Aaron (00:16):
All right guys. Well thanks for joining us for this episode. I think it’s going to be super valuable for paramedics and even EMTs that are considering PA school. I’ve got Mr. Brian San Felipo here in their PA program. He’s going to tell us more about it but I’m super excited to talk to him. I think he’s going to have some valuable information and insight to what it looks like. And he’s in the thick of it right now. He’s graduating next December so he’s about to start clinicals and finishing up didactic, if I’m right. So yeah, let’s talk to Brian and see if we can get some good perspective on if this is something that you want to consider. Brian, thank you for joining us today.
Brian (01:01):
Thanks for having me. I’m honored to be here.
Aaron (01:04):
So the first thing I wanted to do was kind of get your background and hear how long you were an EMT and a paramedic and what your background is.
Brian (01:15):
So educationally, I got my degree in biology at Colorado State University. Graduated in 2006. After that, I went to paramedic school realized that I wasn’t ready for the streets. So I worked as an EMT for a year and a half. And then after that I moved up to be a paramedic. I worked as a paramedic for a better part of 15 years in three different cities Raleigh, North Carolina, Colorado Springs, Colorado, and Sioux Falls, South Dakota. Primarily working in Colorado Springs as a paramedic. And that encompassed mostly nine one responses and some inner facility transport.
Aaron (02:00):
Okay. How long were you a paramedic when you kind of started considering the PA route?
Brian (02:07):
I think I had been a paramedic for about maybe three or four years before I started considering looking seriously at what it takes to become a pa.
Aaron (02:21):
Okay. Yeah. I have to ask you if you remember this one story. You and I were partners for what, six months. We were partners for a substantial period of time as far as partnerships go in Colorado Springs. Do you remember the transfer we did to middle of nowhere Arizona and how we almost ran out of gas.
Brian (02:43):
I remember it wasn’t very high acuity. I think he either had a UTI or needed a new Foley or whatever and then he needed ground transport back down to Arizona board the border of Arizona, New Mexico. How
Aaron (02:59):
Long of a drive was it?
Brian (03:02):
14
Aaron (03:02):
Hours a one way or
Brian (03:03):
Something? I think it was 13 or 14 hours one way, cuz we drove down there. Well you drove the whole way down and then I think we did almost run outta gas at one point. Well
Aaron (03:17):
I remember it was so long that they paid for a hotel for us before we came back and I just remember being so tired in the morning that we just skipped the gas station. It was like, ah, we’ll get gas here in a couple hours. And then the stretch of road, it was so long before the next gas station. I remember putting the ambulance in neutral as we went down downhill as if that would do anything. Yeah.
Brian (03:40):
The way back we drove Phoenix, we drove through Phoenix and we were like, oh, maybe we should get some gas. We don’t know where the next gas station is. And we were in this windy area of New Mexico, kind of rural New Mexico and we were like, man, we’re going to run outta gas. And it was like the digital readout on miles to empty was dangerously low before
Aaron (04:01):
We
Brian (04:02):
<laugh> we got gas. It was approaching single digits and it was less than 20 miles, which those are never accurate. This,
Aaron (04:11):
They’re probably high if anything,
Brian (04:12):
<laugh>. Right. We probably didn’t have, I mean we were just moving on fumes.
Aaron (04:17):
Well, thank God we at least got gas and didn’t die in the middle of New Mexico.
Brian (04:21):
I know.
Aaron (04:22):
I wanted to ask you how many other paramedics are in your class?
Brian (04:26):
I’m the only paramedic which is,
Aaron (04:28):
Yeah, I was too. I
Brian (04:29):
Think that was interesting. I think there’s one other person for sure who was an emt, but I think she worked in a smaller rural type of more, a seemingly volunteer type of agency. Most of the people in my class had their healthcare hours through working as a cna. But we also have dieticians, we have scribes, they had what else? Pharmacy techs. Somebody worked in an ophthalmology office and we had sitters. Somebody got their healthcare experience as a sitter. That was different, but I mean whatever. Yeah.
Aaron (05:19):
Yeah. I had no other paramedics in my class and I think there was one or two EMTs. The EMT was actually from a busier system. He had some experience and stuff but yeah, no other paramedics, which was kind of odd I feel like. Yeah. Cause I feel like it’s kind of a good progression from paramedic to pa, but
Brian (05:42):
It makes sense. Right. With the history of the field, the career field, you would think that with that training and that experience that it would translate well into the profession. But I don’t know for certain how obtain it is when you work as a paramedic and trying to make that work financially with going to school. Oh
Aaron (06:01):
Right, exactly.
Brian (06:02):
Although the prerequisites necessary to get into the
Aaron (06:05):
Aids. Yeah, exactly. The other thing that I thought was weird was a lot of medicine or medical fields have no idea what the difference between E M T and paramedic is either.
Brian (06:16):
Yeah. People still ask me in my class. Yeah, it’s kind of interesting.
Aaron (06:22):
They don’t, so I don’t even know if you’re a PA school applicant reader and you’re looking at applicants and you’re like, oh, paramedic EMT probably makes no difference to you qualifications anywhere. I mean, I
Brian (06:36):
Feel like there are some readers who kind of go through those applications who may not understand fully. But unfortunately for me one of the guys who works as he works part-time now, but he used to be full-time here. He does, he works at Yale now but he was a paramedic for a considerable amount of time. And then he works in the ER now locally as a pa. And then another guy worked as an EMT first before. Oh, okay. He went to become a pa. So I feel like they provided some valuable insight in the pre-hospital arena as to identifying what a paramedic and an EMT do for people.
