Tuesday, April 29, 2014

International Volunteer Opportunities and Missionaries for Physician Assistants

International Volunteer Opportunities and Missionaries for Physician Assistants

Whether you’re a pre-PA, a PA student, or a professional PA looking for international volunteer opportunities or mission trips to enhance your global impact, look no further! In this post, you’ll find a variety of resources to get you started on planning your trip and even links to places you may have never heard of before. If you have any resources or comments to contribute to this posting, please leave them in the comments section below and I’d be happy to include any and all changes or additions.

First off, I’ll start by directing your attention to AAPAs “Before You Go--Preparing for International Practice.” This is not only useful, but essential on so many levels! You’ll find links for researching the country you’ll visit, passport information, visa information, insurance, immunizations, physician supervision, guidelines for working internationally, and much more!

Now, let me direct your attention to AAPAs International Volunteer Opportunities page, where you’ll find out:
  • What you need to know before making a trip
  • The “Before You Go” checklist of travel information and questions to ask before accepting a volunteer position - found above
  • A list of volunteer databases (given by AAPA) known to accept physician assistants including, but not limited to:

In addition, the International Practice guide lists guidelines for international licensure, liability coverage, and transporting medical supplies that may be helpful.

A list of International PA Caucuses involved in the delivery of international healthcare are:
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Friday, April 18, 2014

International Physician Assistants

International Physician Assistants
Updated: 08/06/2015
Whether you are a recently graduated PA, a seasoned PA looking for a fresh career outside the US border, or a pre-PA looking into international opportunities after graduation, you’ve come to the right place. In this post, you’ll find everything you’ll need from physician assistant (PA) schools in other countries to international resources for job listings, to organizations uniting international PAs! As AAPA’s 2013-2015 Strategic Plan does not include any efforts or services associated with international PA practice, it will become increasingly difficult for PAs to learn about changes developing outside the US. If you have any resources or comments to add to this posting, please leave them in the comments below and I’d be happy to include any and all changes or additions.
First, I’ll direct your attention to AAPAs “International Practice” page, which offers information about international licensure, liability coverage, transporting medical supplies, and ethical practice. They also have a FAQ and Guidelines for Working Internationally, which you might find useful. Other resources were previously available, but have been removed from the site. One example was AAPAs “Before You Go--Preparing for International Practice” which included passport information, visa information, insurance, immunizations, physician supervision, guidelines for working internationally, and much more! AAPA also used to have another resource titled International Employment and Training, where you could stay up-to-date on the most current status of employment challenges faced internationally by PAs. Write to AAPA at aapa@aapa.org and let them know if you feel materials like this are necessary and needed in the PA community.


International PA Caucuses involved in the delivery of international healthcare are:
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Wednesday, April 16, 2014

Continuing Medical Education (CME) for Physician Assistants

Continuing Medical Education (CME) for Physician Assistants
After you have finished the PANCE and thought you were all done with the NCCPA, you were wrong! So wrong! Continuing medical education credits are the next place they have come to steal your money, right before the next NCCPA exam, the PANRE. The six areas of PA competencies these CME credits evaluate are: medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning and improvement, and systems-based practice.


  • PAs must log 100 CME credit hours (with a $130 certification fee) every two years to maintain their national certification, per AAPA’s requirements.
  • Your CME earning and logging window is May 1st of the year your current certification was issued through December 31 of the certification expiration year.
    • If you have met your requirements for your current CME cycle, you can begin earning and logging credits for the next cycle on May 1st during the certification expiration year of your current cycle.
  • Additionally, each state may have their own specific CME requirements, which you can check here.
  • Of the 100 CME credits you must earn and log
    • At least 50 must be Category 1 CME
    • The remaining 50 credits can be Category 1, Category 2 or a combination of both.
  • CME can be classified as a Certification Program, Category 1 or Category 2.
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Category 1 CME
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Sunday, April 13, 2014

