 I love people's reactions when I tell them what I do. They're either really grossed out by it or they think that I am amazing. It should not take all day to do a placenta. I was training on twins. Pathologist assistants, we are the eyes and the hands of the pathologists. The draw for me is having a job where I get to work with my hands and I'm not stuck to a computer all day. Fast paced, moving all the time. These are looked at as a leader in the lab anyway. Top of the pay grade, non-faces, masters. I love that every day is different. I'm still seeing new things every day, learning new things. I love that it's so gross. To me, it's kind of like this morbid Christmas morning where you have all these presents to open up and you just don't know what you're gonna find. So the way I would summarize it is if you really love the human body, especially gross pieces of the human body and you wanna see that and work with that every day and you think it's exciting, this is the job for you. Yeah, it's like dirty jobs. So if you love healthcare but you would prefer to be behind the scenes, this is a really good place for you. So I'll just vomit some knowledge on you. That's exactly it. You got a lot of knowledge I don't. That's why you're here. So I'm very thankful for that and I think it's gonna help a lot of people. Hi everybody, my name is Boris. Welcome to my first episode of healthcare career highlights. Today we're talking with Shauna. She's a pathologist assistant, not to be confused with physician assistant. So for the rest of this video, when we say PA, we're talking about the pathologist assistant profession. Shauna, thank you so much for taking the time to meet with me and to tell the world about your profession. I'm happy to be here. So all I really know about being a PA, a pathologist assistant is that you work in the lab in the hospital. You have great hours and you make like a hundred grand a year and that sounds pretty sweet. So what is a pathologist assistant? So a pathologist assistant is just like a physician assistant. We are allied health professionals that are essentially physician extenders. In the case of pathologist assistants, we are academically and practically trained specifically to only work with one type of doctor and that's a pathologist. So to understand the role of a pathologist assistant, you really have to know and be familiar with what a pathologist does. So pathologists, they are behind every diagnosis. When you go in for a biopsy or a skin scraping or, ooh, let's use a mole example. Okay, so you go into your doctor and he is doing a skin check and he notices maybe a funny mole. He recommends that you get a biopsy and see what it is. Is it something concerning or not? So that mole is shaved. It gets sent in to the lab. A gross tech will dissect it. It gets submitted to histology for processing and it gets turned into a slide. That slide then goes to the pathologist and he looks at it under the microscope and based on what he sees, he will, he or she, let's get that in there. Absolutely. We'll make a diagnosis if it's benign, inflammatory, is it malignant, something you need to go back and now you need to have more skin removed because it is malignant. Every diagnosis comes from a pathologist but there's a lot of work that gets done before a pathologist is able to look at it as a slide. Another example to help understand the world of pathology is colonoscopies, right? So you turn 50, you need to go in for your recommended colonoscopy and they find a polyp. Well, they're gonna biopsy that polyp and they're gonna send it to pathology. It goes through processing, gets turned into a slide and then it goes to a pathologist. Pathologists will tell your doctor what it is and your treatment will be determined based on that diagnosis. Now patients never meet their pathologists. Pathologists only work with other doctors. So being in the lab, we are behind every decision that's made especially for cancer but nobody knows who we are or what we do. But it is incredibly important. So what you're saying is you practice medicine but you don't really interact with patients. Yes, so if you love healthcare but you would prefer to be behind the scenes, this is a really good place for you because the only people you're interacting with are your coworkers and colleagues, other doctors. So basically a pathologist is an MD, they're a doctor. They specialize in looking at human specimens, whether that's in the middle of a surgery or that's like a urine sample or a blood sample or anything that's basically taken to help in making a diagnosis. So that's what a pathologist does. And so then what does a pathologist assistant do? So essentially pathologist assistants receive in buckets things that come out of surgery which is a lot of different things. I think most people think of going into surgery for cancer but sometimes you get your gallbladder taken out or your appendix taken out. There's lots of different things. Our bodies are amazing and they grow really weird things and sometimes they have to be taken out by a surgeon and that's where we come in. So essentially we get body parts in buckets and we dissect through them. We are trained to know the different pathologic processes to be able to recognize grossly if something is concerning for malignancy or if it's a benign process like inflammation. So really pathologist assistants, we are the eyes and the hands of the pathologist because the pathologist is not going to see the vast majority of the specimens. So when we give a specimen, we begin the report. It's called a gross dictation, a gross description of that specimen. And then we dissect through it and look for any abnormalities, maybe nodules, areas of firmness, things that we've been trained that are concerning. And then we take small sections and submit it for processing and then those are what get turned into slides. So the pathologist only is looking at what I am submitting. Now the pathologist can always say, I need more and we can submit more tissue if they don't have enough for diagnosis or maybe the sections that I submitted had some autolysis going on and they need more sections that are better for diagnosis. Okay, I like what you said there that you're the hands and the eyes of the pathologist. So basically a specimen comes to the lab from whatever kind of surgery or whatever kind of procedure and the pathologist only really sees it and they're specialized to diagnose things once it's already on a little slide, perfectly made. So they're specialized in that. They don't see the whole body part and they definitely don't get to like cut it up and see what's concerning and what's not. They