Success is the ability to go from one failure to another with no loss of enthusiasm. -Sir Winston Churchill

I’ve come to realize that it’s not the best genetics, the highest GPA, or the most pertinent health care experience that produces the most success… especially when it comes to being a PA or trying to become one.

It comes down to one key word.

Grit.

What the Hell is “Grit”?

Kid tennis

No, not grits like in My Cousin Vinny.

Grit is defined as: “perseverance and passion for long-term goals.”

There we go.

More and more research is coming out that shows in schoolwork, and in life, intelligence is no longer the greatest predictor of success.  It’s grit and character – the ability to push through adversity, challenges, and setbacks to find a new solution or path to success.

Angela Duckworth, Psychology Professor at University of Pennsylvania, has found through her research that:

“Smarter students actually had less grit than their peers who scored lower on an intelligence test. This finding suggests that, among the study participants — all students at an Ivy League school — people who are not as bright as their peers ‘compensate by working harder and with more determination.’ And their effort pays off: The grittiest students — not the smartest ones — had the highest GPAs.”

She also discovered that:

“At the elite United States Military Academy, West Point, a cadet’s grit score was the best predictor of success in the rigorous summer training program known as “Beast Barracks.” Grit mattered more than intelligence, leadership ability or physical fitness.

At the Scripps National Spelling Bee, the grittiest contestants were the most likely to advance to the finals — at least in part because they studied longer, not because they were smarter or were better spellers.”

These findings suggest that the achievement of difficult goals entails not only talent but also the sustained and focused application of talent over time.

Last week in the New York Times, Thomas Friedman published an article that I couldn’t agree with more: “Need a job? Invent one!”  In this article, he references Harvard Education Specialist Tony Wagner, “Today, because knowledge is available on every Internet-connected device, what you know matters far less than what you can do with what you know.”

So what does all this science and job talk have to do with A Physician Assistant Life, getting into PA school, or becoming a Physician Assistant by design?  After all, it’s simple, right?  Get good grades, make sure you have the prerequisite health care experience and work hard, right?

As we all know too well, there is so much more to having long term success that goes beyond getting good marks and finding health care experience that looks good on an application.  It’s not how much information we know, but what we actually DO with that information that will determine our success.

Or, in wanna be PA terms, success is going from an blog reader to an Action Taker. 

Instead of knowing all of the answers, instead of chasing the perfect health care job to pass the time, or waiting to write that perfect essay, people who succeed get started. And then they stick with it.

My Tale of Grit

stephen

I am proud to say that I am on a better road to being proud, confident and strong. 

but it wasn’t always that way

I was cut from my high school basketball team for my size and lack of an outside shot. I was told by my grandmother as I left for college in Seattle that I was being “selfish and not thinking of the family”.  I was told by my college guidance counselor that I would never have the grades to make it as a medical professional. I have struggled from time to time with depression and low self esteem.

It wasn’t until I adjusted my goals, changed my major and started to belive in myself that I finally started to have success. From that point on, it was another six years of incremental improvements, setbacks, adjustments, and research that led to small changes and new tactics.  I imagine I’ll spend the rest of my life learning more, failing more, and trying to discover new ways to improve myself

To some, this might sound boring or daunting.  

However, I discovered that it is fascinating and encouraging to see improvement from week to week, no matter how small they are, to make a difference in peoples lives, to adjust my focus from one of self to “what can I do today to make somebody else’s life better”.

“Boring” became exciting, instead of blaming the world for what I didn’t have I became thankful for all the wonderful blessings I did have. 

I fell in love with small changes and small wins adding up to big transformations.

Instead of saying, “ugh, I have to study, or ugh I have to work out (another passion of mine),” it’s become “I wonder what I’m capable of today? 

Somewhere early in the second half of my journey to a PA life, I decided I wanted to help others feel that same excitement without having to make all of the same rookie mistakes I made during my six years of discovery;  I wanted to help beginners see progress and build momentum and confidence from day one.

This project is part of this mission. 

I’ve learned that grit CAN be developed, and once you have it in one area of your life, it carries over to others

Developing “True Grit”

True Grit Posters

When I moved past my initial goal of becoming an MD I didn’t realize it at the time, what I was doing was identifying the new “normal” and the new “identity” I wanted for myself.

Then I proved that this new identity was actually a future possibility with teeny tiny small wins, building momentum, developing more grit and perseverance.

Here’s how you can develop grit yourself:

1) Identify the new “identity” you want to have. The more specific you can be with it, the easier it’ll be to prove it to yourself. “I’m the type of person that never misses a lecture.”  ”I’m somebody who hardly ever misses a workout.” “I’m somebody who works on gaining health care experience and meeting my prerequisites every day.”  Remind yourself of this EVERY day by hanging up a post-it note on your bathroom window, or using your phone/calendar to keep this at the front of your mind.

2) Prove to yourself you can do it with small wins.  Create a teeny tiny benchmark for yourself to show that you are heading in the right direction.  Make it something you can do every day, that takes less than 15 minutes. 5 minutes is even better.  Build the habit.

