Paul works in pediatric epilepsy at Children's Medical Center in Dallas. He got there from biomedical engineering.

Another one for anyone who didn't take the straight line. Paul walks through how he found the PA profession, what applying was like for him, and what his job looks like now in a pretty specialized corner of medicine.

What we talk about:

• Moving from biomedical engineering into healthcare
• Why shadowing several different providers changed his mind
• Getting honest about your own motivations before you apply
• What pediatric epilepsy care actually involves
• How much autonomy he has as an advanced practice provider
• How his team is structured day to day

Resources:

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

PA Program Map: https://www.thepaplatform.com/pa-platform-map

One-on-one pre-PA counseling: https://www.thepaplatform.com/services/pre-pa-counseling

Today on episode 29, we're interviewing Paul from Dose of PA blog.

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.

Hey, guys.

Welcome to episode 29.

So today our interview is with Paul.

I mentioned that at the beginning he runs a website called Dose of pa, and I think it's getting a little bit of a revamp soon, and so we'll make sure that any links included get updated.

But I virtually met Paul a couple years ago when I started my website, the PA Platform.

And by the way, I'm Savannah.

If you're new to the Pre PA Club podcast, I'm the host and I'm also a dermatology PA and the creator of the PA Platform.

So Paul and I kind of connected over the Internet because he also had a Pre PA blog, and he was in PA school at the time.

I'd already graduated.

And so we've kind of been able to work together and collaborate over these last couple years, which has been awesome.

And I'm really excited to see his new website now that he's a practicing pa and so his job is very interesting.

You'll hear all about it.

And he has great prepa articles, very thorough advice on his website, so definitely something you want to check out.

Paul also edits for MyPA resource, so he's also a personal statement editor, just like I am.

And so you can still use that code Prepa Club if you want a discount there.

We're all PAs who edit, and so you can rest assured that your personal statement is getting a good review by somebody who knows what they're looking for.

But let's go ahead and jump into our interview, and yeah, I'm excited for this one.

So, first off, my name is Paul.

My name is Paul Gonzalez, and I am a pa.

I work in pediatric epilepsy at Children's Medical center in Dallas, Texas.

I started out originally working in a neurology unit.

It was an adult neurology unit, and then later in ICU while I was an undergrad, and I worked as a parent patient care technician and sometimes referred to as, like, a patient care assistant.

I worked there for about two years, and I.

At the same time, I was kind of volunteering at Austin State Hospital, which is a psychiatric facility.

I was studying biomedical engineering at the time.

It was very challenging, very interesting.

So I had a lot going on.

I always kind of knew that I wanted to go into medicine.

And I had shadowed PAs nurse practitioners and physicians while as an undergrad to try to help me figure that out.

And so I sort of knew in a way that I was going the PA route because my family wanted me to go to medical school so badly that I just didn't have the motivation like my classmates did.

There's, you know, a lot of biomedical engineering students to end up going to medical school.

And I just didn't feel like I was on the same level as they were as far as, you know, being, like I said, motivated to, to go that route.

And that's okay.

After four years of engineering, I was going to school nonstop and I didn't have any summers off, I didn't have any winter breaks off.

So as you can imagine, that's like pretty treacherous as it can be.

And I had one friend named Joanna who had just gotten into PA school and she and my partner Connor had told me, you know, you really should consider this.

And before, you know, I hadn't really put much thought into it because everything had been.

My parents were just, you know, hounding me with, you know, take the mcat, this is the way to go.

You're going to want to be a doctor.

And the more I thought about it, I was like, this is not the route for me.

I know other people want this for me, but it just didn't feel right.

And in a way, I feel like it was kind of a last minute decision to where I just decided, like, I don't think I could do another four years plus another two years residency or however long.

And so it just felt like a right fit at the time in my life when, you know, I needed change at that time.

And so there are, you know, as things progressed, I put my application in, I was scared.

I didn't know where my future was headed.

I didn't know if I was going to get an interview or if I was going to be completely rejected and have to apply again.

