Overall PA School Experience

Well, I guess I should revisit my blog I started 5 years ago and intended to write on daily but never touched it once through PA school.  Five years ago, I started this blog in hopes of recording my failures, triumphs, and ultimately memories while becoming a Physician Assistant.  I had no idea PA school would be so hard.

They say the first year of PA school is like trying to drink water from an open fire hydrant.  A lot of information is being thrown at you, but your job is to catch and absorb as much of it as possible.  It was the didactic year, and this was my most stressful year of all.  I broke out in really horrible acne, seborrheic dermatitis, and of course, tears many times due to the overwhelming stress.  Luckily, Benji was there for me emotionally being the supportive and caring boyfriend who he is through each of those times.  Though we were long distance (he being in St. Maarten and me being in Miami), Skype helped make it seem like we were sitting right in front of each other.   

This is an illustration of one of the many confusing
diagrams for Neuroanatomy. "WHAT THE?!" I
know, right?!

I digress...  during the first semester with Barry's PA program, we had 7 classes:  Anatomy, Microbiology, Neuroanatomy, PA Role, Physical Diagnosis, Pharmacology, and Physiology.  My favorite two classes were Microbiology and Physiology. My least favorite was Neuro. I loved the professor, but didn't like the video lectures.  Everyday it seemed like there was a huge dark cloud over our heads...the dark clouds were exams after exams after exams.  

Second semester was better and more interesting because we were finally diving into more clinical material.  There were 10 classes total including:  Genetics, Geriatrics, Medical Spanish, OB-GYN, Pathophysiology, Physical Diagnosis, Pediatrics, Pharmacology, Psychiatry and Surgery.  My most favorite were OB-GYN and pathophysiology.  Least favorite was Genetics.  I believe the professor teaching the class plays a huge role in my learning. Our professor for OB-GYN was Professor Whitney Lester, and I was able to retain most everything I learned in her lectures just because of the way she taught the material.  She was very clear and shared her clinical experiences with the class.  She was a fantastic professor and one of my favorites in PA school.  My favorite professor was Professor Charity Ramsey who had a way with describing anything at all and making it fun to learn.

Third semester was even better than the previous semester.  Although we felt like we gained much more knowledge in the past two semesters about medicine, none of us felt like we were ready for clinical rotations.  This was our last shot at trying to learn as much as possible before being tossed out there in practice.  Third semester was during the Summer time -- the warm, sunny Miami beaches were such a tease.  We had 8 classes:  Pathophysiology II, Physical Diagnosis III, Radiology, Pharmacology, Emergency Medicine, Epidemiology, Research Methods, Health Prevention, PA Role, and a little more Medical Spanish II.  My favorite classes were Radiology and Pathophysiology.  Least favorite was PA role. Gotta say, I didn't really like that PA role class too much =/.  

My roomies and me during the first year of PA school

I don't think I would have been able to survive that first year without my awesome roommates, Bon Bon and 5arah.  They were like my family there in Miami.  We'd quiz each other during our carpools to and from school, vent with each other, cry to each other, go work out together, share foods with one another, and even do some retail therapy together at the mall conveniently located 10 mins walking distance away together.  We even got sick together.  Now that's family there!    

Now for the clinical rotations.  My rotations started off easy with my first one being Psychiatry at the Miami VA hospital.  Most of the experience was inpatient which I preferred more than outpatient.  Honestly, this rotation provided the best hours (7:30 am - 3:00 pm).  I'd get into the psychiatry unit at 7:30 for the morning report of patients, have round table discussions with my attending and resident, a pharmacy student, social worker, and the patient's nurse.  Then we'd see the patients one by one asking them how they were progressing or not. We'd also switch over to the hospital side and check on some patients just out of surgery to make sure they weren't experiencing any delirium.  I loved this experience a lot.  However, one thing I didn't like was the field.  Being an extrovert, I soak in my surrounding environment's energy.  I found that the field was sometimes depressing which depressed me often times when I came home from work.  Although I got off of work no later than 3pm daily, I was depressed and just wanted to curl up into my bed and take a nap.  

