Day 37: You’ve Already Made It

Here it is: Day #37! *cue triumphant fireworks*

Today we had our white coat ceremony and my emotions are running wild. It has been such an insane, unexpected and absolutely transformational year. As I’ve been planning this post a lot of thoughts have gone through my mind as to what I should talk about after 36 days of posts from my wonderful classmates. A lot of excellent advice and thoughts have been shared. I hope that those of you who are preparing to start your own didactic year in 4 (short!!) weeks are feeling the excitement that I did just 1 year ago, when I too was sitting at my desk at home, eagerly reading the posts from the class of ’19, and never imagining that my own didactic year would feel like it lasted only a frantic heartbeat. P.A. school so far has simultaneously been both the longest and the shortest 12 months of my entire life. There were weeks when I was drowning in exams and lectures and I thought it would never end, but when I finally lifted my head from my laptop, suddenly it was April. Then August. Now December. And now in only 4 (short!!) weeks I will be in a pediatric clinic, almost assuredly having an internal panic attack as I prepare to face patients who haven’t been given a script. (Which somehow seems better and worse than S.P.s all at the same time.)

“This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” ~Winston Churchill

To finish out the didactic year I would just share with you some of the lessons I have learned in life, and in school, that have served me well in the last year.

First is that really, truly (take special note ‘cause I know you probably won’t believe me)—grades no longer matter. Now don’t go crazy, you obviously need to pass, but getting straight A’s is no longer the priority. It’s a hard concept to come to terms with as individuals who are often high-achievers and have had to fight tooth and nail with excellent grades (and other achievements) to get here. I remember thinking that if I was understanding something the way that I should, shouldn’t I just be getting A’s anyway? That’s how it always used to work. Well, let me assure you, PA school is nothing like undergrad and so that is no longer always the case.

The didactic year is all a whole, writhing, massive beast. Breaking it into modules is really like trying to wrestle it into submission, one single limb at a time. Because of that you see things only pieces at a time and it doesn’t always feel like it’s all coming together until you’re closer to the end. Only then, when you have (somewhat) wrestled the monster, can you step back to begin looking at the cursed beast as a whole.

Keep in mind that in the process of brawling with such a formidable creature, injuries are inevitable. This is a nice way to say *Type-A Trigger Warning* you will probably fail at least one test during didactic year. (This may or may not have happened to me and I may or may not have immediately turned off my phone, gone to a department store and tried on at least 20 different pieces of clothing, then personally returned them all to their rightful places over the course of 3 hours ‘cause I am too poor to actually buy anything…but I digress.) If/When this happens to you just breathe and remember that it’s not the end of the world, even though it feels like it. Something that really encouraged me was when Dr. Murfin told me that no matter what grade you’re getting, if you are passing the class then you are learning the things that you need to know. The professors are watching out for you and want you to succeed, so trust them and trust the process because it works.

Second is to expect to almost never be in your comfort zone. Honestly, forget that you ever had one, you’ll be happier if you just let it go now. Here’s why—remember when you were young, and your legs ached because you were growing taller? Well the didactic year is the psychological version of that. Uncomfortable at best, but frequently it is painful. And that is expected, embrace it! Nothing amazing was ever achieved in apathy or perfect comfort. Even though sometimes it feels awful while you’re in the midst of it all, more growth than you can imagine is taking place inside your skin. You’re gaining intellectual inches like crazy and the mental growing pains are real, but worth it!

My third point goes hand in hand with point number two. PA school is going to change you. Many challenging things in life do, but this is one challenge that we have the privilege to know is coming. Right now this gives you the chance to prepare, at least somewhat, so do it while you can. Studying (before starting-please study during haha) won’t help so I wouldn’t bother, but you can take some time now to mentally and psychologically prepare yourself. It is just as much an emotional crucible as it is an intellectual one. Because of that I would exhort you to do a couple of things this year.

