Mary Jo Bondy: CEO of the Physician Assistant Education Association (Raise the Line)
Hi, everyone. My name is Shiv.
And today on raise the line, I'm happy to be joined by Mary Joe Bondi, who's the Chief Executive Officer of the Physician Assistant Education Association, which is the only national organization representing PA educational programs.
Before assuming that role last year. Uh Mary Jo spent many years as an academic leader at the University of Maryland in Baltimore and at Anna Ron Community College and was a practicing pa herself for several years.
Mary Joe, thanks so much for being with us today. Well, thank you for the invitation.
I'm, I'm thrilled to be here. Thank you so much.
So, you have a really impressive background as both a leader and educator as well as a clinician. And I just wanted to get in your own words, um More about your background and your current role about at PA EA as well as the organization's mission.
Great. Well, you know, I've been a PA for 27 years and, and of those 27 years, I've been an educator for 25 of them.
Uh P EA has been my professional development at home and returning to PA in February of this year. As the CEO was really a, a great opportunity to bring all of my experience as a clinician and an educator and a leader um in able to serve P EA our mission is to advance the excellence of education, pa education uh leadership and innovation.
And so, you know, to be able to lead this organization uh to be able to help our over 250 programs and our over 2000 faculty uh to provide pa education and excellence in pa education is truly an honor and I'm humbled by the uh opportunity.
It's incredible. I mean, the, the growth in pa I've been observing ever since I started uh my own medical school journey.
Um I'm curious over those 27 years of your practice, how is the profession changed and how is the pa ea change itself? It's a great question, you know, uh at, at our foundation pa education is generalist education and we have not wavered from that, that commitment to uh generalist education has allowed us to maintain flexibility and adaptability to be responsive to workforce needs both at the community level, state and region level.
Um Certainly pa practice has expanded. We now see ps in almost every specialty.
Uh and we continue in our um service at a primary care level and um have expanded that role. We also see some changes related to more pa s uh involved with public public health.
And we also see a change with uh some globalization uh with pa practice. So very excited to see how uh the profession has changed over the course of the last 27 years, just in my, in my uh from my perspective.
And then we're a young pro uh profession 50 years now. And so we have continued to grow uh in number and in scale and in the ability to serve our communities.
You know, um you mentioned that there are 250 programs um that your organization represents. Uh Now when you started, how many programs were there?
And um what is that trend looking like? Sure.
Well, when I started in P to pa education in the early 19 nineties, there were about 50 programs around so 50 programs 27 years ago and now 250 programs.
So that speaks volumes about the ability of PA S, the acceptance of PA S, the utilization of PA S to expand access to care and meet the needs of a growing population and an increasingly diverse population.
That's really interesting and, and are all the programs that you're talking about in the US or uh you mentioned globalization as well?
I'd love to hear more about the international community of PA S. So great question.
So PA A represents the US population of uh pa programs. So those 250 are all bound by the US.
Um They are accredited by our current uh accrediting body, the APA uh, there is a growing interest in pa education internationally and, uh, we see that in Africa, India, uh, and across the, across Europe.
Incredible. Well, I mean, we've, um, we've had the opportunity to get to know a lot of pa s, um, through our work at osmosis and, uh, I've seen a lot of innovation come out of those programs, including, um, Yale has this online pa program run by Jim Van.
I'm sure, you know. Well, I'm curious, are you seeing, what types of innovations are you seeing in pa education?
Uh But certainly Jim Van Ree and the work that they're doing at Yale uh providing online education, uh very student centric uh education.
Um We see more of our programs really looking at team based learning models, problem based learning models, things that can be adapted to an online environment because of COVID.
So there's a lot of innovation at that. At that aspect, there's also increased innovation related to competency based education, clinical education.
We see some of our programs adopting using telehealth and telemedicine as part of their curriculum as expanding clinical uh instruction.
I know at Johns Hopkins University, we, we see medical educators um using cameras on their, on their uh on their helmets and, and as well as the like body CMS um to actually have ongoing rounds with uh with students and educators.
So, innovation is broad and wide and uh um we're learning a lot uh of uh how we can train our, our students to be ready for uh the kind of experiences that they're having.
That's awesome. II didn't, I didn't know that about the Hopkins.
Uh And what are some of the major challenges that's leading to? Uh One example is uh we've talked to several nursing organizations and uh actually getting enough clinical hours when the hospitals are sh kind of shut down in many regards, is tough, especially for certain rotations that rely on elective type of procedures.
Um What are you seeing? And, and what are some of the uh challenges facing pa education right now in the heart of COVID?
Sure. So COVID has amplified the need for um faculty to be ready to pivot to be able to provide student centric learning.
Certainly in an online um situation, almost all of our programs had to pivot to online very, very quickly, not all had been as advanced or had used online as much as Yale had in the past.