Aaron (07:15):
Oh, that’s nice. Okay. So when you were getting ready for PA school, did you have an undergrad degree before you knew you wanted to go to PA school? Or was that something you still had to obtain?
Brian (07:28):
I had my bachelor’s degree in biology. I minored in at the time it was anatomy and neurobiology. That minor doesn’t exist anymore. I think it was turned into biomedical sciences after I left. And really there wasn’t an extreme focus on anatomy and neurobiology that you didn’t necessarily couldn’t have gotten with a biology degree. I think most people get gross anatomy and biology at least at Colorado State where I went to school. But I had my four year degree before I went to paramedic school. And then at the time I had to start taking things pretty seriously. You know, had to do some research, kind of see what had to be done and figure out what an application actually looks like. I realized that I had to retake some classes, so I was current. And to be perfectly honest, I didn’t think that my undergraduate GPA was competitive enough when I graduated from csu.
Aaron (08:31):
Yeah.
Brian (08:31):
I wanted to improve that and demonstrate that I was capable of the rigor of master’s level education.
Aaron (08:41):
So you already took a lot of classes with some motivation just to increase your GPA even if you had those classes already done?
Brian (08:49):
Most of the reason I went to and I went and I attended University of Colorado in Colorado Springs. I think you were there, you might have been there a little bit at the same time I was
Aaron (09:00):
There. Yeah, I think cuz I would’ve finished my undergrad in 20 16, 20 15.
Brian (09:07):
I don’t remember the years, but I’m pretty certain you were one of the chemistry classes around maybe the year after I took it.
Aaron (09:15):
Yeah, it’s definitely possible. I was working on, so mine, I didn’t have my undergrad yet. I knew I wanted to go to PA school when I was in paramedic school. I feel, so around 2011 is when I started having those thoughts and I was like, I went to an information session for Red Rocks in Denver and they present you with, here’s all the requirements, here’s what our average applicant looks like. And I was like, oh my gosh, that’s impossible. Super, super daunting. People with better GPAs than me. Way more schooling from 2011 until I got in 2017 is when I started. I was just taking 11 to 12 credit hours every semester and I had to get my undergrad, which did take my paramedic credits at U C C S. I can’t remember which degree I got specifically, but my paramedic at least counted for some credits. So that was nice. It was Allied Health or something. That was the degree. But even after I got my bachelor’s, I had to get genetics and physics and all this stuff that I never used in PA school but was a requirement at some of these programs.
Brian (10:31):
Yeah, I do notice that feel like the prerequisites are very similar to medical school.
Aaron (10:38):
Some of ’em I understand biochemistry. Yeah. Yeah. Biochem, I kind of get that one. But some of the other ones like genetics, physics, I just don’t understand why you need that to succeed in PA school.
Brian (10:49):
I honestly think that I could be wrong and it’s strictly my opinion, but I feel like it’s a weed out type of prerequisite. Sure. What makes this applicant stronger than this other applicant? They’re virtually the same. How do they do in the natural sciences?
Aaron (11:06):
Yeah. What’s
Brian (11:08):
Their challenging natural sciences gpa.
Aaron (11:11):
Yeah.
Brian (11:11):
How does that compare to other people? Yeah.
Aaron (11:13):
Think
Brian (11:14):
It just leads them another thing to evaluate.
Aaron (11:17):
Yeah, that’s probably true. Did you end up with a pretty high gpa?
Brian (11:22):
When I went back to school I think I got one A minus. So I had a 3.9
Aaron (11:30):
Whoa.
Brian (11:32):
At uccs. But my undergraduate GPA P at Colorado State was a three. Oh it wasn’t very good. It was just kind of nothing to write home about. I never really thought it was that competitive, which is kind of why I felt like I had to retake some classes because, and I felt challenged in my undergrad. It was hard, but I got my cumulative GPA up above 3.25, which I think is the minimum for some of these school programs. And to be honest, I wasn’t sure that I was going to get extended the offer to attendance PA school. I applied four times and there was one year where I interviewed at three schools and didn’t get into any of ’em. Yeah.
