PA Program Graduates 10th Class

PA program director Shannon Ijams, MPAS, PA-C, visits with students at the School of Community Medicine.

PA Program Graduates 10th Class

In November, the OU-TU School of Community Medicine graduated its 10th class of physician assistants from a program that is distinctive for its broad and diverse approach to education.

Traditional clinical and didactic experiences combine with unique learning opportunities, such as Lifestyle Medicine and Civil Mental Health Court, to equip PAs to help their patients with all the factors affecting health. From the first day of their careers, PA students are ready to care for the human beings in their exam rooms, not just their illnesses.

“We want to produce highly trained, competent PAs who can engage with their patients in a compassionate way,” said program director Shannon Ijams, MPAS, PA-C. “Our hope is that by broadening our students’ understanding of what their patients may be going through, such as substance abuse or navigating the criminal justice system, they can help them with a non-judgmental, empathic approach.”

PAs receive valuable clinical experience through PAL, the PA Longitudinal Clinic. It is part of the Bedlam Longitudinal Clinic

on campus, where medical students also care for patients who are underserved and uninsured. On their teams, PA students evaluate patients first, then work with a PA faculty member to determine the best care. Students also work alongside nursing, social work and pharmacy students to meet the entirety of their patients’ needs.

“The PAL clinic empowers PA students to assume the role as a primary care provider for their patients, including ordering laboratory and radiological services, referring them for a mammogram or connecting them with community resources, like Family and Children’s Services for mental health issues,” Ijams said. “And because this is a year-long clinical experience, they care for patients when they return for follow-up appointments for their diabetes management, for example. This helps students learn that incredibly important skill of care management on a longitudinal level.”

Through PA faculty members Bobby Bosse, MHS, PA-C, and Mark Perdue, MHS, PA-C, students also learn about the expanded use of technology in patient care – point-of-care

ultrasound. During the didactic portion of their education, students are taught how to examine patients using these handheld, pocket-sized devices. Soon, they will begin using them in the PAL clinic.

The PA program’s clinical experiences are as robust as any, and students practice high-level procedures like intubation and lumbar punctures. PA students also undergo their six core clerkships alongside medical students, an uncommon feature among PA programs. That collaboration replicates how PAs and physicians will work together in practice after they graduate rather than learning it on the fly.

What especially sets the PA program apart are the ways students come to understand the non-medical factors affecting a patient’s health. Ijams created an opportunity for PA students to collaborate with the First Step Male Diversion Program, a Tulsa program for men ages 18-25 who have non-violent charges. Instead of receiving a prison sentence, they can enter this program to receive intensive outpatient counseling, job training, mentoring and sober living. In addition, many men in the program are uninsured and lack access to primary care services; PA students will be among the teams providing that care.

A related rotation, called Community Impact, takes students into the city to learn more about community resources. Students spend time at the Tulsa Day Center, a program for people who are homeless. At Little Light House, they work with children who are developmentally disabled, and at Clarehouse, they are exposed to end-of-life care. Students travel through Tulsa with a mobile clinic affiliated with the Mental Health Association of Oklahoma, seeing patients in their home environments. They also attend AA and Al-Anon meetings as well as a session of Civil Mental Health Court.

“In the School of Community Medicine, we talk a lot about how the actual medical care we provide only makes up about 10 percent of a person’s well-being,” Ijams said. “When students look at the other parts of a patient’s life and the difficulties they have to navigate, they better understand how that affects health. As healthcare professionals, we may not be able to provide everything they need, but we can connect them to resources in the community where they can get that help.”

The national Physician Assistant Education Association, through a grant from the Substance Abuse and Mental Health Services Administration, chose Tulsa’s PA program as one of 10 nationwide to develop a substance use disorder curriculum as part of a pilot program. Educating students more intentionally about substance abuse not only helps PAs understand how it affects patients’ health, but it fosters their ability to develop trust with patients and talk openly with them about possible substance problems.

PAs also focus on approaches that are known to contribute to

As part of their Lifestyle Medicine course, PA students learn how to cook healthy food and its value for the patients they treat.

good health – the food we eat. During a Lifestyle Medicine course, students work with a registered dietitian faculty member and a professional chef to learn how to cook medically tailored, plant-based meals, complemented by lectures on how good food benefits patients with conditions like diabetes and high blood pressure.

“It’s been fun to see how the course has impacted the students’ own food choices and how they function, and that creates the foundation for how they educate patients,” Ijams said. “As providers, we want our lives to model what we want for our patients.”

The breadth and depth of PA education is paying off, and it has enhanced competency without compromising clinical skills, Ijams said. Since 2012, PA students have achieved a 100% pass rate on the Physician Assistant National Certifying Exam. Eighty percent of graduates stay in Oklahoma to practice clinically, and admission to the program is highly competitive – approximately 1,000 people compete for 24 spots each year.

“Our goal is to keep graduating PAs in Oklahoma to meet the needs of our state,” she said. “Although we love to keep graduates in northeast Oklahoma, we want them to remain in the state where the needs are, which can include varied rural areas as well.”