Guest Post from Jamie: How to Prepare for End of Rotation (EOR) Exams for PA School

Jamie has been a huge contributor to the Pre-PA section of The PA Platform, but now she's giving us some tips on PA school with this post and through the PANCE Blueprint Breakdown video series. This is a very thorough post, which should help immensely with your study plans for EORs. Some of the Amazon links are affiliate links, which means Jamie gets a small percentage if you take her recommendations. 


Hello all, it’s so nice to have you all reading my words again!

First and foremost: if you haven’t already visited Dose of PA’s blog about clinical rotations and end of rotation (EOR) exams, I suggest you start there. Now you’re probably wondering, “Okay Jamie, you’re just going to send us to Paul’s blog? Why do I even need you? I can Google that.” That’s fair, but my man Paul’s blog was last updated August 2016. As you know, we are in 2018. That means there are roughly two years worth of updates to share with you here. So read the above and then we’ll catch up together!

Now most importantly, there have been updates to PAEA’s exam content. The core end of rotation (EOR) exams are still the same: emergency medicine, family medicine, general surgery, internal medicine, pediatrics, psychiatry & behavioral health, and women’s health. The blueprints and topic lists can be found here. A blueprint is the exam breakdown – it tells you the subtopics (e.g. cardiology, gastrointestinal) and what percentage of the exam that topic takes up. The topic list is self-explanatory; it’s the topics covered on the exam – an outline of every disorder/disease covered. With these tools, there is some strategy when it comes to studying for these exams.

Your primary focus should be to study the most high-yield information. For most of these exams, that means cardiology, pulmonology, and orthopedics (which mimics the physician assistant national certification exam (PANCE) as well). One notable exception is surgery which focuses 50% on gastrointestinal. Using this information to your advantage, you know that by studying GI for surg, you’re ready for half the exam.

In my opinion, the best way to do this is to cover the details of each item on the topic list in whatever method works for you. I always suggest podcasts for passive studying (car rides, cleaning, taking a walk) and outlines or flashcards for active studying. I cover the presentation, diagnostic testing/imaging needed, treatment, and “misc notes” which is typically epidemiology and occasionally pathophysiology. I’ve found that knowing the epidemiology is helpful to recognize a case study based on the patient’s profile – it can help you narrow the diagnosis by considering the question is about a middle-aged man, for example, or a post-menopausal woman. Otherwise, the best bang for your buck is signs and symptoms (buzzwords), labs, imaging, and treatment. You don’t need to stress about second-line, third-line treatments. Don’t spend three days trying to understand idiopathic thrombocytopenic purpura when it’s only 1 topic out of 10 in the hematology category and hematology is only 3% of the exam! This again goes back to strategy.

There are many different podcasts available which I like to listen to on my commutes; I made playlists ahead of time to lump high-yield topics together so they’d auto-play on my rides. For most rotations, that was Brian Wallace’s Physician Assistant Exam Review Podcast. I like to edit his MP3s in iTunes to have the tracks auto-start after the 3-5 minutes of “updates” regarding his other activities (book and website stuff) – because frankly, I don’t care about that stuff. For emergency medicine, I listened to EM Basic Podcast by Steve Carroll, DO, which is actually geared toward clerkship and residency for medical students/physicians. He frequently has guest lecturers and sometimes that person is a PA-C which is awesome. His episodes feature commonly seen ER complaints (and can be sped up and understood at 1.5 speed). 

There are several books I bounce between to study from; I shared most of these in my guest blog “Clinical Medicine Study Tips." 

To understand the pathology:

For buzzwords/pearls/mnemonics: 

Lastly, SmartyPANCE (by The PA Life) is becoming more and more worth the membership cost. Not only are there tons of topics, flashcards, videos, and practice questions, there is an all new section for EOREs. He is slowly, but surely, adding practice exams for the end of rotation exams. So far this includes surgery, women’s health, emergency medicine, pediatrics, and family medicine. Trust me when I say these are VERY reflective of the PAEA EOR Exams. Sometimes it seems like the questions might even come from the same bank, if you catch my drift. These are an awesome way to spend your last week of the rotation. Study throughout, take the practice test, and go to your exam feeling confident and ready. If you’re more into printed pages and physical books, there is a decent PANCE question book by Lange (Lange Q&A Physician Assistant Examination) as well as a question book by Dwayne Williams, the author of PANCE Prep Pearls (PANCE PANRE Question Book). Lange is split up by topic (cardiology, GI, pulm, etc.) while the PPP companion is more general PANCE practice questions. 

I think that about covers it; end of rotation exams are a good way to prepare you for the PANCE so learning some strategy to study for them is an important piece of PA school. Best of luck studying and enjoy your clinical rotations!

Introducing the PANCE Blueprint Breakdown Video Series

We're so excited at The PA Platform to introduce a new study tool for PA students. Jamie Murawski is a current PA student at Detroit Mercy, and she will be facilitating a series of YouTube videos as she prepares to take the PANCE this fall. 

For the first video, here is an introduction and general overview of the PANCE and what will be included in these videos. 

General PANCE information, how to navigate the NCCPA's website, and where to find a sample study schedule. - Thanks so much for watching!

Guest Post from The PA Cafe: Motherhood + PA School

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Motherhood and PA school …. As crazy as it sounds, it’s totally possible. But it requires dedication, planning and a strong support system. 

My name is Jennifer, I’m a divorced single mom, Army veteran and 1st year PA student. Like many other women I desired a career in medicine but hesitated out of fear and doubt. I didn’t think it was possible to balance family life while in grad school. Millions of questions flooded my mind, Could I afford it? How would the time away affect my daughter? Could I commit to the schedule?... The list goes on. Then it hit me, I will always be a mom and there will never be a “right time”, so just jump in and get it done. After much prayer and finally finding the confidence within myself, I did just that… I jumped right in. Now I’m wrapping up my 1st year of PA school and preparing for clinical rotations. It’s been a bumpy road and I’ve learned a lot along the way. Here are some tips and advice to help other parents embarking on their PA journeys. 

  1. Have a plan -  Pull up an up-to-date resume and your college transcripts, now compare it to the pre-requisites for the schools you wish to apply. What are you missing? Why are/aren’t you a competitive applicant? Take note of which areas you are lacking in then map out a plan to address/fix those areas. 
  2. Have a support system- Not only to help with your children but to provide emotional and moral support. The PA program can take its toll on you mentally, physically and emotionally. Having a trusted inner circle that is reliable and rooting for you throughout this journey will make it run more smoothly. 
  3. Make time for family – there will rarely be a moment when you’re not studying, but quality time with the significant other and kids is crucial. Use this time to just relax, decompress, catch up on life and express your gratitude for their support.
  4. Save money – Life doesn’t stop while you’re in the program (even thought it may feel like it). Those bills still need to be paid and the unexpected emergencies will come up. Be ready for those rainy days because they will come. 
  5. Prepare - Brush up on basic medical terminology, anatomy and physiology … especially if it’s been a while. That “drinking from a fire hose” analogy is very true about PA school. You don’t want to be playing catch up while trying to keep up with the material.
  6. Have Faith – be proud of yourself for taking the steps to accomplish your goals. You have the desire and the capabilities, now just take the process one day at a time. It will all come together. Your children will be so proud of you when it’s all over. 
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Parents, It’s not too late to chase that PA dream. Anything worth having requires some level of sacrifice. For a temporary amount of time, life will feel like you stepped into a twilight zone. I’m still in the twilight zone but I know there’s a light at the end of the tunnel. Check out my blog The PA Café where moms spill the tea about PA school. We share our real experiences while in PA school in the hopes it will not only motivate but guide you on your journey. 

Interview with @caasapa - Future Palliative Care PA

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Catherine Anna reached out on Instagram to share her interest in the field of palliative care as a PA. I can't say that I personally know any PAs who work in palliative care, so I actually learned a good bit from this interview as well. If you have any questions about UAB or Catherine Anna's plans feel free to reach out to her on Instagram by following @caasapa


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Give me a quick introduction and a little bit on your background (name, undergrad, where you're at in PA school, etc). 

My name is Catherine Anna McCarty. I attended the University of Alabama at Birmingham for undergrad, my Master's in Public Health, and currently for PA school. Go Blazers! I am currently in my first semester of didactic. 

 

What is palliative care?

Palliative care is a specialty that focuses on improving the quality of life for those with serious or terminal illness. Usually, a team made up of not only clinicians but other specialists such as physical therapists, massage therapists, chaplains, dietitians, and psychologists takes care of patients together. The interdisciplinary team works to treat symptoms such as pain, nausea, fatigue, and anxiety as well as assist in advanced care planning. 

 

How did you become interested in palliative care? 

I accepted a position within a palliative care department working with breast cancer patients. At the same time that I was starting that job and really discovering what palliative care was, I was also experiencing the health care system for the first time as someone with a chronic condition. I realized the necessity of a specialty that focused on improving quality of life and allowed patients to define what that meant. It’s empowering as a patient to be listened to and to take back control from illnesses that directly impact how you experience life. I wanted to be a part of a specialty that had the ability to do so much good in people’s lives.

 

Why is it difficult to find PAs in specific specialties?

In regards to palliative care, I think it comes down to the history of the profession and exposure. The history of the PA profession is that of clinicians that practice curative as well as procedure-driven medicine; that which palliative care is not. The most recent literature I have found notes there are only 15 PAs practicing in the field of palliative medicine. Therefore, there are limited opportunities for exposure for pre-PA or PA students. I hope to increase the visibility of PAs in palliative medicine throughout my career and see a huge growth of practicing palliative PAs during my lifetime. 

