Season 1: Episode 11: Emory University PA Leadership

Unknown Speaker  0:08  
Welcome to this episode of the PA path podcast. I'm your host, Kevin Lohenry. We are glad you could join us as we seek to better understand the PA profession.

Unknown Speaker  0:24  
As a profession, our students are going out and working at the top of their license.

Unknown Speaker  0:32  
Well, hello, and thank you for joining us. Today we speak with Dr. Maha Lund, who brings an interesting path to the PA profession from her roots in Germany to her time in medical school, and her subsequent decision to move to the United States and eventually her path to the PA profession. Dr. Lund is an associate professor and program director for Emory University in Atlanta, Georgia. We also speak with Mr. Allen Platt, who serves as an assistant professor and director of admissions for Emory Allen's path to the profession is also interesting given his initial career in engineering, both Maha Neyland share their passion for teaching and inspiring students and the rich history of Emory University, focusing on service to the community. Well, thank you very much for joining us today. I'm really delighted that you could be here, Maha, we're gonna start with you. If you wouldn't mind telling us a little bit about your path. I think your path is really interesting.

Unknown Speaker  1:28  
Absolutely. Thank you so much for having us today, Kevin, my path to the PA profession was definitely not straightforward. So I grew up in Germany with a mother who was a nurse. So I, early on developed love for medicine. And my parents wanted me to go to medical school. And in Germany, the system is such that you go straight from high school into med school, law, school, education, whatever you might be interested in. And so I was accepted into medical school and completed two years. And I have to be honest, I hated it, because I didn't see a single patient for those two years. And so I rebelled a little bit against my parents and came to the States. I put myself through college by teaching German and fell in love with teaching. And so I earned a bachelor's in German, and a master's in German literature. And after college, I worked as an interpreter, translator and language instructor. And then in my early 30s, I had this pivotal experience where I had the opportunity to help care for my husband's grandmother after surgery. And I realized I still had this love for medicine, I kept reading up about her condition, and also recognized that I have this love for caring for people. And so I explored several health professions, including nursing, because that's what I was most familiar with. But I realized that that profession was really not for me. And so I continued my search until we had a conversation with a group of friends, one of whom was a emergency medicine resident, and he suggested that I should become a physician assistant. And I had no idea what a PA was. But as soon as he described it, I was definitely intrigued. And so I researched more about the profession and then was accepted into Chatham University's PA program where I went through their PBL curriculum. And after graduation, we moved to Boston for my first clinical job at St. Elizabeth Medical Center. And then later on, at Brigham and Women's and in both of these hospitals, I worked in hospital medicine.

Unknown Speaker  3:54  
That's great and PBL for our audiences, Problem Based Learning. Yes. Okay. So that was your experience there has that influenced the way you have created your programs in education? Do you have some mindfulness about putting PBL into your curriculum?

Unknown Speaker  4:10  
Absolutely. Maybe not straight PBL. But definitely case based learning so that he really help our students not only recognize or list symptoms, or differentials, but actually walk through a case, what does it mean? And how do you distinguish that it's this and not that and move forward? So we definitely include cases in our curriculum.

