The Why and How of Joining the ‘Best Profession in the World’ - Dr. Katie Bean and Dr. Beth Macintire, Co-founders of Pre-PA Clinic

SHIV GAGLANI: Hi, I'm Shiv Gaglani, and today on Raise the Line, I'm happy to be joined by Katie Bean and Beth Macintire, who are co-founders of  https://prepaclinic.com and hosts of the informative and entertaining podcast Where the White Coats Come Off. Katie and Beth are physician assistants with over a decade of cumulative PA academia experience, including Doctorates in Medical Science. Their clinical backgrounds cover orthopedics, emergency medicine, regenerative medicine, and aesthetics. Their self-appointed mission is to provide medical professionals and students with the tools and tips needed to be competitive and successful candidates for acceptance into a PA program. So Katie and Beth, thanks so much for taking the time to be with me today.

DR. KATIE BEAN: Thanks for having us. 

DR. BETH MACINTIRE: Yes, we're super excited to be here. 

GAGLANI: Can you start by telling us a bit about what first got you interested in a career as PAs, and then ultimately pursuing doctorates, and then hosting the podcast? 

DR. BEAN: Sure. So I was actually on track to go to med school and I didn't even know what a PA was until probably my junior year of undergrad. One of my lab partners had told me about what a PA was and I was totally attracted to the fact that we could switch specialties, and go into different specialties, and I have shiny object syndrome. So that was perfect for me. I always knew I was going to go into medicine. I've always loved science, always loved medicine. I also wanted a career path that would allow me to practice internationally and globally. So that was my big reason. 

DR. MACINTIRE: Yes. I come from a little different background. I was a military kid. My dad was in the military and as most of us know, PAs stemmed from military medics. The military still uses a lot of PAs. So growing up, that's why I never saw a physician; I always saw the PA. My best friend's dad was a PA. So I always knew about the PA profession, and I was a big athlete. My  root was physical therapy, because I thought, “I really want to do rehab.” I was a big soccer player, and half the girls on our team had to have ACL reconstructions and rehab. So I was very familiar with that.

But in undergrad, with a lot of shadowing, I realized that physical therapy wasn't really where I wanted to go. I wanted to more go the diagnostic route. I remembered all the time I had spent with my friend and her dad as a PA. I started shadowing more PAs, and then realized that this is really the perfect blend of medicine. You get a lot of autonomy; you get to make diagnoses; you get to give treatment plans, et cetera, and you have this wonderful relationship with your collaborating physician. I really, really was attracted to that. That's why I ultimately ended up going to PA school. 

GAGLANI: It's an incredible profession. We've been very fortunate to work with I think over 30 PA programs, and have had a number of PAs on this podcast. I'm curious, you both became practicing physician assistants and you started an educational consulting business together, Pre-PA Clinic. First of all, how did you two meet? What made you decide to start this organization?

DR. BEAN: We started working in academia at the same PA program, hired on the same day.

DR. MACINTIRE: April Fools' Day. It was April 1st.

DR. BEAN: They stuck us in this tiny closet and we both have our offices in this tiny closet and we just really clicked. We love trail running. We love to exercise. We were doing push-ups in the office when our students weren't in there with us. 

DR. MACINTIRE: Yes, we figured out we both love to travel. We both had unconventional childhoods. We didn't grow up in the same place, like a lot of people do in United States. I grew up overseas. Katie grew up traveling a lot with her dad. We just had a lot of things in common. In that first week, we were like, "Oh my gosh, we're so alike. We should start a business together," and we kind of laughed it off. Five years later, skip forward, middle of the pandemic, and then we finally just saw the need of these students for informative information about the PA process. The PA career is exploding, and we realized that, "Hey, a lot of people have never heard of it. They don't know about it until they get to be a junior or senior. They're unsure about the application process. They don't know what makes a good PA." If students are intimidated or unable to figure out kind of the crazy PA application process, then we lose those students, and we want to keep those students. We want to keep these amazing students that we have. 

That was kind of the impetus to start pre-PA clinics. It's like, "Hey, not only are we certified PAs, but we also worked in academia." So we've reviewed CASp applications. We've done PA school interviews, and we know what we're looking for, and we don't want students to feel like, "Hey, it's too late. I'm too old. I'm too different. I started my journey too late." We want everybody to be able to be a PA if they have the passion and the drive. 

