‘The Rains of Castamere’ is probably not the best song to be humming when I’m suturing/reducing/splinting down in the ER. People might think that I’m about to bust out a reenactment of the Red Wedding.
I have a couple questions about becoming a PA, and I was hoping you could help answer them. I’m wondering how to know if you’re cut out to be PA. I graduated high school with a 3.4 gpa, and I’ve always done well in school (except math). However, I went to a community college to get my AA degree before I transferred to a 4 year college. Since my mother hardly ever let me go out for most of my high school years, when I went to college I got involved heavily with the “party scene” & my (grades) have dropped considerably. I was able to get through community college despite my party habits, but now that I’m at a university I am on academic probation, probably now having to ask the school to let me back in. My mother, who has never wanted me be a PA, is telling me I need to change majors. Problem is, I know this is what I want to do. I just allowed myself to get caught up with the wrong crowd. I know if I disconnect from those people & actually out all of my focus into school, I can get my grades up.. My focus has just been taken away from school and living the “party” life I never had in high school. I’ve experienced it, and I’m ready to focus on school. The only true struggle is chemistry, due to the heavy math at this level. Now that you know my background, do you think I should pick another career? At the end of the day, it’s what I truly want to do & what interests me.. I’m just not naturally inclined. (I also work as a nurse aid & have medical work experience).
— youngwildfree91
Disclaimer: So, I’m going to be blunt here so I going to apologize in advance if anything I post comes off as rude, sarcastic, arrogant, insensitive, etc.
Ok, so you had a rough couple of years in college. You got caught up in the whole “college party” lifestyle and your grades took a hit. Yikes. So you’re thinking that with the grades you’ve got, there’s no way you can be a PA, right?
Knowing is half the battle. You know what the problem was:
My focus has just been taken away from school and living the “party” life I never had in high school.
And now you know what you have to do to fix it.
I know if I disconnect from those people & actually out all of my focus into school, I can get my grades up.
The fact that you have medical work experience as a nurse’s aide helps balance your crummy GPA. But if you can retake courses, especially your basic science courses, then retake them and ace them. Also, from what I remember from the application process, there are several GPAs calculated including your basic science GPA, your overall GPA, and your GPA calculated from your most recently take 16-24 credit hours. PA schools are competitive and while grades are important, PA schools also want their applicants to be well-rounded. So take that in consideration, hunker down, work on improving your GPA and be prepared to explain those dips in grades when asked.
Now, I’m going to be blunt and jump on my soapbox for a bit. I don’t know you and I’m not going to begin to understand the relationship that you have with your mother. You stated that because your mom didn’t let you go out during your high school years, that was the reason you went all “wild and crazy” when you got to college. I’m going to call bullshit. This is me speaking from my own experiences. My parents were strict on me during high school. I didn’t go out. I was sheltered. And when I went to college, yeah I went a little wild and crazy. But that was all on me. It was no one’s fault but my own. I made the choice to go out and party hard instead of hunkering down in the library and studying hard. And it wasn’t because my parents didn’t let me do it high school. Also you mentioned that your mom doesn’t support you becoming a PA, so what? You’re a grown up. I’m assuming you’re over 18 and therefore in the US, you are considered a legal adult. Therefore, you can make your own decisions. If you made the decision to be a PA, own it.
I’m sorry that you’ve had such a hard time in college and that your grades suffered as a result. It’s a lesson that we all learn in our own way in college. Those years in college are spent finding yourself. You find out who you want to be and what you want to do. For some, it takes longer than others. But at least you’ve got your head screwed on straight again and you’ve found your focus.
You asked me how to know if someone’s cut out to be a PA. I’m going to answer your question using your own words:
I know this is what I want to do.
At the end of the day, it’s what I truly want to do & what interests me.
I guess I have Dr. Cranquis to thank for the influx of new Tumblr followers and I’m going to try to make my posts more frequent. Life and work do take priority but I will try not to leave this blog on the back burner for too long. Suggestions, questions, comments are welcomed as well.
So a brief refresher/introduction for my new followers. I currently work as a Physician Assistant in Orthopaedic Trauma at a major urban teaching hospital. What’s Ortho Trauma, you ask? Simply put, broken bones. A lot of broken bones. I work three 12 hours shifts a week, from 7 pm to 7 am, seeing orthopaedic consults in the Emergency Room. I do the initial history and physical exam, order x-rays and labs when needed, and I get to flex my muscles doing closed reductions, splinting, and drilling Steinman pins. That’s the majority of my job. Other responsibilities include checking on post-operative patients, discharging patients, fielding calls from nurses, and every once in awhile I’ll get to scrub in on some surgeries. Going into this job, I knew I liked orthopaedics but ortho trauma was a whole new can of worms within the specialty of orthopaedics that I had absolutely no clue about. A year into this job, I’m still learning.
