The Death of M&M

Hello gang!

Long time, no see. I've been wrapping up my ER rotation and working on my thesis, all while juggling several other projects. No worries; I head home in one week. No rotations, no studying...just me, my family, and some good home cooking!

Today marks an important day in the life of this blog. For almost 4 years it has served as my outlet. I have enjoyed very much the opportunity to use this platform to communicate the struggles and triumphs I have experienced as I abandoned my musical life and chose to take the leap that landed me into PA school. I couldn't be more happy.

I hereby announce the death of Music and Medicine. It will remain up and running so that others may benefit, and so I may visit frequently to remind myself of how far I have come. I am moving on to higher ground; I'm hoping to take some of you with me!

Introducing my newest venture: GetIntoPAPrograms.com

We've put a lot of blood, sweat and tears into this project to ensure that this site provides timely, relevant information in a refreshing manner. Check us out and spread the word!

Stacey

Rotation 6: week 1

One word: Fantastic!

I'm enjoying the crazy world of Emergency Medicine so far. I've done and seen so much; I'll have to spend this weekend giving you all the details. Stay tuned!

The new website is almost up and running. Those of you who frequent this blog will be the first to see it. I hope it is helpful to those of you who are still chasing the PA school dream. It's been a blast putting it together.

Take care!

BIG ANNOUNCEMENT!

Hello readers!

I am happy to announce that I am currently working on a new and improved website. My hope is that the new site will serve as a hub for prospective PA students who are looking to put together impressive applications in hopes of securing a seat in the program of their choice. I'll also continue blogging about my clinical year experiences. Only 4 more rotations to go!

I love teaching and sharing information, and that's what the new site is all about. You can expect the same quality material you've seen here, just more bells and whistles...and a few surprises that I'm really excited about.

Stay tuned!

Rotation 5: week 5

Tomorrow I complete my Psychiatry rotation. It's been such a wonderful experience. The world of psychiatry can be a bit intimidating, but if you approach it with an open mind, it just might change your life.

I was given the opportunity to present Abraham Maslow's hierarchy of needs to didactic PA students one month ago as a guest speaker. I love to teach; in fact, I intend to teach as an adjunct professor in the future. Click here to read the blog entry I wrote about Maslow a few months ago.

I am reminded of Maslow and his hierarchy every time I interact with a patient in the Behavioral Health Unit. So many of them are homeless, penniless, and without family support. How, then, am I to expect a miraculous change in their behavior when their basic needs are not being met? How can I become upset with them when they tell me they haven't taken their medications, or haven't been to a PCP in decades? Maslow's work has really changed my life and the way I approach patients.

I'll be sad to leave this rotation, but I know that the field of psychiatry penetrates and permeates every single medical and surgical specialty. We will meet again soon.

ED...here I come!

It's 1:22 AM. I'm gonna hate myself when my alarm clock goes off.

A fellow reader wants to know what's next on the clinical agenda. I'm hitting the road again. Next up is Emergency medicine in rural West Virginia. I am very excited. Psychiatry is all about the gift of gab, but I haven't given injections, read EKG's, or even done a physical exam. I look forward to using my clinical skills again.

Graduation is so close that I am considering options for employment. There are so many options to choose from, which is exciting. Because of the detective and our way of living, all options are pretty much wide open. I am in a wonderful place in my life right now! I'll be sure to keep you all posted.

Good night...er, good morning?

Rotation 5: weeks 1 - 4, and a much needed facelift!

Hello Readers!

Today marks week number four in the world of inpatient Psychiatry. Yes, I entered the hospital for the first time with my eyes and ears wide open and my remaining senses heightened. It took no time at all for me to feel comfortable being on a lock-down unit with patients with diagnoses ranging from paranoid schizophrenia to suicide ideation.

Psychiatry is not for the faint of heart. Sure, there are no codes being called or MI's being diagnosed. The beauty of psychiatry is in the dialogue. It's amazing what people are willing to talk about with people they trust. Sometimes you win trust without even trying. Sometimes it takes days or weeks. My favorite patients have been the ones that scare the nursing staff the most: the antisocial personality disorder patient who is super aggressive, confrontational, and self-mutilates to escape his emotions, and the depressed/suicidal patient who feel larvae growing out of her hair, arms, and legs. These are precious, precious individuals, who are battling illnesses not much different than cancer or heart disease.

