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    Surviving PA School

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    Today’s topic will be a little different from previous articles. It will be directed more for those that are currently in PA school.

    In this article, I will discuss tips that worked well for myself, during that time. Bear in mind, everyone is different, and what might work for one person, might not work for someone else.

    I attended Southern Illinois University School of Medicine Physician Assistant program. Our program’s curriculum was primarily taught in a problem based learning fashion. A lot of my learning in the didactic year, was spent in groups of seven to eight students, with one faculty member.

    How Do You Learn Best in PA School?

    We would go through computerized medical cases, learning to take a history and physical exam, creating differentials, ordering and analyzing laboratory results and imaging, and creating treatment plans.

    The first piece of advice, I would have for a student, is knowing what type of program works best for your learning style. If you are a person, that likes interaction, group discussion, and teaching, then problem-based learning might be right for you.

    If you like learning from lecturers, and studying the material on slides and from text, a traditional program might be best for you instead.

    Regardless of the program type you choose or attend, make sure it will work best for your learning style.

    Learning in Didactic Year of PA School

    Once you start, didactic will be nothing but a blur – it goes by so quickly! As one of my faculty said when I was in school, the first year is like trying to drink water from a fire hose.

    The amount of material, you are learning and covering, in the period of time you are doing so, is pretty astounding.

    Physiology, pathophysiology, clinical anatomy, cadaver anatomy, and pharmacology, just to name a few – are all covered in just the first year!

    A large part of PA school, was being good at time management – this gets easier the further advance into your scholastic journey. As stated above, when I started PA school, it was a blizzard of information.

    I did not know where to start. At that point, I just dove in…

    But I did not dive alone. Three of my closest friends was it helped me get through it all. We studied everything together for an uncountable number of hours (thanks again, Zach, Dylan, and Austin).pa school

    Studying with my friends, and now colleagues, not only was fun, but it increased compliance. If one of us was going to study, then we all did for the majority of the time.

    In addition, being able to hear or learn a topic in a different way, from another classmate or friend, made learning easier.

    Needless to say, I would highly recommend finding accountable and motivated classmates to work with throughout your schooling. PA school is tough, but if you have someone going through it side by side with you, it can make things easier.

    How To Study in PA School

    Make sure to go through the PowerPoint lectures that are given. These will often be narrowed down, to the high yield information, onto sets of slides.

    This was particularly helpful when I was studying pharmacology and clinical anatomy.

    In terms of clinical pathophysiology and physiology, resources such as The Calgary Guide’s website and McCance Pathophysiology were also a go-to for me.

    Where I leaned most, however, were with several resources related to PANCE board review and USMLE Step 2 board review.

    As we went through diseases and diagnoses, my classmates and I would grab our review books, and study the entries for the specific diagnoses. This gave us concise, high yield information, on the topics that we were learning about.

    I felt that this was extremely beneficial; it gave us “what we needed to know” for exams and for our once weekly clinic session.

    A big reason, why I believed this method to work well, was because the goal of any PA school is to turn out new clinicians to serve as healthcare providers.

    To do this, their students must pass the PANCE. I felt that if this is a PA school’s number one goal, then they will more than likely test on the things that are needed for the PANCE, and for your career, as a PA.

    So, by studying the material from PANCE review books, this allowed me to meet those goals. And in the long run, I was proverbially “killing two birds with one stone”, because studying for my exams was like studying for the PANCE as well.

    This worked well for learning the diagnoses, including the signs and symptoms, what tests to order to diagnose, and how to treat. But other things, like pathophysiology and pharmacology, required me to study more of the lecture, as previously discussed.

    Clinical Year in PA School

    Next comes the second year of PA school.

    Here, the majority of my time was spent in clinic and the operating room. Of course, after each rotation, we had an end of rotation exam.

    Just like the first year of PA school, the best way I found to study for these examinations, was to use the PANCE and USMLE Step 2 review books.

    Of course, passing these examinations are required by PA programs, but in year two, the most important thing (for me), was learning how to be a clinician.

    Thus far, in PA school, you have learned a ton of information, and have learned how to retain these facts. But how do you apply these to real patients?

    Clay Walker physician assistant student with Dr. Arturo Garza in obgyn December 7, 2015.
    Clay Walker physician assistant student with Dr. Arturo Garza in obgyn December 7, 2015.

    The best advice I could give a student, working with me (whether it be on a rotation or simply shadowing), is to ask questions. If you don’t know why your preceptor did something a certain way, or why they ordered a specific laboratory test or imaging technique, then ask.

    The only way to learn, in these instances, is to look up the answer or to ask questions.

    A big fear I had as a student was if asking too many questions made me look unprepared or dumb. A great quote that encompasses this self-perception is:

    “The man who asks a question is a fool for a minute, the man who does not ask is a fool for life.”

    Something key I did was to write things down. I kept a notepad, and wrote down any piece of knowledge, I learned from my preceptors.

    Lastly, I made sure that once I asked a specific question, and got the answer from a preceptor, I committed it to memory as a learning experience.

    I do these same things today as a clinician.

    If I ask my supervising physician a question, about what he would do with a certain laboratory result, or what he would order in a certain instance, I learn from it and commit it to memory.

    Thinking Beyond the Exam

    Something I would encourage second-year PA students to do, is to learn in an algorithmic approach.

    When I was in PA school, we all were focused on diagnosing, classic triads, what was the specific laboratory test that would give us the diagnosis, and what is the best or first-line treatment for a disease.

    In medicine, often, things are not as clear-cut as this. Diseases are not teed up, ready for you to hit down the fairway.

    When I first started practicing, I would get screening labs, and see something like elevated liver enzymes and think, “okay, now what?” What do I need to order next? Can I just monitor this for now?

    I wish, when I was in PA school, that I would have learned more about how to learn in a step wise, algorithmic, approach; understanding what to do next, if you get an abnormal lab, or test result.

    An excellent resource for this, that I have found, is the American Academy of Family Physicians articles. I use these frequently in my practice to this date.

    These types of questions were not frequently asked of me on exams, nor on the PANCE, but it will be these things that you run into as a practicing clinician, on a daily basis.

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    Final Words of Advice

    I hope, as current or prospective students, that you found this helpful.

    Each individual is different. Every person will find their own niche and pattern, when it comes to studying.

    These were just some things that worked well for me.

    Even though all of us are different, as learners and clinicians, the common denominator is hard work and dedication.

    We all got into the field and profession, for the same reason: to help people.

    And to have the honor, to do this well, you must work hard. You don’t have to be the smartest, you don’t have to be the top of your class, but you must work hard, and you must be dedicated to your craft.

    Remember, hard work beats talent, when talent doesn’t work hard.

    I will close by reminding you that medicine is an art.

    This is why they call it “practicing medicine”.

    Everyone makes mistakes. No one is perfect. Everyone is going to do things a little differently.

    As long as we are living and practicing by our oath of doing no harm, doing that is in the best interest for the patient, and asking for help when needed, you won’t be led astray.

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    Clay Walker
    Clay Walker is a board-certified physician assistant practicing in family medicine and urgent care in rural southern Illinois. He is a graduate of Southern Illinois University School of Medicine Physician Assistant Program - class of 2016. Prior to going to PA school, Clay worked as a histology technician in southern Illinois.  From an early age, he has been interested in medicine. Clay was diagnosed as a type 1 diabetic in the first grade. He began learning about his condition and teaching others about T1DM; since then, he began to have a passion to learn medicine and make a difference in the lives of others. In his free time, Clay enjoys watching sports and going to sporting events, specifically the Chicago Cubs and Philadelphia Eagles.