just kind of do the last step which is their specialty. You as a pathologist assistant actually get to see the entire, for instance, like when I was in the lab with you we saw an entire placenta. Actually, I think it was a twin placenta so it was really interesting to see but you actually see the whole body part just right there on your lab bench and you get to decide what parts you're gonna cut up, what parts you're gonna send to the pathologist for analysis, what parts are normal. That's all you. Yeah. That actually sounds cooler. I feel like I'd rather be a pathologist assistant than a pathologist because if you like anatomy and physiology I think it'll be cooler to see the whole part instead of just like in a little slides. And they are trained. So residents, pathology residents, they go through gross training. So they've done exactly what I've done but their time on it is shorter. And they are also trained in autopsy. I think it used to be 50 minimum autopsies they had to do during their residency but now it's reduced down to I think 20 because autopsy is the number is declining. At least as far as hospitals goes there's always gonna be the need for forensic but that's a whole different, that's all that's involved in. You know, we're definitely gonna talk about that because I think a lot of people who think pathologists also think like, you know, on CSI when they're looking at the body postmortem that's not what you guys do. Yes, that we are trained in autopsy, pathology as well as forensic pathology depending on how large your hospital is most like average size hospitals only have maybe 50 autopsies a year so you're not doing autopsies that often. Now, forensic autopsy, those are medical examiner cases and pathologist assistants while we are trained in forensic pathology there's not a whole lot of PAs right now working in the Emmy's office because they can pay a pathologist and they can pay dinners or autopsy texts which they get paid a lot less. So they, at this moment, things are changing and it also depends on the state. So in the state of Minnesota PAs can work in forensic pathology but they take on many more roles. So they're working on forensic pathology, autopsy pathology as well as surgical pathology. So that's kind of cool. So as a PA, you could work in a lab setting, you could work in kind of an emergency setting but you could also be not exactly a medical examiner but have a lot of those roles in your job too. I think I do see the role of a PA evolving to include more forensic pathology and I know that a lot of people are interested in that. Yeah. It's just redefining the job description and kind of opening up the responsibilities as far as what falls under the certification. So I think at this point, like the PAs, we can write up the clinical history and the PAD and maybe even help work on the FAD but we can't sign it out. We're not gonna sign death certificates it has to be a pathologist. That makes sense. So kind of like the physician assistant profession, the PA pathologist assistant profession is probably quite new and also evolving and getting into all these new avenues. How old is your profession? Oh, I wanna say it's like 30 years. Okay, so it was only around since like the 80s? I wanna say, I mean the 70s. I think it started in the 70s. Okay, so pretty similar. It seems like a lot of these physician extender physicians have only been around for about 50 years, 60s and 70s is when a lot of this stuff seems to have really taken off. So that's pretty cool. And the drive really is a shortage of pathologists. Residents and art residents, but med students as they're going through and they're figuring out what type of doctor they wanna be less and less, they are choosing to be pathologists. So as long as there are shoes to fill because we have a shortage of pathologists, there's always gonna be room for fees to grow and fill that role in different ways. Yeah, it seems like that's the way medicine is going in a lot of avenues. So like there's a health care or there's a shortage of primary care providers for doctors just because it's the lowest paid specialty. And that's probably the main thing. So now nurse practitioners, physician assistants are filling those roles. You can pay them a lot less than a physician because they were trained for less time, two years as opposed to close to 10. But they can do a lot of the same work and it's just a great opportunity for folks like us who don't wanna go to school as long, but do wanna do the work. Yeah. So it's amazing. And I think in the future, there will be fellowships for PAs to specifically train in maybe a subtype of pathology, like maybe GI. So in the future, we can help triage slides. And I would love to see the role open up to maybe even help signing out cases for non-malignant things. Also like you kind of go through the whole process. If it doesn't look nearly bad enough to you to even warrant a pathologist looking at it, a PA would be able to sign off on it instead of it going all the way up to the pathologist. Or at least maybe put all of the report together and it still gets the pathologist would look it over and see if they agree with the diagnosis and still have the final signature on it. But things for like polyps or like inflammatory diseases like Crohn's or UC, things that are not malignant and maybe less like lower risk. Okay. That's a way we could start wedging in our way to microscopics. So kind of expanding your scope of practice. Yeah, yeah. And I think really the only way PAs are involved in microscopics right now is in research. So, which is something that I can see myself interested in later down the road because you're not making a diagnosis. You are conducting research, you're writing papers, based on what you're finding. So a PA can do that. That makes sense. So that's kind of exciting kind of the scope of practice for PAs can move up to be a little bit more similar to like what a physician assistant does in some settings. Like obviously they're really complicated patients or they're really complicated cases, the doctor would still definitely be the one to handle that. But something that seems a little more straightforward, we can handle it all the way up until the very end where the doctor basically just says, this is what I would have done. I'm signing off on it. Thank you for doing basically all the work I would have. So it's just kind of exciting. We get to practice as physicians with that little, well, I guess that big safety net of the actual physician making sure we don't mess anything up. Great. Yeah, that's really exciting. So what is a pathologist assistants day like? What do you do day to day? I