You may have noticed that the name has changed (only slightly), as has the layout. I figured since I was no longer a PA-Student, it was high time to change the name to reflect my new designation as a Physician Assistant (I still feel weird typing that out, with no -S behind it).
I finished my last official clinical rotation in Ob/Gyn (can I go back yet; I miss it terribly....I truly know it's where I belong), and took the PANCE (waiting for scores to return hopefully this Thursday), and I no longer am occupying my time studying with my stack of review books....I don't know quite what to do.
Licensing paperwork is underway, so as soon as my scores are posted with the board, I should have my CT state license shortly after that. This feels very surreal.
Monday, July 15, 2013
Monday, May 27, 2013
Graduation!
It finally happened: graduation from PA school. I went from Katherine Swan, PA-Student, to Katherine Swan, MPAS, PA! I no longer have to introduce myself as a student. While I don't feel much different than I did a month ago, when I still WAS a student, apparently something IS. I won't officially have any privileges until I take my certification exam (the PANCE, pronounced like pants), and then, I'll legally be able to practice medicine.
I had a lovely celebration, seeing former teachers, mentors, friends, and family, and relishing the fact that I'll never have to wear the ridiculous academic regalia ever again!
Now, to enjoy this week, before I start my last make-up rotation for the month of June. But, it's ObGyn, which I'm incredibly excited about. No better way to spend my last rotation than in my favorite specialty in medicine, and the one I'm hoping to spend my career practicing in.
I had a lovely celebration, seeing former teachers, mentors, friends, and family, and relishing the fact that I'll never have to wear the ridiculous academic regalia ever again!
Now, to enjoy this week, before I start my last make-up rotation for the month of June. But, it's ObGyn, which I'm incredibly excited about. No better way to spend my last rotation than in my favorite specialty in medicine, and the one I'm hoping to spend my career practicing in.
Monday, May 6, 2013
Playing catch-up.....and forming new beginnings
Well, I'll be the first to admit that I've sorely neglected my blog these past few months, between clinical rotations, getting sick/having surgery 2x in November, and pushing through the last of clinic, taking my 3rd year comprehensive exams, and getting ready for graduation.
Shortly, this blog will turn into my experiences as a newly minted PA....and what it's like to do a PA Surgical Residency. Somewhere in the past 5 months of being absent from the blogosphere, I applied, interviewed, and got accepted to the Yale/Norwalk Surgical Residency program!
After falling in love with surgery during my 2nd year, I'd started researching the possibility of doing a surgical residency. One of our faculty members had completed the Yale residency upon graduation, and loved it....and after speaking with her about her experiences, I decided that the only program I'd apply to would be the Yale program, given its long history, its very organized format incorporating both lecture/didactic curricula (morning lectures, teaching rounds, and intermittent anatomy, surgical technology, pathology, microbiology, and animal surgery sessions at the Yale school of medicine throughout the year), and clinical time into the experiences. Norwalk Hospital does not have MD surgical residents there, so we won't have to compete for OR time when we operate there. The SICU and post-op recovery units are staffed entirely by PAs, both residents and staff PAs, so again, we get the comprehensive experience without being lower on the proverbial totem pole. We rotate through the different surgical services (general, ortho, plastic/reconstructive, neurosurgery, trauma, GU, Ob/GYN, SICU, and cardiothoracic/vascular), and also have 2 months for elective choices. I'm incredibly excited for this opportunity to learn more, greatly improve my experiences and skills in the operating room, and become well-versed in inpatient medical care. I'm also terrified, and have a constant feeling of nervous butterflies, now that the initial excitement of being accepted has turned into reality of moving across the country in 3 months.
For now, I am focusing on presenting my master's project this week, looking forward to seeing family, friends, and old teachers at graduation, and starting my last clinical rotation in June (Ob/Gyn in Denver; back to a month of deliveries, surgeries, and spending time in my favorite clinical setting). I couldn't imagine a more perfect way to finish PA school than with an elective that will truly be amazing! I cannot wait!
Shortly, this blog will turn into my experiences as a newly minted PA....and what it's like to do a PA Surgical Residency. Somewhere in the past 5 months of being absent from the blogosphere, I applied, interviewed, and got accepted to the Yale/Norwalk Surgical Residency program!
After falling in love with surgery during my 2nd year, I'd started researching the possibility of doing a surgical residency. One of our faculty members had completed the Yale residency upon graduation, and loved it....and after speaking with her about her experiences, I decided that the only program I'd apply to would be the Yale program, given its long history, its very organized format incorporating both lecture/didactic curricula (morning lectures, teaching rounds, and intermittent anatomy, surgical technology, pathology, microbiology, and animal surgery sessions at the Yale school of medicine throughout the year), and clinical time into the experiences. Norwalk Hospital does not have MD surgical residents there, so we won't have to compete for OR time when we operate there. The SICU and post-op recovery units are staffed entirely by PAs, both residents and staff PAs, so again, we get the comprehensive experience without being lower on the proverbial totem pole. We rotate through the different surgical services (general, ortho, plastic/reconstructive, neurosurgery, trauma, GU, Ob/GYN, SICU, and cardiothoracic/vascular), and also have 2 months for elective choices. I'm incredibly excited for this opportunity to learn more, greatly improve my experiences and skills in the operating room, and become well-versed in inpatient medical care. I'm also terrified, and have a constant feeling of nervous butterflies, now that the initial excitement of being accepted has turned into reality of moving across the country in 3 months.
Sunday, November 25, 2012
I have returned
I just realized it's been many rotations (and therefore many months) since I've updated this thing....and much has happened since then:
I hope everyone had a lovely Thanksgiving, and that the impending holiday season brings lots of relaxation (or for those of us in medicine, a crap load of patients trying to get in their visits before the end of the year insurance deadlines). Hopefully I'll find more time to update things in the future.
- I finished orthopedic surgery in September; this was my 2nd go-round in dealing with bones, and I had a total blast (again)! There's nothing quite like hearing a bone crack and pop, watching a femoral head pop out of socket during a total hip replacement, and the sound of an electric drill has hardware is being implanted. (In my down-time this rotation, mostly at the end of the month, I had the opportunity to scrub in on a few more GYN procedures with my old preceptor, which was a huge treat; for the girl who started PA school thinking I'd never do Ob/Gyn, and I'll graduate knowing there's nothing else on the planet I'll be happy doing, I'm the poster-child for keeping an open mind).
- I moved onto ENT surgery next for the month of October, which also involved a LONG commute every day (I logged 1.5 hours each way every day to get the hospital where my rotation was, which meant seeing NO sunshine M-F for the entire month; this, in addition to the fact that this was an incredibly difficult rotation for me (especially after Ob/Gyn being such a highlight in my life), made this month really rough. However, I survived, and gained some valuable experience
- I then started November as the first of 3 months in a row at Children's Hospital Colorado, one of my favorite places on the planet. While I know that pediatrics likely isn't in my long-term future career-wise, I can't imagine a more fun place to spend a rotation. I started out with 2 days of general pediatrics, dealing with a wide array of well-child checks, coordinating of social problems and dealing with parents, and then....
- I had emergency surgery at 3am on November 3rd (boy, I REALLY know how to live it up and have a good time at the start of a weekend....); I spent the next week out of clinic recovering, which wasn't too bad, but not the greatest way to spend a week
- I came back to clinic the next Monday to have the crazy week from hell (or, at least I thought); it was a conglomeration of all of the patients who were super sick, behind on their shots, mad that they weren't seeing a provider fast enough, and dealing with coordinating public benefits....needless to say, my first week back (during which one of my attendings said I looked like "a slightly paler shade of white") was crazy, and sort of like juggling fire.
- The short week before Thanksgiving was just as nuts, but I finally felt more like myself, and not so exhausted and sore, so I was better able to deal with the endless sea of patients, charting, and figuring things out.
- Just one more week left of general pediatrics before I move onto 2 weeks of Pediatric Endocrinology. This will be my 3rd go-round with their dept., so I'm looking forward to spending more time there.
 |
| "What is this crazy lady going to do to me? She's not the one with the pointy things, is she?" |
I hope everyone had a lovely Thanksgiving, and that the impending holiday season brings lots of relaxation (or for those of us in medicine, a crap load of patients trying to get in their visits before the end of the year insurance deadlines). Hopefully I'll find more time to update things in the future.