We just found out there is so much misinformation out there, and so many students who didn't really have anybody to help guide them through the path. We thought that was really unfortunate that students wouldn't have a mentor. So we decided to start Pre-PA Clinic to just give a leg up to those people, to help them, to answer questions, and really just to keep the enthusiasm and the drive for these students. We didn't want to lose them to other professions, because we love our profession. We see it getting even bigger and exploding more in the future. PAs are becoming more international now. It's so exciting and we didn't want to lose some of these students that we think will be amazing providers. So that's why we started Pre-PA Clinic. 

GAGLANI: That's awesome. It was actually a good segue into my next question, because the reason we even launched this podcast is because the problems that we've both identified—of trying to raise the line, of improved healthcare capacity—require us investing in our workforce. First of all, getting a larger and more diverse applicant pool into these health professional programs, getting them through the programs, which is why my co-founder and I even started Osmosis, to help people get through these academic programs, and then keeping them in the profession longer. 

COVID has obviously thrown a huge wrench in it. I think there are some tailwinds where people are like, "Oh, I want to be a frontline healthcare hero, too," where some other people who are currently in the profession are burning out because they've been at this for 18 months and there's no sign of stopping. One of my good friends, Michelle, is a PA in LA, and she was telling me that 18 months later, it's as bad as ever, at least with the pandemic. I'd love your thoughts on how the pandemic has affected your business, as well as the broader PA profession, both in terms of getting people into the profession, keeping them in school or getting them through school, and then afterwards, keeping them in the profession longer. 

DR. MACINTIRE: Yes. I think it's really interesting, as you said, there's a dichotomy. There are people who are just decided, "Hey." The pandemic for a lot of people, it was time to think. It was time to relax, time where you don't have outside distractions. You stayed at home, and you really had to kind of re-evaluate your priorities in life. There are a lot of people who realized, "Hey, I'm not making the impact I wanted to. When I was 16, I wanted to do these things. I haven't done these things yet." It was the reality that we don't know if we're going to be able to do these things yet. There are people who are getting sick. There are people dying. Travel was stopped. So there were a lot of things happening that kind of made a lot of people realize, "Hey, seize the day," carpe diem. 

We had a lot of students who are like, "During the pandemic, I realized I wanted to do more." So maybe I was a medical assistant and realized, "Hey, I wanted to help more," or maybe I was in music or drama and realized, "Hey, this is great. I love this. But this is my recreation. I really want to make an impact in the world." We have seen a lot of students start in COVID. Because a lot of times, it's, too, because they struggled. Maybe they have some mental health, or someone in the family has mental health. They realized, "Hey, there really needs to be more providers."

I do think that we have seen a lot of students move to the PA profession when they were undecided or unsure, or came from other paths. But a lot of our friends who are certified PAs, and us ourselves as well, we were still working clinically in the COVID. It has been a huge burnout, right? There are some people who are like, "I don't know that I can do this." There's people who are going to social media—you've probably seen it, literally crying, saying, "Please vaccinate. Please vaccinate. I don't know how much longer we can do this.” Hospitalists, for example, we've got some hospitalist friends and they have been overrun.  

We have some former students of ours who went up to New York City, and helped run the ventilators and stuff in these big cities. We've really been coming together as a healthcare community. I really feel like that. But I feel like there are people burning out. People are like, "I don't know if I want to do this anymore," because there's this perception that the public doesn't care, right? That they just, "I don't want to vaccinate or I don't want to do this or that," and who knows what the reality of this is, but social media and media in general is saying, "Hey, the public doesn't care. They're not going to do what they want to do."

I know some of this is sensationalized, but I think some healthcare providers are really turned like, "Hey, I'm doing what I can to help you and you're not doing your part for it." They feel kind of like people are ungrateful, or just don't understand the sacrifice. So I do think there's a dichotomy of what we see. People are burning out, but I think that there is also a burning desire in students to actually make a difference and realize, "Hey, this is a great way that I can help people. Not only my family, but my friends and my community." Hopefully, that will all balance out, but I do kind of see both sides. What about you Katie? 

DR. BEAN: Yes, and I totally echo that. Burnout was a huge issue prior to the pandemic, and then it's tenfold now. However, our profession—and we may be biased—but our profession is literally the best profession in the world because we get to see the upcoming generation. We get to work with that generation that's going into PA school. We're so blessed to be able to work with them, because they're just good people. They're good souls who really want to make an impact. They want to serve. They want to do so in our country, globally, they want to make a difference. 