think honestly it also depends on where you work. So you could work for a private pathology group that contracts with a lot of different clinics. So in that case, you are just in a central lab that all the specimens are coming to you from all over or you could be working at a large hospital and you are where the specimens are. And in that, so in the instance of private practice where you're receiving all these specimens from all these different clinics, you won't have some of the responsibilities like frozen sections because you're not in a hospital with a surgical suite. So what you do on the daily basis will highly depend on what type of pathology group you work for and if you are in a hospital or a central lab or maybe you are helping out with autopsies. And the role also changes if the hospital is an academic institution versus a non-academic institution because academic places, if they're attached to their own school of medicine, the PAs also take on the role of training residents. And pathology residents. Pathology residents, yes. So you'll have responsibilities to train pathology residents in grossing techniques as well as autopsy techniques. And what else? Academic. Oh, go ahead. At an academic institution as well, you are probably going to take more sections, take more pictures because they're always thinking about publications. And you'll also be submitting more for perhaps tissue banking or future research projects. So academic institutions, I feel, they open up a lot of opportunities for PAs to do all the things we were trained to do in school. That's pretty cool. So depending on where you work, let's say you like some aspects of being a PA more than others, you can kind of choose a job based on what you really like to do. It's not like every job is the same. Absolutely, absolutely. I know that there are definitely people out there who don't like the stress of frozen sections. So they will be happy to find a job with a private group that doesn't deal with frozen sections. That's available for them. For sure. And I actually want to talk about the job market and how easy it is to find some of these jobs in just a moment. But one thing I'd kind of like to summarize and kind of make sure I understand correctly. So something you were talking about earlier was how pathologists are trained to do everything that you're trained to do. They can do all the gross anatomy. They can do all the sectioning and stuff. But just because it's more efficient for them to do the final product and for you to do that, that's why pathology assistants exist. You're kind of specialized in those parts of their process that they don't do a whole lot. And then because you're the experts in that, you actually train the pathology residents to do those things, is that right? Yes. And I will say too that pathologists, the whole point of us taking over the gross dissection and all of this kind of hands-on work is also to keep the pathologists at the microscope because that's the moneymaker. Yeah, so it's all financial. Yeah. So it's kind of like a surgeon is most financially beneficial when they're in the OR. The way things are going in the surgery realm is like physician assistants are kind of taking the pre-surgery care and the after-surgery appointments so that the surgeons can stay in the OR where the hospital gets paid the most. So it sounds like it's the same thing with pathology. They're paid the most at the microscope. So the hospital wants to keep them there and then they hire people like Shauna to do all the prep and all that stuff. Precisely. Okay. And so even if a pathologist really likes gross anatomy and they really like sectioning and they like preparing the samples and seeing the entire body part, the hospital says, no, you need to stay at the microscope. We're gonna hire Shauna for three or four times less money to do that fun stuff because it's more efficient. Yeah. Okay. So we talked about working in different areas, different kinds of hospitals, different kinds of labs. So what is the job market for a pathologist assistant, a PA? Is it easy to get a job? How competitive are these jobs? I, in my experience, I will say that labs are growing and positions that are open are not because people are leaving there because the practice is growing and they need, there's more work, they need more PAs. Everyone in the class before me, they all had jobs before they graduated. The same for everyone. Wow. The same for the class before and the class before. I will say that if you are tied to a specific city or a specific state, then things will become more difficult for you because our certification is national. There are jobs all over the country. But if you're not willing to go to the job, you will have more difficulty. So it's definitely easy to get a job overall. Like you said, everybody in your class and the class before you had a job before graduating, which is incredible. I know with PA school, it's definitely not like that or with a physician assistant school, it's definitely not like that. You know, the job market's great, but it's not that great. So that sounds extremely good. Are some specialties in some areas better paid than others? I would say the average is around 85 to 95 starting, but that's dependent on where you are in the country just because cost of living is different. So if you're in New York versus the Midwest somewhere, versus the California, I mean, San Francisco is super expensive. So you better get paid more if you're working out in San Francisco. That makes sense, but that's new grad is average of like 90,000. How much can you expect to grow as you get more experience? I think definitely over 100K. And it's also highly dependent on what extra responsibilities do you take on? PAs can function in management roles. Actually being in a senior position, a highly trained position, you are most often PAs are looked at as a leader in the lab anyway. But if you wanna make more money, you're probably gonna have to take on a management role. And I could easily, if you wanna be a lab manager somewhere, even possibly move up into director position. You know, maybe 150. So just a really quick comparison here just because I'm a physician assistant student, Shauna is a pathology assistant student. It sounds like the job market is definitely more reliable for pathology assistants and they make about the same almost identical actually to physician assistants with the same room for growth. So it's really interesting. And so for you personally Shauna, aside from the great salary and the potential for a really good schedule, why did you actually choose to become a PA? I love people's reactions when I tell