Expert Insights from Program Leaders
October 04, 2021
Season 1: Episode 14: Stanford University PA Leadership

The Stanford University Masters of Science in Physician Assistant Studies team speaks with us about their program, their unique curriculum, and their commitment to service and leadership. We speak with Drs. Sue Fernandes, Nicole Burwell, and Jess Butler ...

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The Stanford University Masters of Science in Physician Assistant Studies team speaks with us about their program, their unique curriculum, and their commitment to service and leadership. We speak with Drs. Sue Fernandes, Nicole Burwell, and Jess Butler about their careers and vision for the future of Stanford University.

The purpose of this podcast is to provide news and information on the PA profession and is for informational purposes only. The views and opinions expressed in this podcast are those of the speakers and guests and do not necessarily reflect the official position or policy of the University of Arizona.


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

Unknown Speaker  0:20  
I would say that 75% of the essays that I read, they never tell you why they want to be a PA.

Unknown Speaker  0:32  
Well, hello and thank you for joining us. Today we speak with the leadership team at Stanford University's Master's of Science and Pa studies in Palo Alto, California. These three impressive leaders include Dr. Su Fernandez, who is currently the Associate Dean for PA education and the program director, Dr. Nicole Burwell, who is the director of pre clerkship education for the program, and a director at large for the physician assistant education Association's board of directors, and Dr. Jess Butler, who serves as the assistant director of admissions for the program. All three have very impressive backgrounds, which we will share in larger detail at our PA path podcast comm website with our show notes. And suffice to say, all three have outstanding insights for applicants, students and colleagues around the country.

Unknown Speaker  1:28  
Thank you all three. And for joining us today. I'm so excited to learn more about your program. And you have such a deep history at Stanford for many, many years. But there's been some, when I say relatively recent changes, since I've moved to USC 10 years ago, the program has gone through some changes that look really interesting and exciting. So I'm excited to share with our audience about that as well. But maybe if we can start I'm going to ask su first if you can start with us and talk about your path to becoming a PA

Unknown Speaker  1:58  
sure I actually was a cardiac surgeon ographers worked in pediatric cardiology for almost five years and is feeling the need to do a little bit more clinically than what I was doing. And someone told me about the PA profession. And I knew I wanted to take care of patients with congenital heart disease. And, you know, the option of I was mid 20s. So the option of going to medical school residency and then a fellowship and cajole heart disease, I would have, you know, been mid 30s, by the time I was done and PE profession was I could be doing everything I wanted to be doing within, you know, 30 months or so. And so that was like, okay, that's what I'm gonna do. And the funny part is now I am old, and I've been a PA for a long time, I think it's 26 years or something. Now, I thought you just signed up to go to PA school. So I like filled out the application. And I was only one school, the school up the street, you know, from where I was working. And then I got notified that I got an interview. And I was like what I have to interview to get into PA school. And again, this is a time where most people have heard of the profession before. And then I remembered at the interview them saying that 25% of you are going to get in and I was like, Oh, this is serious. Like I didn't realize how competitive it was to get into PA school. And I was fortunate enough to get into the northeastern PA program at the time. And yeah, kind of the rest of the history but not a very unusual path. I think I think that's what we hear from a lot of even today for applicants that are currently you know, working in some area of medicine and then find out about the profession. So sure.

Unknown Speaker  3:35  
And Nicole, how about you? What was your path to becoming a PA?

Unknown Speaker  3:40  
Absolutely. So first of all, thank you, Kevin, for, for having us here today. I'm extremely excited to talk with you more. I've been listening to some of your podcasts and you're doing some really great work. So thank you for that.

Unknown Speaker  3:55  
Thank you. Thank you very much.

Unknown Speaker  3:56  
Yes. Thank you for having us. I apologize. I'd say that's

Unknown Speaker  4:00  
totally fine. We just jumped right in. So we're good.

Unknown Speaker  4:02  
Yeah. Well, I've been a PA for over 23 years. As you know, I'm a native Washingtonian, so I grew up in the Washington Metropolitan Area, proud to time graduate of an HBCU. So just putting in a little plug there for HBCU programs are not recruiting from historically black colleges and universities then you are missing out on a great group of promising applicants. I graduated from Hampton University with my bachelor's in biology. And similar to what Sue described, I did research for a few years just trying to figure out what my next steps were and then decided on PA school and applied and landed at GW were had a fantastic experience, you know, just fortunate I have some really great mentors there. That's our faculty, many of them still there, and just a cadre of individuals that were leading social change and efforts before it kind of became in vogue. So shout out to them. I was a National Health Service Corps scholar. So after I graduated from GW I, what after I graduated from GW, I went on to work at a private practice, actually, in a rural community for several years. I loved it in internal medicine and family practice. And then probably around seven years or so started to think about broadening my skill set and looked at education.

