Graduated

Hello all,

It has been a really, really long time since I have posted. To those who were following along, I apologize. The last several months have been tough. Not only have they been tough mentally, but physically and emotionally. My loved ones have sacrificed a lot during this time, and I have been feeling like the last two years I was on a deserted island or something. Every time I got a chance to relax for a minute and get on the computer I only wanted to do something brainless because I could not think anymore. Therefore, writing in my blog became less and less of something that I wanted to do.

The good news is, I made it!!!! I graduated and got my big boy coat! Now all I have to do is take the PANCE next week, hopefully pass, and I don't "have" to study for the next 5-6 years. Of course I will be studying everyday. Reading at least an article or getting on uptodate to read about something. But I won't be studying because I have a test to take and I really have to make sure I know the most random knowledge, not necessarily stuff important for patient care, so I can pass. It will be a nice change of pace to read about something because I know it is relevant to my practice and patient, and not because it is on the exam.

Oh! Something I probably should have posted awhile ago: I did get a job! I have had a job for a few months now. I will be working in one of the local hospitals doing inpatient Internal Medicine. I am really looking forward to starting work, and making a paycheck. It will be a far-cry from paying to work ;-)

Anyway, I guess that is it for now. I am looking forward to seeing where this blog goes from here. I think I am planning on continuing to update as I go along. This will give those looking toward PA as a potential career, and those wondering what the first year out looks like, an idea of what they might expect. Good luck to all those finishing up this year too. It feels absolutely amazing!

'Til Then,
M-R

Merry Christmas and Happy New Year!!!!

Just wanted to wish everybody a safe and happy holiday. For those of us struggling through PA school, congrats on making it through another semester/rotation! Relax and enjoy the break. As one of my profs once said, when you're on a break BE on a break! We all deserve it, no doubt!

See ya next year!

M-R

1st Blog of Year 2

Hey guys,

Sorry for the long absence. I don't know if people are actually stopping by anymore. Frankly, I probably would have stopped too. I am often times really busy, and even when I do "have time" to get on here I either want to sleep, or I actually should be studying. Either way, I finally made it to the second year!!!! Woo Hoo!! -- For all those just not starting the 1st year some words of advice: 1) Remember that it is only temporary, 2) Study as much as you can but realize that realistically you can't learn it all in the short period of time you have - get the just and move on, 3) Stay away from negativity - it truly will only bring you down as well and God knows you won't need any help, 4) Try to remember your health - as hard as it will be to do that, 5) You won't like every professor and chances are you will find something about each one that you don't like - do what you can with what they give you and then be a big boy or girl and find out what you need to do to get the information you need to pass, 6) Probably most importantly - if you have a significant other/bestfriend/close family member(s) DONT FORGET ABOUT THEM - set aside one night a week where you spend time with that person and carve that time out early!!, 7) Remember, you aren't going to get an A on every test/assignment/check-off, get over that quickly and save yourself the stress, do the best you can and move on, 8) If you aren't getting the grades you think you deserve figure out why and change whatever it is that you need to change in order to get what you think you deserve - whatever that means for you.

Those are just a few things that come to mind at the moment. I don't mean to sound harsh but this is the reality of PA school. A lot of the time it is going to suck, and it is going to be really hard. But honestly ask yourself, "What did I expect?" Now I will agree that you most likely did not expect this. But if you sit down and analyze the situation for a second it may make sense. You are in an accelerated "medical school" program. Of course it is going to be difficult, and of course it is going to seem like there is no way you can learn it all, because you can't! To be perfectly honest, no one expects you to know it all right now; that would be impossible. However, you will learn. You will learn more than you think you are. Just when it seems as though your brain can't hold another single fact about the cardiac system, low and behold it gets in there somehow.

It's an intense ride, but it is a worthwhile one (see blog title above). As long as you can keep that perspective you will be able to get through it. God speed and happy reading!

