Next Up: Final Exams (Pass the Maalox)

Posted By: Paul   |   Academics   |   6 Comments

These are desperate hours, friends.  For the next few days, we will jam the last bits of information into our heads — heads that are already swimming with information.

How Do Final Exams Work For PA School?

PA School Final Exams

Where did the bruise on my head come from?

My exams this quarter:

  • The toughest one first.  It’s a computer-based multiple choice exam on Primary Care Medicine.  “It’s multiple choice – how hard could it be?” I hear you cry.  Trust me, they’re hard. This covers head, ears, eyes, nose, throat, dermatology, hematology, and pulmonology.  We will be responsible for knowing the various diseases, their etiologies (caused by Moraxella catarhalis, cytomegalovirus, trauma, autoimmune problems, genetic defect?), diagnostic tests, treatments, differentials (how to tell that it’s herpangina as opposed to herpetic gingivostomatitis or aphtous ulcers, or oral lichen planus, etc, etc, etc…  This class is a butt-kicker.
  • The wild card: my computer-based exam on pediatric primary care.  I’m nervous about this one because there are acres of material on vaccinations, how to examine kids of different ages, developmental norms, typical and atypical physical examination findings, etc, and the exam is only 50 questions!  Wait, what?  That’s right, you read me: 50 questions.
  • A computer-based multiple choice, essay, and fill-in exam on behavioral health topics like motivational interviewing and substance abuse.  To be brutally honest, we have all pretty much “triaged out” this class, and I have only the vaguest idea what I will be tested on.  If worse comes to worse, I’ll lean on my psychotherapist background and hope for the best.

    Final Exams

    Finals are upon us

  • The most intimidating exam: My oral practicum.  Here, I meet and greet a standardized patient (if missed out on what that is, read about standardized patients here).  The patient will be visiting our skills lab, which is essentially a modern clinic with waiting room, and will have a specific complaint.  I will be given their vital signs and a sentence or two about what brings them in.  This complaint may come from systems we have covered: head, ears, eyes, nose, throat, dermatology, hematology, or pulmonology.  Beyond that, I won’t know anything about it in advance.  As I examine them, when I check something relevant, they will be trained to give me a slip of paper that tells me what I found (for example, when I examine their lungs, I may get a note that says I notice increased tactile fremitus).  I will then interview the patient, take a focused history, make a diagnosis, write out orders for any labs or treatments that I deem necessary, make recommendations for health maintenance (flu shot, blood sugar, cholesterol check, etc.).  When I leave, I will have a limited amount of time to write a chart note about the visit.  Finally, I will present this patient verbally to a faculty member, as I will be doing soon at my preceptorship.  All this in 75 minutes.  My instuctors will observe me via video, and score me on what I do, and the patient will score me on several dimensions, such as my listening ability, my ability to explain to them what I am doing, etc.
  • After these, the quarter will be pretty much over.  Pretty much, I say because even after all my classes are over*, I have an assignment due for my professional development class.  Why?  Because this class is year-round, so it doesn’t care that all I want to do is go guzzle beer with my friends to sit around in my underwear watching the episodes of the Amazing Race that I missed during school.  And oh yeah, go home to my family for the first time in a month!

In case you’re wondering, I’m still having a blast, and I would rather be doing this than just about anything.  But man, this is going to be a long week!

* In PA school, that never happens — they just pause long enough for you to buy more books.


  1. Carmen September 8, 2011 at 11:47 am - Reply


    I just applied to PA school and hopefully will be starting Summer 2012. I know everyone says you should rest and relax before starting school, but I was wondering if there are any books you recommend (anatomy/pharm/etc) to review that may be helpful before starting school?


    • Paul September 8, 2011 at 2:01 pm - Reply

      Sure. First off, I’d suggest you get a copy (used or older edition, such as 9th) of Bate’s Guide to Physical Examination, By Lynn Bickley. You will almost certainly be using this text, and it’s readable by those who haven’t started. Read it and reread it.

      Also, though I don’t have a particular favorite, a good physiology text is a must. If you like the on you used to take the prerequisite physiology, that should be fine. You’ll be revisiting all those “old” physio topics, but in PA school, you’ll be learning pathophysiology, which is the study of what happens to normal physiological systems when the break down (inflammation, etc). I do think having a little R&R is a good idea though. Take a beach vacation, but bring your Bates guide. That should be relaxing and fun, and it’ll get you ahead of your coursework. Good luck! -P

  2. Fatima January 6, 2012 at 4:20 pm - Reply

    As brutal as all of this may seem to some, I honestly think that is ridiculously exciting to be studying. I was just wondering, though, do you feel that when you do the physical exams, where you are basically testing almost everything, that you are ready? Like do you feel that you are given the proper instruction to be capable of doing this properly?

    • Paul January 6, 2012 at 5:36 pm - Reply

      After doing 20-30 complete exams you feel comfortable touching people and doing the exam. It takes doing MANY exams to start NOTICING things that are more subtle. What usually happens is you get tired of doing so many exams that are essentially “normal,” and the one day after thinking that every exam you’ll ever do will be normal, you’ll do one and something will LEAP out at you because it’s NOT normal. Pretty soon more and more subtle things begin to stand out. I’m still finding things that aren’t rare that I’m picking up for the first time. Every time you do, you do a little celebration in your head…”HEY, I caught that!”

  3. Andrew June 27, 2014 at 11:49 pm - Reply

    Paul, just last year I was diagnosed with severe sleep apnea and that has significantly impacted my memory after decades of not getting into brain restorative sleep. I feel MUCH better now that I have treatment but there are still residual effects. I have ADHD like symptoms and need to spend significantly more time memorizing and studying the same subject than the average person. I am anxious I will have so much thrown at us, I may not be able to keep up. I am just begining to take prereq coursework now.

    • Paul July 6, 2014 at 12:54 pm - Reply

      Have you visited your college’s disability resource center? They can test you for ADHD and similar types of learning and behavioral disabilities and allow you accommodations such as more time for tests, use of a recorder, etc. I HIGHLY suggest you take advantage of what they have for you.

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