Tips for becoming a PA-C

Current critical care PA-C. This blog contains original and reblogged info for PA school, PANCE/PANRE, medical practice, and random interesting things related to medicine.

[we-need-medicine]

Holiday Giveaway

Hi everyone,

Just in time for the holiday season, I’m going to give away 3 copies of the Maxwell Quick Medical Reference!

This pocket guide includes a thorough explanation of everything listed in that picture. I found it super helpful when I was on clinical rotations and is widely regarded as a must-have for PA/NP students and medical students. It also has a pocket Snellen chart and ruler on the back cover, which I still use often while practicing!

Just reblog this post and winners will be randomly selected December 15, 2017. Good luck!!!

[hangrypa]

I have one, so this reblog is for anyone who hasn’t received this awesome pocket guide yet!

[mylifeasapastudent]

Reblogging for my followers!

[crimefighterphd]

Quick reminder, especially for you younger undergrads: Discipline is a skill, not a character trait. And just like any skill, it can be practiced and improved upon incrementally. Try not to get discouraged if you have a day, or multiple days, where you are less disciplined than you would like or need to be. Don’t quit. Don’t spend the next week binging Netflix because you think it’s a hopeless endeavour. Just get up the next day and try again. Each day you try is more practice, and each day you practice, you’ll get a little bit better, and that continual improvement will pay dividends in the long run.

Keep at it.

[simplysupergirl]

So what are you doing Thursday (Sept 7) @ 8pm EST/7pm CST/5pm PST?

A: Vegging out.

B: Drinking wine/liquor/soda/water/drinkofchoice after a hard day’s work.

C: Dancing.

D: Chat with me and @populationpensive and other awesome pablrs on the #pablr group chat on Slack where we’ll be talking about all things rotations or anything else you wanna talk about.

E: All of the above.

Grab your favorite food of choice, your favorite drink of choice, and your wonderful dancing self (and your computer) and join us for a pablr group chat over on Slack on Thursday!

If you’ve never joined that’s totally alright, just send me or @populationpensive a message or email ([email protected]) with a message saying “I WANT TO JOIN THE PABLR GROUP CHAT” with your email address and we can send you an invite to join. It’s totally free to join!

[elkasah-md]

Confused about reading and commenting on X-rays Relax and follow the steps

[dr-azie]

My Professor makes us do this…..

ABCs

[captainmdphd-blog]

Tips for intern year: part 1

THERE ARE FEW SITUATIONS THAT REQUIRE AN IMMEDIATE ANSWER.

This was really hard for me to grasp. I felt like a failure every time I’d get paged about a cross-cover situation that I couldn’t immediately handle. It’s fine, guys. Very few situations require an immediate answer. Take your time. Paged about a patient with hypotension? As long as they’re mentating appropriately, take a few minutes to see where the trend of their blood pressure over the day. Check to see if there’s a recent TTE to determine if they can handle a big IVF bolus. You have time. Don’t let anyone try to pressure you into making an immediate non-critical decision. It’s totally ok to admit that you need to look at the patient’s chart first and you’ll call them back in a few minutes. This isn’t a weakness. This is you practicing good medicine.

[mylifeasapastudent]

a good reminder for us new PAs as well

[we-need-medicine]

Rotation Recap #6 - Women’s Health

My 6th rotation was in gynecology, a required rotation at my school. Unfortunately I did’t get any obstetrics experience as the office I was placed at was just gynecology. 

I went into this rotation not expecting to like it very much, but I did not mind my time at this rotation. 

What I liked about gynecology: I really liked the patient population. We saw women of all ages and they were all very honest and friendly about their issues. I could tell that they all had a lot of trust in the providers at this office. With the increase in hostility towards women’s health in this time period, I felt that I was helping to make a difference in patient’s lives who may be feeling uneasy about their women’s health maintenance and issues. 

What I didn’t like about gynecology: I just simply don’t have an interest in gynecology, and many of the appointments were annual examinations which became a bit monotonous. 

