Filling the Void
November 23, 2011
Campbell's Physician Assistant students expected to fill the void as state braces for shortage in health care professionals
Dr. Brandon Roy didn’t waste any time with his anatomy students.
Pulse points with the student model. Neck muscles with the University’s new plastinated cadaver, “Fred.” An even deeper trip inside the human body via computer software and Smartboards.
Welcome to Day 1 of Campbell University’s new Master of Physician Assistant Practice degree. Thirty-four students make up the charter class of the 28-month program, launched at a time when experts are predicting a shortage of more than 150,000 physicians by 2025. As physician assistants, the students will be trained and licensed to practice medicine … different from a career as a doctor in that they’ll be required to practice under supervision of a physician.
Campbell’s program will focus on primary care with an emphasis on practicing medicine in rural or medically under-served areas, according to Director Tom Colletti.
“Above all, we will train students to be compassionate and competent health care providers who will carry out the mission of community service that is the foundation of Campbell University,” said Colletti, a certified physician assistant himself.
“Compassion” was part of Day 2’s lesson, led by assistant professor and certified physician assistant Betty Lynne Johnson, who guided students through the do’s and don’ts of patient interviews. Johnson called on each student to pair up, don the white coat and go over medical histories with each other at mock clinical stations set up throughout the recently renovated Carrie Rich Hall.
“PAs do patient histories better than anybody, and do you know why?” she asked her class. “Because of our training. You’re going to do these over and over and over … so much, you’ll probably get tired of it. But you’ll be good at it, and it’s very important to me that you are.”
Like A Job Interview, Only More Intense
The students should be pros at the interview process by now. To get into the program, they each went through multiple interviews with faculty and staff to be considered for the 34 open PA spots out of about 200 applicants for the charter class.
“We were looking for well-rounded students,” said Laura Gerstner, Clinical Coordinator and assistant professor for the program, and, of course, a certified physician assistant. “They had to be strong academically, but also have good previous medical experience and almost as important, be very personable. It was very much like a job interview.”
Only more intense, according to student Samantha Bullard, a recent graduate of North Carolina State University who applied for Campbell’s PA program because she wanted a medical career that allowed her more one-on-one time with her patients.
“The faculty met all of us as a group, then we had 2-on-1 and 1-on-1 interviews,” Bullard said while taking a break from patient histories with classmate Kristina Benedict, a University of North Carolina graduate. “Everybody had different questions, and while it was intense, it was all very comfortable, too. I really like the people here, and I think this is a very well-thought-out program.”
The screening process was necessary because of the high number of applicants, Gerstner said. Campbell’s accreditation allows it to take in no more than 44 students in a year, and the University felt 34 was a solid number for Year 1 considering the newness of the program and the size of the lecture rooms and labs.
“Even though the number of PA schools across the nation is on the rise, it’s still a very competitive process to get in,” Gerstner said. “There is a high demand for these students, and we were very selective about which students we wanted to let in.”
And with the growing number of PA programs, students were selective, too. Jackie Hudson, a recent graduate of Wingate University, said Campbell’s reputation in its other graduate schools played a big part in attracting her to Buies Creek.
“It has an excellent law school, a well-known research department and now a (proposed) medical school … that all meant a lot to me,” Hudson said.
Hitting The Ground Running
Because the program takes a little more than two years to finish — 13 months in the classroom, another 15 months in the field — there is little time for reviewing the material these students learned as undergrads. The pace the first few days was fast and productive.
In other words, Campbell didn’t have time to “work out the kinks” of its new program this fall.
“These students are coming in with thousands of hours of medical background and a long list of prerequisites,” said Liza Greene, a certified physician assistant and assistant professor at Campbell. “The medical knowledge is in place, so when they get here, they’re hitting the ground running.
Greene said it’s the people who make the program, and she feels Campbell has the right people in place. Colleti is joined by Gerstner, Academic Coordinator David Coniglio and Medical Director Dr. Christopher W. Stewart to head the program, while Johnson and Greene serve as associate and assistant professors respectively. Then there’s a number of adjunct professors like Dr. Roy, a general surgeon from Wake Med in Raleigh, and April Pope, PAC, who assisted in the labs during the first week.
The years of experience in not only the medical field but the classroom gave those early classes the feel of “business as usual” rather than “we’re new to this, too.”
