I remember sitting in my advisor’s office during our last official meeting of the didactic year. She was telling me how well I had done over the past year and that I was ready to start seeing patients. I remember thinking that she must be mistaken. While I was excited to start clinical rotations, I was scared and worried about what to expect. The first year of PA school went by incredibly fast, and I didn’t feel confident and ready for the next step. Will I remember how to perform a physical exam? Will I be able to impress my preceptors? The challenge seemed insurmountable, but I was eager to push myself out of my comfort zone and see what the clinical year had in store for me.
Now I am on my fourth clinical rotation of the year: Internal Medicine. While some of my classmates spend this eight-week rotation at one site, mine is split between the clinic and hospital settings. My first four weeks have been at an outpatient clinic in rural North Carolina. Most days I wake up around 5:00am to give myself an extra couple of hours to exercise or study before I need to get ready to go to the clinic. I report to the clinic at 8:30am and check the schedule for the day. I generally see three patients in the morning and three in the afternoon. My preceptor has me see the patients first to get a thorough history and physical exam. While I am interviewing the patient, I am documenting their visit on the electronic medical record system. When I am finished, I present my findings to her, and we go see the patient together to complete their appointment. Throughout the day, my preceptor will ask me questions about the patients’ conditions and challenge me to decide what I would do to manage them, specifically what I would do for them today at this visit. If I don’t know an answer, my preceptor will discuss that topic with me and have me research more information about it. However, I am constantly surprised at how much I already know and can apply to my clinical experience. My day at the clinic ends around 5:00pm, and I make the 40 minute drive back to Durham. After I eat dinner and get settled in at home, I study again for another couple of hours and log the patients I saw that day before I finally get into bed.
Having a background in health education and an interest in family medicine practice, I am so glad to get the opportunity to work in a setting where I get to integrate both of these disciplines. Most of these patients have multiple chronic diseases, such as diabetes and hypertension, and return for follow-up appointments to monitor their progress. I am humbled by the amount of work and time it takes to review each of their comorbidities and countless medications. During our discussions, some patients are honest about their health pitfalls, while others are completely unaware about how to better their health outcomes. I am eager to teach them anything I can, and they are always appreciative of the time I spend with them. Any time that I feel overwhelmed with my studies or discouraged in my abilities as a student, I remind myself that I am incredibly fortunate to be able to share my gifts and training with my patients.
While writing this and reminiscing on my PA school experience thus far, I can say that my advisor was right. While there is still a great deal of information for me to learn, I can gradually see myself gaining independence and growing into a confident provider. I am grateful for the educational experiences that the Duke PA program has provided me, and I look forward to the new rotations and challenges ahead.