 

What advice would you give to an applicant who is very interested in a specific specialty?

It is great to have a passion for a specific field of medicine, but it's important not to discount the value of other specialties. Most of your clinical rotations will take place outside of the specialty you’re passionate about. It’s important to be open to absorbing as much knowledge and skills as you can from as many specialties as you can. 

 

What has been most challenging about PA school so far? 

Reframing how I think about learning. During my undergraduate career, I was able to study the night before and make an A on an exam. All of my efforts were focused on obtaining a certain letter grade whereas in PA school, my efforts have shifted to learning the material I need to be a competent and capable clinician. 

 

What is your one best tip for Pre-PA students?

Invest the time, effort, and grit it takes to master your prerequisite courses so you have a strong foundation to start from once you begin a PA program. It will make the adjustment to PA school a little easier. 


80 Study Tips for PA School

A while back on Instagram, I asked for your best study tips, and you guys delivered. I compiled them into a list so if you're feeling stuck, unmotivated, or just need a new study idea to get the juices flowing you'll be able to refer back and find some inspiration. These are great study tips no matter if you are in undergrad or PA school. If you have another study tip to add, comment below to share with others! You may find some Amazon affiliate links in these tips!

  1. Study in groups

  2. Draw out material and make diagrams to visualize it

  3. Rewrite notes on material you don’t understand

  4. White boards!

  5. Use colorful highlighters and pens

  6. Quizlet

  7. Study in the morning

  8. Study after a workout to help clear your head

  9. Study alone first

  10. Make up mnemonics for material retention

  11. Study in a library

  12. Start studying before the night before the test

  13. Make flashcards

  14. Choose a location with no distractions

  15. Talk concepts out

  16. Make visual study guides with colors and pictures

  17. Find videos on YouTube to explain things differently

  18. Highlight your notes for important buzzwords

  19. Take turns teaching the material to someone else

  20. When you feel distracted write down what is distracting your mind on a piece of paper and then come back to it later

  21. Write the material over and over

  22. Practice taking exams in a setting that is similar to your actual testing environment

  23. Take a break when you feel burnt out

  24. Share your resources with your study group and see what they use

  25. If you can’t get motivated, just start and then you’ll get momentum to keep going

  26. Change up your environment to freshen your mind and keep from getting stale

  27. Unplug from all distractions = phone off

  28. Tell your friends and family the periods of time when you’ll be busy studying

  29. Limit your time on social media to designated break times

  30. Use “Focus Keeper” app on your phone or laptop to track your study session and tell you when it’s time for a break

  31. Evaluate whether studying in groups is the best option for you

  32. Snacks!

  33. Find a quiet location

  34. Take breaks every 20 minutes or so

  35. Make a chart so you can compare similar topics

  36. Use different color post-its to keep track of what you understand and what you need to review more

  37. Block time in your planner for studying

  38. Make sure you get good sleep

  39. Eat healthy

  40. Teach the material - even if it’s to an empty room

  41. Use friends to keep you accountable

  42. Record lectures and listen to them again

  43. Review the material each night to keep up the workload

  44. Focus on the material that you don’t know instead of covering what you’re familiar with

  45. Go on a walk to exercise and think through the material

  46. Listen to classical music

  47. Make a summary sheet of the main topics

  48. Listen to podcasts

  49. Use the Pomodoro technique - set a timer and divide your work into intervals with small breaks in between

  50. Make a last minute review sheet for the morning of the test to have a quick review

  51. Study for a shorter amount of time, but more often

  52. Actually pay attention in class instead of having to try to learn it afterwards

  53. Keep snacks and drinks nearby

  54. Drink lots of water

  55. Drink a specific drink or chew a specific gum when studying and do the same thing before the exam to help you recall the material more effectively

  56. Coffee!

  57. Use Google Excel to keep track of important facts

  58. Go over practice questions to practice applying your knowledge

  59. Quiz each other

  60. Take a nap if you are feeling tired

  61. Make up your own questions as you study

  62. Study at a stand up desk

  63. Take mental health breaks

  64. Buy cute study supplies so you want to use them

  65. Remember why you’re studying. What’s the end goal?

  66. Get rid of the computer or internet if it’s distracting you too much

  67. Read about the topic before going to the class or lecture

  68. Figure out your study methods and stick to them

  69. If you’re bilingual, try to think about the material in another language and translate it so you are studying it twice

  70. Use flash card apps if you don’t want to use index cards

  71. Don’t give up!

  72. If all else fails, cram.

  73. Put candy on your notes so when you make it to the next section, you get a treat

  74. Have confidence in yourself and your study skills

  75. Go study outside to get some fresh air

  76. Use Google docs to collaborate with others to make a study guide

  77. Don’t study where you sleep

  78. Link a difficult concept with an interesting story or life event

  79. Use ear plugs

  80. Don’t forget that you got this!


Guest Post from PA Cents: Should You Do a PA Residency?

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You’re in the final stretch of Physician Assistant school: graduation, PANCE, new job, it’s in your sights. You’ve been looking online at job openings and are not sure if you’re ready to join the workforce and be a full-fledged certified PA, practicing real medicine on real patients; so you think maybe a residency might be a good choice.

Possibly you’ve been looking for a job in a competitive area and can’t find a job in the specialty that you want so you want to gain more experience. There is a lot to consider if you’re thinking about applying to a residency.

I went to PA school in Southern California where there are a number of PA schools and a large pool of PA graduates to choose from to fill positions. The hospital where my orthopedics rotation was at had a lot of medical students, residents, PA students and PA residents. I asked one of them why they chose to do the residency and she said she was not able to find a job in that location in orthopedics.

If you’re tied to a certain area and really want to be in a specific specialty then more training in that area could be helpful and might help you find a job in that specialty. You will get a lot more training and might feel more competent after a residency.

A residency is by no means a necessity to get a job in any specialty. After I graduated from PA school I had multiple job offers that were all in different specialties. I interviewed for jobs in orthopedics, neurosurgery, and endocrinology. I ended up accepting a job in general surgery.

Surgeons all use different techniques and they all think the way they do it is the best way. My first job was with a surgeon who was getting older, there were four surgeons in the practice and only one used a PA at the time.

The surgeon I worked with saw the value of having a PA in the OR, as well as in the office, and with hospital rounds and wanted to hire one too. By the time I left the practice the PA that was working there before me had already left and one of the other surgeons also hired a PA. All of the PAs they hired, including the one that replaced me, were new graduates.

An advantage of hiring a new PA rather than one that has been doing it for a while is that they could train them to do things how they wanted it done. They did not have to teach old dogs new tricks. If someone else has trained you then you might have “bad habits” or just do things differently than they are used to.

More education is never a bad thing and doing a residency does let you learn more. If you know you never want to do another specialty than taking a year to learn more in that specific specialty can help you learn a lot and possibly be a better clinician.

The first year out of PA school is like PA school part II - PA school prepares you to take the board exam and the first year of being a PA teaches you how to be a PA. When you’re looking at a first job you should look for something that is still going to help you along in your education and where there is a good learning environment.

This does not need to be a residency. There are plenty of jobs that provide a good learning environment without having to do a residency. The job that I currently work at allows new Primary Care PAs to rotate through different clinics and with different specialties before they start seeing their own patients.

Learning is also somewhat dependent on your supervising physician. The surgeon I worked with for my first job didn’t mind teaching/explaining things, but I had to ask questions a lot of the time to get him going.

There was another surgeon in our practice who was recently out of fellowship and did a better job of naturally explaining things. I think a part of this was he was just in the habit of doing it as he was used to working with residents and students at a teaching hospital, whereas the further out from training you get the less you’re in that thought process.

As a PA we have been trained as generalist and one of the beauties of being a PA is that you can change specialties without having to do more training. My first job was in general surgery and when I was ready to move on I had offers from other places in all different specialties. I was not stuck working in general surgery forever. If some people are doing residencies that may soon become the norm and with residency training for PAs if that becomes the standard we will no longer be generalist and the benefit of being able to switch specialties without more training will go away.

If you feel like residency is your only option as you’re not able to find a regular position as a PA, it’s good to know that you’ll probably have to take less money as residencies usually pay less than a regular position.

At the 2017 AAPA conference I did talk to a residency for general surgery and they were offering $75,000 which is better than the $40,000 I’ve seen in the past but it is much less than what you could get in a regular position.

Whenever you’re looking at a job you always have to weigh the pros and cons. There are some benefits, such as more training and ability to network while you’re in the residency. If you can afford to take less and invest the time to do the extra training it may help you with your skills before taking a regular position. If you’re looking at a first job and have decided to take a regular position be sure that it is a place that supports learning and is going to help you as grow as a new PA.


This article was written by the author of PA-Cents a personal finance blog for PAs; to contact the author or for information on PA personal finance visit www.pacents.com.

Guest Post from Jamie: So You Failed an Exam, Now What?

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Jamie has some great advice today about what happens if you fail an exam in PA school. This will vary based from program to program, but the one thing that's for sure is that PA school is difficult and it's not uncommon to struggle at times. Personally, I failed my very first pharmacology exam. Talk about a reality shock! After remediating, that was thankfully the only exam I didn't pass. Make sure you're following Jamie on Instagram (@jamienicole_pa.s) to get more of her awesome tips. 


Full disclaimer that while I am a student at the University of Detroit Mercy’s PA Program, I am not affiliated with the university and my views and opinions expressed in this blog are my own and do not necessarily reflect Detroit Mercy’s. 