I love talking to patients. The gift of gab comes in handy in this specialty, and I think that's why I've enjoyed it so much. Does that mean I may have a future in psychiatry? Not likely. I like to talk, but love using my hands.

The joys of Psychiatry

I am really enjoying my time on the Behavioral Health Unit. I wanted to really expose myself to the nitty gritty of psychiatric medicine. Boy, did I get it. I will share more detail soon.

Rotation 4: weeks 1-5

Good morning readers.

Today is the last day at my Geriatrics rotation. I can't believe I've been away from the blog for so long. Moreover, I can't believe that this rotation is already coming to an end. I loved it! The office staff is great, my preceptor gives me a lot of independence and he loves to teach, and the patients have been lovely!

I've seen everything from general check ups, to tongue cancer, to MI's. I've always known I had an affinity for the elderly population, so much so that I could work with them as a PA. I'm not so sure now. Polypharmacy is no joke...managing 14 medications and the possible interactions is time consuming and tricky. Not to mention all the other players that are managing different areas of the patients' care. Still, I have enjoyed the challenge over the past 5 weeks.

Next I head south for my psychiatry rotation. It's an inpatient facility, and from what I hear I'll be spending the majority of my day talking to people who suffer from schizophrenia, suicide ideation, bipolar disorder, etc. I can't wait!

Rotation 3: week 2

This week was more of the same with a few surprises thrown in. Lots of otitis media and swimmer's ear. Lots of URI's and strep throat. But I also got a chance to see my first case of herpangina. We also had a 16 year-old come in after sustaining a concussion, and a young girl came in and was diagnosed with an avulsion fracture of her right hip.

Unfortunately, it doesn't get much more exciting that that. The majority of my day is spent doing sports physicals. We are easily doing about 15 - 20 physicals a day, with sick visits and well check visits squeezed in between. Other than that, I try to stay on top of reading. As my former preceptor says, "Students can always read more." How right he is!

Student Case #1

We'll do two cases in one just for fun!

Pediatrics: 3 year-old girl presents with her mother with a 3 day history of fever, stuffy nose and cough. Fever has peaked at 103.4 F. What other history do you want to know? What kind of physical exam will you do?

Ob/GYN: 30 year-old G2P2 patient presents with irregular bleeding. What history do you want? What physical exam findings, if any, do you do?

Let's try to stick with history and physical findings for now, then we will move on the labs/diagnostics. I will only give you what you ask for!

Ready...set...GO!

Rotation 3: week 1

I've gone from measuring baby bumps, and C-sections to sore throats, AOM's, and sports physicals.

Despite the barrage of ear infections and common colds, I've seen some pretty interesting cases in Peds. A young girl, according to her growth chart, has developed microcephaly as a result of an accident sustained as an infant. An adolescent presented with a classic case of mononucleosis. And I've heard quite a few murmurs as well.

I enjoy doing sports physicals, partly because I enjoy adolescents and I like talking to them. Some feel comfortable having an objective ear listen to them gripe and complain about the woes of life. Others prefer talking to people their own age. Most times, I can at least make them laugh or loosen up before heading out of the office. Overall, the most upsetting thing I'm seeing in this population is obesity. I've never really liked that word. Fat works just fine, and to me it more clearly defines the problem. What's more upsetting is parents are in denial. Anyone who is fat knows they are fat. I don't have to tell them that! The challenge is doing something about it, and this is where physicians and PA's can really step in and offer guidance.

I always like to share my personal struggle with weight with patients. They look at me and think I've been a size 4/6 all my life. Wrong! I tell them how I lost 20 lbs and how I've been keeping it off. I tell them about the importance of weight training, especially for girls. More importantly, I share with them the importance of proper nutrition. You won't believe how many people eat at McDonald's for breakfast, lunch, and dinner, and think that because they ordered a diet coke they are eating "pretty healthy." I haven't eaten at McDonald's for over 15 years, and I think that has a lot to do with my success.