M-R

P.S. - My internet access is limited at my current rotation so it may be another while before I can get back on here. However, I will do my best to update you guys on my rotations so far. See ya then!

Rotation Shake Down!!

Well we finally got our rotation schedule. I was really nervous when we found out in an email during class that we would be getting our schedules right after lecture. Needless to say I dont think I remember a single thing that was taught after that. I am not sure why I was so freaked. I had told myself a long time ago that I have no control over where I go. I even told our clinical coordinator that I didnt care where she sent me, asn long as the rotation site was good and she thought I would do well / learn a lot there. Still I was pretty nervous. Well without further ado:

Clinical Rotation Schedule

1) Aug 31st - Pediatrics
2) Sept 28th - Surgery
3) Oct 26th - Psychiatry
4) Nov 30th - Rural Medicine (elective)
5) Jan 4th - Critical Care (elective)
6) Feb 1st - Family Medicine (2 months)
7) April 5th - OB/GYN (3 weeks at a planned parenthood clinic/ 1 week OB in hospital)
8) May 3rd - Internal Medicine (2 months)
9) July 6th - Emergency Medicine

I am really excited. However my motivation has almost completely run away from me. I need to get my head back in the game. If you see my motivation will you tell it to go back home? Thanks!

M-R

Surgery ... Not What I Was Expecting

Well our Surgery module is kicking my butt. Not necessarily because the material is hard, but because we have shunned all of our other classes away in order to fit surgery in one week. Here is our schedule for this week:

8AM - Meet in lecture room for Surgery topic lectures

12:30PM - Break for lunch (and you better woof it down fast)

1:00PM - Back to lecture room for more Surgery topic lectures
4:00PM - Either go home and start studying to try and catch up with the enormous amount of material given to you that day OR:

4-6PM - If it is your groups day you go to the suture and "how to gown up for surgery" lab room and practice, practice, practice.

So far it has been that schedule for the past 3 days. Needless to say (maybe?), this week has found me fighting every nerve and muscle in my body to stay awake during the 4 hour lecture marathons.

I thought that when we did surgery we would be talking a lot about procedures, how to do them, what to look out for, etc. Instead we have been more talking about when is it appropriate to do surgery, pre-op/post-op considerations, and prophylactic therapies. Much of what we have been talking about has been a lot of review from the GI module. We really havent talked much about cardiac surgeries or anything like that. I think it's because the PA teaching us right now is teaching us mainly from what he does at their hospital. That's fine I guess. I just wish we were getting a little more diverse exposure. But maybe thats what next year is for.

Well back to work!!

M-R

Half of ACLS Certification In The Bag!

Well today I was tested on my ability to lead a team of 5 other people in a "megacode" in the SIM lab. I have to say that I was pretty nervous going into the testing portion. I'm not exactly sure why I was so nervous, because I knew I knew the algorithms for each of the different potential rhythms. I guess it puts a different spin on things when you are not practicing anymore and the instructors expect you to know what you are doing. Not only know what YOU are doing, but know what the other members of your team are doing and change things if need be.

It wasn't too bad though. Like I said, I knew what I had to do. I guess I was just psyching myself out right before. The rest of my team did really well too. -- For a second I thought we were going to have to push the mannequin off the table and put a couple of our team members on the monitor because they were so nervous. -- It really isn't too bad. Apparently it used to be WAY worse than it is now. Before, you didn't leave ACLS without pretty much breaking down and crying, unless you really knew your stuff! From what we were told by our profs is that it was the worst part of PA school! (That's CRAZY!) Now it is a lot more laid back and ... dare I say fun? Well lets put it this way: after 10 months of sitting on your butt talking about doing medicine it is really nice to actually be able to DO medicine.

So anyways, we still have the written exam portion to take this coming Monday. Hopefully I pass that and I will officially be an ACLS certified provider-student.

