Winter / Spring 2014 - Health Care

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career options careeroptionsmagazine.com Winter/spring 2014

5 Rewarding

alternatives to medical school

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Where the nursing jobs are

10 Physician assistant: An emerging career in Canada

e Flip tzhine maga ore for meer Car ns!

Optio

A cure for the common career

There are more options in health care than you might think!

career options winter/spring 2014

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Physician assistants: An emerging career niche that will help with Canada’s coming shortage of doctors and nurses

5 10 ALTERNATIVES TO WHAT IS A MED SCHOOL

Introduction by Carleton University Co-op and Career Services

6 NAVIGATING THE NURSING FIELD

PHYSICIAN ASSISTANT?

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By Jordan Adams

12 MEDICAL

TRANSCRIPTION 101

By Tiara Wells

By Grace Kennedy

We Would Like to Thank Our Advertisers…

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American International Medical University (AIMU)

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Athabasca University, Faculty of Health Disciplines

13 Atlantic University School of Medicine (AUSOM) 13 Columbia University Medical Center 4 Manitoba Nurses Recruitment and Retention Fund 8 Marskell Group and Health Careers Interaction 3

New England Center for Children (NECC)

3 New York Chiropractic College (NYCC) 13 Opticians Association of Canada 2 St. George’s University (SGU), Schools of Medicine and Veterinary Medicine (Grenada) 8, 13 Xavier University School of Medicine (Aruba)

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Alternatives

Introduction by Carleton University Co-op and Career Services

to Med School

Applying to medical school is a very competitive process, and not everyone who is interested in becoming a doctor will ultimately be successful in gaining admission. However, many of the aspects that draw people to practise medicine, such as the ability to help people, job security and good salaries, are also present in a variety of other professions and occupations.

Medical Illustrator

Genetics Technologist

Medical illustrators render science and medicine visually by creating both traditional and digital illustrations. It is an ideal job for creative people with a background in both science and art. The field is evolving as new design technologies mean new ways to convey art in multimedia.

There’s just one Association of Medical Illustrators-accredited graduate program in Canada: the two-year University of Toronto Biomedical Communications program. According to the program’s website, graduates work in fields as varied as pharma and biotech visualization, medical-legal visualization, health communication, research dissemination and textbook publishing.

Genetics technologists study the genetics of a cell to help diagnose genetic diseases and disorders. They examine samples of blood, bone marrow, tumours and other biological specimens using specialized equipment.

These laboratory tests are used to diagnose and treat patients.

Scientific advancements and discoveries mean that this field is constantly evolving. Genetics technologists can work in hospitals, private laboratories, forensics and academic research. Two institutions in Canada offer post-graduate training: the Michener Institute and the British Columbia Institute of Technology.

Optometrist

Epidemiologist

Optometrists specialize in the health of the eyes. They treat patients’ problems with vision, and prescribe glasses, contact lenses and medicines. Optometrists can also specialize in different areas, such as pediatric care and low vision. It takes seven to eight years of post-secondary education to complete a Doctor of Optometry. Two universities in Canada offer the program: the University of Waterloo and the Université de Montréal. The average optometrist earns between $70,0000 to $80,000 per year excluding benefits, according to Waterloo, and enjoys a stable working life with routine hours and few emergencies.

Epidemiologists study disease outbreaks and patterns, and develop strategies to control and prevent them. They act as medical “detectives” to find out the cause of an outbreak by analyzing data and trends, and examine the factors that impact outbreaks (environmental, behavioural, microbial and physiological, for example). Their findings often have a large impact on public health programs and policies. Most employers will require at least a master’s degree in epidemiology, which can be obtained at several universities throughout Canada.

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Navigating the Nursing Field

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ow is the right time to be a nursing student. By 2016 there will be more opportunities than ever for young nurses to get their foot in the door of the health care industry, thanks to retiring Baby Boomer nurses. If you are thinking about a career in nursing or have just started your bachelor, by the time you graduate you will be one of the most in-demand graduates in Canada.