Unknown Speaker  4:35  
Thank you, Alan, what was your path to becoming a PA,

Unknown Speaker  4:39  
I started out as a civil engineer at Georgia Tech. I was two years deep into that curriculum. And I was a co op student. So it's, they send you out on real jobs for a whole semester of what you're going to be doing in your career. So that's why I really recommend people get out and see what the career is like before you commit. I found out I I didn't really want to be civil engineer. And but I didn't know what and my fiancee I was dating was going to Emory undergraduate, and she had a catalogue of medical school, but they have this program called PA and I read about it. And I said, this is fascinating. I am not pre med, but I think I have prerequisites to get into this. And I went and found a PA. And right across the street from Georgia Tech is a big hospital that Emory ran called Crawford long at that time, and I just wandered in, because you could at that time, there was no HIPAA, I and I said, Do you have a PA here? And they say, yeah, there's a guy up on the fifth floor, who, who's a cardiothoracic PA? And I said, I don't even know what that is. But I'll go find them, went up on the floor and found this gentleman who worked on the cardiothoracic team, he said, Just come with me, follow me for a day and man that just knock my socks off. I said, I want to be you. How do I do that? And he told me about the Emory program. I didn't know that it even existed, I thought it was just a medical school, nursing school. It was brand new program, because it had only been in existence since 71. And this is 1977. So I changed my path. And I, Georgia Tech had no pre medical, anything except engineering, and they had a hospital systems engineering. And I said I could I could migrate into that it's healthcare related. So I finished my degree and that applied to two schools, there are only two schools in Georgia was the state school or Emory, the state school rejected me to say that you have no experience whatsoever, go away. That was sad. And I had my Emory interview, and it was a PA there. And he said, Well, we've never had an engineer. You're it. That was my interview. So I'm so thankful that I was led in, I was amongst combat medics and people with a vast amount of experience. But I did my senior thesis on a systems project of how PDAs could basically make the emergency rooms more efficient. So he was intrigued by that. He said, That's amazing. I love that. So that got me and so after I started that got a offer to work at Grady Hospital, and spent 25 years there, and amazing career and all the while I got the teaching bug by giving a lecture here and there I precepted students who would come in with rotations form and who would become my future employees, which was amazing, and then migrated over to the education side full time. So

Unknown Speaker  7:36  
that's fantastic. That story of the the PA that had an interest in your background just goes to show you the importance of diversity of applications, right? We we don't want cookie cutters in our profession. We want people with original thoughts, original minds, original experiences. Let's shift gears to Emory, I had the pleasure of going to Emory a few years ago for a Ph. D leadership workshop. Can you tell us about Emery school, what it is about the program that really sets you apart and some of the things you're really proud of.

Unknown Speaker  8:05  
So for for me as the program director, it is very important that we have an environment of diversity, of respect, and of collaboration. And in that environment, people can grow. And that means students but also faculty and staff. And in that environment. There is room for new ideas. And so for example, a few years ago, we developed our ultrasound curriculum, this is now a solid part of our curriculum. And our graduates go into jobs because they want to use the ultrasound skills. And on the other hand, I've also seen employee employers that have picked our graduates because they wanted them to bring these ultrasound scales and then share that with other employees there. Another curriculum thread is what we call them is social determinants of health. We have body systems modules, but throughout every module, we have interwoven social determinants of health so that our students can not only diagnose and write the prescription and find the right treatment, but there is more that they need to be aware of beyond that the patient might not be able just to eat a healthy diet because they live in a food desert, or they don't have transportation. And so it we feel it is our responsibility as PA is to go beyond that and help our patients to be successful in their recovery. Another example that was really special is that we are open to our students to bring ideas to the table. So for example, during the Ebola crisis, I had a student who kept coming to my office and he kept saying I want to do something I want to do Something for these Ebola patients. And I told them, Look, I don't even have access to these patients that were in the hospital just around the corner really from where we are right now. And then eventually, I connected the student with one of our graduates who worked in Sierra Leone and taking care of Ebola patients. And in that conversation, they realized that the providers in Sierra Leone needed scrubs, that they had to wash their scrubs and very harsh chemicals to clean them and that the materials were falling apart. And so we ended up having a scrub drive for Sierra Leone. And we ended up with over 500 articles of clothing that we shipped to Sierra Leone. And I think that class and that semester, we were all united because we felt like we could do something we contributed to this Ebola crisis. And I love that there is space in our program for new ideas to come forward. And in that we together that as a as a faculty and and really, as a program, tried to find solutions to problems or new ideas

Unknown Speaker  11:12  
in law that service orientation of Emory is not new. I my first hire as a program director, was an Emory grad from many years ago named Lisa Chang, who was amazing. And she, in our interview, she talked about the migrant farm working program that your university has been involved with. So this is kind of an ongoing threat as well, right community service and in serving the underserved.

Unknown Speaker  11:34  
Absolutely, yes. So the Emory Promarker project has been going on now for 25 years, started with one faculty member and eight students that saw the need of health care amongst farm workers in South Georgia. And it has now grown to about 200 volunteers. Those are our inner professional volunteers that come with us we have medical students and and the providers we have PT students and PT faculty that come with us, we have nursing, we have family and marriage counseling students and providers that come with us. And we take care of about 1800 patients and their families in a two week time frame. So every summer we go to Bainbridge and Valdosta for two weeks. And then we add one more weekend in October, because it is such a rewarding experience. And when you can talk to that as well.