Friday, September 7, 2012
Back to the construction zone
My week was a nice, slow introduction, after the hectic schedule that I kept during my Ob rotation. I had the long Labor Day weekend off, and my first day back in Ortho. was a surgery day (YAY)! The one thing I didn't quite remember was just how heavy the lead vests weigh (woof; didn't have to deal with those in Ob)....so standing on my feet for a 2 hour surgery was much different this time than a 2-hour salpingo-oophorectomy in Gyn. But, other than that, it was a phenomenal first day back. I saw my first hip surgery (so amazing) and few other routine type procedures. The rest of the week was spent in clinic, and I had Friday off. I know next week will definitely be back to non-stop, busy carousel of seeing patients, and 2 more days of surgeries, but it was nice to start off slow, especially since I'm dealing with a completely different area of anatomy. Being focused on the anatomy of the pelvis is so much more different than dealing with the anatomy of the shoulder, elbow, wrist, hip, knee, ankle, etc. Much more territory to cover with this one. I'm certainly going to be kept on my toes this month! It was so much easier when I was a kid, and the foot bone was connected to the leg bone, was connected to the hip bone.
Saturday, September 1, 2012
Goodbye to Ob/Gyn...for now
I finished Ob/Gyn yesterday, and am still sort of in shock that it's over. It was truly the best rotation for me: the one where I learned the most, did the most, and realized the most about myself and where my future is heading (yes I'm getting reflective there).
Surgically, I think I've come farthest during this rotation. I was challenged by my preceptor's partner, during a c section I was assisting in, to learn one-handed knot-tying during the time of my rotation. I took the challenge head on, and finally got to show off my skills during the last c section I scrubbed in on with him yesterday. It was a nice closure to the rotation for me. And again, every time I scrub into a case in the OR, I learn more about the nuances that make surgery what it is.
The variety of cases and patient ages is wide, which makes it fun and interesting every time I go into clinic. In-office procedures, birth control counseling, prenatal appts, Gyn annuals, and the surgeries/c sections on top of that. Ob/Gyn combines my interests in endocrinology, surgical cases, seeing patients in clinic, and having a wide range of ages.
Overall, it was an amazing rotation to have, where I learned and did a lot, and realized exactly where I belong. Next up: fun with power tools (orthopedic surgery)!
Surgically, I think I've come farthest during this rotation. I was challenged by my preceptor's partner, during a c section I was assisting in, to learn one-handed knot-tying during the time of my rotation. I took the challenge head on, and finally got to show off my skills during the last c section I scrubbed in on with him yesterday. It was a nice closure to the rotation for me. And again, every time I scrub into a case in the OR, I learn more about the nuances that make surgery what it is.
The variety of cases and patient ages is wide, which makes it fun and interesting every time I go into clinic. In-office procedures, birth control counseling, prenatal appts, Gyn annuals, and the surgeries/c sections on top of that. Ob/Gyn combines my interests in endocrinology, surgical cases, seeing patients in clinic, and having a wide range of ages.
Overall, it was an amazing rotation to have, where I learned and did a lot, and realized exactly where I belong. Next up: fun with power tools (orthopedic surgery)!
Thursday, August 23, 2012
Hating (looming) endings, and moving forward
I officially only have 1 week left in Ob/Gyn, and am absolutely dreading the end. Usually, endings are just that....endings (or, new beginnings, whichever way you look at them). But, what really makes this one poignant, is that incredible amount of learning and growth I have done during this short month, and the things I have accomplished. I have found my niche clinically, and would like nothing more than to stay where I am, to continue learning what I'm learning, and have that amazing feeling that comes from the daily reinforcement of being exactly where I'm supposed to be professionally and personally, and know that what I'm doing matters. I have to give so much credit to my amazing preceptor, who has made this rotation an amazing, full-throttle adventure, and given me so many reasons to be thankful for the time and energy he has spent investing in my training. I have gained clinical pearls to use in practice, new surgical techniques, and life lessons that I will carry with me and use for the rest of my life. I also enjoyed enormous respect and patience from my preceptor and his partner; both of them never made me feel as though I was "just" a student. I was able to engage in conversations and question why things are done a certain way in practice, and they actively probed my mind to force me to think about why I do/say/teach my patients a certain way. I know that I am a better provider because of this month, and I only hope I can re-pay the immense gift I have been given with their teaching by emulating their styles in my own practice.
This is also the first time that I (seriously) began realizing that the job hunt is near. Mostly because I am realizing just how enormous the task in front of me seems....especially since only 3-4% of practicing PAs end up practicing in Ob/Gyn....aka my job hunt will be long and difficult. In addition to the academic/practice-based things I have learned this rotation, I also gained a very solid idea of what will be absolutely essential to me when I practice, and the things I will be looking for in a job and supervising physician. For now, I have several surgeries, C-sections, and hopefully a few more vaginal deliveries between now and next Friday, and I am hoping to soak up every possible clinical pearl and patient encounter before then.
This is also the first time that I (seriously) began realizing that the job hunt is near. Mostly because I am realizing just how enormous the task in front of me seems....especially since only 3-4% of practicing PAs end up practicing in Ob/Gyn....aka my job hunt will be long and difficult. In addition to the academic/practice-based things I have learned this rotation, I also gained a very solid idea of what will be absolutely essential to me when I practice, and the things I will be looking for in a job and supervising physician. For now, I have several surgeries, C-sections, and hopefully a few more vaginal deliveries between now and next Friday, and I am hoping to soak up every possible clinical pearl and patient encounter before then.
Saturday, August 18, 2012
Learning and growth
2 more weeks have passed in Ob/Gyn, with 2 more full weeks left to go (plus next weekend on call). I don't know when there has been a shorter amount of time where I have learned so much, and I am absolutely dreading August 31, when this rotation ends, and I have to say goodbye to this experience. It has been phenomenal in terms of personal growth and learning, and finding the excitement that I had been lacking in my decisions to become a PA in recent months. I had the opportunity to work with the other doctor in the practice, which was extremely beneficial. I have become a much more confident provider and surgical assist because of my time spent with him. I have learned countless procedures, refined my suturing techniques (which, being a lefty, provide some interesting, awkward challenges, when everyone else around the table sutures opposite the way I do; I learned some very handy tips to overcome some of the barriers in my way) and learned a ton about why things are done the way they are in Ob/Gyn.
2 more weeks to go, and I hope many more amazing patient interactions, and much more learning awaits me in these 2 weeks. I don't know that I've ever been truly sad that the end of a rotation is in sight, but this one for sure has me feeling blue to leave.
2 more weeks to go, and I hope many more amazing patient interactions, and much more learning awaits me in these 2 weeks. I don't know that I've ever been truly sad that the end of a rotation is in sight, but this one for sure has me feeling blue to leave.
Friday, August 10, 2012
Having a very special privilege
I have finished a week and some change of my OB/GYN rotation, and I really don't want it to end! I have 3 full weeks left, plus my weekends on-call, but I am having way too much fun to think about ever doing anything else. So far, I've assisted in several C-sections, several GYN surgeries, and been there as several babies were born, and a family was changed forever. It's really special being there with a mother and father, as their lives change, and a new life enters the world. It's breathtaking and priceless and miraculous all in one.
Yesterday was my first day off in 9, and I actually found myself extremely bored (you know I must either be very sleep-deprived, crazy, or both, when I am bored during a much-needed day off), because I have gotten so used to the long hours, endless coffee binges, and seeing so many cool procedures, visiting patients of all ages and medical complaints, and learning/doing so much.
I had a suspicion I would love Ob/Gyn before this rotation, given that it has a combo of clinic/well-visits, surgeries, and different areas of medicine that forces me to use all aspects of my training up to this point. However, I don't think I was quite prepared for how much I would fall in love with Ob/Gyn. Now, my dilemma is that I know how rare PA jobs are in Ob/Gyn, and I worry now that my job hunt will be immensely difficult due to that scarcity. But, at this point, I am focused on learning/doing/seeing as much as possible during the next 3 weeks, and praying that maybe, just maybe, I will find a job doing exactly what I want to do.
That's all until next week; I'm on call all weekend (again), and hoping for more babies :-) Here's just a taste of what I've gotten to see countless times this week :-) It never gets old!
Yesterday was my first day off in 9, and I actually found myself extremely bored (you know I must either be very sleep-deprived, crazy, or both, when I am bored during a much-needed day off), because I have gotten so used to the long hours, endless coffee binges, and seeing so many cool procedures, visiting patients of all ages and medical complaints, and learning/doing so much.