Unknown Speaker  5:43  
That's great. And so you, you when you left Northeastern, where did you go clinically into your career?

Unknown Speaker  5:48  
Yeah, I actually went back to the same place, I had been working as a cardiac geographer. So I went back to Boston Children's and I practice in pediatric cardiology, kids all heart disease for 18 years there before deciding to come and do similar work out on the west coast. So yeah,

Unknown Speaker  6:05  
and we also have Jess with us, Jess, you're not a PA, but you have a path to becoming part of the PA program. So once you tell us little bit about your background with your PhD and what led you to Stanford and to working with these fabulous colleagues of yours.

Unknown Speaker  6:19  
Sure. So yeah, I'm the resident, not pa here, and I was sociologist by training. So I got a PhD in Sociology and Gender Studies from the University of Southern California. I don't know if you've heard of it, but it was a pretty good school to go to Yeah. Um, so I left St. And I was teaching at the university level, I was teaching sociology for seven years, moving around to different states, and then found my way to this PA program. I actually it was, so it was interesting when I joined because people are like, What are you doing in medical school? What are you doing in a PA program? That's not what you were trained to do? And I just think it actually is just a profoundly sociological question in terms of how do we think about how to do admission right, how to solve this sort of puzzle, what I see as a puzzle, right of meeting the needs of a program, but also thinking about how to recruit and do our reach to applicants, how we make decisions about who gets into a program, how we think about equity, how we think about diversity. These are all questions I've been thinking about for a really long time. So it just happens that I landed, that I landed here and got to meet some pretty good people in the process.

Unknown Speaker  7:29  
That is fantastic. Congrats on your SC degree. take you a long way with your equally impressive Stanford resume. Yeah, you get the double whammy. That's amazing. So you, you both talking to me in terms of Sue and Nicole, you spoken about the clinical paths you took but now you've been deeply involved in education for a while. sue you, as I understand it, you took over as director of Stanford during this transition from the foothills Community College satellite program at Stanford was part of for so many years with Ron Garcia and others, and and Stanford's really re envisioned pa education, if that's fair in a different way than what had been the historical roots are. So can you talk to us about your decision to get into PA education? And maybe a little bit more about the program?

Unknown Speaker  8:18  
Yeah, sure. I

Unknown Speaker  8:19  
was actually recruited out to Stanford to be a clinical director from the hospital. And so I was functioning in that role, but always sort of tied to PA education and had worked part time for the primary care Associate Program, which was the original Stanford program. So I had been doing that for a handful of years. And the Dean actually had asked myself and one of our current other faculty members to be consultants to kind of look at what was happening with pa Education at Stanford and make recommendations to the dean about where do we go from here? Because it wasn't, it wasn't really clear at that point, whether Stanford would make the transition to offering a graduate degree, as you know, the PCAP program, as we call it, the students were Foothill community college students. And then it was a collaboration with Stanford University. So, you know, to make this transition to a graduate degree, it would have to be a Stanford University program moving forward. And so we spend all my years now seemed to be all blurred together. But a couple of years that we did the assessment of, you know, what was happening with pa Education at Stanford, we interviewed stakeholders across Stanford Medicine community, and you ask PA is whether there should be a PA program at Stanford, of course, are coming back and after looking at the knees for PA within the Stanford community, we had told the dean that we really thought moving forward with this would be really important. And so then we spent the following year writing the proposal for the new program and then know marched it through the university so you know, approval at the School of Medicine and then the Committee on graduate studies and then you go to the Faculty Senate. It's a pretty, very formal process, very prolonged process. But we were fortunate enough to be approved. And I remember the Faculty Senate, they said this was the most comprehensive proposal they've ever seen for a graduate program at Stanford. Because remember, most graduate programs are what a year, you know, they weren't used to seeing this type of professional, graduate degree. So I must say, when we finished that work, I was ready to go back to my other full time position as a clinical director. And the dean said to me, nobody knows this program better than you do. And will you, you know, step into leadership role. And so it was a little bit of a leap of faith, but I did, and I must say that I find things are very similar to my clinical director role, which is around managing budgets, managing faculty, accreditation standards, and things like that. So a lot of the my experiences were very applicable, coming over to the role. And it's actually been, it's been great. I've really, I mean, we have such fantastic faculty and staff on our team. I mean, we really are a close knit sort of what we call us MSPA family. And so I think from that it's been incredibly rewarding to work then to be in this leadership role with the program.

