Well, it turns out the people at the financial aid office were slightly mistaken. I'm pleased to say that tuition is about $1000 less than the $3756 figure that I was told. It seems that there is a cap on how many units students can be charged during the summer semester, so instead of being charged for 12 units we are being charged for only 9 units. That definitely brought a smile to my face.
One interesting part of my life is that I've never had the need to own a credit card. Whenever the time comes to pay for something I almost always pay in cash. Even when I lived in Japan, the thought of owning a credit card never crossed my mind. Japan is a cash-based society and in fact charge you extra fees (around 5% I believe) if you attempt to pay for something by credit card.
Well, at the ripe old age of 27 I finally decided to get my first credit card. It came in the mail about a month ago. I've always thought the concept of credit to be foolish even before our debt fueled economic collapse in 2008. Credit cards are for people who don't have enough money, not for responsible people. Unfortunately, our society says that even if you've never been in debt, even if you've saved loads of money in your savings account, even if you have a stable job, even if you get straight A's your whole life, even if you have a spotless criminal record, even if you saved the life of an old lady crossing the street, without credit you can't get a loan for a mortgage. The only way to build credit is through using credit cards. What a racket.
Now that I've got my credit card I'm ready to use it and build my credit. I was considering paying off my summer tuition with my credit card, but then I realized that my credit limit doesn't even go that high. Frustrating.
I'll just pay it off the way I've always done it. Use the cash that I saved in my bank account.
--------------------------------
On a side note, classes are nearly finished and we only have 3 more tests to go! Pretty soon it's going to be "goodbye" to late-night studying and "hello" to late-night movies / partying / dating / relaxing. That reminds me, it's been forever since I've watched a movie. Avatar is still in theaters, right?
Thursday, April 28, 2011
Saturday, April 23, 2011
A Trip to the Pathology Laboratory / Gross Room
These past couple of weeks have gotten really busy with the end of the semester coming. Tests have been coming at two per week for the past month, but the good news is that there's only two weeks and four more tests left. Everyone is getting wore out, but the end is near (in a good sense).
Yesterday, Friday, was a much needed holiday and I spent the most satisfying day of my life doing almost nothing. That holiday was Good Friday, and like any good PA student I decided to drop by the pathology lab / gross room. (No, it's not called the gross room because there's blood and guts everywhere. It's because it's where the pathologists' assistants observe specimens 'by eye', or grossly, as opposed to using a microscope. Although, I will say that some of the specimens that come in are quite up there on the gross scale.)
All of us students at WVU have a two day rotation in the gross room during the first semester and the truth is that I had already been there a month before back in March. I just hadn't gotten around to making a post about it. So, I am happy to say that instead of studying extra hard for my final tests I'm going to take a break and write about what you've all been waiting for. The gross room. The gross room (or surgical pathology laboratory, whatever you want to call it) is the environment where PAs will spend the majority of their time working.
You might remember in my post on my trip to the histology laboratory that I outlined the progress of a specimen and the different places that it moves through. After a piece of tissue or organ is cut out by the surgeon, the first place it is sent to is the gross room. There are histotechs (I believe they are histotechs and not laboratory assistants but correct me if I'm wrong) in the gross room who will accept the container and log that it was received into the computer system. It would be a disaster if someone had their kidney removed and then we couldn't find out where it went, so specimens are tracked wherever they go.
You might also remember these cassettes from before.
Each of these cassettes will hold a piece of tissue that the PAs cut off of a specimen and submit to histology. A single specimen may require many cassettes to hold all of the different pieces of tissue that the PA cuts off and each of these cassettes needs to have some kind of identifier. Wouldn't want to get the cassettes of one patient mixed up with another. So, the histotechs kindly label each cassette with a case number by using this machine.
I don't know the name of this machine, but it does remind me of a jenga tower.
After the specimen has been inputted into the system and the proper cassettes have been made the pathologists' assistant comes onto the scene. The next picture is what a typical PA's lab bench looks like.
Pretty neat. The gross room at Ruby Hospital here at WVU has four benches like this one.
