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JP86

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  1. Since you are "soul searching" as you shadow, one thing to focus on when you shadow is trying to visualize yourself in that PAs shoes. Something that I noticed was drastically different than I thought it would be is how heavy the responsibility weighs on your shoulders. When I was shadowing before PA school and even to an extent on rotation during PA school, I always loved how it felt to be there in the action and couldn't wait until I had the knowledge to do it on my own. To an extent, I had a false sense that you really have a grasp on things by the time you graduate. Now that I'm 3 years out, it still surprises me how much more stressful it is than what I had imagined. Part of it is because our program harped constantly on covering yourself against lawsuits, so every chart I do I am thinking about how the chart would look like in court if it went that way. Constantly thinking about covering yourself against potential lawsuits takes a good deal of enjoyment out of it for me. It's something I'm currently trying to work through...a mental hurdle so-to-speak. Not everyone views it this way. My take home point is to put yourself in their shoes realizing that even when you graduate, there is so much you don't know. Try to realize the importance of each decision, no matter how small it seems, that the PA you are shadowing makes. If you are someone who can manage that stress level, then keep at it. If you don't like that kind of stress, really give it some thought.
  2. I can also vouch for the BS/MS accelerated programs as the college that I went to PA school at (Kettering College) did this (although I wasn't part of the accelerated program as I went to undergrad elsewhere).
  3. Hey everyone! I'm always looking for a free way to get some extra CME and was referred to the QuantiaMD.com CME site by a colleague. It is a community based CME site where you get a lot of evidence based cases. It is a nice supplement to other forms of CME. It is mostly category I CME. You certainly won't be able to knock out all of your CME from this site alone, but it's good for a few hours throughout the year. The cool thing about it is that if you complete certain videos or puzzles, you earn points towards getting Amazon gift cards. So far, I racked up enough for a $50 gift card. If you refer colleagues to the site, you get a ton of points towards the gift cards as well, hence this post! Just thought I'd pass it along. http://www.QuantiaMD.com
  4. You don't think you did enough?! You did more than anyone I've ever known, but it looks like it payed off and now you're ready to start your career. Time to pay off those loans! I'm throwing a kegger if that day ever comes around... Congrats on passing!
  5. I'm not sure exactly what you are looking for here. Most programs will hit Anatomy and Physiology first as everything else you learn will be building up from here. It is very thorough and is the one class other than medical terminology where everything is practically straight memorization, which is kind of nice I guess. My program tried something different that was aimed at both teaching anatomy, but also to aid us with reading radiology studies (most specifically CT and MRI) where they taught cross-sectional anatomy. I don't know if they are still doing it and I don't believe it helped an ounce, but is hard for me to judge since I had already taken a cadaver course previously in undergrad. As for what they cover...well, pretty much what you'd expect. All of the major muscles, nerves, arteries, veins, glands, and then very detailed physiology of all organ systems. I had taken advanced A&P in undergrad and quickly realized that while difficult, they just skimmed the surface in that class.
  6. I doubt this is anything new as the posts I have read have been full of great information. You simply will adapt unfortunately. Appreciate that you have made it to the program and don't let the faculty intimidate you by giving you those horror stories of no sleep. That is poor form. I am assuming they are trying to emphasize how serious this is and how much work will be required of you, but that just isn't the way to do it. My program did that to an extent, but you will quickly realize what is needed from you. GET SLEEP! It may not be a full 8 hours every night, but if you can't stay awake through lectures or while studying, then how are you going to remember the information? You need a well functioning brain which requires sleep. Why do you think they put these restrictions on residents who were being worked to death? This was what personally worked for me: Get to know your classmates and figure out who you work well with. Form a study group with up to 4 people. You don't want too many or nothing will get done. Come to an understanding that you are going to be each others support system. Study everything together and come up with a system. Quiz each other, simply just lock yourself in a room with them, or whatever works for you. Don't be disappointed if you don't get A's on everything. Most people who get into these programs are used to being high achievers and this is a tough thing to get used to. And for goodness sake, take a night off a week, even just for a few hours. You need to decompress and see your friends/family. Plus, your classmates are always good for a fun night out. It gives you a good outlet to vent your frustrations about the program because everyone has plenty to gripe about! Good luck! It will be over before you know it.
  7. Congrats! Do you mind if I ask what you used to study this time around? I've got a couple years until I'm up to the plate, but always good to hear what has worked for others.
  8. JP86

