As I said a while back, I had to take, and pass, my national certifying exam before I could call myself a PA-C (for 'certified,' as though that were not already obvious).
The test was Monday. I answered my 360 questions in under four hours; hey, I was on a roll. And this morning I got my results. I'm official.
Showing posts with label Because I Rule. Show all posts
Showing posts with label Because I Rule. Show all posts
Thursday, June 25, 2009
Tuesday, June 09, 2009
Febrifuge, MS, PA
Hey! I graduated!
The law of inverse blogging, or whatever it's called, was in full effect this past couple of months. (Seriously, is there a name for that? The more stuff that happens, the less you feel like/ have time for blogging about it?) Rotation #6 was back home at the very ED where I was a tech, but now I was treating patients and doing the same job as the residents. #7 was an elective in Trauma; I had such fun working my ass off in Michigan that I thought of trauma & critical care as a career option.
Turns out I was a genius for picking this elective, because nothing clears up the rosy glow of a great rotation like doing something similar in a crappier environment. Compared to the group of highly-skilled, generally pretty happy surgeons and kick-ass PAs I'd worked with in Flint, the West Side Chicago crew was overworked, overextended, territorial, and maybe shouldn't have had students around in the first place. It was not awesome, but I learned a ton about the work environment I don't want, and how to recognize it.
Oh. See how much more honest I can be now that I have my diploma?
My final eight weeks was in the suburban ER. I liked the idea of this, because whether it was back home prior to PA school, on my EM rotation, doing surgery in the 'hood, or the Trauma elective, all my ER experience has been in the grim n' gritty urban centers. And the jobs really tend to be in the suburbs.
Again, there's a lot to be gained from seeing things from the other side. I liked the work, and I was pretty good at it. The skills I've developed over this whole thing are the ones that sort of have to come to you organically; one preceptor said I have "street smarts," which I loved to hear. And in the 'burbs, those come in handy, if not very often. Maybe I'll tell you the story about the guy who, no kidding, said "my father is on the board of this hospital." I'll definitely be talking about the TV show that reminds me of.
So I don't know. I love emergency med, and I'd bet I'll wind up there for a long time... but maybe not quite yet. I want to do other things too, and maybe for that all-important First Job After School, I should start in an area where I can do more general, hospital-based work. More on that as we go, too.
The law of inverse blogging, or whatever it's called, was in full effect this past couple of months. (Seriously, is there a name for that? The more stuff that happens, the less you feel like/ have time for blogging about it?) Rotation #6 was back home at the very ED where I was a tech, but now I was treating patients and doing the same job as the residents. #7 was an elective in Trauma; I had such fun working my ass off in Michigan that I thought of trauma & critical care as a career option.
Turns out I was a genius for picking this elective, because nothing clears up the rosy glow of a great rotation like doing something similar in a crappier environment. Compared to the group of highly-skilled, generally pretty happy surgeons and kick-ass PAs I'd worked with in Flint, the West Side Chicago crew was overworked, overextended, territorial, and maybe shouldn't have had students around in the first place. It was not awesome, but I learned a ton about the work environment I don't want, and how to recognize it.
Oh. See how much more honest I can be now that I have my diploma?
My final eight weeks was in the suburban ER. I liked the idea of this, because whether it was back home prior to PA school, on my EM rotation, doing surgery in the 'hood, or the Trauma elective, all my ER experience has been in the grim n' gritty urban centers. And the jobs really tend to be in the suburbs.
Again, there's a lot to be gained from seeing things from the other side. I liked the work, and I was pretty good at it. The skills I've developed over this whole thing are the ones that sort of have to come to you organically; one preceptor said I have "street smarts," which I loved to hear. And in the 'burbs, those come in handy, if not very often. Maybe I'll tell you the story about the guy who, no kidding, said "my father is on the board of this hospital." I'll definitely be talking about the TV show that reminds me of.
So I don't know. I love emergency med, and I'd bet I'll wind up there for a long time... but maybe not quite yet. I want to do other things too, and maybe for that all-important First Job After School, I should start in an area where I can do more general, hospital-based work. More on that as we go, too.
Tuesday, February 20, 2007
The view is nicer in middle of the bell curve, anyway
Okay. I've done my first practice test, and it turns out I'm not a biochemistry moron. I got 72%, which sounds like a C until I tell you the class mean is 75%, and the mean is also, somehow, a nice, solid B. (I got an A in statistics, so I know enough to just go ahead and trust that.)
It's like I was saying earlier: this doesn't seem to be the kind of thing where you can possibly survive any length of time if you have to play to win, and give 110%, all the time. This heavy-duty stuff is something you need to respect and work with, not try to conquer. If you think of med-type studies as a game that has to be done with utmost focus and excellence at all times, any simple human failing seems like disaster. And that's no way to live, much less a way to mold the healthcare team of tomorrow. It's a big part of why premeds and med students are sometimes such miserable people, and often so stressed-out and weird.
Here's what I wanted to say in interviews, but never got a chance to: you always hear these driven, ambitious, talented people say, "I'm excited for the chance to compete. I love to compete. I feel I'm very competitive as an applicant for this [school/ job/ reality TV show/ elected office], and I can't wait to prove it." And I call bullshit on that. I think in actuality, what most of these people enjoy so much isn't competing, but winning. They're winners. Always have been. And who doesn't love to win? Winning is great.