You'll see that this bench is all tidy and ready to get to work. The PA receives the container with the specimen in it, the empty cassettes from the histotechs and of course a requisition form for the specimen. Once again, everything is compared to what's in the computer. It's good to be obsessive compulsive here.
The PA's job is to basically look at the specimen, describe what it looks like in words, look for evidence of tumors or other suspicious areas and properly cut the right pieces from the specimen so that the pathologist can make a diagnosis. (The cut pieces will be put into those cassettes and sent to the histology lab before it gets to the pathologist.) It's important not just to cut pieces of tissue that show the tumor itself, but also slices of tissue at the borders of the specimen that can show whether some of the tumor might still be in the patient! The surgeon will have to go back and cut out more from the patient if tumor is along the edges, so for the PA to determine what to cut and where to cut is especially important.
Each specimen has its own procedure on how to prepare it, how to cut it, what sections to submit to histology, how to describe it and so forth, so unfortunately, I can't tell you all on this blog what to do when you get something like a heart or a brain. You'll have to join me for two years of PA school heaven to find out. It's really great. We even get to do things like go back to elementary school and do painting! Don't believe me?
All those pretty colors there are inks that PAs use to paint their specimens. Not only is painting fun, it helps the pathologist. The pathologist wants to see whether the tumor in a specimen extends out and reaches the edge, but it's kind of difficult to tell which border is the outside surface when looking in a microscope. If a PA covers the outside surface of a specimen in, let's say, green ink and cuts out a piece of tissue that includes the green ink, then when the pathologist looks under the microscope he'll automatically know that the border with a line of green ink is the outside surface of the specimen. Any tumor that reaches the green line may still be in the patient.
Now, the PA also needs to describe in words what the specimen looks like. But it isn't as simple as just saying, "The tumor looks like a marshmallow". PAs have to learn a completely new language. Well, it's not completely new, but if you've ever heard a PA dictate a specimen into the computer, you would be in awe of their foreign language skills. Although I haven't learned to speak PAnese yet, I can speak a good amount of Japanese so I should be alright in the end.
The PA speaks through a headset with a voice recorder connected to the computer that looks something like this.
Whatever the PA says is put into the computer as text. The special program in the computer called "Dragon" takes care of the conversion, but it's not always perfect. I would not recommend trying to sing the "Pheasant Plucker" song through here. Even if you don't screw up the program will make sure that you do.
Whenever the computer makes a mistake, you'll be able to correct the mistakes the old fashion way, with a keyboard and mouse.
You'll notice that the keyboard that PAs use is a bit different from your normal keyboard. The keys are completely covered by rubber and it isn't because the fingers of PAs are messy from eating donuts. I'll let you figure it out.
So after the PA has described the specimen and cut out some pieces of tissue to send to histology the PA needs to put those pieces into the cassettes. Not all tissues are the same, so they'll be put into different cassettes and each one will be handled and prepared differently. Here's just a box of cassette holders that some cassettes can be put into before being fixed further.
In some cases, the patient will still be on the operating table while all this is going on. In such cases, evidence of tumor near the borders of a specimen need to be identified with great haste. Everything described up until now has been for specimens that have no urgency. If your patient is on an operating table with their abdomen open and the surgeon is waiting for the word on whether or not more needs to be cut out, it is not the time for you to be doing dictations. In these STAT specimens, you'll have to become both a PA and a histotech.
Fortunately, there is a device that will make sure your head doesn't roll down the hallway. Below is the awe-inspiring cryostat.
Does it look familiar? It's very similar to the microtome that histotechs use, complete with hand crank on the right. Unlike histotechs though, the tissue that PAs cut on this machine hasn't been fixed in formalin. That makes things a bit tricky. Tissue that hasn't been fixed in formalin or some other medium is more fragile and can tear when it's cut into thin slices. The solution is to freeze it.
It's actually pretty cold inside the cryostat. A special cooling gel called "Optimal Cooling Temperature" (confusing, I know) and a huge block of metal called a heatsink are put on the specimen to freeze it. Once the specimen has been frozen, it can be mounted and then cut like in the microtome. It's still a bit trickier cutting with the cryostat than with the microtome, though.