On another related note, my girlfriend bought some CPR masks with one-way valves on them for the two of us to keep in our cars. I gotta say I was a little nervous taking it. I don't know why, but I guess I have this feeling that now that I have the mask either I am going to feel obligated to help out at say an accident, or that a situation will actually present itself for me to use the mask. Like I said in an earlier post, I really hope I never have to before CPR on someone, ESPECIALLY someone out and about. Its one thing to start on someone in a hospital where there is plenty of help from people who REALLY REALLY know what they are doing. But when you are out in the middle of a parking lot things are a bit different.

Alright, enough on here, I gotta get back to studying surgery. We have our suture lab coming up Thurs. Let's see how good I am with my hands!

See ya 'til then,

M-R

Busy Week .... Sorta?

Hey guys,

Well like I said in my last post, we have been working on ACLS quite a bit this week. It has been interesting this week because I am so used to juggling multiple classes with the assignments/tests that go along with each of them over the week. This week the only classes we have had have been lectures on emergency medicine, and ACLS classes (both hands-on and lecture based). The weird part about that is that even though we have not had that many "classes" I have still been really busy. That must be why our program has put a hold on all the other classes during the two weeks that we have emergency med and surgery. There just would not have been enough time to cover what we needed to had we not had all day to have just the module classes lectures.

Well, for me this week has still been really busy. I can imagine that the few of us that have been ACLS certified this week must be pretty easy for them. However, I have not taken ACLS so this stuff is all new to me.

A word on ACLS real quick. This is definitly not something that you can simply learn by reading a book. Being the team leader in a code situation is where it is at in terms of really learning what to do in a code. When you simply read the book and learn the algorithms it seems pretty easy. But when you are the one that is calling the shots in the code, and your team is depending on you to organize all aspects of the megacode it can be pretty intimidating. In my opinion the only way to get past the stage of being completely overwhelmed is to keep volunteering to be the team leader whenever there is an opportunity to when you are practicing.

ACLS has been actually fun, once I got over my nerves that is. I think the best part of it is that it is actually hands-on. We actually get to DO something instead of just read about it. - Come to think of it this week has been really hands on. We had the IV lab and then ACLS most of the week. - I have to say I hope that I never actually have to be in a code situation. I am sure almost no one would actually want to be in that situation. But I know that odds are that I will definitly be a part of one. (Hopefully on the provider side and not the patient side!) I just hope that when the times comes I can take a deep breath and do what I have been trained to do.

Well, we have our "test" for ACLS coming up this week on Tuesday. We will be required to act as the team leader in a code that lasts 6 mins. We have to demonstrate not only that we have the knowledge of what to do during a code, but are able to effectively and efficiently manage a team of 5 other people. It should be fun ... I hope. I just hope I don't get really nervous and forget everything I know. I did pretty well during our practice sessions, based on the feedback from the instructors and me teammates. So wish me luck! :-)

M-R

School First

Hey guys,

Yes I know a little over a month ago I had promised an update "soon". Why do you think I used such a vague word? :-) Actually the real reason for my long absence, as my title states, is I had to put school first. To be perfectly honest, I was struggling with my grades a little bit due to my lack of time management skills and my failure to work on this in the beginning of the year. I am pretty sure I got on my Soap Box about time management skills on here before. Unfortunately I can speak from personal experience that not having this skill down-pat can really cause problems. Not only will this cause problems in PA school (and it will) but in life in general.

Well anyway, I just really needed to take some time to take a long, hard look at my self, and make appropriate changes in my life and my approach to school so I didn't screw up this amazing opportunity! Somewhat unfortunately, that meant putting things aside that weren't really important in terms of getting me through the program. One of those things, as you can tell, was writing in my blog. The good news, if there is any in this, is that the changes I have made are working! I have really been on top of things and my grades are showing it. (Well, at least I am on top of things as much as I can be. I feel by design you really can never be "truly" on top of PA school... speaking from my experience and through talking to my fellow classmates.) Not only are my grades showing improvement but I feel I am better understanding the material. That in itself is probably the most important thing. Although don't let anyone fool you. Yes grades don't determine if you're going to be a GOOD PA, but grades will determine if you are GOING TO BE a PA. -- Anyway, I told you guys I was going to be as open and honest on this thing as I could be so those that are looking at going to PA school can really see what it is like from one person's POV. That is really my reason for sharing this with you.

