Sunday, September 23, 2007

Maimonides Award

One award was given out during the graduation ceremony.

The Maimonides Award.

It is not an award based on academic performance.

300 students graduated from various fields (Physician Assistant, Physical Therapist, Oriental Medicine, Occupational Therapist, Nursing, Public Health) and one student from each full-time program received the award.

The Maimonides Award is for the..."graduating student whose endeavors have demonstrated the highest of professional ideals..."

To my utmost surprise, I was selected from the Physician Assistant program as the Maimonides Award recipient.

The Code of Maimonides:

"May the love for my art actuate me at all times; may neither avarice, nor miserliness, nor the thirst for glory or a great reputation engage my mind; for the enemies of Truth and Philanthropy could easily deceive me and make me forgetful of my lofty aim in doing good for my brothers and sisters.

May I never forget that the patient is a fellow creature in pain. May I never consider the patient merely a vessel of disease.

When wiser people teach me, let me be humble to learn; for the mind of man is limited, and the art of healing is vast. May I have the strength, time and opportunity always to verify and correct what I have learned and to increase my understanding. May I always be able to discover today the errors of yesterday, and to obtain a new light tomorrow on what I think I am sure of today.

I have been sanctioned to care for the life and health of mankind. I am about to fulfill my duties; I am ready for my vocation."

I am still speechless.

Physician Assistant-CERTIFIED (PA-C)

So much has happened since the last time I've written!

1) I took the NCCPA Board Exam on Friday, 9/14.
2) My family threw me a SURPRISE party on Saturday, 9/15.
3) I graduated and received a special award on Tuesday, 9/18.
4) I turned 31 years old and found out I PASSED THE BOARDS on Thurs, 9/20!

I've been trying to recover from all of the excitement and surprises ever since. I am officially "partied out!" I found myself retreating to my desk and books this weekend, for no other reason but for the comfort they have provided me for the last two years!

I sent out two resumes last week and received phone calls for interviews immediately. I set up one interview for this week, but today I realized that I'm not ready yet. Last week was such a crazy whirlwind that this week I know I NEED to relax. Actually, I NEED to re-learn how to chill out and relax because I'm still in somewhat of an amped up "I have to study" mode. So many wonderful things happened last week and I want to give myself a few days for it all to sink in. There are so many friends and family members I haven't seen in so long...I need to plug in and reconnect before I throw myself back into the "real world".

I also have a lot of people that I need to thank. First and foremost is my family. My mother, father, and both of my sisters believed in me from the very beginning...and were ALWAYS there for me when I needed them. Whether it be a hug, a home cooked meal, a patient to practice on, or simply someone to listen to me family was always there. I wasn't always the easiest person to get along with during the most stressful test taking times...but they put up with me, learned how to ignore me, and put me in my place when I really needed to lighten up. There were days when I couldn't stand being around me! So, I'm grateful that my family stuck by me, believed in me and supported me through the very end!

I would NOT be where I am right now without them.

I would not be a PA-C!

Wednesday, September 12, 2007


There are 360 questions on the PANCE exam. (PA National Certification Exam)

There are 6 sixty minute blocks of sixty questions.

I am allotted a 45 minute break that can be broken up any way I choose. Breaks can only be taken after completion of a 60 minute block.

The exam is computerized.

So...that's 6 hours of questions on a computer! That's a long time. The longest exam I've ever taken in PA school was 3 hours...and that was a paper test. So, this will be a brand new experience.

How does one prepare for an exam that encompasses everything they've learned in the last 2 years??? study study study study study study study study

I basically gave myself 2 weeks to prepare. I probably studied anywhere from 2-4 hours the first week and from 8-12 hours this past week! I've done over 1,000 practice questions and read two review books. My school provided us with the e-PACKRAT exam (assessment exam) and I purchased another online assessment exam from the NCCPA (they make the PANCE). The review books: AAPA purple book, Van Rhee's green book and Appleton & Lang yellow book.

Yes, everyone refers to these books simply by their colors!

Do I feel like I'm ready for this exam?


But, I'm ready to get it over with. If I fail, I can retake the exam in 3 months. Although I am not one to fail...the option is there and that makes me feel better. I've got nothing to lose at this point (except my sanity if I had to keep this up any longer!).

Tomorrow is the day before the exam. I'm going to review Cardiology one last time and review exam questions I already completed to make sure I understand why the answer is right and why the wrong answers are wrong.

The thing with this exam....there are TWO RIGHT ANSWERS! My job is to pick the better of the two right answers. (Doesn't make much sense does it?) And no, there is no partial credit for getting the answer half-right.

Like I've said, there aren't many absolutes in medicine and the way medicine is practiced IS NOT always the way it's written in the book. So, it took a while to get my brain back into book medicine. I have to say that its been comforting going back to the books and re-learning the basics. I've been having a lot of "A-ha" moments. I actually have flashbacks from my rotations and something a doc or PA said will suddenly come to mind and it will finally make sense! It's a liberating feeling.

So, tomorrow will be about managing anxiety. I will probably work out like a mad woman in hopes that I crash into bed at a reasonable hour.

The exam starts at 8:30am.

360 questions in 6 hours.


Tuesday, September 11, 2007

3 Days

I'm taking the boards in 3 days!!

Say a little prayer for T-rex! ;)

Friday, September 07, 2007

It's been over 2 months since my last post. I believe that's the longest I've gone without posting in the last 2 years! I think that's a sure sign that I am soooo OVER being a student! I'm ready to move on...and indeed, I am.

My last rotation proved to be the most challenging. I chose Infectious Disease as my elective, mostly because of my experience working with a non-profit AIDS organization prior to PA school. The hospital that I was assigned to advertised having an HIV/AIDS clinic, Lyme disease clinic, and a Chronic Fatigue Syndrome clinic. I was also assured by my school that this rotation was going to be a good rotation.

