Season 3: Episode 49 - PA Carey Barry and Northeastern University

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Welcome to this episode of the PA path podcast, I'm your host, Kevin Lohenry. Glad you could join us as we seek to better understand the PA profession.

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I think that our program is amazing in so many ways.

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Well, hello, and thank you for joining us for episode 49. Today we speak with pa Carrie Berry. Carrie is a PA program director and the chair of the Department of Medical Sciences at Northeastern University in Boston, Massachusetts. She is a PA with 20 years of clinical experience in the surgical setting. She has practiced in numerous surgical specialties including vascular surgery, cardiac surgery and plastic surgery. Prior to becoming a PA, she worked as a medical technologist in a community hospital laboratory, and she has special interest in foundational surgical training. Today, Carrie and I speak at Northeastern University, their PA school and the many different options they provide applicants, including dual degrees in medical informatics in public health, and also a postgraduate training program for a doctorate of Medical Sciences. As always, you can learn more about our guests at our website pa path podcast.com.

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Well, Carrie, thank you so much for joining us today, we're really excited to learn about Northeastern University and about your history as a surgical PA and some of the dual degree options that your university offers. But before we start with that, can you share a little bit about your background and how you ended up taking this path to becoming a PA. My path to becoming a PA probably started in high school when I was interested in the medical field. Interestingly, I didn't have an understanding of fully of what it really was and what the roles were. And also I was interested in doing anything except for cutting people, which is interesting because I've ended up in surgery. So that was where I first started. And throughout undergraduate I explored different areas of medicine, I volunteered on an ambulance as an emergency medical technician. I worked as a phlebotomist and I ultimately got my undergraduate degree in Medical Laboratory Science and worked there for awhile, I really enjoyed that. And as I was thinking about my next steps, and trying to get back on the front lines, so to speak, and it's talking with patients and people and working in that way. I was exploring different options. And I think for me, it was really the PA curriculum that maybe helped make my decision because it didn't really fit what I was looking for. And I think it overall met the goals of what I wanted to be. And I think I know I made the right choice. Now. What do you hear applicants say about Northeastern University? What is it about Northeastern that ultimately ends up having them apply there? So I think that from from my perspective, I think that one of the things that students tend to like is the atmosphere that we try to promote to have a collaborative environment among the students. I think that that's probably one of the most important things to success at wherever students land or where they ended up is learning to be a great colleague. And looking back that is one of the things I ultimately really valued at my program, where I was, and so that mentorship that my faculty had, we are echoing that here. And this has been a long standing program that has had that throughout the years. Do you think Northeastern over the years because you started in 1971? So you've been doing this a long time? Do you think there'd been kind of a different evolution of the program? Or are there some like DNA things there that just never change?

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I think a little of both. I think you have to continue to change as the profession grows. I think there were different battles to fight them. And I think that they're what are the face of the profession looks like now is is different. When Suzanne Greenberg started the program, it was a profession that was just beginning. And there were different

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Different things that needed to be established to get the profession moving. And I think that that was something that with time has grown. The program then progressed and was one of the first in the country to offer a master's degree and moving in that direction as well. And I think that progressing into modern medicine, as we become more technological, more advanced, as far as training with simulation, those things, I think, continue to grow. And, you know, with the program, well, keeping the, the history of the program as well. Sure. So if I'm an applicant, looking at your program, what's kind of your pitch to typical applicants to help them learn about the program and also learn how to be strong applicants? Sure, I think that I like to tell people that you always have to try and find a right fit for you. And I think that our program is amazing in so many ways. I think we have a faculty that are here and really care about our students and the success of our students. I think that's a strong point of our program. I also think that we have an extremely robust simulation program where students participate in high fidelity simulations, we have robust Ultrasound Training, which is

Unknown Speaker  6:29  
a very strong program. And you know, some of the things about our training is that we have several aspects of integration across curriculum. And so our foundation of instruction is one introducing smaller concepts and building on those as you go. And as you're doing that we're integrating across curriculum, meaning, we have students learning about cardiology, in anatomy, then in physics, in physiology and partner. And then also, you're learning about the cardiac medications in the pharmacology course, you're learning about the cardiac labs in the laboratory course, you're learning about

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cardiac medicine and the principles of medicine, and it's all staggered in that way. The second thing is that we introduced concepts that are

