Interview Summary

Rebecca Pelkola has been practicing as a physician assistant (PA) for 20 years and has worked with Twin Cities Spine Center for the past 14 years.
PAs are clinicians who work closely with other healthcare providers, such as physicians, nurse practitioners, or other PAs. They often work closely with physicians, especially in surgical settings.
PAs are trained similarly to physicians with the medical school model and similar level of rigor. To become a PA, you must earn a bachelor’s degree, often with the same prerequisites required for medical school. PA school typically lasts 27 months and consists of 13-14 months of didactics and 15 months of clinical rotations in a variety of medical settings.
Rebecca emphasizes how her career offers a great work-life balance as she works a part-time schedule with 30-hour work weeks. Her week consists of two days in the clinic treating patients and one day in the operating room.
In the clinic, Rebecca sees patients ranging from 12 to 90 years of age, often helping adolescents with scoliosis. In the operating room, she assists the surgeon by doing things like putting in instrumentation and closing wounds. Rebecca also sees patients after their operations, putting in their post-operative orders and checking them out after they are discharged.

Physician Assistant Interview With Rebecca Pelkola

What does a day in your life as a physician assistant look like?

I am lucky enough to have a part-time schedule where I work 30 hours a week, which is great for my work-life balance. Each week, I work two days in the office seeing patients and one day in the operating room.

When I first arrive on operating days, I make sure our schedule is set for surgery that day and that all of the orders for the patients are in. I also do basic chart checks to make sure labs are all ready, help get the room prepared, and position the patient. The surgeon I work with has been practicing for a long time and is very skilled, so we have a good rhythm together. PAs tend to get to do quite a bit in surgery depending on the practice they are in. In my job, I get to put in instrumentation, do some suction, close the patient’s wounds, and assist with retraction.

After surgery, PAs help to manage patients by putting in their post-operative orders. We also have fellows working with us who are orthopedic surgeons completing an extra year of education after residency to gain spine specialty knowledge. Although these fellows usually do the rounding, I also tend to round on the patients while they are still in the hospital. On the days following surgery, I also see patients in the office during the morning and check them out if they can go home.

After letting the patients go home after surgery, I go up to the floor/clinic space and see other patients. In my job, I see kids around the age of 12 all the way up to the elderly in their 90s. I tend to see a lot of kids with scoliosis (spinal curvatures), so I help guide them into wearing braces or having surgical discussions. Although I am not a mental health specialist, there are a lot of mental health components that go along with this part of my job. This allows me to create relationships with my patients by connecting with them personally and using good communication. I get to be there for my patients not only during surgery but also afterwards, and the strong connections that we form. This is one of the most rewarding parts of my job.

What does being a physician assistant mean to you?

The definition of a physician assistant has changed over time. When I started, we were considered medical providers who worked under a supervising physician. To continue our work, we were required to sign contracts and agreements every two years or so. The law also required us to maintain part of our medical records when I first started.

After COVID-19, these laws and regulations that were present when I initially began working made it harder for people to want to hire PAs. As a result, these laws were changed in 2022. The language has also changed and now PAs are considered clinicians who practice medicine collaboratively with other healthcare workers such as clinicians, physicians, nurse practitioners, and other PAs.

All of us work collaboratively, and in most cases we still work in a group that includes physicians, especially in surgical settings. However, there are family practice settings where PAs are fairly independent in their role of evaluating patients. Our job is about solving mysteries, and that is truly at the heart of what medicine is all about.

Can you tell us about yourself?

I have been practicing medicine as a physician assistant (PA) for 20 years, and I currently work part-time in orthopedic spine surgery. I first started working at a general orthopedic clinic in Lake Tahoe with a spine surgeon. There, I did some general orthopedics, but predominantly spine-related pathology and surgery. About 15 years ago, I moved back to where I grew up in Minnesota and have been working with Twin Cities Spine Center since that time.

The Twin Cities Spine Center is a group of orthopedic-trained surgeons, physician assistants, and nurse practitioners. The PAs see patients in the office and then assist in surgery. As PAs, we have a lot of variability in the type of specialty that we might end up practicing in. We also have more flexibility in our job pathway. On the other hand, physicians are specialty trained through their residencies and fellowships, so they typically stay in one specialty for their entire career.