3) Build momentum by completing the small win every day for at least 30 days.  Remember we have limited willpower, so dump all of it into building this one habit.

4) Once you have established your new “normal,” it’s time to stretch again.  Constantly adjust your new normal, but make the adjustment small so it’s not a drastic adjustment.  Slow and steady for the win!

5) If you fail at something, make sure you fail differently next time. Failing is not a reflection on your character. You’re simply crossing something off your list that didn’t work. Move onward and upward.

Physician Assistant Grits

tortis and hari

Rule #1 : It doesn’t matter where you came from, only where you’re going.

This is why I love meeting people and receiving emails from prospective PAs or practicing PAs.  These are people like you and me: normal folks with normal lives and normal problems.  They may not have healthcare experience, they may be deciding between various healthcare careers,  they may not understand what a PA does.  Or maybe they are a PA student or a practicing PA who worked hard but didn’t pass their PANCE or PANRE. Maybe they have tried every tactic out there and struggled to find success for a long time.  Then, for whatever reason, that light bulb went off in their head and they were encouraged to try something different:

  • Joe failed his PANCE: He reached out to those who had been successful, purchased a new review book,  focused on completing questions every day and then took a lot of practice tests. He is now working full time as an orthopedic Physician Assistant.
  • Staci didn’t get into PA school on her first 3 tries: Now she is a 2nd year PA student who is looking forward to graduating head of her class and starting a career in family practice medicine.
  • Ryan didn’t know how how was going to pay for PA school.  He applied for the National Health Service Corps and was accepted after his second try. Now he gets a monthly stipend and will fulfill his dream of working in an undeserved population.

These guys didn’t set out to drastically change their life, but they knew it was a possibility.  They just focused on small wins, building momentum, and building a new normal for themselves.  As a result of that, these men and women are forever changed.

My goal with The PA-Life is to help you build grit and momentum.  I’ve seen it happen with hundreds of people, and it all starts with one thing: the first step.

This is a challenging journey, but one I hope you’re willing to take. There’s no doubt in my mind you have it in you to become the passionate and caring healthcare provider you see in yourself, and I look forward to the day when you start to believe it too. Prove it to yourself.

Don’t ever let anybody tell you that you can’t accomplish something.  

My dad, always said this, and it is true: “excuses are like armpits, everyone has them and they all stink.

Tell me one small victory you’ve had recently and one small change you’re going to make, or drop me a line and tell me what you need help with. 

-Stephen

Note: Clinical Associates Featured 3The Clinical Associates twinning partnerships in South Africa are made possible through the support of the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the US Centers for Disease Control and Prevention (CDC) in South Africa. Activities are carried out through institutional partnerships linking South African universities with counterpart institutions in the United States. These partnerships are managed by the American International Health Alliance’s HIV/AIDS Twinning Center, which is funded by the US Department of Health and Human Services, Health Resources and Services Administration (HRSA).

Volunteer Health Corps Clinical Associates Mentors

The American International Health Alliance is a US government-funded non-profit that works in global health, primarily in Sub-Saharan Africa.

Through the development of the HIV/AIDS Twinning Center, they create partnerships between US institutions and institutions in Sub-Saharan Africa, such as universities, hospitals, and clinics, focused on health systems strengthening and health professions education.

They also have a complementary program called the Volunteer Healthcare Corps that offers unique opportunities for skilled health professionals in the US to provide technical expertise at the host institutions within their partnerships.

The Volunteer Healthcare Corps is actively recruiting Clinical Associates Mentors to serve in 3-12 month placements in South Africa.

Launched in 2008 by the South African Department of Health, Clinical Associates are similar to Physician Assistants and are dramatically increasing the number of mid-level medical professionals in the health workforce who are able to confront the country’s immediate health needs.

American International Health Alliance initiated partnerships with the three universities in South Africa currently offering Clinical Associates programs:

  1. University of Pretoria and Arcadia University
  2. University of Witswatersrand and Emory University
  3. Walter Sisulu University and The University of Colorado School of Medicine

The first year of the 3-year program is spent at the university; after that, the students are deployed to the district hospitals, where the bulk of their clinical training takes place. You can review find more information about the partnerships in our South African country profile and about the program on their official website.

Physician Assistant Clinical Associate Mentor

To strengthen these programs, the Volunteer Healthcare Corps began a South African Clinical Association Mentorship Program, providing US professionals (primarily physician assistants) with the opportunity to serve as mentors and clinical trainers of the students while they are in the district hospitals, often located in rural areas.

This is an unique opportunity for highly skilled health professionals to directly apply their skills and expertise in a place that desperately needs it.

Below is a summary, you can also view the entire scope of work.


Overview of the Walter Sisulu University Volunteer Assignment

The Mentors will be deployed to provide onsite guidance and support to the Clinical Associates students at the district hospitals where they receive the majority of their training, as well as supporting faculty at the University of Walter Sisulu in Eastern Cape and associated teaching sites.