them what I do. They're either really grossed out by it or they think that I am amazing. So the polarization of the response to what I get, what people think, I needed a hands-on job. I love that I get to work with just co-workers and colleagues, I'm behind the scenes. I love that every day is different. I don't know what is gonna come to my bench. I like that I get to be a lifelong learner, you know? I don't see myself getting bored especially with different opportunities like I mentioned before in academic institutions. There's just a lot of things that I could do. So when I do get bored with something, there's something that I can pivot to to keep my interest again. So for me it hits, it checks all the boxes. Absolutely. And more specifically about actually the role of a PA, working in the lab, getting gowned up, working in a kind of a sterile environment, like the actual day-to-day work of being in a lab. Did you always enjoy that? I will say that there are times where you are really, really busy and you feel like maybe you're on a, like a working line and you're just, you know, banging out specimen after specimen. But at the end of the day, every specimen comes from a person, right? So it is incredibly important that we take each specimen seriously. So for me to have that purpose attached to what I'm doing is also really important. So like with every job, especially every professional high-paid job, you know, there's an element of the grind in it. You're there to be productive and sometimes it gets really hard, but it sounds like you really appreciate the fact that your job helps people and every single specimen, even if you get a hundred in an afternoon, every one of those is from a person. And so you do your best because it's literally you're helping a person, you're saving their life. There, I worked at a lab that said, treat each specimen like it came from your grandma. Oh, that's good. Yeah. And then that will change your mindset. Let's say you're getting frustrated because of the workload. Just think of it, treat the specimen as if it was your grandma or your grandpa. Yeah. I think that's something they tell a lot of healthcare providers. And it's funny. It's different ways that it kind of becomes a grind like with hands-on actual patient care providers like I'm gonna be a PA, a physician assistant or a nurse practitioner or a doctor. The grind kind of becomes, I wish I could spend more time with this person and influence their life more or maybe people are rude to you. So you have to kind of have that emotional, kind of thick skin and just really kind of get through the day that way. To you, like you said, it's more of like being on an assembly line. There's just so much work and it's hard to connect. But at the same time, like every one of those, you just want to help a person and you're doing it at such a high level that it is really gratifying. Another thing that I just kind of thought of is if you think about it, every specimen that comes to your bench is a diagnosis, is potentially cancer. So you doing a good job could potentially save someone's life. But you can do that way more times than a doctor or a physician assistant can see patients in a day. So basically the point I'm making is you can get through well over a hundred small specimens in a day and every one of those could be someone's life if you diagnose colon cancer, like we're talking about. Whereas even a very efficient, very, very speedy healthcare provider will never see a hundred patients in a day. They might see 30, maybe 40 if they're insanely fast but will never have the same number of people that we can help per day that you do. So that's just kind of a cool way I was thinking about it. Oh, yeah. So transitioning to PA programs, pathologist assistant training programs. So because it's such a desirable job, I'm assuming PA programs are pretty competitive. So how difficult is it to get into PA school? You know, I don't know if I can say exactly how many applicants. I know that there are hundreds of applicants and each program only accepts maybe two or to 25. I think the largest group is 25. That's pretty old percentage. Yeah, because they're not taking a lot of students every year, it really limits. I mean, that's what makes it competitive, right? There's limited spots. So who gets those spots? Right, so here's what you can do to kind of beef up your application. I think it is incredibly important to be familiar with this profession, meaning that you have worked as a growth tech side by side with a PA. At minimum, you should shadow a PA and know what their day to day looks like and make sure that that's right for you. It's a two year program and it's an intense two years. So you should really make sure that you want to do this before you get started. And if you can't work as a growth tech, I have had classmates that didn't have any grossing experience, but they did have autopsy experience, so they worked as a deaner. So either get yourself some autopsy experience, work as a growth tech, which you don't have to have a bachelor's degree to be a growth tech. You just have to have a minimum number of biology and chemistry classes taken already. So close. Usually it's like junior, senior year of like a biology degree. If you have enough science credits to qualify to be a growth tech. So go do that. Observe an autopsy because I don't think you know you can handle that until you're actually in the room. So if you can, sometimes that can be difficult if you don't already have connections in the hospital to observe. But if you can, try and get as much exposure to pathologies as you can. You're gonna have to take anatomy and physiology. If you have TA experience in anatomy or physiology, that would look really great. They like to see genetics and biochemistry. Those are not required, but they like to see those classes as part of your undergraduate degree. What else? So being proficient in a lot of the higher level science courses, especially obviously anatomy and physiology experience, you said might even be more important than grades. You have to know what a PA does and you have experience in the autopsy lab, preferably in the lab, just making sure you know what you're getting into or that you really wanna do it. Yeah, I think if you can demonstrate you have a good understanding of the profession that that is really important. I had really good grades. I think that that does make you competitive. Some programs require the GRE, some do not. So maybe that's a factor in where you apply. Is there like a minimum number of hours of experience that you need in a gross lab or a pathology lab or anything like that? Or is it just you