PA school is a finite experience: it has a beginning and an end. It should not be confused with your education, which will have started at least a couple of decades prior to PA school, and continues on at least until retirement. Do not expect to learn everything you need to be a good PA in PA school. Like your education, you will have learned many parts of “how to be a PA” from your prior health care experiences. You will develop those skills extensively during your PA schooling, but then continue to learn and grow professionally after your program is done.
Thus, if you treat PA school as the totality of your PA education, you are setting yourself up for disappointment. I recommend taking a long view of the journey, starting with the pre-PA phase as a key ingredient to your overall success as a PA. Within that pre-PA phase, I recommend focusing on three things:
- Work. You should be working in health care, with as much direct patient care, at as high a level, for as long as possible. Note that I don’t say “until you start PA school”, because I don’t recommend quitting until absolutely necessary. As an EMT, I have continued to participate in two separate Volunteer Fire/EMS departments—one in my home county in an adjacent state, one in my school’s county—as time allows. While PA school has curtailed the time I have for the fire service, I have learned more on each call since I started didactic year.As a PA student working with others at your former level of responsibility, you have the opportunity to share your knowledge; more on that in a bit. Serendipitously, every bit of money you can bring in is that much less you have to repay at 6.8% (or likely higher) interest rate.Your program may discourage this, and there are two very good reasons to do so: First, your time will be constrained and continuing to work may steal time you need to study. A fair caution, but one that we will tackle in a bit. Second, if you step outside of your scope of practice and do something that you learned in PA school, you could be in all sorts of trouble: with your school, with your licensing agency, your state medical board (you know, the ones who will be reviewing your license application, assuming you graduate), in civil court, or even perhaps in criminal court!
- Study. It is hard to be neutral on learning—people either love it or they do not. I love it, and to be perfectly honest I do not understand why anyone who does not love learning would go into a medial field.So, as you’re preparing for PA school now, learn. While there is a clearly related set of coursework that most PA students will have successfully completed before matriculation, if you limit yourself to only that course of study, you will be educationally impoverished. Entering PA school at the tail end of my 30′s, I brought an absurdly diverse set of coursework (both for academic credit and not), hobbies, and business experiences to the table, which have served me well. The writer of Ecclesiastes notes that “there is nothing new under the sun”, and that has been borne out in the ways I have been able to reuse knowledge and experiences accumulated over the years. If you’re at a loss for what to learn about (good that you have all your prerequisites nailed down already), my advice is to learn how the world works, how people work, and how the two intersect.While you are studying, teach. Conveying information necessitates you understanding it well beforehand: qui docet, discit actually works. One of the best ways to do this is to continue working in your pre-PA healthcare field and share tidbits with patients or those still working in the field. If done well, this gives you an opportunity to both cement your own knowledge as well as to “pay forward” your faculty’s investment. Since patient education is a large part of a PA’s job, it is a good idea to get good at it now.
- Relationships. One of my classmates grows Bonsai. If I took a full-sized adult plant, and subjected it to the rigors and limitations of Bonsai in an attempt to shrink and sculpt it, the shock would probably kill it. What he does with his plants is much more consistent and sustainable. In the same way, relationships not managed appropriately beforePA school are at serious risk. The closer the relationship—such as that of a spouse, child, or romantic partner—the bigger the possible disconnect between what you will be able to give to your relationship during PA school and what is expected of you.Let’s not mince words: PA school is probably the single most difficult thing most of us will ever consciously and intentionally do to our relationships. Relationship attrition rate during PA school is higher than most like to admit, and many level-headed people arrive at PA school with the expectation that their loved ones are 100% supportive and willing to set aside all their own needs for the two years or more of PA school.Would you run a marathon without training? Of course not. Would you run a marathon by taking two months off, free from any exercise, in the belief that being “well rested” was the best thing for your performance? Yet, I routinely hear advice that goes something like this from PA students:
“Since you’ve got a few months before school, take those months off, be with your entire family on vacation and spend as much time with them as you can, because you won’t have near as much time for them once you’re in PA school”
In the spectrum of bad advice, that is well-intentioned but sub-optimal. My advice is, instead, to gradually establish a status quo that will work for PA school. My own was to work a full-time job, be a full-time student, volunteer as a firefighter/EMT, and continue my extracurricular involvements with Boy Scouts and my church. By the time I started PA school, my family was used to me being absent quite a bit of the time. In fact, once we had settled down in our new location, I tended to be able to see more of them than I had before PA school.
However, just like there’s a fine art to Bonsai, there are also plenty of ways to do this elegantly:
- Start slow. My family had acclimated to my volunteering for two years before I started classes again. Over two more years, I worked from one course per term to three, gradually increasing my efforts and making course corrections as we saw how those levels impacted my family.
- Make your activities count. I would study OChem or do work for my employer in between calls when I was on shift as an FF/EMT. Time management is an essential skill for PA school, so you might as well get used to needing it before you ever arrive.
- Make room by rescuing wasted time. Do you keep textbooks in the bathroom? If not, start now. What’s on your iPod: medical podcasts or music?
- Don’t be selfish, but don’t be a martyr, either. You will need to shrink your own personal time in the process—doing anything else is selfish and unfair to those you love. In fact, your own personal time should probably be the category of time that is pruned most viciously. Having said that, you will absolutely need to zero in on which activities keep you from going crazy, and make time for that self-care: the key to this is sustainability, for both you and your loved ones. The effort before PA school is about finding a sustainable way to handle everyone’s stresses.
- Know what your loved ones need, and always deliver. They have needs. They might volunteer to forego their needs, but that’s unrealistic on several levels. Spouses and significant others might intellectually believe this is an appropriate thing to do, but it really is not. You do not want your spouse resenting what you need them to do for you to succeed in PA school. If you have kids, their needs will change during your PA school journey: they grow up, and two and a half years may not be long in an adult life, but it’s an eternity to a grade schooler.This is your excuse for proactive counseling: find out what the hidden weaknesses are in your relationship—what are you not doing that your significant other needs? What are you doing for them that really isn’t helping? If you don’t find the hidden weaknesses now, stress will bring them out later. And yes, I do mean paying a counselor: consider it an investment in your mutual future.Over all, never take anyone else for granted.
- Spend extravagantly when appropriate. One of my former employees taught me that one will “buy nice, or buy twice.” There is no better place to apply this than in your relationship management. While the monetary costs of PA school may seem daunting, the personal costs are just as high: it’s an experience that will put your loved ones through the wringer with you. If you have a chance for a weekend getaway, and that is what your spouse or family needs, then by all means take it. Frugality can be shortsighted if it results in your partner giving up on you: if you think PA school is expensive, try throwing a divorce into the mix.
This, in brief, is my recipe for Pre-PA work: Learn as much as you can, work as hard as you can, and slowly and intelligently ramp up your busyness to PA school levels so that there’s no huge shock to your relationships once you matriculate.