Clinical Rotations & Rotation Exams for Physician Assistant School

Physician Assistant Clinical Rotations
Updated: 09/17/2018
After you have endured the didactic phase of your physician assistant education, you’ll be on to bigger and better things, like your clinical phase! Generally, students participate in a variety of rotations including private, public, inpatient, and outpatient care. Rotations will vary in duration and lodging accommodations vary from program to program, although most programs allow 4-8 weeks for each rotation. Most programs have 7-9 required rotations and 1 to 2 elective rotations with one or more being in a rural or underserved area. Students in some programs are required to log each patient care experience and to complete evaluations at the end of each clinical rotation site. Below are a few resources (online resources listed first, then texts for each) for the most common rotations and ideas for common elective rotations.


Agency for Research and Healthy Quality (ARHQ ePSS) phone/tablet apps - identifies preventive services necessary for each individual patient based on age and gender, etc.


Family Medicine Rotation
Primary care, ambulatory medicine, general practice, community health, hospice, palliative medicine, and rural medicine are all included under this category
American Academy of Family Physicians - Practice Question Bank
  • Click “Start Now” to create an account
  • Free for students, takes ~3 days to register/verify your account
  • Indicate you are a PA student
The Family Practice Notebook - great resource for any rotation, with phone app available
Family Medicine - What to Expect - includes some handouts
Diabetes, Asthma, Other Cheat Sheets
Medical Texts
Apps
Internal Medicine Rotation
This includes allergy/immunology, ambulatory medicine, cardiology, adolescent medicine, critical care medicine, endocrinology, gastroenterology, geriatric medicine, hematology, infectious disease, nephrology, oncology, pulmonology, and rheumatology as dictated by the American College of Osteopathic Internists and the American Board of Internal Medicine
Internal Medicine Study Guide
Internal Medicine Turkey Book (credit to The PA Life and UW Medicine)
History and Physical
  • First sheet - use during your admission H&P
  • Subsequent sheets - for tracking daily progress, labs, changes, and plan
  • Complete with headings for reminders of what to ask during the interview
Strokes
Pneumonia - when to admit?
Acid-Base Resources
Miscellaneous
Medical Texts
Pediatrics Rotation
Study Guides
Supplemental Resources & Cases
Immunizations
Wellness Visit Information
Developmental Screening Tests
Medical Texts
Emergency Medicine Rotation
Emergency Medicine Study Guide
  • SageDiagram.com - tells you how much IV fluid to give burn patient based on height and weight


Medical Texts
Medical Apps
  • 10 Second EM - less than $5
  • WikEM - free
  • EMRA (Emergency Medicine Residents’ Association) Antibiotic Guide 2013/2014 - $15.99
  • Tox Toolbox - Free toxicology reference; unavailable for iPhone
    • Top 25 Toxins is a list of the most common toxins in America and provides drop-down information on symptoms, clinical pearls and treatment pitfalls
  • Epocrates - Free drug reference


Women’s Health Rotation
Occasionally referenced as women’s health or ob/gyn (obstetrics and gynecology) rotations.
APGO uWISE self-exam - free practice questions for the EOR exam


Obstetrics Resources
Study Guides
Supplemental Resources
Useful Resources for Patients
Medical Texts
Quick References


Medical Phone Apps
Psychiatry Rotation
Also known as “behavioral medicine,” mental health, or “psych” rotations.
Psychiatry EOR Topic List (2016)
Study Guides
SOAP Note Writing
Other
Psychiatric Assessments
Medical Texts
General Surgery Rotation
Also known as general surgery or plainly, “surgery” rotations. Subspecialty elective surgery rotations including cardiothoracic and neurosurgery are not included under this category, but these resources may be helpful for such rotations.
Recommended Study Guides
Notes
Assessment and Evaluation Tools
Practice Questions
Skills
Medical Texts
Recommended Apps
Neurology Elective Rotation Resources
  • Stroke Trials App (iPhone) - great resource with articles on almost any topic related to strokes
Medical Texts
Infectious Disease Rotation Resources
Medical Texts