Where the jobs are: community and specialties According to the president of the Canadian Federation of Nurses Unions, Linda Silas, nurses working currently have filled over 12,000 full-time equivalent positions just in overtime work, representing an immense shortage of registered nurses in the system.

Most of these shortages are in specialist occupations and community nursing outside of hospitals. This trend is due in part to Canada’s aging population and the changing demographics of hospital patients.

By Grace Kennedy

“It may not necessarily be institutional,” she says.

“It may be geriatric daycare or community visiting to do with the frail elderly. It’s not an area that people normally think about, but it can be a really rewarding area where expert nurses can really make a difference to people’s independence and family care burden.”

According to Silas, the idea of the “visiting nurse” is also more in-demand, where nurses visit patients in their home for follow-ups related to chronic disease or preventative care. She also stresses the importance of nurses working in mental health and the benefits they can have for the community.

As a nurse, you can also look into population, rather than individual, care. Public health nurses have spearheaded initiatives such as increasing the use of bike helmets and informing the public on the dangers of leaving children unattended in baby walkers. They also work with governments on policy issues.

It used to be that 70 to 80 percent of nurses were concentrated in hospitals, MacMillan says, but now nurses are everywhere. Their role has been “rebalanced to show equally a focus on sick people and on nursing the well, and making sure that we keep them well.”

If community work isn’t for you, there are more specialized positions that are projected to experience labour shortages. MacMillan cites shortages of nurses working in mental health, cancer and perioperative care (working with patients undergoing operations and other invasive procedures), as well as in emergency. However, nurses working in these fields are traditionally not fresh graduates, she says, “because people generally didn’t get into critical care, for example, until they’d had some experience, so demographically the people who are in the specialty areas are older and will be retiring sooner.” She notes that new grads will likely need post-graduate education in order to have the right skills to fill these specialty positions.

With more seniors entering Canada’s health care system, MacMillan says that they are encouraging students to look into long-term care and gerontology.

“Different specialties are like taking a different job in nursing,” Silas says, which is one of the reasons she thinks nurses are lucky to have so many options.

“We’re certainly seeing a trend to shorter, more intense hospital stays for very, very acutely ill people,” says Kathleen MacMillan, director of the Dalhousie University School of Nursing. “More people are coming in for day surgery and recuperating at home, so you need a community nurse to come in and make sure that they are recovering.”

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RN Job Opportunities Community: • Health clinics • Schools • College and university health services • Workplace wellness programs • Doctors’ offices • Home care • Family planning clinics • Poison control centres • Prenatal and well-baby clinics • Rehabilitation centres • Sexually transmitted disease units • AIDS hospices • 24-hour telephone advice lines (e.g. poison control) • Direct care provider Hospital: • Emergency • Intensive care • Operating room • Post-surgery • Maternity • Cardiovascular • Oncology (cancer) • Psychiatry • Pediatrics (children) • Palliative (dying people) • Geriatrics (seniors)

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Specialization and advancement options If you’re thinking about entering critical care or another specialized area, you should expect to require some post-graduate education.

You can gain certification for various specialities through a variety of different avenues: the Canadian Nurses Association offers certification exams for emergency, perinatal, occupational health, community health, critical care pediatrics, perianesthesia and gerontology, among others. Colleges, universities and teaching hospitals also offer certification courses.

Planning your career path while doing your bachelor’s degree can help a lot with entering the field, says MacMillan. Talk to faculty about doing as many varied placements as possible, as well as where you can do those placements, as they can add substantially to your background experience.

Nurses should also think about working in a rural community to gain wider experience and boost their job prospects. “In rural communities, often you get a much broader experience and you get

nurses could work in the emergency room, obstetrics and out-patient surgery— all in the same week.

to do more things than you do in an urban centre,” MacMillan says. For example, nurses could work in the emergency room, obstetrics and out-patient surgery—all in the same week.

