Episode 1: Things I wish I had known before I started PA school.

Hey everybody and welcome to the very first episode of "P-A-S-F-M-L." The only podcast bay current real-life PA student, that's me. And each episode, I'll try to bring you some tips, tricks, and advice about how to navigate your way through your PA Diedactic Year, as well as some stories and pearls from my clinical year, which I actually just started a few weeks ago. I will also try to get in touch with my classmates, who are also out on their clinical rotations, so that you can hear some stories from other folks, and also hear some of their tips and tricks for how they got through PA school. Because one of the hardest things about PA school is figuring out what works for you. And half the time, you don't even know what tools are available for you to try on to even see if they work for you. So that's why it's really helpful to talk to as many people as you can, and try to use some of the tips and advice that they have to offer to see if it works for you. So that takes care of the first two reasons of this podcast. And the third reason that I want to do this podcast is actually for me. This podcast is actually a sneaky way for me to try to study for the boards that I'm going to be taking in about a year. So I was worried that once I got out of didactic year and got out of kind of that study mode that I wasn't going to study at all. Clinical year is very different, and you're actually seeing patients, and yeah, you have your supervisor there with you so that you don't kill anybody. But it's all very not the textbook stuff that I was used to. So again, I was worried that I wasn't going to study. So I figured a good way to trick myself into studying would be to force myself to look things up, write some notes, and then share those notes in a podcast format. And if other people can listen to it and get some use out of it, then great. And in fact, if even one person finds this podcast useful for the stories or the studying or the advice, then I will consider this a wild success. So that's the inception of this podcast. And I will be your host, PAK, which of course is a pen name, but since I would like to graduate in a year, I didn't want to give my program any reason to consider not allowing me to do that. It's not like I've got test answers or any salacious secrets from the CD underbelly of PA school. I've got nothing that interesting, but I just didn't want to tempt fate. So if that's not your jam, if you're not cool with that, and if you don't like a tastefully placed F-bomb every now and then, well, this probably isn't the podcast for you. But if all of those things are cool with you and you're into it, then let's get going with our first segment entitled Things I Wish I New Before I Started PA School. So the number one thing that I wish somebody had told me before I started PA school is to do the math. And I mean the math of how long you are sitting in lecture receiving new material. I don't mean to do it to try to paint a picture of how bored you're going to be in lecture. Oh, it's 40 hours a week of death by PowerPoint. I mean, because yeah, that's a little annoying. But I actually mean it in a way of these are the hours that you are getting new material every week, and you're responsible for not just remembering that you heard it once, but actually being able to recall it and integrate it with something that you learned the week before or the month before or the unit before. And you're expected to do something with that information. So just by a sheer numbers game, you'll be in class, again, in lecture, up to 40 hours a week, maybe sometime between 30 and 40 hours a week. Sometimes it doesn't go as long as 40. It's maybe only about 35, and then you've got lab or whatever. But still, even in lab, you're expected to know this bone and that muscle and those tendons over there. So it's still information, whether or not it's death by PowerPoint, it's still information that's coming your way. So I'm going to say a pretty good estimate is about 35 to 40 hours a week. And that's just crazy. When you consider maybe how many hours per week you actually got information, either in your prerequisites, prerequisite classes or in undergrad class, I mean, what you maybe took like three classes a semester, unless you were super going home about it and you took like four or five, but like, you know, average person here, taking maybe just three classes that meets for an hour and a half, if it was a chemistry class, that was obviously more annoying and longer, but I mean, you know, do the math there. So you're sitting in class for maybe 12, you know, 15 hours a week kind of a thing. And now all of a sudden you've doubled that with the amount of information that you're getting. So yeah, not only is it time out of your day that you can't go back and look at other material because you're still getting new material, but it's just that. It's new material that you're getting. And so the difference between 15 hours a week, new material versus 35 to 40 hours a week, new material, that's huge. Your greatest problem then becomes a question of how do you condense all of that information? Because it's not sustainable to sit in lecture for eight hours a day and then go home and do another eight hours of