Aaron (12:21):
And that’s a common story though. I, some of my classmates, some of them applied for years and years to, I mean they would apply to dozens of schools every time. And then this was, they were like, this year if I don’t get accepted giving up on this and they got into the program, I got into it’s, it’s tough. It’s so competitive and you can’t predict who’s going to read your application. And
Brian (12:44):
I did the same thing I had actually. So when I applied and interviewed one year, I think it was my second year, I interviewed at three schools. I interviewed at Duke, Emory and Oregon. And I was like, okay, I’ve got a chance. These are really good programs. They all thought that I had something to offer and I didn’t interview well and I didn’t get in. And so I was really taken aback. I had to reassess my process and my application and my essays and then I reapplied the next year and I got no interviews and I even applied to a lot of the same schools. And so that really put me down a path of thinking that I wasn’t going to go to PA school and I tried to make the best out of being a paramedic. Mm-hmm. Tried to assume a leadership role. I wanted to be an fto, I wanted to be a supervisor. I ended up achieving some of that stuff. Not necessarily in Colorado Springs. I was an FTO in Colorado Springs, but I was a supervisor in Sioux Falls for a short
(13:52)
And I grew from each of those experiences. Perhaps I needed to mature a little bit too. That’s always important. But I eventually just decided that I couldn’t do it forever. It breaks your body down and you know, realize that if you’re going to achieve your career aspirations, you gotta try. So I decided to try one more time and it’s the same thing, just shared, it was one of those, Hey, I know we’ve spent $25,000 on this effort to apply to PA school. We’ve committed years of retaking classes and we’ve made trips even let’s try one more time. And if we don’t get it then it’s a wasted effort. It’s a waste of money. I’ll just be a paramedic. And then when I can’t do that anymore, maybe I’ll go teach paramedic school stuff. I mean, that was where I was headed and I applied to 14 schools and I got into two of ’em. So that was a huge surprise. And of course one that I welcomed with quite a bit of excitement and here I am. And the thing I think the rule is for me is you never know when the right person’s going to see your application.
Aaron (15:11):
Yeah,
Brian (15:11):
Yeah. You’re trying to show them that. I don’t know if I benefited from a covid year or what, but I actually sought out some professional help in my application and interviewed for the first time for this application. Once I found out I was getting interviews as the service of a specific PA interview to help prepare me for it so that I went in there in there ready to
Aaron (15:44):
Go. Well it’s a huge investment. So I mean I can see why that’s one thing that when I talk to paramedics that are considering going to PA school, you can’t be wishy washy about it. This isn’t like, oh maybe I’ll go to PA school when I’m tired of being a paramedic. Or if they’re wishy washy about it, it’s impossible. You have to want this with everything. I mean that’s the only way I was able to take so many classes while working full-time was being a PA was the end goal and I wanted it with everything. And you sacrifice a lot. I mean, you sacrifice a ton of extra time and friendships and time with family and we’ll talk about that later. I mean, you’re in a different city from your family, you’re in a different state from your family. It’s a huge sacrifice. So it’s something that you know, gotta want with everything you got.
Brian (16:37):
Yeah, it’s interesting. You do hear stories about paramedics who feel that, hey, when I’m done I’m just going to go to paramedics, it’ll be fine. And they’re kind of aloof about it and you get this sense that maybe they don’t quite understand a commitment that is required because the people that you’re applying with, I mean they are very committed, they’re sacrificing quite a bit and they’ve got stellar GPAs. I mean I have multiple master’s degrees who’ve attended who are attending in my class. I have a guy who was a pharmacist for 20 years and my program, I mean I don’t know how your program is, but I mean we’ve had doctors in there before from different
Aaron (17:23):
Countries. Yeah.
Brian (17:24):
Come in and go to PA school. So the selection process is, I mean don’t know how to put I certain theme to it, how to make the perfect application. But I mean it’s certainly way more competitive than you think it is. And just because you work with some PAs in the ER as a paramedic doesn’t necessarily mean that you have a full understanding of what’s what’s required to get in. And to be perfectly honest with you, there are still some days where I wonder how I got in that imposter syndrome that they talk about. It goes away some you get kind of numb to it because you just have to work so hard to make every week work, but it’s still there a little bit.
Aaron (18:10):
Oh yeah, I totally felt that way when I was in school. It’s especially some of my classmates that had applied so many times, I was like, I applied to Red Rocks twice the first time I knew I didn’t have all the pre-reqs, but I wanted to be able to check that box that said, hey, this is the second time I’m applying the next year. So I applied twice. But even, I mean that was still a pretty quick turnaround to get into PA school. I was like how did this even happen? But I think I just had the right person that interviewed me that kind of saw where I was coming from and saw my potential and the right person that read the applicant before that. And a lot of it is really about getting in front of the right person.
Brian (18:52):
I mean, you do have to protect yourself appropriately, but the timing does definitely have to be right. And there is a little bit of luck I think, too.
Aaron (19:00):
Yeah, for sure. Did you consider medical school at all?
Brian (19:04):
I did and I thought about it and I considered that maybe professionally it might meet a few different aspirations that I may not be able to consider as a pa. But when it came down to it it just didn’t seem like the right fit for me. I’ve always been drawn to medicine and I thought maybe that medical school was the right path for me, but I felt like as a guy in his middle thirties with three kids and a wife that I wanted to, I want to be done with this education and be working and he’ll be able to be in my kids’ lives.
Aaron (19:52):
Yeah, absolutely.
Brian (19:54):
And can you do that as a guy who’s in medical school out outta state? I don’t know if you have to residency, you have to match and have a residency and maybe that’s nowhere near where your family is.
Aaron (20:09):
Yeah.
Brian (20:10):
You’re talking a significant amount of time away from your family and is that marriage going to work?
Aaron (20:16):
Yeah.
(20:18)
So yeah, those are good points. I kind of had the same thought process cuz I was in, it was in my late twenties by the time I was getting into PA school. And I was like, do I want to trade another eight to 10 years of my life? A lot of student loan debt, not working for that whole period of time, not making a considerable income that whole period of time. Is that time income, trade off worth it? I think a lot of people have to make that decision when they decide on PA school, but it’s the big benefit is you don’t have to have a ton of student loan debt. You don’t have to sacrifice a ton more years of your life and you make a decent income and you’re working pretty quickly.