The problem is, if someone always wins, the first time they lose will be the first time they've ever lost. The first time it happens to someone like that, they don't know what just took place. The second time, they fall apart. A bad test score, a lousy evaluation, a personality conflict with someone in charge. Your classic Type A student will do just about anything to maintain stability; that's why they study 10 hours a day, worry about insignificant details, kiss ass with near-sociopathic skill, and never go out to the bars. Keeping their etch-a-sketch unshaken is a full-time obsession.
But medicine -- and it's not like I'm all that qualified to talk about this, except inasmuch as I've spent two and a half years clomping around in my Danskos on the factory floor -- is only partly about keeping the remaining events in your day as predictable as possible. It's largely about keeping yourself consistent, quick-thinking, and useful, while the entire rest of your world gets as unpredictable as it feels like being today.
It's like cards. If all you ever play is some five-card version of the game where nothing can start except with Jacks or Better, you'll be folding and folding again all night, like a cheap lawn chair. And I would think that much of the really relevant learning takes place in the process of playing as many hands as you can. Not so many that you run out of chips, but enough that you get past the bare theories and the expected results, and get into learning from your own observations, including your own mistakes. As someone said, good judgement develops with experience -- and experience usually develops from bad judgement.
The kind of training a lot of students put themselves through is simply wrong for development of this skill. Unfortunately, it's the kind of training that gets great results... for now. It gets them in, and it gets them through, to a point. In other words, the stuff I will be great at doesn't come until the end, and people who are great at the beginning stuff drive me nuts.
I don't mean to imply that a half-assed, vodka-soaked approach is in any way superior to, or even as good as, some discipline and hard work. I only stress the distinction because every now and then, I get concerned. This is the time of year when the system is cranked up to uber-competitive mode. Many of my classmates from last year did fine; many are still up in the air. Match Day is coming up, so today's fourth-years are freaking out about getting to become next year's interns. And out there, somewhere, 50-some people are about to become my classmates.
I hope they're cool, and they'll help me with the stuff I'm not naturally adept with. I promise to help them with their videogame skills.
It's like I was saying earlier: this doesn't seem to be the kind of thing where you can possibly survive any length of time if you have to play to win, and give 110%, all the time. This heavy-duty stuff is something you need to respect and work with, not try to conquer. If you think of med-type studies as a game that has to be done with utmost focus and excellence at all times, any simple human failing seems like disaster. And that's no way to live, much less a way to mold the healthcare team of tomorrow. It's a big part of why premeds and med students are sometimes such miserable people, and often so stressed-out and weird.
Here's what I wanted to say in interviews, but never got a chance to: you always hear these driven, ambitious, talented people say, "I'm excited for the chance to compete. I love to compete. I feel I'm very competitive as an applicant for this [school/ job/ reality TV show/ elected office], and I can't wait to prove it." And I call bullshit on that. I think in actuality, what most of these people enjoy so much isn't competing, but winning. They're winners. Always have been. And who doesn't love to win? Winning is great.
The problem is, if someone always wins, the first time they lose will be the first time they've ever lost. The first time it happens to someone like that, they don't know what just took place. The second time, they fall apart. A bad test score, a lousy evaluation, a personality conflict with someone in charge. Your classic Type A student will do just about anything to maintain stability; that's why they study 10 hours a day, worry about insignificant details, kiss ass with near-sociopathic skill, and never go out to the bars. Keeping their etch-a-sketch unshaken is a full-time obsession.
But medicine -- and it's not like I'm all that qualified to talk about this, except inasmuch as I've spent two and a half years clomping around in my Danskos on the factory floor -- is only partly about keeping the remaining events in your day as predictable as possible. It's largely about keeping yourself consistent, quick-thinking, and useful, while the entire rest of your world gets as unpredictable as it feels like being today.
It's like cards. If all you ever play is some five-card version of the game where nothing can start except with Jacks or Better, you'll be folding and folding again all night, like a cheap lawn chair. And I would think that much of the really relevant learning takes place in the process of playing as many hands as you can. Not so many that you run out of chips, but enough that you get past the bare theories and the expected results, and get into learning from your own observations, including your own mistakes. As someone said, good judgement develops with experience -- and experience usually develops from bad judgement.
The kind of training a lot of students put themselves through is simply wrong for development of this skill. Unfortunately, it's the kind of training that gets great results... for now. It gets them in, and it gets them through, to a point. In other words, the stuff I will be great at doesn't come until the end, and people who are great at the beginning stuff drive me nuts.
I don't mean to imply that a half-assed, vodka-soaked approach is in any way superior to, or even as good as, some discipline and hard work. I only stress the distinction because every now and then, I get concerned. This is the time of year when the system is cranked up to uber-competitive mode. Many of my classmates from last year did fine; many are still up in the air. Match Day is coming up, so today's fourth-years are freaking out about getting to become next year's interns. And out there, somewhere, 50-some people are about to become my classmates.
I hope they're cool, and they'll help me with the stuff I'm not naturally adept with. I promise to help them with their videogame skills.
Tuesday, November 21, 2006
This post has many titles...
1) Progress.
2) "They signed you, Bill! Now you're a law!"
3) I'm in.
