The Externship as a Step to a Professional Position

It might happen by luck but don’t rely on it. You can take steps to ensure you maximize your internship/externship fieldwork placement. Remember, it is not uncommon for your training ground to evolve into a paid professional position. 

Let’s say you are studying to be a Physician Assistant. As part of your education, you are interning for five weeks through my office. Having trained a variety of students, my team and I have focused on several steps that you the student can take to ensure the success of your rotation and perhaps land a permanent position. These steps are transferrable to other professional training programs. Here are seven steps to success.

Call 3-5 business days before the rotation begins to introduce yourself. In our office, you will speak with the Director of Administration. The call will confirm the start date and time. Determine who you should ask for when you come that day and whether that person will be the one who introduces you to the other staff. You should ask about the dress code, start and finish times to the workday, and other points for which you need clarification. 

Also, ask which Electronic Medical records program the office uses. Then research it. Become familiar with it. It adds to your knowledge base and demonstrates a proactive interest. 

Learn beyond the basics about the office’s specialty. What you’ve learned in school about any area is rudimentary at best. It is a starting point only. Network among your peers, professional colleagues, teachers and others to find out what you should review before commencing the externship. Peruse a medical textbook on the subject. 

Get your hands “dirty.” The 5-week externship is for you to learn hands-on. Literally. The only way to learn what is abnormal with a physical exam is if you first learn what is normal. That happens by touching and feeling the patient under the tutelage of the physician. Are you squeamish about direct patient care? Speak to your guidance person in school and work it out before you step into the real world of the externship or else find another externship. You should be seeking every opportunity to be hands on and add to your knowledge base. 

What if your externship places you more in the background, perhaps doing paperwork? Again, speak to your professional program. You must ensure that you have the opportunity to interact with patients. 

You have questions? I love them. I also love asking my students questions. 

Questions affords me a glimpse into your thought process as a health care professional. My colleagues and I are here to help to develop that thought process. You take that thought process when you leave my four walls and it goes with you into the next professional setting to grow further. And so forth. 

You want to take notes while speaking with me? In my office, the Director of Administration will set up a lunch time for the two of us. You can ask questions and take notes. 

Leave the iPad, the iPhone, the tablet or whatever with your personal belongings. You are accustomed to taking notes and Googling questions. I get it. But the gadgets limit what and how you learn. In fact, they impede the hands-on learning process that is key to your professional development. These devices prevent interacting with patients effectively. You may write down in a little notepad you carry in your pocket names of conditions an anything else to be researched and discussed later. 

Roll up your sleeves and be as hands-on as possible. Your lunch breaks and after hours are the times to take notes and research further. Answer your cell phone during these breaks. 

Learn something about the business of medicine. In primary care pediatrics, for example, there are “private” vaccines and there are “VFC” or “government” vaccines. Learn what this means to an office. Why are initial sick visits booked differently than established sick visits? What is the initial newborn well visit about? What is the “payor mix” about? Seek out the office administrator or the equivalent and find out. 

Take the initiative and ask about employment opportunities. You like the office. You are interested in a job once you have completed school. Then say something. Ask to meet me and my Director of Administration. Put your cards out on the table. 

The goal of an externship is for you to acquire basic skills to become a health care professional. This is a proactive process, especially on your part. Your showing interest, developing professional skills and availing yourself of every learning opportunity possible can open the door to your first professional position. It will also give you a taste of the “real world.” 

By Hylton I. Lightman, MD, DCH, FAAP, Pediatrician and Medical Director at Total Family Care in Far Rockaway, New York