Unknown Speaker  11:11  
And then how do you think that cultural concept that you just talked about really translates to the student's educational experience?

Unknown Speaker  11:18  
Well, I think one of the really unique things about the Stanford program that we were very intentional about is we have a very small class size. So we're actually accredited up to having 50 students, but we take less than 30 students every year. And that came from actually looking at other PA programs in the country and spent a lot of time with Tony and David at the University of Iowa and seeing how they had structured their program, we really thought that sweet spot was somewhere between 25 and 30 students, so you really could a gets to know every student in the program. Faculty could work individually with each of the students. And it would create more of this family, if you will. And so I think it has translated very nicely from this sort of culture of, you know, a family within the staff and the faculty, and then the students feeling part of that as well.

Unknown Speaker  12:07  
And Nicole, you've had some experience in education as well, for a while now. And you're also involved in the National Education Association, currently as a member of the board of directors. So could you talk a little bit about that? And and I know that Stanford has a big focus on leadership. So I suspect that you have a particular interest in that related to advocacy and leadership to

Unknown Speaker  12:28  
salutely Yes. So my first role in PA education was at Howard University's PA program, Peggy Valentine, who was the chairman of the program at that time, you know, took a chance on me gave me my start. And then I was fortunate enough to be able to join some of my faculty from when I was in the program, actually at GW and was there for a few years. And then the opportunity came to join the Stanford community, which I was extremely excited about, not every day that Stanford knocks on your door. And it was like a huge honor to be a part of the inaugural faculty. And as you mentioned, definitely a passion for leadership since I've been here. One of the great things I think about Stanford is there's so many opportunities to do whatever it is you want to do. I mean, it's it's amazing. And being on the campus with one of the top business schools in the country, I was able to participate or continue my education, formally in terms of leadership at Stanford GSB, which has been just profoundly eye opening, and ultimately kind of resulted in me considering running for board positions. So with pa So yeah,

Unknown Speaker  13:49  
that's great. And how does that translate for you in terms of the conversations you're having with your students? How to Stanford really promote leadership and advocacy as part of the curriculum? You know,

Unknown Speaker  13:59  
when we were thinking about building this program, the idea that PhDs you know, can be future leaders and healthcare was really like the foundation of how we were going to build this program. And throughout our curriculum, it starts Dr. Burwell teaches right from the beginning, you know, starting off first first quarter, working on aspects of leadership, it continues throughout the students. Our students actually, unlike other papers actually take electives. So our students take classes at the Graduate School of Business at the School of Education. They take some really interesting courses that sort of augment their pa courses. Yeah, so it's really foundational, you know, we're constantly sort of reminding them of the skills required and the things that they should be obtaining to be a future healthcare leader. We have a during their clerkship, they take a course so on their callback days, they're doing additional coursework and leadership things like Crucial Conversations managing up Things like that, that they take. And then really, it culminates with them putting together this capstone project at the end. So they learn the the writing skills, the analytic skills, thinking skills, if you will. And we've been very lucky, we've had at least a few students from each of our three cohorts that have come through to have graduated one is about two that have published papers and major scientific journals from their capstone projects. So now we'll have to see, you know, I always think accreditation, where's that measurable outcomes that we are developing those future peers are so we are staying in connection with our students and hoping to see them as they grow as clinical PA is that they take on opportunities for leadership, and they feel comfortable doing that, because I think that's something we heard from RPAS within Stanford Medicine is that they have never had any training and leadership. So we're hoping that makes a difference for our students.

Unknown Speaker  15:56  
Yeah, I think sometimes students get really nervous about that term leader, and not everybody is wired to be up front. But truly anybody the white coat has the opportunity to lead and communities advocate for their patients advocate for the profession, without having to be out in front of the camera, per se. So that sounds like you're doing a great job, I'm sure and setting them up for success.