GAGLANI: Totally. Some of the best people I've met are PAs. The ones I've met, a lot of times, they come to the healthcare profession a little later in life, after having worked in other careers, as you mentioned, and PA just makes the most sense for a lot of different reasons. It's almost like when people go through a couple of relationships, and then ultimately find the one. Similarly, I think they go through a couple of careers and find the one. Then they're more committed because they know what they don't want; they know what they do want, et cetera. 

Congrats again on releasing the book this year "Secrets, Tips, Tactics & Everything You Need to Know to Get Into a PA School (https://prepaclinic.com/?product=book-secrets-tips-tactics-everything-you-need-to-know-to-get-accepted-into-pa-school)

Can you give us a bit of a sense of what inspired you to write the book, and then how you're distributing it? Any other color you want to share? 

DR. BEAN: Sure. We wrote it because we saw candidates making the same mistakes over and over again. There was also a lack of direction during the undergraduate process to PA school. There are a lot of hoops you need to jump through, a lot of prerequisites that you have to meet to actually get into PA school, so we wrote it for that reason. Seeing those same mistakes over and over, we wanted to help candidates to not make those mistakes, to give them a better chance to get into PA school, and kind of demystify the whole process. 

DR. MACINTIRE: Yes. As you alluded to, it's a second career for a lot of people, and I think that's what makes PA special. A lot of people come with a lot of different life experience. They come with a maturity level. But also, if you imagine you're 32 years old and you've been working, you feel a little intimidated by, "Okay, going back to school, taking prereqs again." A lot of people, when they went to school the first time, it wasn't all online. Right now, the application process is online. All the testing is online, so that can be really intimidating. 

The students we have, as Katie said, we're so blessed, because people who want to be PAs and PA students are the most driven, compassionate population or cohort in the United States. It is so true. If you tell them the things that they need to do, they will go out and do it. They just need some direction, because a lot of schools don't have pre-PA clubs. A lot of students have guidance counselors or advisors who can give them advice, but who don't actually know the inner workings of PAs. So for us, we come not only as certified PAs—we've been through the process ourselves—but we come from, "Hey, we've taught at different PA institutions." We understand why they asked these questions. We understand why this is a requirement. It's not just a check in the box, what it actually means to us and what we're kind of looking for. We come from it from that type of background. Again, we just wanted to kind of level the playing field and say, "Hey, anybody can figure out what you need to do to get to PA school. And here's step A, here's step B. Here are your options here and figure out what fits your background." 

The great thing about PA school is that there's over 200 schools. There's almost 300 schools now in United States. You can find someone right who fits your background, who fits your experience, who fits what you want, your mission statement and your vision for your future. You can find someone. It's just kind of wading through all that red tape of, every school has a different opening date. Every school has a different closing date. Every school starts at a different time. They have different prereqs. It can get so overwhelming that people are like, "Never mind. Maybe it's not for me," and we didn't want that to happen.

We decided a book might be one of the best ways to do that. One, because we love to read. Total nerds here. Two, it was just something that we thought could be updated regularly and just for our students who maybe weren't on social media. If you're forty-five years old, maybe this is your second or third career, maybe you're not on Instagram. But you could purchase the book, and ours is online as PDF. So you get emailed it right away as soon as you get it, and you can go ahead and read it and highlight passages and figure out what you need to do to make yourself the best candidate and make yourself really, really strong, and figure out what we're looking for in PA school to see if it matches you.

That's kind of why we went with the book at first, because we know not everybody's on social media and not everyone wants to be on Facebook, and it kind of transcends generations, transcends cultures. Everybody reads. We just figured that it might be a really good way to, again, reach everybody. As you talked about, we need more diversity; we need more people. We need everybody: all cultures, all ethnicities, all backgrounds. Something like a book, I think,  can kind of reach out to every single person. 

DR. BEAN: That's kind of the beauty of PA school as well. We sat on the admissions board and we don't take the top ten percent of GPA. We look at the entire application. So yes, they may have a lower GPA, but they have all of this incredible clinical experience, they were a medic in the military or whatever. They have a really, really strong personal statement. They have excellent shadowing hours. We look at the whole thing. A lot of applicants don't realize that, so they get really freaked out by a less-than-average GPA, and they don't realize that they just need to apply to the right programs that really value their other strengths. 

