I reclaimed my path at an orphanage in the Ngong Hills of Kenya. The police had admitted two sisters in the dark of the night. They were victims of abuse, discarded because they were born HIV positive. I craved the ability to treat their injuries, but there was nothing I could do. A volunteer Physician Assistant (PA) sprang into action, comforting and providing medical aid, ultimately stabilizing both children. I did not have the licensing or skillset to accomplish what I desperately wanted. Until that point, my life had run on autopilot. I was pursuing an undergraduate medical tract without a defined practice in mind. It took traveling 4,500 miles from home to rediscover my purpose.

Over the next five years, I served as an Orchard Africa volunteer, living in various villages throughout Africa. We initiated feeding programs, developed and introduced a school curriculum applied throughout South Africa, and implemented medical and HIV education programs. It became evident that there was an immense need to build communities with access to healthcare and education. Lacking formal schooling, older village members perceived health education as a threat to their beliefs and their standing in the community. To increase community acceptance, my team and I designed and implemented a participatory model for elder engagement in curriculum facilitation focused on spreading HIV awareness to youth. I remain inspired by the practitioners and village members who worked in unison, relying on their own resilience and capability to find creative solutions despite limited resources and sometimes lacking medical training. I aspire to maintain this tenacious spirit throughout my current and future medical career.

I have a passion for bringing equity to healthcare, which impelled the medical opportunities I pursued serving marginalized communities in the United States. Access to quality care remains a widespread issue for patients from different socioeconomic and cultural backgrounds. I interned at a local family practice that served predominantly first-generation immigrants to further my learning in culturally appropriate medical care. Each day, foreign-speaking patients sought medical care with lacking English language skills. My supervisor, a Ukrainian immigrant PA named Julia, coached me on the importance of patient and compassionate communication. I studied the symbiotic relationship between the physician and the PA, listened to and applied cultural sensitivity, and interpreted the most important universal language of compassion. Julia and her team provide culturally targeted healthcare to a population struggling to find their place in this country. My goal is to mitigate ethnic and racial disparities in the healthcare system. Becoming a PA will enable me to focus on a broad range of medicine, which is pertinent when dealing with a diverse populace.

These experiences and many others fortified my desire to provide quality care as a PA. I completed additional coursework, advanced my experience as a Scribe in the Emergency Department, and earned my Emergency Medical Technician (EMT) license to strengthen my medical skills. Working in Level One Trauma Centers as an EMT on the front lines of the COVID-19 pandemic allows me to be part of a team in a time of uncertainty. With the shortage of personal protective equipment and the fear of the perpetual unknown, we choose to flow as a seamless unit. We are fighting against a novel virus with the tools we have learned in our studies and the empathy we have found among one another.

This empathy has been the foundation for how I interact with my patients. Recently, an attempted suicide patient was flown in just after midnight. I have lost a loved one to suicide, and after assessing the gunshot wound, it was clear the patient was not going to survive. It would have been acceptable for me to leave after a time of death was called. However, I knew from experience the patient on the bed was not the only injury in that room. I approached the patient’s parents and sat in their pain. I wanted to validate their grief and reassure them that they were not alone. I knew they were going to need continued care and that my responsibility did not end with their child’s life.

For as long as I can remember, practicing medicine has always been my dream. Over the years, I have started my own tourism company, served as a Public Relations Director, operated as a Regional Sales Manager, and volunteered across the world. Throughout my experiences, healthcare has remained a constant in my life. Everything is clear to me when working in tandem on a medical team; even in the whirl of a trauma bay, time slows, and the noise dissipates. Treating and caring for people is a part of who I am. I believe each moment has been necessary to prepare me for my destined profession. I would be honored to be given the opportunity to take the next step and become a PA.

Please explain how your patient care experience (direct and/or partial) has shaped your perspective on the delivery of health care in the United States.