Well, it wasn't what I was hoping for. The "clinic" wasn't much of a clinic. The clinic treated 3-4 patients A DAY! And all of the patients were examined by the Fellow and then afterwards the ID Attending. Mind you...I had just finished my second primary care rotation where I was personally examining 40+ patients a day!

Just to clarify, here's the hierarchy in the wacky world of hospital medicine:

Attendings (Top dogs)

Students (runts of the litter!)

The hierarchy can be broken down even further to Chief, Asst Chief, Senior Fellow, Head Resident, (insert any other ego boosting adjective here)

The Chief Infectious Disease Attending that I worked with is a world-renowned ID specialist. He is, without a doubt, the most educated man I've ever met.

My mom was right: "Some people are too smart for their own good!"

Everyday for 4 weeks I would participate in rounds that would last anywhere between 3-5 hours. If you've watched the TV show SCRUBS you have an idea of what I'm talking about. I would walk around the hospital with one attending, one fellow, and two residents. That's FOUR doctors and one PA student (no med students at that point).

We had a list of patients that needed an ID consultation. The residents and Fellow would examine those patients in the morning and in the afternoon the Attending would meet with everyone and travel throughout the hospital, going room to room, to re-examine and then co-sign every note that the Fellow and Resident wrote.

This took forever.

I was ready to lose my mind by the end of the first day. I wanted to see patients but I could tell that that my "posse" was hesitant. Turns out the ID department doesn't normally have PA students rotating through their department. The last time a PA student rotated through the department was THREE YEARS AGO and none of the current Fellows or Residents had ever worked with a PA (let alone a student) in an Infectious Disease specialty setting.


Well, I managed to convince the Fellow to give me a patient the next day. I basically had to interview, examine, review the patient's chart, document new labs and an assessment and plan. Then during rounds, I had to present the patient to the group, highlighting the pertinent positives and negatives and answer questions about my patient's history.

Basically, all of the fears I had before starting rotations manifested during my LAST rotation! I was constantly being put on the spot and constantly felt like I didn't belong. And things only got WORSE!

During my last two weeks, 4 brand new medical students arrived as well as 2 new residents, one new Fellow and the World Renowned ID Chief Attending replaced the previous attending! little crew of 4 suddenly expanded to one PA student (me)!

The last two weeks of my last rotation were the toughest. The Chief Attending constantly pimped all of us throughout rounds. Rounds were now at least 5 hours long. He would pack us all into the elevator (even if we were only going up one floor) and drill us with questions. He was relentless.

My confidence was pretty high going in to the rotation. I had received positive evaluations from every preceptor I worked with throughout the year and received several "Call me when you graduate" job offers...all very encouraging signs.

And then I showed up to this rotation. It was manageable when I was the only student the first four weeks with the original attending. But, when the 4 med students showed up, the new Chief Attending did his best to tear each one of us down. He hammered all of us with questions and my questions weren't any different than the questions he asked the med students. He expected me to know what the med students knew. He laughed at me the same way he laughed at the med students when they didn't know an answer.

It was beyond humbling. It was downright discouraging. I dreaded each day but showed up anyway. I was constantly talking to myself...constantly encouraging myself...constantly telling myself, "you're not as stupid as you feel!"

Luckily, I befriended the med students. They all came from the same medical school which made it even harder for me to break through to them, but I did. And I soon began to realize that they felt the same EXACT way that I felt. They felt just as stupid as I did when I said, "I don't know." In fact, I began to realize that the med students didn't always have an answer for the questions that I didn't know. In fact, I knew some things that some of them didn't know. And everyone felt like a complete idiot when they were put on the spot.

The Chief Attending gave each one of us a new topic to look up every night and report on the next day before rounds. Each day rounds started at a different time and the Chief picked that time! He would ALWAYS show up 30-60 minutes AFTER the time he chose. So, the group of us would sit and wait for him in the hospital cafe. Once he arrived, he sat down with us, drank a cup of coffee and ate a chocolate chip cookie while drilling us with questions about our topics.

The funny thing is that the Chief collaborated on many of the textbooks he wanted us to utilize as well as wrote scores of articles on the topics he assigned us. Basically, he knew everything about everything already. The first few days of this was very frustrating...but after a few days the med students and I would often crack up laughing when he was out of sight. After a while, I didn't care about what other people thought if I didn't know the answer.

There were other students from my school doing rotations at that hospital. Turns out that the hospital is in the process of expanding their PA department. They currently have 4 PAs on each floor and now they are going to have 5 PAs on each floor. A fellow student of mine told me to submit my resume.

I didn't have a resume yet.

So, I put together a resume (took a long time) and submitted it. I got a phone call the next day. I interviewed the day after that. I was told I had a position DURING the interview! It's a per diem gig on the Internal Medicine/Telemetry floor. Basically, I will be taking care of sick patients with cardiac problems.

So, the suffering was worth it. I really like the hospital. It is the friendliest hospital I've rotated through all year. When the house staff is nice to you as a student, you know it will only get better!

I accepted the position right away since it is a per diem gig. The Chief PA told me I could basically work as much or as little as I wanted. Most of the shifts will be OVERNIGHT. If you've been reading know how much I do NOT like overnight shifts. But, its the fastest way of becoming a full time employee and I think getting paid will make it a bit more manageable.

The most encouraging aspect is that there ARE jobs out there. I haven't sent out any other resumes. I didn't want the distraction while I prepare for the boards. After I take the boards on'll be job hunting time.


Oh yeah, that world-renowned Chief ID specialist? He pulled me aside on my last day and told me to keep in touch and that if I ever needed a recommendation to let him know.

Then he handed me a chocolate chip cookie and thanked me for my hard work.