I had a suspicion I would love Ob/Gyn before this rotation, given that it has a combo of clinic/well-visits, surgeries, and different areas of medicine that forces me to use all aspects of my training up to this point. However, I don't think I was quite prepared for how much I would fall in love with Ob/Gyn. Now, my dilemma is that I know how rare PA jobs are in Ob/Gyn, and I worry now that my job hunt will be immensely difficult due to that scarcity. But, at this point, I am focused on learning/doing/seeing as much as possible during the next 3 weeks, and praying that maybe, just maybe, I will find a job doing exactly what I want to do.
That's all until next week; I'm on call all weekend (again), and hoping for more babies :-) Here's just a taste of what I've gotten to see countless times this week :-) It never gets old!
Monday, July 30, 2012
Another ending
Today was the end of my month in plastic and reconstructive surgery. Although I went into the rotation with hesitation (even though I chose it as an elective) I really enjoyed and learned a ton. The spectrum of surgeries I saw was incredible, from pediatric cases to adults, burn surgeries, cancer reconstructions, and everything in between. I learned (albeit clumsily) how to do deep dermal and running sub-cuticular sutures, and learned the names of many of the surgical tools. I can confidently ask for DeBakey, Adson, and Bishop pick-ups, and know exactly what I'll be getting. I overcame many hurdles not normally there for most in surgery, as I am a lefty, and had to figure out ways to hold tools built for right-handed operators. It's still a learning process, but I hope with 3 more rotations involving surgery this year, I'll become better at doing things "wrongly.".
I saw just how much of a difference it makes being in the OR regularly over a month, rather than doing a 2-week surgical rotation in terms of learning how the attending operates, and how to best suit everyone's needs as the student. It was a much more immersive experience, compared toy short rotation that fulfilled the surgical requirement for my program, and only further demonstrated how well-suited surgery is to my meticulous personality, and my love of complex patient requirements. I look forward to what my first job will bring, and learning I have yet to accomplish.
Up next: Ob/Gyn. Here's to a nice combo of anticipatory health guidance, surgeries, and being involved in some pretty amazing moments of families.
I saw just how much of a difference it makes being in the OR regularly over a month, rather than doing a 2-week surgical rotation in terms of learning how the attending operates, and how to best suit everyone's needs as the student. It was a much more immersive experience, compared toy short rotation that fulfilled the surgical requirement for my program, and only further demonstrated how well-suited surgery is to my meticulous personality, and my love of complex patient requirements. I look forward to what my first job will bring, and learning I have yet to accomplish.
Up next: Ob/Gyn. Here's to a nice combo of anticipatory health guidance, surgeries, and being involved in some pretty amazing moments of families.
Sunday, July 22, 2012
Lots of suturing
I have definitely neglected updating this blog in awhile; Internal medicine has come and gone (which was the update from my last post; I had just finished my first week of IM, and now it's already done), and I saw and learned a lot. It was a very nice introduction to full-time clinical rotations, with a wide variety of different patients presenting with different chief complaints, and very complex medical history and allergy lists. I actually did a happy dance when the rare patient presented with no significant chronic illnesses and no known medication allergies. However, my ability to use my pharmacology definitely increased dramatically when I was forced to integrate the list of the patient's medication allergies with what was available to me, and I learned the preferred 2nd and 3rd line drugs (especially antibiotics) for common disorders, when a patient was allergic to the 1st line therapy. I also became confident in when I picked up on an abnormality, because I've already seen/heard so many normals. It's nice when things start jumping out, like a subtle heart murmur, developing abscess/infection, or difference in a neuro. exam from what is expected.
This month has been with the plastic and reconstructive surgery service. While I know that it won't be what I pursue professionally, it has been a great time learning about different common procedures used for breast reconstruction post-cancer, reductions, augmentations, and other reconstructive procedures that may be part of my patients' histories. It has also been a great opportunity to learn different suturing and knot-tying techniques, although I feel like I'm the slowest suturer ever. I have done (although very slowly) sub-cuticular and deep dermal suturing now, both of which I hadn't done in my previous surgical rotations. Sub-cuticular is amazing, because they are done with absorbable suture material and buried beneath the skin; the resulting scar is minimized, and you don't end up with the "railroad tracking" appearance from sutures that are superficial. I hope that with time, I will be able to do more than 4-5 sutures a minute. It is also difficult that I am left-hand dominant, and many surgical instruments are built for right-handed surgeons/assistants. I will have to learn many things in a different way. It's a constant learning experience.
I have one more week of plastic/reconstructive surgery, and then I start my Ob/Gyn rotation, which I'm very excited about. It's at a community hospital, away from the academic medical centers that are not as conducive for students and getting individual attention, and less competition. Hopefully I'll find more time to update things next month!
This month has been with the plastic and reconstructive surgery service. While I know that it won't be what I pursue professionally, it has been a great time learning about different common procedures used for breast reconstruction post-cancer, reductions, augmentations, and other reconstructive procedures that may be part of my patients' histories. It has also been a great opportunity to learn different suturing and knot-tying techniques, although I feel like I'm the slowest suturer ever. I have done (although very slowly) sub-cuticular and deep dermal suturing now, both of which I hadn't done in my previous surgical rotations. Sub-cuticular is amazing, because they are done with absorbable suture material and buried beneath the skin; the resulting scar is minimized, and you don't end up with the "railroad tracking" appearance from sutures that are superficial. I hope that with time, I will be able to do more than 4-5 sutures a minute. It is also difficult that I am left-hand dominant, and many surgical instruments are built for right-handed surgeons/assistants. I will have to learn many things in a different way. It's a constant learning experience.
I have one more week of plastic/reconstructive surgery, and then I start my Ob/Gyn rotation, which I'm very excited about. It's at a community hospital, away from the academic medical centers that are not as conducive for students and getting individual attention, and less competition. Hopefully I'll find more time to update things next month!
Saturday, June 9, 2012
Internal medicine: week 1
Well the first week of internal medicine has come and gone, and I definitely love the confidence and learning that comes with being in clinic full-time. I have seen somewhere around 50 patients, and made 2x as many phone calls to follow up to others. Internal medicine is, if anything, an exercise in keeping the details straight, because most of the adults we see are very medically complex in nature. When I open a chart, I'm no longer surprised to see a history of heart issues coupled with diabetes, hypertension, cancer, psychiatric issues, and allergies to 12 different medications (thank goodness there are so many options, otherwise it would be very difficult to write any prescriptions for some of these people). Actually, I'm more surprised when I'm handed a relatively thin chart, or when the sticker plastered on the front says "NKDA," indicating that they have no drug allergies. I sometimes do a little happy dance in my head when I see that. But, I'm also discovering that it's the really medically complex patients that I learn the most from. I know which other drugs to avoid in allergies to a certain class of medications, resources to give patients, and where to go next when things would seem to get stuck at the fork on the yellow brick road just last year when I was a student in the didactic portion of my training. I'm very happy I had internal medicine as my first rotation, as I am able to use all of the information I've learned while it's still fresh in my mind. I also realize that time goes inexplicably quickly. I only have 12 more days left of IM, before moving onto plastic/reconstructive surgery. Stay tuned for the travails of week 2!
Thursday, May 24, 2012
And the countdown begins
364. It's a seemingly random number. It's also the number of days left until I'm again wearing the fabulous (and ever fashion-forward) black pointy hat, gown with bat-wings, and a tassel, to receive my MPAS degree, and officially become a PA. Today was the graduation ceremony for the class above ours, and watching it was very surreal. Several of my very close friends (some of whom have been my classmates since college) graduated today, and the realization hit me that my fellow classmates and I will be there in less than a year. The fact that we're out starting our 3rd year rotations is baffling to me in and of itself, because when we started anatomy our first summer, it seemed like almost a lifetime would have to pass before we would reach this point. But, here I am, just 7 days away from beginning my first rotation, and I cannot wait!
Wednesday, May 9, 2012
I passed!
I found out last week that I passed my comps, so I'm officially on my way to starting my amazing year of rotations. I'm really excited for my summer ahead, and I can't wait to see what Internal Medicine holds for me in June!
Monday, April 30, 2012
Last week of classes
This week is my last week of classes, after 20 years of sitting in a classroom. Only 2 more days this week left of classes, 1 day left at my AMAZING general pediatrics rotation, and then 5 final exams next week. Still waiting on comps. results, but expect them this week. While I'm not too worried that I didn't pass, I won't feel good until I get that envelope with the official results contained in it. After final exams, we have a week of ACLS/PALS training, and then 2 weeks off before clinical rotations officially begin on June 1! My first rotation is in Internal Medicine, followed by 3 surgery rotations (another month in Orthopaedics, ENT, and General Surgery), and Ob/Gyn....the first 5 months of clinic are going to be very busy, but I'm so looking forward to the intense hours and the amazing learning that's ahead of me! I've been dreaming about this for 2 years....well, actually, my entire life.