Unknown Speaker  12:38  
Got to go several years and work with Tom Heimlich, who's our founder of that it was just basically to wound our students in a way that they would give back in their careers, and would have that sense of, you know, if we're blessed, we need to be a blessing to give back. And I think that's the kind of students we attract, we really want people to come and be a part of our program who want to give back in some way to the people they're serving and to have that heart. And I believe this project solidifies that a lot of people come back saying, you know, it wounds them a little bit to say I need to keep giving back. And they step out into their careers. And some of them actually go take care of minor farmworkers for their career. And so we've had alumni all over the globe, giving back in various ways, like Maha said, the one who went to Sierra Leone went in to the hot zone and was under threat of death, but taking care of people because she just wanted to give back and she was a part of our farmworker project and to hear what great things people do. There are alumni all over now that are sending us great students to who would like to be a part of that.

Unknown Speaker  13:51  
That's amazing. And is it safe to assume that because of Emory's location, you have the opportunity to be part of urban education and urban healthcare delivery and rural as well.

Unknown Speaker  14:03  
That's most definitely we have Grady is the big inner city 1000 Bed safety net hospital that sees people from all over the world who are here in Atlanta, so we're seeing all different levels of socio economics. And then we have rule, we have our students at least do one row rotation, and we provide housing for that to send them out to see what rural medicine is like. So it can be inner city, rural suburbs, so they're getting a vast exposure to all facets of medicine. And a lot of those will actually pick where they're going to land their career from those exposures.

Unknown Speaker  14:41  
We were talking earlier, Alan before we started recording about the benefit of zoom in our world of applicants and open houses and things like that. I wonder either of you could answer this question, which is one of those typical tips that you provide those applicants that zoom in for you nowadays, to help them now navigate the path to getting into Emory.

Unknown Speaker  15:01  
I think it's Be yourself. Don't try and fake it to make it we're looking for genuine, again a heart to serve and showing that, you know, we don't look for pat answers, we're looking for life experience, we really value clinical experience, we require 2000 hours of direct patient care. And that has been a, we're one of the highest programs in the nation, I think I don't think many people require more, but it let life experiences what we really value because people come to us and they've seen the good and the bad, and the heartbreak of medicine, and they still want to continue on. And that makes them strong, strong students. So I think it's more Be yourself, we've adapted to MMI, or multiple, many interviews to try and eliminate implicit bias in our interview selection. The people who do those are faculty and alumni, and they basically are blinded to the background of the applicants, they don't know anything about them. They're just listening to the responses. And I tell people to be themselves just just respond. And really, those are the best interviews you can do. And the high high scores there, get the offers of the seats. So everybody who comes to an interview really has an equal opportunity of getting in.

Unknown Speaker  16:18  
Is it your sense that there's been a growing number of applicants that maybe aren't being as authentic as it could be?

Unknown Speaker  16:27  
I don't see that. I don't. I mean, when I read all the Casbah essays, and there, there are some themes there that I can see over and over and over and over, over again. And those don't seem real, genuine, but the ones that are really from the heart, you can tell after reading 1000s and 1000s, I really love it when somebody just picks up a pen and, and writes from their heart. So I really tell people don't don't look at the internet and all the templates, because I do see patterns along those lines, but really speak from your journey in your life. And those really do stand out to me as being genuine. So I do see the genuineness and, and the applications, we also have a supplemental just for Emory. And I really advise candidates to really investigate us come we have several open houses on Zoom. And we really want you to come and watch those and meet with our students who will do question and answers. So to me, somebody who did their homework really stands out. And when we score things, we really rank those people high. Because I'd love people to know what we're about and have talked to us have met with our students, even on Zoom, because it's cheap that way doesn't cost a dime, it just takes some time. But the people who don't even really read our website and make up stuff like Emery is awesome, I loan income that those just don't, don't speak to us very much. Yeah,

Unknown Speaker  17:50  
we have a supplemental application as well. And to me, that is your golden opportunity to show alignment between your path and background and the institutions. So a failure to take advantage of that and really outline why X program is really what we're you're applying to. And this is why this is my background. And this led me to want to be part of a institution that takes migrant farm working, for example, seriously. So I agree with you. I think that's a critical step. And if they fail to make that alignment, it's really hard to give them an offer to come in and do it right. Yeah. So So Emery is how long, it's a 27 month program.