Unknown Speaker  16:18  
Well, when we try to and just can speak to this, when we look at an applicant, we're looking to see has that applicant demonstrated leadership potential? Have they had leadership roles, and that is a big part of getting one of those, you know, seats within our program is whether you've actually have that leadership potential.

Unknown Speaker  16:37  
Yeah, that's a great transition. Tell us a little bit more about that. What are those key leadership experiences that you think really helped somebody be successful in their application process to Stanford,

Unknown Speaker  16:48  
you know, we've done a lot of work in the last, this is my third year in this program. And we've done a lot of work. Before I got here. And since I've been here to think really carefully about what are our goals? And how do our admission processes actually align with those goals? Right, are we measuring what we want to be measuring? And one of those goals is leadership. Right. And so we've had to have a lot of kind of hard conversations about what do we actually mean by that? Is it just that you know, that I was the president of a club? Where could it be that I was not a part of this club, but I've done all of these other things, you know, in my maybe non health related life, right, that demonstrate leadership potential. So we've had some conversations ongoing as a group about how to think more, you know, spaciously capacious Lee right about what it means to be a leader and not necessarily, as you said, like just people that are on camera, or who have won awards for leadership explicitly, but how to define that in a more spacious way. And I think that's been true for all of our other goals as well. Right. So as we're looking at diversity, we've had some ongoing conversations about what do we actually mean by that? Is it just about increasing the number of racial and ethnic minority groups in our in our program? Is it also about socio economic status, it's also about cultural background geography, like we've had conversations about geography and diversity is one of our goals is underrepresented or underserved healthcare communities. So we're trying to expand out all of these categories to both get clear internally about what we mean by them. And also communicate that to applicants that, even if I wouldn't, if I'm thinking about applying to a program, this is true for all undergrads who are applying to graduate school, right? That maybe nobody's called me a leader before. But I've done all this stuff that really clearly suggests that I have potential to do that in a meaningful way in my future. And so what I'm trying to do when I talked to applicants is communicate that right, to set for everybody to think sort of more broadly about what these terms mean. And even if nobody's ever used that label for me before, how I might frame my story in that way.

Unknown Speaker  18:54  
And that's resulted in some really impressive numbers for your percent of underrepresented minority students that are enrolling in your school. Is that right?

Unknown Speaker  19:01  
It has Yeah, we've seen a pretty big jump in the last couple years. So our incoming cohort is 45% underrepresented racial and ethnic minorities in the we use the definition of, you know, underrepresented in medicine. And yeah, that's been really intentional. That's not accidental. And I'm really proud of the work that we've done in that regard. And it's been sort of how do we build in not just sort of saying, let's evaluate a bunch of applicants, and then at the very end of the day, say, oh, geez, what about diversity, right? That's one way to do it. But that's not how we're doing it. We really want to be intentional the whole way through thinking about how do applicants from underrepresented racial or ethnic backgrounds or underrepresented socio economic backgrounds, sexualities, gender identities, how do they actually contribute to our program, right? How does it actually help us be a better as a program instead of just thinking about it in terms of numbers, right. So I think we've had to be really get really intentional about that as well. And I think We've seen the outcomes of that. And I'm really happy and proud of that work that we've done.

Unknown Speaker  20:04  
So you have, I would imagine quite a few applicants that you have. Yeah. Yeah. So if I'm a prospective applicant, and you're coaching me up on how to really make sure that my path is heading in the right direction, what are some of those classic tips that you all share with applicants,

Unknown Speaker  20:24  
I can do my quick and easy one. So I've advised undergrads even before I came to this program, and so again, I want to say that this applies to anyone who's thinking about applying to anything, honestly. But specifically for our applicants who I talk to, you know, I offer phone, we do phone advising, and I answer questions via email. And so there's the obvious ones, right. Like, have you read our website? Do you meet? You know, really basic, right? Do you meet our requirements? Do you know what our recommendations are? Is your spellcheck working? Right, really minor things, but that can actually matter. In terms of how we make decisions, I think for the sort of medium level advice that I would give, this gets a little bit harder, and you have to be a bit more thoughtful about it. But for in terms of letters of recommendation, I think we get a little bit obsessed with, do I have the right people writing me? Like, do I have the fancy people writing me the letters from where I said, I want to see people who can write you a great letter who know who you are, right? Who can really speak to like, why you would be a good pa over somebody else who also got all A's in their class? Why are you the right fit for this program, and that takes in more intimate kind of relationship with with an applicant. So those help to start getting built early, right, that you can just sort of ask someone at the very last minute you can, but the good letters that I see are based on sort of more ongoing relationships. So to start thinking about that early, I'd say the other thing I would say is to ask for help. I wish somebody would have told me that when I was applying for graduate school that I didn't actually have to do all this research and putting together my application alone, that I could actually talk to other people about it and have them read my app, have them talk to me about like, what what should I include in my personal statement. And that may not be a sort of, again, explicit mentor, but it could just be my friends applying to a sociology program. So we get together and we're talking about our application, I think those conversations actually generate a lot of really good material write for an application just to get comfortable talking about yourself as an applicant, to other people. So I think that's a big one

