By Paula Porter
Paired with a PA student during a rotation in a primary care clinic, this med student learned the value of all the members of the care team and deep respect for her PA colleagues.
The first time I presented a patient to Ty, I was nervous. I couldn’t remember Mrs. L’s complete past medical history, and I definitely added the vitals at the wrong point of the patient summary. But rather than demeaning me, Ty helped me through it- he pointed out things I did well and helped me understand how to mentally organize a patient presentation. Then he presented to our preceptor, Dr. T, in a perfect example of a concise yet thorough presentation.
It was only my fourth day in clinic during my first year of medical school, and Ty was my new hero. No, he wasn’t a medical resident or senior medical student. He was a second-year Physician Assistant student who I had been paired with for a new pilot project at the University of Utah School of Medicine.
Medical students are paired with a preceptor in one of the university clinics for a Longitudinal Clinical Experience (LCE) from January of their first year through the end of their second year. I was lucky enough to be selected as one of a few students that would be paired with a senior PA student in clinic for a few sessions. Ty was just finishing the last few months of his training and looking forward to a career in primary care.
I must admit, up to this point, I had almost no experience with Physician Assistants. While a PA worked in the clinic in my small hometown, my primary care provider was an MD. So when Ty and I discussed what his career would be like, I was pleasantly surprised to hear that it would be very similar to how I imagined my own future career in primary care. Then I realized why I was so pleased that Ty would have a career very similar in practice to the one I expect in family practice. Ty was an excellent clinician. From session to session, he demonstrated a caring, thorough approach to every patient and was an excellent team player. As the junior student on the team, I was fully prepared to take orders from Ty. However, he put the emphasis on discussion and collaboration. In later sessions, when it was my turn to take the lead with patients and presentations, I followed his example and focused on patient care and collaboration. When I talked with my classmates who also participated in this experience, the overwhelming majority reported positive experiences similar to mine. However, I now realized that my attitude toward other health professional students has been shaped by this experience more than I realize.
Rarely will MD and PA students sit in together on patient lectures. I occasionally overhear frustrating comments from my classmates, insinuating that because of our longer training, medical students are in some way superior to PA students. I have to wonder how these med students ignore the fact that medicine is a team activity. I would challenge any one medical student to perform the range of duties required to keep a clinic running- from the duties of medical assistants and lab technicians to those of doctors and PAs. I worry that these students will become the doctors that believe teamwork means giving orders to colleagues who earned anything other than an MD. Healing is not about a doctor’s ability to do everything—it’s for and about the patient. More than any other reason, this encourages me to love teamwork in health care. I got into medicine because I wanted to care for people, to heal them. With caring healers working together, patients receive better, more thorough care. I have a PA student, and a pilot program, to thank for that perspective.
Paula Porter is a second-year medical student at the University of Utah. She received her undergraduate degree in English with a minor in Chemistry at Westminster College in Salt Lake City, UT. Paula is drawn to the patient-centered focus and attention to the whole person that are central to primary care though she is still undecided as to which specialty she will pursue.