Guest Post from XO Hollyd. - Preparing for Life After PA School Graduation

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So, you’ve finally made it through didactic year, and are starting to get the hang of clinical rotations – I am so happy for you! But now what can you do to start preparing for after graduation, you know that thing you thought might never happen (or is it just me?!)? Here is a list I compiled of things to consider as you move toward graduation and becoming a PA-C. Keep in mind that this is non-comprehensive, but covers the big things that I found important to do or know about in the process of myself becoming a new PA-C.

6 months before graduation

Start determining how and when you will be studying for the PANCE. Decide if you are going to attend a board review course. I did, and got a lot out of it, but several of my friends did not and still passed their boards. It really is a personal decision. I decided it was the right choice for me because I wanted a little more confidence and a little less anxiety going into the exam. I used CME Resources, which was $750 for a 5-day course, and I thought it was totally worth it! Don’t forget to add in the cost of the binder ($50) if you want it, as well as the hotel/flight if you are traveling to attend, and money for dinners every night (breakfast and lunch were provided, but double check with your specific review course). Each course might also be a little bit different, so be sure to check out the specific itinerary and details on their website.

6 months before graduation (or later)

Start looking for jobs! There is quite a lot of variance among when students begin to look for positions, but most in my experience tend to have a job lined up prior to graduation or around graduation. However, that doesn’t mean you have to have a job before you graduate! Some students I knew waited until after graduation to start applying for positions. There are so many jobs for PAs in my experience, so you can really take as long or as short of a time finding and accepting positions. However, if you have a specific specialty, location, or any other perks that you are adamant about having in your first PA position, I’d say jump on them because the position may or may not be there when you decide you are ready to apply. Again, it’s a completely personal decision. I applied about 5 months before graduation, had my interview about 3 months before, and accepted the position 2 months before I graduated. Once you accept a position, there is a bunch of credentialing paperwork that your specific employer will send you, in my experience it comes in increments because of the massive amount of information they need. Be prepared to provide a lot of information that you would typically need for any job you’ve had in the past, as well as completing background checks, drug screens, and a check/update on your immunization status.

3 months before graduation

You are now eligible to register for the PANCE exam, or your certifying exam. Your program has to authorize you to be able to do this, but once they do you can register for a location, day, and time to take your PANCE. The cost was $500 when I took it in June 2018. You are eligible to take the PANCE 7 days after graduation and can decide to do it a week after graduating or wait a few weeks like I did. Again, a personal decision, and I waited so I could attend a board review course prior to my exam. It takes about 1-2 weeks to receive your scores back after taking the PANCE, so relax and enjoy your time until then! No need to stress about scores until you see how you did. Here is the link to the description of how many times you can take your PANCE: http://www.nccpa.net/pance-registration  This is the website where your register to take your boards and pay for them, as well as where you will keep track of your CME credits and certification in the future. 

Received Your PANCE Pass E-Mail?

After you’re officially certified (YAY!), now you can start submitting your state board licensing application(s) which allow you to practice as a physician assistant in that particular state. For me, I applied to the State Board of Medicine and the State Board of Osteopathic Medicine because I will be working under both MDs and DOs. Depending on your position, you might only need one or the other, or both like I did. The website you will visit depends on the state in which you plan on practicing in. You can find a list of state boards on AAPA’s website through this link: https://www.aapa.org/advocacy-central/state-advocacy/state-licensing/list-of-licensing-boards/ . This process can take quite a while to both submit and obtain approval for your license depending on the state you plan to practice in, so you should try to do this as quickly as possible without compromising your application. Some suggestions: if you find it is taking longer than expected and you need your license in order to start your new job, try calling your personal state representative and explain to them that you are trying to get your licensing process moving along. I’ve heard many success stories of new PAs waiting for months to have their license approved, but as soon as they contacted their state representatives, they had their license shortly after! I personally contacted my representative after about 6-7 weeks of my application being submitted and having no updates coming in from the state.

You may also need to obtain your National Practitioner Data Bank Self Query for state licensing, which can be found here: https://www.npdb.hrsa.gov/ .

