Family Practice

I am in a rural, under-served area now with a doc who has been here for 26 years. He has his own, sizable practice, admits to the small local hospital, is the county health department's medical director, sees patients in the nursing home and the county jail, plus he covers the ER a couple days a week. I am staying in a trailer in the country where there is no internet and the TV doesn't work. We got a foot of snow last night so we didn't have too many patients come in. Unfortunately he is under the impression that students can't write in the chart so I don't get to do any documentation. Plus he does a LOT of workers comp which he has to see in their entirety so that cuts back more on what I get to do. He is a great doc who is very thorough and he spends 20-30 minutes with each patient. But that means we often aren't done until 10 pm. I wish that since i am putting in all this time I could do more, and in turn learn more. Well, I guess I'll just have take as much away from this experience as I can squeeze out of it.

I am driving back home tomorrow so I can go trick-or-treating with my boy. I sure do miss him already.

ME

A few of my patients and "co-workers" have asked me about my background and how I got into PA school. I thought that it would be interesting to show one PA student's qualifications before entering school, mostly in order.

BA - biology
Master health administration
6 yrs firefighter/EMT
EMT/CPR instructor at college and hospital
PT tech 2 years
10 years in Sr. position in health insurance
2 yr volunteer medical assitant in under-served pediatric clinic
1 yr volunteer EMT private ambulance company
1 yr cutting edge job at #1 rated research hospital

My undergrad GPA was 2.8 but my last 100 hrs had a GPA of 3.75 which helped alot. I worked 20-40 hrs a week in college, paid for most of it myself, hated every minute of and couldn't wait to be done with it.

I applied to 10 PA schools, got interviews to 5, was waitlisted at Pacific University and Drexel, accepted to my program and decided to skip the interview at Cornell since I had already been accepted where I really wanted to go and the person I talked to at Cornell was a jerk. It was the first and only year I applied to PA school, which I consider very lucky.

So far my GPA in PA school is 3.65 but I stopped stressing about getting A's the second semester. I failed 2 tests in my first year and rarely aced any. I really enjoyed PA school even though it was very difficult and very stressful. Being in clinical rotations now I don't have to study every night and have a lot more fun than in didactic year. My preceptors have given me a great deal of praise. In just my second rotation I am seeing patients on my own (roughly 10/day) with the preceptor stopping in to see how I did and to hand me signed, blank scripts and referrals. My current preceptor told me he thought I was ready to see half his patients on my own. I disagree, but it is a great compliment nonetheless for a doctor who has been in practice for 35 yrs and has a strong patients base who really love him and the way he treats them.

So enough bragging. I simply like to point out now and then that regular people can succeed in PA school and that it is not just for the type A overachievers.

More IM

Along with the numerous, somewhat annoying "pain" patients and type 2 diabetics I have seen, I have also come across some interesting cases. I saw a guy with hemochromatosis and polycythemia, Another guy in his 30s with Dandy-Walker syndrome, a 50-some yr old today with epiglotitis and a lady in her 50's who developed severe liver disease from poorly controlled DM. The doc I am working with complemented me by telling me and his staff that I am a big help seeing patients for him and that I have I come up with some good suggestions for dx/tx/rx. He has been in practice for 35 years and is very knowledgeable and he takes the time to teach me and his patients - which his patients love. I am calling patients with lab results, seeing patients almost entirely on my own on occasion and writing scripts for everything. I really am having fun when I stop to think about it. And I am proving to my self-admitted skeptic doc that PAs (students) know what they are doing and can take care of a lot.

I have eaten lunch in the doc's lounge once and was sorta surprised that all the docs talk about is golf. OK I wasn't surprised at all and actually find quite humorous.

Internal Medicine rotation...

So my first week of of my first IM rotation is almost in the books. On Monday my boy took a header at pre-school and knocked in 3 top-front teeth. Later that day we began a 13 hour journey at Children's Hospital because he wouldn't stop throwing up. SO I get home from my first day of IM to greet my beat-up little boy barfing frequently and uncontrollably. Was it from a head injury? Was it the copius volume of blood he had ingested that day? Was it a bug. Well, it took 12 hrs waiting in the room, a couple doses of Zofran, many tests, 15+ episodes of emesis, 5 nurses, 2 ER docs, an hour and a half wait in the waiting room to be triaged and 500mL of IV fluids to feel pretty safe it was just shitty luck and coincidence -and oh yeah, some bug. Today he got the teeth pulled, and I was there by his side for every nasty moment. That kid is tough and resilient. He's back to eating Mac and Cheese despite the severe lac on his gum that the DDS couldn't repair. In fact he is bed now, tlaking and playing, back to his normal self. And I couldn't be happier. IM rotation is going fine. Mostly diabetes and chronic pain. I can write for schedule IIs in my sleep after one week there. The doc is nice and takes time to teach me. He slammed today in front of a patient for recommending Augmentin. He justs hates it and spent 10 minutes expaining to the patient why my suggestion was so bad. Funny, the Peds docs Love it.