Josh works in infectious disease in Texas, mostly HIV care, and it's a specialty almost nobody thinks about when they're applying.

He went to George Mason for biology, then Drexel for PA school, and graduated in December 2017. We spend a good chunk of this talking about the application - how he built up patient contact hours and what he thinks actually made him stand out.

His point about interviews stuck with me. Be specific. Not "I want to help people," but the actual patient, the actual moment, the actual thing you did. Generic answers blend together. Specific ones get remembered.

What we talk about:

• His path from biology at George Mason to Drexel
• Getting patient contact hours that mattered
• What set his application apart
• Being specific instead of generic in interviews
• What infectious disease and HIV care look like day to day
• Why he'd recommend the specialty to students

Resources:

Free application timeline: https://www.thepaplatform.com/services/free-application-timeline

PA School Interview Guide: https://www.thepaplatform.com/physician-assistant-school-interview-guide

Free resume download: https://www.thepaplatform.com/services/free-resume-download

Pre-PA counseling: https://www.thepaplatform.com/services/pre-pa-counseling

Welcome to episode 57.

Today I'm interviewing Josh, an infectious disease PA.

Welcome to the Pre Pa Club podcast.

If you want to learn how to become a physician assistant, you're in the right place.

I'm your host, Savannah Perry.

Let's get to it.

Hello everyone.

Thank you for tuning in to the pre PA club podcast for episode 57.

I'm Savannah, the host and I am a dermatology PA and also the creator, founder, whatever you want to call me of the PA platform dot com.

So thank you so much for taking the time to listen to today's episode.

Our guest today is named Josh and he is an infectious disease PA working specifically with HIV patients in Texas.

And we were connected, but through one of our interview coaches, Nan, and you may remember her, she was back in episode, let me see, 54.

And she's an ENTPA.

So they knew each other.

I think they met actually at a APA conference.

But yes, they connected.

We connected through them.

And his job sounds so interesting, so I'm really excited to share that with you.

And he was able to help out with interviews a lot while he was in school, so he's got some insight into the interview process.

I know interviews are in full swing from the emails I'm getting and things on social media, so it is definitely interview season.

But I'm really excited for you to hear this.

Let's get into our interview with Josh and I think you're really going to enjoy it.

All right, so hi everyone, I am.

My name is Joshua Estrada.

I am a PA working in infectious diseases at Parkland Hospital in Dallas, Texas.

And I started actually living in D.C. where I studied biology at George Mason University for my undergrad.

And since April I've been at Parkland with infectious diseases, but more specifically the HIV AIDS community.

Coolin.

Yeah.

So was your research in HIV aids?

No, actually.

So my first I was doing a research study with thyroid cancer research, so mostly hypothyroidism related.

And then I was doing research related to pregnancy as well, but more so just kind of observational type of study looking at pregnant women in their first trimester to see how if they were, if they had received the flu vaccine or any other maybe anti virals, antiretrovirals as well too.

Not really specific to hiv, but just to see if they've had any medications or changes during the first trimester and then following up with them postpartum to see if there was any birth defects or any issues there.

Okay.

How did you move from wanting to do research to pa?

I mean, was that something in the back of your mind or just weren't kind of getting what you wanted, doing research?

Yeah, I think it's a little.

It was a little bit of both for me.

I was originally going into research, wanting to I guess go for that PhD, go for those publications, which I think in the back of my mind I still would like to be part of research.

But it was my exposure to PAs during that time working at Georgetown with OB GYN PAs as well as with oncology PAs, where I was like, hey, this is, you know, they're doing great work out here.

I feel like I could do this as well.

And I wanted to do more patient oriented stuff.

I didn't see myself stuck in a lab for hours on end or stuck behind a computer doing manuscripts for hours on end.

Yeah, for now, I don't think I would enjoy that either.

At that point, did you have, I guess, the requirements you needed or what did you have to do to kind of start pursuing doing the PA route?