At this time, you can also apply for your National Provider Index number, or NPI number. This number is specific to you and allows you to be identified as a healthcare provider in the United States. Attached is a document providing additional information on the NPI number: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/downloads/EnrollmentSheet_WWWWH.pdf

After obtaining your state license

Now it is time to obtain any additional licenses you may need. Typically, your employer/credentialing specialist will inform you of anything you might need in order to work for them. For me, I had to obtain my DEA license. This license cost me $731, and you must renew it every 2 years. Some employers will pay for it, so make sure to double check! Prior to receiving your DEA license, your employer will also have to submit a Written Agreement to the state, which basically states the physician you will be working under, your provider insurance, and what you will be allowed to do under this provider. This Written Agreement must be approved, which then gives you an Mx number, which links your DEA license to your supervising physician and allows you to prescribe the scheduled drugs that have been agreed upon by your supervising physician and yourself. This portion was a little confusing for me, so I could be unintentionally omitting or confusing information, but the general process and materials that you need to submit are accurate.

The process of obtaining all of the necessary licensing and credentialing documentation is definitely a lot, but remember that most company employers will have a licensing and credentialing specialist that will be assigned to your work load. Typically, you can contact them with any additional questions you might have.

If you’ve got some extra time to kill before starting your new position

Relax, do something for YOU (you deserve it after these past few years!), read up on the specialty you’ll be working in (in the most leisurely way possible – don’t stress too much because you’ll be learning a bunch on the job as well!), or you can start to aquire some CME credits. I personally used Medscape and linked them to my NCCPA account once I read journal articles and answered questions, but you can really use any website that is approved for CME credits. Just make sure that you register your credits as soon as you complete the activities so you don’t forget about them! CME credits need to be completed every 2 years, and you need at least 50 category 1 CME. Most online journals count as category 2 CME, but you can earn up to 50 this way, and why not get a head start if you’re feeling up to it! 

I hope this helps to ease some of the confusion and anxiety surrounding becoming a PA-C with all of the appropriate licenses and paperwork. Good luck in your new job! Go show the world what an amazing PA you are going to be!

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Holly is a newly graduated PA just starting in Neurology. She graduated from 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!

PA School Spotlight: Pace University-Lenox Hill Hospital Physician Assistant Program

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Huge thanks to Kat for kicking off our new blog series. These PA School Spotlights will give you some insight into what PA school looks like at different programs. 

PA Program:  Pace University-Lenox Hill Hospital Physician Assistant Program

How long is your program and what quarter/semester are you in?:  26 months from July to end of August

  • 4 semesters of didactic (1st summer, fall, spring, 2nd summer)
  • 3 semesters of clinical (fall, spring, 3rd summer)

I'm just starting my 5th semester: my first rotation is Behavioral Medicine

Class size:  ~75

Why did you apply to your program?:  

  • Wanted to branch out of my comfort zone (small town, little exposure to diversity, etc.) and knew I would get that in NYC
  • Association with a great hospital (Lenox Hill Hospital) and great rotation sites (besides Lenox Hill: NYU, Columbia, NYP, Memorial Sloan Kettering, Mount Sinai, etc.)
  • Fit with my stats well and no rolling admissions: when I applied this program had a low requirement for PCE, which was conducive with where I was with my clinical experience at the time of my application; the lack of rolling admissions meant I could keep gaining experience but didn't make me sink in the applicant pool since they review all applications starting September 1st

Why did you end up choosing to attend your program?: 

  • Felt the "vibes" at my interview: many students are on the younger side, which I could relate to, and the atmosphere at the interview was very relaxed
  • We get some clinical experience in the didactic year at Lenox Hill Hospital (LHH)
  • Great sim labs and standardized patients are very good at acting since it's NYC!
  • Though NYC was foreign to me, the area where my school is is very safe!

Is there anything unique about your program?: 

  • The opportunity to go to LHH during didactic a couple times
  • 100% PANCE pass rate for the past 8 years!
  • Great access to amazing medical institutions

What is your favorite study resource?: 

For didactic:

What is the most difficult or surprising part of PA school?: 

  • VERY different workload compared to undergrad, but more enjoyable, since every class is very important and is conducive to caring for your future patients - you're motivated to pay attention when everything is in the perspective of another human being
  • 2-3 exams a week were overwhelming at first (enter "Sucktober" in the Fall), but I was surprised how well I acclimated to the same crazy schedule as soon as Spring semester started

What advice would you give to other PA students?: 

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  • Take it ONE EXAM AT A TIME!
  • Make time for what you make a priority - for me this was health and fitness, so I meal prepped on the weekends and made 45 mins-1 hr a day x 5-6x/wk to exercise
  • Believe that YOU can do this! Remember: PA school is only temporary, so work hard and enjoy it the most you can :)

Where can we find you?:

The best place to find me is: @stethoscope.kat on Instagram!