My home state of Arizona is a dichotomy of new developments and rural land inhabited by indigenous peoples, lower-income communities pushed to the edges of urbanization, and Latinx populations working to thrive in this border state. For these underserved communities, the geographic sprawl of Arizona produces extra barriers to healthcare access, including lack of transportation and limited primary care clinics outside cities. Limited English, knowledge of the healthcare system, being uninsured, and fear of deportation for Latinx communities further prevent patients from seeking care. These social determinants increase the risk of chronic health diseases in adults and developmental issues in children.

The power of a culturally competent PA is not just treating a patient’s symptoms but also listening and addressing unexpressed needs. Through my work with homeless youth, I learned how external factors inform health outcomes. Youth dealt with food insecurity, and most had never experienced stable housing. Complex trauma and street living caused them to develop poor affect regulation, lack of vaccinations, and increased risk of communicable diseases. Youth faced judgment when seeking help for mental illness or sexual health based on their lifestyle, lack of health literacy, or even appearance. Fearful of systems that had failed them prior, they chose to self-medicate or simply refuse services. As a future PA, I see ample opportunity to provide a broad range of care to these patients through means that make sense to them, such as mobile health clinics.

Uninsured individuals, who are disproportionately people of color from lower socioeconomic backgrounds, often rely on emergency service as a primary form of care. I have recognized how these patients can feel stigmatized by providers with good intentions. In emergency triage, overwhelmed physicians may fall victim to implicit bias. In response, a physician may excuse the severity of a patient’s complaint based on stereotypes, potentially missing a diagnosis. This is an opportunity for a PA to provide high-quality care to patients of all acuity levels. As a future PA, I seek to address health concerns before they exacerbate into dire and costly conditions. Working at the community level is a prime way for me to provide patients with an alternative to emergency room care.

My direct experience working with underserved populations in various medical settings and on the front lines of a global pandemic has strengthened my understanding of inequity in the healthcare system. I have witnessed how a person’s socioeconomic status, gender identity, age, and race can influence not only pre-determined health outcomes but also the quality of care they receive. My mission is to continue to grow as a compassionate clinician to provide culturally relevant care grounded in an understanding of inequity with the hope of making quality healthcare available to all.

Please describe the factors (such as personal attributes, external challenges, peer support, etc.) that you believe contributed to your academic success.

When I was growing up, family members struggled with severe alcohol and drug addiction, abuse, and proper medical care. In response, I desired to be the medical provider to change that. As I matured, I innately understood the complexities of the aforementioned conditions that my peers and society harshly judged. That quality of empathy would stay with me throughout my work in African orphanages, with the homeless teens of Arizona, and the addictive behaviors facing reservation youth. However, empathy and the desire to alleviate human suffering would not be enough to get me through the suicide of my partner, the manslaughter of a dear friend, the cancer-caused death of my father-in-law, and the sexual assault I would experience. To persevere through this, I needed resilience. I learned to change my narrative and the story I was telling myself, and I turned to my community for support. My friends and family rebuilt my strength after each loss, and my community provided an outlet where I could heal through service. When I think about my goal of completing your program, I feel academically prepared, emotionally supported, and passionately driven to be the healthcare provider that makes a difference for anyone experiencing health afflictions.

For any prerequisite course in which you believe the grade recorded does not reflect your mastery of course material, please describe the factors (such as personal attributes, external challenges, peer support, etc.) that you believe contributed to the recorded grade. 

As an undergraduate, I balanced a full-time work schedule to support myself with a full-time academic program. I was young and confident, often challenging myself to take on higher-level classes in addition to my extracurriculars, which led to some of my grades falling to a C among my otherwise respectable undergraduate marks. I understood that I needed to manage my time more appropriately and have since practiced this skill through proper scheduling and remaining conscious of what I can handle.

After I graduated, I enrolled in community college to finish my medical prerequisites. During my first week of classes, my long-term partner died by suicide. Devastated, I withdrew from classes. The following semester, I repeated the courses and received high marks in both.

