Sitting around and wondering what it'll be like in PA school if and when you get in?

[Doc Savage]

I am recalling something from Doc Evan's lectures... might it be erythropoetin? I am not sure but for some reason that popped in my brain when I read your question.

[Hemegroup]

I am recalling something from Doc Evan's lectures... might it be erythropoetin? I am not sure but for some reason that popped in my brain when I read your question.

 

http://www.ncbi.nlm.nih.gov/pubmed/17630596

http://www.ncbi.nlm.nih.gov/pubmed/14713115

 

"The critmeter is proposed to be a functional unit located at the tip of the cortical labyrinth at the juxta-medullary region of the kidney where erythropoietin is made physiologically."

 

You are correct!

[showard873]

Steve,

 

I just sat here for the last hour and a half reading this thread and I am excited, nervous, and impressed all at the same time! I found your descriptions of what this process of learning and acclimating to full time student life is like extremely helpful. Reading over some of the subject manner has prompted me to pull out my A&P notes to refresh. I was surprised at how much I was reminded of while reading your posts and anxious about things that I should really review! It's a nice heads up of what is to come....hopefully in my near future!

I submitted my application to MEDEX earlier this month for the next academic year and I am hoping that I will have what it takes in the eyes of this school! I am hopeful, but humble because I know there are many qualified candidates. Enjoy your break from PA school with your family and thanks again for sharing your thoughts!

 

Sara

[av345]

Steve- I agree with Sara- Just sat here at work in between patients and read all the pages, printed off some things Id like to review, and discussed some ideas with MD's sitting next to me charting. This thread is awesome. I plan on repeating Anatomy this winter and if I can get in would LOVE to take some genetics just to prep before applying this spring (fingers crossed for next year!)... but keep it coming.

 

Its wonderful to hear that it can be done, you're enjoying it, and congrats on doing great! Have a nice break

[Just Steve]

Well howdy Campers! I hope everyone is alive and well. It's been a bit since my last update. My apologies, but there was a month break for summer vacation that I took full advantage of, and our first two weeks of school has been rather occupying. I thought I'd take a moment to jot some thoughts down, then get back to working on a presentation due on Monday.

 

During the break between summer and fall quarter, the faculty made it very clear for us NOT to work on PA stuff. Turn off the academic brain, turn on the hedonistic center of our collective melons and focus on living life a bit. Once things kick off in the fall, things start rolling fast and pick up speed.

 

I spent my four weeks off connecting as much with my kids as I could. We did several camping trips, a few rafting trips, a bit of hiking, some caving, fishing, visited the zoo of course, and took one weekend to spend with my best friend smoking cigars and enjoying fine bourbon while armchair quarterbacking (rocks and drift wood seats really) the surfers at Short Sands on the Oregon coast. Granted, that was only one weekend, but it was good medicine for sure.

 

Moved up to my abode in the Palm Springs of Washington (Yakima) and settled in with my two very cool roommates. They scored a sweet pad just three miles from school in a nice neighborhood. Have been bike commuting. It occured to me about half way through our first week how fortunate I am to have solid roommates. Seeing how there is a tremendous amount of homework to attend to, I am finding it's imperative to have a stable, supportive living arrangement.

 

School has been fun. Right off the bat we jumped into physical exams. Day 2 we were in patient gowns checking each other out. The days have found us seated for about a three hour lecture, then three hours of doing something active ie: physical exams, interviewing our live actor, or visiting our retiree at the local retirement home. History, review of systems, and basic screening exam has been the primary focus so far. We will get more indepth over the next quarter with branching exams. We are actually taking several courses at once. Basic clinical exams is one....that is matched up with behavioral health, technical skills, professional role development, and pathology. It's been laborious trying to unscramble the confusion that is Moodle, the school's main web presence for information dissemination but it can be done. Just a small learning curve.