First semester of PA school kicked my butt. I did not pass two out of our four clinical medicine exams. Yes, you read that right – only made it through 50% of the exams first semester (and somehow they let me keep going… Kidding!) Failing, for me, meant missing both exams by 1 point. So, then what? That’s what this blog is about: what happens after you fail.

First of all, no one is immune. Second of all, it’s OKAY to fail.

What??? Did I just say it’s OKAY TO FAIL? Yes, yes I did. Because it’s better to fail and truly recognize that you don’t know the material than to memorize/dump it on the exam while never truly learning it. It’s not just Sociology 101 anymore – the content you learn in PA school could be as serious as life or death for your patient. So, if you don’t know it, but you pass anyways, you’re only doing your patients a disservice.

Failing means you have a second chance to relearn and understand the content, to strengthen your weaknesses and become the best provider you can be. There are four things you should do following a failed exam.

  1. Take a deep breath and eat a bowl of ice cream.
    I am not responsible for any lactose-intolerance related side effects that may occur following the consumption of large quantities of Ben & Jerry’s.
  2. Go to your professor’s office hours and discuss your options.
    We will talk about Detroit Mercy’s remediation process below. Some schools do remediation exams, some schools do not require a specific grade per exam and instead do a semester average. This is a great interview question to evaluate your prospective school: “What process is in place if a student does not pass an exam?”
  3. Try techniques to reduce your anxiety during tests.
    Some people need a snack, some people need to wear earplugs, some meditate or pray before the exams, and some have such bad performance anxiety that they do best when they take a beta blocker (but leave this one up to your healthcare provider, please).
  4. Don’t lose your confidence.
    It’s easy to get lost in one bad grade. There is a lot of guilt and self-loathing that comes along with that first score where you don’t meet the mark. I cried both times, even though I knew we had a process for remediation. It’s a scary thing because it means you are one step closer to potentially being dismissed from your career. But if you let this shake you, if you let it ruin your confidence, it WILL affect your study habits for the next one and it WILL cause you to lose focus and potentially even fail again. That’s how I failed exam #2. I failed back-to-back.

Remediating Exams: Detroit Mercy’s Approach

We have a very unique exam remediation policy here at Detroit Mercy. It is a big reason I accepted my seat to this program. Detroit Mercy makes it very clear that it truly caters to student success, from their 3-year, part-time program option to their one-on-one attention from faculty to students. When your program supports you as fully as possible, it creates an incredible platform to learn and grow. So when students do not pass an exam with an 80% or better, Detroit Mercy has a very specific remediation policy and should a student not pass remediation, there is also a very specific appeals process to continue the education.

If you don’t care about how Detroit Mercy runs their remediations, feel free to stop here. Reread the above advice. 

First is remediation. We have a faculty member assigned to meet with students weekly for a remediation course. It is typically about an hour. There, the content from the exam is reviewed again. This goes on throughout the entire remainder of the semester. The Monday after finals week, remediation exams take place. If you do not pass the final, you have one extra day to study because that remediation is Tuesday. You are given a focused review to help guide your studying. This is crunch time; the most important studying of your life. No pressure. You study like crazy until the night before, get a good night’s sleep, and then take the remediation exam.

If you don’t pass remediation, you receive an email from the program administrator informing you of an “adverse determination regarding academic progression”. In this phase, you are considered “dismissal pending”. This means you have received your appeal letter and can set up a meeting with the appeal committee. To do so, one must write a letter to the program administrator describing the basis or circumstances for the appeal within 5 business days of the email. Once this hearing is established, you are expected to demonstrate why the decision should be overturned. The committee is described below.

“APPEAL OF A PROMOTION AND PROGRESS COMMITTEE DECISION:

Refer to the College of Health Professions academic appeals policy and procedure at this link.  

Composition of the Appeal Committee: The program chair will appoint an Appeal Committee as a sub-committee of the Promotion and Progress Committee and designate the chairperson. The Committee shall consist of: PA faculty members (1-2), the public member of the promotion and progress committee, the medical director and one CHP faculty member who is not a PA. Any person selected for the Committee may decline to participate due to perceived or real conflict of interest in the proceedings. A simple majority of the invited members of the Committee will constitute a quorum. Decisions must be approved by a majority of the members in attendance.

This hearing includes a full assessment of the grades from the course, clinical performance, advisor notes, compliance with previous conditions of probation and external conditions impeding success. The committee then sends a “recommendation” to the program administrator based on the student’s potential for success. The program administrator makes the ultimate decision and sends that information to the Dean, who can affirm or conduct a further appeal. If the decision is overturned, the student re-enters the program on academic probation. They must then meet certain criteria throughout the following semester. 

Typically, if the student was full-time initially, they will continue on as a 3-year, part-time student, finishing the courses like pharmacology, anatomy & physiology, and the online courses. The following year, they finish the didactic year PA core classes like clinical medicine, diagnostic & therapeutic techniques, and physical exam practicum. If the person was instead part time to begin with, they typically will have already taken the non-PA classes the year prior (it’s clinical medicine that gets most students). In this case, they repeat that second didactic year. It also highly depends on which semester and the circumstances of the specific student; some repeat all courses, some repeat only clinical medicine. Some don’t have to repeat first semester, but do repeat second semester. 99% of our students will be approved after their appeals process and have a second chance. Ultimately, the program strives to help the student succeed in any way they can.

I passed both of my remediation exams, so I did not have to pursue the appeals process. I referred to my student manual to make this post. I had to remediate cardiology, which is one of the specialties I am considering working in after graduation. After remediation, I feel strong in cardiology and I honestly enjoy all things cardiac muscle, pacemaker and ECG. I really expected to feel scarred from the whole experience, but it honestly helped me grow as both a student and a person. And with that, I will end this blog with a quote: “If it doesn’t challenge you, it won’t change you.”


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Hi all. Thanks for reading! I'm Jamie Murawski, a physician assistant student at the University of Detroit Mercy. I have a Bachelor of Science from Grand Valley State University. I'm a Michigan girl through and through. 

I'm growing my online presence in the PA community through Reddit, where I moderate /r/prephysicianassistant along with some other pretty cool PA students. I also have an Instagram where I pseudo-blog about my journey (@jamienicole_pa.s). Please feel free to follow me or message me with any questions, I'm happy to help!


Guest Post from Jamie: Clinical Medicine Study Tips

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Jamie's back guys! Today, she is sharing some of her Clinical Medicine Study Tips to help you succeed during didactic year of PA school.  You may remember her previous posts, but check them out if you haven't already! - The Unexpected Costs of Interviewing and Attending PA School, Letters of Recommendation: How Do You Ask? and How Do You Get a Good One? and What's in My Medical Bag? Some of the links in this post are affiliate links, which means Jamie will get a few cents from Amazon if you purchase one of her recommendations! 


For Clinical Medicine:

I always read the relevant chapter of Pathophysiology Made Ridiculously Easy before we start a unit. 

Then I take notes from the PowerPoints. I reformat my professor’s PowerPoint slides into a format that suits my study technique. For me, that means creating a new PowerPoint document organized the same way as the book. 

 I try to keep each disease or disorder to one page, but sometimes they spill over. I typically start with epidemiology and pathophysiology, followed by clinical presentation, relevant labs or imaging, treatment and then complications.

Some of my classmates make charts instead in Microsoft Word. They’ll do diseases down the first column and then the columns following will be:

  • “Etiology” (who gets the disease)
  • “Pathophysiology” (why the disease happens)
  • “Signs and Symptoms” (what brings them in)
  • “Diagnosis” (labs and imaging needed to confirm)
  • “Treatment”
  • “Complications”.

I spend about a week creating this document and then I print it. Everything typed is guaranteed to be from the lectures, which makes it easy to reference when I study. 

These are the books I use to supplement my notes as I go: 

  • PANCE Prep Pearls (the 2nd edition just came out and I love that sweet, sweet index). If you’re a PA student and you don’t own PPP, you’re doing something wrong. It’s like a super condensed version of everything you need to know. Great review before an exam, great way to highlight your own notes with the absolute most important stuff. 
     
  • Step-Up to Medicine (worth buying new to get the physical copy AND the eBook). I love this book, very well organized and just the right amount of depth. It’s technically a USMLE Step 2 Prep Book but it’s perfect clinical medicine! This book has more pathophysiology and epidemiology than PPP. 

Once my notes are printed, I go through with multiple pens and highlighters. I highlight the top of the slide based on its importance level on the NCCPA’s PANCE Blueprint. Then I handwrite in additional notes from the books I recommended above. They’re color-coded by source so I know where I got each piece from (everything typed is always from my professor’s notes, and then handwritten comes from Current Medical Diagnosis and Treatment (the course text, in dark blue), Step Up (green), and PANCE Prep Pearls (pink). I usually don’t add any written notes from Patho Made Easy, but I do read it before a unit starts and again the night before an exam. This takes me about one full hardcore day of studying. Anywhere from 10-12 hours. I usually will take two or three days to do it, unless I’ve done a lot of procrastinating, and then I’ll sit down and do the entire thing in one day instead. 

I spend about a week creating the typed study guide, about a week adding notes, and then a week studying what I’ve created and taking practice exams. For practice exams, I like the following:

Lange Q&A Physician Assistant Examination. This technically goes with the course book, but there are a lot of mistakes in treatments and labs. It seems outdated for about 10% of the questions. For this reason, it’s usually the last test I take. It does have full explanations for each answer at the back of each section, though, and the added bonus that it’s a physical book. I like real paper. All of our exams are online, though, which brings me to my next recommendation: 

SmartyPANCE! I LOVE their practice tests. They are broken down by subject, so you can use them before an exam to see how you’re doing. It also has a review by subject with “pearls”. 

