adjk1229 Posted November 19, 2011 Share Posted November 19, 2011 Steve, Thanks for posting these updates. I'm sure that they will help keep me sane as I re-read them in my first year of PA school knowing someone else went through it already, and made it. They're very inspiring and get me excited to get my feet wet with science again!! I'm so excited! Thanks again and look forward to hearing more! :) Link to comment Share on other sites More sharing options...
Just Steve Posted November 30, 2011 Author Share Posted November 30, 2011 Holy smokes...time is rushing past. Week somethingorrather...doesn't really matter. What matters is that Finals is next week and I am about as unprepared as raw hamburger. In fact...using that analogy...I am that cow standing in the field, not even butchered yet...that's how unprepared I am. But...always a but...I like the pressure. I like feeling a bit of weight on me..helps push/motivate me. It gives direction..of course that direction may be straight down the drain but I'll be focused on the way. This time next week I'll be done with the majority of second quarter of PA school...the two large tests behind me and just a couple of smaller practical exams ahead of me. Holiday break and the taste of snow flying off my ski tips will be here. Then comes January...cue ominous music. Rumor has it that things have been pretty much a breeze until now in comparison. To Yakima class 19 applicants...I'll see you all Saturday morning...good luck. Remember...confidence...fake it until you make it. They are not trying to bust your chops, they just want to get to know you. Relax and have fun with it. Link to comment Share on other sites More sharing options...
IdahoPA Posted December 1, 2011 Share Posted December 1, 2011 I, too, have been reading your posts and have learned a lot. Thank you! I have a few questions, though. It seems like there is a lot of info thrown at you pretty quickly. Do you feel that you have adequate time to actually learn concepts? Will you recall this info later? Secondly, do you feel that your prior HCE has been beneficial? (I assume that as a military medic you did basic exams for a variety of reasons, so you would know a bit.) Thanks! Good luck with the rest of the quarter. Hope you enjoy your break! Link to comment Share on other sites More sharing options...
Just Steve Posted December 2, 2011 Author Share Posted December 2, 2011 I, too, have been reading your posts and have learned a lot. Thank you! I have a few questions, though. It seems like there is a lot of info thrown at you pretty quickly. Do you feel that you have adequate time to actually learn concepts? Will you recall this info later? Secondly, do you feel that your prior HCE has been beneficial? (I assume that as a military medic you did basic exams for a variety of reasons, so you would know a bit.) Thanks! Good luck with the rest of the quarter. Hope you enjoy your break! My past experience has been invaluable to me to allow me to live a very comfortable life during my time so far in PA school. I get home almost every weekend to see my family, and dedicate that weekend to them...not locked away in my office. Yes, the information comes fast, but I try to get it all in my head during the week...So far I haven't had an exam or moment where I just had no clue. My 10 years as a Navy Corpsman and subsequent 12 years as a paramedic left me with enough residual education to help me greatly. Has school gone by too fast to absorb....hmm....I don't think so. There are a lot of concepts that I already have seen in my previous experience plus these quarters are building blocks that we keep re visiting. This quarter of physical exams has been building on anatomy which we covered over the summer. Next quarter will be clinical medicine, revisiting physical exams, the spring quarter will revisit all of this information again. Yes, it comes fast, but it comes back around often. So while you may not comprehend it on the first round, by the third time you see it, you're pretty good. There are times that you just scratch your head feeling like there are big chunks of substance missing but the school has designed an education model that has proven pretty effective. Sometimes you just have to trust the system. The school wants you to succeed. The weeding process happened back at the application review and interview. From that point forward, they are very invested in your success. It will not always be easy but it is very doable. Link to comment Share on other sites More sharing options...
