First Year PA Student Blog: Rebecca Gregory

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I was sitting at my desk at Duke University Hospital when I received probably the most awaited email of my life – Offer of Admission, Duke Physician Assistant (PA) Program. The outpatient abdominal transplant team surrounded me, the people who had inspired me to learn, grow, and take this giant leap.  

Becoming a PA was certainly was not a decision I came to overnight.  

I first came to Duke as a dietetic intern in 2016, determined to be an ICU clinical dietitian (RD). This year was also notable for being tumultuous for me personally, as I was one of the caregivers for my grandmother. This also afforded me the unique experience of learning to become a provider while also serving as a caregiver. She died a month before my graduation, and I was with her during her fatal cardiac arrest. Her death was a shock, and she died younger than expected.  

One of our last conversations centered on the fact that I had always wanted to work in medicine, and she worried I would not feel fulfilled in my life as an RD. At the time, I brushed it off and told her not to worry. 

In 2017, as a newly minted RD, I met my goal of working in an ICU. Soon, I realized grandma is always right and felt like something was missing. I missed talking to patients about their lifestyle outside of the hospital and wanted more long-term follow up with them. Due to this desire, I moved to outpatient, and while I was slightly happier, I still felt like something was missing and that my role was limited.  

One day, when lamenting to my colleagues about feeling this way, a nurse practitioner (NP) I worked with suggested I think about becoming an NP or PA (she too agreed that grandmas are always right when I shared that story with her).

This time, I truly reflected upon my professional life and what “feeling limited” meant for me. 

On one hand, I thought of all the times a patient got frustrated with me because I could teach them the renal diet but couldn’t alter their binder, or when I could teach them how to carb count but could do nothing about their insulin regimen. I never felt “bad” about myself for not knowing how to do those things, but instead, I felt sad because I wanted to know the information and to be able to help that patient in that moment.  

On the other hand, I also remembered many times when patients repeated incorrect nutrition information from health care providers - especially in rural and medically underserved areas - and how deeply they questioned me even though nutrition was my expertise. Several patients - and even some coworkers - would comment, “You’re just an RD, what do you know?” or, “You’re just an RD, why are you concerned with this? Think about nutrition, not medicine.” At times, I  felt that being an RD somehow limited my ability even to discuss or ask questions about medicine. I also felt very uncomfortable that nutrition and medicine were viewed so discretely, and again, I saw this phenomenon more so in my patients from medically underserved areas. 

With these thoughts, I started looking into both PA and NP programs. In my search, I fell in love with the PA profession and its commitment to primary care, particularly those in underserved communities. I also knew that I loved the warm, supportive environment at Duke, so it was truly a match made in heaven the day I got accepted.  

My first year has been full of ups and downs, like most PA students.

But there was one particular day in cardiology that stands out. During a discussion on heart failure, the instructor used phrases like “outdated,” “not used anymore,” and “increased mortality and morbidity,” to describe a medication regimen --  the very regimen my grandmother was on before her death. This day stands out so strongly because it was the first time I deeply questioned if my grandmother’s rurality affected her access to more modern treatments and more highly-trained specialists. It then forced me to consider whether or not her outcome would have been any different and made me wonder how many other patients and their caregivers experienced this. This moment solidified that I would become a rural PA in North Carolina. Patients like my grandmother suffer daily due to limited healthcare access, and even though I’m just one person, I’m determined to go back and be the best PA and RD I can be, and serve as an advocate for rural health. 

As I approach my sixth year with Duke, I cannot believe how much I have grown, and I largely thank Duke for that. I still feel the love and support from my old colleagues, as well as the ninety new colleagues I’ve gained being in the class of 2023. I would have never had the courage to even apply to PA school without my team in my corner, and even if I had started crying in cardiology that day, I know I would have probably gotten ninety hugs.  

It’s not just the technology, resources, and commitment to academic excellence that make Duke a special place; it’s the people and Duke’s ability to believe in someone. Someone will always extend their hand, offer to explain something, and rally behind you. I can’t wait to see what next year holds, and I’m excited to take what I learn here and serve a rural community. This UNC grad is proud every day to be a Blue Devil! 


Rebecca Gregory is a first-year student with the Duke Physician Assistant Program. Email rebecca.gregory@duke.edu with questions.
 
Editor’s note: Duke Physician Assistant Program students blog twice a month. Blogs represent the opinion of the author, not the Duke Physician Assistant Program, the Department of Family Medicine and Community Health, or Duke University.

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