need to demonstrate that you understand what you're doing? Yeah, to my understanding at this moment, programs don't have a minimum requirement for shadowing PAs or even autopsy because they know that it's difficult for people to find that if they're not already in, if they don't have a network that allows them to do that. Right. So they don't have that as a requirement but that's what makes you competitive. Okay, so it's not required but it is the best thing for you to do. And so that in addition to good grades is what you really need to get into PA school. Yes. So would you say anything else as far as advice on how to get into PA school for people who might be interested in this profession? I think pick a program, look at their clinical partners and decide how you want your clinical year to be shaped and that can help you decide on where to go when you're applying. I think as far as getting into pathology assisting school as long as your grades are really good and you've demonstrated that you know what a pathologist assistant does, when you interview, I think they also consider demeanor and if you present yourself as someone with energy and a good attitude and a willingness to learn especially in excitement and passion for the profession that that's also really important. There is an interview aspect of this. If somebody out there really wants to be a PA, a pathologist assistant, good grades especially in anatomy and physiology and experience, enough experience that you can demonstrate that you know what a PA does and why you want to be one is the main things that you need. I will say this as well. Having prior working experience is also really helpful. If you work as a med tech, that's awesome. If you worked as a histotech or a histotechnologist that's really great because the specimens you submit as a PA feed into histology. So knowing the histology department is really gonna help you out. Even being an EMT, is that right? An EMT, what's the emergency medical people? What are they doing? Yeah, like the people on the ambulance and EMT. EMT, yeah. So EMT experience is even really helpful because if you are doing autopsies, they come with all those, I don't know if this is morbid or not but the bodies arrive with all the lines and tubes with them. So you need to know what those are so you can document them. Okay, so not just lab experience but basically medical experience being a patient care tech and EMT, something like that could also help you. Yes, 100%. That's cool, that makes sense. So it sounds like there's no strict guidelines for how many hours but you just have to demonstrate that you know the whole medical process, you've worked in the medical field and preferably in histology and things like that. That makes sense. So do you feel comfortable sharing your stats? I know pre-PA, pre-med students always like their stats. What GPA do I need? How many hours? So what was your GPA? Sure, so I graduated with a degree in biotechnology with a three nine. Wow, does everybody need a three nine to have a chance at getting into PA school? No, I think that at minimum you need a three O. Keep this in mind. The reason why I think they look at that is when you are in the program, you need to maintain a GPA of a three point O. So even though you have 18 credit hours a semester and you are under all this pressure, if you don't maintain that three point O, you could be asked to leave program. So they want to make sure that you've demonstrated in the past that you've kept your grades up. So you're more likely to be successful if they accept you into the program. Yeah, it's interesting. One thing, so one of my most popular videos is how to get into PA school with a low GPA. And a lot of people who maybe didn't do very well in college still want an amazing job like being a PA, a physician assistant or a pathology assistant. But one thing that you really need to ask yourself is if you ended up graduating with a low GPA, you may have had some struggles, some obstacles or some things that came up. So maybe you are a good student, but something's happened. But you need to look at it from the school's perspective and they have this incredibly rigorous curriculum. And the job that you're gonna do is incredibly important and difficult academically and people's lives depend on it. So it does make sense that you really do want as high of a GPA as possible so that they can trust you and your academic abilities. But I guess what I'm looking for here is numbers. So like you had a 39, you got in, you said at least a 30, just based on your experience about what was the average college GPA of the applicant that actually got in. Oh, I feel like we're all type A, high, strong perfectionists. So if they all weren't above a three, like six, I would be very surprised. Okay, so definitely high GPA. Yeah, but I will say this, depending on the program that you could make up for it, as long as you meet the minimum requirements, they're not going to throw those out of the window for you. But as long as you meet the minimum requirements, I feel like you could make it up with experience. You've worked as a growth tech for years. You've worked as a histotech for years or a dener to come with that experience. I think you could make up for a poor GPA. That makes sense. So I had a really strong background. I did research projects. I worked as a research assistant while I was in school. And after I graduated, I ended up kind of moving more towards histology and I took, I studied and I took the histotechnologist exam. So I am also a certified histotechnologist and that's how I got into pathology. After I moved into histology, I then wanted to learn more about grossing. So I moved into the gross room, as they call it. And I worked as a path tech, starting on small things, polyps, appendices, gallbladders, things of that nature. And that's when I met a PA and we started working together and said, you know, this is really cool. I would love to handle these bigger specimens. So that's how I got sucked into pathology assisting. So it's kind of like a lesser known profession, at least to me. I didn't know anything about it until we met. And it sounds like you were the same way until you just met one randomly out in the field. No. Is that right? Well, I actually did know about pathology assisting before I met one. I was thinking, I was about to graduate with my bachelor's degree and I was like, do I go on for my master's? Am I done yet? I don't feel like I'm done. But I also don't want to worry about a thesis. So I might have Googled non-thesis master's degrees and pathology. And that's what came up was pathology assisting. So then that search led to