April 15, 2004
Hazel Julius, PA-C
Hazel Julius, PA-CHazel Julius, a Yup'ik from Toksook Bay, was a picture of confidence in her white jacket as she unhurriedly prepared papers for her future role as a medical provider at the Yukon-Kuskokwim Delta Regional Hospital.
"State law requires you to have a license when practicing medicine in Alaska," she said. Just the weekend before, she had taken her NCCPA (National Commission on Certification of Physician Assistants) test and passed it.
The former health aide, and the first graduate of the YKHC Physician Assistant (PA) Scholarship Program, was all smiles. "I'm very happy; I worked so hard at it," she said. "Having the support of the doctors, mid-levels, friends - and especially my family - really helped a lot."
Hazel, who has 5 sisters and 3 brothers, is the daughter of George and Julia Nevak of Toksook Bay. Younger sister Caroline Nevak works as YKHC's Tobacco Education Specialist. Siblings Bessie Francis, a Toksook Bay health aide; Agnes McIntyre, a Career Pathways Coordinator; and Debbie Nevak, Dental Assistant, also work for YKHC. Sister Joann Nevak is a Case Manager at ANMC.
The appearance of the young lady from Nelson Island deceives you, making you believe things went easy for her. But in reality, passing the NCCPA board exam was just one of a string of daunting and trying experiences.
When the PA scholarship program was first created in 1995, the YKHC Board of Directors envisioned it as a way to have a PA in every village, and for village health aides to become those PAs.
YKHC then chose to work with MEDEX Northwest, the University of Washington School of Medicine's (UWSM) Physician Assistant Program, which would assist in implementing YKHC's PA scholarship program.
But to be accepted into MEDEX, many of the health aides desiring to be PA candidates had to pass its rigid math and oral test. "But no health aide could pass those tests...except Hazel," said Wally Richardson, YKHC's Native Hire Coordinator.
Being a health aide teaches you how to treat patients well, an integral part of PA training, said Dr. JR Krevans, a YKDRH physician. "But the experience does not provide the necessary sciences needed for the program, no matter how long the experience," he said.
Chester Mark, a physician assistant for 20 years, said there have been many candidates over the years since the PA scholarship program began, but many failed for one reason or another.
"We knew this was going to be a challenge for people from this region," Mark said. "The schools here are not rigorous in preparing students for college and standardized tests."
Next for Julius came two years of PA school in Yakima, Wash., where the Seattle- based UWSM's MEDEX has a branch.
To attend it, Julius brought her whole family to Yakima--husband David and their children Debrah, Catherine and Darren Julius.
In 2002, Julius graduated from MEDEX Northwest and returned to Alaska, to face one of the toughest tests she's ever encountered: The NCCPA test, which contains 360 questions and takes nearly eight hours to complete.
Taking the exam was a challenge for her, and it took a couple of attempts to learn what was needed to get beyond it. The support of YKHC's physicians and physician assistants became indispensable.
"Basically, we looked at how she approached the exam and I helped direct her to the areas where she needed preparation," said Mark. After the preparations, she returned to the testing and finally sailed through it in March. PAs who pass the national board exam gain the coveted "C" after their title. "PA-C" means "Physician Assistant - Certified!"
Dr. Krevans, who supervised Julius' training, said it actually takes at least four to five years of school to become a certified PA. "Hazel did it in three and a half," Krevans said. "We put together a 'PA training program' at YKDRH to help her get through her boards, so she came out on a strong position."
Julius' accomplishment is a testament to her determination, said Mark. "I'm ecstatic that she passed it--she's hard working and dedicated to her work."
Richardson, who is a member of YKHC's PA Scholarship Porgram panel, also said she was very grateful for Julius. "I can't smile hard enough for her making it."
As for her future, Julius dreams of working in her village, where a new sub-regional clinic will be completed soon. "I miss my family and doing subsistence activities like fishing and berry picking," she said. "My kids really miss being home in Toksook Bay."
Although missing home, she plans to stay on at YKDRH for some time until she gains enough experience and knowledge to work comfortably on her own. Nonetheless, as a PA-C, a physician will supervise her wherever she ends up in the future.
Another thing is certain: Julius is now a role model for young Yup'iks and the new crop of health aides in the Y-K Delta. "For anyone interested in becoming a PA, knowledge of math, science and English are very important," she said. "Including a couple years of minimum exposure in a health field.
"And no matter what obstacles get in the way, you need to keep on going," she added.
None can argue that she's living proof of her own advice, but she's also quick to credit her support team. "I'm very thankful for YKHC, my mentors, and all the people for supporting me in reaching my goals."
The YKHC PA Scholarship Program now includes other professions that need licensing. For more information about this program, visit www.ykhc.org.