So thankfully, yes, because I had a biology undergrad degree that pretty much set me up well to if I wanted to do research or wanted to do PA profession, I was pretty stuff that I don't think I had to do.

The only major thing I had to do was kind of get more shadowing with PAs and then some more of the like patient contact related hours as well.

Okay, so you did that, you applied and you accepted your first round?

Yes, thankfully, yes.

Yeah, I applied.

Actually.

They got, I guess it was the early admission for Drexel.

I applied to other schools upon the east coast, but that was the kind of school that clicked for me during the interview process.

Cool.

Okay, so once you are in the application process, I guess what did you find?

Was there anything difficult about it or anything that you felt like was weak on your application or anything that made you stand out?

Just kind of.

How did that go for you?

Okay, so great question as far as kind of.

It was kind of a little bit of both what made me stand out, but I felt what also made me weak was that I coming from more research background and that was a majority of my patient contact hours.

Because I was trained in phlebotomy.

I was trained in sort of interviewing patients for different things related to studies.

I wasn't like the other applicants where I wasn't a cna.

I wasn't an EMT or paramedic.

I didn't like I said, work in or as like a pharmacy tech as some of my other classmates.

I even had classmates that were nurses originally before doing the PA profession.

So I think for me, research, I thought at first was more of a hindrance.

It was like, oh, I'm not like every other applicant.

But then I think that also helped me stand out in the process too, just because I have more of like a research background rather than a very health care clinic background.

Gotcha.

Yeah, I mean, it's a different perspective.

And I don't know if in your program y' all had to do anything related to research.

We had to write like an evidence based paper.

And for someone who had never done that, it was a little bit tough.

I mean, trying to figure out sourcing and all this stuff and all the logistics of it was not the, the easiest thing I've ever done.

But it was a good learning exercise, I think.

Yeah, for sure.

We had a capstone project.

I think it's like kind of a master's type of requirement.

And so, yeah, that in that case, yeah, there was a lot of reviewing publications and then trying to create some sort of thesis, if you call it.

Yeah.

And then for some of us, we had to create posters and present at.

There was a PA conference just for the local Pennsylvania chapter.

So some of us had to present for that.

And some other people tried to get publications in JAPA and JAMA as well too.

Yeah, I attempted.

I was not successful.

Yeah, they actually emailed me a year after I graduated and said, hey, we'd like to publish your paper, but we want you to go back and change all this Stu.

And I was like, no, I'm good.

I've graduated, we're good.

Back of my mind, I'm working now.

Yeah, I don't even know.

Like, I don't even have those resources anymore.

So I gave up on that one.

Yeah, maybe one day.

So once you got to PA school, was it what you expected?

Was there anything that was difficult about just being in school?

Yes.

Yeah.

Because I've been out of school for a couple of years and so that was the adjustment first.

Was it what I expected?

Yeah, definitely.

As far as everyone warned me of the, you know, the load of information we'd receive, just the long hours of study, of self study especially.

I think that was probably the biggest surprise to me is just having to create.

Create and stick to your own study schedule.

Yeah, for.

I mean, definitely you have to be Self motivated, to say the least.

But okay, so you.

I know when Nan introduced us, she said that you were able to help out with some interviews.

What.

What does that entail?

Yes.

So they had.

So as a first year student and then also as a What we call second year student, our program was about 27 months, so it was like we just pretty much, for the most part, first and second years.

But as a first year student, I got to be a part of the.

Just what they wanted was student interview committee.

Because as far as with our interview process, it went, you interviewed with two faculty members and then you interviewed with a current student.

Cool.

And some of the applicants, they thought, oh, okay, it's just the same student type interview.

But, you know, surprisingly they did.

You know, we do an evaluation just one page long of the student that we interviewed.

And they're pretty generic questions for the most part.

Nothing, you know, more of just kind of like, oh, tell me about your extra, extracurricular activities.

Tell me about YPA versus something else.

Kind of like the stuff that maybe the faculty might ask too, but we don't get to see their application like the faculty does, so.

So that's why it's more of a generic questioning for them.

