Q&A with Lucy Bonnington, BA, BS, PA-C, Physician Assistant at UT Health Science Center in San Antonio, Texas
Lucy Bonnington is a PA educator and admissions coordinator at the UT Health Science Center in San Antonio. She graduated with a BA in English from the University of Texas at Austin in 1978 and a BS in Physician Assistant Studies (graduating Cum Laude) from Baylor College of Medicine in Houston in 1981. After a trip to the emergency room in college, Lucy got a job working in a hospital and has been in the medical field ever since. She began her PA career in cardiothoracic surgery, and has practiced in multiple settings including dermatology, primary care and child neurology. Since 2010, Lucy has been a clinical instructor and admissions coordinator for the Physician Assistant Studies Program at UT Health Science Center in San Antonio (http://www.shpwelcome.uthscsa.edu/).
Q: What motivated you to become a PA?
A: I expressed interest in becoming a doctor before going to college. When I told my father, a physician trained in the 1950s, he replied, "Women can't be doctors. Why don't you just be a nurse?" So I decided to pursue nursing instead.
At UT Austin, I was a pre-nursing student, taking English classes and nursing pre-reqs. If I continued with nursing, I realized I would be waitlisted for nursing school. So, I took time off from college and began working in the community hospital in Austin. It was there that I saw nurses working like handmaidens to the surgeons on rounds. They were never asked to use their knowledge. It didn't look like something I would be good at doing.
Q: How did you make the transition to physician assistant?
A: After I began working at the hospital, my husband found a job there as a phlebotomist in the lab. We both became interested in medicine, as a career, while watching young interns right out of medical school become doctors.
My husband decided to go to medical school and he was lucky enough to get accepted into Baylor College of Medicine in Houston. During his first year, I worked at The Texas Heart Institute as a clerk (Dr. Denton Cooley's institution.) Dr. Cooley had PAs. They rounded, they wrote orders, they wore long white coats, and they went into surgery. Baylor had a PA program, so I applied and was accepted.
Mark and I went to school together. We were very understanding of each other's schedules during school (you're busy, I'm busy) and had lots in common (let's talk about our rotations). It was actually good glue for our relationship and strengthened us as a couple; we've been together for 37 years!
Q: Can you describe the facility where you work?
A: I work for the University of Texas Health Science Center in San Antonio as a faculty member in the Department of Physician Assistant Studies in the School of Health Professions. It is a big, world-class, medical education and research campus.
Q: When and how did you start teaching PA curriculum?
A: Pure luck. After almost 30 years of practicing clinically, the Philadelphia College of Osteopathic Medicine contacted and offered me a teaching position. I assumed an MS was needed to teach and I only had my BS. That's when I was informed I could teach, while earning my MS there for free.
At the time, my mother had been diagnosed with cancer. I debated being the fledgling teacher flying back to San Antonio on the weekends to visit my ailing mother. I thought of 15 different ways to make it work, but in the end, I had to pass on that wonderful opportunity.
I ended up returning to my home state shortly after, and called the UT Health Science Center San Antonio. Dr. Dennis Blessing, professor and chair of the Physician Assistant Studies Program, told me to send him my resume. I was hired as a clinical instructor and admissions coordinator in January 2010.
Q: Typically, what are your day-to-day responsibilities as a PA at the UT Health Science Center?
A: As admissions coordinator, I review applications (we had 1,200 for the class of 2015), set interview dates and communicate with applicants about our program. Our faculty plans and conducts applicant interviews in the fall, and then we choose the applicants we feel best fit the mission of our program: to serve the communities of South Texas with the greatest need for excellent primary care.
As a clinical instructor, I teach Behavioral Medicine, a first-semester, first-year course in the PA program. It covers psychiatric conditions, stress and illness, as well as the use of complementary and alternative treatments. I've also included some positive psychology in the curriculum for the students' benefit and for teaching to patients.
Problem-Based Learning is a second-year course. We use case vignettes and write little mysteries for students to diagnose. They can use the internet as a resource, as well as medical apps. It's different from the days in school when you "had to know" something as opposed to looking it up. It's "knowing where you need to go" to find information. It's a nice contrast.