Lifestyle changes can be challenging to make, but it can be done...and fast! I've seen it work in my own life, and this is something I wish to impart to all of my pediatric patients, and all of my future patients. Change is the only constant. Why not make all change POSITIVE!

Week 2 in Peds is shaping up to be a good one. I do find myself eager to get back into the OR. I really miss it. My general surgery rotation is 6 months away, so I'll have to be patient. That's all for now!

Abraham Maslow

Don't know him? If you are preparing for a career in medicine, you should!

This topic deserved a post all its own. One of the greatest gifts given to me on this rotation is the Maslow hierarchy of needs. Needs...we all have them, and when left unfulfilled, they can wreak havoc on us in many ways. One of those ways is via health status.

When a 19 year-old girl with a flat affect, poor social skills due to molestation and abandonment issues, and a history of miscarriages comes into the office, and after delivering her daughter 10 months ago finds out that she is pregnant once again, think of Maslow.

When a 42 year-old woman who's in an abusive marriage comes in for irregular bleeding, think of Maslow.

When a 20 year-old homeless girl with a history of drug abuse, depression, endometriosis, absent parents, and abusive relationships refuses to be discharged from the hospital because she has nowhere else to go and likes Dilaudid, think Maslow!!

Practicing good medicine is treating the acute condition. Practicing great medicine is understanding the psychology behind the diagnosis. Often times I find myself wondering why patients do the things they do. Why do they take chances with their bodies. How is it possible for a young person to have such a long list of complaints. Why is she having another baby. The answer is Maslow. Understand that, and the picture becomes more clear. Medicine, whether you practice Psychology or not, is all about psychology. Talk to your patients and give them more than pills. Give them your ear. Let them know you are aware of the conditions they are in. Offer them assistance if you can. Refer them to counselors and psychologists. Most of all, let them be heard. If possible, work with them to fulfill whatever need that should be met. Do that, and the behavior begins to change. Do THAT, and the body can begin to heal itself.

Maslow's hierarchy of needs...look it up!

Rotation #2: weeks 4 and 5

My 125th post!!

Hello readers. I'm sad to report that my time in Ob/GYN is coming to an end. Never in my imagination could I have conceived a more articulate, compassionate, intelligent preceptor. Never in my wildest dreams did I ever think that I could fall in love with this specialty. I am sad to see the end of the week draw closer and closer. I know I have lots left to learn and that the rotations I have left will be phenomenal. I just love this hospital, these people, and most of all, my preceptor.

Still, as much as I love this work I still don't see myself working in this specialty. Not at all. I could do GYN all day long, but the Ob side is not the most exciting to me. I do, however, enjoy the OR, and I now know that whatever specialty I do chose to work in, there must be a surgical component to it. Surgery is like music in a lot of ways. You prepare in advance by learning your lines (the procedure), and before stepping foot onto the stage (the OR suite) you must put on your costume (gown, gloves, mask, etc.). The stage is set and once the curtains rise (drapes) it's showtime! And it really feels that way to me. I love it! There is a fanfare associated with the OR. You either love it or you hate it.

I've learned a great deal about myself on this rotation. I've learned that babies aren't so bad after all. I've learned that Ob/GYN is so much more than pap smears and Ob office visits. I've learned that being aggressive in this field is a good thing! I've learned that this really is something I can do for the rest of my life. I love being in the hospital, and I love working with people...the good, the bad, and the just plain ugly! I've seen enough 15 year -old mothers to last me a lifetime. I've diagnosed enough Chlamydia and Trichomoniasis to last my entire career. But the relationships that develop between me and my patients...that never gets old. It means a lot to have been given this much responsibility. It means a lot to touch someone and change their life. It means even more when, serendipitously, a patient touches you and changes your life.

Good-bye Ob/GYN, hello Peds!

Rotation 2: weeks 2 and 3

Sorry for the delay. Time is flying!

