I don't feel competent

[ptokki]

Hey guys, 

I'm halfway into clinical rotations and all this time I've been doing rotations in the clinic setting. Even my ER rotation was in a very rural area and felt like an urgent care at most.

I'm currently doing my surgery rotation at a big hospital and it just occurred to me - I don't know jack squat. I'm having some major anxiety right now. Professors keep telling us that once we graduate, that's it - we're on our own and ready to act as providers for patients and that no one is necessarily going to watch over us. To me this is terrifying.

I feel like the nurses know more than I do, including the surgical techs and assistants. I just feel so incompetent. I don't even know the name of a bunch of medical equipment and supplies. I don't know how to do hands-on stuff like putting on a dressing or putting in a catheter. My clinical rotations are a hit or miss, in some of them I am doing mostly shadowing while in others I feel like I can play a bigger role.

My program is a new program and my classmates are in the inaugural cohort - a lot of us had to do a lot of self-teaching and don't feel like our program prepared us for clinicals. Even with clinicals a lot of us don't feel prepared, or are just mostly shadowing. There are a lot of alarming red flags with my program, a university counselor stepped in and heard our complaints and is very concerned about the way the faculty are behaving towards students, and 90% of us plan to file an official complaint after we graduate, but that's besides the point. A lot of our rotations are out in rural areas - which is a good thing and can make you resourceful - but at the same time I feel like I have not gotten a lot of exposure to things. My internal medicine rotation was at a senior assisted living facility, and we would see 3-4 patients a day max and it was usually for scrapes/wounds, checking their PT/INR if they are on warfarin, or going over their labs. It was basically a geriatrics rotation but even then it didn't feel like a geriatrics rotation because I feel like I got no exposure.

I am not confident in myself at all. If I were in a situation where I had to save a patient's life, I don't think I would be able to do it because I feel like I don't know the information at the top of my head like I should. I go back over my textbooks and study materials and think "oh that looks familiar" but I don't know it at the top of my head. When I'm presented with multiple choice options on a test I can figure it out or I know the answer. But when questioned on the spot my mind goes blank or it takes me awhile to arrive at the answer. 

Is this a normal feeling for new grads or students in their clinical year? I know clinical year is for the purpose of exposure, not mastery, but even with the things I am exposed to I feel like in a few months it doesn't stick because I'm studying for my other rotation. Does most of your knowledge and training come with on-the-job training from your supervising physician? I feel so inadequate and it's scaring me that maybe my education in this program is a waste. 

Edited October 20, 2022 by ptokki
grammatical error

[Sunnyn]

Is complaining to the PA regulatory board an option? Does anyone have experience with that?

[rev ronin]

9 hours ago, ptokki said:

Is this a normal feeling for new grads or students in their clinical year?

Yes, actually. It's very common. There are things you can do to keep studying and learning on rotations even if you're getting lame/minimal patient exposure. There are books, YouTube videos, and hopefully support groups among your classmates. I mean... we're here, but we're not there with you.

Personally, my hospitalist rotation was the hardest for me because 100% of my exposure was outpatient. Surgery was fine because there were always residents to follow, but hospitalist I was pretty much told "go handle it" when I really didn't feel competent either.

It sounds like you're down on your experience overall, and that's unfortunate, but I'm pretty sure every PA has at least one "I have no idea what I'm doing" rotation... except maybe IMGs who are becoming PAs in the US, and still... that's another learning curve.