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i_saw_things_i_imagined

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  1. (Edit: sorry if this is absolutely the wrong place to comment this but I saw people were upset and wanted to help in anyway I could. Feel free to move it elsewhere!) Hi everyone, congrats to everyone who was admitted to Mac Med this year! I’m a first year PA student at Mac, and wanted to chip in some ways that we have made online PBL more engaging. Although we’re in different programs, I imagine the content in first year is virtually the same and these general tips should still apply: 1. If you are using Google Hangouts for your call, make sure you use the “Tiled” layout (which lets you see up to 16 people) because it will emulate an IRL tutorial where you can see all of your peers faces. This is also helpful as body language is really important in tutorial because people will posture/position themselves when they want to say something next. Being able to see everyone is ideal, but for when this is not working, you can also download the chrome extension called “Nod” which allows you to use emojis to raise your hand if you want to speak, and others that express agreement/ditto someone’s point to prevent people repeating things. If you are using Zoom, use the annotation feature if you want to mark up documents (ie putting up an anatomical specimen and labelling it, pulling up a lab report/xray and marking pathological findings, etc). 2. For each tutorial session, see if you can select one person who will play a “check-in” role. People in my group often times assume this role without being asked, and we find it incredibly useful for time management. So, for example, at the beginning of tutorial we might say “alright everyone today we are covering oncologic emergencies and have three cases to go through, how about we start now and go until 2:30 and see if we need a break. If we are running behind at 2:00 I’ll step in and say we should table any tangential discussion and return to the tutorial content. If there is at least half an hour left at the end we can do a practice case. I’ll do another check in at 3:00 to see if people want to entertain that idea.” Being very explicit and proactive in how you plan your three-ish hours online will be even more useful since you can’t see each other. 3. If you are able to, have someone different each tutorial present their screen and have a google doc (we prefer using Microsoft word) running and typing the most important notes (plus any visuals, diagrams) down for everyone to see. A lot of people already do this, but having the visual component of being able to see what people are saying can help someone if they are lost, and also helps summarize things at the end of the tutorial for when people are studying later for tests. 4. We often find ourselves finishing ahead of time, so if you have extra time at the end try and facilitate practice cases online. Usually we use half an hour to go through one. Someone will volunteer to act as the patient, and then we usually go around one by one (everyone asks one question) taking a history, asking for vitals/exam findings (if available), then we have a bigger discussion as a group what our differentials are, and then we order investigations and come up with a management plan. 5. Always debrief! I have friends in the MD program and PA program who find debriefing at the end of tutorial kind of “fluffy” and not helpful. Every group I’ve been in has always emphasized debriefing at the end as a means of actively working towards changing something if it’s not working. We’re in a pretty steady groove now and I think it’s in part to having (and still having) an active debrief at the end where we can talk about what worked and what didn’t work. I don’t think any of these things are groundbreaking or new, rather things that people have always done in tutorial just emphasized more/adapted for an online format. With the right group you can emulate in person tutorial pretty closely online. If your group isn’t the most productive then try reaching out to administration for further tips/help that might be more specific to the MD program and curriculum. Hope this helps! Open to comments/DMs if you want to discuss general tips further, but I obviously can’t comment on anything specific to the MD program, admissions this year, and so on.
  2. Just a friendly reminder that a lot of PAs are also encouraged to participate in research and be able to practice evidence-based medicine so many will either have their masters/PhD before entering PA school (1/4 of my class) and many will go on to complete graduate education after to keep research and teaching opportunities open to them However, many of us do admire the amount of time MDs have spent training and feel reassured in their supervision of us and as mentors!