Thursday, April 19, 2012
2 years of knowledge
Wow. Tomorrow, I will take my written comprehensive exam, a 200-question, 4-hour exam that will assess my knowledge and processing skills on 2 years worth of material. It's so strange, because when I think about where I was in June of 2010, essentially fresh out of college, and starting from square 1 of medical training, it seems almost silly that 2 years of hard-earned knowledge, sleepless nights, endless trips to coffee shops, PILES of notes (I can only imagine the amount of trees that are no longer living, having been sacrificed for 10 page handouts for every lecture, x2 years, x40 classmates) can be whittled down to just 200 questions, and 4 hours. It's amazing to think that I will be practicing medicine in a year. Wow. Just, wow. Where have the past 2 years gone? When I started with my lab group in the cadaver lab in June 2010, 3 years seemed so long. Now, I'm wondering where it has gone. I can't believe my clinical rotations start in just a little over a month. Looking forward to my amazing schedule ahead, and leaving the classroom behind. But first, my comprehensive exam tomorrow morning. I'll see you all on the other side of the dark cloud :-)
Monday, April 16, 2012
Tomorrow's the big day!
Well, tomorrow is the big day....well, one of them, at least. The start of comprehensive exams, required to enter 3rd year clinical rotations. While I'm not terribly worried about them, the thought that this is the exam that I must overcome before I can enjoy the glory of 3rd year is weighing on my mind. And the fact that I'm fighting a nasty cold, care of my very adorable pediatric patients, doesn't quite help things either.
While I'm a little nervous (who wouldn't be; I never really enjoy standardized patient encounters, anyway, knowing that 3-4 video cameras are recording my every move/sound, even though there's only myself and the patient-actor in the room), I know, and have known, that there is no real way to study for the comprehensive exams. Everything we have done/learned for 2 years up to this point has prepared me for this week, and I know that I will do fine. I just have to prove that I know what I demonstrate to know every day in clinic, and in other classes. I just have to remind myself to remember to do the silly things we haven't done since 1st year, and the random physical exam maneuvers not commonly performed, except in specific circumstances....and to remember to properly drape the pt., and pull out the foot-rest on the exam table....having the pts. feet hanging uncomfortably off the table is never good form. Wish me luck! 3rd year is so close, I can taste it!
While I'm a little nervous (who wouldn't be; I never really enjoy standardized patient encounters, anyway, knowing that 3-4 video cameras are recording my every move/sound, even though there's only myself and the patient-actor in the room), I know, and have known, that there is no real way to study for the comprehensive exams. Everything we have done/learned for 2 years up to this point has prepared me for this week, and I know that I will do fine. I just have to prove that I know what I demonstrate to know every day in clinic, and in other classes. I just have to remind myself to remember to do the silly things we haven't done since 1st year, and the random physical exam maneuvers not commonly performed, except in specific circumstances....and to remember to properly drape the pt., and pull out the foot-rest on the exam table....having the pts. feet hanging uncomfortably off the table is never good form. Wish me luck! 3rd year is so close, I can taste it!
Saturday, March 10, 2012
Tiny humans....and minor freakouts
The last 7 weeks of my didactic curriculum (ever) include my rotation in general pediatrics. Can I just say how much I love children?! I knew this long before I ever started PA school, but after doing my last seven week rotation in palliative care, this rotation is a far cry from the end-of-life discussions I observed prior to this. I walked into clinic on Tuesday morning, on the first bright, sunny day Denver has seen in a long while, coffee in hand, and found bright paintings on the walls of jungle and under-the-sea scenes. "The Little Mermaid" was playing on a loop on the waiting room television (try getting "Under the Sea" out of your head after hearing it 9 times in one day; the calypso beat that Sebastian sings to is actually pretty catchy). Immediately, I was welcomed by the doctor who started the practice, the office staff, and several other providers with whom I'll be working with this semester. I was already having fun, and I hadn't even seen any patients yet. Overall, my first day of this rotation was phenomenal, and I loved that all of the providers came in excited to see patients, and were so in love with their jobs. I could get used to this.
The rest of the week was a drag, more so than is usual. There are only 7 weeks left of the semester, including our week of the big comprehensive exam, and I had my first minor freakout session about the comprehensive exam. There really is no good way to study for an exam that essentially tests everything we've learned in the past 2 years, before we're allowed to be let loose into the world of full-time clinical medicine. However, I'm hoping that with the time I spend during spring break studying, I can use everything I know to prove that I'm SOOOO ready to leave the classroom.
Back to studying for the 2 exams that stand between me and spring break (as much of a break as it will be with comprehensive studying). Here are some photos from our recent IV lab (I got all sticks that I attempted successfully on my partner!)
The rest of the week was a drag, more so than is usual. There are only 7 weeks left of the semester, including our week of the big comprehensive exam, and I had my first minor freakout session about the comprehensive exam. There really is no good way to study for an exam that essentially tests everything we've learned in the past 2 years, before we're allowed to be let loose into the world of full-time clinical medicine. However, I'm hoping that with the time I spend during spring break studying, I can use everything I know to prove that I'm SOOOO ready to leave the classroom.
Back to studying for the 2 exams that stand between me and spring break (as much of a break as it will be with comprehensive studying). Here are some photos from our recent IV lab (I got all sticks that I attempted successfully on my partner!)
 |
| Nice little blood splatter |
 |
| Trying not to look at the giant needle |
 |
| My turn....just threading the catheter into the vein :-) |
Sunday, February 19, 2012
And the letter that comes after O is.....
I'm pretty sure that in kindergarten, they stopped teaching the alphabet after the letter O. I'm 100% convinced of this. Why, you ask? Because EKG interpretation is NOT my forte. I really wish it was. Sometimes, it just baffles me, because I'm a total physiology nerd, and how the body works just rolls off the back of my hand. But how the electrophysiology of the heart actually translates into the rhythms that appear on a 12-lead? I find myself always struggling to interpret anything more involved than the rate, rhythm, and whether there's ST-segment elevation or not. Beyond that, it all looks like a bunch of squiggly lines that have varying degrees of points, depressions, and other things that seem as foreign to me as learning another language (full disclosure: learning foreign languages have never been easy for me, either). So, needless to say, my weekend has been full of trying to desperately cram all of the rhythms into my brain for the exam that is coming up on Wednesday. I have actually found the Dubin book to be very helpful, in addition to a few algorithms for interpretation that we've learned in class. But, when all is said and done, I wouldn't trust myself to interpret an EKG. I'll leave that up to the cardiology people.
Drinking from the fire hose
Ever since before I started applying to PA school, everyone I talked to said that during PA school, everything feels like you're trying to drink from a fire hose....getting completely doused in heavy, torrential flow of information, and struggling just to push back against the pressure. Overall, I actually haven't found that to be true, but considering I'm in a 3-year program, it's most likely the pace of the program is a bit better than most.
However, I think this is the first time I've ever felt like that analogy is actually true. I was out for almost 2 weeks recovering from a minor surgery, and I'm definitely struggling to catch up. Even though all of my classes only take place once a week, 2 classes=2 weeks worth of material=Katie running around like a crazy person trying to get back into a routine. Much like this:
On the other hand, I truly feel that in spite of how overwhelmed I feel, every day is a day closer to clinic. My schedule is almost complete for 3rd year, except for my required OB/GYN rotation. Very excited to spend a year with patients, and (hopefully) figure out what specialty I'd like to focus my job search on. It's only a slight comfort knowing that as a PA I can switch specialties throughout my career, but I'd still love some insight into where I'll start. Every day I feel like I oscillate between wanting to do Endocrinology or Surgery, but I have an Endocrine rotation and 2 (hopefully 3 once my final elective is scheduled) Surgery rotations next year, so I hope I can figure that out.
On a final note: think good thoughts....we have our IV lab in Emergency Medicine this week....EEEK!
However, I think this is the first time I've ever felt like that analogy is actually true. I was out for almost 2 weeks recovering from a minor surgery, and I'm definitely struggling to catch up. Even though all of my classes only take place once a week, 2 classes=2 weeks worth of material=Katie running around like a crazy person trying to get back into a routine. Much like this:
 |
| HOLY CRAP! |
On a final note: think good thoughts....we have our IV lab in Emergency Medicine this week....EEEK!
Subscribe to:
Posts (Atom)
Monday, July 15, 2013
New name, new look, new beginnings
You may have noticed that the name has changed (only slightly), as has the layout. I figured since I was no longer a PA-Student, it was high time to change the name to reflect my new designation as a Physician Assistant (I still feel weird typing that out, with no -S behind it).