But then at the bottom, they have us sort of evaluate, kind of like, would you see this person as a classmate?

Could you see this person taking care of you?

And that's kind of, you know, I guess the big thing that I've told other applicants as well too, is that to keep that in mind when you're doing these student interviews.

But I know in some, when the staff and the faculty take into account all of the interviews, they definitely look at the student ones as well too, to see, you know, did you treat the student with respect?

Did you actually, you know, for the interview, be a real person during the interview with them instead of just a robot?

So that's what I've told other students or applicants as well too, is treat every interview as the interview you need.

Yeah, you actually touched on a couple really important things there.

I think one of them is just that every part of your interview is considered.

So it sounds like they definitely took your opinion into consideration.

When I helped out with interviews at my school, it was a little bit funny because at the beginning they would kind of say, like, oh, like, feel free to ask the students anything, like they aren't part of the interview process, whatever.

Which sounds like y' all were more.

But we were just kind of helping out in there.

Yeah.

But then as soon as the students left, they'd be like, all right, tell me about so and so what.

Were there any red flags?

What do you think about this person?

And so it is important, like, you don't want to be talking about anything sketchy or crazy to the students because it will get back to the faculty.

And then my school had a very similar perspective as far as one thing that our admissions director always says is when she's looking for people, would.

I think this person would be a great classmate and a great colleague?

Like, exactly what you said.

Are they gonna contribute to the class and participate and be someone that I would want in my class?

And are they going to be someone that I could send patients to and would feel comfortable seeing patients?

So, yeah.

Did you ever have anyone, I guess, that you feel like, didn't take the interview part with you seriously or maybe was a little too laid back with it?

Yeah, I do recall.

And, you know, unfortunately for them, a couple of applicants at the time where, yeah, they were just a little more laid back, you know, maybe they just gave short answers, just didn't seem enthusiastic as some of the other ones I had, or, you know, they didn't really flesh out, I guess, their background.

They didn't really talk about their background.

Maybe gave a little more generic answering with it.

Kind of like they just wanted to get out that interview with me.

So I don't know if that was my fault or if that was theirs, but probably in any case, yeah.

Yeah, anything as far as.

I mean, you interviewed and you've seen people interview.

I mean, what would kind of your tips be?

What stood out to you as somebody that you're like, man, that person was awesome.

Yes.

So, and this is something I've told other applicants as well, too, is that there's the things that stand out to me most is someone that can speak to their experiences.

Because I feel like when I see everyone on paper, you know, everyone's got the gpa, everyone's done the prereqs, everyone's, you know, even the.

Well, I haven't read anyone's essays as far as actual applicants, but people have helped with their essays.

I feel like everyone's got a pretty solid essay.

It's when they can, in the interview, speak to their specific experiences, whether that even, you know, whether that was as a paramedic, and they can pull out specific stories.

That explains to me why, you know, you felt PA was.

You preferred.

You wanted to go the PA route versus some other route.

Or explain to me what you can bring to this university or what you can bring to this employer that other applicants can't.

So I felt like they stood out in that they told me about their unique experiences rather than just giving me some sort of generic answer.

Yeah, no, that's great.

Great advice.

A lot of people make the mistake of trying to say what they think you want to hear, and you can always tell.

I mean, it just comes off as very ingenuine and a little bit weird, honestly.

So I definitely just have to kind of, like you said at the beginning, like, be a real person.

Don't be a robot.

Which I know when you're nervous, it can.

Oh, yeah.

I mean, it makes it difficult, but, I mean, gotta do the best you can.

All right.

So are you now you're working as a pa?

Yes.

In infectious disease, specifically hiv.

Aids, you said?

In Dallas?

Correct.

Okay, cool.

Was that an area that you had interest in or, like, how did you end up.

How did you end up there?

How'd you find your job?

Yes.

So my.

So with my program, our last two rotations were about two to three months, kind of what they call our, like, primary care preceptorships.

And so I thankfully, was first at the VA hospital where I got to work with infectious diseases there, inpatient and outpatient.