one of the local labs in Salt Lake City where I was living at at the time. They happened to have a pathology assisting opening and it was at the top. If you can sort your search by pay grade and they were at the top of the pay grade. So it started ticking a lot of boxes for me, top of the pay grade, non-thesis master's and then I really started to look more about the profession. And that's actually what changed my direction into histology because I knew that was a way I could get into pathology was through histology. So maybe that should be the slogan for the PA profession, a better paid, more exciting alternative to research. Not to beat up on researchers. No, I mean, it's important. Somebody's got to do it. Research is fun. I think that for me that the turnoff of a PhD was, I felt like you spend a lot of time writing, asking for money, like finding grant money. True. And I don't know that I have the patience for that. I like the more fast paced environment of what I'm doing now. That's really interesting because, okay, so I know a lot of pre-meds. There's definitely way more pre-meds than there are pre-PAs. Everybody goes to college who studies biology thinking, I'm gonna be a doctor or maybe a PA, like a physician assistant. And they always push you into research. And so they always make you like do lab work and all this stuff. And some people end up falling in love with it and going the PhD route and being researchers. And then some people just kind of do it and then go into med school or physician assistant school. But there's this interesting kind of like in between happy median, which is what you do, which is still clinical, still fast paced, still way better paid than research, at least for most people, but you're still in the lab. Yeah, it's great. Absolutely. So can you tell me what the training is like? I think it's about a two-year program, right? It is a two-year program. So the first year is didactic. It's all coursework. I had 18 credit hours every semester. Fun. So it's three semesters, you don't get a break. So it's nonstop for two years, summer, spring, fall, everything. It's a lot of classes. It was a lot of work, a lot of late nights. But the prize is the second year. And the second year is one complete year of clinical rotation. So you rotate through different places and where you rotate is dependent on where you go to school at. So each university has their own clinical partners and they all have their own different way of doing this clinical year. So in didactic year, like you said, it's a ton of late nights. It's a lot of work because you're learning anatomy at a very, very high level, probably more. Go ahead. It is not just anatomy. So a lot of what we're learning is pathology. So we are learning pathology, applied pathology, gross pathology. There's a lot of different angles coming at pathology. So you have to go through every organ system. You have to learn what's normal. You have to learn what's just benign. What is the healing process look like in this organ? Versus, yeah. And then what does cancer look like in this organ? Because you could have, you know, carcinoma in different organs, right? But it looks different in each organ. Right. So what you're basically trained to do is to know the entire body anatomically, all of the disease processes that every organ system can have and what they look like at every stage of the disease and every stage of healing. And the reason for that is because a specimen comes to your bench, you have to know exactly where that came from, what you're looking at, and basically to help make a diagnosis that way. Yeah. So we have to learn about differential diagnosis, right? Yeah. So we have to know, okay, what commonly happens in this organ? Is it an infectious process? What are the common infections of this organ? Like specifically about lung. Oh, no, I don't wanna talk specifically about lung. We could do specifically gallbladder. Or yeah, gallbladder. I mean, I feel like gallbladder has something more of a growth tech would do and not necessarily appear. Oh no. Okay. But it's a good example because people know what gallbladders are. Exactly. So a specific example, let's say you get a gallbladder on your bench and you basically have to know what's normal for a gallbladder to look like. What's not normal? What could be going on with this person? And you also get their symptoms and like what they said they were feeling and the imaging and you have to make that final diagnosis based on what it looks like. We're not a diagnosis because PAs don't make diagnosis but we do steer the pathologist in a direction based on describing what we see. So in a gallbladder, we do know what normal looks like. Very commonly it will have cholesterolosis. Colesistitis is usually why it's being taken out. We look for stones and if you have large stones they can even erode through the gallbladder. So that's something important to note in your dictation. So all of these things like we've discussed before we are the eyes and the hands of the pathologist and the pathologist needs to know all of this even though they're not in a seated gallbladder. Right. So you're training to basically know what every single part of the body looks like normal and abnormal with all the common diseases that that part gets. And best of all, you only get one year to learn all that. So I can see why there's so many late nights. Yes, it feels like a tidal wave of information just coming at you. What's with all the water metaphors because medical school and PA school like physician assistant school they always say fire hose or fire hydrant of information. You got a tidal wave. That's even more dramatic. Yeah. Yeah, because you're just watching it coming at you. Just... And somehow a lot of it's sticking you just don't get to sit there and appreciate how much you've learned because there's always more stuff to learn. There is. Ooh, I have another way of explaining it too. So first year the didactic year is like you're in a tornado full of like book pages and you're in the middle of the tornado just trying to grab onto whatever book page that you need to know or retain. I love all these dramatic metaphors, but that's true because like it feels like you're in like you said, a tornado. You don't know which way is up and down and you realize that you have to know all this stuff and it's all around you, but there's so much of it. It's really chaotic. First year in PA school is really chaotic. I think that the gift is the second year and that's when you get to apply all this stuff and go, holy crap, I actually know a lot. You do, do you surprise yourself because you know more than you think? Right. And