The other review site I recommend is HippoEd. Same thing, they have study materials and videos, and practice exams broken down by subject. I find them to be a little more challenging than SmartyPANCE and usually take these closer to the unit exam. 

Finally, a lot of people really like Rosh Review, but I consistently score 55-60% on every exam I make for myself, which is terrible for my self-esteem. I did not purchase after my free trial expired. Some of my classmates don’t mind the difficulty because of how amazing the answer breakdown is. I love that it tells you how you compared to other people taking the exams, so you can see, “Okay, well I got this wrong, but so did 72% of the other people” or “Well, I’m the only 1% that answered this question this way, so clearly I need work on this.” It’s helpful for sure, but like I said, proceed with caution in terms of confidence before an exam! 


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Hi all. Thanks for reading! I'm Jamie Murawski, a physician assistant student at the University of Detroit Mercy. I have a Bachelor of Science from Grand Valley State University. I'm a Michigan girl through and through. 

I'm growing my online presence in the PA community through Reddit, where I moderate /r/prephysicianassistant along with some other pretty cool PA students. I also have an Instagram where I pseudo-blog about my journey (@jamienicole_pa.s). Please feel free to follow me or message me with any questions, I'm happy to help!


How To Get Married During Physician Assistant School

I question I'm sometimes asked about, and one I feel like people don't want to ask is how to handle relationships in PA school. It's not the easiest, but it can be done! I applied to PA school with a boyfriend, went in with a fiance, and came out a wife! I can't say that was necessarily encouraged, but it was important to me. 

I know this may not be of interest to some readers, but I think it's still important to address. PA school is very time intensive and can take a toll on relationships at any stage. It takes understanding on both sides to come out successful.  My particular program very strongly encouraged students to wait until after school to plan any big events like weddings.  At the end of the day, as much as I wanted to be a PA, I wanted to marry my best friend. 

My (now) husband and I had been dating for 5 years at this point (yes, we met in high school), and we were going to both be in grad school.  If you've followed along for a while, you probably know that while I was in PA school, my husband was in medical school.  So double stress.

I lived at home with my parents for the first year and he had 2 roommates.  Basically the only time we saw each other was to study or grab a quick bite to eat.  Wedding planning was put on the back burner, and if it wasn't for my mom, I'm not sure what my wedding would have turned out like.  

All this to say, we made it work, and if you have concerns about being able to maintain a relationship or take the next step while in PA school, know that it's possible. My wedding was during the break between the spring and summer semester at the end of didactic year, and I had classmates who got married during clinical year.  Some even met their future spouses while in PA school! I'm always happy to answer questions about how I was able to make it work, and if you want to hear more about my story, check out the video below, or at this link.  

Advice From Current PA Students - From White Coat Dreaming

I recently connected with Alex on Instagram (@whitecoatdreaming), and she introduced me to her awesome PA blog - White Coat Dreaming. Apart from sharing her own awesome advice, Alex has also interviewed her fellow classmates in PA school to get their advice as well.  In this post, I'm going to share some of the best points to help you succeed in PA school! If you want to see more, make sure you head over to her blog to see the interviews in their entirety. 


Interview Tips:

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I think that schools like to see that you have other interests besides medicine and that you make time for the things you care about.  - Megan

I would really recommend going on a mission trip before PA school starts because it gives you an opportunity to learn more about the medical field and prepares you for PA school. Not to mention, it shows the interview committee that you are well rounded and more than just your grades. -Norin

Career change?  Be totally honest with yourself about who you are deep down, what you like, what all of your motivations are, whether you could get what it is you think you’re looking for while staying in your current spot or with a less drastic change. -Craig

The number one tip I can give you is to just be yourself! And I know that probably sounds super cliché, but it’s so true. Don’t try to be someone you’re not. Don’t try to put on an act, or memorize all the right answers to ace an interview or personal statement.
— Giftson from White Coat Dreaming

I didn’t do anything to practice so I just showed up thinking I could charm some people. And then they were tough and I bawled in my car after 2 or 3 of them. - Megan

I would truly recommend helping out the community as much as you can. During interviews, they look at more than just your grades. They want to see that you are a caring individual that does more than just study.  -Norin

There is a lot of competition for spots in PA school for good reasons, you’ve got to show that you are the cream of the crop and are a good bet for the school in terms of being able to one day be a skillful, practicing PA. -Craig 

It is so easy to compare to others and feel like you fall short, but it is so not true. We are all worth so much more than how we perform or measure up to the world’s standards. Finding my worth in Christ and knowing that He loves me no matter how small I feel was the biggest game changer. -Michelle


Applying Tips: 

Don’t get discouraged if you are waitlisted! I know plenty of people who were waitlisted and got in as late as April. -Megan

I took a year off before starting PA school because there were still some pre-requisites that I needed to complete and volunteer hours that I needed to add into my application. This really helped me focus on my application and make it stronger. -Norin

While getting into school and becoming a PA might seem like the most important thing in your life right now, don’t fall into the belief that whether you become a PA or not determines your value. You are so much more than your career! Work hard, but rest in the idea that you are going to end up exactly where you are meant to be. You are no more valuable as a PA or less valuable as something else! -Jill

Find yourself a good group of friends who will provide you with love, tissues and wine nights. They will be your backbone throughout the ‘process.’ - Alexa

People are afraid to major in something non traditional (like English, Poli Sci or philosophy), but I think it’s best to follow your own passions and interests. That will show that you are true to yourself, and are not just trying to do what you think you are ‘supposed’ to do.
— Erica from White Coat Dreaming

For me the hardest thing about applying was the cost.  - Erica

I’ve tried to make the best out of every situation. I know right now school is kind of rough, and you have to give up a lot of things that you used to have, but in the end it’ll all be worth it. -Giftson

 It is good to always have a plan B after you apply and focus on areas that you need to work on before you know if you got in that cycle or not! -Norin

The hardest part of applying was sorting through all the various requirements and prerequisites for each program. -Jill

Also, I would recommend a strong personal statement. It summarizes who you are as a person and your purpose for wanting to pursue medicine. Every part of the application is important, however, the personal statements gives them insight into your life so make sure it is strong. -Norin

I feel like location was a big factor in my decision. I knew I wanted to be in an area where I could still be around family, and having a support group nearby definitely influenced that decision but I also was excited to be out of my comfort zone. -Giftson

When the competition is so steep, you want to have as good of chances as you can, and applying to multiple programs is one way to do that! - Jill


PA School Tips: 

Know what you are getting into before you come to PA school. I was not mentally prepared for the amount of dedication that it would take to be a PA student, and it took me about 2-3 months to truly grasp how much my life was going to revolve around studying. - Erica

If your heart is not in it and this is not something you truly want to do, then stop yourself before it gets too late. PA school is hard, and honestly the pressures of the program is going to take a huge toll on you…physically, mentally, emotionally, and spiritually. If you’re not doing it for yourself, then you’re going to crack under pressure. - Giftson

Once you get accepted, stop trying to ‘better yourself’ academically or otherwise– and just relax and enjoy yourself, as much as logistically and financially possible. If you can take a vacation beforehand or some time off, definitely do- you will be so glad later. - Erica

PA school ends up taking all of your time, so you don’t really get a chance to think about how much time you’re not spending with family and friends.  -Giftson

I faced some of my darkest moments in PA school, because, surprise…it’s hard.  And the thing that kept me going above all else was having compassion for where these long nights of studying would take me.
— Silas from White Coat Dreaming

It helped to have a running schedule that I would try my best to stick to. That forced me to workout most days after class even when I didn’t feel like it. -Michelle

Being professional and acting in a way that shows respect to others is honestly far more important than the number of years you have under your belt. I was always worried that patients or even other classmates wouldn’t take me seriously because I was so young, but over time I’ve learned not to worry about things I can’t change. -Giftson

Also, make efforts to stay balanced while in school. So many people seem to put everything aside for their grades- mental health, relationships, exercise, sleep– but those things are necessary to be successful. -Erica

We all are starting at different parts of our life, and just because you don’t have experience doesn’t mean you can’t do well. You have to understand your limitations, and strive to push those limits every day! You’re going to make mistakes. Learn from them, and keep pushing forward so you can be the best PA you can be! -Giftson

I realized when I ate healthy, it definitely helped my energy level and helped me focus better and not get so tired studying. -Michelle

Self-doubt was a huge problem for me. I would always see other people that knew so much, and wonder if I would ever get there (still haven’t got there by the way). -Giftson

Sometimes it can be challenging when you compare and think how far ahead your kiddo classmates are in terms of being about to start their career when you would have still been waking up at noon on a Wednesday to go do a half-shift of bagging liquor- but hey, whatever path you take, you are bound to have learned something that someone on another path hasn’t. - Craig

You learn quickly that your classmates are in the trenches there with you, and you depend on each other far more than for just explaining a concept you didn’t understand in lecture.  -Silas

5 (More) Things I Wish I Knew Before Starting PA School

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A while back, I did a post for Brittany at PA Fanatic on 5 Things I Wish I Knew Before Starting PA School.  When I was working on that article, I found it difficult to come up with only 5, so here are 5 more! 