    Failed PANRE

    Sorry to hear that. I personally haven't been there simply because I haven't hard to recertify yet. My favorite book (and the only one I used for the PANCE) was A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants by O'Connel. There is a newer version out now than the one I used a few years ago. Someone above mentioned this resource as well. In addition to that, I did questions from PAEasy.com and Exammaster. A few of my co-workers in the ED recently recertified using the book I mentioned and did well. It is straight and to the point. For some other ideas, check out the link in my signature. There are several top rated review resources of all different types. Good luck and let us know how much you destroy it 2nd time around!
  9. I saw there was a newer version of the book that I used to take my PANCE a few years ago and I LOVED that book. I thought I'd share for anyone who is studying for the PANCE/PANRE as it helped me a ton. I used this along with some practice tests to get me ready and it worked well. Plus the book is much cheaper than the big week long review courses you can take! Obviously everyone has different methods of studying, but this is a good resource: A Comprehensive Review For the Certification and Recertification Examinations For Physician Assistants by Claire Babcock O'Connell It follows the NCCPA blueprint and is backed by the AAPA and PAEA. Good luck everyone!
  10. Sorry to hear about that. I have to say that we had a PA that was a tech in our ED before going to PA school and then coming back and she ultimate had the same problem. I didn't directly visualize it because I was newer to the group, but from her and the other PAs who saw it, it seemed like the nurses had a hard time adjusting from giving her orders before PA school and then taking orders from her when she graduated. Ultimately, she is one of those people you really don't want to mess with and "put them in their place" so to speak and life went on. But it was rough at the beginning from what I heard. I have a feeling that could be where your issues are stemming from since you worked under them and now technically are on the other end of the spectrum now. If things don't right themselves, I wouldn't be surprised if things went away if you went elsewhere and got a fresh start. I understand your reservation with the package you have. Good luck!
  11. I was trying to make it to this conference this year...but it falls on one of my busiest work weeks and didn't feel like working out tons of trades. I loved it when I went a couple years ago in Tucson! Plus, AZ is just awesome in general and I got to see my Reds at Spring Training which was nice. I hope you all have a great time and of course, learn something ;)
  12. I am an EM PA-C that works in an ER in the suburbs of a major city. We see around 50,000 patients per year. I have been practicing for 2.5 years fresh out of school with little to no prior medical experience. We have 16 PA's in our group. Half of us do acute care (main side ED), the other half do Fast Track. All of the Acute Care PA's graduated in the past 3 years so we have a TON of experience getting new grad PA's going (including myself). With me, I was a student (first at a trauma center for my main EM rotation and then with this group as an elective) with the group and they threw me in with no orientation fresh out of school. Thankfully after doing that with a few of us, they have now implemented a 3 month transition period working side-by-side with a senior PA. Then you must continue to present each patient to your attending physician until they feel comfortable with you (seems to be around 1-1.5 years). Some in our group have not been "cut loose" yet even after 2 years and that is understandable. I agree that new grad PAs these days aren't what they used to be. I'd say at this point, the majority of us are GREEN. Boy are we green. I believe if you are going to hire new grad PAs that it must be the right group. Our attending physicians take GREAT care of us and it works well. They seem to appreciate the chance to mold us to their desire and not have to "retrain us" as they put it. Not every group has that mentality. Good luck!
  13. I read a study this past year saying how in Europe and some of Asia this is the standard of care for uncomplicated Appy. They said not to expect it in the United States anywhere in the foreseeable future as we are stuck practicing defensive medicine in our lawsuit happy society. That's interesting because I too had a patient who presented as epigastric abdominal pain that ended up being an appy. However, I did scan the person because their WBC was near 18 and they had a pretty considerable amount of guarding with their Epigastric to RUQ exam. It was after hours and US was not available to us, so I did a CT with IV only contrast in all honestly trying to rule out ruptured gastric/peptic ulcer vs acute cholecystitis. The radiologist calls me and bet me I'd never guess the diagnosis and said that it was acute appendicitis with the location of the appendix being in the "perihepatic space." He said he has only seen one in that location a couple times. You just never know! And kudos to not overscanning...it's tough not to do in this country full of ambulance chasers!
  14. I also accidentally ordered a quantitative hCG (I have been doing more quantitative hCGs lately as I had a qualitative one come back negative recently, fortunately had high suspicion, then ordered the quant and it came back positive. Would have missed ectopic if I had payed attention to the initial false neg test!) on a 61 year old on a busy shift when I was putting in basic labs on patients that it was going to be a few minutes to see and it came back positive. She ended up having a mass on her ovary with mets if I remember right. It can be a marker for tumors in older patients. Just wanted to compound on your post and experience for others to see!
  15. One of my attending physicians recently recommended this. Is this approved for our CME? How would you log it? I figure as an AMA sponsored program through ACEP?
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