“Everything here is new, but they seem to know what they’re doing already,” said Benedict, the UNC grad who summed up her first two days in the program as “exciting.” “The classes are flowing well, and the program so far is exceeding my expectations.”
Evidence-based medicine is a primary focus in Campbell’s program, as students are being trained to research and interpret medical literature while putting the best evidence into practice for their patients. The 13-month classroom portion will balance lectures with labs and “clinical critical reasoning exercises” aimed at teaching students how to analyze a patient’s conditions.
“We are one of the few schools that require a course in orthopaedics during the first year of training and a clinical rotation in this area as well,” Colletti said. “Statistics show that up to 20 percent of office visits in primary care are for musculoskeletal problems, and I want our students prepared to treat those patients.”
The students also have access to cutting-edge technology, as Smartboards and computer labs are dispersed throughout Carrie Rich Hall, which will serve as the PA program’s home until the School of Osteopathic Medicine’s building is complete in 2013, pending the program’s approval. If the medical school becomes a reality, Colletti says by the fall of 2013, physician assistant and medical students will work together at Campbell to discuss clinical cases and learn how to work effectively with each other.
“Medicine is no longer a cottage industry run by MDs,” Colletti said. “It is a collaborative team approach that utilizes the skills and training of all health care providers for effective, cost-efficient, patient-centered care.”
Filling The Void
According to Gerstner, Campbell’s goal is to train well-rounded physician assistants who can fill a void in the medical field.
And that void is getting bigger.
According to recent statistics published by the Association of American Medical Colleges, with current graduation and training rates taken into consideration, the nation could face a shortage of as many as 150,000 doctors by 2025. And of the physician assistants currently entering the workforce, only 37 percent of them are practicing in primary care (health services by providers who act as the principal point of consultation for patients within a health care system).
Campbell’s program is emphasizing primary care, more specifically, primary care in rural areas like Harnett and its surrounding counties.
“The students here will do rotations in both urban and rural clinics, but it’s rural areas where there’s a real need,” Gerstner said. “And we’re teaching toward that … patients in rural areas, they’ll find, may not have the same access to health care, and PA’s resources will be limited. They’ll see patients with multiple health problems. We have to prepare them for that.”
Physician assistants are licensed to conduct physical exams, diagnose and treat illnesses, order tests, counsel on preventative health care, write prescriptions and assist in surgery. Some even run their own practice and can do so in most states as long as a physician is on staff for supervision.
“They used to joke that PAs were just the ones who couldn’t get in to medical school or pharmacy school, but that’s just not the case,” Gerstner said. “These are well-trained medical professionals.”
It’s All About People
“Trust” was a repeated theme in Johnson’s first class.
A physician assistant who practices in Harnett County, Johnson told her students before setting them free to perform patient interviews on each other that the most important goal of any physician assistant is to earn the trust of their patient.
“Trust comes through building communication and building a relationship,” Johnson told her class, first asking them to drop their note-taking pens and listen intently. “It’s an extreme privilege to be a part of this relationship with your patient. And you’re not going to get anywhere without trust.”
Johnson said she thinks what will set Campbell’s PA program apart from others will be its focus on people.
That focus is part of what attracted Andrita Stokes, a graduate of North Carolina A&T.
“Campbell stood out for me because of its emphasis on ‘teaching,’ whereas I felt a lot of other schools were focused on problem solving, getting us together in small groups or even independent studying,”
“Here, they’re teaching us and nurturing us first. They’re preparing us not to just be certified, but to be successful PAs.”
Her lab partner, Hudson, said she was impressed by the professors’ desire to learn more about her personally, beyond her scores.
“I feel like they want me to be the best I can be,” she said. “And they’re looking at the total package in their students. It’s more than grades … they’re emotionally invested in you.”
A Dream Come True
Campbell University runs in Betty Lynne Johnson’s blood.
The daughter of Campbell President Dr. Jerry Wallace, Johnson graduated from Campbell before entering Wake Forest University’s PA program. She currently works as a physician assistant in nearby Coats.
Watching her alma mater earn its PA school accreditation was a big moment in her life, she said, and being there for the beginning of classes was like a dream come true.
“So far, it’s been an exceptional experience for me,” she said. “I’ve dreamed forever of Campbell having a PA program, and now it’s happening. And it’s here because very good ground work was laid out to make this happen. We had a wonderful steering committee, and today, we have a wonderful and experienced staff. I couldn’t be more excited.”
— Billy Liggett, Assistant Director for Publications