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sort of at the introductory level. And then as you're going along in the program, you start to dig in a little bit deeper as you go. A good example I can think of off the top of my head is arterial blood, glatt gases, we have a very introductory level, beginning for interpretations of ABGs. And really what it means in physiology, then we learn a little bit more in laboratory medicine, about the interpretation and what those look like. And then the students are really delving in more in pulmonary, and then a whole nother level in renal. So it's something that as you're going you're, you're repeating it intentionally, but also digging to that deeper level as you go. So it sounds like you have a real mindful sequencing across all the courses with intentionality. Yes, definitely. That's something that we really strive for here in the program. Sure, I had the privilege of visiting your program maybe seven, eight years ago. And the thing that struck me about your program that's really neat, given the age of the program is the relationships that you have with some of the best health systems in the country right there. So can we talk a little bit about your rotations and those aspects of it that you're very proud of? Yeah, absolutely. I think we have many, many strong partnerships in this area. Some of the things that, you know, we're in the heart of Boston, we're very close to Longwood Medical Center. And we do have students rotating through the larger institutions. We have students at Brigham and Women's Hospital, Massachusetts General Hospital, Lahey hospital. And we also have students in amazing community hospital, in the area. And I think that the, the pairing of both of those gives a really great experience. And I think that when the students have the opportunity to see the contrast and how each complements each other, I think that's a really strong aspect of our rotations that we're really lucky to be where we are. So for the listener, who doesn't understand the difference between maybe a Mass General experience and a community hospital experience, can you explain what those kinds of variations are between the two?

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I think when you're at the larger academic centers, you can have an experience where you're working with with an extra, you know, a larger medical team, you're working with physicians, nurses, nurse practitioners, residents, and it's a treat

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Training Center where and tertiary care center where people with very complex medical problems are referred. They also care for patients for routine medical care as well. So there's a big variation, but you're seeing some of the most complex patients in these settings. And in the community hospital, you may have a different experience where you're working in a collaborative team as well. But also maybe at a smaller level, there may or may or may not be residents. But your experience is, you know, just a little different in both of those realms. Sure, I had a supervising physician, he used to describe it, he was at Mayo for his residency, and he used to describe it that a male you'd see four or five pheochromocytomas on the floor at one time at a tertiary center like that. Whereas in a community hospital, you might see it once in a career. That's a great description. Yeah. So I imagine and I would assume, the students are able to participate in Grand Rounds at the Medical Centers, which typically don't have at the community centers. But you, as you said, you get to do a little bit more at the community centers, one on one with the attending. So definitely, yeah, I think that having both of those complements, really adds to the just exposure and students helping or helping students to figure out what they want to do what they like they may prefer one setting over the other. And I think that exposure is really important. Sure, do you find that the majority of your students come from Massachusetts? Or are you do you get a nice well rounded group from all over that really want to come and learn in a city environment like that? We definitely have a mix of people throughout the country, we do have some international students as well. And I think that we have probably a larger percentage of the class is from Massachusetts. But we do have, you know, a significant amount of people from different parts of the country. We have students from California, we've had people from Alaskan in the past, and then as well as international students. So as a PA who spent the majority of your career doing surgery, and being in hospital settings, what aspects of the program do you feel like really provides students with a great opportunity to develop proficiency in surgery, I think, looking at surgery, specifically, but I guess stepping back and looking at the curriculum and the way it, you know, progresses, the, you know, the, again, the foundational, the physical exam skills, and the foundational skills are introduced early on in the first semester, the second semester, you are moving on to, you know, sort of organ system based learning. And then in the third semester, you're moving on to approach to the patients. And we do have a separate surgery course, where we have emergency medicine and critical care, we have primary care, medicine as well. So we have different specialties, as focused and you're moving into sort of learning about what it's like to be in each of those different fields. I think our surgery course is a strong course I love teaching the suturing. Personally, that's one of my favorite things to do with the students. It's extremely rewarding, because everyone at first feels like it's a very challenging thing. And then seeing the excitement in the quick growth on how well they do at the end is always an amazing thing to see. And so I think that those are some of the things that add to the curriculum at Northeastern, having that break up really gives an opportunity to to learn about each of those fields. So you have three semesters of didactic preparation, followed by a year of clinical rotations. That's correct, yes. So our students have the three semesters and then we have nine rotations that the students participate in. During training, one of those are an elective rotation. So students are able to choose a field where they are really interested in a field that they may feel like they have some opportunities for improvement field that they may never go into and so on to have an experience there and see what it's like. And I noticed that you have a couple of dual degree options too. Can you talk about that a little bit? Yes. The dual degree options here are really innovative, and I really think they're add to someone's clinical practice. One of them is the dual mph so Master of Public Health in a physician assistant program, and what happens is the students will have the opportunity to earn both their Master of Public Health and their pa at the same time, or our other option is health informatics so students can earn a master's in health informatics and Pa at the same time so those are our current dual degree options. The curriculum starts for the SEC