Just Steve Posted December 5, 2011 Author Share Posted December 5, 2011 BAM! Just like that, it's finals week. I swear that just yesterday we were settling into our chairs in the classroom for day 1 of fall quarter. I feel like I sorta zoned out for a few minutes and when I brought my attention back to the "here and now" it was 3 months later. Holy time warp Batman. Ssssoooo looking forward to winter break. Some family time, some ski time, some me time...just put the books on a shelf for a few days while I let my eyes stare at snowy peaks and clear rivers instead of black text on white background. Fall quarter has been busy, but far from impossible. We're expecting winter quarter to be far more intense. I better stock up on Wheaties and Snicker bars. This past Friday/Saturday I had the pleasure to meet about 36 applicants for Medex Yakima class 19. I gotta be honest...it was so much nicer to be on the other side of the welcoming table. I remember being in their position a year ago full of nerves. It seems so long ago but at the same time it feels like it was yesterday. I hope I get to see you all again in the coming year as class 18 touchs base with our incoming "junior class". Back to Neuro objectives...as Robert Frost once said..."..miles to go before I sleep". Link to comment Share on other sites More sharing options...
Just Steve Posted December 14, 2011 Author Share Posted December 14, 2011 OOohhhhhh Holiday break, how do I love thee? Let me count the ways.... 1. seeing my family 2. not seeing a classroom 3. not staring at a Robbins Pathology book 4. sleeping in and being a sloth 5. this list could go forever Well it's good to be here. Finals week went ok. The pathology test was uncomfortable and made me question some of my logic spending as much time goofing off that I did but I passed and stayed sane. In the end, that is what we can all ask for. In a brief recap of finals. Monday was Basic clinic skills written. 100 questions focusing on the exam of a patient, knowing normal from abnormal, being able to translate what you are looking for into what it may indicate. It was a gentle test for most of us I believe as my whole class has had at a minimum of 4000 hours of patient care. Tuesday was pathology...it was not so kind. This was my first exam so far of PA school where I walked out wondering if I passed (80% is needed to pass). Cancers are not my thing and it's evident I need to make it my thing if I expect to get through clinical medicine. Damn you hyper plastic changes and all that stuff. Wednesday was an OSCE. With a fellow student, we walk into an exam room, one student is handed a script to play the patient, the other student plays the practitioner. We interviewed, examined, documented, then presented the case. The students switch roles, get a new script, and the other gets graded as well. We have done similar things for the whole last quarter but this time the body system was "dealer's choice". Previously, we knew what we were being tested on, so of course we boned up on that one thing the night before. This time, we walked in blind. So of course the night before, we boned up on 9 different exams...Probably not the desired education model that the school was looking for, but it is one that is expected to occur. I received the GI complaint so my review of systems was rather extensive. I was hoping for a twisted ankle or wrist pain. I was all keyed up to ask them all about their sexual history so I could tie in their mono articular joint pain with disseminated arthritis from Reiter's syndrome, which can occur with certain STI's (but not only with STIs)...no such luck. Thursday was the performance of a basic head to toe physical exam. We were tested on this during our first week of fall quarter and most of us balked. We thought that the given 25 minutes was wwwaaayyy too short and the required verbalized steps in the process were too numerous. It was a great example of how much we have learned in the past 12 weeks. It was harder to not verbalize more stuff, we performed the exam much slower this time, with much more confidence. Had oodles of time left over at the end. I even stopped mid exam a couple of times to tell a joke or an anecdote. Not because I was showing off but rather I was relaxed and had a bond with my "patient" (fellow student) and the proctor of the exam. It felt really good to be so relaxed, yet so proficient. So have faith ye pre PAs...you can do it. Just trust yourself and apply yourself. In overall review, the fall quarter was pretty painless. Yes, there was some time spend studying and whatnot but I also spent a fair amount of time relaxing and not doing school work. I got home all but 2 weekends of the quarter (before mid terms and finals). I passed all my classes with a comfortable margin and I am still happily married and my kids remember who I am. Next term is supposed to be soul crushing so I gotta buckle down for that. Do I suggest you approach PA school with an attitude of "this will be easy"? No. But if you freak yourself out and lock yourself in your study cave for 12 weeks you'll have a miserable existence and still not have any better grades. My point is that your brain can only handle so much at a time. Studying for hours on end just means you are digesting the same material in the same inaccurate way or you are digesting the wrong material. Getting away from the desk, refreshing your mind, body, and soul allows you to get back to your school work with a new, improved angle which makes you a better student. So y'all get out there and enjoy the holidays, whatever you may wish to celebrate. Do a couple of snow dances for me...the skis are tuned up but the conditions could be better. Come on Uller, god of winter...come visit the Northwest. I have turns to make before class starts back up on the first week of January. Link to comment Share on other sites More sharing options...