4) Febrifuge and The Big Flat Envelope
You may choose whichever one you like best. The upshot is, this is apparently no longer a blog about getting into PA school. As of yesterday's mail, it's a blog about getting ready to go to PA school. In Chicago. Six months from now.
I'll bullet some of the more salient points in a minute, but before I get too deep, I'd like to tell the story of going out there to the interview (which was less than two weeks ago; it's not like I've been holding back, people). And right now, I have some Tiger Woods PGA Tour golf to take care of. It's urgent. Unavoidable. Can't get out of it. Sorry.
Then later, I have a Bond movie to go see with M. Giant, in observation of a tradition that goes back at least as far as Goldeneye... although I could swear there was some Timothy Dalton back there someplace. Hey, I'm a busy cat. The point is, reliable sources tell me that having fun now is vital to my surviving Year One, which is worse than 4-year-med-school year one by some hard-to-pin-down factor.
Oh, and just so there's not a lot of confusion on this point, let me lay down what the heck a Physician Assistant is, and does. Or wait, let me have the AAPA do it for me.
Some sub-bullets:
a) Hey, Chicago. Cool.
Yes! Plus, although I won't mention the school by name, I think it's sweet that there's a four-year school in the same university. That's because most of the time, that's better for the facilities, the faculty, and the reputation of the program in the local medical community. Way too many of the PA programs I researched were founded in 2000 or later, and belong to schools that had heretofore been largely about non-medical pursuits (nursing is very close, but not the same). I also think it's cool that there are PT students, Pathologist Assistant students, and yes, even the podiatry students around. It's an interesting university, in that of the several hundred people attending, nearly all are grad students. So it'll sort of be a Bizarro Bennington for me.
Note: it's not the University of Chicago. Which is too bad, because in one of the Indiana Jones movies, I'm pretty sure he taught archaeology at U of C. House went to Hopkins and then Michigan; they haven't revealed where the Scrubs people went to school, but it seems Californiform; and I honestly don't care where the one PA I've ever seen on TV went. That's about when ER started sucking.
b) So, why this school specifically?
I already pointed out the diversity of programs, which means not everyone I meet will be doing what I'm doing; I consider this to have been one of my not-so-secret weapons last year in Post-Bac. The facilities are crazy good; wi-fi building, digital projectors, and the best anatomy lab I've ever seen, for serious. There's a flat screen monitor and one of those goo-resistant keyboards like at oil change joints mounted on a bracket above each and every dead body. There's a decent fitness center, and a pimpin' fake office with fake exam rooms, used for fake exams of fake patients. See how my theatre training is going to be useful? Mm-hmm.
Airfare to Chicago is pretty cheap; it's like taking an even more inconvenient bus, really. And I like that the degree my school offers is the Master of PA Practice, which is far cooler than the standard Master of PA Studies. I mean really; I don't want a graduate degree in studying something, I want a graduate degree in doing it. (For the record, the only other school I know of that offers a cooler-sounding PA degree is Yale, which awards the Master of Medical Science. Swanky!)
Okay, enough for now. I'm gonna wear a white coat (sometimes). I'm gonna make (fairly) decent cash. I'm gonna heeeeeeeal the sick. I'm gonna play golf.
In fact, I'm gonna play golf right now. The digital character that sorta looks like me will be trying to make the cut at Pebble Beach this afternoon. Wish him luck.
2) "They signed you, Bill! Now you're a law!"
3) I'm in.
4) Febrifuge and The Big Flat Envelope
You may choose whichever one you like best. The upshot is, this is apparently no longer a blog about getting into PA school. As of yesterday's mail, it's a blog about getting ready to go to PA school. In Chicago. Six months from now.
I'll bullet some of the more salient points in a minute, but before I get too deep, I'd like to tell the story of going out there to the interview (which was less than two weeks ago; it's not like I've been holding back, people). And right now, I have some Tiger Woods PGA Tour golf to take care of. It's urgent. Unavoidable. Can't get out of it. Sorry.
Then later, I have a Bond movie to go see with M. Giant, in observation of a tradition that goes back at least as far as Goldeneye... although I could swear there was some Timothy Dalton back there someplace. Hey, I'm a busy cat. The point is, reliable sources tell me that having fun now is vital to my surviving Year One, which is worse than 4-year-med-school year one by some hard-to-pin-down factor.
Oh, and just so there's not a lot of confusion on this point, let me lay down what the heck a Physician Assistant is, and does. Or wait, let me have the AAPA do it for me.
Some sub-bullets:
a) Hey, Chicago. Cool.
Yes! Plus, although I won't mention the school by name, I think it's sweet that there's a four-year school in the same university. That's because most of the time, that's better for the facilities, the faculty, and the reputation of the program in the local medical community. Way too many of the PA programs I researched were founded in 2000 or later, and belong to schools that had heretofore been largely about non-medical pursuits (nursing is very close, but not the same). I also think it's cool that there are PT students, Pathologist Assistant students, and yes, even the podiatry students around. It's an interesting university, in that of the several hundred people attending, nearly all are grad students. So it'll sort of be a Bizarro Bennington for me.
Note: it's not the University of Chicago. Which is too bad, because in one of the Indiana Jones movies, I'm pretty sure he taught archaeology at U of C. House went to Hopkins and then Michigan; they haven't revealed where the Scrubs people went to school, but it seems Californiform; and I honestly don't care where the one PA I've ever seen on TV went. That's about when ER started sucking.
b) So, why this school specifically?
