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Advice to Beginning PA Students

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I’d like to start a thread on advice on starting PA school. Some of my advice you’ll think is useful, some you’ll think is BS. Some advice won’t apply to your school. That’s fine. Life is a lot about keeping what you want and trashing what doesn’t work for YOU. Obviously, these are in no particular order of importance.

I’ll come back to this thread, as I think of things and add things as I think of them, as I hope other people will.


- Almost everybody is nervous beforehand. It’s normal. Almost everybody thinks they aren’t prepared enough to start rotations. It’s normal. A little bit of apprehension is good for keeping you on your toes. Too much apprehension just makes you lose sleep, freaks you out on tests, and tears you down. Everything is about balance.


- Keep a list of “Most commons”. Most Commons are like “The most common cause of ____ is ____. These will ALWAYS pop up on tests and even the PANCE.


- As you go through school, start to keep a simplified list of common diseases. Don’t go into all the variations. Keep it as SIMPLE as possible. Something you could fit on a 3X5 card. On rotations when a preceptor asks you to describe a disease, you won’t just stand there. Having it on your PDA doesn’t count, because it’s in you PDA and not your head. The idea here is it's gotta be short enough that you can review the stack in a couple hours or less, and review them OFTEN. Headings could be…..

Disease: again…in SIMPLE terms so that you can really picture in you head what’s going on

How I’d recognize it in clinic:

What tests I’d run to prove my Dx:

Treatement: Just list the main 1 or 2 tx that are the most common. Don’t list dosages or routes.


- You could do the same thing with 50 common drugs: what class they’re in, where they usually get used…


-ARC-PA: is a governing body that dictates to schools what they will require for a school to have in order for them to “approve” them. Schools contort themselves every which way to make them happy. There will be things you’ll see in school that will make no sense, but it’s not about you, it’s about the school contorting themselves to impress ARC-PA.


-One ARC-PA thing is listing the “Class Objectives” on the syllabus. Usually there are more objectives than any class could study in an entire year, much less one semester. Our class freaked out about the objectives at first, then in the end people just read the notes. Hell, sometimes the physicians who taught the class didn’t even know what some of the objectives meant….Study the notes. You can go over the objectives if you like…just don’t freak out about them.


- A lot of books on the “Book List” are there to impress ARC-PA. Don’t immediately buy EVERY book on the list. Start by just buying the main books. Ask your mentor to start with. I’ve bought a lot of books on Amazon Marketplace. Some really good books I’ve bought for like $5.


- Ask your mentor if you have questions. Mentors are a very untapped resource and extremely valuable. If you get stuck with a mentor who doesn't want to help, ask if someone likes their mentor, and if you can "share"


-If at all possible, get olds tests from you mentors. They’re extremely good practice.

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- Think of it as a marathon, not a sprint. Pace yourself. Get your sleep. Things will change now. It's no longer about getting A's. Forget about that attitude.


- It's now about learning what you need to know to not kill your patient! Some things your school will teach you. Some things you'll have to focus on by yourself in your "spare time", to get ready for rotations.


- Don't think that because you get A's on tests, that you don't need to study for rotations. There are straight A students who suck in clinic. There are C, B students who excell in clinic. Grades, in my opinion, aren't a barometer of future performance on the job.


- Some people are incredible test takers that will mystify and amaze you. Don't judge yourself by them. Focus on learning the way that works for you.

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Thank you so much Toolman, this is an excellent thread and rest assured that I will be checking it out often!


The advice regarding the grades/tests/clinicals was perfect because I am not a great test taker, but am good at "learning" have a great common sense and do very well with people, so that is where I get my confidence of being a good practiitoner.

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Guest TimErick

I have found that the reading assignments are more than I can possibly do well. What I have found is that if I read quickly through the material *before* the lecture, I am able to get a lot more out of the lectures. Then I don't really need to spend my time reading the material in depth; I just focus on the lecture notes and powerpoints from class.


I hear a lot of medical students saying they skip their lectures and just study the material on their own -- I can't imagine doing that in PA school. The lectures are my main input.

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Thanks for this post! All of us who are freaking out right now appreciate the input more than you know! It helps us get off to a good start to be prepared with a few tips from those who have been there.


I think I wrote this on a thread somewhere before, but a friend of mine who finished up the program this year told me that what you don't learn in class you will learn on rotations, and what you don't learn on rotations you will learn on your first job. In other words just try your best to learn all that you can and you can add to what you miss as you go.


I guess a huge fear that I have is concerning how to MANAGE the course load. I'm not afraid of the material itself because I have a strong background in basic science, but I am not sure how to organize myself and my time when I am overwhelmed with things to do and material to learn. Any tips or advice on ways to manage the work and schedule in the first year??


thanks again.

