Maitry, Radiation Oncology PA
Maitry is a Class of 2014 graduate of the McMaster PA Education Program. She started working there as part of the Health Force Ontario Funding. She has been an active team member in the outpatient radiation oncology clinics in breast, lung, eye, endocrine, head and neck, genitourinary, gynecological and brain metastases sites. She acts as a liaison for the University of Toronto and McMaster PA students.
Follow Maitry on instagram @radonc.pa
Maitry Patel, a Canadian Certified Physician Assistant who is a phenomenal patient advocate, PA educator, researcher and clinician!
About Me
I am the first Canadian Radiation Oncology Physician Assistant working on the front line since my graduation from the McMaster Physician Assistant Education Program in 2014.
I am an active member within the outpatient clinics in breast, lung, eye, endocrine, head & neck, skin, genitourinary, gastrointestinal, gynaecology and brain metastases sites. I act as a liaison for University of Toronto and McMaster University PA students at UHN.
I am proactive about creating accessible patient education material using plain language and providing faultless transition to community or palliative care services for oncology patients.
Outside of work, I have recently been elected as the Alternate Director for Ontario on the Canadian Association of Physician Assistants (CAPA) Board of Directors, due to start my term in October 2019. A true Torontonian at heart, I feel committed to being the voice for Ontario PAs in the rapidly changing healthcare environment. Beginning October, I will be working closely with Sahand Ensafi (Emergency Medicine PA at UHN) for leading the development of the PA role at at a provincial level.
1. What is a Physician Assistant?
A PA is an extension of the physician’s role. This term has been used often, but I do find that PA’s are an extension of the entire health care team.
A physician sometimes gets bogged down with work that only they are capable of doing, whether it’s being the primary surgeon, or it’s being the radiation oncologist who has to plan their patient’s radiation treatment.
A PA can bridge the gap between the admin side of things, nursing side of things and the clinical side things.
How I learned about the PA profession
One of my current colleagues at University Health Network – Dhiral is a PA who works in Urology.
She is from the first University of Toronto PA Class of 2010 and also family friend who told me about the PA program while I was in my 3rd year university.
I was exploring options at that time and I knew I wanted to be in medicine but I did not want to go to medical school. I was deciding between nursing, physiotherapy, occupational therapy other allied health programs.
Dhiral told me a little bit about the PA programs at McMaster University and the University of Toronto. I was not eligible for University of Toronto, because at the time UofT required paid health care experience (which is now different). I only applied to the McMaster PA program, and got in.
2. What is Radiation Oncology?
If you have to divide Oncology into three, it would be:
Medical Oncology
Surgical Oncology
Radiation Oncology
Medical and Surgical Oncology tend to be the most known type of Oncology. Radiation Oncology is the treatment of malignant cells with x-ray treatments.
“Radiation oncology is the steady end treatment of cancer using radiation beams in different forms.”
We use IMR/VMAT techniques – these are different types of techniques we use to deliver our radiation.
We also do intra-operative radiotherapy, which is the application of the radiation seeds directly into the surgical cavity to be able to treat the patient while they are on the bed.
We also do brachytherapy which is the insertion of gold seeds into wherever it is we are targeting, whether that’s the prostate, a surgical cavity, lung, cervical cancer patients, endometrial cancer patients. So different modes of delivery treatment.
Common Conditions seen in Radiation Oncology
I work for the entire Department of Radiation Oncology, which is 39 physicians. That can I mean, it means I work at all site groups.
In the last 4 years I’ve worked in lung, breast, GU, Gynecology, GI, Eye, CNS, Paediatrics, Endocrine, Pituitary, and with our Palliative Clinic patients.
In a general week, I see mostly breast and GU patients, as we know breast and prostate cancer patients tend to be the most common in the general population.
A major component of my work is viewing, reading, and interpreting images in various forms, including but not limited to mammograms, X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRIs), and nuclear scans such as positron-emission tomography (PET) and whole body iodine-131 (I-131) scans.
Through this medium, I will share some common and some unique uncommon oncologic findings. So let’s start with mammograms! It only makes sense as breast cancer was the most common cancer in women worldwide, contributing 25.4% of the total number of new cases diagnosed in 2018. In Ontario, where I practice, most women ages 50-74 are enrolled in the Ontario Breast Screening Program (OBSP), through which they get screening mammograms every 2 years.