Corpsman2PA Posted December 14, 2011 Share Posted December 14, 2011 Congrats on getting through this semester! Thanks for keeping us informed of your happenings. Great advice about not locking yourself in a room to study for hours on end. I'll be sure to implement a steady "stress buster" routine when my time comes. Enjoy your time with the fam! Link to comment Share on other sites More sharing options...
IdahoPA Posted December 15, 2011 Share Posted December 15, 2011 It has been an odd winter thus far for the PNW. We normally have snow beginning during Thanksgiving break until spring. Our streets are bare. But I'm glad you survived (and prospered, from the sound of it) another quarter. Can I ask how long the winter break is? I've never been on a quarter system, but it seems like it would be a bit shorter than a semester's break. Here, we have about a month. Thanks! PS. Can I assume all MEDEX classes are on the same schedule, regardless of location? Link to comment Share on other sites More sharing options...
Just Steve Posted December 15, 2011 Author Share Posted December 15, 2011 I do believe we have the same break on all campuses. Since we test on the same days, I can't imagine one campus having a different number of education days prior to any test. Finals week was listed as Dec 5-9. The following week is listed on the calendar as "retest week". The school is VERY clear that the following week (12-16) is a mandatory appearance should you need to retest any exams. If you have no need to retest, enjoy your "extra" week of vacation. The school does not want you buying your holiday break travel tickets, starting on Dec 10th and then suddenly realize "oh no, I have to retest but I already have plans to be in Mozambique" The retest schedule is non negotiable. So the moral of the point...if you are going to make plans to travel during the "re test" week...you better be wicked sure that you personally won't need to retest. There are a lot of smart, talented folks who found themselves having to go back to school this week. A bad test or two can happen to any of us so just keep that in mind. Class fires back up Jan 3. Link to comment Share on other sites More sharing options...
Just Steve Posted January 3, 2012 Author Share Posted January 3, 2012 Well howdy campers! Are we all excited to get back to school tomorrow? Yaaaaaaaa.... It was on track to be a pretty wonderful winter break. I haven't had this much time at home with my family over the holidays in years. Our local ski hill had pitiful conditions so skiing was sparse and I was starting to crawl the walls. The Xmas holiday offered some nice distraction as my children became immersed into their bounty (thanks Grandma/Grandpa/Aunt/Uncle). The snow started to fall once again I got a couple of opportunities to get skied. We even got the kids up for their first ski day ever...it just happened to be the same day it was DUMPING snow and howling wind. I figured if I take them on horrible weather days and they like it, the sunny days will be even better. So as I got my books ordered and started updating my CV, I got a phone call that no one really wants to get. Me: "Hello, this is Steve"....Them:"Is this Gene's brother?". Well crap...I have made a few of those phone calls in my day and knew they weren't calling me to say I won a cruise. The good news is that his grape didn't get smushed aka: head trauma. Bummer news is that he will probably never walk again without pain, if he gets to walk at all. T boned on the driver's side, pelvis/left hip destroyed. I know just enough medicine to scare myself to death. Sepsis, ATN/renal failure, DIC, PE, osteo avascular necrosis, CVA, pneumonia, pneumothorax (he's still on a ventilator)...the potential list of complications rolls on forever. Him weighing 350 pounds doesn't help matters much. I spent the last two days at his bedside and it really tears me up. I know he would be really torqued out of shape if he found out I blew off school to sit and watch over him but holy cow it's tough to not be there. I feel so damn helpless. But I met his general and ortho surgeon. The nurses speak highly of them. In the world of trauma, he ain't that bad. His spine and head are good...issues with is sciatic nerve but that may not be written in stone. Barring complications he should roll on out in another 10 days or so hopefully. Mom and his wife are there and his work mates are super supportive. So it's back to school tomorrow...I'll be a bit distracted for some time to come but all we can do is press on forward. So today's lesson for the pre pa student? Never let yourself think that "this is all I have to worry about". You never know when something is going to pop up from the background. Link to comment Share on other sites More sharing options...