Unknown Speaker  18:29  
We're 29 months, we have dissecting anatomy, which is a cadaver. And the first year we did that we were still short, we were 28 months and we almost killed a class. It was just too much because they were having a whole body dissection and about four other courses all at once. And the class feedback was please never do that to another class. But we added a month and kind of gently spread out on things. So it was a better learning experience. So we're now at 29 months and I think we've we've hit the sweet spot for having what we do in that first fall semester, which is our foundations were anatomy. We do the whole medical history, the whole physical exam and ethics all during fall. And it really does take that extended bond to give the students some breathing room. And then rotations are for how long? whole year. Basically it's 11 months starting January all the way through December. Every four weeks, they're on a new rotation.

Unknown Speaker  19:33  
So I would imagine the two of you you've been in the education for a while and you are probably very familiar with a struggling student. How do you advise your students to pull themselves out of those challenging moments?

Unknown Speaker  19:47  
You bring up an excellent question. I think that many PA students are clearly accomplished when they come to PA school. And then when they you know the first exams hit And the first see comes out of their efforts, they are devastated. And they, I think, you know, they need to remember that the next day is just around the corner. And that they, they need to reach out to their faculty and say I need help because a faculty want to help them and they can help them and guide them in, you know, if they need to study harder if they need to study smarter, and I think when when students are focused on grades, they're missing, really the better motivator for working hard. And that is realizing that every patient deserves competent care. And that when they you know, after graduation, they are responsible for people's lives, and they will make a difference in people's lives and their families lives of generations to come because of the impact that they can have. And so because of that we should study and we should learn and, and become competent. So because of patience, and not because of grades and numbers are being the top of the class

Unknown Speaker  21:07  
Bell and other gods.

Unknown Speaker  21:09  
Yes, we also tell our students from day one, they're their brothers and sisters keeper, they need to watch one for each other, we want all competition to stop, we want them to make sure everyone walks across the stage graduating, and that really, they need to be accountable to each other to make sure that happens. So really, we want them to be non competitive, they share their notes, they share everything together study groups, we put them in groups of nine to 10 students with two faculty called societies where they have a more intimate, I'd say less classroom oriented environment where we do the case based learning, but the faculty are watching over those top seven or eight students all the time watching and seeing if there's any issues problems, they meet with those students individually. And just keep an eye on them to see if they're having any issues. They're paired with a buddy in the class above. So they have someone to talk to as a student, but they really do hold each other accountable. They do watch for each other. And occasionally a student will come to us and say I my friend is in trouble. And then we can step up things. We have great services here at Emory counseling services, we do testing to see how they're academically doing, we picked up learning disabilities, we picked up all kinds of things that people you know, all the way up to a graduate level, nobody detected and are getting their needs met and making sure they're going to be successful. So our job is to see them all the way through graduation.

Unknown Speaker  22:39  
Yeah, I think the concept of team it's a great place to start changing from the individual competitive nature of undergrad, trying to get into PA school to the fact that you're be part of a greater team the rest of your career. And that's a great message to send. Alan, you were talking about the fact that sometimes we pick up students with learning disabilities even this far along. And it seems like through life, they've learned how to self accommodate by their schedules in undergrad or things of that nature. But just the sheer volume and depth and breadth of education makes it really challenging to hide. So I think that's a really interesting point. And as an institution, how do you help those students level the playing field,

Unknown Speaker  23:18  
we have an agreement with a really specialized PhD who can do special testing, just check for learning disabilities and reading comprehension. And we try and get that done really right after orientation, to see if we can pick up things before they become problems. And it's amazing what's been diagnosed and people who may not have had accommodations, they've done survival techniques to get through their undergraduate degrees, maybe given extra time to do their testing, just because they're, you know, what was kind of given to them, but they made it through. But to go through this volume of material, it really does become a hindrance to the students. So we've been able to offer those accommodations. We have a very robust program at Emory for that some special, like I say, testing just for medical students, like our PA group that we have an agreement with. So we've tried to bring all those resources to bear. And again, our goal is to see somebody succeed here, we want to basically pick somebody who's going to be a graduate and not we're not here to watch people out, we're not here to do that. We're trying to choose carefully, but make sure that you have everything you need to succeed, then it's up to the student to make themselves available to those commendations. It's very important for us to make sure we diagnosis things early. So we've moved that way up ahead.