If you want to go even further in your education, you can complete a master’s degree. Nurses with a master’s can go into nursing management and administration, take on senior executive positions in care organizations, and become Clinical Nurse Specialists, or Nurse Practitioners.

Clinicians are often consultants with specialized knowledge for the care of certain diseases or

techniques, while the nurse practitioner spans the roles of physician and nurse, ordering tests and prescribing medications for patients.

After your master’s degree, you could go on to get your PhD in nursing, leading to a career in research or education. MacMillan is keen to get more students to consider a career in academia. “We’re concerned about nursing faculty, because like everybody else, the faculty are aging and we’re concerned about supplies of people to teach nursing,” she says.

MacMillan says there is a push to get students straight through their education if they think they’ll have an interest in nursing academics. “We used to encourage [nurses to work in the field before getting their doctorate] because our perception was that people really needed a strong practice background, but what we find is that people get used to a paycheque and then they’re less likely to come back,” she laughs.

While entry-level nursing faculty are not always as well paid as registered nurses, MacMillan thinks that students should consider the option. “If you’re

really passionate about research and scholarship, you’d be happier here than you would be at practice, so I think it’s choosing what fits for you.”

She notes that benefits for full-time faculty are very good, and competitive at the senior levels.

Advice for aspiring nurses “I can tell anybody that’s thinking about nursing, if you’re getting it from television, you’re getting a pretty skewed view of the universe,” MacMillan says. “So most of our students come in here thinking that they are going to put on the white shoes and the stethoscope and work in the emergency department, and that’s a very small aspect of the job.”

This romanticized view of nursing is something that young nurses should get out of their head.

“If you don’t like old people, nursing is probably going to be a little bit difficult for you, because when you look at who gets sick in our country today, it’s often the frail elderly, it’s the people with a lot of different health challenges, the people that have mental health conditions,” she says. “You have to have a passion for wanting

to help people be the best they can be and be the healthiest they can be, and work with them.”

But for new graduates looking for a way in, there are plenty of opportunities both inside and outside the common perception of nursing.

Nursing by the numbers • 7

“Whether you’re a young man or a young woman who’s considering a career [in nursing], do a little bit of research and find out where nurses are and what they’re doing,” MacMillan says. “I think people will be surprised at the various career options that come out of having a nursing background.

You know, whether they want to be an academic, or they want to be an administrator, or you want to be a policy maker or a public health professional— these are all things that a nursing education can be a way into.” CO

to 9: Percentage of male nurses to $86,000: Salary range—depending on experience, location and specialization • 25%: Increase of available seats in nursing programs in 2005 • 32: Nursing master’s programs in Canada • 15: Nursing doctoral programs in Canada • $41,000

Grace Kennedy is a journalism student at the University of King’s College in Halifax, Nova Scotia. She has done freelance journalism on both the East and West coasts and has a particular interest in science journalism.

T

here’s a new profession in Canada’s health care landscape that could help solve many of the problems experts say are heading our way. It’s a story we’re hearing over and over again: as the massive cohort of Baby Boomers age, more people will need health care services just as many current health care workers are retiring—which will put a huge strain on doctors, nurses and other health care providers. Physician assistants could help take some of the pressure off. While the position is not widely implemented yet, it holds promise for the future as a great career for people who want to work in the health care industry without the full commitment of years and dollars involved in becoming a physician.

The background Physician assistants are highly trained health care providers who support physicians in all health care settings. The difference between PAs and physicians is that the former works under a doctor’s supervision.

It’s a relatively new position in Canada, but PAs have been successfully implemented in the U.S. health care system for decades. As in the U.S., Canada’s first PAs originated in the military. They are widespread in the

Canadian Armed Forces, but are just recently being introduced into our civilian health care system. Manitoba was the first province to introduce PAs in 1999, and Ontario, New Brunswick and Alberta have followed suit.