I finished my last official clinical rotation in Ob/Gyn (can I go back yet; I miss it terribly....I truly know it's where I belong), and took the PANCE (waiting for scores to return hopefully this Thursday), and I no longer am occupying my time studying with my stack of review books....I don't know quite what to do.
Licensing paperwork is underway, so as soon as my scores are posted with the board, I should have my CT state license shortly after that. This feels very surreal.
I finished my last official clinical rotation in Ob/Gyn (can I go back yet; I miss it terribly....I truly know it's where I belong), and took the PANCE (waiting for scores to return hopefully this Thursday), and I no longer am occupying my time studying with my stack of review books....I don't know quite what to do.
Licensing paperwork is underway, so as soon as my scores are posted with the board, I should have my CT state license shortly after that. This feels very surreal.
Monday, May 27, 2013
Graduation!
It finally happened: graduation from PA school. I went from Katherine Swan, PA-Student, to Katherine Swan, MPAS, PA! I no longer have to introduce myself as a student. While I don't feel much different than I did a month ago, when I still WAS a student, apparently something IS. I won't officially have any privileges until I take my certification exam (the PANCE, pronounced like pants), and then, I'll legally be able to practice medicine.
I had a lovely celebration, seeing former teachers, mentors, friends, and family, and relishing the fact that I'll never have to wear the ridiculous academic regalia ever again!
Now, to enjoy this week, before I start my last make-up rotation for the month of June. But, it's ObGyn, which I'm incredibly excited about. No better way to spend my last rotation than in my favorite specialty in medicine, and the one I'm hoping to spend my career practicing in.
I had a lovely celebration, seeing former teachers, mentors, friends, and family, and relishing the fact that I'll never have to wear the ridiculous academic regalia ever again!
Now, to enjoy this week, before I start my last make-up rotation for the month of June. But, it's ObGyn, which I'm incredibly excited about. No better way to spend my last rotation than in my favorite specialty in medicine, and the one I'm hoping to spend my career practicing in.
Monday, May 6, 2013
Playing catch-up.....and forming new beginnings
Well, I'll be the first to admit that I've sorely neglected my blog these past few months, between clinical rotations, getting sick/having surgery 2x in November, and pushing through the last of clinic, taking my 3rd year comprehensive exams, and getting ready for graduation.
Shortly, this blog will turn into my experiences as a newly minted PA....and what it's like to do a PA Surgical Residency. Somewhere in the past 5 months of being absent from the blogosphere, I applied, interviewed, and got accepted to the Yale/Norwalk Surgical Residency program!
After falling in love with surgery during my 2nd year, I'd started researching the possibility of doing a surgical residency. One of our faculty members had completed the Yale residency upon graduation, and loved it....and after speaking with her about her experiences, I decided that the only program I'd apply to would be the Yale program, given its long history, its very organized format incorporating both lecture/didactic curricula (morning lectures, teaching rounds, and intermittent anatomy, surgical technology, pathology, microbiology, and animal surgery sessions at the Yale school of medicine throughout the year), and clinical time into the experiences. Norwalk Hospital does not have MD surgical residents there, so we won't have to compete for OR time when we operate there. The SICU and post-op recovery units are staffed entirely by PAs, both residents and staff PAs, so again, we get the comprehensive experience without being lower on the proverbial totem pole. We rotate through the different surgical services (general, ortho, plastic/reconstructive, neurosurgery, trauma, GU, Ob/GYN, SICU, and cardiothoracic/vascular), and also have 2 months for elective choices. I'm incredibly excited for this opportunity to learn more, greatly improve my experiences and skills in the operating room, and become well-versed in inpatient medical care. I'm also terrified, and have a constant feeling of nervous butterflies, now that the initial excitement of being accepted has turned into reality of moving across the country in 3 months.
For now, I am focusing on presenting my master's project this week, looking forward to seeing family, friends, and old teachers at graduation, and starting my last clinical rotation in June (Ob/Gyn in Denver; back to a month of deliveries, surgeries, and spending time in my favorite clinical setting). I couldn't imagine a more perfect way to finish PA school than with an elective that will truly be amazing! I cannot wait!
Shortly, this blog will turn into my experiences as a newly minted PA....and what it's like to do a PA Surgical Residency. Somewhere in the past 5 months of being absent from the blogosphere, I applied, interviewed, and got accepted to the Yale/Norwalk Surgical Residency program!
After falling in love with surgery during my 2nd year, I'd started researching the possibility of doing a surgical residency. One of our faculty members had completed the Yale residency upon graduation, and loved it....and after speaking with her about her experiences, I decided that the only program I'd apply to would be the Yale program, given its long history, its very organized format incorporating both lecture/didactic curricula (morning lectures, teaching rounds, and intermittent anatomy, surgical technology, pathology, microbiology, and animal surgery sessions at the Yale school of medicine throughout the year), and clinical time into the experiences. Norwalk Hospital does not have MD surgical residents there, so we won't have to compete for OR time when we operate there. The SICU and post-op recovery units are staffed entirely by PAs, both residents and staff PAs, so again, we get the comprehensive experience without being lower on the proverbial totem pole. We rotate through the different surgical services (general, ortho, plastic/reconstructive, neurosurgery, trauma, GU, Ob/GYN, SICU, and cardiothoracic/vascular), and also have 2 months for elective choices. I'm incredibly excited for this opportunity to learn more, greatly improve my experiences and skills in the operating room, and become well-versed in inpatient medical care. I'm also terrified, and have a constant feeling of nervous butterflies, now that the initial excitement of being accepted has turned into reality of moving across the country in 3 months.
Sunday, November 25, 2012
I have returned
I just realized it's been many rotations (and therefore many months) since I've updated this thing....and much has happened since then:
I hope everyone had a lovely Thanksgiving, and that the impending holiday season brings lots of relaxation (or for those of us in medicine, a crap load of patients trying to get in their visits before the end of the year insurance deadlines). Hopefully I'll find more time to update things in the future.
- I finished orthopedic surgery in September; this was my 2nd go-round in dealing with bones, and I had a total blast (again)! There's nothing quite like hearing a bone crack and pop, watching a femoral head pop out of socket during a total hip replacement, and the sound of an electric drill has hardware is being implanted. (In my down-time this rotation, mostly at the end of the month, I had the opportunity to scrub in on a few more GYN procedures with my old preceptor, which was a huge treat; for the girl who started PA school thinking I'd never do Ob/Gyn, and I'll graduate knowing there's nothing else on the planet I'll be happy doing, I'm the poster-child for keeping an open mind).
- I moved onto ENT surgery next for the month of October, which also involved a LONG commute every day (I logged 1.5 hours each way every day to get the hospital where my rotation was, which meant seeing NO sunshine M-F for the entire month; this, in addition to the fact that this was an incredibly difficult rotation for me (especially after Ob/Gyn being such a highlight in my life), made this month really rough. However, I survived, and gained some valuable experience
- I then started November as the first of 3 months in a row at Children's Hospital Colorado, one of my favorite places on the planet. While I know that pediatrics likely isn't in my long-term future career-wise, I can't imagine a more fun place to spend a rotation. I started out with 2 days of general pediatrics, dealing with a wide array of well-child checks, coordinating of social problems and dealing with parents, and then....
- I had emergency surgery at 3am on November 3rd (boy, I REALLY know how to live it up and have a good time at the start of a weekend....); I spent the next week out of clinic recovering, which wasn't too bad, but not the greatest way to spend a week
- I came back to clinic the next Monday to have the crazy week from hell (or, at least I thought); it was a conglomeration of all of the patients who were super sick, behind on their shots, mad that they weren't seeing a provider fast enough, and dealing with coordinating public benefits....needless to say, my first week back (during which one of my attendings said I looked like "a slightly paler shade of white") was crazy, and sort of like juggling fire.
- The short week before Thanksgiving was just as nuts, but I finally felt more like myself, and not so exhausted and sore, so I was better able to deal with the endless sea of patients, charting, and figuring things out.
- Just one more week left of general pediatrics before I move onto 2 weeks of Pediatric Endocrinology. This will be my 3rd go-round with their dept., so I'm looking forward to spending more time there.
|
| "What is this crazy lady going to do to me? She's not the one with the pointy things, is she?" |
I hope everyone had a lovely Thanksgiving, and that the impending holiday season brings lots of relaxation (or for those of us in medicine, a crap load of patients trying to get in their visits before the end of the year insurance deadlines). Hopefully I'll find more time to update things in the future.