After you've got your slice of tissue on your microscope slide it needs to be stained.
You can dip the slides into these containers to get the right stain that you want. After that, all that's left is for a pathologist on call to take a look.
Normally, tissues submitted to histology will be completed the next day after they've been fixed overnight, but with this you can get a slide for the pathologist and they can make a diagnosis all within 10 minutes. Now, the poor patient doesn't have to stay on the operating table overnight with their abdomen open.
There are a lot of neat things in the laboratory that I haven't been able to cover. Here's one that might pique the interest of you photographers. They say that a picture is worth a thousand words and here in the gross room, they aren't kidding. You can take a picture of any specimen that you receive with this camera setup, though it's not going to save you from having to say a thousand word dictation.
Here's a somewhat grim last picture for you all. It's another tool that you would think you would find in a carpenter's workshop, but this saw wasn't made for cutting wood.
Hopefully, this quick run down of the pathology laboratory has given you a little more insight into the workings of a hospital and the lives of PAs. If you enjoy being able to concentrate on your work, use your head and share a love for the biological sciences, then becoming a pathologists' assistant may be a career you should consider. Don't forget, you get to paint like a grade schooler and use a bunch of cool power tools, too.
Yesterday, Friday, was a much needed holiday and I spent the most satisfying day of my life doing almost nothing. That holiday was Good Friday, and like any good PA student I decided to drop by the pathology lab / gross room. (No, it's not called the gross room because there's blood and guts everywhere. It's because it's where the pathologists' assistants observe specimens 'by eye', or grossly, as opposed to using a microscope. Although, I will say that some of the specimens that come in are quite up there on the gross scale.)
All of us students at WVU have a two day rotation in the gross room during the first semester and the truth is that I had already been there a month before back in March. I just hadn't gotten around to making a post about it. So, I am happy to say that instead of studying extra hard for my final tests I'm going to take a break and write about what you've all been waiting for. The gross room. The gross room (or surgical pathology laboratory, whatever you want to call it) is the environment where PAs will spend the majority of their time working.
You might remember in my post on my trip to the histology laboratory that I outlined the progress of a specimen and the different places that it moves through. After a piece of tissue or organ is cut out by the surgeon, the first place it is sent to is the gross room. There are histotechs (I believe they are histotechs and not laboratory assistants but correct me if I'm wrong) in the gross room who will accept the container and log that it was received into the computer system. It would be a disaster if someone had their kidney removed and then we couldn't find out where it went, so specimens are tracked wherever they go.
You might also remember these cassettes from before.
Each of these cassettes will hold a piece of tissue that the PAs cut off of a specimen and submit to histology. A single specimen may require many cassettes to hold all of the different pieces of tissue that the PA cuts off and each of these cassettes needs to have some kind of identifier. Wouldn't want to get the cassettes of one patient mixed up with another. So, the histotechs kindly label each cassette with a case number by using this machine.
I don't know the name of this machine, but it does remind me of a jenga tower.
After the specimen has been inputted into the system and the proper cassettes have been made the pathologists' assistant comes onto the scene. The next picture is what a typical PA's lab bench looks like.
Pretty neat. The gross room at Ruby Hospital here at WVU has four benches like this one.
You'll see that this bench is all tidy and ready to get to work. The PA receives the container with the specimen in it, the empty cassettes from the histotechs and of course a requisition form for the specimen. Once again, everything is compared to what's in the computer. It's good to be obsessive compulsive here.
The PA's job is to basically look at the specimen, describe what it looks like in words, look for evidence of tumors or other suspicious areas and properly cut the right pieces from the specimen so that the pathologist can make a diagnosis. (The cut pieces will be put into those cassettes and sent to the histology lab before it gets to the pathologist.) It's important not just to cut pieces of tissue that show the tumor itself, but also slices of tissue at the borders of the specimen that can show whether some of the tumor might still be in the patient! The surgeon will have to go back and cut out more from the patient if tumor is along the edges, so for the PA to determine what to cut and where to cut is especially important.