I was really surprised, honestly, that I got as many interview offers as I did.

But in the long run, there are things that I regret about that whole application process and things I wish I would have known ahead of time.

And really starting my blog helped me understand a lot of those things that I wish I would have known.

And that kind of further motivated me to continue writing posts because I felt like, well, if, you know, if I find this information really helpful, I guarantee that other students do.

And made it free as well on top of that.

So I felt like it was just a really good outlet, you know, and there wasn't really anything else besides that motivating me.

It was just, you know, I started out writing it because I wanted to know more about the Affordable Care act at the time and how it was going to affect PAs, because I felt like that was a question I could get at interviews.

And it's a valid question.

So I wrote one that was one of my first blog posts.

And after that, things kind of trickled into, well, you know, what is.

What are options for PA students after they graduate besides just working, you know, or what are other certifications that they can get to further their career and really practice at the top of their license?

Like, you'll see that in different places.

And so, you know, that's, you know, I've come a long way.

I did my blog all through PA school, and so impressive.

Thank you.

And now it's just, you know, looking back, it's.

It's just awesome.

I could not have asked for any.

Anything better, you know, like, that I've gotten and positive feedback.

It's just astronomical.

And it's.

It's opened up so many opportunities for me that I just could never have dreamed of it, honestly.

But.

So that, in a nutshell, is how I came to PA school and so happy I did.

I every day thank myself for not going to medical school.

When I look at my physician colleagues who are on call all the time, working their long hours, you know, having to answer very difficult requests, questions of their administrators, their.

The families they take care of, and just the public in general, there's just.

There's a lot of stress that is on them at all times.

And I wouldn't have, you know, I would not change a thing, honestly.

So I have a question.

Were your parents medical, or they just really wanted you to be medical?

I am the first person in medicine in my entire family.

So, you know, there's lots and lots of.

Just people telling me from all sides, really, this is how you have to go.

This is what you should do.

Because in my family, and as in most families, they feel like being a doctor is the top of the line, the top of the hierarchy, like there's nothing else.

And that was it for my family.

My other sister is.

She's the only other person in my family that's gone off to get her master's.

And so, you know, whenever it was just basically being decided for myself what I was going to do for the rest of my life.

That's when I kind of had to put my foot down and make a decision for myself.

Well, if it makes you feel any better, my dad still asks me when I'm going back to school.

He's given up on med school, but he wants me to go get my doctorate.

And I'm like, dad, I'm not getting my doctorate unless somebody else is paying for it.

I have no interest.

Unless, I mean, I would love to get it.

Like, that'd be fun to get it in, I don't know, education or something, but not unless somebody else pays for it.

So, yeah, I think that's.

That's a parent thing.

It definitely is.

They never want us to be done.

So you said you got more interviews than you expected.

Tell me a little bit about kind of how many schools you applied to, how many interviews you got, how many you went on, what were their outcomes?

So I think I applied to six or seven schools.

I can't remember, but so I know that my very first interview was at Tyler University in Boston, and I interviewed there.

I accepted their offer.

Later on, I interviewed at UTMB in Galveston, Texas, and I interviewed there.

I was wait listed.

So at that point, you know, I knew that I really would prefer to go in state just because of costs.

But I applied to all of these schools that I felt like were top tier schools in my eyes, and they had, you know, great faculty, great clinical sites.

So I applied to unt, that was University of North Texas in Fort Worth.

I interviewed there, got accepted, and, you know, again, so that made me have to decline my Tufts University offer.

And then when I interviewed at UT Southwestern, that was like my dream school.

And so when I got accept, interviewed and got accepted there, I was just like, I can't.

There's no way, I cannot go here.

So at that point, I had already interviewed at two places, got accepted and declined the offer.

And so in hindsight, I just realized that what I should have done is looked at the couple programs that I had already chosen and narrowed it down to and tried to narrow it even further because it would have saved me time, it would have saved me money.