I already pointed out the diversity of programs, which means not everyone I meet will be doing what I'm doing; I consider this to have been one of my not-so-secret weapons last year in Post-Bac. The facilities are crazy good; wi-fi building, digital projectors, and the best anatomy lab I've ever seen, for serious. There's a flat screen monitor and one of those goo-resistant keyboards like at oil change joints mounted on a bracket above each and every dead body. There's a decent fitness center, and a pimpin' fake office with fake exam rooms, used for fake exams of fake patients. See how my theatre training is going to be useful? Mm-hmm.
Airfare to Chicago is pretty cheap; it's like taking an even more inconvenient bus, really. And I like that the degree my school offers is the Master of PA Practice, which is far cooler than the standard Master of PA Studies. I mean really; I don't want a graduate degree in studying something, I want a graduate degree in doing it. (For the record, the only other school I know of that offers a cooler-sounding PA degree is Yale, which awards the Master of Medical Science. Swanky!)
Okay, enough for now. I'm gonna wear a white coat (sometimes). I'm gonna make (fairly) decent cash. I'm gonna heeeeeeeal the sick. I'm gonna play golf.
In fact, I'm gonna play golf right now. The digital character that sorta looks like me will be trying to make the cut at Pebble Beach this afternoon. Wish him luck.
Saturday, August 12, 2006
Moo hoo, ha ha
Thursday (and the day before, and several of the days before that) were practice tests. I was being cute about revealing the scores on those, because not only were those scores... not bad, but not awesome, but moreover there was a chance that the actual, real GRE test scores would be similar, or worse. So I didn't want to be blabbing about my 540 on the math part and my 650 on the verbal part, because wow would I look like a dork if the scores I'd actually be using turned out lower.
I did the real test yesterday, on Friday. Not to worry. It turned out very well. Thank you to all who helped, supported, or just wished me well and put up with my weird schedule and lack of availability.
You know, now that I am apparently a high achiever, I'll need to re-think my jaded, hipster disregard for people who succeed at stuff. Actually, all I need to do is refine it a little: here's what I've actually been talking about all this time, when I say snotty things about "straight A students" or "those damn pre-meds."
What I hate is an obvious sense of entitlement. When people crow about their awesome GPAs and their stellar experiences and how their dad the cardiothoracic surgeon set them up with a great guy who happens to be the 3rd most blah blah blah. They make us workin'-class kids think we are in danger of being shut out, because we had to work full-time and pay our own way, and that may have eclipsed some of what might make us amazing applicants in our own right. How could an admissions committee possibly know that a 3.3 for us might be more difficult, and more meaningful?
So if my own crowing becomes annoying, please call me on it. And also, please know that I mean it in the spirit of enthusiastic and grateful good-wishes to everyone who helped me get this far. I can't believe my good fortune, and yes I suppose I do feel like I earned it, but it's still a gift. I don't mean to be obnoxious to anyone, except maybe those dillweeds I mentioned earlier. As rare as they are, and seriously I have met very few, they're toxic. People who behave as though it's the most normal thing in the world to be fortunate, and anything less is a character flaw, are a danger to fortune and to character. And I hope to never be one of those people. I know you'll help me make sure of that.
So, are you ready, then? Here goes: I got--
Awwwww; a day later, and now I'm shy about it. I've re-edited this post. Let's just say I got a math score that's much higher than I had expected, based on the practice tests. In Verbal, meanwhile, I figured I'd do well, but I did well enough that I blew away a little goal I'd set for myself, which had seemed possible but not likely.
The combined score is high; the mean of the two scores is high; the difference between the two is actually not horrible. Based on some Web searching, I'm in great shape. That's the thing.
I did the real test yesterday, on Friday. Not to worry. It turned out very well. Thank you to all who helped, supported, or just wished me well and put up with my weird schedule and lack of availability.
You know, now that I am apparently a high achiever, I'll need to re-think my jaded, hipster disregard for people who succeed at stuff. Actually, all I need to do is refine it a little: here's what I've actually been talking about all this time, when I say snotty things about "straight A students" or "those damn pre-meds."
What I hate is an obvious sense of entitlement. When people crow about their awesome GPAs and their stellar experiences and how their dad the cardiothoracic surgeon set them up with a great guy who happens to be the 3rd most blah blah blah. They make us workin'-class kids think we are in danger of being shut out, because we had to work full-time and pay our own way, and that may have eclipsed some of what might make us amazing applicants in our own right. How could an admissions committee possibly know that a 3.3 for us might be more difficult, and more meaningful?
So if my own crowing becomes annoying, please call me on it. And also, please know that I mean it in the spirit of enthusiastic and grateful good-wishes to everyone who helped me get this far. I can't believe my good fortune, and yes I suppose I do feel like I earned it, but it's still a gift. I don't mean to be obnoxious to anyone, except maybe those dillweeds I mentioned earlier. As rare as they are, and seriously I have met very few, they're toxic. People who behave as though it's the most normal thing in the world to be fortunate, and anything less is a character flaw, are a danger to fortune and to character. And I hope to never be one of those people. I know you'll help me make sure of that.