studying. I mean, you just can't, there's physically not enough hours in the day, you'll, I don't know, die of like sleep deprivation or starvation or you'll go crazy or have horrible anxiety like I did. There's, there's just no way for you to go back over every single piece of information that you get during that one eight hour day. So the problem of math of going from 15 hours a week, sitting in lecture to 35 to 40 is essentially a question of how are you going to condense that information? And that question is the number one question for why PA school is super, super, super hard because it like it defies the laws of time for what you can actually accomplish. And then how you answer that question is the other, another annoying thing about PA school in that everybody does it differently. And you may have study buddies that you work great with for anatomy lab, but they don't work so well when you're trying to talk cardiology or, you know, poem or like skin rashes. And even, even you within yourself may have different ways of going about how you are going to study for certain material. And so how you answer the number one question of PA school, which of course is again, how do you condense 40 hours of information so that you can do something with it at night? Or the next day or the weekend, whenever you have time to go back and study it again, like how are you going to condense it? How you answer that question is totally, totally unique to yourself and is potentially unique to who you choose to study with or if you choose to study alone. So for instance, when I did undergrad and even my first grad degree, the way that I got through studying things was to just type up outlines. I just took the PowerPoint slides and half the time I wrote word for word, what I had written in class, like taken as notes in class. And other times I would try to incorporate other information I had learned or try to sum it up a little bit better, but I was kind of reworking with the information as I typed it out onto an outline. And that's what I did for all of undergrad. And so I got into PA school and I thought, oh, well, I mean, I know how to study, I know how to study. I will just continue to do the thing that got me into PA school, like does and that obvious. And that's the bitch about PA school is that for the vast majority of people that I talk to and myself included, how the strategies I use that got me into PA school were woefully insufficient to get me through that first year of trying to dig through all of the information in a timely and effective matter so that I learned it and learned it well so that I didn't have to go back over it a million times. But, you know, spoiler alert, turns out you're just going to have to go back over and over. I mean, unless you're one of these superbrainiacs, which for sure, there are some superbrainiac folks in my class. And I am in awe every day of how I even got lucky enough to be counted amongst them. And so, you know, take all of this, of course, with the grain of salt. This is just one person's opinion. But by and large, nobody got things usually just on the first pass unless they had some great kind of background and awesome foundation for for which they understood it more easily than the rest of us. But the biggest problem is how do you condense the information in a quick way and in a way that you also understand it because those two things seem to be diabolically opposed. I could either get through the information quickly, but I didn't remember any of it. Or I could actually take the time and I learned things, but I only got through like literally one 18th of that day's lecture. So you have to find somewhere in the middle, you just you just have to and just so you have to find a strategy that works for you. And so for some people that was doing note cards, like I said for myself, I originally tried to write outlines like I had done all through undergrad and that I think I learned within like two days that that wasn't going to work for me. But guess what? I had classmates who sat two rows in front of me and this gal was amazing at writing outlines. She could take an entire eight hour lecture and fit it into two and a half pages and that just blew my mind. So I'm not meaning to say that none of the strategy will or will not work for you. Just again, like here's your toolkit of things to try because I didn't even know what else to try, right? All of my undergrad year, I had gone in, I had used an outline format and then I got to PA school and realized within two days that it wasn't going to work. So I was like, oh my god, what else can I possibly do here? So here's my gift to you. Here's some tools and some study habits or some study methods that you might want to try on if your current method isn't working for you or if you just want to try something new to see if maybe something works better for you. So outlines is a good way to go. I would caution against making them, you know, 40 pages long for two lectures. Again, you want to condense, condense, condense with the right amount of information. But you don't want to make it 40 pages long because that's too cumbersome. You're not going to be able to do anything with that information. You may as well just go back and reread the PowerPoint slides if you have a 40 page lecture