When viewed on a mammogram, women with dense breasts have more dense tissue than fatty tissue. On a mammogram, non-dense breast tissue appears dark and transparent. Dense breast tissue appears as a solid white area on a mammogram, which makes it difficult to see through and identify areas suspicious of malignancy.
3. Starting My PA Career in Radiation Oncology
I work at Princess Margaret Hospital in the Department of Radiation Oncology, so my job hours would be Monday to Friday, technically 9 am to 5 pm, but I’m usually in at 7 am or 7:45 am as I like to prep on my patients and get the day started. I like to read up on my patients so that I know the full history before I go in. Every clinic and every day is variable.
This job was part of the Health Force Ontario funding when my class had graduated. I applied tothis Radiation Oncology position in addition to 7 other positions. Immediately after the interview, I knew this was an excellent position.
My Exposure to Oncology during 2nd year PA School
Part of my 2nd year PA school General Surgery rotation at Mount Sinai Hospital in Toronto was Oncology based.I got to work with a breast surgical oncologist, and the other aspect was also some of the HIPECC surgeries that they do for peritoneal malignancies. That was my first introduction to the clinical aspect of surgical oncology.
I did not do other dedicated rotations for oncology. However, during my internal medicine rotation at Toronto Western Hospital, I did see a lot of oncology patients as it was connected to Princess Margaret Hospital. We would send our neurooncological patients to Toronto Western Hospital as well since Princess Margaret Hospital does not have an ER department.
Getting Oriented as a new PA hire
They were co-operative in that they told me to think of myself as either a 4th year medical student, or a first year resident.
I was told to focus mainly on history and physicals, and eventually as time went on I learned more and more.
I started off by doing a cross-sectional anatomy course, in PA school there was not a lot of focus on reading CT scans and MRIs, PET scans, and radiation oncologists read their own scans whether its diagnostic scans or our own department scans.
We use these scans to plan radiation therapy. I have become proficient in reading these scans, which means that I am learning the anatomical landmarks as we see them on CT scans, MRIs and PET scans.
The staff radiation oncologists were very helpful in getting me to that stage. I was comfortable enough to discuss the radiation plans with the patients a and discuss the dose that we would offer to the patients because sometimes it can refer based on the patient’s co-morbidities will tailor our treatment plan.
And eventually we got to the point where I was able to put in the radiation prescriptions. I am able to obtain consent, and get the process started without a supervising physician to co-sign.
4. Working as a PA in Radiation Oncology
What I enjoy about working in Radiation Oncology
I love working with Oncology patients. What I enjoy about radiation oncology is that each and every treatment plan is custom designed the individual patient. I like being able to look at the entire individual and not just having one set of plan that is for everyone.
For example, sometimes we have somebody on paper that looks like they have co-morbidities – everything from meningiomas to cardiac conditions, to bone issues, but when you actually see the individual – they upbeat and they want everything possible for their cancer care.
In contrast, we could also have someone very frail and need a lot of initial support in getting where they need to get to eventually.
“I like being able to sit with each individual person, planning out a treatment plan which is right for them to be able to get to the point where we are curing all of our patients of cancer.”
Princess Margaret Hospital’s tagline is to come up with a cure for cancer within our lifetime, and everyone that I work with is working extremely hard to get to that point whether its pathologists, radiologists, or medical oncologists, surgical oncologists and just being part of that team, makes me feel like I’m doing something extremely valuable for the patients and I am being back to the community that I’ve taken from all these years.
What I find Challenging about Radiation Oncology
Recently I had a situation where I had to give bad news to an individual with a young family. For a few years I was delivering bad news to this individual – first a diagnosis of cancer, then recurrence that required extensive 14 hour surgery with bone grafts, skin grafts followed by extensive chemotherapy. They were very sick, and they were just getting to get better.
I had to give that patient another piece of bad news, there was another cancer picked up incidentally while doing blood work for the first malignancy. Iti s difficult when you have to break bad news, patients are very resilient, and that’s something I learned about these cancer patients is that they will take everything you can throw their way. But sometimes being on the other side of things get hard.
I try to use it in a positive way, that I can help them to the best of my ability, whether it is just calling them a week later and checking in, and saying ‘how are you doing?’ because that means a lot to them. Just knowing that their health care provider hasn’t forgotten about them, and they are not just a number in your chart. Sometimes that gets difficult, and its something we can all learn from as well.
PAs are filling in the gaps
My schedule changes every 6-8 months based on where the gaps are in the various Radiation Oncology Clinics.
Usually my schedule is the same for 6-8 months. My supervising physician and I will go through my schedule every 6-8 months just to see if there are any particular clinics that need additional help.