Brian (21:00):
Yeah, I think the biggest drop for me for school, the biggest deciding factor is the fact that you don’t have to specifically specialize and match in one specific there. And because you, I’ve talked to physicians who have expressed to me that if you don’t where you’re at, you’re stuck. You could go back and board certifying something else, but I mean you gotta pay for that. You gotta put the time in and it’s just much harder to do as a pa. You can laterally move into your interests. I mean certainly not simply, it’s not seamlessly, but certainly easier than if you were a doctor.
Aaron (21:48):
Oh yeah, absolutely. No, that’s a great point. That is a big consideration. People should think about. Yeah. Cause I mean if you get into some specialty and find out, you absolutely hate it. Especially as a doc. I mean hopefully you have some indication of that when you’re in med school and you’re kind of getting your experience and stuff. But definitely a lot easier as a PA to make a transition if you want to because maybe you decide that after five or 10 years, I mean you still have that ability though if you decide after five or 10 years to switch specialties you can. And it’s not a horrible process to do that. What is the biggest struggle that you’ve had in PA school?
Brian (22:29):
For me it might be unique cuz there’s two things that have been the hardest thing for me. Transitioning from working full-time to just being in a classroom that day every day and then studying till about midnight. And having that be my day has been a little bit of transition. I got used to working every day. I got used to going to work, coming home and doing what I needed to do for my family. So my day to day <inaudible> quite a bit. And then that was just a transition and it was hard, but it wasn’t like earth shattering. The hardest thing for me has been being away from my family. And it did have to change. My priorities had to change quite a bit because my kids are young and my wife needs me and I’m just not there. I mean not cuz I don’t want to be there. Not because I don’t want to be a father or a husband, but this is the sacrifice that my wife and I agreed was worth taking. And unfortunately she has to pretty much be a single mother for two years. Two, and I’m miss, I’m missing birthdays and missing some milestones has been heart for my son Jackson. He’s four I missed his birthday and I’m going to miss another birthday. And so you can argue that he’s going to spend half of his life by the time I’m done with this. Half of his life was with me in school and away. So he knows me through the phone.
(24:16)
And then my daughter, she’s creepy and the struggles that come with that, socially she might need her dad. But I mean I’m there for her when I’m available and I’m on the phone, but it’s not the same.
Aaron (24:33):
Yeah, that’s a huge sacrifice for sure.
Brian (24:38):
And for my wife too. I mean she just doesn’t get a break. She just, it’s always her and it’s one income. It’s childcare’s insane for three kids that you and her have to work, you know, start every month, $5,000 in the whole with just childcare and rent. You start throwing bills and car payments and extracurriculars. It’s a considerable amount of money when I’m not making money and not being able to provide for my family. It’s hard.
Aaron (25:15):
Yeah.
Brian (25:17):
That’s the hardest thing for me. I don’t know, it might be, but it, it’s definitely my
Aaron (25:24):
Struggle. Yeah. Yeah, that’s huge. Yeah, fortunately when I was in, I didn’t have any kids at the time. We actually just had our second kid.
Brian (25:34):
Well
Aaron (25:34):
Congratulations. Thanks. But yeah, we didn’t have any kids at the time so it was quite a bit easier. And of course my hardest thing was commuting to Denver, which sucked. But gosh, being in a whole different state, I mean that’s a big sacrifice, but hopefully it’s going to pay off here in a year and some change when you’re graduating and you can move back home and make a big income for your kids and then have a really good work life balance and make up that time with your kids.
Brian (26:03):
I mean that’s what it’s all about. That’s what we’re working towards. And I don’t set the long-term goals for me to survive in PA school. I, I’ve had to short set short-term goals. So every unit I’m in, let’s coming up next,
Aaron (26:19):
Yeah,
Brian (26:20):
Get lost in that moment because it becomes overwhelming. It, you look at all things that you have to do and it’s just a
Aaron (26:28):
Lot, so many hoops that you have to jump through.
Brian (26:32):
And for me, I have to make it simple and I have to look at achieving the short term goals first. And if I can achieve those, then the long-term goals, I don’t have to worry about those cause those goals will just be met. So right now I’m thinking about my first rotation. It’s in less than two weeks. It’s general surgery and I want to do it. I’ve done all my stuff to make, I’ve done all the paperwork to do that, but I still have to pass cumulative and summative exams before I’m allowed to do it. Right. So you know, still have to study. There’s still things that you have to do. They’re not just going to let you do it if you don’t perform well on exams.
Aaron (27:17):
Yeah.
Brian (27:18):
So for me I’m just looking at, well Friday’s a big exam and then Monday’s a big exam and next Thursday’s a big exam. And so those are the three things that I’m thinking about right now and I’m not really thinking about much anything else.
Aaron (27:33):
Yeah, that makes sense. I remember mean there’s so much testing I weekly in PA school, it’s like they’re constantly throwing, you’re constantly preparing for something. As soon as you finish one test, you’re preparing for the next one cuz it’s coming in a week or there’s just so much that they push you through. Do you feel, I mean you were a paramedic a long time. I’ve been a paramedic a long time, the paramedic cultural stuff. Did you have to change parts of yourself while you’re in school, kind of temper the jokes about morbid stuff and kind of temper that paramedic side of you while you were in school?
