A Day in the Life of an ENT PA: Ngan Lam, PA-C

I’m excited to share with you the second post in our “A Day in the Life of  PA” blog series! Ngan Lam, PA-C, MPAS, MPH (pronounced “Non”) is a PA working in the field of Otolaryngology, also commonly referred to as “Ear, Nose and Throat”. She recently graduated PA school and has some insight into what it is like to work in her field as a new PA.

Tell us a little about yourself, which PA program you graduated from and when you graduated.

My name is Ngan (non) and I am a fairly new PA grad! Prior to PA school, I received my master’s in public health with a concentration in infection control. I graduated PA school as an inaugural member of Florida International University PA Program in Miami, Florida in December 2017.

What is your current specialty? Why did you choose this specialty?

I have been working as an ENT PA for the past 6 months. I chose ENT because the field offers a unique setting in the fact that patients can be managed as an outpatient or in the operating room. ENT is also great because it encompasses a variety of specialties including, but not limited to: primary care. infectious disease, pulmonary, neurology, and oncology.

What type of environment do you work in (hospital, clinic, administration, or a mix)?

I work at an academic outpatient clinic.

What is your schedule like? Do you work Monday through Friday, weekends, holidays, night shifts?

My schedule is Monday – Friday, 8:00-5:00 with one ½ admin day. No weekends, night shifts or holidays.

Do you take call?

No calls.

Describe a typical day like for you? Do you start in a clinic or hospital setting, do you stay there for the entire day? What time do you start and finish?

Working in an academic center is unique in the fact that all of my attendings are subspecialized. I currently work with all of 7 attendings in pediatrics ENT, rhinology, otology and facial plastics/reconstructive. Depending on my assignment for the day, I will work in one clinic in the morning and switch clinic/specialty in the afternoon (i.e. plastics in the morning and then switch to otology clinic in the afternoon).

As I am still in my “orientation” phase, I currently see patients with my attendings. I’ll go in the room first, work a patient up by taking their full history and perform the necessary physical exams. I’ll then go and present the case to the attending as well as my assessment and plan. Together, we’ll return to the patient’s room and finish out the visit.

I typically begin my day at 8 AM. I’ll see the first patient if they’re ready by 8:30 and will continue to alternate patients with the residents working in the assigned clinic. I usually get an hour lunch break, before returning to finish out the afternoon clinic at 1:15 PM. The clinic day will end around 5 PM and I’ll stick around in clinic until 7 or so, finishing my notes/checking my in-basket messages or pre-charting/preparing for the next clinic day.

Are you an hourly or salaried employee? Do you think your wage is comparable to your specialty in your location?

I am a salaried employee. Working in an academic-affiliated center, I believe my wage is fair, but lower than someone working in private practice.

However, with that said, I do get great benefits (free CMEs) and weekends and holidays off (I won’t lie, when I saw that “Black Friday” was considered a holiday, I was sold).

How autonomous are you, what types of things do you involve your supervising physician for and what do you do on your own? Is this typical for your specialty or more specific to your situation?

Since I am a new grad/on probation and due to limited clinic spacing at this time, I have not earned the rights to have my own independent clinics.

A year from now, I hope that I will be successful to run my own clinics, performing cerumen debridement under the microscope or other minor procedures such as nasal endoscopies; which are typical procedures for those working in ENT.

Again, the scope of practice does depend on the clinic/institution. PAs working in ENT can act as first assists in the ORs. Others are capable of placing pressure equalizing ear tubes in clinic, performing tympanic injections…etc.

Do you currently participate in any administrative tasks or have a leadership position, formal or informal? Do you think this augments or hinders your other responsibilities?

One day a week, my fellow APPs (advanced practice providers) and I share the responsibility of designated “phone days.” Our phone calls/messages volume is quite large, that to have greater work/life balance, we have agreed to have a designated day to manage these tasks.

I will be honest that it is not my favorite task, but I do find value as it allows me to provide patient education and overall, provide better-continued care to our patients.

What advice would you give to a PA who is considering working in your specialty?

Join SPAO! – Society of PAs in Otolaryngology- Head & Neck Surgery. There are great scholarship opportunities for PA students that are interested in ENT!

What is the one thing you wish PAs in other specialties knew before calling or referring to your practice?

One of the hardest things to tell patients that come in with sudden hearing loss is that their hearing loss may have been prevented if they were seen earlier/treated with steroids.

If you suspect sudden sensorineural hearing loss, it is important to deliver high dose oral steroids as soon as possible! (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928516/)

Is there anything else you’d like to add?

I think ENT is a quirky field that is often forgotten. I hope I’ve proved my case that we do not just deal with tonsils, strep throats or runny noses! The field is quite complex for just dealing with head and neck anatomy!

Where can we find you online?

Thanks so much to Ngan for sharing her world as a new ENT PA! Follow her on Instagram, or check out her blog above to learn so much more! She posts regularly and I’m always thankful she shares what she has learned from her specialty!

-Courtney