Clinical year

Yup. The first post from PA school is on clinicals. Why? Because there was no time to post during the first two didactic semesters!

I was told that PA school would be an overwhelming amount of information, but somehow that didn't prepare me for the overwhelming amount of information covered. Here are a few tidbits about my didactic semesters:

      -33 other classmates

      -a disappointingly high amount of "bullshit" clinical experience

      -average of 40 hours of mandatory lecture every week

      -for the most part, I loved the information covered

      -I never want to do that again!

And, to hopefully cover some of the FAQ about physician assistants (PAs):

      -PAs practice under the supervision of a physician. This supervision varies dependent on practice setting. It may be that a PA works side by side with a physician who also sees all their patients, or the supervising physician may be miles away, and only meets with the PA periodically to do chart review. It all depends.

     -PAs can prescribe medications. They also do exams, take histories, make diagnoses, order imaging, etc, etc etc.

     -PAs and NPs, in Colorado, perform very similar job functions. An NP can operate independently in Colorado only in a primary care setting. Educationally, a PA receives about 3-4 times the amount of clinical hours.

Now that I've passed the first two semesters of school, I am out on clinical rotations. Half of school is spent in the classroom, and half is spent in different medical settings. The rotations are 1 month in length, and vary. I'll be in surgeries, emergency rooms, family practices, urgent care, internal medicine, and who knows what else. In addition to being on rotation, I will be completing an online masters in medical science at the same time, so I will still be quite busy.

I just finished the first week of my first rotation, and am trying to recover some of my mental energy. My rotation right now is at a state prison. I never thought I'd be practicing medicine in a correctional setting. It has been interesting. Here are a few bits:

-The clinic where I work is full of good-hearted people stymied by a difficult system. Providers are compassionate about their patients, but often lack the resources in order to provide the best care.

-Government moves sllooooooooooowwwwllllly. Between filling out the correct forms, and going through the chain of command, it might take weeks to get a patient to a specialist.

-As a provider, you aren't supposed to know what crimes the inmate committed. I think this helps to maintain unbiased care.

-I can't bring anything useful in with me! Most of my notes and resources are electronic--but no electronics allowed. No reflex hammers. And no fork for my lunch! 

-Compared to some private practices, the patient load is very reasonable--7 to 10 patients per day.

-I've seen stuff that is "cool" to me now that would have been boring as a paramedic. Some examples from this week: uncontrolled asthma, uncontrolled type two diabetes, hand laceration, and new onset CHF.

-I have so much to learn. Crap. Perhaps my biggest daily lesson is that it is the practice of medicine. 

That's all my thoughts for now. Hopefully more clinical updates soon.