you get to make those connections, right? Oh, I read about this, but now I'm actually seeing it. So now that starts to lock information in. Yeah, that's, I mean, for my own experience as well, that's probably the most gratifying thing is like you read about something, you might even see a bunch of pictures of it, but until you actually see it and touch it and know exactly what color it is in real life, you don't really truly appreciate it, that then once you see that, you're hooked. Yeah. It's so cool. So then, so first year is just a ton of information, learning all the stuff we just talked about. Second year is different clinical rotations in various kinds of pathology labs. And how many of those are there? You said you get a whole year? It's a full year in that how many you have is really, you know, dependent on your program and how they manage their students. I know that some places you could have a full year rotation at one place, but that's possible because that one place does everything. Frozen section, autopsy, large complex cases as well as smaller cases. So a student can rotate at one place for the full year if their rotation site can provide all of that. I think most places you're gonna rotate at least four different institutions. So you'd have three month blocks. And I know that at least some programs you will rotate through an ME's office. So you will get your autopsy training at an ME's office because it's really hard to get autopsy training at a hospital when they only have maybe one a week and you're only there for a few months. So it's easier to get your autopsy training at an ME's office where it's all day back to back to back to back. Makes sense. And it sounds like whatever accreditation body gives you your certification, they have requirements of like, you have to have a certain number of autopsies, a certain number of this kind of specimen, certain number of that. And so you need your rotation sites to help you meet all those things. So the accrediting body for the schools is NACLs and then our NACLs, N-A-A-C-L-S. NACLs, okay. And our certification is through the ASCP. You can insert and later what that stands for. I'll look that up. I think it's the American Society of Ethologists. Okay. Something kind of like a pathologist. We'll Google it. Yeah. So that certification through the ASCP is national. And well, it's good in the U.S. and Canada and in U.S. territories. Okay. So you could practice in the U.S., Canada and any U.S. territory with that one certification. With the certification through the ASCP. That's awesome. Now, in addition to that, some states require licensure. California, New York. So basically you take your certification from the ASCP. You say here's state of California. Look, I really got my certification and then you pay some money and then you're also licensed. So it's just paperwork and money to get your license in California, New York. I think there's a few other states that require a license as well. But the vast majority, you only need your certification. Makes sense. Yeah, I know California and New York really like their paperwork and their money. So I've definitely had experience with that. But so at the end of this training, you've gone through your didactic year. You've passed all your exams. You've done everything you had to do. You went through clinicals. Then is there a final certifying exam? Yes. So after you graduate, you qualify for the ASCP certification exam and then you'll schedule your exam. It is a adaptive test. What does that mean? Is that the right word? Adaptive? I think that it's... So it's an adaptive exam, meaning if you get one question right, the next question will be harder. Oh yeah. Until you get, you're just at hard questions. So I've been told that if you feel really bad when you leave, it's because you were answering a lot of questions right. That's good. Stressful but good. Yeah. Okay. So there is a final certifying exam. You sit for that and then you become a licensed PA and you can practice. A certified PA. A certified PA and you can practice. Yes. Okay. Once you come out as a new grad, you're not expected to know everything and you're really, your fine polishing happens at your first job. So that's really key when you graduate to find a job that's going to fine-tune your skills. You know, I've heard the same thing about physician assistants. It's kind of like your first year on the job is basically your residency. You have a lot of training but you're not really gonna become proficient until you're about one to two years in the field. Well, I mean, when you're training in school, it's this broad thing that you're training where when you get your first job, they're gonna have their own specialties and you finally get to hone in on one thing versus know everything. Yeah. Just a little bit of everything but not enough to apply in practice. So you said during the interview, you need to demonstrate that you know what a PA does and demonstrate enthusiasm for the profession, why you actually want to be one, why you're gonna subject yourself to this incredibly difficult training, why do you actually want to be a PA? So I'm gonna ask you, Shauna, what is your favorite thing about the PA profession and why is it that you actually wanted to be a PA? I, like I said before, I love that every day is different. I'm still seeing new things every day, learning new things. I love that it's so gross. To me, it's kind of like this morbid Christmas morning where you have all these presents to open up and you just don't know what you're gonna find. That is the best description that I have ever heard. That is phenomenal. A morbid Christmas morning where you get to work in the morning and you see all these specimens, all these body parts that were taken out of human beings and you don't know what you're gonna get. So you gotta unwrap them and then. Yeah. So here's the thing. I'm waiting in my career to find this. So there's something called a dermoid cyst. Yes. It happens in the ovary and it's a teratoma and it can grow different tissue types. So often you will find hair and sometimes like teeth. You can have brain tissue in it that you'll see microscopically. It's just this modg positive tissue types in the ovary. And one day I will find a red-headed dermoid cyst. That is your goal in life. A red-headed dermoid cyst. A red-headed dermoid cyst. That sounds incredibly rare, but it's possible. Yes. So not to give a big anatomy lesson or an embryology lesson to the general YouTube community because they'll definitely turn the video off. But very basically, anyone who studied biology and embryology knows that you have the three layers, the