Unknown Speaker  24:39  
Now you both had robust clinical careers and presumably still do in some facet, but but your full time academics, correct. Correct. So tell us about that transition, and why do you think you have chosen to stay in education for all these years?

Unknown Speaker  24:57  
So I think I transitioned into academia bit by bit, just like Ellen has. And I became a full time faculty member and part time clinician for several years until it simply became too much with my responsibilities at the university. It was really hard, giving up clinical care, I missed my patience, I missed the daily interactions and making a difference every day in patients lives. But on the other hand, then, and there was some, you know, guilt leaving other providers behind and, you know, looking for people that can take my position, then who had the experience and could jump in. But on the other hand, Ben, for me, it became that the knowledge that I had and my experience and my attitude towards patient care, I wanted to share that with students. And it's felt that was like a ripple effect, you know, that my influence could be much broader by teaching students what I felt was very important. It's the really the students that make me get up in the morning. It's not the paperwork. It's not the meetings, it's not the reports get out for the dean's office. But it's, it's the students and the, I'm sure that many educators have said, it's the aha moment when you see that a student understood a concept and can apply it that is just wonderful. Or when a student comes back from a clinical experience, and said, I made a difference in this patient's life, because of what I learned because of what you pointed out to me because of what you taught. That is what keeps me in education. Thank you.

Unknown Speaker  26:51  
How about you, Alan?

Unknown Speaker  26:52  
My transition was pretty slow and gradual. I never was gonna even thought education was going to be on my radar. But it was, again, precepting students at Grady, I had a blast, and we learned together and they kept me sharp. And I always had those questions all day long. And like, why this why that man. So I say bring that back tomorrow, I've learned with you. But after that, and giving a few lectures and finding that to be fun, a was like I need I needed to move more that direction. And about 24 years of working at Grady again, it's a full time, effort. You know, the patients are complex. And again, you learn something new every day. It was I took basically a position to do an online master's program at Emory for bachelor's trained pa like I was a bachelor trained pa back in the day. And so I like tech. I'm a tech guy I am. I like technology. And I like the online content. So I was offered a ability to set that up. And really, for two years I worked halftime, Grady halftime Emory, I found that to be two full time jobs, Grady you couldn't play you were in and had to do all the follow ups for patient care. And it was it was wearing on me. So I had to make a choice and either go to the education side or stay at Grady and I chose the education side was more fun than after 25 years, I said I can give the clinical experience at rest. And I can give the education of what I've learned over 25 years to the education realm. So I went with full time over to the education side. And that was, I think, a good move for me, mentally, physically, everything I and I, it was not fun to do two full time jobs. So I had to make a choice. And I've really enjoyed the choice. I don't regret it at all. It's our students that really do keep us going that are amazing. And I kept up with the sickle cell activity just by doing patient education and website and doing virtual things, but it kept my hand and that is core to my community service. And also we precepted our good samaritan clinic, we have a monthly Clinic. My wife is a physician, she goes in precepts, the students I am a chauffeur, but I get to talk to the students there and preset. So I live virtually through our students with the clinical side and it keeps me sharp, I have to keep reading and keep updating myself.

Unknown Speaker  29:33  
Let's talk a little bit about the future of our profession. You both been in the profession long enough to read tea leaves probably pretty efficiently and there's a lot of change going on in the PA profession. Just be curious for your thoughts and how that may impact your educational program.

Unknown Speaker  29:50  
I've seen that as a profession. Our students are going out and working at the top of their license. I think they're being given more and more clinical responsibility, more autonomy. Here at Emory, the PA is run the ICUs. You know, it's incredible. You know, there may be a physician in Australia looking at a big, big screen. But really the PDAs are at the bedside doing everything. So I think I've seen over the years, the, you know, the medical community's welcome, the PAC invited the men into higher higher levels of autonomy and in all different branches. And it is, it's an amazing thing to see, I think we're riding way up on the crest of a wave, that's just way up there. So things have been going up and up and up for in a good way. And I think it's a great time to be a PA, it's an amazing career, because you can shift and change, I think Martha and I have both changed and been in various fields that we've been able to migrate to, and, and you always bring skills to that, from your background that help you into the next phase. So I think it's no regrets here. It's been a wonderful career.