Uh Many were still still relying more on a face to face instruction model. So we've definitely seen that and we've been working with our, our faculty to help them support um and create quality learning experiences that can be delivered.
Um Virtually, the other thing is, you know, our students learn a lot of skills and those are typically um all practiced and, and taught in a laboratory environment.
So there's clear need for more innovation in that area. Um But I have been so impressed by our faculty, the um ingenious ways they've come out to be able to teach and then assess students um growth and understanding of, of how to do some of those skills.
Something as easy as history taking or physical diagnosis being taught virtually has been somewhat of a challenge. But um uh you know, the faculty are ingenious in their, in their way of creating solutions.
And then, of course, as you brought up the clinical challenges that um the clinical education is so critical to pa education, typically, most of our students have 2000 hours in, in clinical in the course of 12 months um with multiple uh areas of specialty in which they are required to rotate.
And so out of an abundance of caution for our student safety, you know, recommendations were made much like in medical school um for students to be either um removed from clinical site temporarily um to allow first responders and and and intensivist to, to really address the the acute need of um of a highly uh a highly sick and, and um affected population.
Um but then now reintroducing them back to clinical and making sure that they're going on um clinicals and are safe. But the educational experience is still robust and rigorous that they have the appropriate PPE um to maintain their own safety and the safety of those around them.
And that they're prepared really to um function in this um COVID environment where the epidemiology of this virus is still new um and not well understood at, at significant depth.
So those are things that, that we saw immediately as an association and to help our member programs adjust to this environment, we created response forums.
Um So we brought together uh our academic faculty from across the us. Over 600 participated in a response forum really talking about and sharing problems that they were experiencing and solutions.
It was an amazing sharing community. We did the same with clinical.
So a lot of our um the clinical challenges that were being faced, we had response forms for that. Again, over 600 of our faculty participated in that event.
Um And we were happy at pa to be able to convene and connect our, our faculty at a time of um you know, significant disruption.
We, we were also very lucky that pa had a robust digital technology infrastructure that had already been developed so that all of our programs could share um resources, information ideas in a secure area.
Um and they took great advantage of, of that digital platform. So we were thrilled that they were, they were able to utilize that and that could ease some of the transition for them.
Certainly. So, so are you pre pretty with all this innovation that um tho those who had been finishing up their programs in P right now will hopefully be able to graduate on time and join those front lines and, and, and the healthcare providers or is there a concern around having to change state or federal requirements so that they're able to maybe wave clinical hours or as happening in nursing, make the clinical uh or be uh you know, uh you can earn the clinical hours while actually practicing um at the end of the end of your training.
So it's a great question. So pa a education is founded on competency based education and so our programs were committed that they will only graduate uh students who have demonstrated competency.
And so that meant that there were students that may have been delayed in their graduation. However, it is a commitment to the education and the safety of our, our patients that our programs made that commitment and, and have worked with the students to make adjustments.
And I did, I where they've already met competency and then um identified where there's gaps that still need to be met um related to our accreditation standards and have made the commitment to, to move them through and progress them, uh, at an appropriate rate.
Uh, but they won't let them graduate until they've, they've, um, shown competency. That makes sense.
And, I mean, that's something that I wish more health professional programs adopted as competency based education because, you know, some of the pa s your training probably come in with, uh, EMT experience or ascribing experience, uh, where they can take HP, hi, history, um, uh, of patients and, and whatnot.
And so being able to kind of graduate faster potentially or, or later if they need more time is something I wish we had in medical school.
Um One of my favorite pa a educators used to be at Wake Forest and now is at, at Still University. His name is Ted Wendell.
Um And um they're setting up new pa programs in California, I believe. Um and his vision is to have uh community based training programs um where, you know, in partnership with the National Association of Community Health Centers, they're able to recruit people from the community and then have them stay in the community to work is, you know, I'm curious, is geographic distribution and an area of concern for pa s where like maybe they get trained in a place and then they go to metropolitan areas or do PA S tend to work in the local communities where, where maybe they grew up or, or have affiliations too.
It's a great question, you know, PA S were really founded to meet community need and access to care. Um And so that's in our DNA.
Um we have looked at pa practice and workforce issues and we do see that there is migration to areas of um urban concentration and economic um you know, vitality.
However, there is a core um understanding that PA S were created to meet community needs. And so the innovations that Ted is talking about related to recruiting people from communities, keeping them in their communities to be uh to, to be educated, involving those health systems in, in that education process and then encouraging them to stay is actually alive and well across the uh the USI will say that um I know in Maryland I was involved with on the eastern shore doing just that um being able to help recruit people um from uh the eastern shore and make sure that they were trained there so that then they could stay in that health system we need.
I know that there is a um a great amount of uh research showing that students that have that academic, that support during the academic process.
