What Really Matters When CRNA Programs Read Your Resume w. Dr. Ballister

Good evening. My name is Dr. Michelle Ballister. This is my first time hosting a live Q&A for the CRNA School Prep Academy. I’ve been a CRNA for 18 years. During that time, I have been a clinical instructor. I’ve been academic faculty. I’ve been the chair of admissions for a nurse anesthesia program. And I am currently one of the faculty coaches and mentors with the CRNA School Prep Academy. So I’m here to chat with all of you for the next 20 to 25 minutes about all things CRNA.

A couple of announcements before we get going. Follow CRNA School Prep Academy on Instagram to get notified about these live events. And I’ll be back at least once a month from now until I stop doing it. I don’t know how long that’s going to be, but I’ve been with the Academy now for about three years, and it is something that I really do enjoy.

Something else that we have is an in-person conference coming up in June of this year in Louisville, Kentucky. So if that is something you are interested in, go to Events.CRNASchoolPrepAcademy.com to get more information and find out how you can attend, where to stay and all those fun things. And last but not least, join our free community through the LinkTree in our bio.

Okay, so hello and thank you to all of you who are joining me. I am happy to take any and all questions. Thanks for all the waves. I appreciate it. You can send me a question any old time you like. I don’t have any questions yet. I do better with the questions.

Advancements in Nurse Anesthesia

How to Study as an SRNA

Well, I haven’t been an SRNA since 2008. I do remember studying long and hard. Now, when you ask “how”, I mean, other than all day every day, what specifically are you asking me? I was a note card person. I also used a dry erase board because I would give myself quizzes and I would write it out or draw it out, erase it, and write it out again.

I went to school before we had things like iPads and things of that nature. We actually were given paper notes that we wrote. Be a little bit more specific when you say, “How do you study as an SRNA?” and we’ll come back to that question.

Next question: Tell me about how current advancements in the field of anesthesia are and where you see the future of anesthesia heading in terms of practice and education.

Current advancements- One of the biggest things that changed from the time I was a student when I finished in 2008 and the time that I was faculty, which began in 2014 and finished in 2022, was the incorporation of a whole part of the curriculum around ultrasound utilization and regional anesthesia.

The regional training that the students went through for the program that I taught at was head and shoulders above and beyond what I experienced as a student. So I would say that one of the biggest advancements is the practice of regional anesthesia, the practice of ultrasound-guided regional anesthesia, stepping away from our use of opioids to the degree that I trained under over a decade ago, and really getting into more multimodal, non-opioid, regional, neuraxial, call it what you want, but a diversified anesthetic that has CRNAs doing more of the hands-on regional placements.

Let me scroll back through because you all are typing faster than I am talking. Thank you for the comment about my necklace. My necklace was my mother’s. Not that my mom is still with me, so I don’t want to give that impression, but it was a gift to her on her first Holy Communion. And I’ve been wearing it since I went away for my Army summer. I did ROTC in undergrad. I was not a CRNA in the Army. I don’t even want to begin to give anybody that impression. But I had to train a summer away from home, and mom gave that to me.

Congratulations to the person who commented that you have your first CRNA school interview next week. Best of luck to you.

Calculating GPA: Overall, Science and PreReqs

Okay, there was a question that I missed here. “I had to repeat general chemistry 1 three or four times. Will this really hurt me?”

I’m retaking it in the summer. In my opinion, the people at the programs that you’re applying to, the people that are reviewing those applications and those transcripts, they’re not going to sit there and count through how many times you took a course. The level of detail that that would require, for the scrutiny to each and every application; there were years that I ran 180 applications. I can’t say that I went through every transcript and counted how many times somebody took general chemistry.

Generally, those grades were pulled by the registrar who received the application. They would send to me what the individual got in chemistry, anatomy, and physiology, and then they would give me an overall calculation. The GPA was broken down three ways. One was a cumulative GPA, and that was every college course you ever took. If you took a college course more than once, the cumulative GPA was calculated without forgiveness, meaning if you took it more than once, both grades were figured in. So if you took basket weaving and got a D, and then repeated basket weaving and got an A, then you had both grades figured into your cumulative GPA.

I also got a science GPA that was calculated much the same way, and that was every science course you ever took. And then there was the prerequisite GPA, and that was generally anatomy, physiology, pharmacology, chemistry, and stats. Those are the requirements for the program, and that GPA was calculated with forgiveness, meaning that if you took anatomy and physiology twice, I was given the better grade of the two.

I think that the fact that you took it three or four times, I don’t know that anybody’s going to really notice that. So I would say no, it will not really hurt you. What’s going to be most beneficial is that you learn chemistry, get a good grade this summer, and submit that one.

CRNA Resume: What Programs Want to See

Next question: What are things in the resume that make you stand out and what are programs looking for in today’s age?

The first thing is that your resume needs to be organized. It needs to be easy to follow. What I would find most confusing is if I couldn’t track where you were, when you were there, and what you were doing. And that got a little bit confusing when I started to look at resumes from when people traveled a lot. So I would recommend that you lay out your travel assignments very specifically so that it’s clear where you were and what you were doing.