Favorite things about my site: The office was equipped with a lot to do procedures at, and everyone in the staff (with the exception of one doctor) was very friendly and respectful. 

Things I didn’t like about my site: My preceptor was EXTREMELY religious, to the point that it affected how she practiced. She wouldn’t offer IUDs as birth control because she believed they caused abortions, but would tell patients that they simply “didn’t work”. I was very off-put by her dishonestly to patients. She would also pray with many patients after the visit. It was a private practice, so I understand that she can run it however she wants, but it could be uncomfortable. The other doctor in the practice was also very disrespectful to me, the other office staff, and patients, so I pretty much would just avoid her. I also did not like that there was no obstetrics at this office, as I think it would have been exciting to have experience in.

Common things I saw: Annual exams, birth control consults/refills, PCOS, uterine fibroids, endometrial hyperplasia, vaginal atrophy, dyspareunia, incontinence, yeast infections, UTIs, and osteoporosis/osteopenia. 

Uncommon things I saw: Imperforate hymens, endometrial cancer, infertility, and bacterial vaginitis. 

Common procedures: We performed surgery 1-2 days a week, so we did hysterectomies, D&Cs, tubal ligations, and hymenectomies. In the office we performed pap smears, colposcopies, LEEP prodecures, and urodymanic testing. This office also had a Mona Lisa laser machine that treated vaginal atrophy, so many patients were coming for this. 

Overall thoughts: As I stated above, I liked this rotation more than I initially thought, but I still do not think I would pursue a career in gynecology. I did enjoy all the procedures we got to perform, but my preceptor was off-putting and the days became monotonous. 

Up Next: General surgery!

[mylifeasapastudent]

W. Eugene Smith's Landmark Portrait: 'Country Doctor'

'Country Doctor' was an instant classic when first published in LIFE in 1948, establishing W. Eugene Smith as a master of the photo essay

For his groundbreaking 1948 LIFE magazine photo essay, "Country Doctor" -- seen here, in its entirety, followed by several unpublished photographs from the shoot -- photographer W. Eugene Smith spent 23 days in Kremmling, Colo., chronicling the day-to-day challenges faced by an indefatigable general practitioner named Dr. Ernest Ceriani.

[seasidemedstudent-deactivated20]

The Internal Medicine Post

Internal medicine is the medicine-iest of medicine-y rotations. This post includes a day-to-day, a look at call shifts, admitting/discharging patients, topics I wish I’d known more about and some pro-tips, and finally SHELF stuff. 

Day-to-day:

5:00 am: wake up, kinda mad about it, quickly get over it…

6:00am: get to the hospital and get started pre-rounding on 3-4 patients. Open up the chart and check to see what happened overnight (but also in the last 24 hours). I always looked at nursing notes (patient refusing meds?), vitals, Ins/Outs (Did your rhabdo patient meet the urine output goal?), any consult notes from the previous day (what did cardiology say about your CHF patient?), any new labs or imaging results (Hmm, what does this MRI tell me? Is the H/H still stable?), which medications they received (How many times did your sickle cell patient hit the PCA button?), any new changes to their orders (ex: are they now NPO for a procedure that was ordered late last night?), and any other pertinent information for that particular patient.

Keep reading

[pagingmedicine]

@seasidemedstudent this is great! You put a LOT of thought into this!! 

[raspberrystethoscope]

On being a fat medical student, at the start of our metabolism module

We’re starting our “metabolism” module at med school this week, and I’m dreading it with every fibre of my being. You see, I am going to be a doctor, and I am fat.

I’m not the type of fat you feel after you’ve had a big lunch, and your usually flat belly is protesting against the waistband of your jeans. I’m the real kind. My BMI hovers a couple of points below “morbidly obese”.

I worry a lot about what people will think of me as a fat doctor. For the smartarses among you, of course I’ve tried to be non-fat, it goes without saying. The thing is though, bodies don’t really like weighing less all of a sudden and are pretty good at reversing things in the long run. Mostly my body settles back to the same size 18 shape eventually.