GAGLANI: That makes a lot of sense, having applied to health professions programs myself. When I was in my first year of med school with Ryan, my co-founder at Osmosis, one of the things that impressed me was, there were a few students who were in their 30s and 40s after serving in the military, or bartending, or immigrating and learning English in the US, and becoming an electrician before going to med school, and showed the diversity of paths. But generally, most people will fit the mold of two years out of college, academic rock stars, et cetera. 

What is some of the advice you'd give to our listeners, many of whom are pre-health professions, about getting into PA school and why they should go into PA school? What are some of the biggest misconceptions that you hear from people who come across your site? If you had an FAQ, what would be one or two things that people think about the PA profession, or about getting into PA school, that you constantly have to debunk?

DR. MACINTIRE: That's a great question. Let's start with the second part. Some of the myths that we have, and Katie alluded to this earlier, people think if they don't have a 4.0, that they're not going to get into PA school. So it is truly a holistic process. We have literally told 4.0 students, "No, you're not right for our program," and we've literally accepted 2.75 students. There's tons of studies out there that show GPA does not 100 percent correlate with success in life. We know that, especially if it's a second career for you, you're not the same person you were at eighteen. So yeah, maybe at eighteen, you had too much fun. You partied, whatever. Now you're thirty-eight, been in the military for ten years. You have two kids; you've learned some maturity, and you've learned some things through life. We do take that into account.

There's actually a lot more non-traditional students in PA school than you would think. We get told all the time, "I'm too different. I'm too old. I'm too late.” We hear, “I'm too late” all the time. There is no late. What time frame are you thinking late? Anybody can be a PA. If you still want to work and want to serve and want to impact the world, there is no late. You're on your own timeframe. So those are two things that we really have to debunk, the fact that you have to be perfect, because it's not true.

In fact, our best students are usually the ones that, I mean, obviously they have great critical thinking skills and great grades, but it's things like compassion and things like empathy, the things you can't teach, that make the best PA. We can teach you medicine, right? If you're willing to learn, and willing to put the hard work in, we can teach you what you need to know, but you need to come with the compassion, the empathy, the desire to serve. You need to come with those kind of personal qualities, or soft qualities, or soft skills, as they say, because that's what really makes a difference. Your patients are going to be able to tell if you care about them, or if they're just a number, just a charge, just another chief complaint to get through. So the best PAs are the ones that come with those qualities. 

Your GPA, yes, I mean, obviously, you need to maintain a minimum, but otherwise, I really don't care whether you graduate with a 3.0 or 4.0. If you pass your boards, you're a PA, right? You're certified. So once you have that certification, no one's ever asked me, "What did you get in PA school?" "What did you get in this class?" No one cares. Because once you become certified,  you assume that you have this basic level of knowledge that the certification test shows. So that, and then the whole, "I'm too late” thing. You are not too late. You're not too different. You haven't made too many mistakes in the past, because, again, we know you're not the same person. We're not the same people we were at 18 either, right?

DR. BEAN: Thank God.

DR. MACINTIRE: I know, right? We just love to see that maturity. We love to see that difference, and we love people from different backgrounds, because you come from a different viewpoint than someone else. For example, like maybe, as you said, you immigrated, you learned English, and now you want to serve. Well you come from a background and you have a viewpoint and you have empathy for things that we're not going to be able to have, because we haven't had those experiences. So having people with all kinds of different experiences, like "Hey, I dropped out of college the first time, because I was wild and crazy and didn't want to study." Okay. "When I went back the second time, I realized how important it was, and I really, really buckled down." Those are the kinds of experiences we want, because it just shows that you're a real person. PAs are real people, and your patients are real people. We want people of kind of all different experiences and backgrounds, because you come with a different viewpoint that can really help your patients.

DR. BEAN: Yes. I'd also like to tell pre-PAs, quit being so hard on yourself. That is one of the biggest things: give yourself some grace. We have clients that come to us and they're like, "My GPA is 3.6 and I've got 2,000 patient care experience hours, and I'm never going to get into PA school." We're like, "You're awesome. You're amazing." So just because you don't have a 4.0, like Beth said, we have told many 4.0s no because they're weren't a great fit for our program. The other thing is that same compassion and empathy for being a great healthcare provider. When you're applying to PA school, let that come out in your personal statement. That's really important, because the rest of your application is just basically stats. It's numbers that you can't really change. But your personal statement is a really great place to let all of that passion that Beth was talking about come through. 