So hopefully those that are still following this thing can find forgiveness, just this once? No? Alright, fair enough.

All that being said, we finished up our GI (gastrointestinal) module this past Monday with yet another legendary module exam. I did well on it! I am definitely happy with the scores I received, and am moving on. We are now in our Emergency Medicine module. We are in the process of learning ACLS. ACLS is pretty interesting so far. I am a little nervous to get tested in the "Megacode" though. For those not familiar with what this is we basically have what is called a SIMs lab in another building. The SIMs lab is a patient simulator lab that is setup exactly how an emergency room would be setup. There is a "dummy" on the bed that is controlled in the "control room". The dummy is able to have vitals, a cardiac rhythm, make noises, etc. We are going to be tested on our ACLS skills by being part of a team that basically responds to a code (or when the patient crashes) and appropriately administers treatment to try to "bring back" the patient. I know it sounds a little weird but it sounds like fun. However, I am nervous because there is quite a bit to learn. You have to learn algorithms for different heart rhythms, etc that you need to be able to implement immediately. On top of that you have to know the drug, the dose and when to give them while your adrenaline is pumped up. I just hope I know enough to do well.

Well I have to go and learn how to put in an IV now. I am almost there though!!!! I am almost done with the first year! (Thank God!) Only about a month and a half left until we get a little break and then start rotations!!! We should be finding out our rotation schedule for next year here in a few weeks. Ill let you guys know how that plays out.

Until then my friends, as my friend in the 2nd year class says, "PA school is all about putting out fires." -- I'm going to put out another fire. Seeya!

M-R

Once Again...

the new module starts and I am already feeling behind. Heck, I even read a bit over my BREAK to try and see if I would feel any different. Well I guess I didn't feel as behind as I normally do, but I still felt behind, like usual. I have to say that it is a very common feeling among my classmates and I after the first day. It's sorta a joke now. We will go up to eachother and say something like, "How's it going?", to which the answerer would reply something to the effect of, "Psh, I have NO clue what they heck just happened in there!"

I have so many things to get done this week it is going to be interesting to see how things play out. I have to send out a message again real quick to those wanting to go to PA school ... what I am about to describe is NOT uncommon in PA school. In fact, I would say it is more the rule than the exception.

This week I need to/have to:

1) Write my SOAP note from one of the patients I had seen during my mentoring.

2) Finish up the 53 question take home pharm quiz (that covered about four chapters out of a book our prof printed off for us).

3) Finish a ~about 173 page book for my Patient Health and Promotions class that I then have to attend a discussion meeting about the book during my lunch break, and then write a 1 page response to the discussion group (and that was the easiest option for one of our assignments we have to do).

4) Read up on Anatomy because we are going over the muscles in the entire body and the first lecture covered about 12 pages of notes already.

5) Read 2 case studies on Diabetes and answer the corresponding questions (usually anywhere from 10-15 questions per case) due this Friday.

6) Read a couple chapters in my pathophysiology book

7) Start studying up on the disease states for this module

8) Study the lecture notes and patho book from today and this thursday for a 20 question quiz on friday.

9) Meet with my Professional Issues group to start researching our topic and begin writing up our presentation due in the 1st week of April.

10) Meet with my other group the next day (for Health and Promotions) and start writing the script for the "bad outcome patient scenario" that we have to do and figure out how/when we are going to tape/edit it.

11) Participate in my programs last interview session all of Friday afternoon.

12) Oh yea and sleep, eat, go to class ~42 hrs this week, make sure the "other things NOT in PA school" don't fall apart, etc etc.