Two days into week three and I'm still having a blast. What am I seeing/doing??

vaginal deliveries and C-sections (my subcuticular stitches are looking nice these days)
OB office visits and follow ups
invasive cervical CA
dyspareunia and palpable pelvic masses
incompetent cervix
annual exams and Pap smears
lots and lots of GC/Trich/Chlamydia
ovarian cysts
suction D and C
endometriosis
adenomyosis
leiomyomas
hysterectomies

The list goes on and on. I remember seeing a middle aged woman who had a seven month history of painful sex. Her past medical history was significant, but she had no pertinent family history. On physical exam her abdomen was quite tender. I felt what I thought were small masses in her lowe quadrants. Because she had a partial hysterectomy, I skipped the speculum exam and went straight to the bimanual, and again, another mass measuring about 2 cm was felt at 6 o'clock. I suggested a workup to my preceptor and he agreed! It will be interesting to see what the scans show.

I find myself getting upset when I think of this rotation coming to an end. I'm in love with my preceptor and I'm doing much more than I thought I would be. This rotation has shown me just how much I enjoy surgery...and just how much I enjoy the clinic! I don't think I would enjoy OR work exclusively. The clinic allows you to practice medicine; to get to know your patients and to really put your education to use. I enjoy the process of eliciting a history, performing an exam, and coming up with a diagnosis. I also love using my hands! That's where my fondness of the OR comes in. I enjoy procedure work, and certainly one can do lots of it in the clinic. However, the parade that is the OR is an experience like no other. I look forward to seeing what specialty I find myself in this time next year!

Rotation 2: week 1

Here I am, one week into rotation number two: Ob/Gyn. I'm a little ashamed to say this, but I'm having a blast!

I've always known that I would never go into Ob/Gyn or Pediatrics. Neither one impresses me. However, I am extremely impressed with my preceptor. He is a true physician: smart, compassionate, available, and will say no if it's in the patients' best interest. I love working with him because I'm not only learning medicine, I'm learning the psychology behind the medicine and how important it truly is.

What have I seen this week. Everything! I've done annual visits and Pap and pelvic exams, and I've seen invasive cervical cancer, endometriosis, circumcisions and suction D & C's. I even saw my very first delivery, and was allowed to not only catch the baby (how awesome it is to be the very first person to physically touch/hold new life), but deliver the placenta and suture the mother's episiotomy! I get pimped constantly and I love it. I am realizing every day just how little I know about medicine. I have a long, long road to haul, but I will get there!

Once again, time seems to be flying by. I remember how eager I was to begin rotations. Then I remember how excited I was to go to Alaska. Now I'm in my second rotation with just 4 weeks left to go. I still pinch myself at times...I started out with a dream, and to watch it come to life in this way is fascinating and humbling all at once. I feel so honored to know what I know and to be doing what I am doing.

Week two promises to be jam-packed full of awesome opportunities and surprises. I can't wait!

Rotation 1: weeks 3 & 4

I’m having the time of my life here in Alaska!  The weather could not be better, the activities are endless, and now that the detective is here I have someone to share this all with. 

The clinic is keeping me quite busy.  I’m giving lots of  vaccinations, I’m getting really good at female pelvic exams (they’re actually quite fun to do now), and today, I did cryotherapy all by myself!  Amazing.  We see a variety of illnesses and conditions.   I truly feel like these are my patients, and I am honored to be taking care of them. 

Demographically, this part of Alaska is not very diverse at all.  The most diversity you will see is in the people who come off of the cruise ships and hang out downtown.  Alaska has the third highest population of Tuberculosis in the nation.  There is also a huge alcohol problem here.  Needless to say, I saw my first positive PPD last week, and I’ve seen a few alcoholic pancreatitis patients, too.  The majority of my time here has been spent seeing common things: viral illnesses, medication follow-ups, psychiatric disorders, minor injuries, annual well person exams, etc.  Last week a young child stepped on a rusty nail and got a Td shot.  I probably performed two to three Pap/pelvic exams each day.  And I gave lots and lots of shots…for kids who step on nails, for young adults who are heading off to college, and for older adults who are traveling out of the country.  While at the hospital last week, the radiologist and I came across a rare condition.  Pulmonary intralobar sequestration.  I had never heard of it.  The radiologist had only seen one other case in his career.  Fascinating stuff, and really interesting to see on CT.