And that was one of the things that I regretted about the whole process was just like, I should have looked at this and said, this is too many programs.

I know the Tufts.

It was going to be a really hard move for me, traveling.

Like, I would have to move my entire family, me and my partner, my two dogs, up to Boston in December because school started in January.

And so it was just terrible timing.

My partner didn't have a job at the time.

So, you know, just a lot of going to PA school and getting yourself ready for it is making sure that you have a really good sound support system behind you.

And if you don't, it makes everything just feel like.

It's like you're just so lost and you.

I don't know.

That's how I felt at that time.

So when I got one of my last interviews that came through offers was at George Washington University.

And.

And at that time I was like, you know what?

I can't do this again.

I can't go through another round where I'm flying, paying to fly myself to these interviews.

I'm taking up another spot of somebody else who really is going to go there.

And honestly, I was still on the fence about it.

And so I declined their offer for an interview.

And then I heard back from UT San Antonio, Baylor.

I didn't hear back from Baylor University.

I'm not really sure why.

Something probably didn't make it through their office at that point.

It was kind of like, whatever.

I got interview offers from two schools that I applied to in California, Samuel Merritt and University of Southern California.

But at that point I was just like, you know, I have gone to too many schools and interviewed.

I'm good with where I'm at.

And, you know, I would have again, loved to go to those schools, love to live in California, but it's just, it was so much cheaper to come to school here and my family is here, and I just felt like I had a better support system.

So when I looked at all of the factors going into it, I just.

That I knew that UT Southwestern was the right program for me.

Yeah, I mean, location and cost were my biggest things as far as like, being close to my family.

And I went to a state, an in state school, so it was significantly cheaper.

There was a public school.

So, yeah, I mean, that makes a huge, huge difference.

And it should.

I mean, you kind of have to decide.

Some people want to go off and try something new, and that's great if you do and you have the means to do that.

But one thing I think is interesting about your story, and this is a conflict a lot of people have, is you got accepted and had to accept that offer because typically they don't give you very long to do so.

And it's either we want your deposit to hold your spot or you give up your spot.

And so you kind of have to make that decision to go for it.

Knowing that you may end up losing that money down the line.

Right.

Unfortunately.

And that was part of it.

You know, my family is not very well off and whenever I got accepted to the first school at Tufts, they had a $500 deposit to hold your spot.

And you know, understandably, they want people to commit to going to their school.

So I had to rally up a bunch of family members to get to pay that deposit and I ended up losing that money.

But in the long run, you know, my family was very understanding.

They would rather have me in Texas than, you know, going to that other school.

But there was no, you know, there's no way to tell ahead of time, you know, what, what interviews you're gonna get and where you're gonna get accepted.

And so that was just, you know, last minute decision.

And I talked about with my family, felt really bad.

But yeah, I mean, it's like it happens and you gotta go for it.

Thinking back on PA school, which again, I'm super impressed you had a blog during PA school.

Are you still doing anything with dose of pa?

What does that look like these days?

So right now I am in the process of revamping my site before I launch a new site.

And I have reviewed and revamped some of the posts, some of the most common posts that people go to, and I've written a couple new ones and I'm just waiting for the new site to be done before I release all of those articles.

I'm glad it's not going away.

No, not going away.

Too much good info for it to go away.

Yeah.

And too much hard work, I'm assuming, because I know how much hard work it is.

Thinking back on PA School, what was difficult or surprising to you about PA school?

What did you not expect?

I think I really and truly did not expect for it to be so difficult and challenging.

Not just from a volume of information standpoint, but the expectations that are required of you.

Professionally, academically, physically demanding.

It really took a toll on me because undergrad was very hard.

I studied biomedical engineering.

It was a five year program.

I took a year off between school and PA school.

And when I started back up, I was gung ho about it.

I did very well my first semester and then I was just like.

It's almost like I tanked.

I just.

The energy level that I had going into school was not the same.

I was constantly tired because I was always up late studying, waking up early for school.

