presenting the patient and presenting their diagnosis and what their diagnosis is. And we have a saying around our clinic that is don't guess what their diagnosis is. Tell me what their diagnosis is.
Ashley :Don't say I don't know. Don't just give me a random answer. I want you to tell me what it is. Don't say I think. Tell me what their diagnosis is. Don't say I don't know. Don't just give me a random answer. I want you to tell me what it is, don't say I think. Tell me what it is.
Ashley :Because, I can teach off of that. If you tell me a patient is coming in with a dislocated shoulder based on your physical exam findings, and I go in and it turns out they have a black widow spider bite on their arm and that's what's causing their pain, this is a teachable moment. If you just come in and say, well, I don't know, their shoulder hurts and there can be a million reasons for that, well, that's not teachable. So I think that question that you brought up that is great. Okay. So, jim, we spoke a little bit about students and I think you and I we have this shared passion for teaching and you have a YouTube channel that is called Urgent Care Stories and I watched all of them this morning and I expected to only watch one and I just couldn't stop watching because the stories that you tell about these patients that you've encountered, they're captivating. Why was that important to you to start that YouTube channel?
Jim:Yeah. So what I was finding was when the I had a few PA students work it with me, and what I was finding was that the ability to create a differential diagnosis was really something that was lacking, and I think it's just part of the training process that just a lot of people they don't prioritize. And so my goal was I was trying to create, you know, cause there's so many patient experiences that I've encountered that have taught me so much of like really important lessons of like, if you feel the need to do a workup, it's always worth it because you're going to find something or you know, listen to the patient, they're going to tell you their diagnosis, or never assume you know something about the patient. You know always kind of trust your gut and listen to what they're telling you. And so there were some really important lessons that I've just learned, that I've just found have been very valuable for me through my career in terms of making the right decisions, and so I decided I wanted to create some YouTube stories to just kind of share my experiences through memorable patients, of things that are really important. And so my goal was this knowledge is trying to be directed towards pre-med, pre-pa or even freshly graduated med and PA and nurse practitioners who are new to the field and they're eager to learn.
Jim:But there are some things that only experience can teach you, and so my goal was to try to present cases in a really clear manner of hey, this is what the presentation was, this is kind of what my thought process was, this is how we worked this up and why I chose to work it up this way, and this is what the outcome was and this is what we outcome was and this is what we do with that.
Jim:And so my goal is is each of the videos I'm trying to take you through a patient encounter, give you the history, give you the presentation and kind of teach you through that process. And so my thought was that, you know, videos were the easiest way for me to do this. Spent a lot of time on YouTube anyway. So that was kind of my avenue. I'm not trying to make money, I'm not trying to be Insta-famous or anything like that. My goal is just I like teaching and I like helping people. That's part of why we go into medicine is we care about people and we want to help people, and so this was one avenue for me to try to help people out there in the world of medicine. Learn from my experiences.
Ashley :I think it's a great idea and, of course, the ones you mentioned from a shadowing perspective, which, of course, is how I view the world right now. It's stories for students who are trying to figure out, perhaps, where they want to end up in this medical career. That is so wide entertainment level. Or are these stories interesting you? Because you are just desperate to get your hands into this situation yourself and to do exactly what you're doing and running the tests on these patients and doing the physical exams and making the diagnoses and seeing the results. So I think it's great for a student shadow, but I also think it is fantastic for anybody prepping for their boards too, because the way that you approach these patients is very methodical and the histories that you give, like I said, the physical exam findings. Oftentimes you talk about test results and then you present a differential which is, in essence, a, b, c, d, e. Pick the right, pick the right diagnosis right and say, before they get to the end of your story, they can determine for themselves. You know what could this be? And then you get to give them the answer and you go. You know, you get to explain to them, you know what specific findings led for that. So it was just it was incredible. It's a great idea I'm so excited to share and I'm excited for other people to hear about this.
Ashley :Urgent care stories on YouTube as well. I'll make sure to link it in the podcast description for anyone who's interested in checking it out. But, jim, pa students, pre-pa students, pa shadows you have hosted many of these people. What are some common themes that you find yourself discussing with these people that come?
Jim:and are looking to you as a mentor figure. So vast majority are your pre-PA students. So these are usually undergrad or recently graduated from undergrad students who are in the process of applying or getting everything ready to apply. So I've done a lot of that work and really I just felt like when I was trying to find PA as a shadow, there's a lot of people who say no, and I'm sure you're in the same boat of you're booked up for, I think, a year on your shadows, but there's just such a demand and there's so few people who are willing to do it, and so I think being at an urgent care as an autonomous PA is a really unique experience already. So it's something that maybe a lot of people are not aware is out there in the world of medicine as a PA. And then I think what I do is cool. I think I see a lot of cool stuff, I get to make cool decisions, I get to help a lot of people, and so I wanted to be able to share that with people who are thinking about getting into this career path.
Jim:So some of the common things like the pre-PA students a lot of them are going to ask about you know, what was your GPA? What was your experience applying? How many schools did you apply to? How did you get into PA school? How were you competitive? And then a lot of them are going to ask about the interview process and what that looks like. And so you know, I ended up creating a couple of videos on my YouTube channel about, like, how to be competitive for PA school, how to get into how to do the interviews kind of tips and tricks and stuff like that. There were just three videos that people can watch because I had a lot of people just asking me the same questions over and over.
