Highway 2 Revisited
Physician Assistant Studies student Seth Tramm talks about being a paramedic in northwest Minnesota and what brought him to UND.
Hello, Seth. Thanks for your time. You’re just getting out of clinic now, is that right?
Yes, I’m in a general surgery rotation for my clinical work. I started that after Christmas, so we’re just over a week in. I’ve had the opportunity to be in both the operating room and a general surgery clinic. It’s been interesting and going very well.
So, in PA Studies you have clinic rotations just like medical students.
That’s right. For the last year we’ve been in a family medicine rotation—that’s the primary rotation for the program. This final semester we do a few specialty rotations: emergency medicine, general surgery, and a couple of two-week electives. I’m going to do orthopedics, cardiology, and infectious disease, I think.
Why those specialties?
Good question. My background is in emergency medicine as a paramedic and EMT. I’ll be working in emergency medicine when I am done with school too. For that reason, I feel that ortho, cardiology, and ID rotations will be helpful—we see a variety of ortho injuries and certainly cardiac issues and infectious diseases are encountered frequently in the ER. Before I started, I figured emergency medicine would be my favorite rotation, but I haven’t gotten there yet. That’s in February. My family medicine rotation was with an internal medicine physician who worked in a family medicine clinic. That was really eye-opening for me—completely different from anything I’d done in the past. And it was a good learning opportunity, and I did end up enjoying it a lot.
I imagine the paramedic training prepared you well for this new role. Is EMT work something you did right out of high school or you went to college for an undergraduate degree first?
Well, my freshman year of college I got my certification as an [emergency medical technician], but my undergraduate training is actually in education, so I have a teaching degree from St. Cloud State University—
Oh, man—a UND hockey rival!
—But I wear green now! So, I used my EMT work on weekends to get me through my undergrad. I did that in the summertime around my hometown to pay my way through college. I then got a job as a teacher and ended up teaching for seven years. I had an opportunity to take paramedic training in 2009 and have been working in the EMS field ever since.
Do you find that your teaching experience has helped you in the health care field—connecting with patients or teaching colleagues about patient care?
Absolutely. Even though it’s a different audience—my degree was for middle school, so I was teaching 10 to 13 year-olds—you’re really doing the same thing: communicating with people, whether students or patients, helping them understand Obviously everybody learns differently so you need to find the way that each patient learns, and for that, the teaching degree helped for sure.
You’re from Solway, Minnesota, right?
Right along Highway 2 on the way to Bemidji, if I’m not mistaken. My parents have a lake cabin out in that area. Does Solway still have the sign on the highway reading “Population: 89.”
We’re at 96 now [laughs].
So close to three figures! And you’ve got a bit of a Bob-Dylan-Highway-61 thing going on, having spent countless hours on the road in Minnesota. On that note, talk to me about rural medicine in northwest Minnesota. What is the provider environment like there—I’m assuming there’s a shortage, just as there is in rural areas of North Dakota?
Yes. I grew up in central Minnesota, on the shores of Lake Mille Lacs, in a town of about 750 people. My whole life I’ve been in what you’d call rural areas—northwest Minnesota certainly being more rural than where I grew up, but similar. Here, we’re only 15 minutes from Bemidji, and the hospital there is getting bigger and providing more specialty care. That’s good, but the issue we have is staffing. We have somewhere in the neighborhood of 25 physician or advanced practice provider [APP] positions open in Bemidji alone. That’s not something you can overcome in a few months. So, we face those issues. Bagley’s hospital, about 15 miles in the other direction on Highway 2, has a similar situation, just on a smaller scale. And even though the population of each community is small, we serve a very large geographic region. In the clinic where I did my family medicine rotation, we have something like 5,000 patients assigned to providers in that clinic. When you only have two physicians and four APPs, that’s a lot of patients per provider.
And do you hope to end up practicing at the clinic you’re with?
Yes. Because of having grown up in a rural area and now practicing here, it’s who I am. I don’t mind bigger cities, but my preference is serving the small communities where I’m more comfortable. I’m looking forward to that opportunity. I have a contract with a local provider already, so when I’m done with school and get all my credentials I’ll be working in the emergency room in Bagley.
As you know, our PA program has two “entry points”— which one were you?
Entry point one—where you have previous healthcare experience and likely want to be in a rural setting.
Which makes sense, but on that note, why Physician Assistant Studies in the first place, as opposed to medicine or physical therapy, for example?
While practicing medicine as a physician may have been more appealing years ago, the reality is that the PA profession has grown into an incredible opportunity for people like myself to work alongside physicians to provide excellent medical care, and to meet the needs of patients in rural communities and throughout the nation. It’s something my family and I had been talking about for quite a while, but never really felt like the time was right until a few years ago. My wife and I have three kids—15, 13, and 10—and I wasn’t in a good position to say ‘Let’s pick up the family and move to state X for PA school” before then. UND being only 90 miles away was appealing. I did some research on the program and talked to some folks who’d been through the program and had very good things to say about it. I also knew a few of the faculty in the program, like Jay Metzger, who was a practicing PA in the Bagley area many years ago. So, there was a lot of appeal to UND for us, especially the hybrid nature of it where you spend some time on campus but also time at your “hometown” hospital or clinic. That was what fit for my family. So we applied and got accepted and have been very satisfied with it.