packet that you created for day one of lecture. So try, if you're going to do the outline route, try to find a way to condense it but so that you keep all of the necessary information. And again, you know, hopefully I can get my classmate on the podcast who ended up being successful with that so she could share her tricks about how to do it. But for me, it looked like magic from where I was sitting. But that's one. So outlines are a way to go. Other people used Quizlet or well, I don't really know any other online flashcard things. But so I'm just going to use Quizlet. I'm not getting paid by them. I'm not getting paid by anybody. Of course, I'm paying money to do all of this by being in PA school. So Quizlet there, I'll use the word, some people did really well with that. Some people were actually able to make their Quizlets in real time, in lecture, which seems amazing. And I deal truthfully from the little bit that I was able to do with my study method, which I will tell you at the end of all this. But pro tip, if you can make your material during lecture, then you are already way ahead of the game by the time you leave lecture and go home to study for it, like your materials already made. So if you can make your material in lecture, that's amazing. So again, that gap, my classmate who used outlines as her study method, she made them in class. And then she just had to go home and study from them at the end of the day, which is great. And same with some of my classmates who used Quizlets, the ones who had the most success with it, were the ones who were able to make the Quizlet right there in real time. So essentially, I guess what I'm saying is, don't be kind of a passive learner. Don't just sit there with the PowerPoint slide open and kind of passively highlight whatever the professor is saying. And don't get me wrong. I mean, a lot of people did that. But I don't know if it was the most successful, the most efficient use of time. Because then by the time you leave lecture, what do you have? Or 198 slides of highlights in your notes on it? I mean, that's too cumbersome again. How are you going to condense that information? Is that even functional for you to go home and study from? So whatever it is you do in lecture, I would really encourage you to try to leave lecture with at least a halfway start at your actual study materials. So the only way to do that is to do it in real time. So outlines, Quizlet, other people would do handwritten notes, like right on the PowerPoint slide. And there's a whole bunch of science behind your brain learns better if you're handwriting because the motion's there and you have to put it in your own words, which there's a lot that goes on that there's a lot to say for that particular strategy. I mean, it's probably better than like highlighting words on a page because it's at least a little bit more interactive because you're trying to like write things down and shorten them and condense them and use your own words and abbreviations. So you're kind of already dealing with the material that way. So handwriting is a good way to go. But again, don't just write word for word for what your professor said. And sometimes I couldn't even do that. Sometimes I had to like type things out as the professor was saying it because I just couldn't, they were just going so fast and I just couldn't keep up with how much information was coming at me. So sometimes I had to type. So even in the same breath that I'm saying, don't do this and don't do that. Like, yeah, you bet your ass. I tried some of those things sometimes and like, no, they didn't work or they didn't work that well. Or I ended up spending eight hours that night trying to like figure out what the hell I meant kind of thing. So give it a go and don't feel bad if you're sitting there just highlighting words. Because sometimes that's all you can do. Sometimes if your option is, you know, stare out the window and scream silently in your head about how far behind you are or sit there and highlight. Yeah, you know, okay, sit there and highlight kind of a thing. It's always going to be better than then ultimately checking out of the lecture if you can. You know, hopefully your professors give you enough break so that you can check out when nobody's telling you important things so that you don't have to mentally check out during lecture. But you know, that happens too. And that's okay. So that's kind of the other caveat of PA school is however you end up doing it is, is okay. And it's, it's okay because it's your way and you don't have to make it, you don't have to make apologies for online shopping or for checking your social media accounts or for just sitting there and letting the information wash over you and highlighting and not doing any kind of active studying or active engagement while you're in the middle class. Like, yeah, sometimes that happens and like, and that's totally, totally, totally okay. You know, but if I find that if you have a goal in mind, if you have something that you're trying to do with relative consistency during class, that's a lofty goal to strive to. And if you end up reaching it or if you end up even doing 50% of making your review, review material right there in real time, I mean, it really cuts down on the how much work you have to do at