Rotations: Little fish in a big pond

[2wheels]

  In about a month's time I start clinical year and it's got me a little stressed. So much so, in fact, that I keep waking up in the middle of the night from dreams of patients I didn't know how to diagnose or treat and I can't go back to sleep until I figure it out. I've heard from a lot of people that rotations are one million times better than sitting in a classroom and I'm inclined to believe them but am still more than a bit anxious. I have enjoyed relative academic success in didactic but I know that that doesn't necessarily translate to clinical competence. I had about 4 years of solid, paid clinical experience before school as a MA/EMT/whatever-they-needed at several rural clinics but half of my rotations (ER, Surgery, Peds, IM) are at a very large trauma 1 teaching hospital and I've never been exposed to health care on that kind of scale.

 

  I've had plenty of books recommended to me and I've been reading through some of the Case Files series and will probably dip into Surgical Recall as my surg rotation gets closer but I was hoping to get some practical tips (and maybe a little encouragement?) from anyone who precepts, works or who has rotated at a large hospital with Attendings/residents/interns/med students/PA students all over the place. All advice is welcome and much appreciated.  

[EMEDPA]

you will be fine. just show up early, have a great attitude, try new things, be fearless, stay late, and always make life better for your preceptors, not worse. make them happy to see you.

"that 2wheels works really hard!" is a much better impression than " I can't wait until 2wheels is off the service".

[gbrothers98]

Case files are great, I use them a lot in preparing reviews for 2nd year PA students.

Secrets are good too, they are great for little snippets of info during any downtime.

Anxiety is not necessarily a bad thing, it can give direction and motivation.

I would make sure right now you are getting some exercise during the day and some sunlight.

Both can suffer during clinical year esp if you have to commute to a site or there are long hours, ex. my ortho rotation started at 430am and ended usually after 8pm. 

Looking at patients as diagnoses you have to figure out is a worthwhile endeavor. Most patients come to you with a set of symptoms, they dont come with a diagnosis taped to the forehead.

Instead of figuring out what the deal is in the middle of the night, write it down and work on it during daylight hours.

No screentime an hour prior to bed, your mind wont shut off.

If this keeps up, you need to talk with someone. You will get psychotic from lack of sleep.

The big medical center is just like your little clinic, just a lot bigger and you will have to walk further when you park. You will pick up the rhythm, just be observant, be polite, thank people when appropriate. There will be a lot of parallels, you just have to look for them.

When you actually get to see a patient, this is your mantra....take ownership.

You will get every ounce of learning from every patient encounter if you take ownership.

Good luck.

G Brothers PA-C

[surgblumm]

I have a new book out for the last three months entitled: Surgery for the Physician Assistant" It is specifically designed for a surgical PA Program and for a PANCE rotation where all of the questions asked by your surgeons are available to you. It is a simple format and is sold on Amazon and is for electronic devices as well as a book. It will enhance anyone seeking to know surgery. Bob Blumm

[whoRyou]

Thanks Mr. Blumm