Pain Management Resources
Patient Reported Outcomes Surveys for Pain:
Clinical Elective Rotations
There are so many choices for elective rotations, although your program may only offer a handful of these listed below. In addition, I’ve listed a few international and domestic rotations you might not have heard about. Some of these I’ve found links for online, but others are just listed from PAEA’s survey of students who have done international rotations. Some of these sites may now be inactive. If you have any to add to the list, please leave them in the comments below! Additionally, as a resource, you may check out the International Federation of Medical Students’ Associations. You can also join PAs for Global Health for $15.


Physician Assistant Rotation Exams
During each of your rotations, you’ll need to study for the PANCE in addition to your Rotation Exams. The Physician Assistant Education Association® created an exam used to assess student progress and facilitate program evaluation in the clinical phase. End of Rotation examinations were first released in January 2013 and only 25% of PA programs originally purchased them according to PAEA. Currently, PAEA states that over 90 PA programs nationwide are utilizing the exams.


While programs are not currently required to purchase these exams and use them for evaluation, they can provide less workload for faculty, provide increased test security, allow for student performance comparison across programs’ clinical phases, and can familiarize the student with the test taking environment of the PANCE.


Pitfalls of the EOR are that they are new, scores might be lower than “in-house” produced exams, faculty cannot view the exam content, and they are somewhat expensive to incorporate, especially for smaller programs. Programs may still opt to use their own “in-house” exams for rotation evaluation. For example, some programs utilize ExamMaster for evaluation in addition to writing assignments and preceptor evaluations. You can read about other program evaluations here. Generally, it seems that schools are giving you two chances to pass the EOR. If you fail the second time, you must repeat the entire rotation or undergo some remediation process. You can view a preview of the policy at East Carolina University, here.


These 120 multiple-choice question, peer-reviewed exams utilize relevant up-to-date information following content blueprints and topic lists for each of the specific rotations mentioned above. The exam is divided into 2 sections of 60 questions with 60 minutes allotted for each.


Programs are allowed to break up the exams with 5, 10, or 15-minute breaks. In addition to the topic and blueprints above, a Core Tasks and Objectives Learning Supplement is also included in the requirements for each rotation. Further, PAEA goes on to say that “comparative data is reported on specific test forms and not across test forms, and the exam forms may not necessarily have the same difficulty level.” Thus, each rotation’s exam may vary in difficulty and passing or average scores will vary. Only the performance of students who have taken the same exam version should be compared. The exam also includes 20 unscored questions, but which questions are not disclosed to the examinee.


The cost of each EOR exam currently $30 per exam, per student for each of the 7 exams.


A sample exam is posted on PAEAs website.