 

Things are busy, but not yet hard. We have had a few essays to write, a SOAP note or two, behavioral health has quizzes to complete based on the assigned reading for the following day's class (ensures that the student is pre reading) but most of this has been a review of my previous experience. The school is HUGE on collaborative learning and those of us who have held an otoscope before are doing our best to help those who haven't. I have been able to come home to my wife and kids (about 2.5 hours away) and spend quality time with them for the past two weekends for which I am grateful for. The winter and spring quarters are legendary for their difficulty and time suckage so I need store up some good family karma while I can.

 

Good luck to everyone as applications get submitted and interviews start to happen. I'll try to keep y'all posted on how things are going here in the land of PA-S1. Fire away any questions you may have, I'll see if I can answer them.

[Just Steve]

There is always a lot of discussion on this board, and I am sure in other arenas as well, debating the merits of having previous health care experience before going to PA school.

 

As the readers of this thread probably already know, I am attending UW/Medex's program, which requires 4000 hours of direct patient care before showing up for school. One of our current homework assignments is labeled as a "clinical resource project" or CRP. What this entails is that we are given a written story line of a patient with a particular chief complaint, then we start off listing our differential diagnoses based on that complaint. We then list all the questions that we would like to ask to help narrow our ddx (completing a problem orientated history). A history is then presented to us, we re list our ddx, adding or removing ddx's as we see fit, but having to give rational why we are changing our answer. Next we list the specific physical exam procedures that we would want to do, then we are given a written physical exam to review, and again, we re fit our ddx based on what the findings are, giving rational for any changes. Next we are to write a list of procedures and labs that we would like to perform and specify why we are asking for these..what is it are we looking for? And as you can imagine, they give us a list of lab findings, we are to interpret, then again revise our ddx. To close, we write a complete soap note.

 

It is an individual assignment (no study group), but you are allowed to use any books or resources (other than people) to assist you. This was assigned in the second week of PA school, before we learn any disease processes, or lab tests, or clinical procedures, or one bit of clinical practice medicine, outside of the lesson on how to perform a complete history and physical. (which was taught week one).

 

I could not imagine being able to even come close to a half way correct answer if it was not for my previous experience. Of course they say there is no "wrong answer", they want to see how your brain operates and if you are able to function in a problem orientated mode.

 

I have no idea how other PA schools get the ball rolling but if I was fresh with no medical experience, I'd probably withdraw at this point.

[jphadall]

Thanks for your posts Steve. It's great getting a taste of what's to come!

[Just Steve]

Friday of week 3. Home once again with my family, taking time to unwind a bit from the week. Our "assignment due" calender is filling up fast for sure. This week we had a branching exam of HEENT..delving in deeper into just that collection of systems. Dabbled in some pathology lectures, ambled off campus to a practice lab doing urine microscopies. This morning was a graded practical exam on the HEENT branching exam, this afternoon was all about reviewing the Myer Briggs exam that we all partook in. I happen to be an ESTP..no real surprise there.

 

Had my first "holy &*%@ I am over my head" moment on Thursday after the three hours on neoplasms and cancers. I thought I had some clue on what was going on in that arena...turns out, I don't know squat. That in turn cascaded into "I don't know anything about medicine" despite my 2 decades of direct patient care experience. A healthy dinner and a good night's sleep helped me regain my focus and get back into my usual state of mind. I was slipping into a crappy diet and horrible sleep pattern habit that was wearing me down. The sore throat/runny nose should have been my first clue. The few minutes in the car thinking "what the hell have I done" on Thursday was my second clue. Luckily I listened that time.

 

Be sure to take the time to take care of yourself. Neglecting yourself physically will just lead to breaking down mentally.

 

Have a funtastic week

[AEspy]

Are you in class every day of the week? M-F?

[Just Steve]

Are you in class every day of the week? M-F?

Yes we are. Class starts at 8:30, typically scheduled to 4:00, sometimes run a little over, sometimes get out a bit early. We get an hour for lunch most days. Today we attended Grand Rounds at the local hospital during our lunch break. I only know of one person out of 27 of us that is working on the weekends. Everyone else is just a full time student.