The Canadian Association of Physician Assistants (CAPA) is working to implement the position across the country through awareness campaigns and stakeholder outreach. “Although it’s starting out slowly, we’re hopeful that eventually PAs will be practising in all provinces across the country,” says Natalie St-Pierre, CAPA communications and marketing manager. “CAPA is working hard with stakeholders and partner groups to try and progress the profession in other provinces. We are hopeful that in a few years time that the profession will be fully integrated throughout Canada.” Right now, there are approximately 300 PAs working in Canada, with 160 students enrolled in programs; CAPA expects this number to grow as the profession advances.

What does a PA do?

“A PA is very similar to a physician in regards to what they do day-to-day, except they have to practise under a physician’s supervision,” says Chris Rhule, president of CAPA and the first civilian PA regulated in Canada. Rhule works in cardiac surgery—one of many options for PAs.

What is a

Physician Assistant?

By Jordan Adams

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What does a physician assistant do?

It varies depending on their agreement with the physician, but some duties can include: • Conduct patient interviews, histories and physical examinations • Perform selected diagnostic and therapeutic interventions • Counsel on preventative health care • Assist in surgery • Order and interpret tests • Write prescriptions Source: Canadian Association of Physician Assistants

earn more

about being a physician assistant at capa-acam.ca

Nancy Aza is an emergency medicine physician assistant and the academic coordinator of the McMaster PA program. “As an ER PA, I work a variety of all shifts in the ER (days, evenings, nights, weekdays and weekends),” she says.

“I see patients of all acuity levels, do full assessments on those patients, order tests (bloodwork, imaging, etc.) and interpret those tests. I do a variety of procedures in the ER, from suturing and casting to lumbar punctures to endotracheal intubation. Upon discharge, I provide detailed discharge instructions and arrange necessary follow-ups. Every day and every shift is different for me, which is one reason why I love the emerg!”

St-Pierre says that physicians benefit from the collaboration: “They enjoy working with physician assistants because they’re able to maintain control over their patient population while still improving the care that’s delivered to their patients.”

How does this impact the system?

“So far what we’ve seen here in Manitoba is the ability to decrease wait times to get procedures or to get into appointments, because adding PAs into the mix increases the efficiency of the program or the physician, and allows for them to see patients quicker or even double up because the PA sees some of the patients and the physician sees some,” says Rhule.

“It increases retention of physicians, too, because now they’re not as overworked as they were before. We help share the on-call burden and those kinds of things to make their practice environment much better,” he says. “And we’ve actually been able to recruit specialist physicians and surgeons easier because we have PAs that help them out.”

PAs can also have a huge impact on providing care to rural communities, Rhule says. “You can have a PA working in a rural area, like we have in Manitoba, and the physician may not even be in the same town as them, and so they supervise from a distance,” he says. “That provides the ability to give medical care to a community that otherwise wouldn’t have a physician. It also helps staff in rural ERs and rural hospitals.”

How can I become a PA? Four schools in Canada currently offer PA training: the Canadian Forces Health Services Training Centre, the University of Manitoba, McMaster University and the Consortium of PA Education (University of Toronto, Northern Ontario School of Medicine and the Michener Institute of Applied Sciences). All four programs are accredited through the Canadian Medical Association’s Conjoint Accreditation Services.

and self-improvement, so we can provide the best care possible to our patients.”

If you do manage to get into one of the programs, your employment prospects after graduation are very good. The Ontario and Manitoba governments, for example, have been supportive of the PA profession by creating jobs for new graduates as they’re coming out of school, says St-Pierre. While a job is not guaranteed, “the chances are very high,” she says.

“With the amount of Baby Boomers that are coming into the system, there’s going to be an increased demand on our health system,” says St-Pierre. “And because there is a limited number of physicians, they can’t possibly be expected to take on all of the patients without having some sort of help and assistance.” CO

Jordan Adams is an editor and writer for Career Options and a Carleton University journalism graduate.

St-Pierre stresses that it isn’t just an alternative career for those who don’t get into medical school.