The next thing I would look for is to make sure that your resume was congruent with your application. So if you listed schools on the paper application and the degrees you got at those schools, and it didn’t match up with the education that was listed on your resume, I wanted to see congruency there.

I also wanted to see where your RN license was from, what your certifications were. They needed to match, it needed to be consistent. So I did do a little bit of checking between the two to ensure that there was consistency. Part of that was also to make sure I had the right resume with the right application, because sometimes things would get cross-attached in the software system.

Then I would look for any kind of leadership, whether it was part of the ICU experience or in the community or something aside from the community. Best examples I can give are people who volunteered in their religious organizations. They taught youth sports, those kinds of things. I would annotate anything that showed involvement in leadership. Certainly you’re going to get credit for anything that you do within your unit, whether you’re on committees, you’re precepting, you’re taking charge. Any leadership on the unit counts.

If I would see a lot of people participating in some kind of organized research project, oftentimes they were doing data collection at the bedside, that totally counts. Occasionally somebody would have a poster presentation or even a journal article published because of participation in one of those research studies. So if you have anything like that, certainly throw it in. Essentially, anything and everything is fair game.

There were sometimes interesting things that would raise questions. If you moved within a year from a job and it wasn’t a travel assignment, why were you jumping jobs from having a job less than a year and then repeatedly jumping if you weren’t traveling as a goal at that particular time? Certainly I would recognize people whose spouses had been transferred or they had military spouses and had to move. But a pattern of having jobs for less than a year, especially right out of undergrad, that was a bit of a red flag.

The other thing was if there was a big gap in the time that you were working. The best answer that I would get when we would ask individuals about that is that they sought a job outside of the profession. And that’s fine, but you want to just put that in there. When you list your employment, it should really be clear where you were that entire time.

Your shadowing can go on there. It doesn’t have to be as detailed as it is on your shadow log. You can list your references. I would either follow a traditional resume format, or if you have more than one page worth of information for your resume, I would go ahead and put that in a traditional CV format. You just want to make sure that it’s clear and organized and easy to follow.

Boosting a Low GPA for CRNA School

There’s a question: I’m currently applying, but I know my GPA is low. What else can I do to boost my GPA? I have completed Chem one, organic Chem one, organic Chem two, physics, advanced pharm, and retook health assessment. God bless you. You have worked very hard just to get admitted.

So your GPA is low. What else can you do to boost your GPA? You have to think about your GPA. Once you accumulate a certain amount of credits, think of your GPA as a glass of water and you take a drop of food coloring and you drop it into an eight-ounce glass of water. You really don’t see much of a difference with one or two drops of food coloring. That’s how you kind of have to think of a one-to-three credit course against the other hundred and something credits you already have. You’re not going to make a huge impact just from retaking one course or adding three or four courses on top. You’re not going to see a huge impact. You might see a change of a tenth to a hundredth of a degree.

So sometimes it’s better to present your recent academic achievements and frame it a different way. That is going to be working outside of your paper admission. It’s going to involve calling faculty, making appointments with faculty, attending information sessions for those programs that you really want to go to, and getting some facial recognition from those folks.

There were many students that I met with who were just interested in the program. I met with a lot of candidates and potential applicants before they applied to the program, before they became my students. I was able to offer them the same kind of guidance and mentorship that the Academy is offering to you now. It was slightly more personalized because I was faculty at that program and they were looking to apply. It was more of a one-to-one conversation that offered them specific guidance for them to be successful in applying to the program I was faculty for.

So I would encourage you to reach out to the faculty members because they need candidates. They need students. They can’t have a class without you. If you’re looking to be successful at a particular program, reach out to their admissions people. You might have to start with the program director. You can start with the registrar’s office. You can start with student services for the college that the program is housed in. One of those people should be able to set you up with the person who runs admissions for that particular program and can offer you guidance.

It is not out of the ordinary for a faculty person to meet with a candidate and offer guidance. I did it all the time. So that way, when you have that meeting, you can bring your recent academic achievements with you. Bring all your transcripts. Highlight the ones that are recently obtained, showing your academic success, showing the difference between then and now, and asking them, how do I be successful in applying to your program? What else can I do? And then you do what they tell you.

Part of it might be taking a graduate level science course. I often recommended that applicants who had less competitive GPAs take a graduate level science course. Graduate level physiology is a great course to take. It’s news you can use right now. It shows that you can do graduate level work. It’s a nice complement to a less competitive GPA. If you take it at a program that you get accepted to later on, you might be able to decrease your workload one semester while you’re in school, and that’s a big bonus.

Now, you will have to check with the registrar and the program as to whether or not you get a tuition break that semester. Some programs you pay by credit. Other programs you’re paying in a lump sum per semester. So there are two things that are going to be very valuable to you as a student. One is money and the other one is time. So you might get some time back doing the course ahead of time.