[just_me]

after this week I can tell you about MHC-II and T-Cells as well as B Cells but ask me to calculate the risk of 3rd degree family member of a child with Trisomny 21 due to non-disjunction developing Downs and Ill look at you like you're insane.

 

Took me two days to learn basic immunology but in genetics I cant seem to get beyond just knowing the names and phenotypes of anueploidy, x-linked, autosomal dominant and recessive disorders...ask me anything about risk or what tests to use to detect them and I draw a blank:saddd:

[Just Steve]

Time for another Friday update...quick glance back over the previous week:

 

Monday: Cardiovascular Physical exam, heart sounds, and practice on our peers. Evening session at the local Heart Center listening to 5 different patients, all with confirmed heart murmurs. Faculty were there to help discuss what we were hearing and put a finer point on the nuances of doing the actual listening. Quick objective write up of one of the patients. On line quiz surrounding issues of aging, rest of evening spent reading pathology book, studying objectives.

 

Tuesday: Cardiovascular history taking presentation, practice on our peers who are reading from a pre assigned script, writing a SOAP note based on the history we obtained. Afternoon spent with a geriatric care manager discussing the mobility issues of the aging, then an hour trying out different mobility assist devices while we had splints taped to our fingers to replicate arthritis, sunglasses blacked out with electrical tape to simulate blindness, cotton in the ears to muffle hearing, and our knees hobbled together with an elastic band to throw off balance and our natural gait. Another evening in the Heart Center for heart tones, then more pathology reading/objective studying.

 

Wednesday: HEENT pathology lecture. Three hours of pictures on the big screen with a local physician discussion what we were looking at. We have studied the anatomy/physiology already, it was really great to see things through the eyes of a clinician instead of an academic skew. A "working lunch" at the local hospital for Grand Rounds, the lecture was on Robin's syndrome in pediatrics. Afternoon was spent visiting our patient in the local retirement home performing a cardiovascular exam and the subsequent SOAP note to correspond. The subjective portion of the SOAP is based on the complete history and ROS we obtained a couple of weeks ago. On line quiz about difficult patients, and another on hematological tests. The rest of the evening in the pathology book reading and studying objectives.

 

Thursday: Mental Health therapist presented a course on the "difficult patient" which translates to a review of a variety of personality disorders. The afternoon was spent in a team based learning (TBL) format discussing case studies on patients from a hematological view, helping reinforce material that a provider gains from basic labs and how it can help support your working diagnoses based on history and physical. Evening spent reading pathology, studying objectives, and an hour with a study partner performing a cardiovascular exam.

 

Friday: Practical exam performing a cardiovascular exam on a peer this morning, this afternoon we head back for an afternoon packed with dermatology.

 

So it was a moderate week. I did go home last weekend, and my wife and kids are coming to Yakima to visit this weekend but I am feeling some pressure as we have our first big pathology exam on Tuesday, followed with a mid term over all the basic clinical exam material the following week. Maintaining the fantasy of getting with my family every weekend is getting strained but I just need to be more diligent during the week to read more effectively and stay on top of the objectives for studying. I have been allowing myself too much time to just "unwind and space out" after the "official" school day has wrapped up for the day. I have room to improve and that's ok...it's a good place to be when compared to the alternative of "I'm maxed out and have no more wiggle room".

 

Good times for sure. I just keep reminding myself that this didactic year is like being pregnant. Basically it's the same time...about 40 weeks. The other day I tried heating up water for the coffee in the cabinet instead of the microwave...sometimes I space out and pour the hot water into my waiting coffee cup instead of the French Press so I end up with a coffee cup full of hot water and a French press of dry coffee grounds...easy fixes but man do I feel stupid. I just blame it on my "pregnant brain". Being a male, it is probably the closest I'll have to experiencing it. As long as the final exam for the year isn't as painful as passing a kid, I'll be ok.