I'm not whinning (really), just giving you a taste of what this week will hold for me. I am sure I am forgetting something, if that is possible haha! See why we say it isn't the material that is hard it's the amount of material and other stuff you have to do in the short period of time you have to do it that makes PA school so difficult?? Not enough days in the week and hours in the day! Just gotta take one thing at a time and prioritize the BEST you can.

Well ... back to work!!

M-R

We've Crossed the Half Way Point!

Well this post is way, way over due. I dont really know if many people are really following this blog or not, but I guess I will keep typing away. Maybe somebody will come across this sometime.

Anyway, my absence from this blog has been due to the fact that I have a lot of free time on my hands and have been spending it playing my guitar, video games, and spending time with my girlfriend ... .... Yea, yea I know you aren't buyin it, of course that is a lie. I have had my face in the books for the past month and a half now first learning about the kidneys, and then OB/GYN (female-land as my anatomy prof put it)!!

But there is some good news to be shared, we have finally made it to the half way point through the first year!!! That is definitly something to celebrate, and boy did we as a class after our OB/GYN module exam. It feels good to sit back and realize how far my class and I have come in just this short 6 month period. I gotta hand it to my program, it really does a good job. Despite all the bickering, doubt and reisistance on our part, I think I can say that I have finally come to the realization that this is just how things are in PA school. It's stressful, and at times seems impossible, but some how we are getting through it, learning a ton, and slowly but surely becoming clinicians.

Right now we are on Spring break which could not have come at a better time because I was starting to get a bit burned out, crispy even. I know what you are thinking, "Again M-R?" Yes .. again. I swear, it's a wonder that we made it through last semester. We went pretty much straight through until Christmas break (besides the two days we had off for T-Day) and had one of the more difficult modules (Cardio) right at the end before break. No wonder a portion of us were thinking we weren't going to be able to make it. That's a long time going at a constant 150mph with no stops along the way. -- I am enjoying Spring break, even though I did not actually go on a trip. It has been great catching up with friends/family and being able to actually see my GF for longer than a couple of hours before I would go to the library again. Heck, I even got a chance to pick up the ol' guitar and play a few songs. The other thing that we have been working on accomplishing is getting this house back in order. It got crazy there for a little while!! I mean I am no clean freak or anything, but there comes a point when enough is enough and that point came and went, but neither of us had the time to get on it. So that was definitly the first thing to get caught up on.

All in all things are going pretty well. I did really well on the renal exam (the second hardest exam of the year), which felt great and gave me a little boost in my confidence. I did well on the OB/GYN exam as well. I tell ya, I am really glad to be done with that module! The one nice thing about that module was I didn't have any moments where I was thinking, "Crap, I think I have that!!" during lecture :-)

I finished up my last week at the family practice clinic I was at for my mentoring. It was a great 6 weeks, and I am going to miss working with my PA and the rest of the staff, and patients. I hope that the rest of my mentors are as easy going and as great of a teacher as this one was. On my last day, I got to do two knee injections on my own!! That was pretty sweet I must say, and to add to it I didn't hurt the patient when I did it either! I was pretty nervous, but had to keep my poker face on and act like I had done it a thousand times before. -- I am starting to gain some confidence in my clinical skills and decisions, even though that isn't necessarily the point of mentoring. Yet, it still surprises me when I throw out a correct suggestion to my mentor of what a patient may have going on with them or what the plan should be. I swear I am going to catch the person who whispers those ideas in my ear one of these days!! :-)

M-R

Mentoring Setup Woes

Well today I sort of get an ear full. Not really bad, but enough to make me realize I messed up! Yikes!

Let me explain ... before school started in the Fall we got this packet of info that had a bunch on information in it and some instruction on what to do with some of it. Part of that information regarded immunizations. Well, to try and make a long story short, I misunderstood what it was that we were supposed to do with our immunization information and almost ended up not being able to mentor. What happened was I thought, for some reason, that the only reason they wanted us to give our imms records to our student health center was so that they could look it over and tell us what we were missing and what not. For some reason it didn't click in my mind that the only way they can verify that we actually have our imms done is if we give them the information that we have on them. So instead I found my information on the MCIR (which is basically a database of imms records from childhood on) and found out what I was missing and what I needed to get. So I went and got that stuff done. Turns out I was supposed to give that info to our health center on campus as well! OOPS! So now I have to get up earlier than needed for class so that I can figure out this mess, because we need to send out this info to our mentoring sites by Monday.

