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Wednesday, March 26, 2014

Advice for Students Beginning Physician Assistant School

Advice and Tips for Students Beginning PA School
Updated: 08/08/2015
Everyone wants to be prepared for physician assistant school, but there isn’t a formal “way” to prepare. Every student has their own process, ideas, and opinions about what you should and should not do. Ultimately, it is your own prerogative to decide how to spend your year, month, or days before your program begins. Only you know what type of learner you are and what you don’t know or don’t remember. Keep this in mind as you read this article because you’ll find yourself over analyzing everything and getting nothing out of it.


First off, remember that everyone in PA school is just as nervous as you are. You’re not alone; this is normal. Everyone is equally freaking out that they won’t be prepared for rotations, for the PACKRAT or for the PANCE. A little bit of anxiety and apprehension is good to keep you on your feet, but too much can bring you down. Mastering physician assistant school is all about balance.


Here are a few tips from previous and current students:
  • Before PA school begins.
    • Study anatomy and physiology briefly if you haven’t taken it in a while. This is not required and I personally took an online anatomy course prior to PA school, but I didn’t feel like it helped me any. Your program was built to help you become a clinician and you have to trust them that they will. You’ll definitely learn enough anatomy and phys during PA school, so do not fret if you don’t do this.
      • Central nervous system & Peripheral nervous system
        • Cranial nerves
      • Cardiovascular system (veins and arteries)
      • Bones and muscles
    • Review medical terminology and medical shorthand books. This is probably one of the more important “refreshers” you could do. You don’t have to go out of your way with it, but using a free phone app or online resource will do. It’s nice to have some background of medical terminology if you’ve never had it before.
    • Review the basics of an EKG - Not required. I’m sure your PA program will have an entire course in EKGs where you’ll learn enough, but if you’re feeling bored and want to become well-versed in heart blocks and tachydysrhythmias, by all means go for it.
    • Take a medical Spanish or Mandarin course online or in person. This would probably be at the top of my list now. So many clinics and hospitals have a large Spanish-speaking population that it would be extremely helpful to have taken medical Spanish prior to PA school. It’s not easy fitting in a course like this after you’ve started PA school.
    • Become accustomed with important topics PAs are currently facing.
    • Of course, leisure reading
  • Keep a list of most commons. Or follow my blog and use the ones I have created. These are helpful for tests, the PACKRAT, and PANCE. They are also quite commonly used (no pun intended) in challenge bowls at the local and national level, which highlights their importance in test taking.
    • For example: “The most common cause of ____ is ____. These will always pop up on tests and even the PANCE.
    • Keep a simplified list of common diseases. Don’t go into all the variations. Keep it simple and short. On rotations when a preceptor asks you to describe a disease, you’ll at least know where to start. Having it on your phone doesn’t count, because it’s on your phone and not your head. The idea here is it's gotta be short enough that you can review the stack in a couple hours or less, and review them often.
      • Take a 3 x 5 notecard and create the following for each:
        • Disease
        • Symptoms/Signs
        • Tests to Prove Diagnosis
        • Most common treatments. Don’t list doses or routes.
      • The same thing with 50 common drugs:
        • Class
        • Typical Use
  • Class objectives.
    • There are more objectives than anyone could study in an entire year, much less one semester. Study the notes. You can go over the objectives, but do not rely on them. What I would do is study the lectures, creating tables to help you organize the information. Try to quiz yourself after learning a lecture or make a Quizlet as you go. Go back over the objectives when you are finished studying the notes and see if there is one that you cannot answer - not all lecturers follow the objectives 100%. Anything on the objectives is always fair game for a test, so make sure you do additional reading if there is one that wasn’t covered. Trust me, it has happened to me more than once.
  • Books and medical equipment.
    • Don’t immediately buy every book on the list. Start by buying the main books. Ask your mentor or “big” what to buy. Use Amazon for cheaper prices and sign up for Amazon Prime as a student for free 2-day shipping. No cost to join.