I am always aware of my fatness, but perhaps more so here at medical school. We are training to work with bodies, and mine is a type of body we warn our patients not to have. It is the first thing described in every list of ‘modifiable risk factors’. A colleague suggests “just don’t let yourself get too fat” as we talk about preventing a certain type of cancer. A final exam question asks us to list four poor health outcomes associated with obesity. I sit through lectures with slides that have sniggering titles like “how BIG is the problem?”

Keep reading

[doctordconline-blog]

It might be very helpful to all of you .

@@@@@@ if you think so, please share with your friends @@@@@

#anesthesia #anesthesiologist #radiology #radiologist #xray #usmle #physiology #pathology #anatomy #usmlestep1 #usmlestep2 #doctor #doctordconline #nhs #nurse #nursing #mbbs #md #medicine #medlife #medschool #medstudent #amc #plab @doctordconline

[adenosinetriesphosphate]

Skin Assessment Hgb Trick

Had a patient last night with a hgb 4.6. The doctor immediately knew his hgb was under 6 when he assessed him using this little trick:

You lose the color in your conjunctiva around a hgb 10.

You lose the pigment color that lines your lips with a hgb less than 8.

You lose the color in the skin creases of your hands with a hgb less than 6.

Not sure how easy this is to assess in a darker skinned patient, but works in lighter skinned folks.

[regionstraumapro]

Video: How To Remove A Chest Tube

There’s lots of info out there on how to put a chest tube in. But what about on taking it out? There are a few nuances that you should be aware of so you can do this as quickly and complication-free as possible.

Have a look at this 5 minute video and let me know what you think. Please leave your comments on YouTube.

[drdessertfox]

I suck at drawing but this was fun regardless

[srsfunny]

Biologist Humor

[pre-med-timelord]

Sometimes I think this is very true

[mylifeasapastudent]

[melodyinthemaking]

Rotations

(source:whatshouldwecallme)

[livingthepadream]

Rotation Chronicles #11 (The finale): Dermatology

What I like about dermatology: I like how derm is its own world but you still have to have a broad knowledge of systemic conditions, as many of them manifest with skin symptoms. 

What I didn’t like about dermatology: It’s really hard to be sure 100% what someone may have.

Fav things about my site:  The doctors were really nice and taught me a lot. Though there was not much medical dermatology, they tried their best to teach me common skin disorders. I also got to learn a bunch about proper skin care since this was a cosmetic dermatology office. (I have to step up my spf game yall). 

Not so awesome things about my site: This was a medispa dermatology office so most of what they did was cosmetic dermatology (botox, face lifts, lasers, cool sculpting, etc). Though I learned a lot, much of that info isn’t really helpful for primary care (aka where I want to work). It was also pretty far away from home. Most patients were really wealthy and privileged but most were very kind.

“Common” things I saw: Rhytides, rosacea, acne, actinic keratosis, basal cell carcinoma, squamous cell carcinoma

“Uncommon” things I saw: wegners granulomatosis, SLE, nummular psoriasis

Things I got to do: 1st assist with facelifts, blepharoplasties, brow lifts, biopsies, etc

Misconceptions: cosmetic derm does appear pretty superficial compared to other medical specialties, and in a way it definitely is. But some people who get cosmetic procedures have legit deformities or medical problems and just want to look “normal”. Even the patients who do this solely for vain reasons are really distressed by how they look and providing this service really makes them happy. I still am not a huge fan of this area, but I definitely acknowledge how society standards influence the growth of this industry.

Overall Thoughts: I really wish I had a medical dermatology rotation over this one. The way to get good at derm is to see tons and tons of rashes/lesions. I got to see some on this rotation but not enough for me to feel stronger in derm going into my first job. I’ll definitely want some more derm experience in the future.

And that’s a wrap! This was my last rotation. Next is board review, graduation, dreaded board day, and hopefully starting my new job soon :)