There's just constant testing that I just, I wasn't used to testing that frequently And I think the biggest thing is, you know, like, finding a work balance, work life balance, because, you know, I have.

I had a partner, I had a dog.

Emily lived in Austin, which was three hours away.

So it just, you know, having a good support system, again, people who understand that you don't always have time, you know, to go out on the weekends, or you don't have time every holiday to spend with them, you have to make a lot of sacrifices.

And again, that was something that I don't feel like you hear it, but you don't really feel make sense of it until you're in that situation and say, you know, this is.

I'm not going to be able to make Thanksgiving this year because I have a test the following Monday and I really, really need to study for it.

And a lot of family members, you know, either they understand it or they're frustrated.

And it's, you know, it's really difficult.

It becomes really difficult.

I think some of my classmates who had family members who live the DFW area, it was a little bit easier because you could go for dinner and then come back and study that night.

But for me, you know, it was really challenging because my family lived three hours away.

And so, you know, I think that was the biggest thing with school is just like, finding a good balance between everything and just the sheer level of difficulty with the content and what's expected of you.

But I guess one of my most challenging courses in all of PA school was pharmacology, because I personally.

I personally didn't have, like, a whole lot of experience with drug names and side effects.

And, you know, it just.

It really took me by surprise because I knew it was going to be a lot of rote memorization.

But at end of the day, the.

At the same time, like, I just did not realize, like, how much and how fast it was going to come at you on top of all of your other coursework.

Yeah, no, I failed my first farm test, actually.

Even though failing was below 75, I think I got a 72.

But, yeah, I feel like farm is hard because it's hard to learn unless you're doing it.

Like, once I was on rotations, a lot of that made a lot more sense.

And it was easy to remember, like, when I saw a side effect.

Like, I remember when I saw, like, tardive dyskinesia.

And I thought it was so interesting.

But, like, just learning about it, I can't say that it completely made sense to me.

So, yeah, I think farm, like, you just gotta get out there and actually, like, be doing it to learn it.

But, yeah, farm.

I think that was my hardest class in PA school as well.

And hemonk was hard, but, yeah, we did.

We didn't have as much oncology, but definitely hematology.

Yeah.

Covering hematology in two weeks was very difficult.

Yeah.

And that's what I mean.

It's like you said, there's volume, it's fast, but then some of it is also difficult.

So from.

Did you know.

So you said you work in pediatric epilepsy.

That's very specific.

I do.

Okay.

And it is very specific.

Did you know that that was an area that you were interested in?

Absolutely.

It was like, my number one choice throughout into all of PA school, and I just didn't know that there was going to be a job opening at the end of it.

My little sister has epilepsy and has since she was younger, and so I've always been interested in it.

And when I did neurology rotations through PA school, it just kind of solidified that working in a neurology unit as patient care tech, I just felt like neurology was the area that I wanted to go into.

It's interesting because, you know, there's black and white, but there's so much gray in between.

And that's what really I like about it, is that there's.

There.

There's a lot of new upcoming, you know, findings and groundbreaking research.

There's just so much areas for development.

And so that's really what I like about it.

But I knew that I wanted to do that.

It just was a matter of getting there.

And my very last rotation that I had was in pediatric epilepsy.

And so it just worked out that there was a job position open, and I'm here.

That is awesome.

Did you have a difficult time transitioning from student to pa?

I mean, I don't really remember if we had a pediatric epilepsy lecture, but if we did, I'm pretty sure it was like, five slides.

Say that question again.

Sorry.

Like, did you have a hard time transitioning?

Like, how did you transition from the student role to, like, being a PA and then being in something so specialized?

I mean, that's a big learning curve.

So, yes, it was initially because there is just so much information that you don't learn in PA school specialty, and especially in pediatrics, because my program only spent six weeks covering pediatrics.

As far as epilepsy goes, I mean, you spend like a day going over that, so not in the near as much detail.

As you need to know, pharmacology wise, you know, you learn the side effects and maybe the monitoring, the names, but it's only the first line medications.