Today marks the beginning of the end.  I leave Friday evening.  I hate thinking about it.  I have grown to love this place.  Has my time here been enough to convince me to pack up and relocate here?  Maybe!  I’m a pretty spontaneous person.  I love the idea of living here, but I don’t know about working here full time.  Perhaps once I become a hot shot PA I can do some locum work here.  For now that is the goal.  This time next week I will be on my way to Ohio to begin my Women’s Health rotation at one of the nation’s most respected hospitals.  It will be a lot of early mornings and late nights, and a lot of OR time, or so I hear.  I’m looking forward to a change of gears, and I’m really excited about spending the majority of my time in a hospital setting.

Rotation 1: week 2

This week has proved to be the busiest so far. I've been challenged in lots of ways. More than anything, I realized just how much I have to learn.

This week I saw everything from hernias, irregular menstrual bleeding, and sore throats, to allergic drug reactions, abscesses, and alcohol-induced pancreatitis. I even got to do my very first Pap smear and male genital exam. Cool! The most challenging case of all was a follow up interview with a grieving mother who had recently lost a child. This job is A LOT more involved than I thought it would be, and I guess the lesson in this is that we as future PA's do a lot more than stitch people up and give meds.

Alaska is a beautiful place. Could I see myself living here? Maybe, but not year round. The patient population is exactly what I thought it would be, and I am so happy that I chose to come here. The detective will be here next week. I've been dying to get out and explore all that Alaska has offer. I can't wait to share this experience with him.

Stay tuned!

Rotation 1: week 1

My first week here in Alaska has been absolutely amazing.  Aside from the snow-capped mountains and gorgeous weather, I work with the most inspiring, intelligent people.  I have a total of three preceptors, but I am learning so much from all the staff members.  Each one is so eager to share whatever knowledge they have, and that certainly is enriching my experience here.

Juneau is a small, rural town with a population of about 30,000.  There is one 55-bed hospital, and there are no cardiologists or Ob/GYN physicians.  There are a total of two radiologists who read everything from mammograms to ultrasounds to nuclear medicine studies.  The family practice providers deliver babies, do pap smears, suture minor lacerations, and everything in between.  The family practice clinic is the one stop shop for all medical intervention not deemed an emergency.  And I am so fortunate to be rotating in this kind of environment.  To work here one needs to be a jack of all trades.  There really is no such thing as specialization.  Everyone trains to practice medicine outside of their expected scope of practice.  The amazing thing is they all do a hell of a job.  I’ve never seen such competency.  I feel honored to be working with such intelligent, educated providers.

I spend four days of the week at a local family clinic and one day of the week at the local hospital.  I didn’t expect to be thrown into the fire so quickly, but my preceptor seems to think I’m more than ready.  So far, I’ve given vaccines, removed skin tags, heard murmurs, done breast exams, and seen patients all on my own.  At the hospital I work with the radiologist and look at dozens of films, scans and nuclear medicine studies.  What an opportunity!  I’m having the time of my life! 

It has been a challenge integrating all of the information I’ve learned in the classroom and applying it to a patient.  For instance, a young girl came in complaining of a cough, SOB, fatigue, myalgias, and sputum production.  On physical exam, her breath sounds were equal on both sides, however I heard abnormal sounds on the lower right section of her posterior chest wall, the same location that caused her pain when I palpated.  In the very same spot I heard egophony, and this caused concern for pneumonia.  She looked and sounded ill, but not toxic.  In retrospect I should have taken more time to listen, but I knew the sounds were abnormal as soon as my stethoscope touched her back.  I presented my case to my preceptor, and she immediately diagnosed her with bronchitis/walking pneumonia.  Not bad for the first case of the day, but my differentials need a lot of work.  I should have had at least five diagnoses on my list. 

This weekend I intend to rest and study.  My body still has not adapted to the 4 hour time difference.  I really haven’t had time to adjust, but I’m so busy when I’m at the clinic that I don’t recognize just how tired I am.  I love learning and I love using my hands.  My preceptor said to me yesterday, “You’re going to love being a PA!”  She’s absolutely right!

Sleepless in Seattle, headed for Alaska

Jet lag can be a killer. Especially when you're running on two hours of sleep. To make matters worse, I don't sleep well on airplanes. I don't know many who do.

I am currently sitting in the Seattle airport. One more flight and I'll be at my final destination. I'm looking forward to settling into my apartment in Juneau and acquainting myself with the area. More than that, I'm looking forward to a good night's sleep. It's not that I'm nervous, or even excited. I think I'm too tired to be excited. This past week has been so very busy.