So, are you ready, then? Here goes: I got--
Awwwww; a day later, and now I'm shy about it. I've re-edited this post. Let's just say I got a math score that's much higher than I had expected, based on the practice tests. In Verbal, meanwhile, I figured I'd do well, but I did well enough that I blew away a little goal I'd set for myself, which had seemed possible but not likely.
The combined score is high; the mean of the two scores is high; the difference between the two is actually not horrible. Based on some Web searching, I'm in great shape. That's the thing.
Monday, May 29, 2006
Skillz, +/- the "Mad" part
Oh, sure. I've enjoyed the microbiology, the genetics, the neuroscience, even the statistics. But you know what's really fun? Learning actual clinical skill-type stuff. The PA I've been shadowing most recently decided to send me home with some extra supplies from the Urgent Care, and I'm learning to sew. One of my housemates saw the tray full of instruments on the kitchen table, and yet didn't see the grapefruit skin, and got a little... concerned. But it's totally benign. Check it out:
This is a pretty crappy suturing job, to be honest about it. But it's the first time I've ever sewn on a grapefruit skin, and I was primarily happy that I didn't stab myself with the needle.
4-0 nylon is one of your basic all-purpose suture materials. It's a little more bendy than thin fishing line, and way more rigid than the thread I used to fix a pair of jeans earlier today. I guess I'm just in a sewing mood.
I got better with the convex shape of the sections, and learned not to cut through the grapefruit with the suture. And then I did another row...
A better camera (or a better photographer) might make this more obvious, but in general, yes, this is already a superior job.
This is Vicryl, which is an absorbable suture material. It's also way happier to work with, because it's more flexible. But it's more fragile too, and so demands some patience and some style, all at once.
I'm a little geeked out about this. But hey: the next time you accidentally cut a grapefruit and then realize you don't want it yet, you can call me.
This is a pretty crappy suturing job, to be honest about it. But it's the first time I've ever sewn on a grapefruit skin, and I was primarily happy that I didn't stab myself with the needle.4-0 nylon is one of your basic all-purpose suture materials. It's a little more bendy than thin fishing line, and way more rigid than the thread I used to fix a pair of jeans earlier today. I guess I'm just in a sewing mood.
I got better with the convex shape of the sections, and learned not to cut through the grapefruit with the suture. And then I did another row...
A better camera (or a better photographer) might make this more obvious, but in general, yes, this is already a superior job.
This is Vicryl, which is an absorbable suture material. It's also way happier to work with, because it's more flexible. But it's more fragile too, and so demands some patience and some style, all at once.
I'm a little geeked out about this. But hey: the next time you accidentally cut a grapefruit and then realize you don't want it yet, you can call me.
Wednesday, April 05, 2006
Ideally
The Mayo Clinic (quite possibly the very best medical practice anywhere, anytime -- and one of the schools I'd love to attend, why no I'm not sucking up pre-emptively, thanks) has just published an interesting new paper, which one of my classmates sent around today. It aims to identify and describe the qualities that patients are looking for in their providers. My response to it is one part "duh"-based affirmation of common-sense things, one part quietly impressed at the things patients notice and react to, and two parts relief that The System is paying attention.
For good or ill, and I happen to think it's mostly good, this whole idea of "customer service concepts have important ramifications in the medical world" has become quite mainstream. As a patient, this makes me happy because it affirms the times I've felt slighted, or felt the doc's style had a negative effect on my care. As an emergency medical paraprofessional-slash-hospital flunky, it makes me happy because my jocular, light touch might actually be noticed and appreciated by somebody. As an applicant, it makes me happy that I:
For good or ill, and I happen to think it's mostly good, this whole idea of "customer service concepts have important ramifications in the medical world" has become quite mainstream. As a patient, this makes me happy because it affirms the times I've felt slighted, or felt the doc's style had a negative effect on my care. As an emergency medical paraprofessional-slash-hospital flunky, it makes me happy because my jocular, light touch might actually be noticed and appreciated by somebody. As an applicant, it makes me happy that I:
- Have a relatively heavy run of patient-care experience on my resume
- Have done a boatload of shadowing (and not just for the letters, either, but for the experience and perspective)
- Am such a freak about communication skills
- Used to friggin' teach customer service in the corporate world
Tuesday, March 21, 2006
I feel your pain
Over at Ah, Yes, the Fake Doc continues to impress me with a possibly-still-kinda-drunk post about interviewing "standardized patients." These are, in a nutshell, actors hired to play the part of patients, so medical trainees can hone their skillz with history-taking and exams (although not even the med schools that are literally off-Broadway actually have the students do much by way of examining; the actor/patient gets a little card with various results and outcomes listed). I had enough to say in response that I'm copying myself here.
1) I just read something in (an admittedly last-year-ish) JAMA about how lame standardized patient "encounters" are. I think the jist of it was, "wow, these suck, but I guess they're slightly above totally useless." I'm paraphrasing.
2) Speaking as a dude with a Theatre Arts degree, who is now heading into the medical-education meat grinder, my first day with a standardized patient is going to be the BEST DAY EVER.
Pt: "I, um, have this chest pain. It feels like--"
Me: "Bullshit. I didn't believe that for a second. What objective are you supposed to be playing? Are you trying to bring that weak-ass Uta Hagen crap in here? Are you? Huh? Oh, does this bother you? Criticism of your lousy technique? You want to cry? Yeah? Well, imagine that irritation you're feeling toward me is coming from your chest... Okay. Now do it again."
