Tips for Rotations

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 So once you've successfully completed your didactic year of PA school, it's time for the clinical year.  This is an exciting time because you finally get to put your knowledge and skills to the test and it's so much easier to remember a disease or medication when you see it in practice.  Most PA programs try to incorporate some clinical time during the didactic year, but after that it's no more classroom time, which is awesome and scary!  Here are some of my tips for making the most of your clinical year.

  1. Be confident. You've worked hard to get to this point, and although you might not feel ready to see real patients, you are likely more prepared than you think.  So trust yourself, and trust that the answer you're unsure about might just be right! Or it could be wrong, but there's no harm in getting an answer wrong and you'll at least learn something in the process.  I got plenty of answers wrong when being "pimped" (this means quizzed) by preceptors, and there were times I didn't answer out of fear of being wrong and I would have gotten it right!
  2. Be honest.  When your preceptor asks you a question, whether about yourself or what field you want to work in, just give them a real answer.  I thought at first I should tell all of my preceptors that I wanted to work in their specialty so they would give me a job, but that didn't work. What did work, was when I started saying I would actually like to work in Dermatology or Surgery, and then my preceptors helped to use their connections and that's how I ended up with my job.
  3. Ask questions.  If there's something you don't understand, then ask about it.  As a student in a new setting, it can sometimes feel like you're in the way so you try to be invisible.  Most preceptors are not getting paid to spend time with you, and even though some will try to use you like free labor, a lot of the physicians and PAs love to teach and want to pass their knowledge to you.  The only problem is they may have been practicing so long that they assume you know things that you may not.  This is your education, so get the most out of it by asking the experts while you have access to them as a student.
  4. Be helpful.  Having a student can slow physicians down at times, so try to be helpful when you can.  Whether that's going to get printed prescriptions, doing tasks that you think are pointless (like making copies for the psych resident, but that's another story), or setting up for a procedure.  Try to think ahead and do anything that the nurse or MA might do if they are not around to do it.  Sometimes PA or med students feel these tasks are beneath them, but really it makes you look good to show that you are willing to do some grunt work.
  5. Be nice to everyone.  You are a guest and need to keep that in mind.  Whether its the nurse or the front office staff or the drug reps, kindness goes a long way, and you'll likely need their help at some point during your rotation.  This goes for other students you may be on rotations with as well.  You don't want the reputation of someone who isn't supportive of their colleagues, or the "gunner" (someone who goes out of their way on rotations to show off or look better than someone else).
  6. Be professional.  This should be common sense, but no matter how close you get with staff or other students on a rotation, stay professional.  As in don't bad mouth the doctor or staff ever, dress appropriately, be on time, and don't complain.
  7. Know your boundaries.  As rotations go on, towards the end you'll feel more comfortable with what you're doing, but keep in mind that you are still a student.  Sometimes preceptors will forget this or not take it into account as they should.  Just be sure not to do anything that could get you into trouble.  On my internal medicine rotation, it became very common for the preceptors to tell me the patient could leave after I gave my report and potential plan, which is not appropriate by the way.  I would have to say, I really think you need to see the patient and confirm my plans or diagnosis.  So don't be afraid to say no if there's something you don't feel you should be doing or if you don't feel you're getting adequate supervision.  And if you are ever put in a situation where you're asked to do something inappropriate for your skill level, tell your clinical directot so they will know the practices that are in place.
  8. Be bold.  Again, you are there to learn, so if there's a chance for you to do a procedure or take a history and do a physical, go for it!  As long as you feel comfortable(see #7 above) and are capable, take every opportunity given to you.  And as long as you have someone supervising and guiding you, there's no reason to pass on a chance to learn a new skill.
  9. Keep PANCE in mind.  So once clinicals are done, there's boards.  And if you thought the first year of PA school went by fast, then the clinical year will fly by.  As you study for end of rotation exams, really think of it as practice for boards, and use this to focus your studying.

I hope these help to get your mindset ready for your clinical year, and congrats on making it this far!  You're on the homestretch!  I'm going to start doing some specific articles on different rotations during clinical year, so if there are any specific questions you have please leave a comment!

Here is a blog that has some posts about a student's experience while she was on rotations.  And here is a different blog with tips gathered from 2nd year students.