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In degree before the PA curriculum, so students complete most of their curriculum online before they arrive to campus for the start of the PA program with the rest of their cohort, and so much of that training is already completed. And then as they're going through the PA training, there's one or two courses that are separate. But there's also integration of their capstone project with their dual degree. So they're completing something that integrates the practice of medicine as a physician assistant, and then also public health or health informatics and how those intersect. So what would be the average amount of time they spend in that part of the curriculum before they start PA school is that a semester a year? It's two semesters, so they're starting in January. So they do the winter semester online, and then the summer semester, online. And then at the end of the summer, our program starts in August. So two semesters before. That's interesting. So I imagine that the MPH students and your health informatics students have the opportunity to contribute a different perspective during your regular program for the students who maybe don't partake in those. Yes, definitely, I think it adds to class discussions, when we're talking about particular areas related to public health, the students have a different insight because of their background, and then looking at the students from health informatics as well. If you're talking about, you know, different aspects of, you know, bringing, there's so many aspects that get the student could focus on from health informatics that that can bring into the classroom as well. That's great. And roughly what percent of your students are taking each one. It's different every year. So I think that the highest cohort we had were eight students in the Master of Public Health, and it just depends every year on the sort, I guess, the whole makeup of the class, we don't reserve a certain number of seats for those programs. We inter view everyone as a whole and look at you know, the students from the aspects. So it is varies year to year. Okay. I see you and your class sizes, how many students typically 50 to 52. Okay, so we're max of 52. Yeah. Now you yourself, you you left the you attend to PA school where I was at Quinnipiac. Oh, Cindy Lord,

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built called half. Yeah, yes. Absolutely. Wonderful. And so you alluded to in the story of your path to becoming a PA you, you never really envisioned yourself being a cutter,

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getting into surgery, but but at some point in time you change your mind, because you did your entire clinical career so far in surgery, right? Yes, yeah, that's. So this is my advice to students is to go into things with an open mind. And I really was trying to go into things with an open mind by my preconceived notion when I went to PA school was that I was going to go into maybe hematology oncology, because of my lab background and my interest in hematology, or I was going to go into emergency medicine because of my EMS background. And I loved both of those. But as we were going along, I had, you know, amazing rotations, I really was interested in inpatient medicine and internal medicine as I was starting my training, I really enjoyed being with the patients throughout their care, I being in the outpatient clinic, being in the emergency room, being there to communicate with them and their families after surgery, and really supporting them through that I think that those things were really so enriching, and you just felt I felt like I was making a difference. And really caring for these patients. Not not that everything else wasn't wonderful, but it just I really liked the change and the in the pace of, you know, taking care of patients in that way. I don't know if this is the same for you. Sounds like it might be but for me when I was doing hospital medicine, hospital and outpatient medicine, what I liked about what you're saying is literally you'd get a console down in the ER for when your patients who showed up you counseled surgery and you know, infectious disease and what have you, but you're the quarterback of the case. And you're tracking it every day in ICU CCU or on the floor after surgery, and you can see the ups and downs and the and the changes in their labs every day, because either we're over watering them or under watering them, or we gave him too much blood, or he didn't give him enough blood. And they you know, they get adenomatous and so you have to give him a little Lasix, but then you send their kidney and do a little bit of failure. And you know, so you have to adjust that. And it's I just found it to be like a chess match almost not that I ever played chess, but just that constant changing until you can get them into the more of a homeostatic kind of space where they're safe to discharge

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And then you can zoom out, you know, a couple of weeks later at the outpatient. And by and large, they're feeling much better. Yes. Yeah. It's, it is amazing to see the impact you can make on on really, in these high acuity situations, it just really, I guess, overall just makes a difference. And, and you can feel that. Yeah, I agree with you.