[Just Steve]

after this week I can tell you about MHC-II and T-Cells as well as B Cells but ask me to calculate the risk of 3rd degree family member of a child with Trisomny 21 due to non-disjunction developing Downs and Ill look at you like you're insane.

 

Took me two days to learn basic immunology but in genetics I cant seem to get beyond just knowing the names and phenotypes of anueploidy, x-linked, autosomal dominant and recessive disorders...ask me anything about risk or what tests to use to detect them and I draw a blank:saddd:

 

That was our summer session...we called it summer science camp. Two weeks of A&P review to wrap up the 14 weeks of online class then 4 weeks reviewing genetics, immunology, bio chem, and something else I can't recall right this second :-) Nice to have that pushed to the back burner and let us actually be out of our seats during the day doing some hands on stuff. Really helps the days fly by.

[Calhoun]

My favorite thread so far in my short time posting here.

[Calhoun]

My favorite thread so far in my short time posting here.

[Just Steve]

Week 5 of fall quarter is in the can. The routine is starting to feel a little familiar but I still feel scattered. We are taking several courses at once, each one of then under a different heading on the scholastic program called Moodle. If you fail to be diligent in checking each individual class file, it's super easy to miss an assignment. I find that to be most tiring. I struggle to find a rhythm that is proficient in doing daily sweeps to find all the assignments but everyone is in the same boat. The school is very into the collaborative style of learning and as a result, the vast majority of students are very good about helping each other keep track of what's coming down the pike.

 

We just had our first large test over a few pathology sections which went well. I found the test was fairly congruent with the posted objectives of learning which made studying a bit more streamlined. This next week we have our midterms over "basic clinical skills" which cover things like "When you observe the eye for jaundice, what does it indicate when you find it?" or "What does hair loss, pallor, and ulcers on the lower extremities indicate?" This is on top of a weekly practical exam on the performance of clinical exams (this past week was respiratory)...then there are the various quizzes on things like laboratory exams, professional development, and behavioral medicine that are done on line, on your own time. This past Monday we video taped ourselves while we interviewed an actor while they returned to "our clinic". My patient is a bit of a multi system health maintenance presentation (HTN, hyperlipidemia, anxiety that sort of thing). Some of the other students had to tell their actor that they had HIV...heavy news to deliver for sure.

 

So back to studying, I have a few chapters to cover.

 

Good night, see you next week.

[showard873]

I have been diligently following this thread and I am really glad that you take the time to post how your first year at MEDEX is going week by week. I appreciate your candor and humility. When/if I am accepted to the program I will remember this when I am ready to pull my hair out and wondering what I got myself into. I'm sure there are many like me who would feel the same. I think everyone expects PA school to be tough, as it should be, but this thread gives all of us "hopefuls" a glimpse as to what it will really be like. It also gives piece of mind that everyone goes through the same feelings and misgivings. All this information is both inspiring and motivating!

 

Thanks again for doing this :)

Sara

[Planteater]

Yes Steve- thanks for sharing! I get all happy inside when I check the pre-PA section and see you've posted an update :;;D:.

[Just Steve]

Fall midterm wrapped up. HUGE realization moment during my drive back to the pad. GOOD STUDY GROUPS HELP IMMENSELY! I know there is a large population of you study bugs that already know this. You have your flash cards and quiz each other in line while waiting on your Starbucks order. I now realize how much it helps.

 

So I am looking at all you introverts and cowboys. Shy quiet ones and renegade loose cannons...those folks who think they can just buckle down and push through PA school worrying about Numero Uno...while I am sure you may be able to, WHY DO IT? There is a triangle with work at one point, fun at another point, and results at the third point. Slaving away by yourself is a lot of work and no fun. Having fun and not working will give you poor results. Keep that triangle at the isosceles angle...all nicely balanced. Have fun while you work, get great results.