Um and who are familiar with the health system and then who are also recruited from that health system tend to be very successful.
Um So we definitely want to see PA S in community training environments um in partnership with the health systems and, and local communities and then retained in those communities.
Uh We we see an, a growing number of pa programs in rural areas um because the need is so significant totally. Um That's ii guess that explains why there's been such exponential growth in terms of the program as well.
Number of programs and number of students, um, two other kind of hot button topics in health professions. Uh you know, nursing and medicine.
I know for sure are burnout, um as well as uh debt, student debt. And I'm curious how does um how is your association and the profession as a whole?
Um deal with both of those issues right now? So wellness is, is a focus of part of the education process, right?
We have to focus on both faculty wellness as well as student wellness and really building those skills for resilience and self care from the very beginning.
I know as a program director and certainly, um in leadership, one of the things I often found myself talking about with faculty and students were really taking care of self before they could care for others uh and making sure that they were self monitoring, uh their ability to be able to care for others.
And, and we see that um it's so important as we see what's going on with COVID-19 right now, um how burnout is being accelerated.
And uh so I'm very concerned about that and it's something that the Education Association is working to emphasize and provide resources for uh to help um educate students on how to maintain their, their health and wellbeing throughout the education process and then um ultimately into their career.
Um the other issue is student debt and student debt has been steadily climbing. Uh We know that there is we have some concerns that student debt also um may restrict uh the interest of our students of going into primary care or um specialties that just traditionally do not have um a uh a higher salary if you will.
Um So we advocate consistently to, to be able to reduce student debt or provide aid of oftentimes through the National Health Service Corps, um and through loan repayment uh and uh to meet the most uh the needs of the most vulnerable and you'll see our students definitely meeting that call um to serve in underserved communities.
And many of our programs have that in our mission uh to serve under serve committed uh communities. And we work to advocate on their behalf that they might have title seven funding uh to help them recruit, retain and decrease debt of their students.
That's, that's great. That's great to hear in both of those accounts that it's front and center um back on the debt uh issue.
Have you heard of the concept of uh income share agreements? I SAS I'm curious if that's made its way into pa education yet, it's getting more popular in like data science and computer science education to is, is where it started, I believe, you know, I think that that financial model has probably not moved its way too much into pa education yet, but II am open to innovation and, and creative thinking related to how, you know, we can lessen student debt um and, and encourage them to, to meet the needs of, of workforce needs of the state and regional le level, especially if we're trying to recruit um people who, who otherwise may not uh go into the profession to, you know, because of financial reasons, as you were saying, um I know we're almost at the time.
So I guess one core question I'd like to ask, given the, you the hats you've worn both in leadership and, and being a clinician yourself and in education, um is since we y you know, our audience, we have over 2.5 million current and future health professional students.
Uh I'm curious what advice you would give to them if they're considering going into uh a career as a physician assistant, um especially given all that's happening in COVID if you could rely in 27 years and you were starting your career, what type of advice would you like to have heard?
Yeah. You know, 27 years ago, um I was inspired and encouraged to become a pa a um to help serve in, in, to help serve the underserved uh in North Carolina.
I have absolutely no regrets on the decision that I made um to become apa particular, it has my pa education has provided incredible flexibility, adaptability, my ability to work in multiple specialties because of my generalist education uh then to pursue academics, education and leadership.
Um So the sky is the limit for anybody who's thinking about uh pa a education. I would say that, you know, your personal goals should align with the, the goals of the institution that you're looking to um you know, join as a, as a student.
And then to understand that this career is a lifelong commitment to learning that you will always be learning, you will always be in service.
Um And it is truly noble. There are definitely inspiring words and uh couldn't agree more.
So, um is there anything else I should have asked that you, you wanna kind of get a grasp or comment about? Um You know, I think I would, if I, if I could have the opportunity just to highlight again our faculty and how amazing they've been and the response to um COVID, you know, they have shown tremendous resilience, tremendous innovation.
And one thing I didn't mention to you is that we know that 86% of our academicians are and faculty are clinically practicing.
So they're, they're not only balancing the challenges of uh shifting to online learning or um managing innovation and how to teach.
So I just have to give a shout out and recognize them. They're amazing totally.
And, and I mentioned two of them that I know uh Ted and, and Jim, it's uh incredible that every pa faculty member and student I've met, I've uh um been very impressed with.
So, thank you for all the work that you're, you and the organization are doing. Mary Joe.
It's been such a pleasure having you on today. Well, thank you for the invitation and the opportunity to speak with you.
And I'm so grateful for your leadership in this space and, and I look forward to speaking with you again. Same here.
So, uh with that, I'm Bulani. Thank you again for checking out today's show and remember to do your part to flatten the curve and raise the line.
We're all in this together. Thanks again.
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