And then my last rotation was at a federally qualified health center where we worked with specifically HIV AIDS patients on an outpatient setting.

And so those experiences opened me up to the world of HIV AIDS care.

And I pretty much fell in love with it during rotations and was like, this is something I want to do.

Unfortunately, didn't find anything in Philly, but I have family in Texas, so that's what kind of drew me out here.

And so the kind of went online and saw the opening, popped up here at a hospital in Dallas, and thankfully, they liked what they saw or they brought me in.

Yeah, I'm enjoying it.

Awesome.

What is your schedule kind of look like?

Okay, so majority of my time is spent outpatient, so thankfully, I'm pretty regular.

You know, sort of Monday through Friday, 8 to 5, sometimes 8 to 6.

Type of schedule.

That all just kind of depends on whether patients show up or not.

Know how that goes?

Yeah, exactly.

So that's pretty much the basis of schedule a bit.

But I have my own patient panel that I'm seeing.

And on the outpatient setting, it is more of a primary care approach.

But then with HIV AIDS care, it's quite unique in that it's also infectious disease on top of their primary care.

So we're not just dealing with hypertension, diabetes, you know, Cancer screenings, other health screenings.

But we'll throw on top of that, managing their HIV regimen and sometimes having to change it if there's resistance or other viral issues that come up.

Okay.

And then.

So if somebody, let's say, gets an opportunistic infection, y' all are going to take care of that.

Exactly.

So on the inpatient side, which I do rotate through sometimes we take.

My group takes care of specifically the HIV AIDS population in the hospital.

And so unfortunately, as many of them have the opportunistic infections, and I think that was something that sort of came at a shock to me from coming from the Northeast.

This is a little separate topic, but it seems like there's more opportunistic infections down here in Texas compared to Northeast.

And I found out that's for a multitude of reasons which I don't want to get into, but mostly having to do with also there's regional differences related to certain infectious etiologies.

Whether, like, there's more.

Seems to be more histo down here.

Interesting.

And then as well as some more PJP sometimes.

And a lot of it, I heard, has to do with the soil or with mycobacterium infections, too.

Separate topic.

That's interesting, though.

I mean that.

Yeah.

I always wonder, since I do derm in Georgia, if I were to go to, say, I don't know, somewhere up north, like Wisconsin, if I would see the same amounts of skin cancers and the same types of things or if it would be different.

Yeah.

Do you see a lot of ks?

Thankfully, no.

I've actually never seen it in real life, so you probably have, but hopefully.

You don't have to.

Yeah, that would be one that I would be like, let me go get my supervising physician real quick.

We might have a bra problem.

But no, just biopsy it.

Feel like, ah, this might not be good.

Yeah.

So thankfully, I haven't seen that yet.

Now that you've said that, I probably will see it.

It's my first patient next week when I get back from Maternity loop.

No, I'm just kidding.

You also let me know.

Yeah, I'll be like, hey, I need a consult from Texas.

But no, thankfully, I've only had to send.

I've had to send one patient to Infectious Disease and that was for like, a deep, like, pyogenic gangrenosum infection.

And he was not immunocompromised, not an HIV AIDS patient.

It was just very strange.

So we ended up having to send.

Send him to Infectious Disease and they admitted him and took care of him and stuff.

Just basically these huge ulcers that kept getting bigger no matter what we did, which was a lot of fun.

So, yeah, so that's my only.

Only time.

And then we see a lot of rheumatology patients and I have a lot of patients on biologics and so thankfully most of them do great.

I haven't necessarily had any issues, but every once in a while if somebody has a strange history of a weird fungal infection or something, we'll have to kind of consult with ID before we put them on something.

But for the most part, my patients are pretty healthy.

Good.

At least you have a place to access.

I think that's always the important thing, especially for me as a new pa, having being able to consult other people when it's necessary and get a timely response.

Yeah, no, it's very helpful.

I was thinking back to when I was in PA school and we had just this great guy come talk to us about HIV AIDS in our area and he.

You'll have to help me out with this.