Jim:So one of the common things that you'll do in a PA school interview or med school is you'll do a group interview and so the group interview for those who don't know you're going to, once you're invited for an interview, you've already made it to like the top 10% of applicants already. So that's a really big thing. But once you get to the interviews, you'll have a few one-on-one interviews and then you'll have a group interview. So the group interview is you sitting in a room and there's going to be somebody who's grading you maybe one or two people and so you'll have a question prompt and then there's going to be a timer for 10 minutes and then you're just going to discuss that topic among yourselves.
Jim:These are typically political topics or just kind of things that are going to have a one side says this. One side says that, should medical providers have the ability to remove your firearms from your house, know that you're a threat to yourself or others. Obviously there's one side who says, no, nobody should take your guns away. That's your right. Second Amendment Other side's going to say, well, absolutely, if it's for the greater good or if you're a threat to yourself, we should be able to take that away from you. And then we're going to grade you on it. And so a lot of people they're trying to find a way to be competitive in that process.
Jim:So one thing that's a common pitfall is there's going to be some aggression to try to be like 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. It doesn't mean a whole lot to us, 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 that to students. Really, the hard part is like when you're watching these interviews as the grader. One of the crazy things is like some people will just not talk, and it's amazing, because you're sitting there and you're like, hey, man, like why aren't you getting involved in this, why aren't you talking? You're just sitting there being quiet the whole time. I have nothing to grade you on.
Jim:So what I would recommend to people is I would sit back and let people discuss it for a little bit, maybe throw something in there, but I'd be watching the other people in the group, looking for who is not talking, who's being a little shy, and then what I would say is I'd jump into the talk, I would put my opinion out there, and then I would turn to that person and say, hey, jason, what do you think about this? And what that's going to do is it's going to show that you have compassion for other people, and so at least I really respected people who would try to involve other people in the process, and so it's a really classy move. It doesn't come across over the top or anything. It just shows that you care for somebody else, and that's really important in medicine is to find providers and PAs that are compassionate, and so that was a really easy way to just make yourself look good in the group interview is just ask somebody else from the group who's been a little quiet or shy, you know a question. So that's kind of a quick, easy thing for people to do.
Jim:And then on the one-on-one interviews, some of my advice for people would be a lot of times the interviewer is going to ask you a lot of questions why do you want to be a PA? Why this school? What are your strengths, what are your weaknesses? You know what happens if you don't get into PA school this year. What are you going to do? Those sort of questions you should have really well-rehearsed, well-practiced, professional answers to, because you're going to expect those. They're obviously going to throw some oddballs at you. What kind of a superhero would you be? What's your favorite color and why? Just kind of random stuff that they're going to ask. But one of the best things is they're going to ask you do you have any questions for me? Instead, phrase it as what are you most proud of about this university?
Ashley :Like what makes you want to?
Jim:work here Because that is going to really make them feel oh well, I'm really proud of this, or I chose to work here because of that. So just the way that you're phrasing questions to the interviewer can really affect how you're perceived. And then the other advice I have for people is ask them questions about themselves. Everybody has a really easy time talking about themselves and everybody gets nervous about interviews, even the person doing the interview. They're still nervous. You can ask them what do you like to do for fun? What fields of medicine have you done that you really enjoyed? Why did you decide to go into education? Then you can talk about that stuff for a while.
Jim:And then the goal is when they're looking back at the pictures of all of the people they interviewed that day, they might not remember what you answered as to why you want to be a PA. Everybody says the same thing. What they're going to remember is they're going to look at your picture and they're going to go. Oh my gosh, we had this wonderful conversation about dogs and about the dog park and why I love this field of medicine. I really enjoyed that conversation I had that's. All you're looking for is just positive points, and so it's really easy to kind of just game the system and just kind of make the experience positive for you.
Ashley :Jim, those are all such great recommendations and really really very tangible tips for students and it's people are going to think I set you up. I didn't. You mentioned two things when you were talking about those interview questions. You mentioned access invite people into the conversation who might feel like they don't belong there, or perhaps they're just a little shy, or perhaps they just need an invitation. You're giving access and then telling stories, right? That's ultimately what an interview is.
Ashley :Let me tell you a story about myself, and I would love it, too, if you could tell me a little bit about yourself. So I think access and stories it is what brings humanity into these things that we do, which, for you and I, happen to be medicine. So thank you so much for sharing that. Thank you for dedicating so much of your time to hosting shadows. Something that you said that just really resonates with me because I always say it too is I'm proud of what I do as a clinician. You're proud of what you do. What we do is cool, and sharing it with people is one of the highlights of my day, as it is with yours. Thank you so much for taking the time to join us here on shadow me next. I appreciate it. Oh my pleasure.
Ashley :Thank you so very much for listening to this episode of shadow me next. If you liked this episode or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday, as always. If you have any questions, let me know on Facebook or Instagram Access. You want stories you need? You're always invited to shadow me next.