I have no doubt that Alaska will be a wonderful rotation. My preceptor seems excited to have me work with her, and I am looking forward to being exposed to a rural population unlike any other in the country. I am to arrive at the clinic every day at 7:30am, except for Thursdays. Every Thursday I am to report to the local hospital to work with the Radiologists there. I am really looking forward to this opportunity.

As I embark upon this portion of my training, it is my intention to relay my experiences to the readers of this blog as clearly and honestly as I can without compromising the privacy of my patients. I hope you will enjoy reading as much as I will enjoy sharing. I start Wednesday morning. Stay tuned!

One more notch in my belt

Just completed ACLS training this afternoon, and now I am ACLS certified! And I feel like I know absolutely NOTHING.

Perfectly normal feeling, right? Many of you who are well into PA school can attest to this, I'm sure. The more you know and learn, the more you realize just how little you do know. Today as we ran mock codes, I found myself stopping and thinking about the algorhythms (which have recently changed a bit), second guessing my choice of drug and doubting that the intervention I suggested was correct, all while the "patient" lay there dying. Talk about pressure. It didn't help that the instructor at my station was sharp as a tack and tough as nails. I always manage to get the BEST instructors who give just a little bit more education that what is called for.

Again, it's all about integration. How can I take this piece of information that I learned months ago and apply it to this new information today. It's like building blocks, really. This is when medicine becomes fun! I have some fun moments. Moments when answers to questions just fly out of my mouth without a thought. And then I have not so fun moments when the only words that come to mind are, "I don't know."

I have many reasons for being so excited about clinical year. First, I'm tired of the classroom. There's no real fun in learning lots of medicine if one can't practically apply it. I'm a hands on type of person, and I learn by doing. Second, I miss the patients. I love the interaction with patients and I miss talking with them and hearing the stories they tell. Third, I love to travel. I love moving around. I look forward to being in a new environment with new people every 5 weeks! We will see if I eat those words 2 months from now.

Good night, folks!

3 months in, 1 month out

Warning...this will be a long blog. Why? It's the least I can do for being away so long.

Hey gang! Wow...where do I begin? I can't believe I've let this much time pass since my last entry. I see I've gained a few more readers. Thanks to all of you who read the blog. I hope it is serving a purpose and answering questions. At the very least I hope it's allowing you to live vicariously through me while I journey through this thing called PA school. So, without further ado....

I'm three months in, and so far this semester has been another rollercoaster ride, albeit much easier than last semester in that I know what is expected of me, and I know what type of work ethic it will take to successfully complete it. The material is very interesting, and this semester we are really learning how to integrate. Early on the instructors stressed the importance of NOT integrating to avoid confusion. At this stage of the game, integration is key. Now I'm expected to take the anatomy I learned this time last year and apply it to the Neurology and Nephrology that I'm learning now. Not an easy task, but when it's done it makes learning a lot easier. Medicine becomes fun because you now are able to answer the most important question: why?

I'm enjoying the material for the most part. I would guess my weakest subjects this semester are endocrinology and neurology. My strongest subjects are nephrology, ortho, and EM. I've discovered that I'm really good with my hands and calm under pressure. I've also discovered that I need to work on developing a better differential list, and on my physical exam techniques. We all have strengths and weaknesses. It's important to acknowledge them, pat yourself on the back for the strengths, and work on the weaknesses.

Today we began our ACLS training. How exciting!! Recent changes have been made in BLS and ACLS, so we began learning the BLS changes (its CAB's now, and not ABC's), then we went on to learn how to intubate and place IO lines. Out of all the skills we learned today, I think intubation was my favorite. I got it in the very first time with no help, and the instructor praised me when I finished. Talk about an ego boost. Keep in mind, we practiced on dummies. Let's see how good I am when I intubate my first real patient...old school style, without a Glide-o-scope!