  1. Don’t worry about loans, but be aware of them.

    For the majority of PA students, loans are a fact of life (unfortunately).  There's no need to dwell on your loans while you're in school because there's really nothing you can do about them at that time because most PA programs do not allow working while in school. And honestly, I think you would be crazy to try because PA school is a full time job. While you don't want to let your impending debt weigh on your shoulders too much, don't go crazy.  I had classmates who ate out for every single meal (using loan money), and then promptly bought a new car after PA school. If you've read my story, you'll know that I worked as hard as possible to pay off my loans after I graduated, but I also tried to be frugal throughout school.  Here's some tips to help you save money while in PA school! 
     
  2. Don’t be afraid of your teachers or preceptors

    The faculty of your program should be part of your support system.  Whether it's an advisor, teacher, director, or preceptor, find that person you can go to if you're struggling. And be honest about any challenges you may be facing.  If you're finding a particular section difficult or not sure how to study most effectively, ask for help! This goes for undergrad too. Your teachers and preceptors are the people who will be able to help you get a job in the future and they'll be your best references. I would frequently visit my advisor for advice or even just to decompress and talk about how stressed I was, and it was nice to talk to someone who had been there and understood what I was going through. You'll also want to keep in touch with these people after school. 
     
  3. Make time for yourself. 

    This is something I was terrible at when I first started PA school. I would go to school, study constantly, and basically never do anything else. I was living at home for the first year, and even if my parents asked me to go grab a quick dinner, I refused and stayed hoe to study. I was also supposed to be planning a wedding at that time. About halfway through didactic year, I loosened up a bit. I started going out to eat and doing some fun things (like going to see Taylor Swift with my classmates), and my grades actually improved while my stress decreased. The lesson I learned is that 30 extra minutes of studying when I'm tired or hungry won't make a huge impact on my grade. I also never read a book for fun while I was in PA school, and I love reading! Why did I do that?
     
  4. Be honest about what you want to do. 

    Somewhere during clinical year, I decided that to get a job, I needed to tell every preceptor that I wanted to work in their field. Basically, I was trying to suck up. In my heart, I knew that I had a passion for surgery or dermatology. Once I started being honest about that with my teachers and preceptors, I actually started hearing about the open jobs in the area and getting more valuable information that would actually help me find the job I wanted. If I could do it again, I would have taken this approach from the very beginning of school. 
     
  5. Always be professional. 

    I feel like this should go without saying, but as a PA student and future PA just always carry yourself in a way that exhibits professionalism.  Whether that's in class, on campus, when you're having fun on the weekends, or certainly on rotations. Just always keep in mind that you are representing your school and the PA profession. 
 That's my girl Taylor Swift back there!  Last minute floor seats can't ever be passed up! 

That's my girl Taylor Swift back there!  Last minute floor seats can't ever be passed up! 

What tips do you wish you knew before starting PA school? Comment below to share! 


Guest Post from Jamie - What's in my Medical Bag?

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I'm really excited to share this post today from Jamie, which was first published on Reddit.  It does contain some affiliate links, which means if you purchase any of the products from Amazon, Jamie will get a small cut. You may remember her previous post - The Unexpected Costs of Interviewing and Attending PA School

What’s in my medical bag?

Firstly, I carry two bags. The salmon colored bag is a little backpack by Dickies and the black bag is actually a diaper bag from Eddie Bauer. The Dickies bag was ~$23 at Sears and the Eddie Bauer bag was $39.99 at Target, but I used a 10% off coupon. On the outside of the backpack, I have a hand sanitizer (just Purell). I also carry a water bottle (Contigo brand because I hate having to bite the straw) and an umbrella. Because it’s a diaper bag, these pockets are actually insulated, which I think is funny, but awesome.

I don’t actually plan to carry both bags every day. I just don’t carry a purse and the med bag has stuff that I don’t really need on days like today or Wednesday when I only have one lecture. I do need the med bag on Tuesdays and Thursdays, though.

LET’S DIVE IN!

Medical Bag: Front Pocket(s) from left to right

Medical Bag: Inside View of Main Pocket

Laid out so you can see contents left to right

I am horrendously guilty of forgetting to put on deodorant, so I keep a little one in my bag along with some Kleenex!!

Backpack Front Pocket

Backpack Main Pocket

  • Microsoft Surface 3, 128GB Internal Storage, 4GB RAM ($399.99 from Best Buy) – this for me is an absolute MUST. It is lightweight, so I can carry it easily in my bag, it can be charged with an external USB power bank if the classroom doesn’t have outlets on the table, and it has the full functional Windows 10 operating system, including Microsoft Office. I live by OneNote for my notes. I use the cloud to store everything (with hard backups, of course), but it’s SO nice to be able to pull up my lectures from my phone or tablet, or my laptop at home. I can’t suggest this enough. I just hate that you have to buy the keyboard separate, and $400 is the cheapest I’ve ever seen it. I’ve had a Surface since the initial RT, though, and I’m a fan.
  • Microsoft Surface Type Cover - $116
  • Microsoft Surface Pen - $44.72 – I love this puppy, but you don’t need it if you prefer typing. I like being able to handwrite things easily, but it’s definitely not for everyone.
  • Tablet sleeve - $14.99
  • Bare Bones Anatomy textbook by Dr. Tracey Bee - $213
  • Flashcards for Unit 1: Intro and Back (came with textbook)
  • Folder - $1
  • Planner (MY LIFE) - $10
  • Pencil case - $1
  • Pilot G2 Pens - $10
  • Chargers, extra headphones
  • Glasses

And again, super forgetful with deodorant, so my backpack gets one, too – remember, I said I don’t always have both bags? And hey… sometimes I go to the gym… Also lip balms and a prescription topical steroid cream for my hands – I have contact dermatitis that gets bad with excess glove usage.

What’s in my pockets?? I just wore scrubs today, but this is the contents of my lab coat pockets!

  • Bath and Body Works lotion - $3
  • Bath and Body Works hand sanitizer - $1.50
  • Alcohol swabs
  • Pilot pen
  • NYX Soft Matte Lip Cream in Antwerp - $6
  • $2 for possible snacking needs
  • My locker combination

Not pictured:

  • Lab goggles - $1
  • Lunch: turkey sandwich, peppers and carrots with hummus, grapes, cantaloupe, and strawberries, Goldfish crackers.

Grand total: roughly $1600


Hi all. Thanks for reading! I'm Jamie Murawski, a physician assistant student at the University of Detroit Mercy. I have a Bachelor of Science from Grand Valley State University. I'm a Michigan girl through and through. 

I'm growing my online presence in the PA community through Reddit, where I moderate /r/prephysicianassistant along with some other pretty cool PA students. I also have an Instagram where I pseudo-blog about my journey (@jamienicole_pa.s). Please feel free to follow me or message me with any questions, I'm happy to help!


Guest Post from Holly: How To Study and Succeed in Didactic Year of PA School

Holly has some awesome tips on how to survive didactic year of PA school.  If you thought getting into PA school was the hard part, you better get ready for the didactic portion.  This post is great for whether you are just getting ready to start school or already pushing through PA school. I agree with so many of these tips, and I experienced or learned a lot of this stuff myself in PA school. 


Congratulations! You’ve finally made it to didactic year of PA school (likely your ultimate dream, just as it was mine). It’s a HUGE accomplishment so be proud, but now it is also time to start working the hardest that you ever have academically (or at least learning in a fast-paced environment that I definitely had not experienced prior to PA school). Didactic year was definitely something I was absolutely terrified of when I first started the journey a year ago, but I am here to tell you that it is not impossible, and in fact, was one of the best years of my life! Being fresh out of didactic year, I’d like to provide some study tips I learned throughout my time as a PA student in the classroom. 

  • Don’t be afraid to completely change your study habits. Your previous study habits may or may not be as effective during your time as a PA student. This was something I was initially super resistant to (I always took hand written notes in all of my past college classes), but I quickly learned it was hugely beneficial to tailor my note taking to each individual class, and what I needed out of lectures in order to properly study and succeed in learning the material. Think about how you might best benefit during lecture for retaining the material long term. I used print out PowerPoint slides for Anatomy (they were all pictures, so I would bring a bunch of colored pens to color in what I was writing about and then write any additional notes about the structure we were discussing). In most of my classes, I realized it was most time efficient for me to type out notes on PowerPoints, and either study from them or create Word document study guides to print out. Pharmacology and Laboratory Medicine were 2 classes I struggled with, especially when only viewing the PowerPoints with my notes, so I made sure to create my own personal study guides for each of those, organize the material in a way that made sense to me, and would print out and write additional notes on my notes especially a few days prior to exams. Flash cards are also a great idea for subjects that require a lot of route memorization (Infectious Disease, for example). Figure out what works best for you, and constantly be willing to re-evaluate if that method is working well for you.
     
  • Work with others and study alone. This was another thing I was initially resistant to as a new PA student. In undergraduate classes, I never studied in groups because I assumed I wouldn’t be as productive. And it worked for me then, but I found it took way too much time to figure out everything on my own in PA school. I tested out quite a few study groups before I found the right group of people, but it was especially helpful to have a few classmates and friends to rapid-fire study. During finals, we usually had about 2 exams every day for 2 weeks straight, so even if we tried not to wait until the last minute, sometimes it was inevitable, and having others to quickly help me retain information and make me think about aspects I wouldn’t have on my own was extremely beneficial. Again, do what works for you, but definitely don’t be resistant to change if you have not tried a study technique in the past!
     