One of the biggest issues that I’ve noticed when working with trauma patients is the tendency to focus on the obvious injuries. Where I work, whenever a trauma patients rolls into the ER, depending on their injuries they will be evaluated by emergency medicine, the general surgery trauma service, neurosurgery, and ortho trauma. A patient rolls in with an open fracture of their extremity and everyone starts yelling, “Call Ortho!” Starting out, I assumed every ortho injury qualified as an emergency and wondered why the night float resident would drag their feet to go downstairs and see the consult. Of note, literally out of the hundreds of broken extremities that I’ve seen and evaluated in the past year, there were maybe only a handful of true orthopaedic emergencies.
What qualifies as an ‘orthopaedic emergency’? Compartment syndrome and neurovascular injury that threatens the viability of the limb. Really it’s only those two. Ortho injuries fall under the secondary survey of the ATLS protocol, after all, the patient has to be alive in order to treat their ortho injuries right? Of course, I’m not saying that I’m not going to treat a fracture but in the list of life-saving priorities, I think ortho falls pretty low on that list.
What happens more often than not is that when a patient rolls in with an obvious ortho injury, it’s like everything else falls to the wayside. An example is awhile ago there was a patient that came with open fractures in their foot. The cause of their injuries was a motorcycle crash at high speed and they were not wearing their helmet. However, this patient came into the ED, awake, oriented and quite combative. What was the first call that was made? Orthopaedics. We were called to see the patient even before they were taken to CT to be imaged! The initial CT scans were negative and it seemed that this patient’s only injuries were the foot fractures so with Trauma’s approval the ED wanted to admit this patient onto the Orthopaedic service. However, it was hard to believe that anyone could be that extraordinarily lucky to come away from a MCC with only foot fractures. And sure enough, at our insistence, a repeat brain CT showed a blooming subdural hematoma. Then panic sets in, Neurosurgery is quickly consulted, Trauma is called back and the patient is admitted under the Trauma surgery service.
My point? Don’t be distracted by the obvious. Examine the patient from head to toe. Don’t trust the exams of others. Do your own exam. Don’t assume the best. Expect the worst. My supervising attending physician constantly harps to me and the residents to “Always seek disease and don’t hope for wellness.” It’s a pessimistic view, yes, but in expecting the worst you’re surprised when the outcome is for the best.
Guess the diagnosis: I’m gonna leave this here CT (made festive with colors by yours truly) right here without any further information. If you have a basic knowledge of anatomy, you should get this one.
Oh, I’ve seen bigger. (That’s what she said…)
Worked the night before.
Early morning flight.
Flight delayed.
Have less than an hour to book it to hotel, check in, and book it into conference workshop.
Sitting in workshop learning about PA reimbursement policies.
I need caffeine. (-_-)
arstudentpa asked: I'm trying to decide whether or not to keep my X-ray licensure current while in PA school (CE credits). I wondered if you'd have some insight since you likely had RT licensure when you started. I can't imagine a situation where it would be an advantage, but still, letting it lapse seems so wrong. Any thoughts?
To be honest, I let mine lapse while I was in school. When my license was up for renewal, I declined to pay it. I wasn’t collecting CEUs and what I was learning didn’t apply to my licensure. I went from being a respiratory therapist to now practicing in Orthopaedics so I didn’t see the need to maintain it. Then again, it will be up to you to decide whether to maintain your previous licensure once you finish PA school. I know of some PAs who do and they went on to practice in an area related to their previous occupation. It seems like a waste to let it fall to the wayside but my employer pays my PA licensure fees and maintaining my RT license would have meant spending money out of pocket for a certificate to practice in an area of medicine that I no longer practice in. For me, it was a financial and career decision, for you, it might be different.
12 hour shift and only one new consult overnight.
Just hit me that a year ago today, I stepped foot into this hospital as a totally new and wet behind the ears PA grad that didn’t know the first thing about Orthopaedics. ‘Wow’ is the only succinct way I can describe the opportunity to have this job, to work with people that have become like family, and to have some pretty amazing stories to tell. After a year, I think I can say that Ortho doesn’t intimidate me but I definitely still have a long ways to go.
Fell asleep during morning conference. Awaken to paper whacking by attending. Oy, embarrassing.
Blog Recommendation: "Orthopedics Residency in gif form" -
It’s not on Tumblr, but it’s still hilarious. Enjoy!
This is my work life.
Came into work. Found out that 3 of the Orthopaedic operating rooms were contaminated with raw sewage. And apparently it’s been dripping for DAYS.
Disgusting.