Brian (28:16):
Oh yeah, without a doubt. I mean, you and I both know the conversations that happened in the front seat of an ambulance would close doors and raise windows can get a little dark. And I know that it’s a coping mechanism and I know that sense of humor is also potentially a testament of the culture that you’re in. I mean it may not be everywhere, but you and I came from pretty much the same place. So I kind of understand exactly where you’re coming from and frankly there’s a lot of people who don’t resonate with that. They don’t understand that type of humor.
Aaron (28:52):
And
Brian (28:53):
You’re right, I still do have to monitor some of the things that I find funny and humorous. I have to be careful about what I say because taking outta context somebody could have a problem with that and then it can become a professionalism issue.
Aaron (29:11):
Yeah, I’m glad you said that. It’s totally how I felt the whole time. And it did come down to professionalism. They’re so huge on professionalism in paramedic school that nobody’s talking about professionalism. But in PA school they’re like, this is a different career than you were in before. PAs are very professional people and they just reiterated that so much. So eventually I would just have to stop any of the joking that I would do cuz it would just fall flat on people that didn’t understand where I was coming from.
Brian (29:44):
Yeah, I’ve made some jokes that have not really taken what been taken very well. And the other, of course for the most part it’s been in situations where I’m not at risk of damaging myself professionally in this setting. But I spent a lot of time with my classmates trying to group study and figure stuff out. I’ve made some friends, I’m not trying, it’s hard to do this alone. But yeah, I’ve definitely had to redirect some of my humor. And there’s some people who understand or they say they understand, but sometimes they even don’t. Well
Aaron (30:23):
The other thing too is we talk about people’s experience levels before PA school and people would tell their medical stories like, oh I was doing this or whatever and I can top all of those stories and eventually I just had to stop doing that. They would tell a story about something I, I’d be like, well this one time I was driving lights and sirens down the road trying to innovate this trauma patient and my stories were just pretty insane compared to theirs. But I feel like you can’t beat the experience level of a paramedic either. Mean, especially in a system like ours,
Brian (31:02):
We have invaluable experience. I mean we worked in a busy system, we saw everything. We saw critical medicals, critical traumas, and we had high standard medicine and we worked with competent people
(31:16)
And the receiving facilities were good at helping us get better. And we worked in a system where medical direction was progressive. And so that stuff was all beneficial to us in our development as clinicians, not just paramedics. And I don’t know, I don’t personally feel that there’s a better place to learn the knowledge, the appreciation for the patient, how to actually talk to people and critical thinking processes than being a paramedic that prepares you for PA school. Obviously you can do different things and be better at certain aspects of medicine outside of paramedics training. But I think I came to PA school much better prepared than a lot of my constituents cause of that training and that career.
Aaron (32:14):
Yeah, I had some of, it’s hard too. I mean I had a doctor that was one of our professors get up and say, none of you have any bedside manner, that’s what you’re here to learn. And I was like, no bedside manner. I’ve been at thousands of bedsides the left side of a cop, what are you talking about? And I was kind of offended by that. I was like, what are you talking about? No bedside manner. I would like to think after thousands of patient encounters, I have some bedside manner but I feel like you just kind of gotta roll with the punches and it’s not worth making a big deal about when you’re in the program. It’s just put your head down and do the work and no one cares what you did before.
Brian (32:57):
You know it. Yeah, you’re right. And they don’t know. But it’s easy for them to stereotype us as two years of experience at the lowest level and high GPA performance in the natural sciences. Most of the people that I’m in school with, most of them are in their mid twenties, most of them are female and most of them were CNAs. And so it’s very easy to look at my class and say everybody’s in their mid twenties and they haven’t really lived a whole lot of life yet. So how could they have developed bedside manner that I have as the doctor because they haven’t had that type of experience yet.
Aaron (33:45):
Yeah,
Brian (33:46):
I understand the stereotyping and I’ve been part of that too. I mean our presenters will come up. Our lecturers will come up and say like, oh you guys are all super young and healthy and you know guys all exercise all the time and guys when you get older it’s going to be harder. And I kind of listen to that stuff but I’m like well I know who you’re talking to. You may not be talking to me specifically, but I understand your point.