Each specimen has its own procedure on how to prepare it, how to cut it, what sections to submit to histology, how to describe it and so forth, so unfortunately, I can't tell you all on this blog what to do when you get something like a heart or a brain. You'll have to join me for two years of PA school heaven to find out. It's really great. We even get to do things like go back to elementary school and do painting! Don't believe me?
All those pretty colors there are inks that PAs use to paint their specimens. Not only is painting fun, it helps the pathologist. The pathologist wants to see whether the tumor in a specimen extends out and reaches the edge, but it's kind of difficult to tell which border is the outside surface when looking in a microscope. If a PA covers the outside surface of a specimen in, let's say, green ink and cuts out a piece of tissue that includes the green ink, then when the pathologist looks under the microscope he'll automatically know that the border with a line of green ink is the outside surface of the specimen. Any tumor that reaches the green line may still be in the patient.
Now, the PA also needs to describe in words what the specimen looks like. But it isn't as simple as just saying, "The tumor looks like a marshmallow". PAs have to learn a completely new language. Well, it's not completely new, but if you've ever heard a PA dictate a specimen into the computer, you would be in awe of their foreign language skills. Although I haven't learned to speak PAnese yet, I can speak a good amount of Japanese so I should be alright in the end.
The PA speaks through a headset with a voice recorder connected to the computer that looks something like this.
Whatever the PA says is put into the computer as text. The special program in the computer called "Dragon" takes care of the conversion, but it's not always perfect. I would not recommend trying to sing the "Pheasant Plucker" song through here. Even if you don't screw up the program will make sure that you do.
Whenever the computer makes a mistake, you'll be able to correct the mistakes the old fashion way, with a keyboard and mouse.
You'll notice that the keyboard that PAs use is a bit different from your normal keyboard. The keys are completely covered by rubber and it isn't because the fingers of PAs are messy from eating donuts. I'll let you figure it out.
So after the PA has described the specimen and cut out some pieces of tissue to send to histology the PA needs to put those pieces into the cassettes. Not all tissues are the same, so they'll be put into different cassettes and each one will be handled and prepared differently. Here's just a box of cassette holders that some cassettes can be put into before being fixed further.
In some cases, the patient will still be on the operating table while all this is going on. In such cases, evidence of tumor near the borders of a specimen need to be identified with great haste. Everything described up until now has been for specimens that have no urgency. If your patient is on an operating table with their abdomen open and the surgeon is waiting for the word on whether or not more needs to be cut out, it is not the time for you to be doing dictations. In these STAT specimens, you'll have to become both a PA and a histotech.
Fortunately, there is a device that will make sure your head doesn't roll down the hallway. Below is the awe-inspiring cryostat.
Does it look familiar? It's very similar to the microtome that histotechs use, complete with hand crank on the right. Unlike histotechs though, the tissue that PAs cut on this machine hasn't been fixed in formalin. That makes things a bit tricky. Tissue that hasn't been fixed in formalin or some other medium is more fragile and can tear when it's cut into thin slices. The solution is to freeze it.
It's actually pretty cold inside the cryostat. A special cooling gel called "Optimal Cooling Temperature" (confusing, I know) and a huge block of metal called a heatsink are put on the specimen to freeze it. Once the specimen has been frozen, it can be mounted and then cut like in the microtome. It's still a bit trickier cutting with the cryostat than with the microtome, though.
After you've got your slice of tissue on your microscope slide it needs to be stained.
You can dip the slides into these containers to get the right stain that you want. After that, all that's left is for a pathologist on call to take a look.
Normally, tissues submitted to histology will be completed the next day after they've been fixed overnight, but with this you can get a slide for the pathologist and they can make a diagnosis all within 10 minutes. Now, the poor patient doesn't have to stay on the operating table overnight with their abdomen open.
There are a lot of neat things in the laboratory that I haven't been able to cover. Here's one that might pique the interest of you photographers. They say that a picture is worth a thousand words and here in the gross room, they aren't kidding. You can take a picture of any specimen that you receive with this camera setup, though it's not going to save you from having to say a thousand word dictation.
