Sooooo, you wanna be a PA?

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.

Monday’s M&M #18

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.

Q: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?

arstudentpa

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.

One year.

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.

The Running PA: Hope to all the 1st years out there

therunningpa:

The first year is awful, as I’m sure many of you know/have experienced. A constant merry-go-round of exams, mandatory lectures, presentations, piles of reading you will never finish, piles of pants you will never iron, piles of dishes not getting done… Shudder. But somehow you push through it all,…

I concur. And the even sweeter feeling is the feeling when you’re completely done. When you walk across the stage and shake hands with the dean of your school, get that fake diploma in hand, hug your chairman, smile for photo ops and then receiving that actual diploma in the mail. That feeling makes the tears and the stress worth it. And when you reach in the end of the academic tunnel, you’ll find that there’s a whole network of colleagues who know EXACTLY what you’ve been through.

Monday’s M&M #16

The first week of July is over and done. Now onto the second week…

This past week at work was spent getting used to a whole new wave of residents on the trauma service and teaching the junior residents (intern and the PGY-2’s) the routine of the service all while enjoying a BBQ induced coma and thanking my lucky stars I wasn’t working on July 4. After a somewhat stressful Saturday day shift, I’m looking forward to a couple of days off and being productive around the apartment and maybe even start tackling that running program I signed up for.

So July essentially is the start of the new “academic” year, residency-wise. Newly minted doctors start their residency as interns, the interns become PGY-2s, and the junior resident becomes an upper-level, and so on and so forth. As everyone gets adjusted to their new roles and responsibilities, I find myself getting adjusted to a whole new group dynamic. The work dynamic has changed for me as well, in the five months I’ve been working, I’m now graduating from the fresh-faced “I know nothing of orthopaedic trauma” to “Let me show you how I’ve learned how to do this.” I’ve gone from learning the routine to teaching the routine, which is mind-boggling for me because sometimes I do feel like I know squat and it’s like a case of the blind leading the blind.

We also have medical students, fourth year medical students interested in pursuing Orthopaedics as their designated specialty and now the hardest thing for me to do when they are on-call with me and the night float resident is to allow them to have a shot at taking an H&P and having a hand during the procedures. I was in their position not too long ago, so it’s hard to be critical of their performance when I only have a couple months more experience than they do. But I had a student with me one night who seemed to know next to nothing about assessing and managing acute Ortho trauma. And he wanted to be an orthopaedic surgeon? Not winning brownie points with anyone, especially not me.

But one thing that I will take away from having students on the service is the fact that I think I would want to be a PA preceptor in the future. I’m finding that I like teaching one- on-one, teaching what I know and hopefully sparking some interest in the student. And having students teaches me patience, something that I lack in high-octane situations because I have a tendency to want to do it all myself. So, who knows? Maybe after a couple years under my belt and after bringing it up with the superiors, I may get a chance to start having PA students shadow with me.

Question: What are your thoughts and experiences with precepting or being precepted?

Q:Hi! I'm planning on becoming a physician assistant and i was wondering if most PA schools accept pre-req courses from community colleges because that where i am starting. Well I already have but i haven't done any pre-reqs yet though just some basics to transfer for my bachelors

beautysurrounding

Most PA programs should accept prerequisite courses from any accredited college or university, which includes community colleges. However to be certain, that’s a question you would need to broach with the individual PA program you want to apply to. To be honest, I don’t see the difference of completing basic science classes in a community college and then transferring those credits over to a university and finishing your degree there. However, as the profession grows and applicants become more competitive, some programs may require that all prerequisites be completed at a four-year college/university.

But again, it’s a question that I would ask the individual PA program because every program’s requirement differs in various areas.

Keepin’ It Classy

I tried. I really tried. But when my patient starting to gyrate their hips to the beat of whatever song was running through their head while I’m trying to hold their wrist reduction, I completely lost it. My sides are still sore from laughing so much.

And I wasn’t the only one who was laughing at my patient’s ketamine-induced antics. The ER attending, nurse and pedi resident were all on the same boat with me as well as the patient’s parents who recorded the whole episode on their cell phones. I’m pretty sure I heard the words “Facebook” and “YouTube” from the parents.

Kids and ketamine, always an entertaining combination.

Q:hi i am an l.p.n looking into going to school for p.a and i wanna know what degree do you have a masters or bachelors and how was school and clinicals ?

jadee24

I have a Master’s in Physician Assistant Studies therefore to apply for PA school, I needed to have a Bachelor’s degree in some study as well have taken the pre-requisite courses in order to apply.

I think most current PA students in their didactic (coursework) year will agree with me when I say the classes in PA school is comparable to drinking water from a gushing fire hydrant. Another analogy I like to use when asked about classes in PA school is the treading water analogy. The water is up all around you and you’re barely keeping your head above it. The clinical year is much more relaxed and not as rigidly structured but you are still studying and reading and taking end of rotation exams.

This isn’t meant to discourage you, jadee24, or other interested pre-PA students from pursuing Physician Assistant studies. Your question of “how was school and clinicals” is a very broad question that I feel I would fail to convey in a succinct paragraph let alone an entire post. There’s no amount of information I can provide you that will make you emotionally or mentally prepared for the onslaught of the PA program of your choice. 

Maybe to answer your question more specifically, here’s a list of Tumblr blogs written by current pre-PA and PA students (that I know of):

I hope that at least I was able to partially answer your questions and again, my analogy of drinking water from a gushing fire hydrant isn’t meant to be negative or discouraging. It’s the truth and if you can mentally be prepared for that, then that’s half the battle.

Dr. Cranquis' Mumbled Gripes: MSNBC article: 13 ways to avoid common in-hospital medical mistakes (besides "not getting sick in July")

cranquis:

July is coming, and in the US that means a new batch of nervous and inexperienced interns handling a large proportion of medical care for hospitalized patients… which likely contributes to the July Effect: a “10% spike in fatalities in teaching hospitals in July.” So don’t get sick enough to be…

Reading this makes me feel like I should be brandishing a slab of OrthoGlass proclaiming down the halls and to the patients that “July is coming”. Totally inappropriate but the things you think about at 4:45 in the morning tend to be more on the ridiculous side anyways.