Aaron (34:09):
Yeah, that’s a good point. I think you have to have that attitude to get through PA school. Otherwise I was saying you just take it too personally and it just makes you angry and that’s pointless. That’s pointless emotion while you’re trying to get through a tough program. A lot of wasted energy that doesn’t need to be wasted. <laugh> cardiology especially EKG reading. That was the only part in PA school where I was like, I feel like I got, this is reiterating some things, but all the other anatomy topics, I was like, oh man, my knowledge was really superficial with, even with GI anatomy, I was superficial
(34:51)
Knowledge almost embarrassingly. But you don’t need it as a paramedic, I just kind of care if they’re abdomens tender. I don’t really care what organs are under that particular area cause what does it matter to me? They have abdominal pain, they’re going to the hospital, give ’em some pain meds and some Zofran it doesn’t really matter. Versus if you’re considering what surgeries could this patient need and what do they need in a workup, you actually care what organs are under those areas that you’re pushing on. Cuz I think it’s kind of part of the paramedic culture to be pretty cocky and to act like everything. And I think for a reason, I think paramedics kind of need to have that mentality because when you’re on a scene and everything’s going crazy, nobody’s taking the lead, somebody’s dying. You need somebody that can be cocky and for better or for worse make a plan stick to it or a plan’s not going to take place and a patient’s going to die. So I mean you kind of have to have that mentality I think as a paramedic is you have to act, even if you don’t feel like you really do to get a plan together or else your inaction’s going to result in patient harm. And
Brian (36:00):
I think decisive paramedic’s a dangerous
Aaron (36:01):
One. Yeah, exactly. And so I think they kind of hammer that into you. You gotta make a decision for better or for worse, you know, gotta make a plan. And I think PAs, you
Brian (36:12):
Better be right. Exactly. Yeah.
Aaron (36:16):
And then you go through PA school and it’s like my program, 27 months of them beating into me, you don’t know anything. Here’s all the stuff that you don’t know. Yeah, we’re going to kind of give you a glimpse of all of it and you’re still going to get outta school having a ton of learning to do. But it’s, it humbles you, I think, especially as a paramedic, to realize how much you don’t know. Cause I think medicine’s kind of unique in that you think you have a really complete picture of medicine when it is just the tip of the iceberg. And even being a PA is just the tip of the iceberg. I, you have to really understand how much you don’t know. And that was something the PA school just hammered into me over and over again.
Brian (36:52):
I felt like I kind of achieved that enlightened instead before PA school. I learned a long time ago that the more you know don’t know, and I feel like that’s not appreciated in paramedics, that’s not appreciated as a brand new paramedic, you think a whole lot more than you do. And what being a paramedic really is in my mind is I truly specialized clinician for what it is. You’re really good at 40 things, but that’s what you’re good for. And it’s all the things that being a pre-hospital clinician is, and you really have to be really good at those things because if you make big mistakes, make bad decisions, it could be life changing for people, but the PA process is certainly different. I mean, you know, definitely have to think deeper than the surface that is the paramedic stuff. But I think that also it also makes you an asset when it comes to the critical thinking and looking at the emergency medicine type stuff that a lot of people who come to PA school are afraid of. It scares people to think about working in the ER where if you were IDA walk in, they were just like, ah man, here we are. I’m back.
Aaron (38:14):
The more closer to death the patient is, the more comfortable we are because you know, go back, these
Brian (38:20):
Are my people. I may not know a lot, but I know enough. This is the most comfortable environment for me. So I feel like we’re definitely unique in that
Aaron (38:30):
Perspective. One thing that did surprise me was, as much as I learned in PA school, starting in the er, the learning curve for the first year, year and a half, and even now, two and a half years into it is so steep mean now it’s tapered off a little bit and I feel like I’m not just treading water every shift, but man, for a year and a half I was, I was a paramedic before and I went through PA school, I should be able to work in the er. But I mean, they just throw things at you so quick and you have to be so efficient that man, I was very shocked by the amount of learning you have to do even after school, even in the er. And I mean some of these other specialties, sure it’s just as steep, you know, don’t have time to go and Google everything. You’ve gotta know your stuff and you gotta know it quickly.
Brian (39:18):
That does give me a little bit of caution and that’s why I’m not willing to tell you that should I be so fortunate to complete my education and graduate that the ER is the next best thing for me, the right fit. Because I respect medicine at that level too much to say that I know that I’m going to be ready because I don’t know. That’s good. And I’m not too proud to say that I might need a few years working elsewhere if I ultimately want to end up in the er. I may not be ready when I’m done with school. I might, but I may not. I don’t know quite yet how I’m going to fit, but
Aaron (39:59):
I get your point and I get her point. It was way harder than I thought it would be. It was a shock to the system to really realize how much learning you have to do after PA school. But I mean, that’s what paramedics are good at though. I mean, that’s what a lot of being a paramedic is too. I mean, paramedics will only prepared you so much and you do so much learning on the job too. I mean another similarity that
Brian (40:23):
Is very difficult. You have to adapt. You have to adapt. And paramedics are known for standing up to the challenge. I mean, you’re faced with something that you’re not necessarily prepared for, but you’re going to take do it anyway and you’re going to do whatever it takes to do it. And I think that you bring up a point of efficiency and I don’t know if I’ll be efficient. I don’t know. I’ve never really been a PA before. I mean, I know how to be a pretty good paramedic and I’m comfortable saying that, but I don’t know if I’m going to be a good PA yet. I certainly hope so. I think that I’ve got a certain foundation that I’m building and that I have built that is going to help me be successful. But am I going to be efficient in the er? Could it be too much for me?
(41:09)
I don’t know. I don’t. And I hope it slows down for me. I hope. I mean I haven’t been in there yet, but I hope as a provider it’ll slow down enough for me where I can be more of an asset as a student than a detriment what I’m saying. Sure. I don’t, if I’m with you, I don’t wanna slow you down and I know I will. But how much and do I get better over time the month in the er, enough time to get me to a place where when I apply for a job that yeah, I had a month in a rotation. I did okay, you should hire me. I don’t think I’m a good fit. Is it going to be enough? I don’t know, but
Aaron (41:50):
Well I think that humble attitude and kind of understanding your limits is kind of the mindset you need to exceed in whatever specialty you decide to go into. I think that’s what, that’s all people want is somebody who can take on the challenge and not think they know it all.
