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The Practicing PA-ramedic: Worth the Struggle

A possible next step from paramedic on the career ladder is physician assistant. What’s that job like? Gain some insight with this new series, “The Practicing PA-ramedic,” which follows the journey of NRP-turned-physician-assistant Sarah Bowman.

I’d been through it before, the agonizing delay after completing a national certifying exam and waiting for official results. First as an EMT-B, then an EMT-I, and ultimately an EMT-P, I remember how I sat anxiously at my computer, refreshing the registry site more often than necessary, hoping for the “best news ever” to post any second. Waiting for the results of my Physician Assistant National Certifying Exam (PANCE) was not all that different.

With a final “one more try” of refreshing the site, a most auspicious keystroke declared I was indeed certified as a physician assistant (PA). The moment hit me full force. I passed the PANCE. PA school is a marathon of what feels like major accomplishments: surviving that pharmacology exam, acing another cardiology quiz (paramedics, cardiology will be relatively easy for you), submitting a journal review, completing a required reflective essay. Every success feels like it might deserve great celebration, but you grind on because there are more assignments, exams, and projects lying in wait. In what started at a looming distance and now suddenly feels as if it has arrived at alarming speed, there is this thing called the PANCE. Your entire life feels like it gets squeezed into a six-hour exam that encompasses all of medicine in 300 relentless questions. It is what defines the completion of your initial PA training and marks the beginning of life as a PA-C.

Passing this behemoth of an exam was met with a great verbal exaltation of joy, jumping up and down, messaging the classmates who’d become like family, and sharing the news with my former-faculty-turned-colleagues. My mom answered my FaceTime call on the first ring, and even she immediately squealed with euphoric glee and satisfaction that I did, in fact, “crush the pants,” as she has so lovingly put it these last few years. Let me explain: Every time I’ve tried typing PANCE in a text message (quite a few times during PA school), my phone autocorrected to pants, followed by the suggestion of an emoji of a lovely pair of blue jeans.

After hearing I’d crushed a pair of lovely blue trousers came the sudden realization that it’s over—the training wheels are off. Granted, there will be an onboarding process at my new position, and there will be plenty of times where I will reach out to colleagues for advice, recommendations, and feedback. But the part of the visit where I introduce myself as a student is no more. The buck stops here (unless it doesn’t, which I’ll get back to later). The profound responsibility of someone’s life is yet again in my hands. It’s a feeling I know all too well from my paramedic days.

In PA school, every time you pass an exam or assignment, it means you get to keep going. Even if you don’t do that well, you get to keep going, but perhaps with more tutoring or assistance from faculty. I love that my faculty were genuinely invested in our success. I’ve missed social events and far too many sunny days on my favorite trail because I was studying test banks, watching videos, and repeatedly flipping through the pages of my well-worn review book. I wish I’d listened a little harder when everyone explained just how fast school zips past, because it’s completely true. The moment of seeing my name, followed by PA-C, is the moment I’ve worked toward for several grueling years. It was worth it. All of it.

About that buck stopping: I love that I will still continue to work on a team that includes countless support staff, nurses, medical assistants, psychologists, social workers, physicians, PAs, and nurse practitioners. The teamwork and collaborative element with which I was so familiar as a paramedic drew me to this profession. Transitioning from my role as a paramedic to the role of a physician assistant is a work in progress. Instead of radioing in for medical control, I can reach out to a colleague at an adjacent work station; the presentation is more polished and pertinent, and my plans much more detailed. Everything I’ve done as a paramedic, student, and provider has nourished me to become a better PA. When your advisors and preceptors tell you you’ll make a great physician assistant, believe them. Everything you do in life has the potential to prepare you for greatness. Revel in this.

In case you’re wondering, I’m keeping my NRP. While I’m comfortable leaving the world of abruptly waking to station tones at 3 a.m., I’m not yet ready to say the words “I used to be a paramedic.” I love being a paramedic, and I now love sharing the news that I’m a PA! I am beyond excited to kick-start my career in the amazing clinic that has offered me a job, the same clinic where I spent the last four months during one of my clinical rotations.

Next I’m headed to Guatemala for a three-week Spanish immersion program paid for by my new clinic. Stay posted for updates on my journey. You can follow me on instagram @thepracticingpa.

Sarah Bowman, NRP, MCHS, PA-C, is a physician assistant at Columbia Valley Community Health in Wenatchee, Wash., and a recent graduate of the University of Washington School of Medicine MEDEX Northwest physician assistant program. She has worked as a paramedic in Alexandria, Va., and began her career as a volunteer EMT with the Fairfax County Fire and Rescue Department. Sarah has experience as a paramedic, physician assistant, and EMS educator.


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