Unknown Speaker  22:32  
clarity, look for

Unknown Speaker  22:33  
Yeah, yeah, what

Unknown Speaker  22:35  
I'm saying making sense, does it matter?

Unknown Speaker  22:39  
Exactly. Um, because I think a lot of times, and this is true for all of us, this is so true for me that I think I've written something out, and I'm getting ready to share it with others. And I think it makes perfect sense. And then somebody else reads it. And they're like, what, what does that paragraph say? What is the point of this sentence? And so just another set of eyes on it can be really meaningful, I think, I think the last thing I would say is that this is a two way street. Like, I think a lot of times applicants think Oh, my God, I just have to like, I'm at their mercy. Right. And you know, it's a two, again, like I said, it's a two way street. So I think really familiarize yourself with what program is actually a good fit for you. Not just What program do you think you might get into? But what do you actually want out of a program? We've thought a lot about this as well, in terms of like, non admission stuff that we're doing, how can we become a program that a wider range of applicants is going to feel at home in our program, right, because I want applicants to be evaluating us as much as we're evaluating them. And I think we have to if we're taking seriously what it means to have a diverse and equitable program, we have to be taking that those questions seriously as well. So just that it's more of a two way street,

Unknown Speaker  23:50  
just was just reminded me of, you know, a few things. And one of them is particularly around the essay, you got to read the prompt, right? I would say that 75% of the essays that I read, they never tell you why they want to be a PA. And so I think that that's really important. I think that, you know, for us, we want to see that applicants have had exposure to health care, we want to know that they know what the PA profession is, and that they're sure that this is the right decision for them. We're you know, unlike other programs, we don't have a thing that says you have to have 2000 or 3000 hours of hands on clinical experience. We certainly have we've had applicants who have 10 or 15,000 hours, but we've had applicants who have had none. We had one of our applicants was a lead reviewer for the FDA. Well, that's great healthcare experience and she actually did phenomenal in the program and has graduated so and I think the other thing too, is I think applicants are so critical on themselves. They see that you know, they have this one deficiency and think, Oh, I have this one thing on my record, maybe I got a C in organic chemistry or whatever it is, and I have no chance of getting it And we can say for our program, that one deficit does not eliminate someone from being competitive within our program.

Unknown Speaker  25:09  
I think everything that you ingest said, Excellent, excellent points. I like to share something that often students might not hear. And that is identify a mentor. And I say that, especially for students who may come from underrepresented backgrounds or marginalized backgrounds, you know, I didn't have anyone in my immediate family that was in healthcare that could help guide the way. So identify someone who can give you tailored advice, and hopefully champion and be an advocate for you. And hopefully, one day, even be a sponsor, someone that is willing to kind of leverage their knowledge, their network, their kind of social capital, to help you move forward. So I encourage identify mentor, you know, that was something that was ingrained in me kind of growing up, I came from a family, I had eight, nine aunts, and uncles, and they each put the next generation through college. And so the idea of mentorship and reaching back is very much ingrained

Unknown Speaker  26:20  
in me. Mike DeRosa, from salmon merit in the Bay Area, was talking a little bit about that in terms of the difficulty of students from underrepresented backgrounds finding, like navigating that mentorship possibility, because they, they're equally disadvantaged, because there's not as many minorities that are in healthcare. So So can you talk to that a little bit, Nicole, and just give some advice on? How do you do that? How do you navigate the world today and find somebody that might be willing to give you some of their time?