 

Dividing and conquering the material will lessen your work load, offer more time for fun, and maintain good results. Don't go at this alone.

 

We're off until 5:30...I'm headed to the mountain to find some snow and unwind with Mother Nature. Ciao'

[Hemegroup]

As long as the final exam for the year isn't as painful as passing a kid, I'll be ok.

 

Oh don't worry ... it will be ;)

[Just Steve]

Howdy folks. I realize it's been awhile since my last post. Time flies by faster than I realize until I glance at a calendar and realize "Holy Cow! Time is really flying by."

 

So tonight drew the curtain on week 7 of fall quarter. Today was a practical test on the neurological system...it was a daunting piece of performance when we first peered upon it. Someone counted and reported 142 different steps that needed to be done, most of them in order, while asking key questions along the way and taking note of findings. While we have had the exam in our hands since August, we haven't really dived into learning it as we have spent every week of fall quarter learning a physical exam on a different system. Last week was GI...I think. It may have been respiratory, I don't remember to be honest...All I know is that I believe all 26 of us cracked open the neuro gig on Monday and all of us went "THIS IS CRAZY!" Daunting is a good word. 4 days to learn made things feel a little compact...not to mention our usual weekly workload of SOAP notes and studying objectives, clinical reasoning problems, nursing home visits, and pathology report papers.

 

However, as with anything, we just started pecking away at it. Some folks sat down with their papers, opened their Bates manual, and just went for brute memorization. Other folks such as myself made a little game/dance out of it. I think we all agreed though if we dissect it into segments, then find a key to unlock the transition from one segment to the next, we could digest it. And digest we did. The test went well. What seemingly seemed impossible to pull off in the allotted 25 minutes ended up taking me about 16 minutes. I was cautioned to slow down as a typical patient won't be able to keep up with my pace. So I made a note to give my future patients a can of Red Bull during their visit to ensure they can keep the pace :-)

 

We had about 50% class turnout for our Friday evening "Journal Club" meeting to discuss the current trends in PA education...no..not really. It's Happy Hour with decent food and great prices. Keeping that balance of some relaxation in the mix is a re iterated key that you'll always hear me stress. Tuesday is a large pathology exam and we all need a breath of fresh air before diving back into the books. This weekend will be the first that I haven't gone home to be with my family. I was struck with a GI bug Sunday night that kept me from eating or retaining any food for 3.5 days. There are few things in life that sucks more than trying to concentrate in class while your GI system wants nothing more than to void itself with little warning. As a result, I am behind in my studying a bit and need the weekend to catch back up. Fortunately my wife and kids are super supportive and understand I'll be home next weekend for Veterans Day Holiday for three days. I'm a Vet, it's my birthday, and it's a weekend. That's some sort of trifecta. While I won't be going home this weekend, I do plan to coerce some classmate into grabbing the books, objectives, and go for a drive to the mountains for lunch and study time.

 

Being a kinesthetic learner, it is a real struggle to sit still and simply read and memorize. Nothing makes me fidget more and find ways to distract myself than to sit down with some thick book full of heavy reading and try to understand what the heck it's saying. However...a few folks hanging around goofing off on a slack line or kicking around a soccer ball while playing "stump the chump" over the learning objectives is AWESOME for me. My point? Find a way that works for you then seek others who can help you with that.

 

I see the collective future PA class of 2014 is starting to form nationwide. Congrats to those of you who have been selected. Good luck to those who are waiting, and a shout of encouragement to those who did not make it this year. Keep working hard, keep your eye on the prize, and don't get discouraged. All ya gotta do is break it down into manageable pieces and digest it. You can get through it. See you next week

 

Steve

[Just Steve]

Week 8 polished off. Pathology 2 exam wrapped up. Research paper due date is looming. Clinical reasoning plan write up taking shape. SOAP notes for the week are 50% completed, pathology 3 and basic clinical exam finals need to be studied for......when I it write it all down, it looks as busy as it sounds in my head. Oooph... 12 class days until finals week, then a week of final exam testing, then holiday break. It'll be nice to turn off the brain for awhile.