  • Use any mean of studying you can think of! Some examples include (but are certainly not limited to!) videos, audio, flashcards, study guides, charts, pictures, writing on chalk/white boards, sketching out images, and more. Really, use anything that will help you to retain the information and truly understand it on a fundamental level. Some of my favorite tools included Khan Academy, Online Med Ed, PANCE Prep Pearls (I highly recommend this book, even for didactic year! It is meant as a review for Boards, but I found it quite helpful for exam reviews and also for freshening up prior to OSCE’s and the PACKRAT exam), Physician Assistant Boards (I found both the Pharmacology and Boards Review audio files particularly helpful for my commutes, especially for solidifying information prior to exams), and the Physician Assistant Exam Review podcast. Many of my classmates shared groups on Quizlet so that we were able to use each other’s Quizlet online flashcards. Our class even had a shared DropBox where we would upload any helpful information or study guides we completed for the rest of the class to utilize. I found it super helpful to hear information over and over through multiple sources, and it has certainly helped me to retain a lot even after exams were finished. 
     
  • Connect the dots. I cannot emphasize this enough, but making connections between classes is super important. This helped me to not only better understand material in all of my classes (everything eventually starts to overlap!), land a pretty awesome PACKRAT score (the PA student exam that predicts how well you might do on the PANCE, or certifying PA exam), and helped me to feel much less stressed when it came to OSCE’s where we had to put all of the information together in order to diagnose and treat a hypothetical patient. It certainly shows if you are learning the material for life and not just for exams, especially at the end of didactic year when your professors will expect much more out of you. Don’t let yourself fall into a place of complacency – after all, as one of my favorite professors stated, “you are learning this for life and to keep your future patients alive”. It’s a pretty serious task, and I always want to make sure I am doing my best for my future patients. 
     
  • If you are losing speed and struggling to continue studying, change gears! This happened multiple times to me. Didactic year was a lot of studying. If I found myself losing focus or feeling burnt out, I would make sure to have some fun or reward myself to keep up my motivation. My friends and I often made trips in between classes or during day-long study sessions for coffee, cupcakes, chocolate, ice cream, you name it! Of course, it wasn’t the healthiest choice, but it kept us going and motivated to move on to more material. Another tip I can provide you with is to exercise! I didn’t do much exercising during my first 2 semesters, but at the beginning of my third semester, my friends and I decided it would be a great idea to attend work out classes twice a week through our school’s gym. It was actually a brilliant idea because we held each other accountable to attend every class, and we got in a great work out and felt mentally and physically refreshed afterward to continue studying if needed.
     
  • Know when you need help. This is probably the most important piece of advice, in my opinion. You’ve worked so hard to get to where you are at, and you don’t want anything to get in your way of continuing through the program and becoming a future PA. Know your limitations and shortcomings, and realize when you need to ask a professor, advisor, classmate, friends, and/or family members for help. Didactic year is super challenging, mostly because of the amount of information they throw at you all at once, and because of the time constraints you might find yourself in because of your dedication to studying and passing your classes. Unfortunately, 2 of my classmates were disqualified from continuing the program due to poor academic performance, and from what I observed, both were too late in asking for help. If you see a classmate struggling, make sure you reach out if possible. Had I known these students were struggling, I definitely would have, but by the time they let me and other classmates of mine know that they needed help, it was too late to bring their grades up enough to pass. I personally struggled with Pharmacology and with my first Psychiatry exam. It was actually a double whammy because I failed both exams in the same week, and immediately went to both professors (one while I was in complete tears). Take your professors’ advice – they are there to help you and it certainly will only benefit you if you can obtain tips for how to succeed in their specific classes. I also let my friends know that these were 2 subjects I struggled with, and asked them for advice especially if they did well in the classes. I studied with classmates that were able to help me in these classes, while I was able to help them in other subjects, and it worked out really well. I also made sure to change up my study techniques to ways that helped me retain the information in a more efficient way, and was able to pass both classes with pretty decent grades! 
     
  • Know that you might not be perfect, and that is perfectly okay! I watched a few of my classmates strive for perfection, and sometimes it worked but other times it simply stressed them out more than they needed to be. I learned that even though I may not be the smartest person in the class, and certainly did not receive straight A’s by any means, I could still succeed in PA school and make sure I was learning everything I needed to along the way. My hard work paid off and was evident with my PACKRAT score, and if you keep motivated and work hard, I am positive you will succeed! 

Holly is a second-year PA student at Marywood University. Prior to attending PA school, Holly graduated from Temple University Honors Program in 2014 with a degree in Neuroscience and minor in Psychology. She then worked for two years as a mental health worker, direct service professional in an autism center, and as an emergency department scribe. You can find Holly on Instagram at @xohollyd and on her blog XOhollyd for more PA tips!


How I Paid Off my PA School Debt

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So have you heard that PA school is expensive?  Well, that might be an understatement.  Any graduate program is going to be a little pricey, but medical programs tend to be on the higher end of things.  If you look at estimated costs for PA school, you'll see a broad range from 5-digits all the way to hundreds of thousands of dollars.  That's a lot of zeros.  And you have to look at tuition + fees + books and other resources + tools + traveling for clinicals + housing + food + everything else!

Thankfully, I went to a public program so that initially cut my costs.  My second choice school would have cost 4x as much as my program cost.  Unfortunately, that's the norm.  I had a few other advantages that helped me to cut back on the amount of loans I had.  Which brings me to Tip #1 - Take the minimum amount of loans possible!  I was able to live with my parents for the first year, and although they couldn't cover all of my expenses, they covered my fees.  I only had to take out loans to cover my tuition.  I also went to a public program, and that decreased costs significantly.  Tip #2 - Don't take out extra money to put into savings.   The amount of return you get in savings is so much less than the amount you're being charged in interest, so it's just not a smart financial move.  

I took out federal loans though Sallie Mae, which is now Navient.  I made an interesting, somewhat subconscious, decision to not ever look at how much I owed until the end of PA school when they make you do financial literacy training.  I guess I figured that it wouldn't make any difference since I wasn't able to start paying them off yet anyways.  And although I was not able to do this, here's Tip #3 - If there's any way that you can make payments during PA school, do it.  (Even if it's a small amount.)  If you get any extra income, have a spouse who works, or have savings you're sitting on, think about putting some of it towards your loans.  Those small payments make a big difference in the long run, especially with high interest rates.  

So anyways, when I pulled up my loan summary, I owed around $75,000, and that was shocking to me.  Now I know that PA school costs a lot more for a lot of people, but you can't deny that 75K is a big chunk of money.  I mean, that's the average starting salary for a new grad PA.  About 55K was principal (meaning that I had actually borrowed that much), and the other 20K was interest (the fee for the money I borrowed).  My interest rates were varied, but averaged at about 6%.  

After you graduate, there's a grace period where you are not required to make payments on your loans.  Tip #4 - If possible, start making payments during your grace period.  While you don't have to make payments, your interest is compounding and growing.  From day 1 of getting a paycheck, it helps if you start making payments right away.  You won't miss the money if you already have it dedicated to your loans.  I committed to this at first, but then I got a little lazy.  My original goal was to put at least 1/2 of my salary each month towards my loans.  But then I got the great idea that I would just put whatever was left over at the end of the month towards them.  Just kidding.  Not a great idea.  That only lasted about 2 months before I got myself back in check.  After working so hard for 2 years in school with no compensation, it can be easy to go a little crazy.  I would love to tell you to make a budget and stick with it, but I'm personally terrible at budgets, so I can't give you much advice in that area.  

So I went back to committing at least half of my salary to go straight towards my debt.  Tip #5 - Decide how much you want to put towards loans each month, and do it.  As you see the amount you owe decrease, it's so reassuring.  There are differing views on what loans to pay off first.  Dave Ramsey has the "Snowball" plan, meaning you pay the one you owe the least on, without regard to the interest percentage, and go from there to gain momentum.  I paid off the one with the highest interest rate first, and then worked my way down.  If you do automatic payments, you may get a decrease in the interest amount.  

After you've put your committed amount towards loans, if you have any extra money coming in, consider putting it towards your loans.  Tip #6 - Try to put extra funds towards your loans.   Every little bit makes a big difference.  It may not seem like it at the time, but I don't think I would have paid off my loans as quickly as I did if I hadn't done that.  And I can think of specific purchases that I made that delayed my final payment, and they probably could have waited.  

So back to my loans.  After I found out how much I owed, I committed to paying half of my salary each month to my loans, and any bonuses I got.  There were a few hiccups along the way, but I got better at it with time.  I tried to put any extra funds to my loans.  I started working in August 2014, and this past January 2016 I made my last loan payment!  It felt awesome.  Took my entire bonus/commission, and drained our bank account, but it was worth it.  I feel like a weight has been lifted off my shoulders, and I have a lot more freedom at this point.  Instead of going to the beach a few hours away, I can afford the trip to the DR without feeling guilty for not paying towards my loans.  Tip #7 - Make frugal choices while paying your loans, not extravagant ones.  

Everyone is different, and I'm sure not everyone will agree with how I did things.  But that's ok, and I'm extremely happy with where I'm at.  Debt-free, and able to start saving more and making good financial decisions.  Tip #8 - Do what works for you.  I'm a generally frugal person anyways, but I can splurge on something like a vacation or good meal.  Making big purchases, like furniture, are a lot more fun now too.  

At the end of the day, whether you're still in undergrad or worried about affording PA school, your loans will be paid off at some point.  It may not be as soon as you would like, and you'll probably make some mistakes, but it will happen!  If you have any other tips for others about paying off loans, please comment!  Or if you've paid off you're loans, I would love to share your story and help others to have confidence that it is possible!  

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PANCE/PANRE Review Course - The Resource You Need to Pass Boards!

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From the first day of PA school, you are fully aware that boards will be necessary at the end to practice as a Physician Assistant.  Although some people wait until after school to buckle down and study exclusively for the PANCE, I think it's best to start studying from day 1.  All of the tests during didactic year and clinical year are important, but that last test is the MOST important.  

