Jump to content

First Semester PA Questions

Recommended Posts

Hey everyone! Im currently in my first year of PA school and I wanted to post on the forum here to seek some advice and wisdom from some of the more seasoned PA's found in this forum. The questions I have are as follow: 


Our class ranges in #'s of age, background, and years of experience. One of the common things our program does is start very early in the helping us think outside of the box and come up with differential diagnosis in a plethora of clinical based scenarios. So as expected with the levels of clinical experience, age, and various backgrounds we commonly have these audaciously long differential diagnosis (like something off of the tv show "House").


My question is, when you were in school... did you find yourself constantly having to go back through notes, powerpoint, and books to think your way through these clinical scenarios? As a first semester PA student is this stuff that should be expected, or are they trying to get our thought process on a good clinical tract for the future semesters. Right now we feel like the majority of our class takes a shotgun approach and throws all kinds of typical and atypical differentials based off of the clinical presentation of symptoms found in the case study patient. Is this normal especially in the first semester of PA school? Any suggestions on how to better relate the vast amount of material we are learning with how we should be thinking clinically?


Second question: Although my knowledge base is relatively weak in comparison to the amount of information how can I/my classmates better prepare ourselves over the next few semesters as we progress to clinicals? I understand being a PA, or working in medicine in general is a life long learning process.... but Im looking for better ways to make associations between the material and how I should critically think so that I can be a better PA of the future. 


Last question: I think it would be fair to say that everyone in our program didn't know how to study for PA school during the first few weeks of PA school. There was an eagerness to learn material, but when compared to the amount of information we went about it the wrong way. Now, the majority of us find ourselves "cramming" (although we study all the time) from test to test... just because our program makes us maintain a certain gpa or we go on academic probation. Therefore, is it normal to feel like you are cramming and the information bleeds/runs together we everything else. Second semester we will have a better grip and be able to study multiple subjects with more ease. 



Thanks in advance, 


Mr. Medwar

Link to comment
Share on other sites

Good questions!


A lot of PA school is getting you to think a certain way, especially when it comes to differential diagnoses. It takes a while for you to pull things together and thrashing through your notes is common. You have to see things a lot (especially in practice) before much of what you’re doing becomes second nature. The goal is to keep a wide net in diagnosis and then slowly pare it down so that you don’t overlook too much. This is not second nature to many students.


As to how best to progress, have some faith in your program and its faculty. They are (hopefully) working to introduce material to you in a sequence to build your knowledge for clinicals (and passing the PANCE). Just do your best with each new subject and task and trust that the process will take you where you need to be


As far as cramming, I suspect many students end up there. I recommend studying to stay up with the material. Try different techniques to organize the information for your own unique brain. In my case, over the days and weeks leading up to an exam, I built an “all-star” set of boiled-down notes that I didn’t think I could remember on my own. Then, the evening or two (or three) before the exam, I reviewed those notes. It worked for me; I can’t guarantee that it will work for you. Be an experimentalist and find the best techniques for you. Get some sleep before every exam!


As far as your third comment, yes, I do think that the first semester is spent trying to figure out how to deal with new material, multiple subjects, and finding techniques that work best for you. Many people have stood exactly where you are right now  and the vast majority found their way through. You probably will too!


Good luck!

Link to comment
Share on other sites

  • 2 months later...

" Any suggestions on how to better relate the vast amount of material we are learning with how we should be thinking clinically?"


I'm a big fan of med board review books. There's a lot out there and much of the material is the same, often with a little more depth. Step 2 has a lot of clinical stuff and step 1 is good for patho. It's good practice for pance. I really like the First Aid series as they have detailed explanations of both the right and wrong answers. BRS and High Yield series are good too. They also mix some pharm in and it's being in the context of cases will help you absorb it.

Link to comment
Share on other sites

Hi Medwar -


The process of developing a differential diagnosis should become much less haphazard as you go through school and the shotgun approach should hopefully go away. It is important to cast a very broad net when initially developing a differential - if you leave something important out, it can take a long time to circle back to it. Most likely your school will help you develop a systematic approach which will become easier as your knowledge of anatomy and physiology improves.


For example, if you have a case with chest pain, you can take a shotgun approach, or you can think anatomically. Anatomic thinking will help you to quickly develop a list of usual suspects:


Cardiac: MI, pericarditis

GI: Esophageal spasm, stuck food bolus

Musculoskeletal: Costochondritis, muscle strain, spasm

Neuro: Radiculopathy, zoster

Pulmonary: PE, pleuritis

Vascular: Aortic dissection


Systematic people tend to not miss bad things.

Link to comment
Share on other sites

Those are great questions! What you're experiencing is completely normal. In general when creating differentials, at first it will be a shot gun approach because lots of things can present in very different ways. Eventually you'll learn the most common presentations, most common diseases and most common populations and start to work with that. In practice, I run with the most common stuff almost exclusively. If something is really rare, I'm consulting a specialist. It's important to cast a wide net at first though because it's the best way to learn. Outline your diseases by looking at epidemiology, etiology, signs/symptoms, diagnostic tests, treatment and prognosis. Once you're organized and you keep working with different diseases, it will all come together. For now, relax. There is no way around the learning process, you have to go though it. We've all been there. Don't let yourself get discouraged. If you're bright enough to ask for help and efficiency tips, I'm sure you're doing great!

Link to comment
Share on other sites


This topic is now archived and is closed to further replies.

  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More