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Issues with clinical placements


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Hi everyone,

 

I'm a first year student but I wanted to share some concerns I have with my program and clinical placements. My program hired a new clinical coordinator who, so far, seems significantly less capable than the previous person in that position. I am not in my clinical year yet, however many second year students have expressed frustration of being placed at locations that are over an hour from school (which they did say was a possibility before enrolling), but also the tardiness of being placed; one student found out her location for her July rotation on July 3rd. It may be a separate issue, but this new staff member has also been very condescending, arrogant, and hostile towards students when they express concerns. 

 

I know with the increasing number of PA schools there is bound to be some saturation for clinical rotation sites, but seeing as how the consensus is zero confidence for the new clinical coordinator, I am a little nervous about not getting quality rotations next year. Have any students had similar experiences? I know that whatever happens the best thing to do is work my butt off, which of course I will, but I'd be lying if I said it wasn't in the back of my mind. 

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You really have no choice at this point.  Well, not really, you could apply to different PA programs while in your first year, but that seems quite risky and expensive for a perceived problem.

 

I was told to expect that no more than 5 of my 10 rotations would be within an 8-hour drive of the school.  The real number was 9 of 10, and the 10th was the international rotation I'd requested.  I suspect that rather than malice or incompetence, the clinical team at the time tried to under-promise and over-deliver, and your school may be the same way.

 

A few of my peers had last-minute changes in rotations--not through the fault of the school staff, but because preceptors flaked, or quit, or died, or in one case because the student showed up on a no-fly list with a ridiculously common name, he wasn't able to work at a federal prison.  All of mine worked out OK, despite a the angst and anxiety I had before.

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I specifically asked for rotations that were within an hour (family obligations), two of my nine rotations were 1.5 hours. It was painful for 5 weeks each time, then it went away. 

 

Finding placements can be tough. One way you can make things easier for the next cohort, is to behave professionally and do your best during your rotations. Also, if the preceptor is not teaching while you are on rotation, let your program know.

 

Last minute changes will happen - as Rev says, many times not the fault of the program, but something on the preceptor side. You just have to roll with it.

 

Good luck! I suspect that everything will turn out fine, in the end.

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Problems like this happen at even the most established schools with the most experienced clinical coordinators.

 

If I'd gotten a single rotation within an hour of my home I would have been ecstatic. Suck it up unless the quality of the rotation suffers - you can do anything for six weeks.

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What you have done is to lump all your concerns into one issue which is how your clinical year will be affected.

 

First, every cohort develops a personality. The cohort out on rotation now sounds disillusioned, upset and frustrated. They have focused this perception on the CC. If this CC is new and has not done the job before, that person has a learning curve. Most people don't respond well to criticism that is not constructive. If the CC is lashing out due to this, no one is surprised....if he is actually condescending, arrogant and hostile.

 

2nd, who has zero confidence in the new CC? While the current students may, the admin may not. So it is likely you may have to work with this individual whom you have already developed a negative attitude towards. How is that going to go for you next year? Anecdotally, most individuals, especially those who hold your future in their hands, respond better to respect and politeness along with a little sugar thrown in.

 

3rd, the state of clinical rotations whether PA, NP or physician are in dire straits nationally. Patients want competent providers but dont want to see them during training. Competent providers are busy and are flat out refusing to take students unless paid. They they do things like outlined above like get sick, go on vacation or die.

 

4th, define a quality rotation. 

 

5th, if you are taking time to write this post, it is taking your time away from what you can control, your didactic performance. There is no crystal ball any student at any program can provide in this situation or any including their own.

 

Good luck.

G Brothers PA-C

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it's a bit late now, but the best way to get quality rotations is to attend an established (been around > 20 years) PA program with a strong reputation. at my program we had (and I assume they still have) far more sites than students so students could pursue subspecialty interests like trauma surgery or GYN surgery or ENT surgery to fulfill their surgical requirement. I did peds em to fulfill my peds requirement. the other advantage of attending an established program is that their sites are likely to all be good. they have already gotten rid of all the bad sites and preceptors. newer programs often take whatever they can get, even folks who should not be teaching and sites not amenable to a good experience as a student. I have never been offered money to be a preceptor and would not ask for it. if they sent me a check I would say thank you, but I don't expect to be paid to precept. apparently I am one of only a handful of em preceptors in a 2 state area now and almost always have a student, even though the rotation is 100% nights.

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  • 4 weeks later...

What you have done is to lump all your concerns into one issue which is how your clinical year will be affected.

 

First, every cohort develops a personality. The cohort out on rotation now sounds disillusioned, upset and frustrated. They have focused this perception on the CC. If this CC is new and has not done the job before, that person has a learning curve. Most people don't respond well to criticism that is not constructive. If the CC is lashing out due to this, no one is surprised....if he is actually condescending, arrogant and hostile.

 

2nd, who has zero confidence in the new CC? While the current students may, the admin may not. So it is likely you may have to work with this individual whom you have already developed a negative attitude towards. How is that going to go for you next year? Anecdotally, most individuals, especially those who hold your future in their hands, respond better to respect and politeness along with a little sugar thrown in.

 

3rd, the state of clinical rotations whether PA, NP or physician are in dire straits nationally. Patients want competent providers but dont want to see them during training. Competent providers are busy and are flat out refusing to take students unless paid. They they do things like outlined above like get sick, go on vacation or die.

 

4th, define a quality rotation. 

 

5th, if you are taking time to write this post, it is taking your time away from what you can control, your didactic performance. There is no crystal ball any student at any program can provide in this situation or any including their own.

 

Good luck.

G Brothers PA-C

 Gbrothers --- You capture the frustration we feel as students well.  We forget that faculty really are trying hard to help.  I have rarely seen aggression towards faculty end well.  Especially when it is someone who basically owns you for the next year.

 

I would add that an attitude that comes across as condescending might be the product of different emotions.  It is more than likely the CC feels quite a bit of pressure, and wants to do well.  In addition to assigning students to positions and tracking paperwork, a new CC has to establish relationships with preceptors and clinic administrators, get to know the policies of the university, and sometimes adjust to a new community.  This is going to slow things down in the first year.

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Everybody told me "Oh, you'll have at least one rotation that sucks..."  and "Nobody gets along perfectly with all their preceptors."  I had 7 rotations and each one was beneficial and good.  I enjoyed them all.  It was all about how I approached my rotations and my preceptors.  It was all about how much work I put into the rotation.  Yeah, my preceptors had to show up.  But every time I showed up (mentally and physically) they saw a desire I had to learn and they showed up, too. 

 

I had a couple of rotations which I did not enjoy at all - state mental health facility and endocrinology.  At the mental health facility I spent more time doing chart review than anything (I once had to summarize a patients chart who had had 43 admissions to the state facility over a 35 year period).  But I learned how to do chart review well.  I also learned about atypical antipsychotics in my spare time and a whole crap load of other stuff.  It was beneficial, if not enjoyable. 

 

My endocrine rotation I got to shadow the PA I was working with.  I didn't touch a single patient or conduct one single H&P while I was there, but I still learned a crap load about managing diabetes and specifically diabetes in pregnancy.  It was still an invaluable rotation and I use information gleaned from it to this day. 

 

Your rotations will be what you make of them.  Wherever they are.  Keep that in mind.

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