PA student here.. My good friend started med school today. Not sure how I feel

[TPA16]

It took my friend starting med school today for me to really reflect on my experience in PA school so far.

I am coming close to the end of my second semester of a 12 month didactic year. I've always heard people joke around saying "they feel like they know nothing".. But with the way my school is ran, I really do feel like I know nothing. I would say that I'm in the top half of my class. I cram for exams because there really is no alternative. With 3 tests a week there's just not enough time. I feel like I don't have an internal understanding of a lot of the topics were learning and I am just spitting out facts on the exam.

 

For example: my friends and I already joke about still not knowing what cirrhosis means, or what induration means, or "my mom got burned the other day, I couldn't even tell her what to do, I didn't know"

 

I went into this instead of med school because I felt confident I would be able to know almost as much/ do as much as a doctor, but now i see myself in the ER for example, Feeling like il just be using guidelines and algorithms to come to my actions without fully understanding the reason for my actions.

 

I am happy that I am almost through what I've heard is the hardest part of PA school and I am happy that I am not dedicating 8 more years of my life before I practice. But I feel like I am not prepared to take on my career so far.

 

I see myself going into dermatology, so maybe it's not important to fully understand all this stuff anyways,

But for the chance that I'd like to do any other specialty, this worries me.

 

Any advice would be appreciated

[Guest JMPA]

It took my friend starting med school today for me to really reflect on my experience in PA school so far.

I am coming close to the end of my second semester of a 12 month didactic year. I've always heard people joke around saying "they feel like they know nothing".. But with the way my school is ran, I really do feel like I know nothing. I would say that I'm in the top half of my class. I cram for exams because there really is no alternative. With 3 tests a week there's just not enough time. I feel like I don't have an internal understanding of a lot of the topics were learning and I am just spitting out facts on the exam.

 

For example: my friends and I already joke about still not knowing what cirrhosis means, or what induration means, or "my mom got burned the other day, I couldn't even tell her what to do, I didn't know"

 

I went into this instead of med school because I felt confident I would be able to know almost as much/ do as much as a doctor, but now i see myself in the ER for example, Feeling like il just be using guidelines and algorithms to come to my actions without fully understanding the reason for my actions.

 

I am happy that I am almost through what I've heard is the hardest part of PA school and I am happy that I am not dedicating 8 more years of my life before I practice. But I feel like I am not prepared to take on my career so far.

 

I see myself going into dermatology, so maybe it's not important to fully understand all this stuff anyways,

But for the chance that I'd like to do any other specialty, this worries me.

 

Any advice would be appreciated

perfectly normal, carry on

[ventana]

think of PA school as merely buying the ticket to get on the train.... It is just the very beginning of a life long journey.

 

There will be about 6 years when you are practicing, make 100k per year while you friend still has nose to grindstone and gets pimped and worked to death.....

To get out and if they choose PCP - do the same thing you have been doing for the past 5-6 years.....

 

 

You will be scared and afraid of killing someone for the first 6-12 months out, then you will finally think you know a little bit, and then the real learning begins....

[Poetsiren]

My program, when I left didactic I was scared, too, and thought I didn't know anything. Professors even said, "We teach you medical basics. You learn medicine in clinical rotations and the real world."

 

When I went out on clinical rotations I was really worried when a doc told me to order what I wanted for a patient. He said, "I trust you." My first thought was to laugh and say, "You shouldn't!" LOL.

 

The reality is that PA school DID give me a great basic knowledge to work off of. I found that, as my clinical education and rotations progressed, I ACTUALLY knew more than I thought I did and could recall things much faster.

The trick is to be inquisitive - and whether you read, ask your preceptor questions, surf medical reddit, or just watch what your preceptor does for a patient (OR are even forced to do it yourself!), you WILL retain that information if it is important to you. My goal in every rotation was to make my preceptor's job easier - that made it easier for me, in turn, to jump in and just help out and do things! It was awesome!

 

This is why everyone says that feeling inept at the beginning is normal..... You will be afraid, you will think, THEN you will learn and be more confident as a provider. 

KEEP GOING!

[Reality Check 2]

One of my good friends and PA educators had been a paramedic in one of the worst Burroughs in New York City - he is an amazing PA and educator. He is a really good guy.

 

His wife of 15 years had been in a lab field - she popped up and decided she wanted to go to Med School - not PA school - Med School.

 

I wasn't sure how it would affect them. 

 

They did well for a while. They are divorced now.

 

I cannot truly say that the MD/PA thing caused it but I have to suspect that it didn't help either.

 

I made good friends with med school students while I was a PA student and I have had one friend opt for med school instead of PA.

 

To each his own, I have to think. It was very hard not to see it as a slight to my profession or to me personally. A person has to have their own reasons for choosing their path. I don't always have to agree with it.

 

Maybe it is an ego thing - "I'm a doctor" or maybe it was not a choice for them but what their family forced (I know a guy from this perspective and he is a LOUSY doctor) or maybe it just felt like the right fit.

 

I am too old to go back and question a lot these days. I am where I am because I went where I went. Bloom where planted....

[UGoLong]

From the remarks above, you may have gathered that many of us felt the way you do at your stage of education. And appreciate the role of lifelong learning.

 

That said, you will be surprised at what you will pull out of your jumbled mind when you finally start seeing patients during your clinicals. Each rotation will start with several days of feeling lost, then understanding, and then feeling like you are actually contributing. But by then it will be time to go to your next rotation and feel stupid all over again.

 

There are differences program to program, but all follow a similar recipe. Have faith, grasshopper! Others have successfully followed your path.

 

Stop worrying and keep studying!