  3. Hello! I’m a current PA student and thought I would chip in. I think I might be the only one commenting here so far, so I’m going to acknowledge my bias as I’m obviously a huge supporter and advocate for the profession’s growth in Ontario and Canada as a whole. It’s funny how there is radio silence on this forum until something remotely controversial happens and people start talking - I recognize that is good though, seeing conversations happen among students and professionals outside of the PA sphere. I am in support of PAs receiving pandemic pay, full stop. It is complicated by the lack of a stable funding model. Physicians (and NPs I believe) are able to bill for their services, whereas PAs tend to be employed by a physician/group of physicians, family health teams, by a hospital, the list goes on. So, this immediately complicates WHO exactly would provide the pandemic pay for PAs because there are a lot of different parties involved depending on the PAs position. So, the way I see it, pushing for pandemic pay is a means of advocating for the profession in of itself by making sure the government and the ministry can see us, and know that we are working. In my circles, which consist of current PAs and students, I have not heard much about people losing their jobs to COVID. I am sure it’s possible, based on some of the other comments above, but I have mostly heard of PAs being relocated from family med clinics to EDs & ICUs. It is important that PAs get compensated fairly during this time, but there are numerous challenges associated with that. For those of us in the PA sphere we know these issues quite well and have good people in leadership positions doing their best to advocate and move us forward. In regards to some of the other comments/questions you made: -Is there a need for PAs when we have NPs? I would say yes, if NPs are providing care under a nursing model and PAs are providing care under a medical model. That leads into your next point. -If a PA is doing the same work as an MD, why aren’t they compensated the same? PAs also work in medicine, and provide care to patients but MDs should generally be viewed as specialists who have undergone extensive training to practice independently where PAs should be viewed as generalists who work in collaboration with MDs (and other members of the healthcare team) with a fair degree of autonomy but ultimately deferring the final say to the MD (in most cases). With that being said, it makes sense why MDs make more. However, for only going to school for 2 years and then entering the workforce to be lifelong learners and providers, the median PA income in Canada is still around 81k (and that’s good if you ask me). In my opinion, PAs are here to stay. Last year there was about 70-80 new jobs for about 50 grads in Ontario. I was told that everyone in the class above me found jobs except one person who wanted a job in a speciality that was not hiring. Once again, funding models are where we lack stability, but to my knowledge most people keep their job. -Finally, of course MD is a more stable choice. It’s been around forever! In the next 10 years it’s hard to predict what the landscape will look like for the profession, and what new and ongoing challenges we may have then, but I am confident that we are in this for the long term, even if it might not seem like that on your end. Our program heads have always been very open with us since day 1 about the very real challenges associated with being in a growing profession. None of us are leaving this program blind about the potential challenges we may face but we are doing the best we can in these uncertain times. One final story: our program head and other faculty members were in the first graduating class of PAs and told us that they got jobs after graduating only for them to be cut several years later. At the time they were cut, it was mostly due to funding I believe, but there may have been other reasons. Several years later, that same hospital began to rehire PAs because they realized the critical role they played in continuity of care and actually keeping the flow of patients steady and moving. Today, one of them is working in subspecialty medicine and has been for several years. She says her supervising physicians see her as more of a colleague, and she has a great job teaching for the program as well. The other is in a very high position of leadership for the program and continues to practice part-time on the side. If you have concerns, trust me, we have them too. We are working hard to make sure people never worry about us in the future! Feel free to DM me if you have any more questions.
  4. Your best is to send the payment right now/today and email the program to explain. Worst case Ontario they decline the payment and don’t let you apply.
  5. To answer your questions: yes they can work in sport medicine (physiatry and orthopedics are both areas where PAs currently work), no they typically do not travel with a pro level sports team (these positions are generally reserved for physicians), and generally speaking PAs do not work abroad. If you want to work abroad you should strongly consider going to medical school. The PA profession in Canada is still growing, and we need Canadian trained PAs who are going to stay and work in Canada to help grow the profession.
  6. Congratulations on getting into the PA program! It seems like you have a tough decision ahead of you. If you aren't 100% sold on the idea of being a PA, then you should probably give up your spot to someone on the waitlist. Being a PA is not supposed to be seen as a "stepping stone" into medical school. PAs are competent professionals who practice medicine with indirect or direct supervision, but more importantly work as part of a health care team to treat patients. If this sounds appealing to you, and you like the idea of a career in medicine with flexibility and lateral mobility, then you should become a PA. If you want to become a physician and practice medicine independently in a given specialty, you should take time and reapply to medical school. Time off school is not the worst thing, and students benefit from it more often than not. Message me if you need anymore advice!
  7. Join the facebook group here if you were accepted: https://www.facebook.com/groups/651724981940951/
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