SELF STUDY RESOURCES:
Help Campus (same as Help Zebra and also known as Hancock)
  • 4,200+ questions
  • 3 Months of access - $324.95
  • 6 Months of access - $399.95
  • 12 Months of access - $400.95
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  • Davis PA Review included with every subscription
  • 1,200+ questions and explanations
  • One month subscription: $99
  • 12 month subscription: $199
  • $495
  • 12 months of access
  • 5% off promo code: AAPA2day
  • $75.99
  • 1,300+ questions
  • $55
  • Subscription lasts until your exam
  • $19.99 for 60 days
  • 300 questions and explanations
  • 1,200 Questions+
  • 1-Month Subscription: $79.00
  • 3-Month Subscription: $139.00
  • Free demo and savings coupon
  • PANCE or PANRE prep: $795
  • PANRE PLUS Lifetime Subscription: $1,900
  • 840 Questions
  • 13 Topic Areas
  • Individual License - $169
  • $19 for 1 month of access
  • $26 for 1 year of access
  • $23 for 3 months of access
  • 1,125 PACKRAT board review questions (5 225-question exams)
  • 5 Quizlet Flashcard sets (each with 225 questions)
INTERNET SOURCES:
AAPA’s Rotation Do’s and Do Not’s - page 8 and 9
PAST for Physician Assistant Programs - by TyphonGroup Healthcare Solutions
  • Electronic student tracking system, including patient encounter logs and reports, an evaluation component for assessments, management of student rotation scheduling, student electronic portfolios, preceptor biographic databases, clinical site databases, curriculum mapping, and more.
Surviving Clinical Rotations by Cynthia Booth Lord, MHS, PA-C
  • Includes what to bring on your first day
  • Questions you may be asked by preceptors
  • How to present to a patient
  • Tips
The Turkey Book - pocket guide to medical clerkship
Wal-Mart $4 Prescription List - helpful for patients of low-income or without insurance
P450 Drug Interaction Table - very helpful if you are ever considering a drug-drug interaction
Emily Cooper’s Med-Source
Physical Exam Skills - Dartmouth
  • H&P Cards and Forms
  • Daily Rounding Logs
  • Specific Sheets/Forms for each rotation
  • Includes resources for every rotation
Pre-Physician Assistants - How to Succeed in PA School
UpToDate.com - clinical decision support resource
MedZoom - Links to medical websites
  • Details the evaluation your preceptors will likely use to judge your clinical knowledge
PA School Clinical Year YouTube Video