Brian (42:05):
Yeah man. I know. I don’t know it all. I’m more than comfortable. That’s the most thing, most comfortable thing I am say I most comfortable thing to say for me is that I know that I don’t know everything. That’s for sure.
Aaron (42:20):
What advice would you give Brian San Felipo five years ago, or EMT Aaron that wants to go to PA school down the road? What advice would you have for them? Generally
Brian (42:38):
Do your research. Figure out what program you want to go to what type of programs that interest you and figure out what you need to meet those prerequisites. Do something interesting, do something for your community. Do something philanthropic. Stand out from the page. I got the fire department and the police department involved in a coloring book in Crayon Drive. Nice. That we donated to the children hospitals in Colorado Springs. It made the news. It was kind of cool. That’s awesome. It wasn’t like a huge deal, but we came together as public service to do something like that. Study hard, get good grades. They do matter. I mean, if you’ve done everything great and your GPA is on the cusp, that might be the reason that you didn’t get in. And I think the last thing is don’t give up if this is your dream, if you have to apply four times, five times, six times, just do it. Because if you don’t try don’t hard enough. Might the time, the day that you decide not to try might have been the time that would’ve worked for you. I’ve talked to physicians who applied to med school seven times. I talked to countless PA students who applied more than once. And in essence, I feel like part of the rite of passage is to deal with not getting in because it makes you stronger. It proves to these programs that you wanted. And are you getting better? Are you improving your application every time? And when it comes to the interview, once you get one you can’t have the attitude that I interview. Well, so I’m going to go knock it out the park.
Aaron (44:28):
Yeah,
Brian (44:29):
You should get somebody to give you some professional advice on how to interview. And I only paid a hundred bucks or something, 120 bucks for my interview workshop. But it was invaluable. I gave oh
Aaron (44:40):
Priceless.
Brian (44:41):
So much from that feedback I, I gained so much from that. I utilized that to its fullest potential that, I mean that’s the difference between getting in and not right. I mean, and have to be able to also be honest with yourself and ask yourself if you’re willing to do what it takes. I’ve seen some of my classmates get in the PA school and not really understand what it takes. And to be honest, they’re not willing to make the sacrifices that are necessary to succeed. And if you’re the paramedic who thinks that they’ve learned enough and that it’s going to be a breeze a little bit of humility would benefit you. I personally didn’t have a ton of volunteer or shadowing hours. I think it has a little bit more to do with the fact that I had other commitments outside of work, my family and stuff. But I certainly would’ve liked to put more volunteer hours in. But that’s why I did that philanthropic type of thing. And it was fun to do. Honestly, I enjoyed doing it. But you know, can’t just say that you care. You have to do something
Aaron (46:02):
About it. Yeah, you gotta prove it. Yeah.
Brian (46:04):
I really care about people. I want the underserved community to have better access to medicine. Well, how are you going to do it? What can you do? Yeah, do something that’s interesting. Do something that’s different. Prove that you’re willing to do something and not just talk about it. Yeah, I think that that is a huge difference in the application. And of course not being somebody who audits applications, I don’t know how emphasized that is, how important that is. But I feel like that’s what stood out on my application potentially that in my years of experience, that goes a long way too.
Aaron (46:45):
And for people that are, for EMTs and paramedics that are debating it, I really encourage them to do it. I feel like it is the right path to go if you’re inclined to, I think a lot of people are born to be paramedics and if you’re satisfied with that milestone, that’s great. Go be the best paramedic you can be. But if you’re curious about becoming an advanced practice provider, I really think it’s a great path to go. I don’t regret it. I think it was worth it. And I know you’re not done, but I’m sure you’re going to think it’s worth it when you’re done and you’re going to set up your family for success too, that the time you’re sacrificing now, it’s going to be worth it later. You’re going to have a much better work life balance and be encouraged. Brian going to do it. I believe in you. Thank, I know you’re taking a one test at a time. I remember I appreciate taking one test at a time, but you’re going to make it, you know, went through the hard part, which honestly is getting in, right. I mean,
Brian (47:42):
I don’t know man, at the time it was the hardest part and I agree it is the hardest part, but you’re going to have to put the work in once you get in, right? Yeah. I mean it’s not going to be easy. They’re not going to just give it to you. Yeah. And one thing I can echo what you’re saying is and I might have said it earlier, but I truly believe that free hospital medicine, especially 9 1 1, and even in a facility transfer type stuff, if you work as an EMT or a paramedic, that really is an education in itself to prepare you for that next step should you want it. I remember feeling mostly satisfied with my career ambitions as a paramedic, but there was something missing and I always felt like it wasn’t enough. And I felt like I had a reach. My reach in medicine was far. I felt like it was far to begin with. But then the more I did it, the more I felt like it wasn’t long enough. And that’s why I pursued being a yay. I know that there’s going to be a lot of people who feel that way
(48:51)
Short of being a navy corpsman. I don’t think that there’s, or maybe a nurse, I don’t think that there’s a better profession that to prepare you for that next step.