  • Get in the habit of self-reflection and correction. This is so important for the coming year, and quite frankly for a career as a medical professional. You will hear and learn things that will make you uncomfortable. So far you have lived only a portion of one life and there are currently more than 7.5 billion people on the planet. You will get to treat some of them and you will likely disagree with many of those you treat. Consider that you might have to challenge some ideals that you have long held and don’t fight back against positive change and growth. Also consider that you can disagree with people and still be able to treat them with dignity, respect and compassion. You will also become acutely aware of many of your imperfections, and if you don’t find them out for yourself then someone (a professor, classmate, preceptor, patient, what-have-you) will likely tell you. Because of this it’s important to learn how to accept criticism humbly! It can be hard to accept criticism if you are already feeling vulnerable (which happens a lot in didactic year, and I’m sure in clinic too), but it is a skill you will need for your whole life. Dr. Bennett has said several times that this year is like a practice year for real life, because the mistakes you make here don’t affect you the way they will in the clinical year and beyond. It is the ideal time to think hard about how everything you’re learning needs to apply to you in working with real people and how you might need to change to be the competent, compassionate provider you dream of being. That’s always the end-goal and the most important thing to learn during PA school.
  • Get in the habit of communication. You are going to spend a lot of time with the same people over the next year. Disagreements, offenses and hurt feelings are inevitable occasionally, but they don’t have to be permanent or crippling. When things like that occur, communication is key. Realize that everyone is human and we all have our off days, but most importantly remember that when something happens you need to talk. Nothing gets resolved without action. Conversely, if someone comes to you to talk about something you said or did that hurt them, listen. Doing those 2 things tactfully and respectfully will help you solve many of the problems that occur in your personal and professional life.
  • Keep a journal. Trust me, the person you are now and the person you will be this time next year are different people. I feel like documenting my thoughts and feelings has been so helpful this year. It is a turbulent time and journaling can help to ground and focus you. Going back to read through your journal is a great way to realize just how much you’ve actually learned and grown. You will not regret have a personal recorded history of this time of your life. Even if you’ve never journaled before, give it a try: in a book, on the computer, through drawings, in a bullet journal, even just 1 line a day—it doesn’t matter just do something! I use an app that backs my entries up online and is accessible on my phone and computer and it’s really convenient!

My last point is simple—remember your priorities. You are a person with a life right now, and that life will drastically change come January. Think about the things you do that are most important for that life to be a good one. Now, plan to do whatever you need to do to ensure that you don’t give those things up! You will feel pressured (mostly by your own anxious brain) to let them slide, and while lots of other things will have to change to accommodate school, your top priorities should not be among them. Those priorities will be different for each one of you. I had many long conversations with my husband prior to school starting about how our life would change and what we would need to do to be good, because my marriage is the #1 priority in my life. If it came to it I would drop out of PA school in a heartbeat to make sure my relationship stays good—so we took the time beforehand to strategize and make sure we could do both. (Pro-tip: if this is a priority for you—make-out with your S.O. for at least 2 minutes a day. It doesn’t seem like a big deal right now, but even just 2 minutes of not studying during Modules 2&3 can feel prohibitive, so making sure you have at least a couple minutes of affectionate alone time per day really makes a difference, trust me). I encourage you to evaluate your own priorities, be they exercise, church, family outings, brunch with your friends or weekend getaways, etc….and maintain them. PA school should be a part of your life (albeit a major one), not the other way around. And the faculty are great about this so don’t be too proud to ask them for help if things are getting too overwhelming. I personally experienced this at the beginning of the year when it turned out (surprise!) that school ended up being the least stressful thing about my life at the time. The faculty were all extremely supportive and engaged with me and really helped me through.

Wrapping up our 37 days and the didactic year for the Class of 2020 feels insanely intimidating, but I think I just want to leave you with one important reminder.

If you’re here, you’ve already made it.

Getting into the program is the hard, competitive, uncertain part. You alone fought doggedly against other qualified people to get here. Being in the program is the hard, but supported and assured part. You are no longer fighting alone. You got in because our faculty members believe in you and your ability to improve this program, this community and this profession. You will have 37 classmates who will no longer be competition but who will become colleagues and priceless resources. If you are willing to put in the work, then you will be met where you’re at and helped to reach the rest of the way. You will be encouraged, constructively-criticized, pushed, prodded and motivated for 27 long months. But, if you’re willing to do it, the outcome is inevitable: you will become a PA. So just remember through all the stress, mental breakdowns and tears, that you’ve already made it, now you’re just waiting to get there.

See you in January, on the other side!