Nevertheless, I knew I needed adequate time to grieve to ensure my future success. I decided to take a break from my studies and pursue volunteer opportunities at that time. In the small villages of Africa, I was healing alongside people who were attempting to recover from life’s tragedies themselves. I learned more from them about facing adversity than I could have ever learned from facing grief alone.

A few years later, I stopped traveling to Africa as often and enrolled in higher-level courses, receiving a post-graduate cumulative GPA of 3.84. I can now confidently balance working full-time between four hospitals, managing a company, and applying to school.

Please provide your definition of “success” as it relates to academic achievement and professional development.

Throughout my life, I have experienced personal adversity and witnessed it in the livelihoods of the communities I serve. Success has meant persistence and the ability to pivot to meet changing circumstances. Academically, I knew the next step was achieving my PA Degree, and I also knew I needed to strengthen my medical experience. I wanted direct patient care in a fast-paced setting within a year. Without a significant amount of formal medical training, I returned to school and then applied and graduated from the Emergency Medical Technician (EMT) program with honors. I began working as a medical scribe, rotating between three emergency departments, and within a year, I applied to a level-one trauma center as an EMT. My work and schedule are challenging, but my persistence allowed me to successfully build the medical experience and knowledge I now possess.

Thinking about my mentors acknowledges a common attribute they possess, the willingness and desire to always learn and grow. As a professional early in my career, I take the opportunity to shadow the PAs and ask them to walk me through each step of advanced medical procedures, such as chest tube placement and intubation. While it is currently outside my scope of practice, it will better prepare me for my career in the future. In my downtime, I explore and learn about issues at the intersection of patient care, such as therapeutic modalities, trauma-informed care, and the interplay of cultural and community dynamics on health and wellbeing. As healthcare providers, our duty to our patients and ourselves is never to get comfortable and always be challenged to find better solutions and preventative measures for optimal whole-person health.

Please explain how your experiences shadowing a PA have shaped your perspective on the roles and responsibilities of a PA in the delivery of health care in the United States.

The primary care PA, Julia, whom I shadowed, exemplified the impact that PAs can make in healthcare in the United States. Julia ensured all of her patient’s needs were met by scheduling longer appointment gaps and assessing patients’ socio-environmental factors. One of the more impactful moments I witnessed was when a patient with new-onset insomnia came in for treatment. Julia performed a physical exam, took time to establish rapport, and talked through possible triggers. The patient explained a recent divorce and feelings of worthlessness. Instead of providing insomnia medication to treat a symptom, Julia was able to uncover the root of the problem and refer the patient to a psychiatrist who prescribed proper medication. This was a powerful lesson in putting the patient first and providing compassionate high-quality care. Julia taught me about the responsibility PAs hold in centering the patient’s health needs while considering the psychosocial and environmental factors that influence their well-being. As a future PA, I think of the patient-clinician partnership I want to create, where patients feel understood, validated, and empowered to make the medical decision that is right for them in collaboration with their provider.

Please provide any additional information you wish the Admissions Committee to consider when reviewing your academic performance and healthcare experiences.

Certain moments have the potential to derail a person’s plans, and some may never recover without proper aftercare. In 2016, I was assaulted on a business trip, and my father-in-law was diagnosed with stage IV cancer. I had just applied to a PA program, but my application was not considered due to rolling admissions. I paused on future applications to spend the next few years serving as my father-in-law’s caretaker while pressing criminal charges against my attacker.

To be successful in graduate school, I needed to be strong mentally and academically. I defined my resilience by fighting my attacker in a four-year-long legal battle. These events resulted in a longer gap between my undergrad and graduate school. However, this experience gave me the platform to advocate for others when they feel hopeless and to stand in solidarity with the assault survivors I encounter in the hospital where I work. I have overcome many hardships throughout my life, yet I remain steadfast in my pursuit of practicing medicine and becoming a physician assistant.

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