    • DO NOT break the bank buying fancy medical equipment. On that note, ensure you set aside money for purchasing equipment.
      • Invest in a high end stethoscope ($200). Don't scrimp here. Get the best one you can afford. You won't regret having quality.
        • Littmann® Cardiology III™ Stethoscope is a good choice. This is the one I personally use.
      • Ophthalmoscope and otoscope are expen$ive! Your program may offer discounts at local stores or try buying them in bulk with your fellow students. You can get group discounts if you speak to a representative. If at all possible, try them out before purchasing one. I have the WelchAllyn brand. WelchAllyn also now sells the new PanOptic, but for our purposes, I don’t think you’ll really need it. I personally do not recommend buying it unless you plan on going into EENT.
      • Purchase cheap equipment for everything else (tuning forks, reflex hammer, pen light, tape measurer, blood pressure cuff) or buy from graduating students. Many students sell their equipment when they finish because hospitals or clinics provide them.
  • Lecture and studying.
    • Always attend lecture and pay attention. If this means printing out your lectures and recording them while you take notes, then do that. Don’t bring your computer to class if you aren’t going to pay attention. It’s preferred to take your notes on a computer word processor because you can edit your notes as you learn more. You might want to create your tables, adding in important information as you go through lecture - killing 2 birds with 1 stone.
    • Focus on lecture notes and PPTs from class. Your professors will more than likely follow the lectures and handouts. Any disputes within the text will be presented in class and are fair game for the exam. If there is anything in the notes you are unclear about, look it up in more than one text or source. Afterward, simplify your notes or make flashcards and review what you have not committed to memory yet. Remove all unnecessary words to form focused thoughts on the concept you are learning. Do not rely on highlighting.
    • Most reading is optional, but professors highly suggest that you do your reading because it re-emphasizes and supplements the material you’ve just learned. As a new student to medicine, you should help yourself now by learning the pathophysiology behind diseases so that when you get pimped on rotations you know where to start.
    • If you are a “highlighter,” use one color to signify things that are extremely important and another color to highlight everything else. When you review, you should only be looking at the most important highlights, otherwise you’re just rereading the book.
    • Create study guides with the class and save them for clinical rotations.
    • Create analogies or anecdotes to remember the hardest material. You can even create acronyms or use mnemonics. If you can do this, you’ll remember them. I personally have had great success with this.
    • PA school is not about getting A's, unless you plan on doing a fellowship or residency afterward. Forget about that attitude. It's now about learning what you need to know keep your patient safe! Some things your school will teach you. Some things you'll have to focus on by yourself in your "spare time,” to get ready for rotations and the PANCE.
    • Don't think that because you get A's on tests, you don't need to study for rotations.There are straight A students who will not perform well in clinic.There are B/C students who will excel in clinic. Shoot for 85%'s on tests, and spend the rest of your time going over practical things you'll be asked to do on rotations.
      • Write clear professional notes on a chart
      • Practice taking a quick history
      • Performing a physical exam
      • Look over your simplified disease lists and memorize how you'll recognize and treat it
      • Listen to lung and heart sounds
      • Be able to present the patient history to a preceptor in a clear and direct manner
    • Find a learning style that fits your own needs. Don’t rely on what everyone else is doing to get you through PA school.
    • Not everyone in your class will like you, but don’t focus on them or let them bring you down. In the end, you need to focus on why you came to that school and what your purpose is.
    • Study for the PANCE often. Most people will study questions from books while studying for an exam or begin your studying during clinical rotations.
    • Keep yourself organized. Whether that means a file cabinet, binders, hole punchers, staplers, or folders. Do what you have to do to keep everything nice and neat. You’ll thank yourself later. This includes your email.
    • You may consider purchasing a dry erase board to draw out diagrams or concepts.