Friday, September 7, 2012
Back to the construction zone
My week was a nice, slow introduction, after the hectic schedule that I kept during my Ob rotation. I had the long Labor Day weekend off, and my first day back in Ortho. was a surgery day (YAY)! The one thing I didn't quite remember was just how heavy the lead vests weigh (woof; didn't have to deal with those in Ob)....so standing on my feet for a 2 hour surgery was much different this time than a 2-hour salpingo-oophorectomy in Gyn. But, other than that, it was a phenomenal first day back. I saw my first hip surgery (so amazing) and few other routine type procedures. The rest of the week was spent in clinic, and I had Friday off. I know next week will definitely be back to non-stop, busy carousel of seeing patients, and 2 more days of surgeries, but it was nice to start off slow, especially since I'm dealing with a completely different area of anatomy. Being focused on the anatomy of the pelvis is so much more different than dealing with the anatomy of the shoulder, elbow, wrist, hip, knee, ankle, etc. Much more territory to cover with this one. I'm certainly going to be kept on my toes this month! It was so much easier when I was a kid, and the foot bone was connected to the leg bone, was connected to the hip bone.
Saturday, September 1, 2012
Goodbye to Ob/Gyn...for now
I finished Ob/Gyn yesterday, and am still sort of in shock that it's over. It was truly the best rotation for me: the one where I learned the most, did the most, and realized the most about myself and where my future is heading (yes I'm getting reflective there).
Surgically, I think I've come farthest during this rotation. I was challenged by my preceptor's partner, during a c section I was assisting in, to learn one-handed knot-tying during the time of my rotation. I took the challenge head on, and finally got to show off my skills during the last c section I scrubbed in on with him yesterday. It was a nice closure to the rotation for me. And again, every time I scrub into a case in the OR, I learn more about the nuances that make surgery what it is.
The variety of cases and patient ages is wide, which makes it fun and interesting every time I go into clinic. In-office procedures, birth control counseling, prenatal appts, Gyn annuals, and the surgeries/c sections on top of that. Ob/Gyn combines my interests in endocrinology, surgical cases, seeing patients in clinic, and having a wide range of ages.
Overall, it was an amazing rotation to have, where I learned and did a lot, and realized exactly where I belong. Next up: fun with power tools (orthopedic surgery)!
Surgically, I think I've come farthest during this rotation. I was challenged by my preceptor's partner, during a c section I was assisting in, to learn one-handed knot-tying during the time of my rotation. I took the challenge head on, and finally got to show off my skills during the last c section I scrubbed in on with him yesterday. It was a nice closure to the rotation for me. And again, every time I scrub into a case in the OR, I learn more about the nuances that make surgery what it is.
The variety of cases and patient ages is wide, which makes it fun and interesting every time I go into clinic. In-office procedures, birth control counseling, prenatal appts, Gyn annuals, and the surgeries/c sections on top of that. Ob/Gyn combines my interests in endocrinology, surgical cases, seeing patients in clinic, and having a wide range of ages.
Overall, it was an amazing rotation to have, where I learned and did a lot, and realized exactly where I belong. Next up: fun with power tools (orthopedic surgery)!
Thursday, August 23, 2012
Hating (looming) endings, and moving forward
I officially only have 1 week left in Ob/Gyn, and am absolutely dreading the end. Usually, endings are just that....endings (or, new beginnings, whichever way you look at them). But, what really makes this one poignant, is that incredible amount of learning and growth I have done during this short month, and the things I have accomplished. I have found my niche clinically, and would like nothing more than to stay where I am, to continue learning what I'm learning, and have that amazing feeling that comes from the daily reinforcement of being exactly where I'm supposed to be professionally and personally, and know that what I'm doing matters. I have to give so much credit to my amazing preceptor, who has made this rotation an amazing, full-throttle adventure, and given me so many reasons to be thankful for the time and energy he has spent investing in my training. I have gained clinical pearls to use in practice, new surgical techniques, and life lessons that I will carry with me and use for the rest of my life. I also enjoyed enormous respect and patience from my preceptor and his partner; both of them never made me feel as though I was "just" a student. I was able to engage in conversations and question why things are done a certain way in practice, and they actively probed my mind to force me to think about why I do/say/teach my patients a certain way. I know that I am a better provider because of this month, and I only hope I can re-pay the immense gift I have been given with their teaching by emulating their styles in my own practice.
This is also the first time that I (seriously) began realizing that the job hunt is near. Mostly because I am realizing just how enormous the task in front of me seems....especially since only 3-4% of practicing PAs end up practicing in Ob/Gyn....aka my job hunt will be long and difficult. In addition to the academic/practice-based things I have learned this rotation, I also gained a very solid idea of what will be absolutely essential to me when I practice, and the things I will be looking for in a job and supervising physician. For now, I have several surgeries, C-sections, and hopefully a few more vaginal deliveries between now and next Friday, and I am hoping to soak up every possible clinical pearl and patient encounter before then.
This is also the first time that I (seriously) began realizing that the job hunt is near. Mostly because I am realizing just how enormous the task in front of me seems....especially since only 3-4% of practicing PAs end up practicing in Ob/Gyn....aka my job hunt will be long and difficult. In addition to the academic/practice-based things I have learned this rotation, I also gained a very solid idea of what will be absolutely essential to me when I practice, and the things I will be looking for in a job and supervising physician. For now, I have several surgeries, C-sections, and hopefully a few more vaginal deliveries between now and next Friday, and I am hoping to soak up every possible clinical pearl and patient encounter before then.
Saturday, August 18, 2012
Learning and growth
2 more weeks have passed in Ob/Gyn, with 2 more full weeks left to go (plus next weekend on call). I don't know when there has been a shorter amount of time where I have learned so much, and I am absolutely dreading August 31, when this rotation ends, and I have to say goodbye to this experience. It has been phenomenal in terms of personal growth and learning, and finding the excitement that I had been lacking in my decisions to become a PA in recent months. I had the opportunity to work with the other doctor in the practice, which was extremely beneficial. I have become a much more confident provider and surgical assist because of my time spent with him. I have learned countless procedures, refined my suturing techniques (which, being a lefty, provide some interesting, awkward challenges, when everyone else around the table sutures opposite the way I do; I learned some very handy tips to overcome some of the barriers in my way) and learned a ton about why things are done the way they are in Ob/Gyn.
2 more weeks to go, and I hope many more amazing patient interactions, and much more learning awaits me in these 2 weeks. I don't know that I've ever been truly sad that the end of a rotation is in sight, but this one for sure has me feeling blue to leave.
2 more weeks to go, and I hope many more amazing patient interactions, and much more learning awaits me in these 2 weeks. I don't know that I've ever been truly sad that the end of a rotation is in sight, but this one for sure has me feeling blue to leave.
Friday, August 10, 2012
Having a very special privilege
I have finished a week and some change of my OB/GYN rotation, and I really don't want it to end! I have 3 full weeks left, plus my weekends on-call, but I am having way too much fun to think about ever doing anything else. So far, I've assisted in several C-sections, several GYN surgeries, and been there as several babies were born, and a family was changed forever. It's really special being there with a mother and father, as their lives change, and a new life enters the world. It's breathtaking and priceless and miraculous all in one.
Yesterday was my first day off in 9, and I actually found myself extremely bored (you know I must either be very sleep-deprived, crazy, or both, when I am bored during a much-needed day off), because I have gotten so used to the long hours, endless coffee binges, and seeing so many cool procedures, visiting patients of all ages and medical complaints, and learning/doing so much.
I had a suspicion I would love Ob/Gyn before this rotation, given that it has a combo of clinic/well-visits, surgeries, and different areas of medicine that forces me to use all aspects of my training up to this point. However, I don't think I was quite prepared for how much I would fall in love with Ob/Gyn. Now, my dilemma is that I know how rare PA jobs are in Ob/Gyn, and I worry now that my job hunt will be immensely difficult due to that scarcity. But, at this point, I am focused on learning/doing/seeing as much as possible during the next 3 weeks, and praying that maybe, just maybe, I will find a job doing exactly what I want to do.
That's all until next week; I'm on call all weekend (again), and hoping for more babies :-) Here's just a taste of what I've gotten to see countless times this week :-) It never gets old!
Yesterday was my first day off in 9, and I actually found myself extremely bored (you know I must either be very sleep-deprived, crazy, or both, when I am bored during a much-needed day off), because I have gotten so used to the long hours, endless coffee binges, and seeing so many cool procedures, visiting patients of all ages and medical complaints, and learning/doing so much.