Unknown Speaker  26:51  
Yeah, I think, you know, just first of all, putting yourself in settings, where you will come into contact with people or individuals that have a similar mindset, aspirations and values as yourself when that some of the professional organizations like any pa that are open to students, well, student memberships as well, or FNMA, I would I have students all the time that reach out to me and say, Hey, would you be willing to meet with me, and I think most of my colleagues feel the same as at work, you know, as much as we can do? Absolutely. I met with pre pa student yesterday by zoom. And it was the exact situation where she's like, I don't have anyone else to ask. And she literally was just like, Well, can you help mentor me? I'm definitely willing to do that. And I know that many of my colleagues are as well. So I think you know, it is incumbent upon some of the applicants to reach out and contact people and ask them, but definitely seek them out. The National Society of Black TAS is another new and growing organization that has a great mentor program for not only PA students, but pre PA students.

Unknown Speaker  28:09  
So that's fantastic. Great. Thank you for that advice. So you've been in PA education for a while, and you've been at Stanford now for three years. Surely, there had been some occasions for some student challenges. So for the students who listen to the podcast, could you maybe share some of those pearls of wisdom for the students who are navigating life? I mean, you you've had three years of a program and 18 months of it is included this horrific situation with the pandemics. I'm curious what your kind of advice has been to students to help them hunker down and get through this?

Unknown Speaker  28:42  
Yeah, you know, Kevin, one of the things I think that I see most often at Stanford, given that year, after year, Stanford writes, long one of the most competitive institutions on the undergraduate and graduate level, if the students struggle with imposter syndrome. And obviously, having, you know, an environment that is so competitive, you have lots of brilliant students, brilliant faculty, very task oriented, achievement focused people. And that can be a very intimidating and difficult phase to navigate. I think one of the ways that we try to combat that is by fostering a sense of belonging for our students to help breed confidence. And I'll just use this as an opportunity to underscore the importance of inclusive representation that everyone can feed themselves in leadership roles.

Unknown Speaker  29:42  
I work with a Jedi West group here at Keck. And one of the things we're looking at in terms of how to how to really symbolize that it's the tab this conversation that we belong, yeah, that everybody belongs and that we're stronger because of the diversity and the inclusion of all perspectives in our time. conversations in our classrooms so that that's really great advice. Any other pearls? Anybody else would like to share?

Unknown Speaker  30:06  
Right? You know, I think that this is more of like sort of our response to some of the challenges that our students go through. I mean, we all know that pH kitchen is really hard, right? We always say it's drinking from a firehose, you know, it's a very, there's much more self directed learning, sort of in graduate programs. So that transition for students from undergraduate to graduate can really be a challenge, we are trying to put in place more support for students, academically learning specialists, and things like that. But one of the things that we were very intentional about at Stanford were a pass fail program. So we tried to at least remove a little bit of sort of like, what's your class rank, and I think they still get scores on a test, and they know where they're where they're at. But I think it, it definitely helps decrease a little bit of that stress and the competition that happens within a program. And our program is structured a little differently in the fact that our students are in class, Monday, Tuesdays, Thursdays, and Fridays, and Wednesday is used for scholarship, it's used to take electives. All those things are very intentional to create an atmosphere that would make this sort of curriculum feel a little bit more manageable to our students. So some of the things that we've done, and we've the feedback from our students is that it has been really helpful. That's really wonderful. And we also just want to also highlight we also, and this was really pushed by the students within the School of Medicine, but the School of Medicine actually has our own wellness team. So it's a group of psychiatrists and psychologists that are specifically dedicated for our students to recognize, you know, it is a stressful time and never mind, you put on all the other things that are happening between the pandemic and social justice issues. And it's a really tough time to be a student. And so I'm really proud that we're actually able to provide that support for our students and to help them through this time,

Unknown Speaker  32:02  
gesture, the first sociologists I've had on. Great, and actually the first sociologists I've spoken to about PA. So I have one question for you. That's kind of special, because I always kind of contended that there's a different sociological process to the average pa than we see with other health professions. And I'm wondering if you've had an opportunity thus far to make that observation and see what is different about the typical pa that you're dealing with? Or pa student maybe as compared to other medical students, or nursing students or other things? Or am I am I wrong, because my sense is we just relate a little bit better to the average patient than some others do.