Here's a somewhat grim last picture for you all. It's another tool that you would think you would find in a carpenter's workshop, but this saw wasn't made for cutting wood.
Hopefully, this quick run down of the pathology laboratory has given you a little more insight into the workings of a hospital and the lives of PAs. If you enjoy being able to concentrate on your work, use your head and share a love for the biological sciences, then becoming a pathologists' assistant may be a career you should consider. Don't forget, you get to paint like a grade schooler and use a bunch of cool power tools, too.
Friday, April 15, 2011
Changes in Lifestyle
One of the things that I have always wanted to do was go hiking in West Virginia. West Virginia is known for its abundant natural beauty and I sure am not going to miss out on it. But, I am sad to say that despite having lived here for the past 5 months, I have yet to get outside of Morgantown and see any nature! Not even once. It’s not like me to stay in one place. When I was living in Japan I was sure to get out and sightsee at least once a month. Something about PA school seems to have sapped the energy, time or willpower out of me, and I think I know why.
Since getting into pathologists’ assistant school life has really revolved around studying and classes. It’s as if all of your energy is being spent on studying and there’s too little energy left to devote to other pursuits. I wouldn’t have expected anything less from graduate school, but it’s something that you have to experience to understand the transformation that takes place. Many of us in graduate school have been perfectionists for most of our lives and it’s one of the reasons why we were able to make it this far. But, considering the difficulty and volume of the material in PA school, being a perfectionist does not go without its consequences. Obviously, studying hard to learn medical related material and get passing grades takes significantly more time and effort than doing the same for your average general education undergraduate course. But, for the perfectionist, the time and effort spent on school is so great that most everything else becomes an afterthought.
On average, I’d say that I have about 45 minutes of free time to unwind at the end of the day before I go to sleep. The rest of the day is usually spent studying, listening to lectures in class, eating, showering, sleeping, keeping in contact with family and friends, etc… At the end of a long day (and most days are long), I just want to relax or zone out zombie-style. I’m not thinking about what I’ll do on the weekend (mostly studying anyways). I’m not planning on any trips to see the countryside, nor am I thinking about hitting the theatres to see any movies with my buddies. For those precious 45 minutes, I’m just in zone out mode.
During their scant free-time some of my fellow classmates just zone out on the couch and watch TV. It seems that they too have not gone untouched by ‘graduate disease’, which I will now define as lethargy secondary to chronic studying, stress and malnutrition. I prefer to spend my zone out time spacing out on the internet, replying to friends via facebook and email and checking up on the latest news sites.
So while my ambition to succeed in PA school is at higher levels now than ever, my ambition to find the time to do anything outside of that has dropped through the floor. My old hobbies, which included watching movies, astronomy, board games, biking, hiking, camping, photography, working out, practicing Japanese, target practice and reading novels have been pushed to the sidelines. I’ve noticed another strange thing about this. The absence of these hobbies has actually diminished my desire to do them.
For those of you who are perfectionists and are entering into PA school, you need to understand that your lifestyle will be transformed. Expect to lose many of your interests and hobbies outside of medicine.
That reminds me, a long time ago I came across a very insightful saying. It goes along the lines of something like this:
There are three things that make up our lives.
-Family
-Career
-Hobbies and interests
You can choose any two.
Friday, April 8, 2011
West Virginia Summer Tuition and Fees are $3756 for 2011.
The summer fees are not included on the cost of attendance pdf file from WVU, so I just want to make sure that all potential applicants to WVU keep these costs into account so as to better prepare for graduate school.
Assuming that the summer tuition and fees for 2012 will also be $3756, the true cost for out-of-state students attending WVU for two years in the pathologists' assistant program is $55,440. Tuition for in-state-students is slightly less. Still, it's a good deal when compared to the cost of tuition for the other schools.
Of course, you should choose a program not solely on its cost but also on its quality. So far all of the pathologists that I've spoken to outside of WVU have given their highest accolades about the program, so I must be in the right place.