CRNA Resume: Sometimes it’s better to present your recent academic achievements and frame it a different way. That is going to be working outside of your paper admission.

CRNA Interview Readiness: What to Know and How Deep to Go

How do you evaluate an interview’s true understanding of physiology or mechanisms? Is explaining the G protein coupled proteins and pathways enough? I feel like I still brush the surface of knowledge.

The G proteins. There’s a ton of them. The G proteins are important because they are very active inside of your autonomic nervous system as well as the pathways for pain control. Two things that we are manipulating all the time are your pain receptors and your autonomic nervous system. So the G-protein-coupled receptors.

I think if you understand the difference between a Gs protein and a Gi protein, that would be important. But generally you’re going to want to be able to explain whatever it is that you bring up. So if somebody asks you a question about a drug and a receptor, and you say it’s a G protein coupled receptor, if they ask you to explain what a G protein coupled receptor is and you can’t, then that’s not going to be helpful.

So you want to make sure that you understand the structure and function of what it is that you’re saying. You can’t just say it’s a G protein coupled receptor. You have to understand what the actual transfer is from the ligand to the receptor to the G protein to the alpha protein that’s sometimes in the middle there, and then the second messenger, and whether it’s going to cyclic AMP or IP3 and what the action is after that fact.

So I would focus it on the drug that you’re speaking of and not just the general receptor. It depends, and you’re going to get that answer a lot when you ask questions inside of anesthesia because it really does depend. Are you asking about general physiologic knowledge of what is a G protein coupled receptor? Or are you asking about a pharmacology question as to what happens when the ligand acts upon this particular G protein coupled receptor?

Keep in mind that there’s a reason that you’re going to anesthesia school, and that is because you don’t know all this stuff yet. So it’s okay if you don’t have a firm, solid A-to-Z grasp on all of this stuff. If you’re looking to focus on one thing, a good working knowledge of the autonomic nervous system is always the best place to start. Because as a CRNA, you will manipulate it up, down, left, and right constantly. I hope that I answered your question.

Torn between NNP and CRNA. Any reasons to lean one way or another? NNP, neonatal nurse practitioner, is that what the NNP stands for? Or I’m not sure what you mean there. The only thing I can think of is a neonatal nurse practitioner and a CRNA. Those are two very separate lines of work.

Retaking Courses for CRNA School 

I’m going to close with the last question I can see. I got C’s in my nursing prereqs, anatomy, physiology, pharm, and micro. Should I retake or focus on higher level courses?

I’m going to kind of kick that back to you and frame it for you, depending on where you want to apply to school. Don’t forget that time and money are resources that you have and things that you’re going to need when you get to anesthesia school. So if you spend a lot of money retaking courses, then you will have less money for your tuition when you get to anesthesia school and you’re not working.

If you got C’s across the board, I would say yes, you should retake them. If those courses are within the last five years, then it’s probably a good idea to retake them, especially if there is a time requirement for the prerequisites from the programs you’re applying to. You may see it’s a recommendation or it’s a requirement.

First of all, if there’s a requirement on the application from a program, you do not want to call the program and ask for it to be waived. A requirement is a requirement. It’s there for a reason. You do not want your first impression with the faculty and the admissions department to be asking for leeway on something. No. A requirement is a requirement. Those are the rules. You produce what is being required. Or you don’t apply to that school.

When I was applying to schools, there was a program that wanted undergraduate physics. I had no desire to take undergraduate physics, so I did not apply to that school. That’s what I’m talking about. So if you see that there is a requirement for the courses to be within a certain time frame, and your prerequisites are not within that time frame, then retake the courses.

If it’s a recommendation, then you have another option, and that is to take a higher level course. Take a graduate level physiology. Take a graduate level clinical pharmacology. Because then you get the two-for-one. You get the proof that you can do graduate level work, and then you also get the advanced knowledge.

If the program does not accept those credits into their particular program, and then you have to retake that physiology and the pharmacology while you’re in anesthesia school, that’s okay. Because you will get reinforcement of the knowledge that you recently gained, and you’ll most likely do really well in those courses.

So I think you can take it either way. I would investigate first whether it is a recommendation or a requirement. Then see if you have the option to take those graduate level courses in a program that you’re looking to attend, and then again make your workload lighter for one semester possibly. It also would give you an opportunity to establish a relationship with that program, get some name recognition, and so forth.

I know that was a very long answer inside of about three minutes, and if that wasn’t clear, you can find me at the Academy and I will answer that for you in a little bit more detail. But thank you all for joining me. That is my time this evening. This again is my first live session with CRNA School Prep Academy. You’ll see me back next month with some fun topic of interest that you always wanted to know about.

Again, just to reinforce those announcements, follow us on Instagram, CRNA School Prep Academy. Check out Events.CRNASchoolPrepAcademy.com for our conference coming this June in Louisville, Kentucky, and then connect with our community on the Link Tree. All right, thanks everybody. Have a good night.