jphadall Posted January 3, 2012 Share Posted January 3, 2012 Steve, Sorry to hear about your brother Gene. I wish you and your family the best during this difficult time. Sincerely, Justin Link to comment Share on other sites More sharing options...
panelson Posted January 3, 2012 Share Posted January 3, 2012 JustSteve, You weekly posts on here have really made me excited to start PA school (which is now less than a week away). I wish your brother the best of luck and a quick and full recovery. Best wishes, PA Brescia Link to comment Share on other sites More sharing options...
showard873 Posted January 3, 2012 Share Posted January 3, 2012 Thinking about you Steve! I hope your brother has a speedy recovery and that he will shock em all and walk again without any problems. Sara Link to comment Share on other sites More sharing options...
LESH Posted January 3, 2012 Share Posted January 3, 2012 Sorry to hear about your brother Just Steve. Here's to a speedy recovery. Link to comment Share on other sites More sharing options...
swooshie1 Posted January 3, 2012 Share Posted January 3, 2012 Wow, so sorry to hear about your brother's accident. Best wishes to you and your family. Link to comment Share on other sites More sharing options...
Planteater Posted January 3, 2012 Share Posted January 3, 2012 I am sorry about your brother, but I am glad he is in good hands! Prayers/thoughts for you and your family. Link to comment Share on other sites More sharing options...
swimbikerun4fun Posted January 3, 2012 Share Posted January 3, 2012 Steve, sorry to hear of your brothers accident. Good for me to be reminded once again never take anything for granted. Lifting your brother and your family up. One day at a time bro. Cathy Link to comment Share on other sites More sharing options...
Just Steve Posted January 4, 2012 Author Share Posted January 4, 2012 Unexpected but welcome news...he was extubated today. Neurologically intact..grumpy and hungry like always. It was nice to hear his raspy voice on the phone. I'm off to sleep for a few hours before I dive into tonight's homework/reading list. Link to comment Share on other sites More sharing options...
IdahoPA Posted January 4, 2012 Share Posted January 4, 2012 I'm sorry to hear about your brother. It sounds like he's in good hands, though. Hoping for the best! And good luck on your new quarter. :) Link to comment Share on other sites More sharing options...
cmi5017 Posted January 4, 2012 Share Posted January 4, 2012 Just Steve, I am sorry to hear about your brother's accident. My dad was in a very similar accident 4+ years ago. He was t-boned in the back seat, "jaws of death" on scene, broke everything besides his back including both hips, femur. He has 7 screws and a plate that keeps his pelvis intact (he travels a lot for work and beeps at every airport security check :-P) We were also told he might not walk again, and if so probably never without pain. He has no recollection of the first 1-2 months in the hospital. He was bed ridden for several weeks, in a wheelchair for 6 months, then rehab. BUT a year later he was walking long distances, could even jog! (He was 48 at the time) So always keep hope and motivate HIM to get better!! Thank you for all your updates on PA school. I will be entering school in 2012...hopefully just wanted to share my story, because I know what it is like for you right now - stay strong! Good luck this semester! Link to comment Share on other sites More sharing options...
