Accepted!

This weekend has been a pleasant yet busy life changing experience. Although my interview was to be held on Monday morning I had Saturday afternoon and all of Sunday to spend some much needed time with my family in Clovis.

It is interesting to come home after being away for so long and to see all of the changes that have happened around the house. My mom and dad are always working on the house despite being retired and I could see the fruits of their labor. The house was getting new shingles and the kitchen had a new microwave, refrigerator and toaster oven. Some more striking changes were outside though. A small twister had come through in the spring and wiped out a whole bunch of things such as the arch to our driveway, a few old eucalyptus trees, and a gigantic old tree which fell over and squashed a whole row of bushes along the side of our house. My father had been busy chopping up all of the wood and the place just seemed a little empty without all of those trees. The most striking change for me, however, was to discover that my younger brother had invaded my room! What was once neat and tidy was now chaos with posters on the walls, my desk filled with his items and a floor that was in desperate need of some cleaning.

I was looking forward to the interview on Monday, but I didn’t know what to really expect so I prepared for any interview question that might come my way. In the morning I put on my best suit and with my portfolio in hand headed to the lab. There I met with their COO who was very friendly and enthusiastic. I learned some of the history behind the lab as well as its future direction. He drove me to another hospital from which the lab receives its specimens to meet with some of the other pathologists. I briefly met with each pathologist and introduced myself to each of them one-by-one. Everyone was very kind and the process was not nearly as stringent as I had partially feared. We headed back to the laboratory and met with a few of the other pathologists where I had the opportunity to talk with them one on one. Lunch was provided and I then moved on to the gross room.

I was happy that the supervisor of the gross room had remembered me when I first came to shadow at their lab nearly two years prior. I was given a tour of the place and introduced to the talented and hardworking PAs there. It’s quite a busy lab and they receive over 50,000 surgical specimens every year. The laboratory receives specimens from a number of hospitals and labs, so the range of specimens that they receive is pretty much everything from A to Z. For me personally, I couldn’t have asked for a better place to increase my abilities. I was also impressed in that the lab was specifically built with grossing in mind during the construction. Specimen processing is very stream lined and PAs are used efficiently to spend the vast majority of their time doing what they do best, that is grossing. Specimens are received on a one at a time basis and cassettes are created on the fly, nearly instantaneously. They use the Voicebrook speech recognition software that I’m familiar with, but I will still have to get used to their information system which is Power Path. It was amazing to see the PAs gross through complex specimens on the computer just as fast as a person speaking into a dictaphone could. The benches are high tech to maximizes efficiency and eliminate lost time. 

It’s also fortunate that the supervisor and everyone else at the lab are very focused on helping its employees achieve their highest potential and professional growth. I got the feeling that I was very welcome there and it really made me want to put out my absolute best. 

One of the other interesting parts about the interview was a special test that I was given. It was a test designed to measure my descriptive abilities as well as how much time it took me. I was given three everyday objects and asked to describe them on paper. I had heard of a similar test in a book I read a while ago for prospective surgeons having to carve a bar of soap. The test was a good mental exercise for me and I found what I had wrote to be surprisingly detailed, although it did take a little longer to put my thoughts onto paper than I had hoped. 

On Tuesday morning I returned to the lab and was elated to discover that they had offered me a position there. I couldn’t imagine a place that I’d rather be and so I was eager to accept. I’m still moved at how understanding everyone was that I wouldn’t be able to start work until mid-January (visiting Hanako and her family in Japan). Everyone was very professional and had not just their heart into the business but also their own workers lives. I still can’t believe how lucky I am. I’ve made it my mission to become the best PA that I can be and to repay them by adding to their team. Man, I can’t wait to graduate!

Week Three at UPMC Presbyterian Hospital

Finally, after having labored for three weeks and two weekends, my power point presentation on lung neoplasms is complete. It's quite a task to make a presentation designed to last only 30 minutes when there are so many things to be talked about. The only thing left for this is to remember what to say when the presentation day actually comes.

The biggest thing that I'm looking forward to right now is my interview on Monday. I'm reading up on some of the many questions that they may ask me, but it always seems that no matter how much you prepare there is always one curve ball of a question which comes your way. Even though our monthly test and my presentation is just four days after this interview I can't think about anything else at the moment.