I'm really excited to be able to share an awesome resource when it comes to studying for the PANCE - the PANCE/PANRE Study Guide and Review Course. There are so many aspects to this that will be helpful to every kind of learner.

The Study Guide - When studying for this all important test, you want to make the most of your time and focus on high yield material. The Study Guide is a 109 page PDF that focuses on everything you need to know. It's short and sweet, and to the point. It's essential that you are able to recognize buzzwords and match them with diagnosis, imaging, or treatment. For example sausage mass on palpation in a pediatric patient should automatically make you think of intussusception. This is the resource you need to focus your brain on what you NEED to know. If you just want the guide, you can download the study guide for 9.99.

Online Content - For the review program , you log in, and are able to access a ton of content. The course is organized based on the NCCPA Blueprint, so again, the focus is everything you actually need to know. In each section, you'll find an introductory video, the NCCPA Blueprint information for that section, the percentage it is on the PANCE, an audio review section, the PANCE Study Guide for that section, quizzes, flash cards, and more review material. Basically, there's a little bit of everything and the material is reviewed in multiple ways.

Quizzes - There are different options available when it comes to the quizzes.  There are basic ones that just ask pretty straightforward questions and some situational ones, and then there are buzzword matching ones.  Practicing actual questions is the best thing you can do because you are testing your understanding and knowledge.  Knowing buzzwords for the PANCE is also necessary.  Like other standardized tests, there is strategy involved, not just knowledge.   I was reminded just how much I don't remember from school after taking just 2 quizzes.  

So why should you invest in this review course?  Well, if you don't pass your boards, you get a full refund.  That's a pretty bold promise.  There's a free trial available that still has a ton of valuable knowledge, so you can try it and see if it would work for you.  For lifetime access, it's $199 (and there's a discount below!), and you get access to so much knowledge.  And that means you can start it the day you start school and use it throughout your program.  This is a resource that I will use to stay up to date on the material I need to know and I plan on using it when I have to recert.  The creators have worked really hard to make this an all-inclusive study guide, and I think they have succeeded.  

I think if I was using this today to study, I would do a practice quiz, then read through the study material, listen to the audio review, and then take more quizzes.  It's basically everything I did to prepare for PANCE 2 years ago, just in one source instead of multiple books.  

If you are interested in checking out the study guide or review course here is a coupon code that will get you 15% off of your purchase!! - thepaplatform15

 

I was provided access to the course and a copy of the study guide for free, but my thoughts are completely my own!  

My Favorite Books to get through PA School

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If your program is anything like mine, they will give you recommended books or resources for each section.  While a few of these were helpful, there were other books that I used during the entire didactic and clinical years, and I don't think I would have made it without knowing where to find the information I needed.  The internet is a great resource, but I love being able to flip through a book and highlight and make notes too.  Here are some of my favorite books, and make sure to comment below with anything you think I left off!

A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants - This was my main PANCE study book, but I used it all year long.  It is based off of the NCCPA Blueprints for the PANCE exam and goes through every single section with the main ideas that are important for PA school.  I would always read through the related section the morning before a test just for a refresher.  My only complaint about this book is that the medications are not always specific in the treatment section, and I could use a little more info there.  

Step Up to Medicine - While this book is technically for medical school, it's great for studying all of the basics of PA school, especially all of the Internal Medicine topics.  It's split up really well and easy to read.  This book fills in what the PANCE review book leaves out, and I wish I had known about it for more of didactic year, but it's great for clinical year too.  

Pocket Medicine - This is a pocket reference for your white coat that I actually didn't have, but I wish I knew about it.  My husband currently uses this book on his medical school rotations, and it's really cool.  It has all of the current recommendations for Internal Medicine subjects, and also all of the articles that the recommendations are based on, so it's truly evidence-based.  If you're in an academic center, the attendings love it when you can reference an important study.  There's a Pediatric version as well.  

Maxwell Pocket Reference - This is another book you should have in your white coat.  It's really small, and for $5 it comes in handy.  This little book has outlines for different types of notes in the hospital, ACLS codes, physical exam and history, and all kinds of other important topics.  Unless they've stopped, if you join the AAPA as a student, they will send you a copy of this.  

Lange Smart Charts for Pharmacology - This was my go-to for pharmacology, aka the worst class of PA school.  It's just so hard until you're actually seeing these drugs on rotations or practicing .  This book is a flip chart of all the drugs separated by class with everything you want to know, including brand name, mechanism of action, side effects, and contraindications.  I love a good chart, and these made studying so much easier.  

Bate's Physical Examination - This is basically the go-to book for learning how to do a proper physical exam.  It was required by my program, and my husband used it as a reference in medical school too even though it was never recommended.  There's pictures and great explanations for any part of the physical exam that you can imagine.  And there's even a pocket version as well.  

Lange Q&A Book - This was my main book for practice questions.  Doing questions and attempting to apply the knowledge I'm trying to learn has always been the best way for me to evaluate where I'm at.  I used this book during the clinical year and studying for the PANCE, but I wish I had it for didactic year as well.  The questions cover all subjects, and have awesome in-depth explanations.  

Tarascon Pocket Pharmacopoeia 2015 - Shirt version and White coat version - This is another reference book you can use on rotations.  I know you have Epocrates on your smart phone, but I liked having this book as well.  It's really easy to find what you're looking for and they update it every year.  

Basic Concepts in Pharmacology - This is a small book, and it has really short and straightforward chapters about different drug classes.  I liked to read the relevant sections before Pharm tests as just a quick overview.  I probably just need to read this book every month to retain some of the knowledge from PA school.  Sometimes it feels like all I prescribe are topical steroids and acne medicine! 

First Aid for the USMLE Step 2 CS - If you have physical exam or practical examinations with standardized patients, then you need this book.  This is another one that I unfortunately did not have while in school, but it would have made my life so much easier.  I spent hours trying to come up with practice cases, and come to find out, here's a book with everything I was looking for.  There are checklists for each case, and you'll need a partner to get the most out of this book.

Pance Prep Pearls - This book had just come out when I was in study mode for PANCE, but a few of my classmates did use it, and they passed!  I've heard a lot of buzz about this book recently, and I definitely plan on using it when it comes time for me to recertify...in 8 years! 

Here is a blog post from a fellow blogger with her recommended resources, some of which are the same as the ones you will see here.  

Clinical Year: Pediatrics

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There are a couple of rumors that go around about pediatric rotations.  I heard them multiple times, and I've heard them from students in all different programs.  

  1. The parents are the worst part of working in pediatrics.  
  2. You will definitely get sick while on this rotation.  

Unfortunately there is some truth to these rumors.  Most of the time parents are fine, but every once in a while, there will be one that is very difficult to deal with, but they weren't that bad.  And I definitely got sick because kids don't even try to not cough or sneeze in your face.  I felt kind of bad for the last week of my rotation, so after multiple negative strep tests, I went to the student health clinic. Just a mild case of pneumonia, but that was resolved with some steroids and antibiotics.  And I learned my lesson and decided I should probably go to the doctor if I'm feeling bad for a week or so and it's not getting any better.  

My pediatrics rotation was at a small clinic in town.  All of the staff and the physician are hispanic, so about half of our patients were mostly Spanish-speaking.  I took some Spanish in high school and college, but I am in no sense fluent.  I can understand some things and carry on a very basic conversation.  So that was a challenge, but I tried!   And everyone was really nice and understanding about my lack of ability to communicate.  

My preceptor was a great teacher.  He had been practicing for years, and had seen some tough cases.  He liked to pimp me, whether we were in the room with patients or during lunch, and his questions were extremely specific.  I rarely knew the answers, but I would always try, and I learned a lot.  He was always nice when I didn't know too.  We had a document as a class with notes of questions he had asked other students in the past, so I tried to study that, and it helped me to get a few right.  There are so many strange congenital defects and diseases that it's impossible to feel prepared to know them all coming out of PA school.  We learn the basics.  

Kids can be tough.  If they're sick, then they are already upset and really don't want you messing with them.  I think its's hard for them to realize that you just want to help.  Some kids will automatically start sobbing when you come in the room.  I learned to look for tears because otherwise they are just putting on a show.  There are a lot of well checks, along with the sick visits.  

One of the interesting things I got to see on this rotation was a child with chicken pox, which my preceptor said he hadn't seen in a few years.  It was a textbook appearance, but it's become very rare to see it in clinic.  The pt was about 2 weeks away from getting her chicken pox vaccine.  I also saw a teenager in sickle cell crisis, which seemed to be very painful.  He had experienced it before and really needed to be at the ER, but it was still a good thing for me to see.  

I enjoyed pediatrics, but it was a little exhausting as well.  My preceptor would just hold kids down if he really needed to, but he was a big guy, and I'm not.  Even now I don't even try to restrain kids while I'm treating them because I usually end up getting kicked or not being able to do what I need to do.  In dermatology (at my practice), I do get to see a good bit of kids.  I think if that's all I saw, I wouldn't like it as much, but I do like getting to see them occasionally.  

Here are some other resources to check out as well:

  • A blog post about a student's experience during pediatrics

Clinical Year: Internal Medicine

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I'll go ahead and say this was one of my least favorite rotations, not because of the area, but because of where I was.  Just a disclaimer. 

My internal medicine site was an outpatient clinic that also took care of multiple nursing homes and did home visits, so I spent some time at those as well.  There was an MD and a PA in the office, and a PA who only saw nursing homes and home visits.  