Ahhh, I miss undergrad sometimes.
1) I just read something in (an admittedly last-year-ish) JAMA about how lame standardized patient "encounters" are. I think the jist of it was, "wow, these suck, but I guess they're slightly above totally useless." I'm paraphrasing.
2) Speaking as a dude with a Theatre Arts degree, who is now heading into the medical-education meat grinder, my first day with a standardized patient is going to be the BEST DAY EVER.
Pt: "I, um, have this chest pain. It feels like--"
Me: "Bullshit. I didn't believe that for a second. What objective are you supposed to be playing? Are you trying to bring that weak-ass Uta Hagen crap in here? Are you? Huh? Oh, does this bother you? Criticism of your lousy technique? You want to cry? Yeah? Well, imagine that irritation you're feeling toward me is coming from your chest... Okay. Now do it again."
Ahhh, I miss undergrad sometimes.
Friday, January 20, 2006
Back in the Empire State, and the... flannel and Subaru state
And lo, it did come to pass that the non-trad did set out from his home, and traverse the miles. He did eat of the Steak N' Shake, and find a really decent, cheap motel in Elkhart, IN, and so it was that he was finished paying tolls for crappy roads and did settle back in rural New York.
And the school did begin, at the college on the "nice" side of the town, and as far as he could tell, he was appropriately registered and ready to rock. And thus did the study of blood commence.
And in that time of vacation, some modest events had transpired, and those stories would eventually be told on their own, but the main points were that the long-distance relationship was healthy and intact; the non-trad discovered he enjoyed single-malt Scotch; his mobile phone did plummet into an icy storm drain; and the chick from Friday karaoke with the book deal's book did indeed come out, and furthermore it did not suck. (Fuller review to follow, yo.)
And the Playstation football did recommence, and the non-trad found a very curious thing happening: a three-game winning streak. And thus was he moved to talk of the trash, as that is how the housemates did show their manly regard. And, it was good.
And the school did begin, at the college on the "nice" side of the town, and as far as he could tell, he was appropriately registered and ready to rock. And thus did the study of blood commence.
And in that time of vacation, some modest events had transpired, and those stories would eventually be told on their own, but the main points were that the long-distance relationship was healthy and intact; the non-trad discovered he enjoyed single-malt Scotch; his mobile phone did plummet into an icy storm drain; and the chick from Friday karaoke with the book deal's book did indeed come out, and furthermore it did not suck. (Fuller review to follow, yo.)
And the Playstation football did recommence, and the non-trad found a very curious thing happening: a three-game winning streak. And thus was he moved to talk of the trash, as that is how the housemates did show their manly regard. And, it was good.
Tuesday, January 03, 2006
it's weird to be proud of this...
...but that's what working in healthcare is all about: re-ordering what used to be a normal, somewhat sane sense of how the world works.
I was back in the ED today for a few hours, doing my job. Wearin' of the maroon scrubs again. It was good to be back, nice to see some people. I even got to talk a little with a PA there who's been a great source of info and encouragement. And I was happy to find that my prime ED tech skill, the thing that sets me apart from the rest, is intact. Just as reliable and strong as if I hadn't been away six months. And that's what's weird, because while it's a pretty cool skill, it's not exactly "hits the vein every time" or "can instantly estimate heart rate within 2 beats a minute." I'm reasonably good at those things, but what do I win in the tech-skill lottery, as something I'm awesome at?
"Obtains rectal temp without baby crying."
Hey, whatever. You probably have some odd stuff you can do, because of your job.
I was back in the ED today for a few hours, doing my job. Wearin' of the maroon scrubs again. It was good to be back, nice to see some people. I even got to talk a little with a PA there who's been a great source of info and encouragement. And I was happy to find that my prime ED tech skill, the thing that sets me apart from the rest, is intact. Just as reliable and strong as if I hadn't been away six months. And that's what's weird, because while it's a pretty cool skill, it's not exactly "hits the vein every time" or "can instantly estimate heart rate within 2 beats a minute." I'm reasonably good at those things, but what do I win in the tech-skill lottery, as something I'm awesome at?
"Obtains rectal temp without baby crying."
Hey, whatever. You probably have some odd stuff you can do, because of your job.
Wednesday, October 26, 2005
A modest manifesto
We had a little bit of weather out New England way last night, ayuh. A Nor'Easter, they call it. About two to three inches of snow fell, out at the homestead. The sticky, snowball-fight type stuff. Interestingly to this flatlander, the slightly higher elevation we have on our ridge was enough to keep the town itself from seeing much more than on campus, where they only got a dusting.
We'll see about how my Midwestern sensibilities handle the wool-wetting squalls of a proper Upstate NY/ SW Vermont weather system. I can tell you that about two solid weeks of dribbling grayness has left me unimpressed and with a fine head start on my latest bout of Seasonal Affective Screw this, I'm Going to Take a Nap disorder. I did find a fine woolen topcoat at the local Goodwill for $12.99, so the "wool-wetting" thing above is not just an artful phrase.
Speaking of artful phrases, I said I'd divulge the reason I'm so happy-go-lucky lately, and as a matter of fact I did make time to squeeze in the watching of a four-hour Shakespeare documentary over the long weekend (as well as The Big Lebowski and Ninja Scroll). Meanwhile, my classmates slaved like beaten dogs to prepare a stack of work for their courses. And say, come to think of it, I haven't adequately explained why I'm not in those same courses, nor how it is I'm nonetheless their classmate if that's the case.