“It is competitive to get into the program, and really, people that are coming into the program don’t want to be physicians,” she says. “They want to practise medicine but without all of the responsibility included that a physician has.” As the CAPA website puts it, “Physician Assistants want to be Physician Assistants.”

Most of the programs ask for a background in health sciences, though they all have different requirements. McMaster, for example, takes students from a variety of backgrounds, says St-Pierre.

Education aside, Rhule says communication, ­decision-making and empathy are three essential skills for aspiring PAs. Aza lists similar skills: “Interprofessional practice is the nature and benefit of our health care system, so a good PA must work well in a team environment and have effective interpersonal communication skills,” she says. “Strong critical-thinking and problemsolving skills are a requirement, as well selfmotivation towards continuing medical education

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• • •

•

Medical Transcription 101

as necessary. These documents eventually form part of the patient’s medical record.

The transcribed reports must comply with legal policies and adhere to patient confidentiality.

MTs may consult medical terms and procedures to verify for inconsistencies.

They may have to follow up with the doctor if they find any discrepancies within the voice recordings.

They must keep a log of all the transcribed reports, perform quality checks on them and submit them to the doctor for approval.

By Tiara Wells

I

often get asked what my work as a medical transcriptionist is all about. I will say this: it’s the perfect career for anyone who wants to be a part of the health care industry without toiling away in med school for half a dozen years. Here’s the lowdown on this rewarding, flexible profession.

An Overview of the Medical Transcription Process What exactly does an MT do? Doctors, with the help of voice-recording software, record the details of every patient meeting, including the physical examination and medical problems, any lab and diagnostic tests that were requested or their results, diagnosis, plan of treatment and instructions given to the patient. The MT transcribes this audio file into a report or record.

Training/Educational Requirements In order to become an MT, you would ideally complete an associate degree or enroll in a diploma program after high school. Many vocational schools and colleges offer training and some, such as CareerStep, also offer online courses that you can complete in as little as four months.

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Coursework for medical transcription includes subjects such as anatomy, pathophysiology, pharmacology, medical terminology, and English grammar. To be a really good MT, your skill set must include: strong attention to detail, excellent written English, typing speed, computer skills, and an ear for accents (in Canada, you’ll find doctors come from many cultures!).

You can also choose to obtain certification, although it’s not mandatory. But certification shows a potential employer your dedication toward your calling. Certifications are maintained by the AHDI (Association for Healthcare Documentation Integrity) and are known as RMT (Registered Medical Transcriptionist) and CMT (Certified Medical Transcriptionist). Fresh graduates with little or no experience under their belt can take the RMT exam, whereas the CMT exam is for experienced MTs who have worked in a medical specialty such as acute care.

Job Duties of an MT • MTs listen to the voice recordings of doctors or nurses and then transcribe them into referral letters, diagnostic test results and other documents ca re erop ti o n smaga zin e.com

Typical Work Environment MTs usually work in hospitals and doctors’ offices.

Or they can work in offices for corporations that provide transcription services for hospitals, medical centres, and health care establishments.

MTs can also telecommute (work from home), either as an independent contractor or an employee of a firm or doctor’s office.

Job Outlook/Pay Rate According to statistics, the job outlook for medical transcription is bright and there’s a huge potential for growth. The compensation is fairly high: $21 an hour is the median wage, so if you’re really good at what you do and have enough experience, you can earn as much as $27.50 an hour.

Medical transcription doesn’t require extensive training and it could be the ideal choice, especially if you are looking to work from home. If you’re truly interested in making this your career choice, look for reputable schools that offer on-the-job training. Good luck! CO

Tiara Wells is a successful AfricanAmerican medical transcriptionist who has lived in Canada with her husband for the past six years. Since her accident in 2010 she refused to be discouraged by her disability and continued to seek career options that allow her to work from home.

She now heads a team of five medical transcriptionists and enjoys writing in her spare time.

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