by Matt Englund
Mary Beth McGranaghan, PhD, has been a teacher, in one form or another, for her entire professional life. After graduating from high school in Philadelphia, she joined the Congregation of the Sisters of St. Joseph, a Roman Catholic order of women devoted to finding and meeting the needs of the communities in which they live. Within three years, she was teaching third graders in a Philadelphia elementary school through the Sisters.
McGranaghan has since left the order, but she remains committed to the spirit of service that first led her to the Sisters. Today, as one of the faculty members of the newly launched UNC Physician Assistant (PA) Program, she is passing on her medical expertise to a new generation of students entering an area of medicine created, in part, to address the growing shortage of primary care providers.
“The founder of the Sisters of St. Joseph, Jean-Pierre Medaille, wanted those who joined to become part of the community, find what needs to be done, and do it,” said McGranaghan. “A similar calling underlies the mission of UNC’s PA Program: recognizing that there is a need in North Carolina and meeting it.”
Many Paths to Service
McGranaghan first came to North Carolina -- and to medicine -- when she was asked by the order to pursue a PhD in chemistry to fill a faculty position at Chestnut Hill College in Philadelphia, which is owned and operated by the Sisters of St. Joseph.
Though she had initially considered the chemistry program at UNC, the timing of her application made it impossible for her to enroll that year. Instead, she went to Duke.
During the time not occupied with coursework and research, McGranaghan became a paramedic.
“It was a hobby,” she said. “I had always loved medicine, and when I came to North Carolina I got hooked up with the rescue squad. I went through the Orange County Rescue EMS-training process and worked my way up. When I moved back to Philadelphia after finishing my PhD I joined a volunteer squad there.”
Back at Chestnut Hill College, McGranaghan began teaching general chemistry and analytical chemistry. She also served as dean of first-year students. Her new responsibilities left her with little time to pursue her medical hobby.
“I knew being a paramedic was not going to be a long-term pursuit for me – not just because of the physical demands of the job, but because I had become faculty and it was publish or perish.”
After McGranaghan had spent almost a decade on the chemistry faculty, Chestnut Hill began exploring the possibility of adding an allied health curriculum, which led her back to Duke to research their physician assistant program. It was there she discovered the career path that would bring together her desire to serve and her love for medicine.
“At the time, physician assistant was not a career path I was aware of, but when I interviewed with the program, I thought it sounded great,” said McGranaghan.
Because she pursued becoming a PA with the help of a scholarship from the National Health Service Corps, she was required to serve two years at a site identified by the U.S. Department of Health and Human Services as 'high need.'
This was how McGranaghan came to work for the state of North Carolina. With help from the Office of Rural Health, she secured a position at a small clinic in Gates County, in the northeastern corner of the state.
“We were pretty much the only show in town,” she said. “Elizabeth City and Ahoskie both have a hospital, but both were about 45 minutes away from Gates County, so the day I started I was the only medical provider in the area.”
Providing Care Where It’s Needed
The position of physician assistant was first proposed in a 1961 editorial in the Journal of the American Medical Association, penned by Charles L. Hudson, MD, as a response to a growing shortage of primary care providers in the United States. Using the training of military medics during World War II as a model, Hudson argued that such assistants could help doctors see more patients or free them to deal with more complex cases. Four years later, Eugene Stead, MD, welcomed four Navy Corpsmen to Duke’s PA program, the first in the country.
Nontraditional students, especially former military personnel, continue to play an important role in the PA community. Many veterans return home with medical skills but without the credentials to utilize them. Additionally, of the 22 million veterans nationwide, nearly a quarter of these live in rural areas -- the same areas likely to be underserved by health care professionals.
According to McGranaghan, offering PA training to veterans and other nontraditional students is a way for them to put their skills to use while bringing much-needed care to these communities.
“We often use the term ‘health care shortage’ to describe this problem in the industry. We’re not really short; we’re just not distributed right. The flexibility of a PA’s training makes a more equitable distribution of resources possible, and gets people into the communities where they’re needed,” she said.
PA programs like the one at UNC are working to address this. McGranaghan said that it is the strong dedication to the mission that sets UNC’s PA program apart.
“When I first heard about UNC’s program, my feeling was, ‘this is a nice job that seems to fit me,’ but I didn’t want to be part of just another PA program. After interviewing, my feeling was, ‘I have to be in that PA program,’” said McGranaghan. “What’s different here is the passion with which everyone talks about the service component, identifying these 'white spaces,' as I had experienced in Gates County, and finding providers to care for these communities.”
Bringing care to people where they need it has been long been a motivating factor for McGranaghan, who moved to Wake County several years ago to take a position at the WakeMed Rehabilitation Hospital, around the same time that she decided to leave the order.
"I felt God had another plan for me, so after a long discernment, I left," she said.
Her nontraditional pathway to a career as a physician assistant makes her a perfect role model for the students we recruit to the program, many of whom took a circuitous route to autonomous medical practice. --Dr. Paul Chelminski, director of the UNC Physician Assistant Program
In the years leading up to her appointment at UNC, McGranaghan’s clinical focus has been serving the geriatric population by working at local retirement communities and with Doctors Making Housecalls, which provides home-based primary care for geriatric patients.
Putting the Mission into Practice
As a faculty member for the PA program, she is taking her love of teaching and her strong sense of duty to a different scale.
“I can take care of patients, say, ‘do this, do that,’ but if I don’t educate them about their health, they’re never going to get well. I’ve always been a teacher because I’ve always had patients. Now, as a faculty member for the PA program, I get to teach the future teachers,” she said.
UNC professor of medicine and PA Program director Paul Chelminski, MD, believes that the experiences that led McGranaghan to UNC make her an invaluable resource to the program and its students.
"We are very lucky to have Dr. McGranaghan as one of our leaders," he says. "She has a very broad and diverse background in education and medical practice. Her nontraditional pathway to a career as a physician assistant makes her a perfect role model for the students we recruit to the program, many of whom took a circuitous route to autonomous medical practice. Her calm and reflective nature, combined with her passion for classroom teaching and clinical practice, are invaluable to the academic excellence that the UNC Physician Assistant Program has already achieved."
In recruiting the first class of students, McGranaghan said an important part of the process was finding individuals who were not just eager to learn, but were also dedicated to the mission of the department.
“Until we did the interviews, I had never met so many people from Yadkin County, but these people came here with a passion and talked about how the hospital had closed and how they want to go back and serve in their own communities. Those are the kind of people I want to teach.”
As the program opens its doors this month, McGranaghan is eager to see its mission put into practice.
“Ultimately, I want to see good PAs practicing in these white spaces.”
To find out more about the UNC’s PA Program, visit their website at https://www.med.unc.edu/ahs/unc-pa