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So often, we tease the primary care folks to the surgical folks, you know, a chance to try it as a chance to cure and you know, there's

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not a lot of time for niceties. You're just Yeah, yeah, to quickly get get in there and cut them up and save your life. And I think one of the things about being in surgery is that you are dealing with precarious situations. Can you talk a little bit about how you adjusted to that, and the times that you had outcomes that weren't what you were hoping for, given that they are so critically, Ill sometimes

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think it's really about listening, listening to your patient and your family and trying or their families and trying to figure out what they need, and what their needs are in those moments. It's funny, because my own family, a family member once told me, why are you in surgery, you're, you're good at talking to people, you need to do that. And I was like, but I do. And so a lot of my job is actually, as a surgical PA is communicating with families who have, you know, surgery is a stressful time for for people for their families. And I think that that communication, and really having empathy for patients in those moments and understanding how stressful it can be for them and their families, is really an important aspect of it. Yeah, I alluded to this in a previous episode, once my father had a intercranial hemorrhage and had a neurosurgery. And what I was just so proud of was that the PAs really were the translators. For the surgeons, the surgeons came in literally 30 seconds to a minute, and then they're off to the case. But the PAs were in two or three times a day, checking on things community, getting the family, calming everybody down, because information is valuable to you know, helping people have some confidence that they're heading in the right direction. So I think that skill set is, like you said, it's often under misunderstood. But in fact, so critical to a successful surgeon's office, having that extension of somebody like a PA, that can be the face of the practice in that way. Yeah, yeah, I just I have been extremely lucky in the groups that I've worked with throughout my career. And I've really enjoyed it. So when you as a program director have opportunities to impart knowledge on students on those kind of critical skills and traits like empathy, compassion, what are some of the lessons you'd like to share? Oh, I have one, but I'm not sure it's something I want to share.

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I like to share a story I have about a moment where I had some impatience and how in those moments I was in that moment. And I stopped and I could see myself being impatient with with a patient. And just I had to stop myself in that moment when they spoke, and I said, I had to say this, this person needs my empathy right now. It's a challenging time. And so I think hearing those things, hopefully, will help others to avoid them.

Unknown Speaker  23:36  
And it's something that's one of the things that I think I always share every year, it was a specific situation with a patient that needed a lot of hands on care, I'll say, and so then I really, the patient in the end, ended up making me a scarf. And so I call it my scarf of humility. And I wear it to lecture. And I talk about that every year when I have my lecture and tell them to remember that each patient has their own story. And it's challenging in every way. And so try to remember the at all those moments in it, especially in the moments that are the most challenging. Yeah, I agree. I have one that I am not proud of, as well. It was a patient who had worked at the health system that we the hospital I was at and you know, I made the mistake of putting extra expectations on her as a patient because she was a staff member of the hospital and she was berating the nursing staff and I was out in the ICU, checking her charts when I heard this and I I admonished her and two things I learned from that. Well, more than two but the two main things one is I had not at that point had a health scare so I didn't understand what a I've never been in her shoes. I didn't understand what was the difference was between being a colleague at the hospital and so

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Are you having your fear of being in the ICU, and I wasn't very person centered, I was at night syndrome with our nursing staff. And that's not my role. My role. My colleague and physician boss said, this is yes, it is frustrating. But it is never our role in this situation to be admonishing a patient, it's our role to try to understand why the patient's struggling so much that they would behave that way. And how do we mitigate those struggles for them and those fears or concerns to help make their day better, and he was right. And he said, the other thing is, you know, now you've made an enemy for life and her as a patient. And if you ever have a mistake, you know, you're not going to get any grace from her and you don't deserve it, because you didn't show her grace in that that really difficult time for her. And he was absolutely right. So, you know, I think those Person Centered moments are really important. Yeah, definitely hard lessons that we've learned, but hopefully others can learn from ours as well. So as you as a Program Director at Northeastern, as you look to the future of the profession, what are the things that Northeastern is thinking about mulling over talking about in the faculty lounge, as you see where their professions kind of heading? Well, I think we talk about a lot of different things, we have a really strong team. And I think we're forward thinking as far as you know, where the profession is heading. And also the the maturation of our profession. And, as we're continuing in this field of medicine, talking about expanding what we do, and part of that is the dual degree program, you know, having pas who are, have the knowledge and background of being a physician assistant, or soon to be Physician Associate, thinking about going from a PA to also, you know, incorporating leadership in health informatics leadership in business leadership in the hospital setting. And as part of that, we've recently developed a Doctorate of medical science degree at Northeastern, which we are very excited, we just have the inaugural class who came in that is that we've been working with the program is, I think, really developed for health care professionals who want to become leaders. And I think one of the strengths of our programs, when we look at it, is looking at the different concentrations that we have, we have something in business with. So it's similar to a business track for those and that's taught by our business school. It's not us teaching business, it's business experts teaching business. And we collaborate with our health informatics cohorts in

