Weeks 46 & 47: Scrubbing In

And so it has begun—my final semester of classes. I feel somewhat different about this semester. One part of me can’t wait for June and the change of pace to come with rotations, while another part of me doesn’t want to leave the classroom, but rather keep learning new material and reviewing old information for as long as I can before being thrust into the real world of medicine. But, after surviving last semester, I feel like I can get through anything at this point, especially when it comes to managing the workload. Honestly, I can’t complain about these past two weeks, but things have started to pick up a little bit, especially now that all classes for the semester have started. I’ll fill you in on what we’ve been up to…

The semester started last Tuesday with our first lecture of Clinical Skills III (the class we learn how to perform hands-on procedural skills that we’ll use in the emergency/office/and surgical settings). We learned and practiced how to scrub-in prior to surgery in addition to the order in which to don all of our protective equipment (face mask, gown, eye shield, gloves…etc.). The order and the manner in which we dress are imperative to maintain a sterile environment and ultimately avoid contamination of ourselves and, most importantly, the patient. Each week the professors observe and grade our ability, by the end of the lecture, to perform the demonstrated procedure or task, so this assessment obviously focused on our ability to dress in a sterile manner, avoiding any contamination along the way. Next week, we’ll be sticking each other with needles, so stay tuned for that story (if I’m not too bruised up to type).

The first two weeks of my Clinical Decision Making course have been interesting. At the start of each class, the professor states a complaint, as a patient would, such as “my belly hurts.” The next several hours are spent working up the patient for this general complaint. The professor says nothing unless it’s in response to a question that one of us students asks about the history and/or physical exam findings. So, we can be sitting in silence for an awkwardly long period of time. Before we order any lab tests, we must supply the professor with the reasoning behind each ordered test and also state the cost of the specific test we wish to order (insurance taken into account). With both the answers and lab results supplied by the professor, ultimately, by the end of each session, we all attempt to diagnose the “patient” and treat him or her accordingly. This class takes a lot of thought and challenges us to remember and integrate information we’ve learned over the past three semesters. It’s so great to have such a massive review.

In Family Practice (primary care for all ages), we have been focusing on immunization schedules for adults, in addition to reviewing the work-up for complaints such as headaches and sore throat (more welcomed review!). Last week in Pediatrics, we focused on assessments and screening tests indicated for children based on their age, in addition to milestones that we would expect to observe in children of varying ages. This week of Pediatrics focused on the diagnosis and treatment of vaccination-preventable diseases (measles, rubella, tetanus, hepatitis…etc.). In Pathology, we learned the mechanisms of cell death and acute/chronic inflammation. Finally, in Emergency Medicine, we learned how to work-up a patient who presents to the emergency department with a complaint of chest pain. All of the EKG practice I did last year definitely helped with this week’s lecture!

These two weeks flew by (the one snow day this past Tuesday didn’t hurt either). I’m sure things will get just a tiny bit more hectic, but I really feel like the next 13 weeks will be bearable, at least from what I’ve heard. We’ll have to see…

Question of the week: Injury is the leading cause of death in children over one year of age. What are the two most common (and most importantly, preventable) injuries accounting for these deaths?

Last week’s answer: Atrial fibrillation exhibits a faster heart rate relative to atrial flutter.

Clinical Phase Countdown: 122 days

The End: Didactic Phase, Semester Four

About one and a half years ago, I wrote my first blog post titled “The Beginning.” And now, eighteen months later, it’s already the beginning of the end of my didactic phase of PA school. A mere fifteen weeks of classes remain, in which time we will learn all material that is left to cover, before meeting our first, real patients in June. So, as usual, I am anxious to begin this final semester of classes. But, unlike at the time of my first post, this anxiousness is not comprised of both excitement and nerves, but rather just excitement. I cannot believe how far along I already am in the schooling, and, come June, I’m sure I will be ready for the next chapter of the program to begin. Let me fill you in on what’s to come in these final fifteen weeks of classes…

I will be taking a total of fifteen credits this semester, and, from what I have heard from both upperclassmen and professors about this semester, it’s notable as one of the easiest to handle. The courses left to complete include Emergency Medicine, Family Practice (outpatient care), and Pediatrics (medical management of children). Other courses include Clinical Decision Making, a discussion-based class, which will integrate all that has been learned over the past three semesters, Clinical Pathophysiology (study of the basis of diseases, down to their molecular/cellular mechanisms), and our second (of four) research class, in which we will continue to progress in the conduction of our Master’s degree research study. Finally, we will complete the last of our three Clinical Skills classes. As described in past posts, the Clinical Skills classes in the second and third semesters focused on the hands-on physical examination techniques that we will use to diagnose patients. This final Clinical Skills course will focus on procedural techniques that we will use in practice, such as suturing wounds, casting fractures, IV insertion/drawing blood, performing imaging procedures, like ultrasound…etc. It should be fun/a bit painful using each other as patients this semester, but the more practice, the better! I’ll have good stories to tell each week about this class no doubt…

And that’s all of the courses. This semester is one massive review of all the information covered in the past three semesters. Each class will incorporate and build on the knowledge we have thus far acquired, and so I am looking forward to the review. Also, at last, we have Friday’s completely off! In fact, my weekends begin Thursdays after 1:00 pm. I’m sure the course material won’t be any easier than in the past, but I will undoubtedly have more time to dedicate to each class, especially relative to last semester. Though, I’m sure I will be taking advantage of all of that extra time!

I begin this semester next Tuesday. In the mean time, here’s a question to keep you busy:

Question of the week: Which abnormal heart rhythm exhibits a faster heart rate, atrial flutter or atrial fibrillation?

Clinical Phase Countdown: 138 days