Sarah Hoffer (first year PA student) goes through her experience working in the Radiation Oncology department during her longitudinal placement. What LP did you do? I was in Radiation Oncology with Dr. Wright at the Juravinski Cancer Center. Specifically, I attended follow-up clinics with head and neck cancer patients who had completed radiation and/or chemotherapy treatments. How did you go about contacting and arranging the LP? I knew that I wanted to do an LP in radiation oncology because in my Masters program I studied DNA repair, and I felt that it would be a good place to see the clinical side of this (radiation therapy works by breaking cancer cells’ DNA to kill and stop them from growing). I used the McMaster directory to find Dr. Wright’s contact information and he kindly let me join his team for four half days! What were the two main things you learned from this LP? At this LP I had the opportunity to observe laryngoscopies. This allowed me to look at patient’s vocal cords through an endoscope, which was very exciting and fascinating! A very important thing I learned was that treating illness isn’t just giving a patient therapy – it's also monitoring the patient to prevent recurrence, and helping them manage complications of their treatment. For this LP, I attended clinics with follow-ups for head and neck cancer patients who had completed their radiation and chemotherapy. Common complications of radiation therapy that I saw amongst patients were a loss of saliva (and consequent dry mouth, tooth decay, and difficulty swallowing), tinnitus (ringing in one’s ears), and a loss of sensation of taste. These problems can persist for years and in some cases indefinitely. In addition to providing radiation therapy to cancer patients, practitioners must help them cope with the side effects of radiation and monitor patients’ improvement over time. What did you wish you knew to help you in your LP? Unfortunately, we had not covered oncology in class before I did this LP. However, I felt comfortable doing it with my background knowledge about biochemistry and cancer from my undergrad and Masters degrees. I also wish I had known more about interpreting CT imaging prior to this LP. How has this experience helped you clinically, in class and/or in career decision making? As mentioned above, this LP gave me the opportunity to talk to many patients whose lifestyles had been affected by their illnesses, long after they had been treated. Some patients no longer enjoyed their favourite foods and others’ voices had changed permanently. It really gave me an appreciation of the factors that patients must overcome after treatment as well as the importance of following up with patients once treatment is complete. Until I did this LP, I would break up my notes for each illness into a subheading for “Pathophysiology”, “Causes”, “Risk factors”, “Investigations”, and “Treatment”. Now I’ve added a very important subheading: “Follow-up”. I would definitely consider a career in Oncology and think that PA’s could be very helpful with oncology follow-up clinics. If a PA is working in a follow-up clinic, the physician could have more time to make radiation plans for new patients and to see more patients in the day. Hannah Peace (first year PA student) goes over her time doing a longitudinal placement in Obstetrics and Gynecology (OB/GYN). What LP did you do? I participated in four days with an OB/GYN in the McMaster area and one day in Labour and Delivery with this same doctor at McMaster. How did you go about contacting and arranging the LP? It was recommended to me both by my advisor and our academic coordinator to contact the person who organizes these placements for our program to help me connect with local OB/GYNs. She reached out of my behalf to find an interested physician. What were the two main things you learned from the LP? Something that is simply bewildering that I wasn’t aware of before this placement is the fact that you can press into a pregnant woman’s “tummy” and physically feel where the head, back, feet and hands of a baby are once it becomes large enough. By showing me over and over again the process of locating a fetus, the physician helped me begin to develop a skill set in “baby finding” and subsequently, how to perform an ultrasound to listen to the heart! After a few sessions with this physician, we built a relationship of trust and amicability! As he began to become more familiar with myself and my skill set, he let me help and eventually perform pelvic exams. This is something that can only be perfected by practicing, so having someone look out for me, my technique, and the comfort of the patient while I performed exams was unbelievably valuable. What did you wish you knew beforehand to help you in your LP? I wish I had saved this LP for after we had finished (or even started) the reproduction unit in class. I could have started from a more advanced position if I had waited until the summer to undertake this LP. How has this experience helped you clinically, in class and/or in career decision making? The very young, the very old, and pregnant women are three populations that have unique requirements when dealing with them clinically. I think it’s very important to spend some time with each population because, no matter where you work, you will be dealing with all three! Appreciating diversity is essential to success as PA. |
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May 2019
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