Aaron (49:00):
Yeah, I agree.
(49:06)
Well cool. I don’t think I have any other questions for you. I think this will be really valuable though for people that are debating it to digest and see truly how hard it is and how much you gotta devote to it. And kind of a glimpse into the life of what a PA student looks like and hopefully helps ’em kind of make that decision whether it’s worth their time or whether they’re like, ah, you know what? I don’t have what it takes. I don’t think I can do it. And that’s an okay decision too. But my goal is to help people make that decision one way or the other. Cuz I think it’s the right career path. I think it’s totally worth it, but everybody’s gotta make that decision for themselves. So
Brian (49:44):
I mean we could do a 20 minute, 25 minute segment on a day in the life first semester versus second semester versus summer and then maybe during rotation’s, way different a day in the life would certainly be enlightening. And I don’t offer anything in the clinical part clinic clinical aspect of that, but mean every hour of your day is accounted for. And for me sleep and self care tends to be the lowest priority because there’s a lot riding on it, I think. And we don’t have to be the only resource on that. And I would certainly be willing and open to answering questions that people might have about my personal experience.
Aaron (50:34):
But yeah,
Brian (50:36):
It’s still a privilege to be here. I haven’t lost that. And I feel like just if I could say this real quick, even though I feel like paramedic school has prepared me immensely for this step, I look around my classroom and I look at all the people and once you get to know these people, man, it’s some special people around you and it’s really easy to look around and be like, man, these are really cool people. They’ve done a lot of really cool stuff. And they might be young, but they are really impressive. These are really intellectual driven, ambitious great people who are going to make medicine good for a lot of
Aaron (51:19):
Places. Yeah, that’s a good point.
Brian (51:22):
So to be part of that community is also it’s humbling and it’s also an honor.
Aaron (51:30):
Yeah. Well yeah, if people watch this and come up with questions, I’d love to talk to you again and we can run through their questions and talk more about what it looks like to be in PA school. And I mean, of all the people I know you’re in the thick of it right now, so I you have a great perspective and I love your mindset about it too. Cause I feel like now that I’m out from it a little bit, I’m kind of like, how dare they say I didn’t have any bedside manner. But when you’re in it, like you gotta realize this is what it is and just be grateful that you’re there and this is what you’re getting to do. So I think that’s a good mentality.
Brian (52:04):
Yeah. Yeah. I mean unfortunately people are going to stereotype, but they’re going to generalize. And I think you have to understand when they’re talking to you and when they’re not, and sometimes they’re talking directly to you, sometimes they’re talking to everybody else. There’s still a message in there for you. Maybe your bedside manner is good, but yeah, it’s not a bad thing to be reminded how important. Yeah,
(52:28)
I mean we just had an ethics case that talked about bedside manner regarding certain social aspects of care people’s daily lives. And it really does go a long way mean patients want to feel comfortable with their provider. And if you’re not being nice to them, I mean it’s not hard to be nice. I mean it doesn’t cost anything. It’s all on you. It’s a decision. And it also is important to remember that you can get burned out and it can be gradual. You may not notice it but sometimes you have to sit back and reflect on how you are as a clinician and as a person, how am I being received by my patient?
Aaron (53:12):
Yeah, yeah, that’s good.
Brian (53:14):
So anyways, I know we could talk about that for a much longer time.
Aaron (53:18):
Yeah, well maybe we will. I’m going to have Casey Shifflet hopefully next week to talk about burnout and stuff cuz I think he’ll have some good perspective. But anything else you wanna say here in the last minute or so that we didn’t get to
Brian (53:31):
Other than thank you, Aaron for having me. It’s a privilege. I hope that I can meet you professionally at your level someday. I’m excited about the path I’m on and I’m going to continue to work hard and I hope to be working alongside you someday.
Aaron (53:48):
Yeah. Well thanks so much for your time, Brian. I know you’re super busy and you probably got hours of studying to do tonight, so
Brian (53:54):
I do.
Aaron (53:55):
I believe in you, man. You’re going to make it through. I know it’s one test at a time, but you’re going to get there man. So I’ll leave you to it and stop using up your time.
Brian (54:04):
I appreciate you. Have a good night. All
Aaron (54:05):
Right, see you,
Brian (54:06):
Brian. Bye.
Aaron (54:07):
All right guys, hopefully you got some good value out of that. I really had fun talking to Brian and catching up. If you have questions for him, just comment ’em and I can kind of collect him and we can always talk to Brian again and get more into the nitty gritty of PA school if you have specific questions for him especially in the context of his EMS background. I think it’s super helpful to see what challenges he has in PA school and I think his mentality towards it is super valuable to kind of understand cuz that’s what you have to have to be successful. And hopefully it motivated some of you guys to realize that you can do it even though it’s hard and take the steps to move in that direction. If you guys found value in this, I’d love it if you comment, share it, like it, subscribe, do all the things so that I can keep doing these and find you guys and provide more content. If you have ideas for episodes, send those to me as well. I’d love to hear from you guys. All right guys. And just know that there are very few professions where you can actually say you genuinely save someone’s life. That opportunity doesn’t come every single day. It does happen. So you need to be prepared for it when it’s there for you. So go out there and be the best provider that you can be and I’ll see you guys next time.