Over time, the site I was at had somewhat transitioned into a pain management clinic, which is questionable territory for an IM practice.  There were a lot of suboxone patients (a medicine to help patients addicted to pain medication) and a lot of chronic patients, some who were getting over 300 pills of hydrocodone or oxycodone a month (if that sounds a little excessive, it's because it is).  This practice also regularly prescribed drugs for ADD and weight loss.  There were also some regular IM patients just coming for check-ups, but not as many as I would have expected for an internal medicine residency.  

Anyways, I definitely learned a lot during my month there.  They would call me to come and do every physical and rectal exam.  Lucky me!  (Thankfully, I don't have to do those in dermatology, but I got plenty of experience there.)  It was the 2nd day when I was let loose to go see patients on my own, and when I started to feel slightly uncomfortable.  Everyone was very nice, but after presenting to either preceptor, there were times when I was encouraged to go forward with my treatment plan and let the patient go (without them ever seeing the patient).  That is just not appropriate.  I was a student.  I learned to stand my ground and I let them know that I was not comfortable with that.  I also let my clinical director at my program know what was being encouraged.  

The good things about this rotation were I got lunch everyday because if there wasn't a rep on the schedule, they would call around and find one.  I did get to see a lot and I learned a lot, especially about pain management and being in uncomfortable situations.  That physician has recently lost his DEA license, so I think that speaks a little bit to what was going on.  

So this is an example of how where you do your rotation can make a huge impact on your feelings for the specialty.  If you have a bad experience, you may want to consider doing one of your electives in that area just to get another look in a different place.  And again, never do anything you aren't comfortable with and tell your program if you feel like a rotation site wouldn't be good to use in the future.  

Some other blog posts and articles that may be helpful: 

  • A blog post with an interview with a cardiology PA
  • A blog post with an interview with a nephrology PA
  • A blog post about a student's experience on her IM rotation.  And some recommended resources.  

Clinical Year: Endocrinology

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At my program, we had 8 weeks of internal medicine total and could break it up into 2 separate 4-week rotations.  I did one of mine in general IM and the other in endocrinology.  My initial thoughts about endo were that I didn't know that much so I needed to do it, and lots of diabetes was in my near future.  

So what I learned on this rotations is that I was right that I didn't know much and that endocrine does see a lot of diabetes, but there's a bunch of other stuff too.  And there's a lot more to diabetes and treatment than we learn about in school.  Probably because they have new drugs and insulin more often now.  

My rotation was about 30 minutes away in a small town, and the office was a really cool old Victorian house (which I later found out was apparently haunted).  There was a physician and a PA and I was able to spend time with both of them.  The MD at this practice was a little picky about things, and would have a mini breakdown if you happened to forget the patient if they were taking aspirin or another minor detail.  I would always remind him that the patient was still there and go ask as promptly as possible.  Interesting dynamics in that office.  

There is a huge lack of endocrinologists right now, and that need is just going to grow as America continues to lack understanding about their health.  The patients would come in and have vitals done, occasionally a DEXA bone scan, and then be seen.  It's really important that diabetes patients keep a good record of their blood sugars, meals, and medications, especially if they are uncontrolled.  I would say about half of the patients actually brought these with them, which was a little frustrating.  The office I was in would do something called continuous glucose monitoring on patients that were having trouble getting their sugars under control.  Basically they wear a monitor for 3 days that takes periodic measurements of their blood sugar and then provides all kinds of graphs.  These can be done from blood glucose monitors too, but take a little more work.  If the patient is diligent about recording their meals and medications, that data shows when they may need more or less insulin or what meals they need to adjust.  It was really neat.  

Besides diabetes, there were also a lot of thyroid issues.  Whether it was hypothyroid or hyperthyroid or thyroid nodules or masses.  The MD had an ultrasound that he would do on patient's thyroids and he also performed fine needle aspiration biopsies as well when needed.  Those were very neat to see, and similar to what I had seen on my surgery rotation for breast mass biopsies.  

I went into this rotation thinking I was going to hate it, but I actually ended up liking it a lot.  In fact, I think if I wasn't working in dermatology, I would have looked for a job in endocrinology.  My husband is a 4th year medical student applying to internal medicine residencies right now, and I secretly hope he ends up doing an endocrine fellowship so I can work with him some.  I considered endocrine "lab medicine," and while labs are important, it's also important to talk to the patients and educate them on their disease state.  Unfortunately, I never saw the ghost of the little girl that had been seen multiple times in the office, but that's probably for the better.  I think doing this rotation helped me on boards a ton, and gave me a much better understanding of diabetes medications and interpreting thyroid labs, so I would definitely recommend doing one if you can!

Clinical Year: Emergency Medicine

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Going into my Emergency Medicine rotation, I was a little apprehensive.  I mean, anything can walk through those doors right?  At this point about halfway through my clinical year, I wasn't really thinking of myself working in the ED.  

The hospital I was working at was a smaller one, where there are usually 2-3 physicians and 2-3 PAs or NPs on at any given time.  My preceptor was great!  He loved to teach, and if we had any downtime, he would try to fit in a quick lesson about one of the many essential topics in the ER.  Everyone at that hospital was so nice and helpful.  I was the only student there and if anything interesting came in, the nurses or physicians or PAs would always come and get me.  

Basically the way the ER works is that a patient comes and signs in and they are triaged.  Their name and chief complaint are displayed on the provider's computer, and then each MD or PA decides who they are going to pick up.  It's important to keep a good balance of straight forward cases (like a cut that needs sutured) with more complicated cases that will require labs or imaging.  Since I was there, my preceptor would usually pick up 2 cases at a time and I would go see one patient while he saw the other.  

I was definitely right in assuming that the ED is unpredictable.  There would be some days that we were sitting around with not much to do, and then other days that there were so many patients, they were being treated in the waiting room.  Literally, one of the PAs would go in the waiting room, and if there was something simple they would treat the patient there.   Since the shifts are usually 12 hours, there would often be busy times and slow times during the same shift.  I ended up staying late a few times, just because it had gotten so crazy by the time I was supposed to leave.  

Working in the ER is a really great opportunity to see a lot of different cases and also to practice a lot of skills.  It's not the time to be shy.  If they give you a chance to do something, and you feel comfortable, then go for it!  There are so many skills I got to practice or see during this rotation, that it was extremely valuable.  I'll list a few off just so you can get an idea:

  • Suturing a cut from a chainsaw - I did this all by myself!  My preceptor said he would come check on me, but I finished before he had the chance.  I had a little suturing practice from my surgery rotation, but those were cleaner cuts.  My patient was really nice, and I remember his son was there and they were watching a show about puppies on the Animal Planet, which didn't seem quite characteristic, but was funny.  
  • Lumbar puncture - I was able to see an LP on a 4 day old (which was really hard to watch), and practice on a pt with advanced diabetes who we suspected might have meningitis 
  • Start a central line - My preceptor helped lead me through this one because I had only ever done it on models, but he helped me to find the femoral artery and go through the process, so that was really cool.  That's not something they do a ton at the ER I was at, so I was glad I got to see it
  • Intraosseous IV - I performed this on a pt who was currently having CPR done, and both efforts were unsuccessful unfortunately.  You really want to make sure you go in at a 90 degree angle to have a successful intraosseous IV
  • Remove a fishing hook from a pt's neck - Definitely interesting.  I just used a pair of pliers that look like they came from my dad's toolbox.  The pt did great though! 
  • See CPR - I didn't actually participate because by the time the pt got to the ER, the respiratory team was bagging the pt and they had the LUCAS machine on that does chest compression.  Pretty crazy to watch.  
  • Staple a child's head - Not the most fun, but good practice for working on kids.  You just have to be fast and hold them as still as possible.  
  • Drain a cyst - This was good practice for my current job in derm.  I still hate draining cysts.  The smell is just too much. 
  • Set a broken radius- I don't do well with bones.  Like those videos with people breaking their arms and legs?  I just can't handle them.  So when an 8 year old has a broken arm and they asked me to set it, I said sure just like any good student would do.  And then I almost passed out.  Whoops.  The feeling and sound and the MD "recreating the injury" to then put it back into place after I failed, that just didn't work for me.  So I turned sheet white and started blacking out as I ran out of the room to find a place to sit down.  I got made fun of just a little bit for that one.  
  • Watch a dislocated hip be realigned - More bones.  This was after the arm, and once the MD was standing on the bed and pulling on the patient's leg, I just decided to look at the ground.  But I heard it go back into place! 
  • Pop a dislocated shoulder back into place - For some reason I handled this ok.  It wasn't that bad.  Basically you pull down on the patient's arm, and then rotate their arm backwards and up and it slides back into place.  

So by the end of my ER rotation, besides the bone stuff, I really felt like I would enjoy working in that field.  I really liked the hospital I was at, and it would be a wonderful place to work.  Of course, in the ED, you get some drug seekers and difficult patients, or patients who really should just be at prompt care, but what can you do?  All of that is really just a part of medicine, so we deal with it.  The one thing I didn't love about the ER was the long shifts.  I felt like I went to work, came home, ate, slept, and then did it again for 3-4 days in a row.  So it was pretty exhausting, but I think it would be something you get used to if you do it all the time.  

Other Resources:

  • Here is a blog post with an interview with an ER PA.  And another one as well.  
  • "Advice to New Interns" - or to new PA students on rotations.  
  • ALiEM (Academic Life in Emergency Medicine) - This is a site with great articles and videos about emergency medicine
  • Here is a blog post from a fellow student about her experience and tips for an ER rotation.