DR. MACINTIRE: Yes, and it's scary to kind of be vulnerable and to tell stories and to tell how much this means to you, but that's what you have to do. Because there are a lot of people who apply to PA school, and if you want to stand out, you have to be true, because the people interviewing you are clinicians. Our job for a living is to talk to people and get the cues and kind of figure out what's really going on: what they're telling us, what they're not telling us. We are very good about ferreting out what the truth is. So don't tell us what you think we want to hear. Tell us the truth, because clinicians, we just know. We know if it's sincere. We can tell if it's sincere, especially during the interview.

So don't feel like, "Hey, I read this answer online and this is what I need to say." No, we really want to hear from you, because the whole point of the PA interview process is to see if you fit with our school, right? Every school has a different culture, different values, different mission statements. You might not be right for every school, and that's okay. It's just like, as you said, with people, you just need to find that one person. You need to find that one school that works with you, that matches your experience and backgrounds. Maybe these 10 schools don't, but maybe these five schools do. 

Every school weights things differently. Every school has a different characteristic that they're looking for in PAs. Look at their prereqs. Look at their mission statement. Look at their values. Look at what they do in the community, and figure out which one you think matches best with your passion and drive. Then it's really just a shoo-in. When you find the school that matches you, and you show them your passion, your personality, as Katie said, then they're going to want to accept you.

GAGLANI: That's wonderful advice that you packed in there, and it applies to really all professions, but especially I think PA, which you guys know so much about having been on the admissions committees. 

Quick question I had about the PA degree, because what we're finding is, there a lot of people in the medical school world, and increasingly in nursing school, too, who are doing joint degrees. I was on an MD/MBA track. I haven't finished my MD; I took time off to start Osmosis, but I did finish my MBA. I'm curious, are a lot of PAs pursuing Masters in Public Health, or Health Administration, or even something else? Is that something that's common? Are there any joint programs at this point?

DR. MACINTIRE: There are a few dual degree programs. Most of them are like the SMS. It's a five-year thing. You come in as a freshman, you take two or three years of undergraduate, and then if you meet certain criteria, you automatically graduate into their master's program. There are about half a dozen schools or so that do have this dual degree. Most of them are that. I think there is one school that has an option to get a public health and PA degree at the same time, but most of them are dual degrees with the bachelors.

Now, we do have a lot of students come in with master's degrees already. Public health is a big one; any kind of biological sciences is a big one. We've had people with engineer degrees, with history degrees, nutrition, people who have RN degrees, occupational therapy degrees, et cetera. There are a few programs that are like, "Hey, if you know as a freshman like this is what you want to do, you can enroll in these dual degree programs." Then again, one school offers a Public Health Masters along with the PA Masters. You do have to take extra classes for that, and so it's a little bit longer. 

GAGLANI: Got it. That's helpful. I'm sure as more schools offer the PA program or degree, I'm sure there'll be more cross-collaborations between the public health school or the business school or maybe engineering school. Who knows? 

So you guys are obviously super-engaging guests on our podcast, but you also run your own podcast, Where the White Coats Come Off. There's an episode where you talk about why failure is actually a good thing. I wanted to delve into that topic because a lot of people, especially people listening to podcasts like this, are very hard on themselves. As you said, Katie, they don't give themselves much grace. So can you talk a bit about why failure can be a positive? 

DR. BEAN: So failure is absolutely essential to growth. It's just part of life. You're going to fail at something eventually, and we actually learn so much more from our failures than our successes sometimes. For instance, if you think back to a big exam. I'll use myself as an example. When I was in PA school, I had an OSLER, and I totally blew it. I mean, blew it. It was terrible. So I learned more from that, and I will never ever miss that diagnosis on a patient, and what I need to order, how to diagnose and treat and all that jazz, I will never miss that, because I failed that. 

DR. MACINTIRE: Yes, I actually think failure's a really good thing, and I think you should fail as a child, so you learn to get over it. But a lot of kids these days, they're not allowed to fail. We can talk about society, school system, whatever. They're not allowed to fail, because that would hurt their self-esteem, or for whatever reason, but the problem is, it's a lot easier to deal with something as a six-year-old. A six-year-old blows off stuff. If they get the answer wrong, they don't care. But by the time you get to be 16, you're not going to raise your hand in class unless you're 100 percent sure you're going to get the answer. Because again, you don't want to look like a failure in the eyes of your peers. You don't want to be made fun of.

