PA to MD "blog"

[CSCH]

I did one for my PA residency, so I figured I'd do one for med school.

First semester done and dusted, so I'm going to try to roughly summarize.

We started out slow with orientation for a week, a little bit of glorified shadowing in the hospital "so that our first patients wouldn't be cadavers," and a really easy class. Great, one month in and I was wondering whether medical school would ever start. Classmates were super nice, lots of people curious about my experience as I am the only PA in the class (unsure, but may be the first PA this school has accepted in recent memory). Something I found encouraging is that multiple people wanted to talk to me about the differences between PAs and NPs. They seemed generally well-informed. Maybe gives me a little hope for the future, but we'll see. I do feel a little pressure to make sure I represent the profession well.

Then we finally started getting into content. The stuff we started with was the most foreign to me as it was all basic science, cell bio stuff. I was a bio undergrad many, many moons ago, but this was at an entirely different level. The professors were good, I was big on going to class, I showed up prepared and did my time in the library, and scored well. I go to a pass/fail school, but I always check to see if I'm above the class average because I'm just a teensy bit competitive.

As time went on, we crept closer and closer to more clinically-applicable content. I found the basic science stuff interesting but not exactly my cup of tea, but as we went on, I saw how each thing built on the next, and it all kind of clicked for me. Obviously I wouldn't have gone to med school if I didn't think it would teach me things in a new and deeper way, but I really feel like I get the magic of it. Do I think med school is the secret sauce of making physicians? No, I think residency and fellowship do that. But I do think this is a big part of what makes them think differently. I know plenty of PAs who think about the why behind things pretty often (maybe even one or two NPs), but we don't usually have the time to be diving all the way into it. Med school is that time for me, and watching each part of it build up from the molecular level up to tissues has been kind of magical. I have gotten my fill of why and then some. One example: In one of my former jobs, I would use ivabradine. It may have been mentioned in PA school, but it certainly wasn't on boards and so when I first encountered it I asked the cardiology fellow to explain it to me. They offered a quick explanation using the phrase "funny channels" which I went and googled and got a somewhat satisfactory answer. Definitely a good level for a PA, and I was able to explain it well enough to my PA students and residents. But then in school when we did some very basic EP and we actually talked through each of the channels and got to the funny channel, I swear you could have seen that 200W lightbulb over my head. It was so exciting to really, truly understand the why behind what I was doing.

Yes, there have been lots of things that have probably been different for me as a PA. It's weird sitting in on small group discussions where we practice giving bad news. I worked in an ICU through the pandemic...been there, done that more than many physicians do in their entire career. Group study can be difficult for me, because I make connections to things I've seen in real life that don't mean anything to my classmates yet. I do a lot of biting my tongue in group settings because as the stress of school has mounted, my classmates (who are also largely quite a bit younger than me) have shown their own neuroses and competitive natures, and it's not worth getting a reputation as a braggart just to tell a relevant story. I do feel a little isolated from time to time. Not to get too emo on you, but no one really seems to understand how this process might be different for me than for others. Thankfully, I've made friends with a few other career-changers, and we can relate on just being older and having different interests than our fresh-out-of-college classmates. And someday, with this plus my DMSc, I want to make a better path through med school for experienced PAs.

Final thoughts on anatomy: My PA school didn't have cadavers, but we did have the most extraordinary anatomy professor. He made it all come to life for us and tied things into clinical relevance in the most amazing way. That said, when I graduated and went into critical care, I pretty much flushed everything I'd ever learned about the tibialis anterior and posterior. So anatomy with cadavers is pretty much starting from scratch for me. I guess at least I've seen the words before? But it's hard, it's a lot of hours, and the instruction is just nowhere near what I got in PA school. This is the first time I've said that, and it feels a little weird. I'm taking it as a rite of passage and paying my toll for admittance to the next level of med school.

I'll try to check back in an add to this every so often. If you're one of the people who got your knickers in a twist last time I posted because I used ~bad words~ don't bother following. Who knows if I can restrain myself?? I'm mostly posting this because my old residency blog got lots of people to DM me (still to this day) and I really want to invite people to do the same. I know when I was considering making the leap, I felt kind of alone and a little crazy. So if you're reading this and wanting to talk to somebody, consider this your sign. Also happy to answer questions here!

[PAtoMD]

Congratulations and I look forward to keeping up with your journey!

[sas5814]

I always like following these stories. I had 2 classmates that graduated PA school with me and left immediately for medical school. I often wonder how they did and where they ended up.