I had a suspicion I would love Ob/Gyn before this rotation, given that it has a combo of clinic/well-visits, surgeries, and different areas of medicine that forces me to use all aspects of my training up to this point. However, I don't think I was quite prepared for how much I would fall in love with Ob/Gyn. Now, my dilemma is that I know how rare PA jobs are in Ob/Gyn, and I worry now that my job hunt will be immensely difficult due to that scarcity. But, at this point, I am focused on learning/doing/seeing as much as possible during the next 3 weeks, and praying that maybe, just maybe, I will find a job doing exactly what I want to do.
That's all until next week; I'm on call all weekend (again), and hoping for more babies :-) Here's just a taste of what I've gotten to see countless times this week :-) It never gets old!
Monday, July 30, 2012
Another ending
Today was the end of my month in plastic and reconstructive surgery. Although I went into the rotation with hesitation (even though I chose it as an elective) I really enjoyed and learned a ton. The spectrum of surgeries I saw was incredible, from pediatric cases to adults, burn surgeries, cancer reconstructions, and everything in between. I learned (albeit clumsily) how to do deep dermal and running sub-cuticular sutures, and learned the names of many of the surgical tools. I can confidently ask for DeBakey, Adson, and Bishop pick-ups, and know exactly what I'll be getting. I overcame many hurdles not normally there for most in surgery, as I am a lefty, and had to figure out ways to hold tools built for right-handed operators. It's still a learning process, but I hope with 3 more rotations involving surgery this year, I'll become better at doing things "wrongly.".
I saw just how much of a difference it makes being in the OR regularly over a month, rather than doing a 2-week surgical rotation in terms of learning how the attending operates, and how to best suit everyone's needs as the student. It was a much more immersive experience, compared toy short rotation that fulfilled the surgical requirement for my program, and only further demonstrated how well-suited surgery is to my meticulous personality, and my love of complex patient requirements. I look forward to what my first job will bring, and learning I have yet to accomplish.
Up next: Ob/Gyn. Here's to a nice combo of anticipatory health guidance, surgeries, and being involved in some pretty amazing moments of families.
I saw just how much of a difference it makes being in the OR regularly over a month, rather than doing a 2-week surgical rotation in terms of learning how the attending operates, and how to best suit everyone's needs as the student. It was a much more immersive experience, compared toy short rotation that fulfilled the surgical requirement for my program, and only further demonstrated how well-suited surgery is to my meticulous personality, and my love of complex patient requirements. I look forward to what my first job will bring, and learning I have yet to accomplish.
Up next: Ob/Gyn. Here's to a nice combo of anticipatory health guidance, surgeries, and being involved in some pretty amazing moments of families.
Sunday, July 22, 2012
Lots of suturing
I have definitely neglected updating this blog in awhile; Internal medicine has come and gone (which was the update from my last post; I had just finished my first week of IM, and now it's already done), and I saw and learned a lot. It was a very nice introduction to full-time clinical rotations, with a wide variety of different patients presenting with different chief complaints, and very complex medical history and allergy lists. I actually did a happy dance when the rare patient presented with no significant chronic illnesses and no known medication allergies. However, my ability to use my pharmacology definitely increased dramatically when I was forced to integrate the list of the patient's medication allergies with what was available to me, and I learned the preferred 2nd and 3rd line drugs (especially antibiotics) for common disorders, when a patient was allergic to the 1st line therapy. I also became confident in when I picked up on an abnormality, because I've already seen/heard so many normals. It's nice when things start jumping out, like a subtle heart murmur, developing abscess/infection, or difference in a neuro. exam from what is expected.
This month has been with the plastic and reconstructive surgery service. While I know that it won't be what I pursue professionally, it has been a great time learning about different common procedures used for breast reconstruction post-cancer, reductions, augmentations, and other reconstructive procedures that may be part of my patients' histories. It has also been a great opportunity to learn different suturing and knot-tying techniques, although I feel like I'm the slowest suturer ever. I have done (although very slowly) sub-cuticular and deep dermal suturing now, both of which I hadn't done in my previous surgical rotations. Sub-cuticular is amazing, because they are done with absorbable suture material and buried beneath the skin; the resulting scar is minimized, and you don't end up with the "railroad tracking" appearance from sutures that are superficial. I hope that with time, I will be able to do more than 4-5 sutures a minute. It is also difficult that I am left-hand dominant, and many surgical instruments are built for right-handed surgeons/assistants. I will have to learn many things in a different way. It's a constant learning experience.
I have one more week of plastic/reconstructive surgery, and then I start my Ob/Gyn rotation, which I'm very excited about. It's at a community hospital, away from the academic medical centers that are not as conducive for students and getting individual attention, and less competition. Hopefully I'll find more time to update things next month!
This month has been with the plastic and reconstructive surgery service. While I know that it won't be what I pursue professionally, it has been a great time learning about different common procedures used for breast reconstruction post-cancer, reductions, augmentations, and other reconstructive procedures that may be part of my patients' histories. It has also been a great opportunity to learn different suturing and knot-tying techniques, although I feel like I'm the slowest suturer ever. I have done (although very slowly) sub-cuticular and deep dermal suturing now, both of which I hadn't done in my previous surgical rotations. Sub-cuticular is amazing, because they are done with absorbable suture material and buried beneath the skin; the resulting scar is minimized, and you don't end up with the "railroad tracking" appearance from sutures that are superficial. I hope that with time, I will be able to do more than 4-5 sutures a minute. It is also difficult that I am left-hand dominant, and many surgical instruments are built for right-handed surgeons/assistants. I will have to learn many things in a different way. It's a constant learning experience.
I have one more week of plastic/reconstructive surgery, and then I start my Ob/Gyn rotation, which I'm very excited about. It's at a community hospital, away from the academic medical centers that are not as conducive for students and getting individual attention, and less competition. Hopefully I'll find more time to update things next month!
Saturday, June 9, 2012
Internal medicine: week 1
Well the first week of internal medicine has come and gone, and I definitely love the confidence and learning that comes with being in clinic full-time. I have seen somewhere around 50 patients, and made 2x as many phone calls to follow up to others. Internal medicine is, if anything, an exercise in keeping the details straight, because most of the adults we see are very medically complex in nature. When I open a chart, I'm no longer surprised to see a history of heart issues coupled with diabetes, hypertension, cancer, psychiatric issues, and allergies to 12 different medications (thank goodness there are so many options, otherwise it would be very difficult to write any prescriptions for some of these people). Actually, I'm more surprised when I'm handed a relatively thin chart, or when the sticker plastered on the front says "NKDA," indicating that they have no drug allergies. I sometimes do a little happy dance in my head when I see that. But, I'm also discovering that it's the really medically complex patients that I learn the most from. I know which other drugs to avoid in allergies to a certain class of medications, resources to give patients, and where to go next when things would seem to get stuck at the fork on the yellow brick road just last year when I was a student in the didactic portion of my training. I'm very happy I had internal medicine as my first rotation, as I am able to use all of the information I've learned while it's still fresh in my mind. I also realize that time goes inexplicably quickly. I only have 12 more days left of IM, before moving onto plastic/reconstructive surgery. Stay tuned for the travails of week 2!
Thursday, May 24, 2012
And the countdown begins
364. It's a seemingly random number. It's also the number of days left until I'm again wearing the fabulous (and ever fashion-forward) black pointy hat, gown with bat-wings, and a tassel, to receive my MPAS degree, and officially become a PA. Today was the graduation ceremony for the class above ours, and watching it was very surreal. Several of my very close friends (some of whom have been my classmates since college) graduated today, and the realization hit me that my fellow classmates and I will be there in less than a year. The fact that we're out starting our 3rd year rotations is baffling to me in and of itself, because when we started anatomy our first summer, it seemed like almost a lifetime would have to pass before we would reach this point. But, here I am, just 7 days away from beginning my first rotation, and I cannot wait!
Wednesday, May 9, 2012
I passed!
I found out last week that I passed my comps, so I'm officially on my way to starting my amazing year of rotations. I'm really excited for my summer ahead, and I can't wait to see what Internal Medicine holds for me in June!
Monday, April 30, 2012
Last week of classes
This week is my last week of classes, after 20 years of sitting in a classroom. Only 2 more days this week left of classes, 1 day left at my AMAZING general pediatrics rotation, and then 5 final exams next week. Still waiting on comps. results, but expect them this week. While I'm not too worried that I didn't pass, I won't feel good until I get that envelope with the official results contained in it. After final exams, we have a week of ACLS/PALS training, and then 2 weeks off before clinical rotations officially begin on June 1! My first rotation is in Internal Medicine, followed by 3 surgery rotations (another month in Orthopaedics, ENT, and General Surgery), and Ob/Gyn....the first 5 months of clinic are going to be very busy, but I'm so looking forward to the intense hours and the amazing learning that's ahead of me! I've been dreaming about this for 2 years....well, actually, my entire life.