 

They say next quarter simply picks up at the intensity that this one lets off at, and continues to climb. At least we are not underwhelmed. :-)

[Just Steve]

Cruising along through week 9. Tonight I wrapped up the clinical reasoning problem (CRP) #2...17 pages, typed.

 

It just sorta stuck out to me...here we are in the first quarter, haven't even gotten into clinical medicine yet. We've done quite a bit of pathology and history/physical exams, but the basic thought process of clinical reasoning hasn't really started yet. However, the assignment starts with "Sallie Mae is a 24 year-old graduate student who presents to the urgent care clinic complaining of abdominal pain and nausea for the past two days. She has not been able to eat, but she is taking fluids." From there we are to create a list of differential diagnosis and then a list of questions that we would ask to confirm or dismiss our initial suspicions....the exercise continues with physical maneuvers that you would want to perform and the results of a history/physical. Later we get lab results, read a wet mount KOH slide...then write a SOAP note over it all including treatment and education plans. (threw in ICD and DSM codes just for brownie points...the DSM is because the history reveals pertinent findings)

 

17 pages..which is about on par with our CRP #1 which I scored well on.

 

So if you're wondering what PA school is like...well...it's fun. It's busy, but fun. I just wonder what our CRPs will be like when we actually get into the clinical medicine portion of our course where we are expected to take things to the next level...will the finished product be so streamlined and smooth and turn into a quarter of it's current size? Or will all the extra knowledge manifest into even more pages? I'll let you know in a few months.

[Deadliftyourspirits]

Always enjoy reading these.

[Just Steve]

It's 12:23 in the morning...it's been a pleasant evening at the weekly journal club meeting. Tonight we discussed which appetizer plate was the best match for our fluid electrolyte balance. After three different visited establishments in search of the best combination we wound back up at our usual favorite. I have to say...wearing business casual (came from school) and walking into a bowling alley in small blue collar town was good for a hoot. I figured it would be interesting when the biggest truck in the lot parked by the door with a sticker on the back window reading "Ditch the *****, lets go huntin'" Seemed a little Broke Back Mountain to me...nothing wrong with it but I just couldn't begin the see the wrath of crap I would get if I called my lovely bride a "*****" and follow up with "I'm going hunting". I can bet response would be "Take your nice shoes...I'm throwing everything you own into the wood chipper."

 

Ah week 9, what can I say about you...little bit a'country, little bit rock and roll. Scholastically we keep busy writing charts, doing exams, learning pathology, writing papers. A pathology paper is due on Monday, then Turkey weekend, then start tuning up for final exams. We are busy...very busy....people feeling the pressure...like the lid is on the pot and it's getting hot in here. People starting to squirm, but also settling in. Finding their niches and spots in the pecking order. We lost a member of our class for non school related cause..he was a roommate sharing bills...my other roomie and I will have to figure out what to do about the bills and all...pay them of course but suddenly that little emergency fund you save for a rainy day may have to get rained on soon.

 

Tonight's evening out was a great medium lubricated with dis inhibitors so that one my fellow classmates felt comfortable to talk to me about how my direct and sometimes intense ways of asking questions doesn't really jive with what she feels would be a better way of asking questions. I was given ample time to respond and point out of my view...I was glad to get that conversation handled as it helps clear the air which was getting a little hazy. I felt like we were a couple of string beans inside the pressure cooker, just getting shook around a bit, helping us settle in tighter than ever. It's a weird metaphor but it works for me. :-) It's all good.

 

The work load is increasing..I wish my home work was down for the weekend so i could ski but there is always next weekend. 30 inch base at White Pass in Washington...opening day is Sunday. This is what I deserve for not doing my work earlier. Oh well.

 

good night folks...my electrolyte balance is off....see if it will remedy tomorrow