However, I'm still angry that the fees were left out. Both WVU and the AAPA need to update their brochures.
http://adm.wvu.edu/r/download/44965
You can find the 'COST OF ATTENDANCE' file in the above link. Costs for the pathologists' assistant program can be found on page 3.
Assuming that the summer tuition and fees for 2012 will also be $3756, the true cost for out-of-state students attending WVU for two years in the pathologists' assistant program is $55,440. Tuition for in-state-students is slightly less. Still, it's a good deal when compared to the cost of tuition for the other schools.
Of course, you should choose a program not solely on its cost but also on its quality. So far all of the pathologists that I've spoken to outside of WVU have given their highest accolades about the program, so I must be in the right place.
However, I'm still angry that the fees were left out. Both WVU and the AAPA need to update their brochures.
http://adm.wvu.edu/r/download/44965
You can find the 'COST OF ATTENDANCE' file in the above link. Costs for the pathologists' assistant program can be found on page 3.
Thursday, April 7, 2011
More studying.
There are about 4 weeks left to go and another 10 or more tests to take. It's gonna be one of those 'last 100 meter dashes' type of deals. Despite all of the studying, the main thing that keeps coming back to my mind is how I'm going to spend summer vacation.
I'll be going back to California from May 8th until June 2nd. Not quite a whole month, but I've got to plan well because Hanako is coming over from Japan to live with me in California for that time. It's her first chance to go overseas and the first time we've seen each other in about 10 months, nearly a year. We'll need to make up for lost time, but also, I need to start planning now what parts of America that I want her to see. Even though she is a little introverted, I can't just have her cooped up inside the house the entire time. I'm definitely set on showing her Yosemite and San Francisco. My finances are especially tight, so I'll see what magic I can weave to get the most value for the dollar.
Which reminds me, it has been unclear to me so far how much our tuition at WVU *really* is. According to the WVU 'Cost of Attendance' pdf file, for the year 2010-2011 it shows that Pathologists' Assistants pay $23,964 for the year. Now, my spring semester fees and tuition were already $11,982, which makes sense because that's half of $23,964. BUT, we also have 12 units of summer courses. I have not received any information on whether we will be paying summer school fees, but if we do, it will be over $10,000 for us out-of-state students.
If this turns out to be the case, I will be extremely pissed. I would even go as far as to say that it is false advertising and I will definitely be complaining. The AAPA brochure also says that the WVU Program for 2 years is approximately $40,000. $47,928 (twice $23,964) I can handle. $67,928 is outright robbery and I will be raising my voice. Hopefully, this will all be cleared up soon enough and I can stop worrying about money and start worrying about tests as I should be.
I'll be going back to California from May 8th until June 2nd. Not quite a whole month, but I've got to plan well because Hanako is coming over from Japan to live with me in California for that time. It's her first chance to go overseas and the first time we've seen each other in about 10 months, nearly a year. We'll need to make up for lost time, but also, I need to start planning now what parts of America that I want her to see. Even though she is a little introverted, I can't just have her cooped up inside the house the entire time. I'm definitely set on showing her Yosemite and San Francisco. My finances are especially tight, so I'll see what magic I can weave to get the most value for the dollar.
Which reminds me, it has been unclear to me so far how much our tuition at WVU *really* is. According to the WVU 'Cost of Attendance' pdf file, for the year 2010-2011 it shows that Pathologists' Assistants pay $23,964 for the year. Now, my spring semester fees and tuition were already $11,982, which makes sense because that's half of $23,964. BUT, we also have 12 units of summer courses. I have not received any information on whether we will be paying summer school fees, but if we do, it will be over $10,000 for us out-of-state students.
If this turns out to be the case, I will be extremely pissed. I would even go as far as to say that it is false advertising and I will definitely be complaining. The AAPA brochure also says that the WVU Program for 2 years is approximately $40,000. $47,928 (twice $23,964) I can handle. $67,928 is outright robbery and I will be raising my voice. Hopefully, this will all be cleared up soon enough and I can stop worrying about money and start worrying about tests as I should be.
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