He was in charge of like the government funding.

I think it has a name.

Ryan White.

That's it.

Yes, he was in charge of that program for our area and so he was just super knowledgeable about population and able to really kind of help us to understand like what we could do to help out and where kind of the needs were.

And like with that funding, I mean, it's really great for helping patients get the care they need from what it sounds like.

Oh, of course.

Yeah.

Majority of my patients are, you know, considered low income or homeless populations in which thankfully, with the Ryan White funding, they can get a lot of their meds covered for because yeah, these meds are not cheap.

They're actually.

It always surprises when I tell the students too.

It's like it's about 3k a month.

Wow.

Yeah.

If you can imagine spending $3,000 a month and that's the average price of them for just your medications.

And so thankfully Ryan White covers that.

It also covers what?

Our clinic also has an acute care center as well.

So for walk inside as well and then any labs that they need and imaging that they need related to HIV or even part of their primary care, but unfortunately does not cover emergency room visits.

So that's why we always.

That's why we have the acute walk in clinic, so we can hopefully avoid emergency room visits for patients.

Yeah.

Interesting.

Is that something you see yourself doing from now on as a new grad or do you kind of think you may end up in a different area?

At some point, I think, honestly, I enjoy it.

I think that's what, like I said when I fell in love with it in Philly, like, this is kind of the population and the type of medicine that I want to do.

So.

So as far as for the time being, I see myself doing it for the years to come, you know, or I think the only changes I see coming is maybe taking on maybe more of a leadership role within the this or maybe getting more involved with the.

We have what's called the AIDS Education Training center, which is a national center and that educates providers, educates patients.

So maybe getting something involved in that capacity.

But definitely still see myself working with HIV AIDS care.

Okay, cool.

So what would your advice be?

I always ask everybody this.

What would your advice be to somebody who.

Who is considering becoming a PA but maybe isn't exactly sure if that's what they want to do?

Yes, I say do your research.

As someone from a research background, make sure this is something that you want to commit to.

It's not something that you need to look at to do with the rest of your life unless you want to.

But the next two or three years, if you decide to take this route, is going to be one of the toughest years of your life.

And so you really have to evaluate is this something that I want to do is something I want to invest in, not just, you know, financially, but emotionally and physically have to find it, you know, invest in.

So that is something that I always tell people to kind of, you know, make sure you do research, shadow, you know, talk to as many people as you can and I guess before you apply and make sure, you know in your heart that this is something you want to do.

And I think.

And that's what something I've noticed too, with the interviews as well too, if some.

If I knew this was someone that this wasn't a plan B for them, this is something they definitely want to do.

It came out in their answers.

Not because they actually said that, because no one actually said that for the most part, but you could just tell the enthusiasm, you could tell the positivity, and just.

You could tell that the.

Just the genuine nature of their answering, that this is.

They.

This is.

They feel they belong in this setting.

They feel they belong as a pa. And so I think when you get to that point, it becomes easier.

I mean, the stress and the challenges are still going to come as a pa, but I think it becomes easier to work through those papers, to work through the study because you knew, you know, at this point.

This is something that you want to do.

Yeah.

No, I agree.

That is great advice.

That's my long answer.

That's okay.

We'll take it.

Well, thank you so much for taking the time before your busy clinic to share your insights, and I'm sure it will be much appreciated.

Yes, for sure.

Have a great day.

Thank you.

Okay.

I really hope everyone enjoyed that.

We got into a little clinical talk, but I think it was really a lot of useful information.

Again, sorry for the background, baby.

She just always wants to be included.

So, anyway, thank you so much for listening.

If you're not already a part of our Pre PA Club community, make sure you join on Facebook.

You can just search for it or use the link in the description to join our group.

A lot of great conversations going on there.

You can get feedback from myself and from other PAs who are in our group.

But yeah, we'd love to have you there.

And if you're loving the podcast, leave a review on itunes, reach out on Instagram, the PA platform.

We'd love to hear from you.

Hope you're having a good day.

See you next time.