Unknown Speaker  32:43  
So I can say this as a sociologist, I can also say it as a patient in the US healthcare system, right? That I'm being I'm being so serious about this, that the PA is that I have interacted with, right, as a patient, I have felt have had better interpersonal skills, right in terms of how that they that I feel seen by them, right when I am in their care in a way that I don't always feel in other kinds of health care contexts. And I think that I found that to also be true, in my experience, working with applicants and working with the students as they come into our program. Right. So I'm also the we have a dei committee as well that I'm the chair of our in our program, and I work with students in that committee. And often right, these students are saying, Hey, we're noticing that we're saying that we're doing this, but I'm not really feeling this, or we're saying that we're providing this kind of care, but I'm not actually feeling like I'm getting that. And so they're really tuned in to not just am I getting an A? Am I doing the best that I can do? Am I completing all my classes? They're really tuned in to like, how are we feeling about this? How is the sense of belonging happening? How are my classmates doing? How are you do it? Right? Like students are asking me how I'm doing, like, how am I? They don't have to do that. Right. And so I have absolutely noticed this level of kind of interpersonal tuned in Ness that I think is unique,

Unknown Speaker  34:09  
and probably complements the team based care of patients, right. Yeah. Because, I mean, watching my father go through this few years ago, the combination of the neurosurgeon who is very short, and not in stature, but in his time. Yeah. And, and so he comes in for literally 60 seconds, or maybe, maybe we give them two minutes. But the PA is the nurses, the physical therapists, everybody else really fills in the gaps. And I think the TAs have really been inculcated to be that kind of human touch that the docs just don't have the time they may have the nature, but they just don't have the time in the business of medicine these days to dedicate what they used to maybe I'll also

Unknown Speaker  34:52  
add another I think sociological observation to this. I was really interested in like, Ooh, how do these people navigate going to class With MD students, right, like, what's that? What's that going to look like? Because I think there's one way that it could go where it's like, everybody is trying to be better, right? Everybody is sort of obsessed with status and trying to, like, prove themselves in some way. Right. And I think that that's not actually what I've seen with our students. It's been this sort of collaboration and kind of banding together and say, what actually, that it's not like, I'm, I'm lesser in some way. But then I can contribute something different in within this system, and that we can kind of like bond on that, and also collaborate with our MV colleagues as well. And I have found that just like as a sociologist who's obsessed with how people be status, actually really surprising, right, that I didn't see that kind of status, that I'm not observing that with our students, and the way that maybe I had expected before I started,

Unknown Speaker  35:52  
do your students train with the medical students in the same classes? Or is this part of an interprofessional? Experience? Or how does that work?

Unknown Speaker  35:58  
Yeah, so 50% of our classes are integrated with the medical students. So a lot of their classes in the first quarter, a lot of the foundational classes, and then they take it's called the practice of medicine, it's our where you do your history, physical exam, technical skills, they take that with the medical students for the five, six quarters that the program so that they are I mean, they're learning side by side, and I will highlight what just said, I mean, I was a little bit nervous that we took that leap, because the Stanford PA program previously, the pika program was not integrated with the medical students. And, you know, give a shout out to Tony and Dave, and at the University of Iowa, kind of showing how it's done. And we didn't go to the full extent that they did, but we went with 50% of our curriculum, and I think it was the best thing we could have done. I think the seeing them work together in teams seeing the collaboration, and, you know, I was worried I didn't know how it was gonna go. And our students were, you know, taken in with open arms. And it's been great. We've been really happy with with the integration.

Unknown Speaker  37:01  
Yeah, I have to agree with that as well, they actually was one of the most attractive features about the program for me having gone to a program very similar that was into into professional integrated. And it's tough, it's really hard because you're exposed to all of this material. And then you have to figure out what what really applies to me. Right. But I think it is just so powerful, in have making those connections. And it's done so much just in terms of raising awareness about not only the program, but about pa as a profession, in the community. So

Unknown Speaker  37:42  
yeah, I think there's no better way to develop mutual respect than to have shared experiences like that. Yeah,

Unknown Speaker  37:48  
you kind of Yeah, and as you can imagine, our students come in with a lot more hands on clinical experience. So particularly in the class that they're integrated with. So they're often teaching the medical students some of these things, and then the medical students are teaching them some of the other, you know, more fundamental science stuff. So it's a really nice, nice collaboration.

Unknown Speaker  38:08  
Were there any other things that you hope to share with us that we haven't discussed today?