the end of the day because if you even have half of your study materials prepared by the time you leave campus, then you're already 50% ahead for studying the rest of the night because you don't have to go back and reorganize anything. You have your material already made and you can dive right into giving getting as many touches as you can with that material. So there's another theory involved in this that says, you know, if you take like six touches with the information with any new information to get in your brain and the touch is something, you know, can be something as simple as talking about it or writing it down or thinking about it in your head. You just have to interact. It's just a stupid way of saying interact with the material in some way. So I don't know. I was first taught about it by calling it a touch. So that's what I say. And I don't mean it's on creepy, but that's just what I say. So however you can interact with the material or touch the material, you need to do that six times in order for it to like, in order for you to really truly know it. So again, if you can make your material while you're sitting in class in real time, in lecture, then that's one touch. And then you go home. And if your material's already made, you can jump right in to getting a second pass with that material other, other than having to come home and be like, okay, what do I do with this information? Like how do I, okay, I highlighted this piece, this word right here. Okay. What am I going to do with that? And I mean, don't get me wrong. It's true, however you choose to get that highlighted information off of the highlight and onto something more constructive that you can use. That's another touch. But it's slow. It's slow that way. And again, I started this whole rant off with saying that you've got 40 hours of new information coming at you during a week. How are you possibly going to condense that information? And so that was my struggle, was I can go slow and I can spend a lot of time with this information. I can get into my brain, but invariably, I would end up being like three or four days behind in lecture. And that's not sustainable. So, really and truly, the greatest question is, can you make your study material in real time in lecture, either by making an outline or handwriting it somewhere or using a Quizlet or writing note cards? The girl who sat two chairs away from me was like the goddess of note cards. And she did. And it worked for her. And I think the small space of the note card probably is helpful because you don't have this blank slate upon which to write whatever it is you want or the full sentence that professor stroke spoke. And truthfully, that was actually my kind of silver bullet to how I came into my way of studying, which is to take a regular piece of computer paper and I would either divide it into either four squares or eight squares. And for me, for the four square was a topic that had a lot of information to it. So like congestive heart failure. I mean, there's just a ton of information there and I and each square represented different information. So the first upper left hand corner was always like background and pathophysiology. The second square to the net to right next to it was signs and symptoms. The first square on the bottom, bottom left was diagnostic and work up and then treatment was the fourth square. And so that way I had one item, I had one topic on one piece of page and it's entirely possible that the professor spoke about CHF for three and a half hours and yet somehow I was able to condense it down onto this one eight and a half by 11 page. And don't get me wrong, things bled over into other pages and sometimes I needed a fifth box and sometimes I had to flip it over and like write it on the backside and that wasn't an ideal but like you make do and you just kind of, I just kind of figured it out and I got teeny tiny pens like super fine tip colored pens, non-smudge proof to write with because I'm a very visual person and it was super helpful because all the information was written right there on one page and in a different color. So for instance, background information was written in purple, background and pathophys was written in purple, risk factors, orange. Signs and symptoms, pink, workup and diagnostics, like teal blue and then treatment, green and complications, red and do not miss things, red like buzzwords, red. All of those things are sometimes, you know, if I couldn't write it in red because I had the black pen in my hand like, okay fine, like write it in black but then I would, but then I would put a box around it in red and that was something that helped me as I was honing in on my studying then later on, I would go at a quick glance, I would go, oh man, you know, like what were those signs and symptoms for CHF and I would go to my one page and I would look for the things in pink because I, because I already know that I'm looking for signs and symptoms and so, you know, everything was, my signs and symptoms were always written in the same upper right hand corner in the same pink color and that streamlined my studying for me, I didn't have to like flip all over looking for anything, I always knew where it was. Oh, and also pro tip, of course, any handwritten, anything that you ever write, make