Thursday, April 19, 2012
2 years of knowledge
Wow. Tomorrow, I will take my written comprehensive exam, a 200-question, 4-hour exam that will assess my knowledge and processing skills on 2 years worth of material. It's so strange, because when I think about where I was in June of 2010, essentially fresh out of college, and starting from square 1 of medical training, it seems almost silly that 2 years of hard-earned knowledge, sleepless nights, endless trips to coffee shops, PILES of notes (I can only imagine the amount of trees that are no longer living, having been sacrificed for 10 page handouts for every lecture, x2 years, x40 classmates) can be whittled down to just 200 questions, and 4 hours. It's amazing to think that I will be practicing medicine in a year. Wow. Just, wow. Where have the past 2 years gone? When I started with my lab group in the cadaver lab in June 2010, 3 years seemed so long. Now, I'm wondering where it has gone. I can't believe my clinical rotations start in just a little over a month. Looking forward to my amazing schedule ahead, and leaving the classroom behind. But first, my comprehensive exam tomorrow morning. I'll see you all on the other side of the dark cloud :-)
Monday, April 16, 2012
Tomorrow's the big day!
Well, tomorrow is the big day....well, one of them, at least. The start of comprehensive exams, required to enter 3rd year clinical rotations. While I'm not terribly worried about them, the thought that this is the exam that I must overcome before I can enjoy the glory of 3rd year is weighing on my mind. And the fact that I'm fighting a nasty cold, care of my very adorable pediatric patients, doesn't quite help things either.
While I'm a little nervous (who wouldn't be; I never really enjoy standardized patient encounters, anyway, knowing that 3-4 video cameras are recording my every move/sound, even though there's only myself and the patient-actor in the room), I know, and have known, that there is no real way to study for the comprehensive exams. Everything we have done/learned for 2 years up to this point has prepared me for this week, and I know that I will do fine. I just have to prove that I know what I demonstrate to know every day in clinic, and in other classes. I just have to remind myself to remember to do the silly things we haven't done since 1st year, and the random physical exam maneuvers not commonly performed, except in specific circumstances....and to remember to properly drape the pt., and pull out the foot-rest on the exam table....having the pts. feet hanging uncomfortably off the table is never good form. Wish me luck! 3rd year is so close, I can taste it!
While I'm a little nervous (who wouldn't be; I never really enjoy standardized patient encounters, anyway, knowing that 3-4 video cameras are recording my every move/sound, even though there's only myself and the patient-actor in the room), I know, and have known, that there is no real way to study for the comprehensive exams. Everything we have done/learned for 2 years up to this point has prepared me for this week, and I know that I will do fine. I just have to prove that I know what I demonstrate to know every day in clinic, and in other classes. I just have to remind myself to remember to do the silly things we haven't done since 1st year, and the random physical exam maneuvers not commonly performed, except in specific circumstances....and to remember to properly drape the pt., and pull out the foot-rest on the exam table....having the pts. feet hanging uncomfortably off the table is never good form. Wish me luck! 3rd year is so close, I can taste it!
Saturday, March 10, 2012
Tiny humans....and minor freakouts
The last 7 weeks of my didactic curriculum (ever) include my rotation in general pediatrics. Can I just say how much I love children?! I knew this long before I ever started PA school, but after doing my last seven week rotation in palliative care, this rotation is a far cry from the end-of-life discussions I observed prior to this. I walked into clinic on Tuesday morning, on the first bright, sunny day Denver has seen in a long while, coffee in hand, and found bright paintings on the walls of jungle and under-the-sea scenes. "The Little Mermaid" was playing on a loop on the waiting room television (try getting "Under the Sea" out of your head after hearing it 9 times in one day; the calypso beat that Sebastian sings to is actually pretty catchy). Immediately, I was welcomed by the doctor who started the practice, the office staff, and several other providers with whom I'll be working with this semester. I was already having fun, and I hadn't even seen any patients yet. Overall, my first day of this rotation was phenomenal, and I loved that all of the providers came in excited to see patients, and were so in love with their jobs. I could get used to this.
The rest of the week was a drag, more so than is usual. There are only 7 weeks left of the semester, including our week of the big comprehensive exam, and I had my first minor freakout session about the comprehensive exam. There really is no good way to study for an exam that essentially tests everything we've learned in the past 2 years, before we're allowed to be let loose into the world of full-time clinical medicine. However, I'm hoping that with the time I spend during spring break studying, I can use everything I know to prove that I'm SOOOO ready to leave the classroom.
Back to studying for the 2 exams that stand between me and spring break (as much of a break as it will be with comprehensive studying). Here are some photos from our recent IV lab (I got all sticks that I attempted successfully on my partner!)
The rest of the week was a drag, more so than is usual. There are only 7 weeks left of the semester, including our week of the big comprehensive exam, and I had my first minor freakout session about the comprehensive exam. There really is no good way to study for an exam that essentially tests everything we've learned in the past 2 years, before we're allowed to be let loose into the world of full-time clinical medicine. However, I'm hoping that with the time I spend during spring break studying, I can use everything I know to prove that I'm SOOOO ready to leave the classroom.
Back to studying for the 2 exams that stand between me and spring break (as much of a break as it will be with comprehensive studying). Here are some photos from our recent IV lab (I got all sticks that I attempted successfully on my partner!)
|
| Nice little blood splatter |
|
| Trying not to look at the giant needle |
|
| My turn....just threading the catheter into the vein :-) |
Sunday, February 19, 2012
And the letter that comes after O is.....
I'm pretty sure that in kindergarten, they stopped teaching the alphabet after the letter O. I'm 100% convinced of this. Why, you ask? Because EKG interpretation is NOT my forte. I really wish it was. Sometimes, it just baffles me, because I'm a total physiology nerd, and how the body works just rolls off the back of my hand. But how the electrophysiology of the heart actually translates into the rhythms that appear on a 12-lead? I find myself always struggling to interpret anything more involved than the rate, rhythm, and whether there's ST-segment elevation or not. Beyond that, it all looks like a bunch of squiggly lines that have varying degrees of points, depressions, and other things that seem as foreign to me as learning another language (full disclosure: learning foreign languages have never been easy for me, either). So, needless to say, my weekend has been full of trying to desperately cram all of the rhythms into my brain for the exam that is coming up on Wednesday. I have actually found the Dubin book to be very helpful, in addition to a few algorithms for interpretation that we've learned in class. But, when all is said and done, I wouldn't trust myself to interpret an EKG. I'll leave that up to the cardiology people.
Drinking from the fire hose
Ever since before I started applying to PA school, everyone I talked to said that during PA school, everything feels like you're trying to drink from a fire hose....getting completely doused in heavy, torrential flow of information, and struggling just to push back against the pressure. Overall, I actually haven't found that to be true, but considering I'm in a 3-year program, it's most likely the pace of the program is a bit better than most.
However, I think this is the first time I've ever felt like that analogy is actually true. I was out for almost 2 weeks recovering from a minor surgery, and I'm definitely struggling to catch up. Even though all of my classes only take place once a week, 2 classes=2 weeks worth of material=Katie running around like a crazy person trying to get back into a routine. Much like this:
On the other hand, I truly feel that in spite of how overwhelmed I feel, every day is a day closer to clinic. My schedule is almost complete for 3rd year, except for my required OB/GYN rotation. Very excited to spend a year with patients, and (hopefully) figure out what specialty I'd like to focus my job search on. It's only a slight comfort knowing that as a PA I can switch specialties throughout my career, but I'd still love some insight into where I'll start. Every day I feel like I oscillate between wanting to do Endocrinology or Surgery, but I have an Endocrine rotation and 2 (hopefully 3 once my final elective is scheduled) Surgery rotations next year, so I hope I can figure that out.
On a final note: think good thoughts....we have our IV lab in Emergency Medicine this week....EEEK!
However, I think this is the first time I've ever felt like that analogy is actually true. I was out for almost 2 weeks recovering from a minor surgery, and I'm definitely struggling to catch up. Even though all of my classes only take place once a week, 2 classes=2 weeks worth of material=Katie running around like a crazy person trying to get back into a routine. Much like this:
|
| HOLY CRAP! |
On a final note: think good thoughts....we have our IV lab in Emergency Medicine this week....EEEK!
Subscribe to:
Posts (Atom)