And when you work in a subspecialty, you're learning line patients, you're learning about surgery options, you're learning about ketogenic diet.

I mean, there's just so many other things.

And now with CBD oil out there, and you have other new devices like the seizure watch was just approved by the fda.

And so there's just so much in epilepsy.

It's a constantly evolving field and you got to keep up with it.

So I think one of the nice things about my job is, number one, my team.

I love my team that I work with.

You know, if I could give anybody job advice, it is find a place that you find a field that you want to work in.

But two, find a team that you like and get along with.

It just makes it.

It makes work not seem like work at all.

And every day you come in, you have, you know, people to talk to about things non work related to keep you going.

But yeah, so it's.

It's been a really big struggle as far as, you know, improving my examination from just a basic and kind of tailoring it to infants or a toddler adolescent or an adult learning information about their development.

I mean, we learned some of that, but there's a large learning curve.

And so that's been, again, balancing all of that with life and getting back into the swing of things.

It takes a while.

And like most PAs, I think say around six months is how long it takes to finally become comfortable.

But I felt like mine was closer to a year.

And so I think it's different for everybody.

Everybody.

But.

Well, and that's what.

We talked about this a little bit beforehand.

But I was saying how I like.

It took me six months of basically coming home and I would lay on the couch and not get up.

Like, I was so exhausted just from trying to learn and just the grind of every single day.

But after about six months, that got better.

But I work in dermatology, so it's interesting that there's different things and I don't know if you kind of have this as well, that I would get comfortable with one thing and then it was a new thing.

So at first, like, I felt completely uncomfortable with psoriasis.

I didn't know what to do.

I would freak out, think, oh my gosh, this person has this crazy rash.

My supervising physician would walk in and just go, it's Psoriasis.

So now I feel like I have a great hand on psoriasis.

But then after that it was pediatrics and me feeling like I didn't know what to do with kids.

But now I feel pretty good about that.

Most of the time they still have weird stuff.

And then it was lupus.

Like, it's just kind of.

There's always something new that it's like, oh, I really need, like, to learn more about this and get better at it.

So I feel like that even three and a half years out still kind of happens.

And I go through phases like they're just different things that are more difficult than others, that are hard to get a handle on.

But that's where kind of that lifelong learner thing comes in a little bit.

What is, tell us, like, what is a day?

What is, what is your typical day look like or your job or, like, what?

I don't know, your shifts?

Sure, yeah.

So my job is very unique and it's one of the things that I love the most about it.

I work two weeks in the outpatient world, and I only work four days a week, period.

So I'm in clinic four days and for one week, the second week I'll be in clinic for four days.

And then every third week, I work in what's called the epilepsy monitoring unit or the emu.

And that's just basically a video eeg.

And so I'll work four days at that time.

I work one Saturday every six weeks.

And we alternate between the six nurse practitioners that are there.

So we have a really large team.

And it makes it easy for scheduling because you can always swap with someone in the clinic.

We work, you know, normal, it's 8 to 5, and in the inpatient side, it really varies.

So sometimes you can be there 10 hours, you know, maybe less, but, you know, sometimes maybe 12 hours.

It really just depends.

But either way, we're salaried.

So four days a week, it's really not bad.

And it offers you the ability to have three, sometimes four day weekends, depending on how your schedule overlaps.

And so that's been really nice because I don't necessarily have to take PTO for those days, and I accrue PTO really quickly because I don't use it.

So that's been really nice.

I really love my schedule.

It's one of the best parts of my job.

Do you work closely with a supervising physician?

Are you seeing patients on your own?

How much autonomy do you have?

I think that is.

That's a good Question.

And it's really interesting because it's so different for our epilepsy program compared to other PAs and nurse practitioners that may work in epilepsy.

We are one of the few locations throughout the entire United States that actually allows the.

What we call advanced practice providers, or apps, to work solo.

So we see our own new patients, we follow up on our new patients, and to the point where unless there's something that we feel is out of our comfort zone, that's the only time we get our supervising physicians involved.