If you're a current PA student and would like to share about your program in a PA School Spotlight post, send an email to savanna@thePAplatform.com or use this link to contact us at The PA Platform now.

Dear PA School: A Letter For PA Students

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Hi everyone! Thanks for reading! My name is Tiffany Andrade and I am a new graduate of Northeastern University's Physician Assistant Program. Prior to PA School, I obtained my Bachelors of Arts degree in biology from Hamilton College. After taking my PANCE this summer, I hope to practice at a large academic medical center in Boston. I am looking forward to building longstanding relationships with patients and helping them achieve their healthcare goals. I am always looking for opportunities to connect with other PAs and would love any comments about this piece! 


Dear PA School,

Did you know that everyone agrees that the time spent with you is the worst time of our lives? You constantly challenged my endurance, patience, and stamina. Keeping up with you was more than intense, it was insurmountable at times. Despite the number of times that I felt defeated and overwhelmed, I always reminded myself that I chose to have you in my life. Although you were accompanied by the worst of emotions including anxiety and what DSMV would definitely classify as depression, I still find you to be one of the best challenges of my life. With you, I learned the true meaning of endurance and achievement. Within 2 years, I learned over 300 diagnoses, passed over 60 exams, treated over 1,000 patients, met over 30 clinicians, assisted in over 20 surgeries, and learned to perform over 15 procedures. But I didn’t do this alone, I was accompanied by 38 other people who also endured on this journey to getting to know you. Without them, the journey would have been quite traumatic. I always sought comfort in knowing that there were 38 other people alongside me who were equally scared, yet motivated to stay on this rocky road with the hopes of climbing this mountain. Upon deep reflection, I wanted to let you know that you’ve taught me lessons that no other life event taught me. This letter is addressed to you with the deepest gratitude because without you, I am unsure of when I would have learned the following lessons: 

Lesson learned #1: You know more than you think you do; Trust yourself!

There were numerous encounters where I was asked a question and was somehow able to produce the correct answer within seconds! It was often the first thought that appeared in my head and it was correct! I can tell you that I impressed many of my preceptors with this but had no idea that I possessed the answer! I’ve always struggled with my confidence as a clinician and these moments served as a thoughtful reminder that I am prepared and know more than I think I know. Was this a result of a well-built curriculum? I would say so and the dedication of the volunteers and administration that share their clinical insight and experience with us. So thank you PA school for restoring the inner confidence I know I always had, but needed a boost to unveil.

Lesson learned #2: Know your limits and always ask! There are no stupid questions.

I’m not sure what it was, but I have a fear of asking questions. I think it may be a combination of fearing the perception of being stupid or embarrassment. News flash! If you do not ask questions, you don’t learn and you will likely make a mistake that might potentially compromise the safety of your patient. This point was made clear to me by a surgeon at Faulkner and I thank him to this day for making me realize that ignorance does not equal bliss. Humility is what makes us great clinicians. The ability to identify what your limits are is far more insightful then ignorantly approaching a clinical situation with a fear of asking for help. After all, it is a team sport right? I vow to ask questions no matter how ridiculous they may seem with the intention of learning. Thank you PA school for this life lesson. 

Lesson learned #3: “Success is a journey, not a destination”

I cannot count the number of times that I questioned whether this career was appropriate for me.  I often thought that I could fall back on some amateur talent of mine if this didn’t work out. But then I realized that my worries rested on the end destination: becoming a PA-C. I wanted to hurry up and reach the finish line without facing all of the challenges in between. But I’ve come to learn that there is beauty in fear, disappointment, and anger. Once I realized that these experiences are collectively part of the journey, I enjoyed every bump in between. Every rotation offered an item that I could add to my toolbox and skillset. Each encounter offered a new friendship and meaning to what makes this career so worth-while. 

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In closing, you were essential to my growth over the last 2 years. You have truly made a positive imprint in my life and I want to thank you for all that you offered me. I will deposit our relationship into my memory bank and reflect upon them throughout my entire career as a PA. I look forward to recalling these memories and using them as frequent reminders of why and how I became a PA. 

Sincerely,

Tiffany Andrade


PANCE Blueprint Breakdown: Normal Physiology of the Heart

Jamie's back with a very basic overview of normal heart anatomy and physiology to serve as the basis for pathology like cardiac murmurs, hypertension and heart failure. Check out her video, and you can get the notes and powerpoint below. If you're viewing this as an email, here's a link to the video


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! This post contains some Amazon affiliate links. 

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.