Q: Do you ever encounter patients directly?
A: No, but I recently took my re-certification exam in Texas. The UT Health Science Center offers the "Faculty Practice Plan," which allows clinical instructors the opportunity to work in a medical setting one day a week. I hope to find a practice in pediatrics or primary care.
Q: What is the most rewarding part of teaching PA studies at the UT Health Science Center?
A: Teaching a big, diverse mix of students. I have students from Mexico, the Congo, Pakistan and Moldova, as well as Texas. They have medical and non-medical backgrounds—including a few former science teachers. One student worked in land conservation for the state before he came to us!
The average age of a PA student in the first year class at the UT Health Science Center is 31 years old. I admire my students so much; they come to us at mid-life, some of them, and change their direction entirely. They are drawn to this profession for the right reasons. It takes courage.
Q: What advice do you have for students interested in applying to a physician assistant program?
• Be academically competitive. As interest in PA programs mounts, a 3.0 GPA might not be high enough.
• Join college organizations, namely a Pre-PA group. Take advantage of networking opportunities.
• Perform community service in an area that touches your own heart.
• Find a PA to shadow who's not a friend or family member, and observe in as many settings as possible.
• When writing your admissions essay, explain why the PA profession is important to you and be sure to incorporate the mission of the school you are applying to.
• Be well rounded. Try to have a life outside of school.
Q: Are there other areas of interest for you, either clinically or educationally, that you plan to pursue?
A: I teach stress management and positive psychology as part of my course. In their first class meeting period, I give the students a stress scale to fill out, so they can determine their baseline numerical rating of their stress levels. Then I follow up with instruction on stress-reduction for their own use. I taught this last fall at the end of the semester. Students responded, "We should have gotten this the first week!" They were very enthusiastic about it. It's my hope that they will share some of these ideas and activities with their patients, and that I can continue my work in this area.
Q: What are the greatest challenges you face as an educator of PA studies?
A: PA Education is a challenge because the days are never long enough, and you can always improve on something you did. You can always know more and be a better teacher or role model. Anyone who thinks trading a clinical career for an academic appointment will be easier has a lot to learn about teaching.
I also struggle with being a figure of authority sometimes. I enjoy interacting with my students, but I can't really become their friends, which runs contrary to my nature.
Q: What do you like most about working in PA education?
A: It is both rewarding and challenging. I give students the tools they need to keep them competent, and help them deal with frustrations, long hours and the need to excel academically, but remain balanced in their lives. I like to catch them off guard when I see them struggling, and I encourage them to take some time on the weekends to just do something fun.
As a physician assistant in clinical practice, I've worked in internal medicine, surgery, family practice, child neurology, dermatology and viral research, and now, education. I love the flexibility of being a PA!
Q: Is there anything you dislike about being a PA?
A: In the clinical setting, I like to know as little as possible about how I am paid. Thankfully, in my current position, I don't have to think about reimbursement or how something might affect my bottom line.
Q: Do you feel that the role of PAs has changed over recent years?
A: While PAs have been around for more than 40 years, the profession has been under the radar for a really long time. In the past few years, however, job opportunities have skyrocketed and are likely to grow rapidly. Now we're becoming more visible.
I would say 70% or more of PAs win the trust of physicians and patients. A patient will meet a physician who explains the physician-PA relationship by saying, "We work together as a team," and will only need that explanation once. We win people over. PAs like people and we communicate well. We are born communicators.
Q: What do you feel is of the greatest concern to PAs today?
A: Once they are out in practice, I imagine they have the same everyday stresses of other healthcare providers: In an increasingly fast paced world, how can I best care for my patients, and how can I keep from losing the passion that drew me to this career?
Q: What is the most important thing you've learned over the course of your career?
A: I think it would be that most people are basically good, and they want to be understood and listened to, and acknowledged as people. We need to keep the person who is the patient in view, not just the condition or the illness.
Q: If you could sum up your job in one word, what would it be and why?
A: A privilege. Healthcare is the highest calling. It is a privilege to care for people.
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