It's a great system.

It allows us to see a higher volume of patients.

And, you know, again, we have our attending physicians there.

There's always someone there because the EMU is open Monday through Friday.

So if you ever have a question, you can always call the person the attending physician in the emu.

So, you know, yes, I do have a supervising physician, and she's also the director of our program, but she may not always be at our facility.

She may be at another one, but there's always someone there at our facility.

So the way they have it worked out, it works really, really well.

Like I said, we have six of us.

There's three PAs and there's three nurse practitioners, and then there are six epileptologists that work with us.

So very, very large program.

Cool.

That's really awesome.

Yeah.

The only thing I know about the.

And I don't even know if this is right, the Dallas.

No, that's probably Houston.

Never mind.

I was gonna say the Dr. Jen Arnold from the Little Couple works in the NICU there, but I think she's.

She was in Houston, not Dallas.

There's a lot of children's hospitals in different areas, and everybody confuses them, too.

Yeah, well, Texas is so large.

I just went to Texas for the first time in the fall, and I was in Houston for two days, and I mean, didn't really see anything, but ate at a place called Torchy's Tacos.

I don't know if you all have that, but I wish I did.

I looked into franchising, but they don't do that, so maybe Georgia will get them eventually.

I gotta come back to Texas to eat some tacos.

Anyway, off topic.

What?

Any last advice that you'd give to someone who is just kind of on the line?

They're not sure if they want to do pa.

They just aren't decided.

I guess the biggest thing would be, you know, now that I've had people shadow me, is definitely get as much shadowing experience as you can, both in the Inpatient and outpatient world to one kind of figure out, like, is this.

Not only is the lifestyle right for me, but, you know, what do you prefer?

Do you prefer surgery or do you prefer working in a family med clinic or a subspecialty?

And really try to tweeze out, like, why am I not going to nurse practitioner school?

Or why am I not going to medical school?

Whether it's, you know, osteopathic school or an allopathic school, just try to figure out, you know, like.

And figure out where you belong, because that's going to end up, you know, determining, you know, where.

It could determine where you live in the future after you finish PA school.

You know, if I had gone to Tufts University, 1.

Not one of their requirements, but they really recommend that you take Mandarin, which is totally new to me because I just didn't realize that there were that many people that spoke Mandarin in Boston or in that area, I guess.

But in Texas, you know, it's the.

It's Spanish, and in other parts of the country, it may be another language.

So just, you know, like, I guess, weigh everything and look at all your options before you make a decision.

Yeah, good advice.

I would say that's most people's advice is get out there and shadow and really think about it and shadow.

Different things.

But, yeah.

Well, thank you for coming on the podcast.

Yeah, thanks so much for having me.

Yeah, no problem.

There you go.

So Paul is a really great example of a very specialized PA and just shows that even though we are taught as generalists, there are options out there.

If there's a field that you're really interested in that is more specific or specialized, it can be a little bit tough to find those jobs.

He's in a big city, so that makes it easier with a great children's hospital.

But, yeah, so I really like hearing his experience because his daily job is a lot different than what mine looks like.

And I always think it's valuable to hear from other PAs kind of what their day to day is like.

Well, I hope that that was rewarding and helpful to you and that you enjoyed it.

So in the next couple weeks, we're going to have a couple more interviews.

A while back on Instagram, I did a mock interview, a live mock interview with Jamie, who she was on a prior episode.

You may remember her.

Let's see, she was on episode 16.

So she's a PA student.

And so we did a live mock interview.

And I'm going to be sharing that with you guys here so that you can hear that.

And my book on interviewing the Physician Assistant School Interview Guide is set to come out April 1st, so that'll be on Amazon, on my website, you'll be able to get your hands on it.

And I'll be talking about that and interview prep a lot more in the coming episodes.

And if there's something you want to hear about, I'm always planning out new episodes.

So please shoot me an email, follow me on Instagram, send me a message, and we'll make sure it happens.

All right.

Have a good week.