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I guess a huge fear that I have is concerning how to MANAGE the course load. I'm not afraid of the material itself because I have a strong background in basic science, but I am not sure how to organize myself and my time when I am overwhelmed with things to do and material to learn. Any tips or advice on ways to manage the work and schedule in the first year??




Agree with that fear - I know I can handle any class on their own - took Physiology, biochem and Microbiology in the same semester and got B, B and A- along with an A in Medical Sociology...


BUT those were 12 tough credits and 3 easy in a 16 week semester -


how about my first semester in PA this summer - in 12 weeks I have Gross Anatomy with Cadaver, Clin Med, Pathophysiology and patient interviewing (the easy one) - and after that there are 18 credits per semester - Always Clin Med, Pharmacology 1 then 2, and other classes.


So it's the course LOAD the learning to manage that freaks me out. What happens when I'm having an "ADD" day where I can't focus/concentrate? How does one make up for that? :eek: :confused:


Whew! Thanks for getting it off my chest! :)

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Tim, I think a lot (or at least some) people get OVERWHELMED by the amount of reading they assign. I have found that people who try to read EVERY, SINGLE, PAGE, just exhaust themselves. We've all been there...you're trying...to...(grunting) finish ...the...damn...reading ...assignment...only...20...more...pages...

How much are they really retaining??? When the test comes, their head is swimming, with factoids.

- Just read the notes! If there are things in the notes that you are unclear on...then go to the reading assignment and get clear.

- After you've read the notes a couple times and looked up what you don't know, work on simplying the diseases they're talking about so you could put it on a 3x5 card. (I'm not suggesting you put it on cards, just that it's that condensed).

- Go thru the notes and pull out the "most commons" on a separate document


I guess a huge fear that I have is concerning how to MANAGE the course load. I'm not afraid of the material itself

- The material IS NOT hard. It's the VOLUME of 'not hard' material.

- PA school is above all....one thing....RELENTLESS!!! It just goes on, and on, and on. It's funny, when we first started, everyone could tell you what test were coming 4 weeks ahead of time and started studying for it right then. At the end, no one looks further ahead than 1 week, and starts preparing for the test like 2 or 3 days beforehand.

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- IMHO PA didactic year teaches you how to pass the PANCE. Rotations teach you how to actually do the job. The two are NOT the same thing. I think that's why some people are so clueless on rotations is they've JUST spent the year trying to become an expert at taking tests and haven't been rehearsing practicing medicine.


- I think I would advise people to shoot for 85%'s on tests, and spend the rest of the time going over practical things you'll be asked to do on rotations.....writing clear professional notes on a chart, doing a Physical exam in your sleep, looking over your simplified disease lists and memorizing how you'll recognize it/ treat it, listening to lung sounds CD's, listening to heart sounds CD's, getting good at taking a quick History, being able to present the pt history to the preceptor in a clear and direct manner.

Does that make any sense?

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Absolutely, it's all about "balance" - my school went from taking in people with practical experience to choosing last year to go for the GPA and I hear that many of the 20 something year old graduates in molecular blah blah are not doing so great in the physical exams/people skills part of the program, but are kicking ass in the exam.


In the end, will a patient prefer someone who has knowledge and people skilss or someone who has a 4.o and not a clue about how to make them comfortable???


So, I totally agree with your point.

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happens when I'm having an "ADD" day where I can't focus/concentrate? How does one make up for that?

I don't know if all schools do it, but a lot of schools have Graduate Assistants who tape record the lectures, then provide notes. They don't do it on all the classes, but usually do for things like Pathophys, Clin Med, etc.

Lots of people have days "where you just can't listen anymore", then fall back on the notes. That's OK.


What do you do if your school doesn't have a note service?....I don't know, maybe have friends take turns taking full concentration notes and exchange.

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No notetaking service - and I heard the Gross Anatomy teacher does not allow students to video tape or record (using school equipment which would be better than our own little tapes) - And I heard she's all over the place and 100 mph - so I have to resort to being "on" whenever I go to her lectures... :mad:

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I can’t emphasize enough how important Test Banks can be.

I’ve listed some of the books I’ve used. I’m not advocating Amazon, I’ve just used them to show you the name, ISBN, and cover. You can get ‘em anywhere. Get them used if you can. Get as many as you can or care to.

