Since I’m heading into another rotation (and therefore will be pretty well buried for a month), I thought it would be a good time for a program update.  There’s plenty going on, and plenty to do before the big day – June 9 – when I will graduate.

Here are some of my recent activities:

  • We just finished a week of testing, during which we completed 5 exams in 4 days.  They were:
    • Endocrinology – our third big exam on the topic, with more detail, and harder vignettes, of course.
    • Psychiatry – historically, my strongest area.  It was still a hard test.
    • Our final OP (Oral Practicum).  My standardized patient (a patient actor) was kind, and I think I killed it – the exam, not the patient!  Strangely, I find OP’s more difficult than real patients.    Real patients are cooperative and help you when possible, unlike standardized patients.  Standardized patients never seem to do you any favors.
    • OSCE (Objective Structured Clinical Examination).  This is basically a hypothetical patient on paper, in written format.  You get the patient’s basic information and complaints, and then have to brainstorm the diagnostic and treatment possibilities.  OSCES are given in stages, so that after the each stage (interview, history, labs/imaging results, etc.,  what you have written is taken from you, and you are given a little more information.  Your job is to tell them how you would handle the patient, which helps them to see your clinical thought process.  I actually wish we had done more of these and fewer oral practica.  OSCES aren’t bad at all, actually.  Lately, we’re getting pretty good at piecing together these kinds of information and coming up with the most likely diagnosis (or diagnoses).
    • The PACKRAT, which stands for the Physician Assistant Clinical Knowledge Rating and Assessment Tool.  It’s a multiple choice test that mimics the PANCE exam that we will be taking after we graduate, much like how the PSAT mimics the SAT.  It was 225 questions in 3 hours, and we will get a completed copy of the test, with answers, when it is scored. The exam will give me a ranking among my class, and a ranking among all test takers nationwide.


That’s right, next week I start the biggie – heart and chest surgery.  It’s known to be a pretty intense experience: 5 AM to 5 PM and later, 6 days/week, for 4 weeks.  I will spend a week doing chest surgery (lung cancers, outlet syndrome, pneumonectomies, etc.), a week doing cardiac surgery (bypass grafts, valvular repair, etc.), a week doing pediatric cardiac surgery (congenital defects mostly), and a week in the Intensive Care Unit (ICU).

I’ll be staying in Sacramento at a classmate’s so that I won’t waste 2 hours of sleep per day by driving to and from the hospital.  I’m studying all things surgery to prepare, and I have to admit, I’m pretty intimidated by the whole thing.  I’ll try to post here and there during the rotation.  When CT surgery is over, I’ll only have 3 more weeks until graduation.

Truly, I don’t want school to end.  But there are plenty of exciting next steps, including getting a solid job that I love to do, and learning what I want to learn about medicine for a change.  My classmates are beginning to talk heavily about jobs and salaries, and it is exciting, but it’s daunting too.

Anyway, all for now.  Send questions if you have them – I’ll do my best to answer.[subscribe2]