So, dear reader, sit back for another lengthy story. Not that it's a complex or difficult thing to explain. I'm just so much more laid-back about my pre-med stuff now... or, to be more precise... (needless pause)... my pre-PA stuff.
Yes, these days I've been tooling around the winding mountain roads, the back seat loaded with books on not Organic Chem but Human Anatomy & Physiology. Not Calculus, but Statistics. The weather guy has been predicting rain, the Kaiser Chiefs have been predicting a riot, and I've been feeling like finally instead of "potential," I have a future I am excited about, and a way to get there.
A side note... true, technically I might be able to say I'm a pre-med or I'm headed to "med school" and be correct, because I do plan to apply to a mess of schools, and many at of the top of the list will be schools where the PA program is part of a med school that also trains young MD's (and if I can have a Scrubs moment, going someplace where Young MC is on faculty would be a bonus. Bust a move!). But let's be clear: in this day and age, in the good ol' US of A, the bare fact of it is, you don't gotta be a doctor to practice medicine. And I'm not talking about some 'alternative' thing either. Good old paternalistic, ego-driven, Western know-it-all medicine can be done, and done very well indeed, by Physician Assistants. For dudes like me, that's a concept that is just brimming with intrigue and attraction.
I would have been remiss not to seriously think over my options, once I got on the road and discovered how well "the system" used for training future doctors and I get along... or don't. I might have been too proud or too stubborn to consider the advantages of finding another way... but I wasn't. What sealed it was my thinking long and hard about what I want to do, how and where I want to practice, and then combining that with what I don't want to do, and the things about the job I frankly don't want to have to deal with. It all adds up very nicely to exactly what the PA profession is (according to one way of looking at it). It's practicing medicine without a lot of the intervening stuff that makes docs crazy.
Now, sure, absolutely, you want your doctor to be someone who could conceivably pick up the nuances of Orgo (or Physics or Calculus), sufficiently well to get a decent grade in a course. But having worked in pretty much exactly the place we're all trying to get to, I know how far down the list of important characteristics that really is. You want smart, yes. You want quick-thinking. You want knowledgeable, even encyclopaedic. You want 'able to talk like a person.' You want a lot of things, and so few of them have anything to do with academic achievement, after a while it starts to become scary to think that such a large proportion of doctors started out as kids who got great grades in science courses.
This is not to say that poor achievers have any better shot at becoming good doctors, or that they should. Getting good grades usually means working your ass off, and you need people who can work their asses off, both to be decent students and to be decent actual working physicians. But the thing is, the PA way of doing things isn't all that different, in terms of the things that matter to people (meaning practitioners and patients, a group often overlooked in this whole training thing). Before I get into the guts of it (literally!) in PA school, I'll have to prepare with some of the things pre-meds don't see until med school year one: a buttload of anatomy, physiology, statistics... hey, waitaminnit, those are my courses now. Hmmmm.
I anticipate an objection here: No, it wasn't because I had an academically bumpy Summer. It wasn't even because more terms like that one would assuredly have helped me get lost in the pile, kept me from getting interviews, and made it unlikely I'd get the shot to get into med school in a year, or two, or maybe more. Nor was it any doubt about my ability to get through med school (and do it damn well, as a matter of fact). It's more that I already know what it's like to slog through something that's almost what you want to do.
If the going is tough, that's fine. If it's circuitous and time-consuming and expensive and stressful, that's fine. But only if where you're headed to is where you really want to be. So if you're smart about it, you think a lot about where you want to be. And you don't stop thinking about it, now and then, just because you're on the way to someplace people respect and think is cool. So, I thought about it.
I don't want to own and run a small business. I don't want to head up a department. I don't care (that much) about huge piles of money, or my name being synonymous with a maneuver or a weird-shaped surgical tool. I don't want to pay malpractice premiums higher than my income was when I worked in the corporate sector. I don't want to set policies. I don't want to call all the shots, just those that constitute care for my patients. I don't want to be the only guy within 50 miles who can do something. I don't want it to ever be considered a weakness if I feel I want to consult somebody.
I want to teach a little, write a little, do a little research into things that interest me, and mostly just practice medicine. I want to work on a team, as one of its leaders. And oh yeah, I want to have a life. As a PA, I will be "limited" to practicing, and I'll have to do it as part of a team. I honestly don't see the down-side here.
So around Labor Day, I made the decision. My pre-reqs are for PA school, and the classes are much more directly applicable, which is nice for an impatient and energized student like me. Hey, I like understanding things for their own sake, I really do. But I have a tough time being graded on things when I can't see the connection, and because of limitations of the system I can't be given time and space to find my own. I have a tough time believing that academic performance is an indicator of smarts or ability.
Oddly enough, I'm currently on track for A's in everything. Hmmm.
We'll see about how my Midwestern sensibilities handle the wool-wetting squalls of a proper Upstate NY/ SW Vermont weather system. I can tell you that about two solid weeks of dribbling grayness has left me unimpressed and with a fine head start on my latest bout of Seasonal Affective Screw this, I'm Going to Take a Nap disorder. I did find a fine woolen topcoat at the local Goodwill for $12.99, so the "wool-wetting" thing above is not just an artful phrase.