sure to get yourself a page protector, that's just, it's just dumb, like coffee will happen, snacks will happen, chocolate happens, wine happens, so just protect that shit because it's more valuable than gold or your computer, I promise you that. If I spilled wine on the floor and my only two options were use my handwritten notes to try to soak it up or my $2,000 computer, you bet your ass, I'd be chucking that computer out it faster than Bob's your uncle, so protect the pages that you hand end up handwriting, protect your online notes, back that shit up, put it on a hard disk, I had, I think I had two classmates who had computers crap out on them over the year, so just, you know, who was that rapper? Back that shit up, the hell song is that? From the 90s, is it the, I think it was the 90s, I'm showing my age. Back that shit up, something like a dump truck, she got dumps like a truck, I don't know, that's the thong song, okay never mind, I digress, I'm terrible with, with music. So back your shit up and protect your handwritten notes. So anyway, that was how I got through PA school, by my four squares and my eight squares. My eight squares were for much smaller topics that didn't require an entire page. Like Musculoskeleton was a really good unit for me to use my eight square and because it's like a super-accongular fracture, which is in the elbow, doesn't take up a lot of information. So it just fit kind of like sideways in a one eighth of the page. And I would still use my color scheme, but everything would just be shrunk down to fit in that one eighth of a box. So background information was the very first way that I started and, you know, the heading was written in purple and the rest of the information was written in black. And then risk factors, heading, orange, information, black, signs and symptoms, heading, purple, or excuse me, pink, and the rest of the signs and symptoms actually written in black. And all of that information I would cut down, I would try to figure out a way to make, you know, a four sentence thing that a professor just said, fit in like three words. And I used a lot of abbreviations. So knowing your medical abbreviations would be super helpful if you end up taking handwritten notes, you know, like the lower case C with a line over it stands for width. Anybody who maybe speaks one of the like Latin-based languages, you know, width in French, actually that's a poor example, because width in French is a veck. But Spanish, go out Spanish, right, cone, width. So anyway, I'm sure it's all Latin-based, but C with a line over it means width. And so I would employ those kind of strategies to try to make it all fit onto one little itty bitty, one eighth of a box on a computer paper. So again, if you end up going a handwritten route, colors are your friends, make use of all the space, space on the page, write small and make use of abbreviations. And hopefully that is a way to condense all the information, but so such that you don't lose any integrity of the information as well. Obviously, you're not doing yourself any favor if your professor says 14 really important things, but you only write down two of them because like some dumb girl on a podcast told you to save space on your worksheet, like that's don't do that. Find a way to take the really important part of what was said to you and put it on your no card or your page or put it in your outline or make a question on quiz lit of it kind of thing. So again, whatever you do, whatever way you figure out how to condense your information that works for you, the sooner and the quicker and the easier, well, easy as a relative word, but the better your life will be in PA school, the faster you can figure out how to do that for whatever works for you. And don't be alarmed if those methods change based on what you know you're doing or what kind of a day you're feeling like, but just know that there's a vast variety of different ways that you can use to condense information. Making charts is another one. Somebody in my class was the master charter and he was amazing at writing like all of the side effects for all the medications that we learned about and the dosing schedule and patient education information and what is it treat, obviously. So some people making charts is a way to do that, but you can see kind of how every suggestion that I'm saying has some sort of condensing the material facet to it, either you're making note cards or your quizlet or you're putting it into a chart that you can, that is like ten pages at the end of one week kind of a thing or probably more like 20 pages, really. But however, you can condense the information so that you can quickly and adeptly dig through it so that you get as many touches and as many repetitions with the information as you can. Really and truly, that is the secret to getting through PA school. And again, I wish somebody would have told me just do the math for how much information is going to be flying at your face, most likely in the format of PowerPoint slide. But how much information is going to be assaulting you during PA school because you have to figure out how to sift through it, how to put it down on paper and how to make it easily accessible so that you can get through it again and again and again and again. So there, math, I