PAs are trained fairly similarly to physicians as they both follow the general medical education model. This prepares PAs to first come out of school and potentially go into any specialty. There are also options where PAs can attend post-doctorate programs that offer extra specialty education. These are one-to-two year added programs that allow PAs to get an extra certification to work in a specialty like emergency medicine or general surgery. Over the past ten-to-fifteen years, there has been a growing trend where students complete their two-and-a-half to three-year PA program and then get this extra education to focus on a more specific field of medicine. For the most part, however, you can really get a job in any specialty once you graduate from PA school without needing to get the extra education.

Personally, I was not particularly interested in orthopedics or spine surgery. I actually wanted to work in women’s health or dermatology. However, when I moved to a smaller community in Lake Tahoe, there just was not as much opportunity for those specialties I was interested in. As a result, I ended up working with an orthopedic group.

Full Q&A With Rebecca Pelkola

What is the career outlook for a physician assistant?

The outlook is great. They are still predicting a physician shortage, so they are looking for PAs to fill that shortage.

When did you realize that being a physician assistant was what you wanted to do?

My realization that I wanted to be a physician assistant just kind of happened. I went into my undergrad really not knowing what I wanted to do and began with a general education focus. Through the personality and career tests that I took, I learned that I really excelled in the sciences. I decided to start focusing more on science and met my husband during my second year of undergrad. His sister was doing her general surgery residency at the hospital, so she was a big help in guiding me down a path in the medical field.

I initially was considering becoming a physical therapist. But, after learning about physician assistants, I changed my mind and started to work towards a career as a PA. I had considered a MD, but I was also getting to a point where I wanted to be done with school. As a result, the PA track seemed to best fit my needs at the time, and I luckily got into PA school in my first application cycle.

How much education is required to become a physician assistant?

To become a physician assistant, you will typically need to complete the same prerequisites of medical school. This means that you will need to earn a bachelor’s degree and that it will tend to be very science-based. For me personally, I earned a Bachelor of Science with a major in biology and a minor in chemistry. While I was an undergraduate in college, I worked as a nursing assistant at the hospital. During this time, I also worked at an after-school daycare and did research. It is strongly recommended that you get a lot of job experience working in some type of medical field where you can get involved in patient care. I would say that it really helps to have a good base of different types of activities on your resume in order to get into PA school.

The process of getting into PA school is very rigorous and similar to getting into medical school. Aspiring PAs do not have to take the MCAT exam in order to get into PA school, but they do have to take the GRE.

PA school is usually about 27 months. For my PA program, there were about 13-14 months of didactics where we would maybe get a week off for winter or summer break, but we would be in the program otherwise. Didactics had a medical school model focused on all of the basic courses that we needed to know. During that time, we also would get paired up with a rural clinic because PAs were initially brought into the scope of medicine to serve a need in underserved communities like family practice rural medicine. As a result, the education was very focused on family practice, especially because we had three months of rotations in family practice settings. We were also required to volunteer in a rural clinic during our didactic time frame.

For the remaining 15 months of PA school, however, we did clinical rotations in a variety of medical fields. From what I understand, every PA program is a little different. I completed my PA program at the University of Wisconsin-La Crosse, and it consisted of a variety of about six or seven clinicals. At that time, many of the other PA programs required the students to find their own clinics to complete their clinicals. In my program, however, all of our clinicals were set up for us.

Some of the students in my program had to move around for their clinicals. For my family practice clinical, I went to a rural community in Waukon, Iowa. During my time there, I really got to become part of the community and meet so many new people. I would spend my whole day at the hospital/clinic, and then I would study for the rest of the night. Part of our courses were also through Mayo Clinic. I spent a summer at Mayo Clinic learning to do procedures, take certain labs, and put in IVs and catheters.

During my time in school, I learned a wide variety of knowledge, which was intense but also extremely rewarding. This is another reason why some people may want to pursue a career as a PA instead of a physician. Becoming a doctor is a much longer investment in your life, granted that being a physician is just as fulfilling and pays more than working as a PA.

At the end of PA school, students are required to take a certifying exam to get their license to practice. When I was in school, there used to be a lot more PAs in family practice. However, there are now a lot more PAs in surgical specialties, especially because PAs working in these settings tend to be paid more. There is no residency to be a PA, but there are extra one-to-two year certification programs that some PAs decide to complete in order to gain specialized training in a field like emergency medicine. By completing these programs, PAs tend to work in more specific specialties and often make more money.

What advice would you give to someone who is interested in the healthcare field and is trying to figure out what profession is best for them?

I would strongly encourage job shadowing. It is extremely valuable to get experience with a variety of people, whether that is radiology techs, surgeons, physician assistants, or even just working in the clinic. Getting exposure to different fields and looking into what you want for your future in regards to your interests and work-life balance is really important.