So far being in the gross room at UPMC Presbyterian has been another big learning experience. It seems almost like a polar opposite of grossing at Charleston. Since we are once again using CoPath to make our dictations, the pace of grossing specimens has dramatically decreased. But, that is because of all of the attention to detail and procedures that must be followed. The grossing system at UPMC Presbyterian introduces a whole new set of minute issues to deal with as opposed to just speaking into a microphone. Some of the things which come to my mind are...
- writing our name in the 'grossed by' field
- using dictation templates for a whole variety of specimens
- being super careful to make sure your dictation is absolutely correct
- taking photographs of a wide variety of specimens from small to big (and excellent quality photos at that)
- ordering cassettes and waiting for them to print (at Charleston they are hand-written)
- writing the patient's name on the side of the cassette as well as any special notes for histology (decal, on-edge, etc...)
- being super careful to make sure your dictation is absolutely correct
- recording the amount of time that the specimen has spent in formalin
- providing the clinical history of the patient (at other places the transcriptionists may handle this for you)
- correcting spelling and punctuation mistakes made by Voiceover or yourself
- for gross-only specimens, being able to use the correct templates to insert the correct final diagnosis
- being super careful to make sure your dictation is absolutely correct
- for specimens in which frozen section has been performed, to know the right format and structure to report the findings
- for specimens that need to be sent to other labs for further studies, know which special forms to fill out or log book to record it in
- have a PA proofread your dictation to make sure everything is correct
and of course, it's important to not forget...
- being super careful to make sure your dictation is absolutely correct
I'm fairly good at making an easy to read and easy to understand dictation which includes all of the information that you will need to know. But, when all of the above little things are thrown into the mix my pace goes way down again. There are a lot of good things about this system however. It has really given me the time to reflect on how I word my dictations so that I understand the specimen in-depth. At some of the other places, you may be doing specimens so quickly that little thought goes into the disease process or techniques involved in cutting the specimen. Also, because a lot of the specimens involve taking photographs, it has given me an excellent source of example specimen templates and their associated pictures for my own personal use. It's very satisfying to open up a word document of a previous case that you've done and read your dictation and correlate that with the picture. It brings back a kind of nostalgia and you can think to yourself "What a job well done."

There are always going to be a lot of new things to get used to when moving to a new lab. I will worry more about my interview first, then focus on getting into the flow of the lab.

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Moving Back to Pittsburgh and a Pleasant Surprise

Our time at Thomas Memorial Hospital has come to an end and a new chapter will be opening at UPMC Presbyterian in Pittsburgh. Thomas was a really great place, not just because of the wonderful people, but because it's a really great place to improve on one's speed. It was just the rotation that I needed.

At Thomas, us two PA students are in full charge of grossing the specimens. Of course, we always have the pathologists on hand to help us when we have questions, but it is up to us to complete all of the specimens before they have to go on the processor at 3 PM. The pressure is on for us to go as efficiently as possible and we find different ways to maximize our capabilities. The specimens are laid on on a counter for us to choose from and we can do them in any order so long as we finish them. In this way, we'd choose to save our messy specimens (gallbladders, placentas, etc...) for last and do our less messy specimens earlier. If we worked quickly and finished our specimens early then there were times where we could study or relax in the side office until the next batch of specimens came in. It really felt as if we were really working as PAs and not as students. Also, because the grossing stations were left up to us, our responsibilities were greater. No helpful fairy godmother was there to remind us to put a certain specimen in decal or to process a specimen a certain special way. We had to be on top of our game just as any other working PA. If given the opportunity, I would have chosen to work at Thomas until graduating at the end of December.

Besides having done relatively well on our monthly test, there has been another thing which has made me extremely happy. I have kept in contact with a laboratory in CA where I am from and I have recently received a call from them to have an interview in the near future. They are the same place where I first shadowed a pathologist's assistant. I was very impressed with their laboratory and if I am accepted for their position it would be like a dream come true. I'll be sure to write more as events develop.

In the meantime, there is a presentation that needs to be made and another not so distant test that needs to be studied for. Have a great week!