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the school as well. And they are again teaching in that area. They also have a legal track where health law or concentration rather a health law concentration that's taught by our colleagues who are were lawyers, and in the in the law school or at other law schools as well. And right now, we, Mary Jo Bondi is teaching a course right now or our leadership course. And the students are just amazed. It's a really great course. And we're lucky to have her as part of the project as well. We have a really amazing team. Yeah, that's a nice get getting married. Joe, that's wonderful. Dr. Bond is I mean, she has such great experiences and leadership as Associate Dean and program director and in PA and all these other places. So that's kind of a great course. Yes, definitely. It's a great course. And I remember taking a course or with her myself as it was through PA, and she was running a workshop that I took, and I was just amazed at her educational progress, I guess is the way to do it, to say it, but it was just really impressive. And Dr. Bondi is amazing to work with, and I feel really lucky that she's a part of our program. So how long is the dmsc program? So our dmsc currently is two years part time and it's all virtual online. Nice. And for students that graduated from your program, I presume that that degree is a not a not an entry level degree but a terminal degree or a alternative degree for people to jump into after they get out of school. Yes, so the anyone who are alumni are can apply and become members of the class and they can do that we do offer a double Husky so people who went here for another degree get a specific discount so our double Husky is appealing to our current alumni. But it's so anyone who has a background in any aspect of healthcare and some experience or a master's level is

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In the healthcare field is meeting criteria, we have an interprofessional aspect to our program. And that's something that we're really proud of. It's so it's not just for pas, but it pas are part of our the group that we think could benefit from this. And it's great. I think there are more and more schools that are looking at that. And from my perspective, I think it's a great way to prepare for the potential of an entry level doctoral program down the road. So kudos y'all for doing that. Yeah, definitely. So Carrie, when you when you think about, like the things in the future of our profession that are out there that concern you, what would be your one or two things that are most concerning, and that you're trying to kind of figure out how you might adapt if it happens. If anything, I think that we are a group of adaptable people. And we bring a lot to the table. So I think that I'm confident that our profession will adapt, as we've done over these last 50 years to meet the upcoming needs for health care. Sure. That's fantastic. Well, I always like to give our guests an opportunity to add anything else that we maybe didn't cover. Is there anything you were hoping that we were talking about today? No, I don't think so. I think, again, we're just my advice to students, I guess, is just find a place that fits and feels right to you. And, and good luck. It's really amazing to see how impressive all our applicants are. It's challenging out there, but stay persistent. Oh, I guess I have one more thing. I always do like to tell people, I was a weightlifter. And I didn't get in the first time. So if it's something that you're really interested in, in your passion, don't give up and keep pursuing, pursuing that passion and figuring out what you need to do to get there. Yeah, that's good. That's good. I think I, as a director, I've seen that happen so many times where a student is just crushed by that. But then something happens in their life that year that they couldn't have done well in PA school if they had been there. So the universe knows how to take care of them in many instances. And then they come in the next year, and that issue has been resolved. And they're ready to go. Yes, yeah. So yes, stay at it. Your time will come back. Yeah, exactly. Well, Carrie, thank you so much for sharing your time and insights about the profession and your program. I know our our listeners are gonna be excited to learn about Northeastern University and the dual degree options, which is I think, really, you know, not every PA school has that very few do. And I think, you know, learning in a place like Boston that is just so famous for great health care, that has to be a really exciting place to go. So we wish you all the very best. All right, thank you so much. It was great to be here.

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We want to thank our guests pa Carrie Berry, the program director and department chair for Northeastern University in Boston. Carrie provided us with great insights into her program and the dual degree options and the dmsc that they're offered as well.

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Tune in next week for our 50th episode. As we speak with Dr. Sharon Luth, the executive director of the accreditation review commission on physician assistant Education, Dr. Luke shares her unique path to becoming a PA and PA program director and ultimately the executive director of the national accrediting body for the PA profession.

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Until next time, we 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 on this podcast are those of the speakers and guests and do not necessarily reflect the official position or policies of the University of Arizona.

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