The beauty of having me versus a Nurse Practitioner or a fellow, is that I am extremely flexible. Like I said, I work for all the physicians, so I can be put into any clinic and could get started.
Fellows, strictly speaking associated with one site. You cannot just take a lung fellow, and put them in a gynecology clinic, even if gyne is behind in terms of the consults.
5. My Weekly Schedule
Monday:
I start off Monday morning with a breast clinic, usually most of my clinics are clinics we see some new patients and some surveillance patients. Our follow-up patients could include those who are active surveillance or patients we are just following without any imaging or blood work. Sometimes we follow patients with mammogram, or sometimes we see patients as part of our follow-up schedule, but they are coming in sooner than they’re appointment because they have concerns, questions about what they’ve gone through or what to anticipate.
I go to gyne clinic in the afternoon where most of our patients are endometrial and cervical cancer patients. We will see every now and then, palliative patients in those clinics. These are individuals, because of their gynecologic malignancies are bleeding actively, we do have to intervene sooner rather than later.
In clinic we will see review patients, who are patients that are undergoing radiation treatment right now. We need to keep a close eye on them and are experiencing anticipated side effects, but we need to keep on top of things.
Tuesday:
Tuesday mornings starts off with a busy GU clinic, where I mostly see prostate cancer patients. Most of them require post-operative radiation therapy either in an adjuvant setting or salvage setting.
And then I end off Tuesday with an eye clinic, which is ocular melanoma. I have been doing that clinic consistently over the past 4 years since it was a new addition to this schedule when I joined the department.
Wednesday:
Wednesday I would do prostate cancer and breast cancer clinic in the afternoon. Again, prostate and breast tend to be my heaviest workload.
Thursday:
Thursday morning, I have a head and neck and lung combined review. This is where we see head and neck, and lung patients who are currently undergoing treatment. If we are overbooked or behind in terms of Cancer Care Ontario (CCO) guidelines and when we have new patients, we will see 1-2 add on patients.
Thursday afternoon, I have an endocrine clinic, where I see mainly thyroid cancer patients, and every now and then we see neuroendocrine or pituitary cancer patients.
Friday:
Friday morning up until recently used to my brain metastasis clinic, in a multidisciplinary fashion we would see all of our cancer patients who have known brain mets, either they need surgery, radiotherapy, or one of the other form, or surveillance because they are on immune therapy.
Then Friday afternoon I attend resident teaching, finish up on my charting. If I have students at that time I will use that time to catch up with them which may include a teaching session, and I also use that time for research.
6. Impact of a PA in Radiation Oncology
How I work with 39 physicians in the department
What’s great about my department I have constant access to all of my physicians. We’re all on the same floor and most of them have an open door policy. I can just walk into their office and we can chat about whatever we need to, whether it’s patient care or clinic concerns.
My supervising physician is the one who is in charge of my entire schedule, and that is Dr. Richard Singh. We will sit down every 6-8 months and think about where I am needed most. I tend to go clinics that are very busy or full.
Over the years we have known that when a staff Radiation Oncologist leaves there is a gap that needs to be filled, and I end up covering those clinics.
For example, we had a radiation oncologist who moved out to British Columbia, and he had a big prostate practice. One of the other staff and I took over that clinic for a while. That would tend to be my role in how I interact with the physicians. Unfortunately, I have not had the opportunity to work with all 39 of them over the 4 years, as that is a lot to go through, but I have worked with a lot of the senior staff.
Patient Experience with a PA vs. MD
In clinic, there is not a lot of difference in whether a patient sees myself (PA), a fellow, a resident or the staff physician. Our practices are pretty similar for new patients. It involves history taking, physical examinations, communicating about the diagnosis, obtaining consent, going through side effect profiles, and talking to patients about the anticipated future timeline.
The biggest differences in patient care is what happens behind the scenes.
Behind the scenes, the radiation oncologist including the residents and fellows are involved in creating an individualized, personalized plan for each and every patient – because we are all anatomically different.
All of our organ sizes are different and how we are structured is different. We can’t just use one plan for every breast patient, for example, it has to be carefully designed so that you are not giving toxicity to the nearby organs.
I don’t have any training in that aspect, so I am not involved in that part of patient planning aspect, which is where the radiation oncologist can dedicate more of their time if I can help them clinically.
How I work with a NEW physician team member
Anytime I am starting off a new clinic with a physician that I have not worked with before, I usually sit down with them, and I ask them about what their expectations of a PA is.