Just Steve Posted January 4, 2012 Author Share Posted January 4, 2012 Thanks everyone...While my father's own illnesses did eventually take him, it was a gradual onset, very predictable, with nothing but time to help process. This situation with my brother was SO acute and so close to death it really rattled me. It serves as a stark reminder that bad stuff happens to good people without warning and no one is really safe, no matter what we tell ourselves. In a educational sense, this has been an eye opener. I have been around medicine since 1988. I have always enjoyed an "all access pass" to anything that I was remotely curious about concerning a patient (yes, even with HIPPA laws). I didn't have to gain access via unit secretaries or "hope" that the doc will find the time to talk to me...I just went to their office. Now I find myself in a hospital where no one knows me and they really don't care what I think I know. I don't have a hook up who can network me in. I am getting a brilliant education in what families go through when their loved one is behind the curtain. As I jump through the visitation hoops I am discovering how flippin' frustrating it can be. If anything, this experience will leave a long lasting impression on me and it has changed how I will approach families in the future when it comes to their loved ones. So while this lesson has occurred outside of the traditional classroom, it is as valuable as any class I have had to date. I am sorry my brother had pay the metaphorical tuition costs on this and I'll make damn sure it's not forgotten. Link to comment Share on other sites More sharing options...
Just Steve Posted January 8, 2012 Author Share Posted January 8, 2012 Week one of winter quarter is wrapped up. Or as I like to say, one day closer to retirement. Outside of the familial events that have occurred, this week has been a busy one. The amount of reading is fairly staggering for thi kinestetic learner. Adult medicine, emergency medicine, pharmacology, maternal/child health, technical skills, professional role development, and behavioral medicine. Tinintelli's on the iPad and a stack of books on the desk...it is rather impressive how easy it is to ignore such an oppressive study list. It boils down to "study a bit, goof a bit" cycle. We're deep enough that I can no longer get by on luck and dashing good looks. I have been seduced by the kudos of a strong GPA and no longer will the mantra of "good enough" be truly good enough. I am going to need to resupply my stash of Snickers and Wheaties. My brother's surgery went well and he should be out of the ICU tomorrow. So hard to see him suffer. Time can't go by fast enough. Link to comment Share on other sites More sharing options...
Just Steve Posted January 10, 2012 Author Share Posted January 10, 2012 We had a problem based learning gathering today, doing a group session to discuss a case. We mostly had a solid idea of what the most common diagnosis may be but then we started to wander out into the safari in search of zebras (less common causes). When making your list, consider our lesson of the day... VINDICATE Vascular Inflammation Neoplasia Drugs Infection Congenital Autoimmune Trauma Endocrine I dig it. I'm sure it will come in handy in the future. Link to comment Share on other sites More sharing options...
Just Steve Posted January 19, 2012 Author Share Posted January 19, 2012 Hey everyone. I realize it's been a little bit since I updated, sorry about that. Life really does have a way of flying past. It's really amazing how fast a week or so can flash by. I settle into my class seat at 9 on Monday morning and before I can blink, it's Friday afternoon and I'm headed home for the weekend. If I aged as fast as time seems to fly I would look like the 100 years old in about 2 weeks of real time. The information comes fast and furious. Medex is pretty clear that the lectures are only here to give pearls of knowledge for you to file away for the days of your eventual practice. The speakers are given the test objectives for that particular section of material but they do not insist that the speaker touches on them at all. The test objectives are written from the study material. PA school continues to be one of the hardest, most expensive self study program that I have been part of. Having a very solid medical background has helped immensely in allowing me to maintain my sanity and keep my face fresh in the memory of my loving family. The material that I read is sticking pretty well...it's just that I really struggle to sit and just read. It is taking a ton of discipline to make myself do it and some days I just fail to read at all. It's a struggle, a bit stressful knowing that I am only harming myself but so far I have been able to catch back up by attending study groups and engaging in the discussions. I feel like I'm walking a tight rope. I did experience a new medical event the last night though. I have never been exposed to woman's health. Well...that came to an end last night with my first performance of a pelvic and medically directed breast exam. While the experience went well, it was not without it's own moments of "holy cow". Our faculty had been telling us that the live models have been allowing students to perform exams for quite some time and they also work at the local medical school. We were told