Internal medicine was my next rotation and that one was fun!  Surprisingly, it was more outpatient than inpatient, but I didn't mind because my Preceptor (Dr. Abassi)  was awesome.  Since I was her only student, we traveled together to hospitals, nursing homes, and even to patient's houses as she made house calls.  It was here where I finally mastered my physical exam in under 5 minutes.  We had to do it daily to each patient, so there was lots of opportunities for practice.  It seemed as if every patient had diabetes, hypertension and/or hypercholesterolemia.  Every now and then there will be an extraordinary case like neurosyphyllis or unsuspected colon cancer.  I would have loved to do another rotation with Dr. Abassi, but time just did not allow it.  I learned a lot during this rotation.

Then came Family Medicine with Dr. Wollschlaeger.  He was AWESOME.  Dr. W's office does not take insurance, so he can practice as freely as he wants to.  He's not regulated to order certain tests or give certain drugs just because an insurance company will pay for it or not, which makes his practice great. In addition, he is a one man show meaning he runs his family clinic all by himself.  He occasionally has students from the University of Miami School of Medicine, though they usually just sit in for one day.  My classmate Ali and I were pretty much the only students coming in daily.  We drew so much blood and gave so many injections during that rotation.  Although I would have like to have done more, it was a good experience.  Oh, and he always had house calls at the most luxurious places in Miami.  How he gets his connections, I have no idea...

Some other students were goofing around.  Being the good student that I
am, my head was always in my books.  Btw, that's not me on the left. That's
my evil twin sister.

Fourth rotation was Emergency Medicine at Westchester Hospital.  This is an all Spanish speaking hospital.  In fact, every four hours, a nurse would come around with a tray of small cups of colada (cuban espresso) for all of the Physicians, nurses and sometimes if we're buddy buddy with them, the students as well =D  It was here where I had lots of opportunities to practice my medical Spanish. I'd interview each patient in Spanish. Often times, I wouldn't know the word, so I'd have to act it out.  Let's just say, my acting skills were awesome. lol.  I noticed each patient arriving to the emergency room would get an IV.  So, on the first day of rotation, I practiced my IVs.  Second day, I practiced doing ABGs.  Third day, I inserted an NG tube for a woman with bowel obstruction. Fourth day, I did a couple of foley catheters....then the very last day of the week, I wanted to do something really cool!  I was thinking something like a chest tube for a pneumothorax or a pleural effusion, or something like that!  Nope, just changed an adult diaper packed with stool.  

Sometimes I'd get off of work at 5:30pm which was a perfect
time to get stuck in Miami traffic, so I'd stop at the nearby
McDonald's and talk to Benji via skype since it was 10:30pm
where he was in the UK then.

Fifth rotation was my least favorite, but surprisingly I gained a lot from it both medicinally and emotionally.  This rotation was during the time Benji and I had our wedding celebration in Miami, so it was a lot to manage.  It didn't help that this rotation site was 1.5 hours away making my total commute for the day to 3 hours.  Luckily, I was able to do a lot of wedding planning during the commutes, so it all worked out great.  Oh yes, this rotation was OB-GYN with Dr. C.  He was the meanest Dr I'd ever worked with.  During the first week, he yelled at me in front of his patient and then yelled at me some more once we were outside of the patient's room.  I broke down and cried right in front of him and then excused myself to cry some more in his office alone.  This was probably not the most professional thing to do, but I didn't care.  He didn't have to yell at a student like that for asking questions.  The MAs and office staff were very nice, understanding and comforting, which made me feel much better.  I spoke to my school's clinical director during that day's lunch break, and she helped me get through that obstacle.  I talked to Dr. C afterwards about the incident and tried to understand why he was so upset. At the end of the discussion, we were able to see eye to eye on a lot of things.  Afterwards, he allowed me to first assist him in hysterectomies, cancer staging, cervical cerclages, and delivering babies.  As a student, this was big stuff for me.  All in all, I started this rotation with fear of my attending, but later left with a friend.  As he wrote my overall evaluation at the end, he read it to me with tears in his eyes.  It was the most humbling rotation I'd ever had.  

