Tales from Clinical Year

Before I get any farther behind, I thought I’d go ahead and write a blog post! I started writing this during Rotation 2 in between patients, because it’s true what they say about making time to do something instead of waiting until you have time!

A lot has happened this year; in addition to starting clinicals, we’ve bid a fond farewell to the Class of 2018, who graduated in February, and we’ve met the incoming Class of 2020. It’s sad to see one class leave, but exciting to see a new one arrive! It’s hard to believe we’re already 12 weeks into clinical year and on our spring break. We’re still at that phase (at least I know I am) where we are excited to start something new—and excited to get out of the classroom—but also slightly terrified and a little lost. These are real patients after all!

Everything we learned in didactic year is coming back to us by degrees (“I remember learning about otitis media during HEENT in Clin Med last February…how do I treat it again?”). It’s very rewarding to be able to draw on the knowledge we spent a year cramming into our brains…and at the same time frustrating to try and remember something you knew really well six months ago!

My first rotation was primary care, and for me it was a really good place to start. For the first few days, my preceptor let me shadow him and observe patient visits in the clinic. My first weekend, I worked with my preceptor at the Walk-In clinic for a few hours, and that was where I got my first chance to do a solo patient visit—I could almost hear Ms. Skillman’s voice in my head: “Take a deep breath, put on those beautiful smiles, knock and enter…” Once I finished interviewing and examining the patient, I came out and presented to my preceptor, who would then go in and perform his own exam and finish the visit.

The training wheels came off for my second rotation, pediatrics. On my first day, my preceptor sent me in to see the patient on my own, then come out and present to him. Within those initial eight hours, I saw everything from sore throats to well child visits and an evaluation for ADHD. Pediatric medicine has proven to have its own unique set of challenges—the adult patients I saw may have been squeamish about needles, but most of them didn’t scream or cry when I tried to look in their ears. At the same time, it is harder to placate an adult patient with a bouncy ball when you have to give them a shot.

The days can be long, and I miss being surrounded by my classmates, but the patients I see serve as daily reminders of why I wanted to go to PA school, and my preceptors give me a glimpse of what my future as a provider might look like. Instead of studying hypothetical cases on a powerpoint slide, we have the opportunity to see living lessons on a daily basis, as well as observe the difference that method of care can make for a patient. I still feel clumsy and awkward whenever I walk into a patient’s room, and I don’t always have a clear diagnosis in mind when I present to my preceptor, but I have achieved other accomplishments. I have made my first infant patient smile at me (and cooperate when I tried to look in her ears), and I have received my first hug from a pediatric patient, both of which were very rewarding experiences. As long as it will take to really master all the clinical knowledge necessary to practice as a PA, I have a feeling it will take even longer to gain an understanding of how to build relationships with patients, and this understanding will not be gained by studying flashcards. This is a daunting realization, but also a reassuring one; we don’t have to have it all figured out, even when we graduate. Our training is preparing us to be lifelong learners, and we’ve only just begun.