mesoderm, exoderm and endoderm. I know I got the order wrong while you're developing. And from those layers of the embryo basically come different kinds of tissue. So muscles, brain tissue, skin and a dermoid cyst and it's basically when that goes awry and kind of a pseudo fetus starts developing and all those little layers develop into this big cyst that has just basically mystery meat in it and you don't know what kind of tissues in there. And so it could like she said, hair, teeth and all that kind of stuff. So a red-headed dermoid cyst is basically one of those happening with what would have been a red-headed baby. And she wants to find that cyst that has red hair inside it, which is already very rare. Oh yeah. We're gonna get some serious views on this video. Maybe we'll leave with a red-headed dermoid cyst. Yeah. But so I think what that basically did is it illustrated exactly the kind of person that should become a PA. Somebody who just loves anatomy, who thinks the human body, even when things go wrong, is the coolest thing in the world and they just love seeing specimens and different parts of the body and working with them. Yeah. Pretty much. Yeah. Okay. Yeah, that's definitely gonna make it into somewhere around the intro. And maybe I'll post a picture of a dermoid cyst, but I'll put it at the very end so it doesn't turn anyone off. Or turn somebody on. Right? Okay, you know what? Maybe we should put the dermoid cyst in the beginning because if, so this video is for prospective PA students and PAs. So if that turns you on, you should probably be a PA. Yeah, that's a good sign. It's a good start. Basically, okay. So the way I would summarize it is if you really love the human body, especially gross pieces of the human body and you wanna see that and work with that every day and you think it's exciting, this is the job for you. Yeah. It's like dirty jobs. Kind of dirty jobs, but people find pleasure in them. They love them. So it sounds like you're exactly where you wanna be and that's amazing. You've really found your niche in the world and in the hospital. And we as healthcare providers, as scientists, and especially on this channel, we like progress. We like things to get better every single day and nothing should just ever stay the same as it is. So is there anything that you would change about the pathologist assistant profession? Oh, anything that I would change. I think, give me one moment. I think I wrote something. Take your time. And I know you talked about residencies and like new avenues, so you can go that route. What question number is that? Nine. Number nine. Actually, the numbers may have changed a little bit. It's the second to last one. Okay, there we go. So, as far as what should change, I think that, I think as we discussed before, kind of opening up the responsibilities, having fellowships available to, in order for PAs to specialize in something, especially if you have, it's a larger pathology group. You have multiple PAs. Why not have each of those PAs be a specialist in something. So you have a GI specialist, a GU specialist. Maybe you have a GYN specialist. That way you have someone to turn to that has put in the extra time to really know the disease processes of that system. So you have an expert, essentially, with you at all times. I think another thing that I would really love to see is more of a standardization of how PAs are used. Because really it depends on where you work, what you're allowed to do as a PA. There are some places that are really, really great and you can do everything. So you can do search path, autopsy path, forensic pathology. They allow you to work in research. Whereas other places, maybe they're smaller and they don't have some of those things available, but you're really just, you're just grossing. You're at the bench all day long. And I think that it would be really great to just open up the profession to prevent burnout, to prevent maybe getting bored with what you're doing. Yeah, allow your PAs to grow and to specialize in something that they feel passionate about. So now you have an expert in that sub-specialty. I think that would be really cool. And I know a lot of the mid-levels nurse practitioners, physician assistants are going that route. So I don't see why pathology assistants wouldn't go that route too. Yeah. It just takes time. It just takes time. Progress takes time. And they're all new professions and they're moving into new avenues. So I'm definitely excited to see where both of these professions will go. All right, Shauna, well, this was amazing. I learned a ton about your profession and honestly, I hadn't even heard about it until I met you. So thank you for coming on the channel and teaching everyone. If anyone has any questions about the profession, leave them in the comments. Another great resource is Path Assist website. Or is the Path Assist website, can you talk just a little bit about that? Yeah, so if you go to pathassist.org, it's a website specifically for pathologist assistants, either current students or graduates. There is a job board there. We have student delegates from each program. So if you do have questions about a specific program, there is a part on the website that you can find your delegate from the program you're interested in. And you can email them specifically with questions that you have. It's just a really great resource. There's also grossing guides based on CAP guidelines. Anyone in pathology knows that CAP comes up with all the rules and regulations that we need to follow in our path lab. There are also really great resources for setting for the certification exam. There are even practice exams and quizzes on there to test yourself and see where you're at. There's a really great reading list that outlines the books that were used to create the certification exam. There are also video lectures, or no, not lectures, there were video recordings of conferences passed. So I know like they're 2017 AAPA conferences up for you to watch. And there's also ways to volunteer if you're a student or if you were to graduated, maybe you feel like you need to get it forward. There are volunteer opportunities for you as well. So it sounds like anywhere you are in the pathologist assistant process, whether you're just someone looking into it, you wanna know more about it, or if you're already a student or practicing PA, Pathesis definitely has a lot of information for you. Yeah. All right, so if you're interested in becoming a PA, definitely start there. For show. For show. All right, folks, thank you for watching. Please consider liking the video and subscribing to my channel. And I'll see you in the next one.