wish somebody had told me to do math before I started PA school. All right, so that last segment was a little bit longer than I anticipated it to be. And certainly future ones won't be that long. But it was important to get out kind of the main like 80% of the pro tips that I think will actually get you through the majority of PA school. So if you can figure out how to condense the information and keep its integrity and keep all the important parts, but condense it down so that you're able to quickly and soon go through all of the information, get all the touches that you can, get all the repetitions that you can in before your exam. I mean, that's really and truly like 80% of the hurdle of how to do PA school. So hopefully you caught some tips from that rambling mess that I just left you with. And if not, don't despair. That's what my other, that's what my classmates are going to be called in for. So if you can't learn it from me, hopefully you can learn it from somebody else. That's kind of another rule of PA school. Don't despair, just go ask somebody else because it may resonate with you when if somebody else uses their own words in their own way. So future episodes will not be this long, but this is the maiden voyage and we're all learning together. So I'd like to end today's episode with just a little clinical pearl from my clinical rotation. I have started my emergency rotation and in the field, we call it the ED. So you know, I'm going, I'm going to work and I'm, it's at the ED. But like to people who aren't necessarily inside medicine, ED carries a totally different meaning. Like everybody, everybody that I've happened to mention to, oh yeah, my first rotation is an ED rotation. They always get these like huge wide eyes and they don't know what to say because to them, I just said my erectile dysfunction rotation. I mean, it says those like people think like the medical community is so concerned about men getting boners that we've got like students dedicating their six week rotation to figuring out how we can get them to pop more boners. And that's obviously not what's going on. But it's always, it's always kind of fun at this point. I just kind of do it to be a dick, no pun intended. So I lead with, oh, that's my ED rotation. But it stands for the emergency department and everybody probably, everybody would understand what I was saying if I said my ER rotation, but we just don't call it that. I don't know. That's probably another, it's probably from the 90s, you know, that that show the ER. Got another 90s reference. I'm showing it. Like you guys are going to figure out who I am, probably more, more quickly than I imagined. But at any rate, so I'm on my ED rotation. And we see a whole bunch of things that come through the ED, people slicing up various parts of their body to various severities. And because on the student, it's important for me to do all of those things, of course, under the guidance of my mentor. And so a couple weeks ago, I was given the opportunity to stitch up a patient who had come in after falling off of their bicycle, pretty gnarly bicycle accident. So I was stitching away in there various places that I needed to do that in. And so I was in the patient room for about 45 minutes or so. And when I was all done, I came out, I mean, it was grueling probably more for the patient than it was for me, but they were really nice about it. But man, 45 minutes of just sewing and sewing is hard. And I came out, but like somewhat victorious because I did it, I did the thing. And everybody at the nurse's station is staring at me. The nurse, the tech, the scribe, and then, of course, my mentor. And I'm just going to shrug them like, what are you guys looking at? Like, do you want to go in and like, take a look at my work? What's going on here? And finally, I think it was a nurse who said something like, we just thought you would have passed out from the alcohol fumes at this point. And everybody starts laughing. And I didn't get it. And they could see that I didn't get it. So they were kind enough to explain the joke to me in that they were kind enough to explain to the patient that I just spent 45 minutes sewing up was apparently drunker than a skunk. And everybody could smell it except me because I'm the girl who gets a sinus infection, like her third day of her, like, first clinical rotation. And so it was terrible. I was like, I was, you know, blown my nose every like 30 seconds and I told everybody it was allergies, but I don't know. It doesn't matter if they believe me or not, but I couldn't smell anything and I couldn't smell how drunk this patient was. And so in that instance, it was a superpower of mine. But I could imagine in many others that not having the ability to like smell how drunk your patient is, like probably would be not helpful. So at any rate, the ability to smell turns out in the 80s is both a good thing and potentially a bad thing. But that's my clinical pearl, try to keep your nose clean. And that's my, that's my clinical pearl for the night. And that concludes our very first episode of PAS, FML. I have been your host, PAK, and thank you so much for tuning in today. Stay tuned for more episodes, we'll have more tips and stories, and of course some good old panic studying. So bye bye for now. [BLANK_AUDIO]