Speaking of artful phrases, I said I'd divulge the reason I'm so happy-go-lucky lately, and as a matter of fact I did make time to squeeze in the watching of a four-hour Shakespeare documentary over the long weekend (as well as The Big Lebowski and Ninja Scroll). Meanwhile, my classmates slaved like beaten dogs to prepare a stack of work for their courses. And say, come to think of it, I haven't adequately explained why I'm not in those same courses, nor how it is I'm nonetheless their classmate if that's the case.
So, dear reader, sit back for another lengthy story. Not that it's a complex or difficult thing to explain. I'm just so much more laid-back about my pre-med stuff now... or, to be more precise... (needless pause)... my pre-PA stuff.
Yes, these days I've been tooling around the winding mountain roads, the back seat loaded with books on not Organic Chem but Human Anatomy & Physiology. Not Calculus, but Statistics. The weather guy has been predicting rain, the Kaiser Chiefs have been predicting a riot, and I've been feeling like finally instead of "potential," I have a future I am excited about, and a way to get there.
A side note... true, technically I might be able to say I'm a pre-med or I'm headed to "med school" and be correct, because I do plan to apply to a mess of schools, and many at of the top of the list will be schools where the PA program is part of a med school that also trains young MD's (and if I can have a Scrubs moment, going someplace where Young MC is on faculty would be a bonus. Bust a move!). But let's be clear: in this day and age, in the good ol' US of A, the bare fact of it is, you don't gotta be a doctor to practice medicine. And I'm not talking about some 'alternative' thing either. Good old paternalistic, ego-driven, Western know-it-all medicine can be done, and done very well indeed, by Physician Assistants. For dudes like me, that's a concept that is just brimming with intrigue and attraction.
I would have been remiss not to seriously think over my options, once I got on the road and discovered how well "the system" used for training future doctors and I get along... or don't. I might have been too proud or too stubborn to consider the advantages of finding another way... but I wasn't. What sealed it was my thinking long and hard about what I want to do, how and where I want to practice, and then combining that with what I don't want to do, and the things about the job I frankly don't want to have to deal with. It all adds up very nicely to exactly what the PA profession is (according to one way of looking at it). It's practicing medicine without a lot of the intervening stuff that makes docs crazy.
Now, sure, absolutely, you want your doctor to be someone who could conceivably pick up the nuances of Orgo (or Physics or Calculus), sufficiently well to get a decent grade in a course. But having worked in pretty much exactly the place we're all trying to get to, I know how far down the list of important characteristics that really is. You want smart, yes. You want quick-thinking. You want knowledgeable, even encyclopaedic. You want 'able to talk like a person.' You want a lot of things, and so few of them have anything to do with academic achievement, after a while it starts to become scary to think that such a large proportion of doctors started out as kids who got great grades in science courses.
This is not to say that poor achievers have any better shot at becoming good doctors, or that they should. Getting good grades usually means working your ass off, and you need people who can work their asses off, both to be decent students and to be decent actual working physicians. But the thing is, the PA way of doing things isn't all that different, in terms of the things that matter to people (meaning practitioners and patients, a group often overlooked in this whole training thing). Before I get into the guts of it (literally!) in PA school, I'll have to prepare with some of the things pre-meds don't see until med school year one: a buttload of anatomy, physiology, statistics... hey, waitaminnit, those are my courses now. Hmmmm.
I anticipate an objection here: No, it wasn't because I had an academically bumpy Summer. It wasn't even because more terms like that one would assuredly have helped me get lost in the pile, kept me from getting interviews, and made it unlikely I'd get the shot to get into med school in a year, or two, or maybe more. Nor was it any doubt about my ability to get through med school (and do it damn well, as a matter of fact). It's more that I already know what it's like to slog through something that's almost what you want to do.
If the going is tough, that's fine. If it's circuitous and time-consuming and expensive and stressful, that's fine. But only if where you're headed to is where you really want to be. So if you're smart about it, you think a lot about where you want to be. And you don't stop thinking about it, now and then, just because you're on the way to someplace people respect and think is cool. So, I thought about it.
I don't want to own and run a small business. I don't want to head up a department. I don't care (that much) about huge piles of money, or my name being synonymous with a maneuver or a weird-shaped surgical tool. I don't want to pay malpractice premiums higher than my income was when I worked in the corporate sector. I don't want to set policies. I don't want to call all the shots, just those that constitute care for my patients. I don't want to be the only guy within 50 miles who can do something. I don't want it to ever be considered a weakness if I feel I want to consult somebody.
I want to teach a little, write a little, do a little research into things that interest me, and mostly just practice medicine. I want to work on a team, as one of its leaders. And oh yeah, I want to have a life. As a PA, I will be "limited" to practicing, and I'll have to do it as part of a team. I honestly don't see the down-side here.
So around Labor Day, I made the decision. My pre-reqs are for PA school, and the classes are much more directly applicable, which is nice for an impatient and energized student like me. Hey, I like understanding things for their own sake, I really do. But I have a tough time being graded on things when I can't see the connection, and because of limitations of the system I can't be given time and space to find my own. I have a tough time believing that academic performance is an indicator of smarts or ability.
Oddly enough, I'm currently on track for A's in everything. Hmmm.
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