Unknown Speaker  31:01  
I 100% agree with Alan, what I see as a current, something that we need to be very intentional about is the growth or the increase of number of PA programs, and the lack of experienced faculty and the lack of rotations. And I am concerned that that we need to be focused on keeping the education as strong as it has been that we keep the standards very high because the the community or the medical community is looking very closely at what we do. And I think we we have, we owe it to our patients to keep our standards high and to graduate competent PHS. There are programs that graduate more numbers of students that are more interested in the quantity versus the quality. And I would advocate that we need to keep the quality high to protect our profession, and to protect patients and serve our patients.

Unknown Speaker  32:11  
I had a chance to talk to Tony Miller from Shenandoah University yesterday. And he was talking about this kind of interesting period of time in our profession where the number of applicants is flattening off a little bit. And on top of that the baby boomers are going to be slowly passing on. And the growth of programs all three things all at once is likely to put some pressure on programs that don't have distinction in some way, shape or form to attract the number of applicants, they need to keep their seats full. He reminded me a little bit of PT back when I first started in the academic world PT had a drop off of their applicant pool. And the school I was at at the time had to contract to their class size down from what was probably a way to large class size to a more reasonable one. But ultimately, they did eventually rise back up. So it'll be interesting to see how that impacts us. Given that we have these two competing factors, applicants dropping programs growing, right, I would imagine a program like Emory is probably in good stead.

Unknown Speaker  33:15  
Well, I think I've seen one COVID did change things quite a bit. We had, again, a very rich applicant pool, but a lot of people decided to stay closer to support systems did not want to travel across country. So stay local, that was a big shift. And I don't know if other programs had a lot of that going on. I think we attract a crowd that could apply to the top 100 schools and would be offered you know seats. So I always tell people, if you're coming to an interview here, you should be getting 10 different offers, and you should be interviewing at the top 10 schools. So our crowd is is I think the top of the tier and we really do appreciate them, you know, we have to show Emory for them to be able to come here. So with during COVID We missed out on everything, nobody had a chance to come visit because everybody was locked down. But this year after our MMI interviews, we're going to bring people to campus, the top 100 To really see us to get to know us to meet with us physically and see the campus and to do that in spring. I think that's what we missed this past year with COVID. And so COVID thrown in a lot into the recruiting. I think that's a new twist that nobody ever predict.

Unknown Speaker  34:31  
Yeah, I think in every major societal change, there's always good and bad. And the pros in this one are we learned a way to do some things that are perhaps going to make it a little bit more accessible to students who come from economically challenging situations. So Well, thank you both so much. This has really been delightful and I can understand why Emory has been trucking along for so many years with such excellence when they have such great caretakers at the helm like YouTube. We Appreciate your time and the opportunity to highlight the school and your careers and your paths and wish you the very best in your future.

Unknown Speaker  35:06  
Thank you so much.

Unknown Speaker  35:09  
Well, I want to thank Dr. Lund and Mr. Platt for joining us today to share their insights on applying to the profession and for sharing the rather unique paths to becoming PA. I was interested to learn about Emory's admissions process, their passion to serve others through the work they do in both Atlanta and in rural Georgia as well. You can learn more about Emory University's program and about our two guests on our episode 11 show notes and Pa path podcast.com. Tune in next week as we speak with a man who is widely known in our professional circles as the father of Casper, the centralized application service that our applicants participate in. He is also the founder of the Oregon Health Sciences University physician assistant program in Portland, Oregon, and has made significant impacts in our profession that we will see for generations to come. Mr. Ted rebacked joins us for episode number 12. Until next time, I wish you success with whatever path you are walking in life. And thank you for joining us. The purpose of this podcast is to provide news and information on the PA profession and is for informational purposes only. The views and opinions expressed in this podcast are those of the speakers and guests and do not necessarily reflect the official position or policy of the University of Southern California.