This is because I am the first PA to be working in the Radiation Oncology Department at UHN, and it is likely they have not worked with a PA before.
Although, we do have some American staff Radiation Oncologists who have had opportunities to work with PAs in the United States.
“Most physicians, in fact, would expect me to do everything they are doing, which is being able to see a patient, discuss treatment plan, obtain consent, walk them through their entire cancer journey that the patient would expect to go through.”
Every now and then there are physicians who are either part of clinical trials and I may not be aware of all the clinical trials they are apart of, or trying to recruit patients for. It tends to be a learning and teaching opportunity for both myself and the physician.
Once I get started with the physician, and I am in a routine, we know exactly what we are doing. I see all the new patients for the clinics I am part of. If there is a resident, then the resident will see new patients and physicians will dedicate a little bit of extra time to do the teaching.
For example, I’ve been going to the endocrine clinic for the past four years. I can determine the dose to give to the patient for the radioactive iodine. We would go through the treatment plan, and for residents it ends up being the first time they are introduced to the concept of radioactive iodine treatment. Subsequently, there is a teaching component for staff physicians when they work with residents, as opposed to working with me as a staff PA.
Our radiation oncology residents are shared between Princess Margaret as well as Sunnybrook Hospital, and they do have some rotations they either have to do uptown or in rural areas. They will rotate through different site groups and we will go months without having a resident because they are doing their rotation at Sunnybrook.
Impact of having a PA work in Radiation Oncology
Benefit #1 – PAs help with reduced staff coverage on holidays
The feedback that I have received is, “its nice to have one person who can essentially cover any Radiation Oncology site group”. For example, during the week of Christmas, a lot of the staff members are away and we can get urgent consults from anywhere or patients who drop in. This may be difficult if you can’t find a covering physician and resident.
But if you have a PA who can attend to any of the patients for any of the staff it makes the process a lot easier. For example, on Remembrance day weekend, which is technically a stat holiday, our clinics were cancelled. We had a radiation oncology patient who bleeding fungating mass and they needed to be attended to.
The patient would have to go to the ER and wait a long time, but since the Radiation Oncology department has a PA – I was able to attend to them, and update the physician about what my plan of action was, and allow physician take over the care the next day.
“It makes the transition smoother for the patients, for the physician in charge and I hope it is reducing the load we are having to put on our Emergency departments and our inpatient beds.”
Benefit #2 – PAs can help take on the Physician workload
In the first year that I was there, we did collect data of PA use. We are keeping track of those numbers still. We have noticed reduction in two full time staff physicians, we were able to compensate for that reduction by hiring a PA. I was able to see the same number of new patients that a staff would see.
For example, there is two radiation oncologists who treat endocrine malignancies, so both pituitary and thyroid cancers. When I was introduced to the practice I was seeing 1/3rd of the patients.
“I was contributing just as much as a staff physician in terms of the number of new patients and follow up patients I was seeing, which made it financially feasible to keep me around, as well as improve our access to care.”
Benefit #3 – PAs can help increase # of patients seen while reducing wait times
One huge thing we noticed, is that we only have one neuroendocrine clinic per week, and like I said we only have two radiation Oncology physicians that are in charge of it. We also cover a wide catchment area, so our wait times at one point were up to 2-3 months, and although thyroid cancer tends to be slow growing, and it is safe to wait that long and pituitary tumors tend to be benign more often than not.
“When I was introduced, we were able to see a lot more consults and a lot more follow up patients. Our wait times is now 3 weeks, decresaed from an initial wait time of 3 months.”
The multiple site groups have had that opportunity, that’s why they’ll put me in a site group where there is a lack of a staff physician or where there are more consults than anticipated for that time frame.
The idea that “PAs replace physicians” is a misconception
PAs are NOT replacements for Radiation Oncologists. Like I said, there is a lot that happens behind the scenes that only the radiation oncologists can do, which I absolutely cannot help with. But what I can do is help Radiation Oncologists with their clinical workload, which is seeing patients. This frees Radiation Oncologists to perform treatment planning so that these patients can actually be planned and tee-ed up for their treatment, and treatment can then be delivered in a timely manner.
Cancer Care Ontario (CCO) mandates that we see our new consults within two weeks of the referral being sent to us. Radiation Oncology is not like other specialties where we can just hold on to these referrals and say ‘Oh we’ll see when we can get to you’.