I was taught about test banks from a physician who was triple boarded in IM, Pulm, and Critical Care…so the man had taken a lot of tests. His advice is as follows:

Say you’re studying Internal Medicine in class and you’ve got a test coming up on Cardiology. You then just go to each test banks section on Cardiology. There may only be 50 questions in each bank on Cardiology so it will only take you a few hours to go thru 4 or 5 test banks. Each test question usually has ONE POINT that the author’s trying to make. You could write or type on a separate piece of paper, the MAIN POINT of each question. When it comes time to review for that test, or even in 2 years for the PANCE, you have a shorter list of main points to go over, (instead of trying to review all of Harrison’s).


PA schools tend to use test banks a lot to write tests questions. There are only so many ways you can phrase a question.

APAP A must have

Appleton & Lange A must have

Review Questions A must have

Primary Care for PA's A must have

Newer version of Primary Care for PA's Check it out if you have extra cash. It has different questions than older version

A&R's Quick Review A simpler form, but sometimes I HAD to start with this one.

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Those were the PA books. Now we're getting into USMLE Step II books. I love these!

If you're in med school, you take USMLE Step I to go from 2nd year didactic to 3rd year rotations. Step 1 is mainly the basic sciences. You take Step II after your 4th year. Step 2 is clinically oriented. Don't be intimidated by these. You WILL DEFINATELY be able to understand (and get the right answer) on many, many questions. You're gonna be on rotations with residents...these are books they studied. I've known a few med students who JUST studied test banks, and that was it!


Start practicing to take the PANCE on day ONE of school, not 3 weeks after you graduate!!!!!!!!!


In general, Family Practice Step II's or Internal Medicine Step II's work well. For didactics, you want a test bank that divides qestions up in the same categories that you're taking tests on (IM-cardio, nephro, etc)

Family Practice A very nice test bank

Swanson's A classic

Medical Student Pearls series These are great. and fairly simple reading. They also come in different flavors...Internal Medicine, Pediatrics..

USMLE Step 2 Secrets Again, easy reading

Appleton & Lange review IM A little tougher, but doable.

PreTest Series These are GREAT. They also come in many flavors.

The Secrets Series Equally wonderful! Easy to read. A must have

Blueprints Series Q&A Equally great! very quick reading. Available in Medicine, Ob, Peds, Psych, Surgery


Whew! I'm exhausted. Maybe I'll lay down for awhile :p

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Hold on a minute...a few favorite text books.

5MCC Remember how I was saying to "keep it simple" This is a great start.

The Scut Monkey!!!! aaaagggg!!!! need I say more. This is my life.

Dr. Netter A legend. It makes me happy just to pick this book up and hold it.

Rohen Utterly amazing and beautiful. Like pristine artwork.

Grant's I like Grant's. It just nice to use both Netter's and Grants to get different views of something

Essential Clin Anatomy A nicely done, simple little book

Acute Med Algorithms Sure, Sure...it's nice about HLA-B27...but what am I suppose to DO next???? this helps

Decision Making in Med A bigger, fatter cousin for your desk.

PA Review Sorry I forgot this one in the PA section. Very well done review for the PANCE. No Q&A, but a outline format. very good.

Harrison's I saved the best for last. Pardon me a second....I have to bow before Harrison's....It's like a shrine....the Mother of All Textbooks!!!!!!!! It makes me feel smart just opening it's pages. (which I need all I can get)

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Just a few more and then I'll quit

Lippincott's Pharm Nicely condensed. You can keep your daddy Lange, and his ugly kid...baby Lange. I like this book better.

Pharm Made Riduculous Silly...yes. but by God it breaks it down. Learn it...Know it...Live it...

Atlas of Derm Great book...I laughed...I cried.....I nearly spewed chunks.

ABC's of Lab Data Wonderful book! a must have for you lab coat or desk

Medical Abbreviations How many abbreviations are there in medicine?? 14,000 and growing. Thanks to this book...I can now write an ENTIRE paragraph using ONLY abbreviations. (and other people actually know what I said!) "A 50y/o WDWN WM c PMH of COPD x15yr c/o PND, , SOB..." It's a sick world.

Tarascon Great for class or wards.

Sanford's The bugs don't stand a chance with "ole yeller" by your side.


There are a few more...well...read these and get back to me!

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"Listen to me now...and believe me later"....Most commons will haunt you from this day on!!! It'll be on EVERY test you EVER take in medicine. On rotations, it's the mother of all pimp questions. People love most commons! I should write a book and sell it to residents and students to pay for my student loan!


I should be able to wake you up at 3am and and ask you, "what's the most common congenital heart defect in ped's?"....

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Guest Negeen

So on top of the books we get in school (of course..not all) you guys suggest the above books? wow....there goes most of my financial aid check!



Thanks SOOO MUCH for all your feedback, you guys are so great!

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