Next rotation was Surgery with Dr. Legaspi.  Surgeons have it bad and are known to be the meanest people in the world.  They work long hours, have unconscious patients' lives in their hands, could easily nick a vein or artery, and so they yell at everyone around them and are known to be cocky and rude.  However, Dr. Legaspi was far from this and probably the nicest surgeon I'd ever met.  During each surgery, he'd hook up his laptop in the OR to some Mana tunes playing from Pandora and jam to them during cholecystectomies, liver resections, ablations, and more.  I got to experience and assist in my first whipple procedure which is a huge six hour surgery.  We removed a 15lb liposarcoma from one gentleman, then took out his right kidney because it necrosed due to the compression of the liposarcoma, removed his appendix, and also noticed his inflamed gall bladder so we removed that as well.  I'd say the patient lost a good 20 lbs instantly from that surgery. During this rotation, I got to work with other surgeons as well during the down times.  We amputated legs which easily seemed like a scene from Saw III.  Overall, this rotation with Dr. Legaspi at Mt. Sinai Hospital was a fantastic experience.

Dr. Quereshi and the Immunization Schedule he made for me

Seventh rotation was much less stressful:  Pediatrics!  The kids were so cute, and I'd often catch myself goo-ing and gah-ing over the cute kids and babies.  In the beginning, the kids didn't allow me look inside their ears, but with the help of fellow classmates and their tips, I managed to say "choo choo" as I checked their ears, and asked them if they had just had some chicken nuggest from McD's while checking their abdomen.  They were much more cooperative after that.  Dr. Q was my attending and an awesome one.  In between patients, he'd allow us to do our readings and studying in his office.  Every now and then, he'd make a quirky joke or share his excitement over some new techy gadget he wanted to get. lol. It was cute.  

Last but certainly not least was my rotation with Dr. Horwitz in Dermatology.  Stepping into this rotation without any experience at all was challenging.  The staff there probably expected me to know more, but my clinical experiences were poor while my knowledge of the material was adequate.  I was able to give treatment options but was not able to even recognize the diagnosis.  By the second week of this rotation, I was able to put 2 and 2 together.  The MAs there were extremely helpful and in the end, I was able to learn so much from this rotation that I scored a perfect 100% on the PANCE for the derm section.  

This was me introducing the keynote speaker for
Barry's 2013 graduating class!

Now, a lot of PA programs such as the University of Florida end their program after just two years.  Our program extended it to one more semester as 'Advanced Didactic.'  We prepared for the Physician Assistant National Certification Exam (PANCE), had the option of doing a 6 week supplemental rotation in any field of your choice, and took the following classes:  Clinical Therapeutics, Thanatology, Ethics, Board Review and we had to write a thesis paper.  I did my thesis paper on the efficacy of vaccinations and why individuals do not comply with their schedules.  I also spent my advanced didactic semester serving as an anatomy TA and tutor for physiology and anatomy.  Surprisingly, there were some questions on the board exam that made me so thankful I signed up to be an Anatomy TA.  After taking our exit examination out of PA school, it was all celebration from there.  Our class threw a huge graduation party on a boat drifting down the Miami intercoastal and it was magnificent!  Afterwards, it was tears after tears as we all graduated after suffering and struggling 2.5 years together.  

Did I suffer during PA school?  Yes.  Did I ever have a break down and cry?  Oh yes.  Would I do it all over again?  As my buddy Ryanadine would say, "Yeaaaaaaahhh buddy!"  It was the hardest period of my life, and I'm not sure if it was because I was away from home, my family, my significant other, and/or the stress of the program, but I'm so glad I did it.  I may not have invented the toaster strudal, or designed the Eiffel Tower, but this is far greater than I would have expected myself to do, and I am darn proud of myself.  I owe a huge appreciation to my friends and family who supported me all the way through and for their constant encouragement.  I'm so thankful to them!

Sincerely, 

Irene Gung Ho, MsCS, PA-C