These are cancer patients, and time is of the essence. We have to get to them sooner rather than later, and if I can help see extra patients in clinics, it frees up that much more time for the radiation oncologist to work behind the scenes, both for resident and fellow teaching, as well as being able to plan the radiation treatment plan for the patients.
I would not say that I am replacing them, I would be better described as an extra pair of hands that helps radiation oncologists cover the clinical load that we have.
7. How to Add a PA to a Radiation Oncology Department
If a group is contemplating adding a PA to their Radiation Oncology Department or Practice, I would urge others to do what we did – and that is to look at what their numbers are.
Numbers do talk. We were able to show with our first study that introducing a PA to an academic centre, which is very busy as is, not just from a clinical point of view but a research point of view, if you can hire PA or two in that setting, they can help significantly in a clinical aspect and the quality of care that the patient’s receive is identical to what the residents, fellow or staff would provide. And a lot more time can be freed up for research, teaching, and other activities that the radiation oncologists want to participate in.
If the hospital is part of a busy academic centre, or even if they are not an academic centre, and are a community hospital, if they have the numbers to show that the addition of a PA will help them see extra new consults per year, or help them cut down wait times to be seen by Radiation Oncology, that would be a good start to look of.
How My PA Job Was Funded
The first year I started off, like I said, I was part of the Health Force Ontario Career (HFO) Start funding. The plan was that HFO was going to provide 50% of my salary, 25% of was going to come from my department, which was all of the physicians have a pot and the pot pays for their salaries, and that pot would have paid 25% of my salary. The remaining 25% came from UHN.
Starting in my second year of employment, the plan was 50% was going to come from the department, 50% from UHN. But we had a change in our administration and as part of budgeting, they removed all of PA funding. What that meant was, my department’s goal to hire two PAs had to be put on hold, because now they had to use the same money to pay one PA, which is what they did for the second year.
In the interim, we were able to do our application for their Ontario Oncology Association (OOA), which is an association which helps other departments (Oncology Departments, Radiation Oncology) hire additional staff, in the form of either: GPOs (GPs in Oncology training) Clinical Specialists or Internists who help with Oncology workload, or PAs, or NPs. We used this process to apply for funding for a PA, which was approved.
Now we have finally gone into having me as a permanent part of the Department of Radiation Oncology. I am being funded by the ‘pot’ as we call it, which is where all of the Radiation Oncologists put their billings, and they all have set salaries, and I am paid through that same salary.
I technically indirectly help the pot but I do not do any of my own billings.
What Hospital Staff (nurses, support staff, allied health), can expect when interacting with a PA
With the nurses, they know they have somebody to go to if the radiation oncologists are not immediately available. They can expect the same kind of response from me as a PA, as they would from a staff radiation oncologist, which includes following up imaging results, triaging incoming referrals, facilitaitng referrals, updates on the treatment plan, and updates on how the patient is doing clinically.
In addition, we have a triage line for every Radiation Oncology site group which is manned by the nurses. They do try to cover all the triage calls as much as they can, but every now and then there is a call that comes through which has to be redirected to the Radiation Oncology staff.
Prior to having as a PA, the nurses would have to try to track down staff. However, if the Radiation Oncologist on staff is on leave, or at a conference, the nurses would have to try to find the covering radiation oncologist. Since I started working as a PA in Radiation Oncology, the nurses know I work in all of these different site groups and the triage nurses to know to turn to me if there are any concerns that crop up and it can be sorted a lot quicker and easier than having to hunt down the staff. At the end of the day, you do get the same answer whether from the staff PA or Radiation Oncologist.
Working with PA Medical Directives in Ontario
I do work with medical directives. So UHN has a set of base medical directives, which thankfully does cover a lot. So in my own department, we had to add the directives, including allowing the PA to be able to put radiation prescription, which obviously is a significant deal. If you put in the wrong prescription it can be lethal for the patient. Thankfully we have multiple check points where things get assessed and re-assessed before the dose is actually delivered to the patient. However this is a pretty important medical directive to get.
After 6 months of me working at Radiation Oncology, I had an assessment with all of the physicians I was working with at the time, they individually observed me with multiple patients to everything from new patient interactions, histories, physicals, obtaining consent, talking about side effects, seeing patients onboard with treatment, putting in radiation prescriptions, putting in radiation doses, the diagnoses in our radiation system, and once all of that was approved by all of the physicians I work with at the time, those medical directives went in.