The objective of the Clinical Preceptor is to provide training, support and onsite mentoring for the clinical associate program for WSU students during their second and third year of training at the district hospitals. The Preceptor should impart preceptor skills to faculty and clinicians, as well as clinical skills to students. This includes supportive supervision, mentoring, and specific technical assistance as needed.

The Clinical Associates Program at WSU currently has 78 students enrolled. The first cohort of 23 students started in 2008 and graduated at the end of 2010. The second cohort of 30 students started in 2010 and will graduate at the end of 2012. Intakes are now approximately 25 students per year. There are approximately 8 students at each district hospital clinical site.

In-country placement site:

While some time will be spent on site at Walter Sisulu University, the volunteer would be assigned to one of four district hospitals in the Eastern Cape Province: St. Barnabas, Madzikane kaZulu, Dr Malizo Mpehle, Mthatha General.

South African Provines Where Clinical Associates are Being Trained

Length of the assignment:

3-6 months, part-time or full-time (full-time assumes 40 hours per week with a variable schedule depending on program needs; part-time schedule assumes 16- 24 hours per week with a variable schedule depending on program needs)

Volunteer qualifications:

Required:

  • Experienced Physician Assistant
  • Eligible for licensure/registration in South Africa (as a volunteer)
  • At least 3-5 years of Primary Care experience
  • Flexible, energetic, and positive attitude

Preferred:

  • Can work independently with strong leadership skills
  • Strong written and oral communication skills
  • Previous experience working in a low-resource setting with a large case-load, internationalexperience preferred
  • Experience in providing training and hands-on support in a high case-load, primary care environment
  • Experience/Knowledge of HIV/AIDS issues
  • Knowledge of and familiarity with opportunistic infections and treatment
  • Some experience with education and preceptorship, including providing feedback to students and bedside teaching in the clinic setting

If You Are Interested in Becoming a Clinical Associates Mentor

Please send your CV and cover letter as well as complete our short online VCH Application:

Complete The VHC Application

For more information about the program or if you have questions please contact the HIV/AIDS Twinning Center program analyst Sara Adelman (She is super nice!)


Resources and Other Uselful Links

The Physician Assistant Applicant Attack Plan: PERSONALIZED GOAL SHEET

by Stephen
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Note: This goal sheet was adapted from “The Ultimate Guide to Getting Into Physician Assistant School“. It is available here as a resource and not intended to be a substitute for the book which is chock-full of wonderful information! Fill out the following sheet and keep a copy on your person at all times. Read this sheet [...]

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Are you a Physician Assistant Practicing Medicine by Design or by Default?

by Stephen

Default is the status quo. It is cookie cutter medicine. It is flow chart medicine. It is brainless medicine. Default medicine is continuing to prescribe Paxil when studies show it to be no more effective than a sugar pill, default is telling a diabetic patient to increase whole grains when you know it should be no [...]

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Free PANCE and PANRE 120 Question Exam with Interactive Q&A

by Stephen

This PANCE and PANRE exam is touch screen ready with 120 questions from the official board review course. It is 100% free and makes a great review for both the PANCE and PANRE. There are in-question answers and hints which provide immediate feedback. This is an excellent exam for board review and to introduce topics [...]

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Physician Assistant Program Tuition and Costs – Comparison Table

by Stephen

Below is a cost comparison table of most Physician Assistant programs in the United States. Tuition and cost data of resident and non resident tuition including length/duration of the PA program. Keep in mind that these are estimated costs and variables such as tuition and fees will vary greatly from year to year. Make sure to visit the appropriate [...]

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Physician Assistants in Primary Care – A Dying Breed, Indeed!

by Stephen

Today I read this interesting article from the Annals of Family Medicine. It is titled: Physician Assistants in Primary Care: Trends and Characteristics It proved the point of a recent conversation I was having with my cousin, an orthopedic Physician Assistant, this weekend over dinner. My theory was that Family Practice PA’s would soon see the [...]

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Physician Assistant Salary Map 2013

by Stephen
Thumbnail image for Physician Assistant Salary Map 2013

Here at the PA Life I am always trying to develop tools that make your life (and my life) easier. This might be one of my favorites. Trying to negotiate a salary is hard enough. This becomes even harder when you have to adjust for the never ending list of variables such as previous salary [...]

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The Costco Vitamin and Supplement Shopper: Patient Cheat Sheet

by Stephen

When it comes to vitamins I am not big on all the hype.  That being said, I am a big fan of supplemental vitamin D3 and fish oil for most patients. I have some other recommendations in this area as well, as you will see below. The key though is compliance and in the world [...]

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The Top 46 Physician Assistant Applicant Interview Questions

by Stephen
Thumbnail image for The Top 46 Physician Assistant Applicant Interview Questions

Physician Assistant school interviews are extremely challenging. Here is a wonderful list of 46 high frequency questions that you are likely to encounter. This list of the “Top 46 Physician Assistant Applicant Interview Questions” is adapted from Andrew Rodican’s wonderful book “The Ultimate Guide to Getting Into Physician Assistant School“, Christina’s helpful video post from PrePARC, actual [...]

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