that the volunteers were very comfortable with educating and that we, the students, just need to relax and trust that these women were also relaxed....yeah...well....not so much. My first actress was a 19 year who 1. has never had a gyn exam performed by a male. 2. has never/ever had a breast exam by anyone. Ever. She was as nervous as my fellow classmate and I combined. The nervous energy in that room was ELECTRIC. Holy Cow. But...all that was kept under the wraps of the appearance of confidence. We chatted about her one child, the birth, general health...anything to try to help cut the tension. Fortunately the exam went without issue. The appropriate body parts were located in the appropriate places and things went by quickly. The second patient for the night was in her mid 20s and has indeed been a model for the program for several times. Having polished up my conversation skills from the previous room, we quickly engaged in an easy going, relaxed conversation and we were at task in no time. She was quite comfortable telling the student to adjust the angle of the speculum when needed. She was para 4 and had a large, retroverted cervix and things required quite a bit more manipulation to get the correct angle to visualize the os. At one point after wrestling with the speculum, a faulty light source, and the affect of inexperience, I had to withdraw from my attempt at visualization, take a moment to gather my thoughts, then go back in. It reminded me a bit of intubating patients...cold steel, dim light, leverage and angle being so critical...what can I say? I fall back to my previous experiences to help guide me on new ones. I did appreciate a compliment from her though...when it was all said and done she looked at me and said "right up to the moment where you put the speculum in, I was under the impression you had done this many times before." My bedside manner instilled comfort and trust in my patient. I find this to be such a critical part of medicine and feel very proud that I was able to achieve this, despite a very new, and yes, awkward, procedure. Tomorrow morning it's a lecture on antibiotics, afternoon lecture is GI. Friday morning is a continuance on GI, then an afternoon of video taping ourselves interviewing actors who we have been working with over the past several months with under the umbrella of behavioral medicine. Monday morning is our first big test of winter quarter over a bit of Emergency medicine...initial assessment, shock, eye emergencies, ENT, and dental. Name the infection, name the bug that most commonly gives the infection of the particular body area, name the drug that kills that bug...sure wouldn't mind having a bit of microbiology up my sleeve right now. Guess I better get to studying. Link to comment Share on other sites More sharing options...
Just Steve Posted January 23, 2012 Author Share Posted January 23, 2012 This week's pearl of wisdom...for those of you fortunate enough to be around medicine during this Pre PA phase, start chatting up the various medical reps. Yes...the heydays of pharmacy reps giving away stuff like it's nothing are over. (and for the better I think) but there are still some things out there for those inquisitive enough to be in the right place at the right time. http://www.usp.org/products/pharmacistsPharm/ Pharmacopeia is one suggestion. http://www.sanfordguide.com/Sanford_Guide/Home.html Sandfords guide is another http://accessmedicine.com/resourceTOC.aspx?resourceID=40 Tintinalli's is a third hit up your local medical/pharm reps, attend any sort of medical conference that may be rolling through, see if they are giving away SWAG. (Stuff We All Get). Use discretion, manners, tact, and timing please. It is rather unpleasant to watch a feeding frenzy unless it's on the Discovery Channel and those reps are there to persuade the people who actually make (or have influence over the ones making) purchases. They may be a bit hesitant to give away $100+ dollar books to just anyone but at the same time, they really don't feel like lugging a stack of texts with over 2000 pages a piece back to their Toyota Corolla. WAPA conference is going down next weekend (Washington Association of Physician Assistants). May be the perfect spot to cruise around, see what's on the current cutting edge, that sorta thing. Other ideas...I'm an older student. I use my computer for internet access and word processing. The notion of spread sheets and all that is lost on me. However...I wish I knew more organizational skills on the computer. The amount and speed that information is coming now is pretty flipping' impressive. So if you are not super organized, I suggest you re think that. I am not super organized and I am feeling the squeeze...well that, and I get distracted SO FREAKING EASY. I hate my ADD. Anyways...these are the thoughts as I look up from reading all about shock. Emergency Med test 1 tomorrow. Wish me luck ps: have been listening to a podcast called EMCrit on my commute. Love it. Really really really recommend it for those who have some emergency medicine background. It can be great for anyone but it is given at a level that will leave you scratching your head if you don't have at least some experience in that arena. Link to comment Share on other sites More sharing options...
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