Weeks 59 & 60: Four Down, One Year To Go

It was about two years ago when I first began posting about PA school, so eager to begin the program, excited to learn more about medicine, and share my experiences with others. As evident over my two years of posting, I’ve had many ups and some downs, but I wouldn’t change anything that has happened throughout my schooling thus far. A couple of weeks ago I completed my last five finals of PA school, walked out of the same classroom I entered for the first time not so long ago, and couldn’t feel any better about the change that’s to come in my final year of the program.

I think it’s needless to say at this point, but the final two weeks of the semester were just as chaotic as any other finals week I endured before. Long story short, each final (Emergency Medicine, Clinical Skills, Family Practice, Pathology, and Pediatrics) went well and I never felt more relaxed after completing the seemingly endless two weeks leading up to exams. We finished the semester focusing on HEENT (heads, eyes, ears, nose, throat), Psychiatric, Dermatologic, and allergic emergencies in Emergency Medicine, and in Clinical Skills we practiced suturing skills on chicken thighs and pigs legs (the skin of pigs resembles the texture and tension of human skin). In Family Practice, we learned how to work-up patients who present with complaints of vertigo/dizziness and also how to clear patients for surgical procedures. Pre-operative clearance is much less about simply signing off on and clearing a patient for surgery as the name implies; it has much more to do with ascertaining that the patient is in good enough health and condition to endure the scheduled procedure. Pathology focused on disorders of the nervous and musculoskeletal systems, and Pediatrics focused on the diagnosis and treatment of urinary/kidney, reproductive, muscular, and metabolic disorders. And just like that, in the span of two years, we finally completed the curriculum to be learned prior to our clinical phase year…

So what’s to come over the course of this next year? Let me fill you in…

Less than three days from now, the next phase of my PA program will begin, called the Clinical Phase (rotations). As mentioned before, each rotation spans a period of either four or eight weeks, in which time I will be placed in a variety of settings that specialize in the treatment of specific medical specialties (Psychiatry, Orthopedics…etc.) or medical populations (Pediatrics, Primary Care…etc.). Over the course of each rotation, I will also need to document at least 25 patient encounters per week, track performance of a variety of procedures (required to graduate and including things like rectal exams, history/physicals, Pap smears, injections…etc.), and submitting board review practice questions in preparation for my certification exam, which I plan to take early next summer. Every four weeks, regardless of rotation, we also must report back to school, called a “callback” day, to submit the work we have been completing at each site, and also to take a comprehensive exam that covers information pertaining to the rotation specialty. For example, after four weeks of my Psychiatry rotation, I will have to pass an exam that questions me on any topic pertaining to Psychiatry (literally, anything of relevance…). For each rotation, I will be paired with a preceptor/supervisor (an MD or PA) at the site who specializes in the field, and who must sign off on any documentation/medical intervention I plan to write or administer to patients. Based on the graded assignments, callback exam, and grade given to me by my preceptor, I will receive a grade for each separate rotation. So, as it appears, each rotation entails much more than just showing up to my site every day; there seems to be a lot of work that I will still have to come home to every night/morning (if overnight shifts) as well…

As of now, I begin my clinical year with a four week Psychiatry rotation, and I definitely plan to blog at least twice (halfway through and at the completion) over the course of the next month. There is definitely nothing I will or can legally say about the site or patients, but I’m sure I’ll have plenty to say about my personal experiences/feelings about the rotation in general and any cool procedures I get to observe/assist/perform throughout the month. Over the past two weeks I’ve been brushing up on a bunch of psychiatric disorders and especially reviewing medications (most of which have a huge list of side effects), but there’s only so much I can look over before Monday, when I start. Before starting the didactic phase, I remember saying that I was anxious (85% excited, 15% nervous), but my feelings entering the clinical phase have changed just a bit…I’m still anxious, now more like 75% nervous, 25% excited. It’s undoubtedly going to be an interesting year!

Psychiatry question of the week: Can you list three signs/symptoms of depression?

Last week’s answer: The most common cause of syncope (fainting) in patients younger than eighteen years of age is low blood sugar levels (from skipping meals).

Clinical Phase Countdown: 2 days, 7 hours, 20 minutes

Graduation Countdown: Coming soon…

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