General Books for Any Rotation:
Sanford Guide to Antimicrobial Therapy by Gilbert, Moellering, and Eliopoulos
Current Medical Diagnosis and Treatment 2014 by Papadakis, McPhee, and Rabow
USMLE Step 2 Secrets, 4e by O’Connell
Physician Assistant: a Guide to Clinical Practice by Sullivan, Brown, and Vetrosky
PHONE APPS:
CareZone - Free app that allows your patients to scan in their medications from their bottles at home. It documents all information from the label and will remind patients (via alerts) to take their medications to increase compliance. It also reminds them when their refills are expiring and provides them with the phone number of the prescribing provider so they can call to request a refill or an appointment. Patients can keep a journal with information and photos about their progress with new medications to show providers. Very useful app in my opinion!
Canopy Medical Translator - Very useful app for wards to communicate with patients in languages other than Spanish. It has pre-recorded phrases for each specialty (emergency medicine, pediatrics, dermatology, etc.) that are specific. It programs your school’s or work’s translator phone service into the app so you can easily press “call” and it dials the number for you if you can’t communicate what you need to.
ASCVD Risk Estimator - the American College of Cardiology and American Heart Association present this helpful app to determine your patient’s 10-year risk of atherosclerotic cardiovascular disease (ASCVD)
MELD Calculator - Used to determine a patient’s eligibility for liver transplant.
MyNetDiary - This app lets patients keep track of their daily calorie intake and also provides an area to track the amount of physical activity per day. It is pretty accurate and lets patients set their own goals (maintain, lose, or gain weight). The app lets you know how many calories you have left for the day, calculating in your exercise each day. It can calculate specifics about your fat, saturated fat, vitamins, minerals, etc. consumed each day.
PA Toolbox by Medical Wizards - $28.99
Physician Assistant Exam Review McGraw-Hill - $49.99
PEPID - Free
Epocrates - Free drug content, $159.99 disease content
Skyscape - Free; In app purchases up to $129.99
  • In app purchases up to $19.99
  • In app purchase up to $29.99
Medscape by WebMD - Free
UpToDate - Free
AgileMD - Free
Micromedex - $2.99 annual subscription
Diagnosaurus (McGraw-Hill) -$1.99
PANCE Flashcards - Lange - Free, Expansion Pack - $34.99
Physician Assistant LANGE Q&A - Free download, $49.99 for access
  • Contains 1,211 questions from PAEasy.com
Physical Exam Essentials (HippoSoft) - $2.99
iTriage - Free
ErRes - $4.99
Physician Assistant Rotation Blogs:
Below is a list of student blogs from various physician assistant programs across the nation (and international) that have written about their experiences in the clinical phase. I’ve done my best to go through each one and highlight what rotations they talk about so you can hand pick which blogs to read.
Pre-Physician Assistant Blog - Various schools represented
  • Various rotations referenced
Life of a PA - South University PA Program
  • Orthopaedics
  • Psychiatry
  • Pediatrics
  • Ob/gyn
Timothy Loerke - The University of North Texas Health Science Center Fort Worth
  • Emergency Medicine
  • Family Medicine
  • Ob/gyn
  • Pediatrics
  • Psychiatry
  • Surgery
  • Underserved Medicine
  • Orthopedic Surgery
  • Pediatric Cardiothoracic Surgery
  • Inpatient Medicine
Jenna Lombardi - Philadelphia College of Osteopathic Medicine
  • Emergency Medicine
  • Psychiatry
  • Family Medicine
  • Internal Medicine
  • Primary Care
  • Surgery
  • Ob/gyn
  • Pediatrics
Bianca Belcher - Northeastern PA Program
  • Emergency Medicine
  • Ob/gyn
  • Critical Care
  • Surgery
  • Orthopaedics
  • Psychiatry
Snow Feng - Philadelphia College of Osteopathic Medicine
  • Surgery
Jen Pilchman - Philadelphia College of Osteopathic Medicine
  • Emergency Medicine
  • Surgery
  • Dermatology
  • Behavioral Medicine
  • Family Medicine
  • Pediatrics
  • Internal Medicine
  • Infectious Disease
  • Primary Care
  • Pediatrics
  • Surgery
  • Emergency Medicine
  • Internal Medicine
Harrison Reed - Yale University PA Program
  • Ob/gyn
  • Surgery
  • Pediatrics
  • Emergency Medicine
  • Psychiatry
  • Internal Medicine
  • Surgery
  • Surgical ICU
  • Orthopedic Trauma Surgery
  • Pediatrics
  • Psychiatry
  • Emergency Medicine
  • Ob/gyn
DJ and the PA Journey - Pacific University Oregon
  • Emergency Medicine
  • Family Medicine
  • Surgery
  • Primary Care
  • Women’s Health
Irene Gung Ho - Barry University
  • Psychiatry
  • Internal Medicine
  • Family Medicine
  • Emergency Medicine
  • Ob/gyn
  • Surgery
  • Pediatrics
Ashleigh - The Life of a Physician Assistant
  • Psychiatry
  • Emergency Medicine
  • Surgery
  • Pediatrics
Memo Sanchez - George Washington University
  • Pediatrics
  • Surgery
Katie Swan - University of Colorado PA Program
  • Ob/gyn
  • Surgery
  • Pediatrics
  • Orthopedics
  • Endocrinology
Chase Hungerford - University of Southern California Primary Care PA Program
  • Emergency Medicine
Paul Kubin - University of California Davis
  • Cardiothoracic Surgery
  • Inpatient Hospital
  • Outpatient Primary Care
Physician Assistant Ed - Various schools represented
Anne Dang - McMaster University PA School
  • Orthopaedics
  • Internal Medicine
  • Surgery
Eden Jerao-Shedden - University of Manitoba PA School
  • Ob/gyn
  • Family Medicine/Primary Care
  • Pediatrics
  • Orthopedics
  • Emergency Medicine
  • Internal Medicine
  • Ob/gyn
  • Family Medicine
  • Primary Care
  • Psychiatry
  • Emergency Medicine
  • Surgery
  • Emergency Medicine
  • Psychiatry
  • Geriatrics
  • Pediatrics
  • Ob/gyn
  • Inpatient Medicine
  • Orthopedics
  • Surgery
  • Internal Medicine
  • Pediatrics
  • Hospitalist
  • Emergency Medicine
  • Ob/gyn
  • Psychiatry
  • Family Practice
Credits and References:
Huge credit goes out to The Running PA!
Emily Cooper - Med Source
Free Medical Texts for any rotation provided by our friendly medical residents
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