There's a lot of societal reasons for this. Somewhere, growing up, we come to think, "Hey, failure's a bad thing." But scientists fail 100 times before they find the right antibiotic, or before they find the right mechanism of action. In life, you are going to fail. We love people who've shown that they've failed, because it shows that you have coping mechanisms. It shows that when things don't go perfectly in life, whether it's academic, or I didn't make the team, or I missed the goal shot to win the championship—whatever it is, being able to overcome that is so important because life isn't going to be perfect. 

In PA school, out of PA school, there will be things—whether they're work things or personal things—that are going to happen to you, and you have to be able to be able to move on from that. Again, it's a lot easier to learn to fail with grace and give yourself like, "Hey, I tried my best” type thing, or "Hey, I'm going to do it a little bit different next time," than it is to learn that as an adult. They say a lot of times, “You fail, you fail, you fail, you fail 100 times and all you need is that one success.” I think in this kind of business, we understand that. Not everything works. But being able to realize, "Hey, I didn't do perfect, but I'm still going to keep going." So something like failing an OSLER, Katie did have the coping mechanisms to realize, "Hey, that doesn't mean I'm a failure."

You are not a failure. You just failed at something, right? To pick yourself up and be like, "Okay. What am I going to learn from this? I need to study differently. I need to figure out these diagnoses. I guess I realized I didn't understand how to look at this," or whatever it is. She learned from that. She's like, "I'm never making that mistake again. This is what I've learned." That's growth. If you can't do that, how are you going to do that as a clinician? Because sometimes we don't know what's going on. We have to get some tests. Sometimes, we think this is the diagnosis, and we find out later, actually, it's something else. 

There are just times when you're just going to have to fail, or be unsure, or not know. And if you don't have those coping mechanisms, it's going to make it really hard in life. So my thought is that we should let children fail, and we shouldn't punish it. In school, you're punished for failure. If you're like, "Hey, how do you spell this word?” or “What is the middle of the cell called?” and you get a point off. Instead of using it as something positive, like, "You tried, and why did you think that way?" figuring out where it went wrong and changing the thinking process so we get the right answer, we just say, “Ah, sorry, point off.”

I know that this is getting deep ingrained into what our society and our school system does, but it punishes failure until you get to the time that when they're 18, they are too afraid to tell an answer out loud, because it might be failure. They see failure as something bad, instead of as, "Hey, I was curious. I thought this might be the right answer. Why was it wrong?" Because that's really what's important. They just care that they got it wrong. But really, the important part is, "Why did you get it wrong?" Was it wrong thinking, was it wrong information, did you just have no idea? I like to think, "Okay, we need to figure out where we went wrong, and think where the thinking process went wrong."

This is a big thing in PA school. On your differential, if you have a standardized patient and you get it wrong, well, it's not the fact that you got it wrong, it's the thinking process. “Okay, you thought it was pulmonary. Why did you think was pulmonary?” “Well, because they complained of shortness of breath.” “Well, did you even think about this, and this type of thing?” We need to figure out where the thinking process goes wrong, and fix that, instead of just punishing the failure. At least that's my opinion. Sorry. I rambled on a lot about that. 

GAGLANI: Well, no, you're clearly passionate about it, and it's good advice. Again, not just for people going into PA or health professionals programs, but in general. That's why I resonated. 

So I know we're coming up on time. I had two last questions for you. The first is, what's one big piece of advice you would give to people considering careers in health or PA right now, about meeting the challenges of COVID and beyond?

DR. MACINTIRE: So my biggest piece of advice is, find your deeper why. You ask people why they want to be a PA, and they're like, "Oh, flexibility," and they can tell you all these surface things. But to make it through the PA application process and to truly make it through PA school, you really have to dig deep on why. So, okay, I want to serve people. Why do you want to serve people? What in your background, or what in your person, your soul, whatever it is, makes you want to serve? Because when times get hard, the students that have the deeper why, that are doing this for a reason, are going to fare so much better than the students who maybe when times get tough, they're like, “It's not worth it,” because they don't have that deeper why. Because it is tough, it's expensive, it's time of your life, life energy. It's everything to get not only to PA school but to get through PA school, so find out really why.

