So, you survived didactic year, and now you are ready to tackle clinical year. I would definitely say that clinical year is more enjoyable than didactic year, but I would not say that it is necessarily easier. The best part is getting to see real patients and interacting with your preceptors and other medical staff that will soon be your colleagues. The downside is that after doing this for 8-12 hours a day you have to go home and study. So, here are my tips for surviving clinical year:
- Make a good first impression on you first day of a rotation.
- For your first day at any particular rotation in your clinical year be sure to make a good first impression by showing up on time and introducing yourself to all of the staff. Your preceptor may have you shadow for the first day or they may just throw you right in to seeing patients. You have to be prepared for anything so be sure to follow tips 2, 3, and 4 as well. After your first day you should get a sense of what their expectations of you are. If you are not sure just ask! It is always good to ask for feedback no matter how you feel you are doing. It shows interest and is definitely more likely to get you a better grade when it comes to evaluations!
- Do your research on your clinical site before your first day
- Preparation is key when it comes to clinical year of PA school. There are two parts to this tip. Part 1 is to research the actual site. Get the address, map out your commute, figure out what time you need to be there, and who your preceptor is. If your school provides their email, send your preceptor a quick email introducing yourself, state what date you are starting and ask any questions you may have. Part 2 of this tip is to do research on that specific specialty. I recommend looking up the most common chief complaints and diagnoses for that particular specialty and knowing them inside and out. Ask your fellow classmates that have been to that clinical rotation site before you. They can tell you not only the logistics, but also what the preceptor is like and how they like things done. Some preceptors are very particular about things so these little bits of info can really help you make a good first impression.
- Have a good oral presentation in your back pocket
- Practice, Practice, PRACTICE your oral presentation before starting your clinical year! You will use it for every rotation and if you have a good one you will stand out. Create a template in your head and be able to come up with one on the fly. When I would go in to see a patient I would outline a page on my little notepad like an oral presentation so that I could glance at it while I was presenting to my preceptor. I made a section for chief complaint, history, review of systems, physical exam findings, and what I thought was the diagnosis and proper treatment plan. If you are not sure what the diagnosis present a short list of differentials. If you are unsure of the treatment look it up really quick in Medscape or epocrates if your school provides it for you. Be sure to keep all of the info you present relevant and concise!
- Be prepared for procedures
- Depending on what specialty rotation you are in, there is a very good chance you will be doing procedures. Which is great, the more experience the better! Some preceptors will have you watch a procedure before you do one, others might just walk you through it as you do it for the first time. You never know, so you should be prepared for anything. At the very least practice suturing. You will be doing a lot of that in both surgery and emergency medicine. You can look up the most common procedures done in that specialty or ask the classmates that went before you what they did. It all really depends on the specialty!
- Know how to study for your EOR exams
- Full disclaimer I failed my first EOR by 2 points! I had never failed a test before so you can imagine the impact it had on me. I will really never forget that feeling of my stomach dropping when I found out. I really did not take it seriously enough. I assumed that I would just pick up enough knowledge through my clinical rotation to pass the test. This is absolutely not true and do not be as naïve as I was. My school used the PAEA EORs and they are no walk in the park. They do get easier as clinical year goes because a lot of the content overlaps and your knowledge builds on itself. This is how I studied:
- Print out PAEA EOR blueprint
- Go topic by topic from the blueprint in Pance Prep Pearls and whatever I don’t already know commit to memory by writing it down or reading it multiple time
- Rosh Review question bank for testing my knowledge, whatever topics I am weak in from the practice tests, I will spend some more time on.
- Full disclaimer I failed my first EOR by 2 points! I had never failed a test before so you can imagine the impact it had on me. I will really never forget that feeling of my stomach dropping when I found out. I really did not take it seriously enough. I assumed that I would just pick up enough knowledge through my clinical rotation to pass the test. This is absolutely not true and do not be as naïve as I was. My school used the PAEA EORs and they are no walk in the park. They do get easier as clinical year goes because a lot of the content overlaps and your knowledge builds on itself. This is how I studied:
- Give the specialty a chance even if you don’t think its for you
- Most people have an idea of what specialty they want to go into before clinical year starts, and most people have some that they think they absolutely do not want to go into. For me, I wanted to work in dermatology from the beginning and absolutely did not want to work in pediatrics. Although I didn’t think I wanted to work in pediatrics it was important for me to go into the rotation with an open mindset. If you come in with the mentality of “lets get this over with” you are not going to learn very much and your preceptor may be able to pick up on that if you don’t have a great attitude. So go into all rotations with an open mind, and you never know what you will end up liking!
- Make yourself useful
- As a student in an outpatient office your role is not necessary for daily clinical operations. So it is important to be as helpful as possible. If you get there before your preceptor, start seeing patients, and start notes for them. When you are seeing a patient before your preceptor don’t take too long. If patients are rambling on about random things, don’t be afraid to cut them off in a way that is as nice as possible. Just do your best to not hold up the day. If you are not sure what to do, Just ask what you can do to help! If they say nothing at the moment, use that time to get some studying in. Scrolling on Instagram is not a great look. Pull up Rosh review, study guides, or just search a topic on Medscape to keep yourself busy if there is some downtime during clinic.
- Be kind and respectful to all of the staff that you encounter
- This one feels obvious, but I think it is important to make an effort to show appreciation to other staff members like nurses, medical assistants, CNAs, and front desk staff. They can make or break a rotation and can be so helpful if you need something. Go out of your way to introduce yourself, say thank you often, and ask if there is anything that you can do to help.
- Make the most out of the commute
- There is a good chance that you will have a pretty long commute for some of your rotations. Mine ranged from 20min to up to an hour. You can really optimize this time by listening to podcasts or lectures. My favorite podcast to listen to during clinical year was Cram the Pance by Scott Shapiro. He has episodes by disease topic or system. He also has 50 high yield question episodes that are amazing for both the PANCE and EORs! Some other good ones are Medgeek and Curbsiders.
- Write a personal thank you for your preceptor and keep in touch after your rotation.
- Writing a thank you card is a really small gesture that can go a long way. Even if you did not enjoy that particular rotation or mesh well with the preceptor, this is important. Preceptors are not easy to find and they are taking time out of their busy day to teach you. A little token of appreciation can go a long way, you may need a letter of recommendation or to use them as a reference when looking for jobs. That is why it is also important to stay in touch even after the rotation end by email or text. This is something I didn’t do and I regret it. When it came time to apply for jobs I felt a little weird asking for a reference since I hadn’t talked to my first preceptor in almost a year. Every few months just send an email saying hi or ask a question specific to their specialty. Little efforts like that go a long way, especially when it comes to finding a job!
In conclusion, make it your goal to learn as much as you can and create good professional relationships all through out your clinical year. I was so nervous for my first clinical rotation I showed up an hour before my preceptor even with having to stop in the middle of my commute for an anxious bathroom break at a sketchy gas station! Always keep in mind that you are still learning and are not expected to know everything. You are not going to know the answer to every question and that’s okay! You learn better that way. Just show up with a smile on your face, do your best, and you will be fine! Good luck!