[newton9686]

Don't worry dermatologist don't have to know much. They just biopsy, read the results and are home by 3:30.

[Febrifuge]

Think of it this way: no matter who you are, someone far dumber has made it through the program you're just starting. Your Med school friend will not have 3 tests in a week. He or she might, depending on the Med school, attend only 3 lectures in a week, and camp out in the library for the rest of it. If 4-yr Med school is a marathon, PA school is just the uphill parts.

[Guest ERCat]

What you're feeling is totally normal.

 

When I started PA school, I felt like a fraud. When I started my year of rotations, I felt like a fraud. When I started my first job, I felt like a BIG TIME fraud. And I will never forget something that one of my physician mentors told me, when I told her that some days I feel like I don't know what I am doing. She said, "For the first five years of my career, I felt like a fraud every day going to work and wondered when 'they' were going to find out about me and find out I shouldn't be doing this." Luckily I am almost at my year mark and the feeling of being a fraud is going away, but sometimes it comes creeping back full force - for example, when a patient asks me to explain a disease process in general and I feel like I am fluffing things up.

 

A lot of what you're describing also means to me that you need to be doing a lot more outside reading if you want to understand things in greater depth. PA school gives you a very basic framework. VERY BASIC. I would say that twenty percent of what I know now came from the didactic year of PA school, and the other eighty percent has come from rotations, on the job learning, and TONS of outside reading. While some of my PA school peers were simply reading review books and trying to learn "buzz words," I was one of the students who picked up a copy of Harrison's and read about things in much more detail. It helped me a lot when it came to the boards, and it helped me feel a lot more prepared for my first job. In short, PA school WILL NOT teach you what you need to know. It basically gives you a framework of knowledge, and you need to fill in the pieces.

[MainerRD12]

I am in my second clinical rotation. I appreciate the feeling of being completely overwhelmed and thinking I'll never know what I'm doing and what the hell were people thinking allowing somebody to be a health care provider with 2 years of training. I get so frustrated sometimes because I want to know everything now, and it just doesn't work that way. But then you see PAs working and they are badass, so we can and will get there. I will say that I thought I would have more free time 2nd year, but I have found that I spend a lot of time reading, listening to podcasts, and learning as much as possible so I don't look like an idiot ALL of the time.

[BruceBanner]

Normal feelings. 

 

I also felt like a fraud in PA school---like wow I'm finally being exposed for the mediocre academic student I am. How did I even get in?

 

But I made it by the skin of my teeth at times, and smoked the boards.

 

Then after graduation for about a year I felt stupid and incompetent to varying degrees. And again when I started FP a couple years ago.

 

Now I feel mostly competent and like I have good judgment even if I dont know what to do---which is really what being a competent provider is all about.

 

You will likely find if you work in a full-time capacity that medicine isn't all you thought it would be. Not to rain on your parade but it's just a stressful career, the more people you see and the more hours you work.

 

The folks who say it isn't either A) work part-time, B) see <12 PPD, or C) have gotten into a great niche specialty.

 

Not saying it isnt a good JOB--in the compensation, job-security sense---it's just not a walk in the park.

 

I guess my point is, dont look back and regret not going to med school.

[jmj11]

My first rotation was the one everyone dreaded, a large inner city (Louisville) ED/Trauma Center. It felt like if you had taken books on anatomy, human physiology, human diseases, terminology and lab sciences and threw them into a blender and poured them in my empty head. Nothing made sense or was organized. I was terrified and not supervised very closely. BUT it slowly came into order and made sense, just like with physicians (we rotated with medical students and first year residents who weren't much better off, they just "faked it" better), it takes years for knowledge to jell into intuition and good judgement.  

[sotaskimmer]

As has been said, perfectly normal, carry on :).

 

Curious though... with the name TPA16, are you by chance at South University - Tampa?

 

 

 

....that would explain some of it.

[ohsnapPA]

Thanks for everyone who posted in this thread, and validated that these feelings during rotations are normal, and it gets better. Definitely needed this! :)

 

A lot of my friends are in med school too, and there are times where I pondered if that was a better route in gaining comfort and security around clinical judgements/decisions. But then, I think about the amount of responsibility, sacrifices, and burdens made to get to being a doctor - and I'm so glad I'm in PA school instead :P 

[Poetsiren]

A lot of my friends are in med school too, and there are times where I pondered if that was a better route in gaining comfort and security around clinical judgements/decisions. But then, I think about the amount of responsibility, sacrifices, and burdens made to get to being a doctor - and I'm so glad I'm in PA school instead :P 

 Just remember that when you are out and practicing and getting a paycheck, they will still be in school tallying up more debt. It makes you feel alot better! ;)

[newton9686]

MDis for sure the better brand. People assume you know what you are talking about when you are an MD. You have to usually prove you know what you are talking about when you are a PA. As for what you learn while you are in school and how you perform in clinic, that is up to you. 

[Lauren R]

It'll all come together.  Everyone feels like they don't know anything, but somehow most PA's are excellent.  Keep your chin up and keep at it, you'll get it. 

[Houstonian]

Remember, you are only half-way through your educational program.  Believe it or not, by the time you finish, you will understand medicine.  Doesn't mean you will have mastered it; no one ever masters medicine, they just "practice" it.  And you will still feel like a fraud during your first year of work, at a minimum.  Or likely, whenever you change fields.  Takes about a good 2-3 years to get "the basics" of any area of medicine, whether it is primary care or a specialty.  That's why family practice and internal medicine are both three-year residency programs, and many specialty fellowship programs last 2-3 years.  During school, they basically just introduce you to various aspects of practice.  The real learning comes after you graduate.