  • Utilize your resources.
    • Ask your mentor if you have questions. Mentors are a very untapped resource and extremely valuable. If you get stuck with a mentor who doesn't want to help, ask other students for help.
    • Visit sites like Med Comic to aid you in studying for exams.
    • If possible and ethical, obtain olds exams from classmates. They’re extremely good practice. Each test question usually has one point or focus the author’s trying to make. You could write or type the main point of each question. When it comes time to review for that test, or even in 2 years for the PANCE, you have a shorter list of main points to go over.
    • Ask your insurance company if you can receive a discount for good grades. I know Geico insurance does this for auto insurance.
    • There are many phone apps available to aid your experience in PA school. One is called PA ToolBox by Medical Wizards. Useful aids include:
      • Abx wizard
      • ACLS
      • Calculators (ex. creatinine clearance, anion gap, etc.)
      • Medi tools (ex. childhood vaccinations, laboratory normal values, orthopedic glossary, EKG info, etc.)
      • Fluid wizard
      • PA consult
      • PediCode, PediDrugs, PediFever, PediGrowth, PediOTC
      • Toxicology
      • Davis' Drug Guide
  • Live, enjoy PA school, and grow as a person.
    • Get your sleep and maintain a regular sleep schedule. Don’t stress yourself out or try pulling all nighters.
    • Go out on the weekends, watch TV, workout, run a 5K, visit your family or friends, spend time with your significant other, don’t study during breaks or holidays. Don’t stress yourself out about money or loans.
    • Take out enough loan money to live comfortably, but make a budget for yourself at the beginning of school so you don’t have to worry about it. Apply for scholarships or sign up for a scholarship or loan repayment program.
    • Purchase groceries or toiletries in bulk so you don’t have to use study time to go grocery shopping as often. This is recommended for people in 2-year programs because of the fast paced nature of the programs.
    • Take any opportunity to get involved in patient care during the didactic phase. The more experience you have, the easier patient care will be during your clinical phase.
    • If manageable, attend a PA conference either at a state or national level (AAPA or PAEA). While there, take a walk through the drug representative area and load up on freebies (medical equipment). You can easily score blood pressure cuffs, reflex hammers, measuring tapes, penlights and much more. Talk with physician assistants and explain where you are currently at and ask for advice or wisdom. Network and make connections with them! They could be your foot in the door.
    • Don’t burn yourself out by studying 24/7. Spread your work out evenly throughout the week.
  • Extend your knowledge outside the classroom.
  • Rotations
    • Surgical Recall, 6th Edition -  is the best book out there for surgery and the only one used for surgery rotations.
    • Pay attention to every initial H&P case given for newly admitted patients. You will be doing this for the patients that you will be following, but listen when they are presenting patients that you may not have to follow. You will learn a great deal from each case. Think about questions like these as you go:
      • Is it more important to gain the definitive diagnosis right away, or stabilize the patient?
      • What drugs are likely to interact?
      • How do you rule out the differentials?
      • What nerves and vessels are likely to compromised with an injury, and how will you test for their integrity?
    • Listen & think about how each patient presents and figure out what you would do with the patient and see if you agree with the course of action taken by the residents. Learn from the choices that were made with each patient.
    • Never be afraid to ask questions & offer suggestions for patient care, if appropriate.
    • Use UpToDate.com for any questions you may have on rotations.
  • PANCE/PANRE Review Resources


Last of all, never give up. You've worked this hard to get where you are and you can't afford to give up after all of the effort and time you’ve put into it. When you feel like you have no fuel left in the tank, take a break. Relax, exercise, see a movie, or watch NetFlix. Do the things that make you happy and be with the people who make you happy. Go to your parents house and study there for the weekend and drive back on Sunday night. Don’t make yourself feel like another world outside of school cannot coexist. Just be happy & enjoy your days left until you’re out in the working world and you retire.


Credits: Toolman from PhysicianAssistantForum.com

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