Sometimes, it takes a lot of asking yourself, "Okay. I want to serve, but why do I want to serve?" "Because I want to make a difference." "Well, why do I want to make a difference?" It's really getting down and keep asking why, until you get to the core of who you are, and hold onto that. Because when times get tough, it's the people who are in it for the right reasons that are going to weather the storm, whether it's burnout, or testing, or getting into PA school. Whatever it is, you are going to weather that storm, and you are going to be an amazing PA if you can hang on to that why.

DR. BEAN: Great minds think alike, because Beth took my answer. I'll go with a more practical answer then. Make sure you get some really good solid patient care experience, for all the pre-PAs that are coming in, because this really builds a solid foundation for when you get into PA school. It's much harder for the students that we've had who have zero clinical background, zero clinical experience, to come into PA school blind, essentially. They're learning a new language. The medical language is totally different than any other language they've heard before. They don't have the frame of reference as the other students that we have, that have had a good background in patient care. So think about things like Patient Care Tech, Medical Assistant, phlebotomy. If you're in the military, medic is amazing. Every single medic we've come across has been incredible. Really, really try and get some patient care experience hours underneath your belt, because it's going to make PA school so much easier, and to go a little bit smoother for you. 

GAGLANI: That's awesome advice. My last question, anything else you want our audience to know about you, about the book, about pre-PA clinic or the profession as a whole?

DR. MACINTIRE: I guess we're biased but we just think it's the best profession. We think that anybody who truly wants to be a PA can succeed and can become a PA. So never stop striving. Never stop achieving. Everybody's journey is different. We have worked with people who've taken four cycles to get in, and we've worked with people who got in their very first cycle. So don't compare yourself to others because comparison is the thief of joy, right? And we know that.

Students end up comparing themselves, like, "Oh, I had the exact same stats as him and he got into this." I'm like, “You're not him.” “You're not her.” You have different experiences, and you're unique. Hold that uniqueness, and be proud of that uniqueness. Just realize that your journey is going to look different than someone else's, but it's okay. Because at the end of the line, when you become that PAC, and we all become colleagues, it doesn't matter if you got in your first time or second time or third time. We all end up in the same place. We all end up serving and impacting our communities, so just realize that your journey might be a little different than someone else's, but that's not bad. 

DR. BEAN: My last thing is, if you love PAs, wherever you are, whether you're a doc, whoever's listening—a doc, an NP, a PA—advocate for PAs to go global. Beth and I have a huge passion for international PAs. We think that PAs should be in every single country in the world. There's no reason why we shouldn't be. So if you love a PA out there, advocate for our profession to go global. 

GAGLANI: That's awesome. It's definitely close to our heart. One of my favorite pages at Osmosis is osmosis.org/world, and we have stories from nurses and doctors all around the world, and increasingly PAs now. In the UK, there's a huge PA contingent, but do you know how many countries PA is in at this point or?

DR. MACINTIRE: Like 18 or 20?

DR. BEAN: We've interviewed quite a few, so it's about—

DR. MACINTIRE: UK, Canada...

DR. BEAN: Twenty-two, I think?

DR. MACINTIRE: Yes. I mean, even Africa has PAs. India has PAs. UK, Canada, obviously, that are close to us. Netherlands has PAs. We do a lot of international PA podcasting, too, and it's really quite amazing. Sometimes, they're called different things like they're Physician Associates in UK, and then, in South Africa, they're called...

DR. BEAN: Clinical Associates, I think? 

DR. MACINTIRE: Something like that. They have different names, but they all stem from the PA profession. I think it's amazing. The good thing about it is that they're kind of tailoring it to the community needs. The community needs in Africa, for example, are going to be more infectious disease, and less chronic disease, right? They realized that and tailored their PA education to the things that their community needs. It is very much like organically, "Hey, what do we need in our community and in our country?" which makes so much sense, because if you just carbon copy what we do the United States, it's not going to be appropriate for patient populations in different areas that have different healthcare needs. 

GAGLANI: Awesome. Well, that's a great thing to end on. Katie, Beth, thanks so much for not only taking the time to be with me on the podcast today, but more importantly, for the work that you're doing to help get people into PA professions, and then ultimately to raise the line and improve health care capacity. 

DR. BEAN: Thank you. Thank you for having us. 

DR. MACINTIRE: Yes. Wonderful talking to you. Really appreciate it. 

GAGLANI: With that, I'm Shiv Gaglani. Thank you to our audience 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. Take care.