Moral of the story? GET YOUR IMMUNIZATIONS AND THE TITERS DONE AS SOON AS YOU CAN!! It is just a mess when you don't follow/understand the directions completely lol! Also, for the parents out there, make sure your kid gets his imms done on time and when they are young. It's a pain to deal with when you are older and you have received your Hep B shots from three different providers!!!

M-R

And So It Begins

Greetings from my local coffee shop. I am typing this entry on my phone because I thought this place had free wifi and it turns out you have to pay for it. So since I am not going to do that let me apologize now for any misspelled words and aweful grammer.

With that being said hAaappyg NeW yeer! :-) OK, for real this time Happy New Year! Another year come and gone. Well classes started up again this past Monday. The morning before class started my gf had just gotten home from work (she is a peds nurse), and she asked me how I was feeling about classes started again. I was honestly having mixed feelings. Besides the fact that my stomach was upset because it had not required to work before 12pm over break, I was excited, anxious, sad, eeger, and scared outta my mind. I was sad because I knew that school starting up meant that the time I would get to spend with my gf, and friends, was going to be cut extremely short again. It was going to go back to seeing eachother for maybe an hour or so over dinner, if we are LUCKY!

I was excited and eeger because it meant that we would be working and getting closer to graduating. Also this semester we start mentoring. What that basically means is that for one half day a week we work/follow a PA or doc and actually get to start seeing patients and practicing exam skills we know and taking patient histories, and even practice writing orders and diagnosing patients! However, this is also the source of my feeling of anxiety and fear. Wait, you mean you are sending me out into the world?!? Hold it, you want me to see REAL patients and practice on them!?! Hang on, you want me to show my mentor what I am made of and be aggressive enough and put myself in situations that give me opportunities to do this!??! O....K... Ill do my best.

Lets be honest here folks, this is sorta terrifying lol. What if I look like a complete putz and leave my mentor wondering, "Is this kid really in PA school?" What if the patients I see think I am a fool and ask to see the actual PA/doc because I clearly do not know what I am doing? Am I ready for this? I guess I better get ready, because ready or not they are sending me out. If you get sick don't go to the clinic for awhile! :-)

To be honest, I do have those things running in my head, but I am honestly excited and, I believe, ready to get my hands dirty (so to speak). I have been told that it gets better and the more you DO the more comfortable you become. However, I've also been told that if you are not somewhat aggressive it is really to just sit back and sit in the corner watching and never doing. However, that isn't going to help anything. I WANT to get more confident. I WANT to get more comfortable, and I WANT to look back on my mentoring and know that I got out of it everything I could, and sisnt waste any opportunity or chance to learn and improve.

Well, we don't start that for a couple of weeks. Right now there is a more pressing issue and that is that we got a great welcome back gift from our program. We started dermatology, guess what the 'gift' was? Hey, welcome back, how was your break? here's your derm book and oh yea you have A WEEK to learn it, test is next Monday! Talk about not wasting any time, huh? Oh well, what better way to get back into study mode than being forced to learn an entire system in a week? Do you think some of PA school is like an initiation process, kinda like a gang where you get beat up for awhile before they let you in or a frat with hell week? ;-)

Anyway, its too bad that derm is only a week. Not just because I have no idea how I am going to learn this stuff in a week, but because the prof that is teaching this module is awesome! We don't get to have him teach us often because of his heavy involvement in the AAPA, and it sucks because he is a great guy and teacher. Oh well, I guess that's life right?

Until next time, hang in there, keep pushing forward and doing your best, that's all anyone can ask of you.

M-R