You put an immense amount of effort into completing your bachelor’s degree, applying to PA programs and finally being accepted… now what? Time to start PA school! The in’s and out’s of how PA school works is not always clear and pre-PA students often have questions. To start, PA school is divided into two main portions: didactic and clinical.
The didactic portion of PA school is the first half. This time involves taking a large load of credits and a lot of studying. Some programs ease you into PA school with a lighter semester first, but some throw you right into the thick of it! Often times the first semester of didactic consists of going back to the basics: anatomy, physiology, microbiology, etc., as well as less familiar classes such as physical diagnosis and clinical medicine. The first few weeks are not too tough, but it takes time to get adjusted. As the weeks progress, multiple exams are scheduled every week. Prioritizing which exams need more studying vs which exams you could pass without extra hours of work is important. Time management is key!
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Managing your time in PA school with 100+ exams during didactic year is a skill that comes with experience. During the first semester, I often found myself extremely overwhelmed by exam after exam after exam, but by the third semester, the constant exams were expected and I had learned how I best dealt with it. Each student is unique and has their own way of achieving academic success. Success in most PA programs consists of earning at least an 80% on every assignment, quiz and exam. If you do not score at least an 80%, you must go through some sort of “remediation.” Remediation may require you to take another exam with a passing score, completing a high impact outline on topics you missed, or meeting with your professor to review the exam thoroughly.
Progressing into second and third semester, the courses became more clinically based. The bulk of PA school consisted of “clinical medicine” courses. Each week or every two weeks we covered a main Physician Assistant National Certifying Exam (PANCE) blueprint topic. By the end of PA school, we had learned and been tested on the cardiovascular system, dermatologic system, endocrine system, eyes, ears, nose and throat, gastrointestinal system/nutrition, genitourinary system, hematologic system, infectious disease, musculoskeletal system, neurologic system, pulmonary system, renal system and reproductive system. Each Monday at 8am we had a 50 multiple choice exam with “PANCE-like” questions.
Aside from written and multiple-choice exams, you will be tasked with clinical skills assessments. These took place during my physical diagnosis course. Our skills exams started off basic, progressed to full head-to-toe exams, then to problem focused skills exams. We were paired up with a fellow classmate who was given a script to pretend to be your patient. We were tested on taking a full HPI (history of present illness), past medical history, family history, social history and review of systems. We then moved onto performing vital signs and physical exams for whichever body systems we saw fit based on the HPI. Once this was complete, our proctor would recite the exam and labs findings. Using all the information gathered we would present the whole case in our oral case presentation plus five justified differential diagnoses, our primary diagnosis, and our treatment/plan. This was one of the most challenging parts of didactic year for me. Bringing everything together that we have learned in lecture to real-life scenarios is exciting though!
After didactic year is complete, clinical year begins. This is the year to gain in-person hands-on experience under assigned preceptors. The core required clinical rotations span multiple weeks and usually consist of the following: internal medicine, family medicine, women’s health, pediatrics, surgery, emergency medicine, and psychiatry. Preceptors in these different specialties take you on as a student and allow you to interact with their patients. Your responsibilities in your clinical rotations vary based on clinical site, rotation type, and preceptor preferences. Once your rotation is complete, most PA schools require you to pass an end of rotation exam, EOR.
Clinical year has been much more laid back compared to didactic year so far. The transition period between solely attending lectures, studying and taking exams to being in a medical setting seeing real patients has been great. At first, I was filled with anxiety, but as I got accustomed to the facility, the providers and the other students on the rotation, most nerves were put at ease. You are a student, and you are in PA school to learn, so make the most out of it!
