Once I decided to go to PA(Physician Assistant) school, I started taking all of the required prerequisites while I was working full-time as a X-ray technologist in Idaho Falls. I also did some moonlighting in Rexburg and at Teton Valley Hospital in Driggs. During this time I was meeting and working with PAs that I looked up to and admired greatly. I did this until the summer of 1995 when we moved to Seattle for school. While in Seattle, in addition to school, I worked part-time at an orthopeadic surgery clinic where I took all the x-rays and applied and removed all the casts. It was during these experiences that I realized I really liked using my hands and treating conditions that I could actually see. As I was learning about all aspects of medicine, I always loved when we would get a lecture on dermatology related problems like acne, moles, skin cancer, and all of the interesting rashes that patients have. I decided to do a clinical rotation in dermatology during my clinical year. Although I pretty much just shadowed the dermatologist, I learned a ton and was excited to put what I learned into practice once I graduated. The University of Washington Physician Assistant program focuses on training PAs to work with minimal supervision in rural under-served populations, so most of my training was in family practice and general medicine. I felt it was important to initially work in an Urgent Care or general family medicine clinic. I was also going to do whatever I needed to to get my loans re-payed. I had job offers in Alaska, Wyoming, and the Utah State Penitentiary, all of which would have repaid my loans, but I was holding out for an offer somewhere in Eastern Idaho because that was where most of my family lived. That offer came from the Blackfoot Medical Clinic in Blackfoot, Idaho. I would be working in an brand new Urgent Care facility, as well as in the Emergency Room at Bingham Memorial Hospital. My first day on the job I learned the need to chart after every patient, because I saw 30 patients in 8 hours and didn’t chart until the end of the day! Not a good idea, and I have avoided that practice ever since. I enjoyed what I did there and got a lot of great experience, but I really enjoyed when a patient would come in with acne, or a rash, or an irregular mole. Even the other providers would ask me to come seen different skin conditions because they knew that I had special training and experience in dermatology. This is when I decided I needed to start looking for a more dermatology focused job. I contacted all the dermatologist in Idaho Falls. At that time, none of the dermatologist had a PA and none were quite ready. But I did hear of a clinic that was not owned by a dermatologist but it focused on dermatology. It was initially called Clearskin, but the name was changed to Physician Skin Care. It was connected to an Urgent Care facility and initially I took the job on that side of the clinic. I will continue the story in the next blog.