Studying for first job?

[jlumsden]

I have now passed the PANCE, and start my first job in an internal medicine/primary care clinic attached to a mid sized hospital in an urban area on November 11th.  It serves adults only.  Would you recommend reviewing some of the PANCE stuff again before beginning? For those of you who are new, is there anything you wish you had gone over, now that you are working? 

 

Alternatively, would it be better to enjoy my time off while I have it, and accept that there will be a learning curve wherever I go?  Support for new grads and the transition period is excellent, by the way.

[newton9686]

I wouldn't recommend re-learning material on the PANCE. PANCE knowledge and clinical knowledge are not equivalent. 

 

I am interested in what others have to say on this subject as I am still a student myself. However, my vote would be to read books that focus on differential diagnoses if you studied anything. 

 

Obviously there is going to be a learning curve no matter what you do. Like the NFL, even successful rookie quarterbacks have a learning curve, but its the ones with support around them that excel. 

[SedRate]

Disclaimer: I work in a surgical subspecialty.

 

Enjoy your time off! Sure, if there's an area you're nervous about or want to review, go for it. But the PA career requires a lot of on-the-job training wherever you go, so get some R&R time in now so that you're ready to bust your butt and ride that learning curve. Good luck!

[jlumsden]

I like your answer.  More tapas and workouts it is!

[moestown1016]

Get some good resource books like five minute clinical consult or a few books that you can quickly reference for when you do start your job and dedicate some YOU time! I would take 2-3 days before you start to get back in the groove and review stuff you're most likely to see

 

 

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[WeBuyAndSellJunk]

Gonna rep HippoED ER, urgent care, and primary care RAPs (reviews and perspectives) podcasts. They are some of the best, affordable, CME that is clinically relevant that I have found.

[SedRate]

As the above posters recommended, I'd also recommend getting some good references you can use when you do start. I found a few websites and books that were extremely helpful. I still use them to this day. Consider reaching out to your future colleagues for advice or additional resources.

 

Moestown has some good advice of giving yourself a few days to reset and prepare. I felt that this was helpful for me also.

[GetMeOuttaThisMess]

If I might make a suggestion, go to each specialty organization and look at current guidelines/treatment recommendations for the more common conditions that you would see from each (not what you were taught but what THEY recommend).  You need to have your lipid, HTN, RAD/COPD, DM, hypothyroid, UTI/pyelo, back/joint pain, influenza/cold/sinusitis, and sleep/anxiety/depression guidelines down pat.  Know the adult immunization recommendations back and forth (can't believe the number of folks that are dx'd with DM or have had RAD and their PCP never recommended a PCV).  Also do a general review of abdominal pain and differences in presentation for the more common conditions (PUD/duodenal ulcer, gallbladder, pancreas, small bowel/colitis) and what to recommend (avoid anti-diarrheal agents in pt.'s that are in fetal positions, spewing bloody/mucus-filled stool, and running a fever).

 

I've said before but it warrants repeating; learn how to recognize who's sick versus who thinks they're sick.  Avoid friction from the get go by asking your SP how THEY want to address the big bear in the room, i.e.-abx prescribing and controlled substances.

[mackjacks]

If you can, it might be good to review some of your SPs charts to see how they do things before you start. Every clinic has its own weird quirks. For example, my doc loves the old TCA Sinequan for sleep/anxiety and I'd never heard of it in school or on the PANCE.