8. Teaching Responsibilities
Most of the resident teaching in Radiation Oncology happens with one-on-one with the staff physicians, but in the endocrine clinic, I do tend to do a little bit of the resident teaching before the residents start their rotation, because it tends to be a little bit different than some of their other clinics – both with how the patients are seen, what kind of issues we need to keep in mind, and the concept of radioactive iodine treatment tends to be new for them.
I am more involved in medical student and PA student teaching, as these students come through the Department of Radiation Oncology. I am responsible for orienting them, and ensuring they are aware of how things are process at University Health Network, what to expect out of their rotation, and to have a clinical point of contact who can act as a liaison with other staff radiation oncologists, or team members if they have any concerns along the way.
How I enhance resident teaching
Many residents and medical students often tell me I am the first PA they have interacted with. Every now and then, they have done a rotation at Sunnybrook, and as we know Sunnybrook does have a lot of PAs – so they have interacted with a few of the Sunnybrook PAs. Or if they have done a rotation in America, they will sometimes be familiar with the concept of PAs.
If residents have to dedicate all of their time in assessing patients and doing the clinical workload, they can’t dedicate some of that time to their research requirements as part of being residents at University of Toronto. They learn the treatment techniques they have to learn, the planning, etc. Having somebody in clinic, who not only helps them with their patient workload, but helps them with their transition to the treatment plan, really helps them in meeting their curriculum goals, so they can dedicate that extra time to work with them and their requirements.
So far I’ve had excellent rapport with all of the residents I have interacted with, some of the residents that I started off with are now staff at our department so its really great to see that transition over time.
9. Tips for Learning about Radiation Oncology
If a student was interested in doing Radiation Oncology, I would really urge them to use their electives to do a rotation where they are exposed to different types of Oncology settings whether its inpatient, outpatient, surgical, clinical or radiation – or a combination of those. It is good to immerse yourself in those settings, you come out learning a lot more about process and it really puts in the right mindset you can find out if Oncology is for you, or you found out its not for you.
If you still don’t find out, then that’s okay but at least you’ve had the exposure to the kind of setting you can potentially work on in the future. If there is a new graduate looking to work in Oncology or just started to work in Oncology, there is a lot of resources online, both from UofT, MD Anderson, Princess Margaret.
Cancer patients are not only going through cancer treatment, they are going through a lot simultaneously and their families are going through a lot – whether its social concerns, family concerns, how they perceive themselves (image concerns).
Make yourself aware how to treat a cancer patient holistically, when you see somebody, try to pick up on what their issues might be, which may or may not be directly related to their cancer diagnosis. But if you can help them through the entire journey, it makes the entire process a lot easier and treatment a lot more bearable for them.
How I stay on top of current medical knowledge in Oncology
My department tis very cooperative and encouraging. They do send me to a lot of relevant conferences. The one I go to every year is the American Physician Assistants in Oncology (APAO), as I find it extremely relevant to me as I find that I am up to date on the Oncology updates that have come in the last year. I tend to go a lot of different sessions, whether its surgical, medical or radiation – as we are trying to treat our patients with a tri-modality approach.
I will also try to go to radiation Oncology specific conferences. They tend to be a lot more technical and a lot more intense in learning, but it helps me keep up to do ate with the new clinical trials that are ongoing, the new clinical trials that my patients could be part of, or new data that has come that could change things over time. And In my course of short career, I have noticed we have transitioned to minimal treatment and less number of days of radiation, minimizing toxicities. It’s important to keep up with all of that. Most of my CPDs come from conferences.
I do have tumour boards that I go to, which tends to be the non-accredited CPD credits I can account for. And some of it comes from resident teaching and learning sessions that I am apart of.
10. Final Notes
I went into the PA program wanting to learn a lot more about what the profession was, which I definitely did. When I was doing my rotations, I was very much interested in working in the Emergency, because I really loved the ER, I loved being hands on, I loved being able to help patients in that time.
And Oncology is such a contrast because it’s such a longer process, and because you want to help them right away but you can’t. So I think a lot have transitioned, I did not see myself working in Radiation Oncology, that was one prospect I had not considered.
I wanted to work in either ER or Oncology, and if was Oncology I wanted to work in surgical or medical oncology. Its funny how things work out over time. Now that I do what I do, I don’t think I can imagine myself anywhere else. I’ll probably retire in this position!
Reflecting on Deciding to become a PA
There is absolutely nothing I would change about my role, or how I got to where I am, which was going to McMaster, getting the training, getting exposed to all these individuals in first year and clerkship, meeting all these PA colleagues and friends over time. I would highly recommend the PA profession to anybody.