In the midst of studying for 3-5 exams per week, being in class from 4-8 hours a day, and having a social life, we've had to prepare for the clinical year, which officially begins one month from now. I'll be heading off to Juneau, Alaska to complete my primary care rotation. I can't express how excited I am about this opportunity. This is a wonderful site that will allow you to do what you want as long as you are competent and confident. I will be working both in the clinic and the hospital, and I'll even be working with the radiologist on occasion. I'll be sure to take lots of pictures, and if I remember to bring the appropriate equipment, I will post them here for those who are interested.

This blog will no doubt morph into something quite different as I embark on my clinical year. I plan on sharing as much information as I can with the readers here, being careful to maintain the anonymity of my patients. I'll let you know what I see regularly, and what I'm allowed to do. Something I would love to do is post student cases here. If time allows I will surely do that.

Ok...not much else to say other than have a good weekend, and if you're in the NW part of the country, try to stay dry!!

Let's get back to work

I've three more days before I board the plane that will take me back to PA school. These six weeks have come and gone so quickly. By far this has been the best school break ever. I think my mind and body were so exhausted; I definitely needed every hour, every minute of this break. Now it's back to work!

I've already outlined what lies ahead of us this semester. Looking at the spring calendar is like looking at the calendar for last semester. We'll be as busy as ever, but this time we know what to expect. I say bring it on!

Happy New Year!

Hey gang. I hope all is well, and I trust you all had a Merry Christmas and a wonderful New Year's Eve/Day. Time is just flying by.

I am officially a second-year PA student. In retrospect, I'm amazed that I have three semesters behind me. I've learned a lot, but there's so much more to learn, and now that clinical year is 5 months away I've got to kick it into high gear. What I love about my program is we have some say in where we want to go, and we are allowed to pursue preceptorship in any area of the country. The bad news is each and every one of my prospective rotation sites here at home have fallen through. But who cares! The great news is...

I'm going to Alaska!!

Our program is affiliated with a private Primary Care office in Juneau that has state of the art facilities: labs, micro, xray are all on site! They also have hospital privileges so I will have a chance to participate in that as well. Needless to say I am excited and appreciative. What a great opportunity this is for me. I will be the second student from my program to attend this site. The first student to go gave this site rave reviews, so I'm expecting to learn a lot. No word yet on any other rotation sites, but I feel like I will end up exactly where I need to be.

Now, the following is for any pre-PA students out there. Repeat after me: there are no shortcuts. There are no shortcuts. One more time...There are no shortcuts. Good!

I recall mentioning this before, but it bears repeating. PA school is a well demarcated path etched in the road. There are many side paths that feed into it, but there is no one way that will get you to your destination (a seat in PA school) the fastest. There are no shortcuts. Yes, PAs make a comfortable living and they are an integral part of the healthcare system, and they get to wear the cool white coat. Before you can begin to enjoy these perks, you've got to get your "C," and before you get your "C" you've got to graduate and pass the PANCE, and before that you must do well in your respective program. And in order to do well in your program you must lay the ground work.

There are many common threads floating around on the forum as of late, the most common being "What are my chances," and "Am I competitive." The most recent one to irritate the heck out of me is "Which schools don't require HCE." My response is if you don't have the time to acquire direct HCE you may want to reassess your goals. I have personally journaled my experiences in the unit where I racked up my hours, and you can refer to the 2009 entries to learn more about it. It sealed the deal for me in more ways than one. Not only was I touching patients, sticking them, drawing blood, run EKG's and do preliminary interpretation, doing wound dressings, talking one on one with patients' families, doing post mortem care, and drawing flushes for codes, I got a chance to stand bedside as I watched lines being put in and ventriculostomies being performed, and in my down time I read SOAP notes, learned how to read a basic chest xray, read lab values, etc. You can't begin to understand how this has helped me during didactic year. And I bet I won't truly appreciate my time on the unit until I reach clinical year.

The question is do you want to hit the ground running or do you want to play catch up? When questions like this come up, it screams that many of us coming into this profession don't know its history. No one expects you to know it all. No one expects you to be a PA on the first day of PA school. Knowing the basics, however, goes a long way in prepping you for success during didactic year and clinical year, and it just might help you land the job you want once you graduate. It's a snowball effect. Ok, I'm done.

I have two weeks left until we start up again. I am renewed and refreshed, in part because I know this is my last semester in the classroom. I couldn't be any happier about that! I miss the patients.