Unknown Speaker  38:11  
I did want to, if we can circle back, because I think it's important. One thing I haven't talked about today is that when we were putting together this proposal for the program, it was really important that we didn't lose. You know, the sort of history of PE Education at Stanford, and actually, this year is 50 years of educating a PhD at Stanford, in trying to be true to that part of one of our goals is to deploy graduates to underserved areas, we have two hubs for clinical training, one of them is down by the Mexican border. And our students do women's health and pediatrics primary care, emergency medicine down there. And then also in the Central Valley, similar type of clerkship training, all of our students do at least three or four clerkships in these underserved health care sites. And that's really our our tribute to the the PCAP program to say, you know, that really important part of the mission is retained and still there. And I think for me, and I know for many of our other faculty that everything we do for PE Education at Stanford is to make the 1500 graduates of PA education Stanford proud, right, like, you know, we have our forgotten about what they've done what those leaders have done, and we are really working hard. We want people to be proud that they graduated from the Stanford program. So

Unknown Speaker  39:35  
it sounds like to the best of both worlds, right? You have your students learning in world class facilities with world class physicians and leaders and researchers. And also, speaking to the underserved component, you're getting them out into the communities that are desperate for PDAs to contribute. So congratulations. Thank you all for taking the time to share your story with us and we wish you the very best in your upcoming cycle of missions.

Unknown Speaker  40:00  
Thank you so much. Thank you.

Unknown Speaker  40:04  
Well, I want to thank doctors Fernandez, Burwell and Butler for sharing their time and talents with us today. It is clear that they have put together a very thoughtful program with a strong nod to their deep history dating back to the early 1970s. And now their students sit alongside their outstanding medical student colleagues, learning together about the benefits of both professions. What an ideal way to highlight interprofessional ality. In addition, what a treated was to finally speak to a medical sociologist. Tune in next week, as we speak the leadership from the University of Iowa PA program, Dr. David Asprey and Mr. Tony Brennaman share their stories of both their paths to the profession, and the unique program they lead that Dr. Fernandez alluded to in her remarks. In addition, both Dave and Tony share their history of service to the profession with the Journal of physician assistant education, PA and the aarC PA. Until next time, I wish you success with whatever path you are walking in life. And thank you for joining us. The purpose of this podcast is to provide news and information on the PA profession and is for informational purposes only. The views and opinions expressed in this podcast are those of the speakers and guests and do not necessarily reflect the official position or policy of the University of Southern California.


Jess Butler, PhDProfile Photo

Jess Butler, PhD

Assistant Director of Admissions

Dr. Jess Butler received her PhD in sociology and gender studies from the University of Southern California. She was an instructor of sociology and gender studies before transitioning into her current role as Assistant Director of Admission for the MS in PA Studies program at Stanford School of Medicine. Her research background and interests are focused on the scholarship of teaching and learning, gender and sexuality, and educational equity.

Nicole Burwell, PhD, PA-CProfile Photo

Nicole Burwell, PhD, PA-C

Clinical Associate Professor and Director of Pre-Clerkship Education

Dr. Burwell is a Clinical Associate Professor in the Department of Medicine, Division of Primary Care. She currently serves as the Director of Pre-Clerkship Education for the Stanford School of Medicine, Master of Science in PA Studies program. Dr. Burwell previously served as a member of the PA program leadership team at George Washington University for more than 8 years. Dr. Burwell is a seasoned clinical PA with almost twenty years of experience in Internal Medicine and Occupational Health. She completed her PA training at George Washington University where she earned a MSHS. She also holds a Ph.D. from Howard University School of Pharmacy and Allied Health. Her research interests include Health Disparities and Nutritional Sciences with a focus on the pivotal role it plays in cardiovascular disease.

Sue Fernandes, LPD, PA-CProfile Photo

Sue Fernandes, LPD, PA-C

Associate Dean for PA Education and Director

Dr. Fernandes is a Clinical Professor in the Departments of Pediatrics and Medicine, Divisions of Pediatric Cardiology and Cardiovascular Medicine. She completed her PA education at Northeastern University, where she also received a master's degree and a doctorate in law and policy, with a concentration in health policy. Dr. Fernandes has held numerous leadership positions in her 27-year career. She is currently the Associate Dean for PA Education and the Program Director for the Master of Science in PA Studies program. When not providing leadership for PA education at Stanford, Dr. Fernandes provides care to adolescent and adult survivors of congenital heart disease and dedicates time to research focused on improving access to specialized healthcare for adult survivors of pediatric disease.