Third Semester at UT Southwestern

Third Semester at UT Southwestern

They say that the further you move along in PA school, the tougher it gets, and “they” are right. In light of the fact that it is only our third semester, this has been the busiest one, for sure. It feels like we had just started the GI block, but before long we had completed neurology, orthopaedics, endocrine, and nephrology/urology. Alas, we received information about our clinical rotations beginning in the fall about 2-3 weeks ago and I am ecstatic. Not only that, but I now have my very own little. If you were unaware, our program has the big/little system. I am able to pass down helpful information and books to my little to help her navigate through PA school.

This semester more than any other I have felt our class really pulled together more like a family. We are all so helpful to one another and provide links, tables, reviews, Quizlets, etc. to help one another get through the semester. It makes it that much easier to be a PA student and lead a somewhat normal life. Team-work is the key to success in PA school.

Our social chair has done a great job of celebrating birthdays once a month and raising funds for any wedding gifts throughout the semester. We even held a faculty and staff appreciation breakfast at the end of the semester. Toward end the semester, one of our classmates graciously hosted a end of semester party at her place and everyone was able to come out. I can’t wait to see what the rest of our didactic education has in store for us, but until then, we are now second year PA students and it feels so good!

End of semester shenanigans. Class of 2016. 

MPA 5130 Evidence Based Medicine

This semester we were introduced to the foundations of research in a course taught by Tiffany Kindratt - soon to be Dr. Kindratt. She is a new professor to our department but has worked with ARC-PA and has vast knowledge of PAs, although not one herself. She is a research guru and was very open and knowledgeable about any questions we had throughout the semester. This course had in-class and out of class assignments to complete, but nothing that was overwhelming. A few in class worksheets would be completed in groups. In this course we learned about the different levels of evidence and study designs, how to develop our own PICO/PECOT questions, how to determine internal and external validity, bias, and confounding variables and a basic understanding of statistical tests and when to use them. We learned about sensitivity, specificity, how to estimate risk, incidence/prevalence, relative risk and odds ratio, likelihood ratios, prognosis and harm studies, and we wrote a POEM. Not an actual POEM, but a Patient Oriented Evidence that Matters Project. I think the idea is that we will eventually write more of them in the coming months during clinical rotations, so this class prepared us for that. We had a final exam that was comprehensive, but we were provided a review and since this semester was based on team based learning, we took the final alone and then as a group and averaged the two grades for our final grade. It took a lot of pressure off of us, but this information will actually prove to be useful in the future with PI-CME, etc.

MPA 5510 Clinical Medicine II

Clinical medicine began the semester off with 4 weeks of gastroenterology. You’ll never wish to learn so much about diarrhea in your life, but you forget that the GI system encompasses so much more than IBS/IBD. You have hepatobiliary disorders and LFTs to interpret as well. Next was 3 weeks of neurology. This block began with a review of neuroanatomy and delved into movement disorders, headaches, seizures, and cerebrovascular and neuromuscular disease. Next was 2 weeks of orthopedics and 1 week of rheumatology. Orthopedics included a review of how to read basic x-rays, including examples of the “normals” which helped us to compare our anomalies to something. We learned how evaluate each of the joints and each type of arthritis. We also learned about splinting and casting with the caveat that we would learn and perform both in the summer. The rheumatology block included more about rheumatoid, spondyloarthritis, JIA, crystal-induced arthritis and vasculitis, scleroderma, myopathies, and SLE. It seemed like a lot to cover in one week, but our main lecturer, Daytheon, did a great job condensing the information to the important points to remember. Finally SPRING BREAK! Then came 2 weeks of endocrine which encompassed lots and lots of diabetes and diabetes complications. Just when you thought there wasn’t any more to know about diabetes, surprise, diabetes! I know this information will be super helpful in rotations. Every forum I have read has students saying that they felt super unprepared for their diabetes patients in rotations. We also covered pituitary disorders, thyroid and parathyroid/calcium homeostasis, and adrenal disorders. The last 3 weeks were in nephrology and urology. This was probably the most unique block as it encompassed the most team-based learning. We worked in groups to create presentations and presented the material to the rest of the class. Prior to the lecture on glomerulopathies, we were given the powerpoint and information to self-learn. We then took a quiz by ourselves in class and then as a group afterward. We averaged the two for up to 4 points added to our final grade, which helped so much! We learned lots about the kidney, acid-base disorders, kidney stones, incontinence, UTIs and pyelonephritis, IV fluids, hyper/hypokalemia, hyper/hyponatremia, prostate and other male GU disorders.

MPA 5206 Patient Evaluation II

The great thing about patient evaluation was that we had the same preceptors as the previous semesters and I loved mine! The concept was the same as the previous semester - we would practice either on one another or on a simulated patient for 2-3 weeks and then take the physical exam with 2 “stations” where we answered questions relevant to the diagnostic information we were being tested over. We spent 2 weeks on the abdominal exam, 2 weeks on the neurological exam, 2 weeks on the musculoskeletal exam, and had 2 weeks to prepare for our final integrated comprehensive physical final exam. The comprehensive physical exam seemed daunting at first, but it wasn’t as bad since we had basically practiced half of it at the end of last semester. It will help us with patient evaluation 3 when we will be required to perform a full physical exam with patients each time to sharpen our skills. In addition, this semester included an arthritis lab and glucometer/insulin lab. In these, we met with patients with different types of arthritis who were certified to teach us about their condition and allowed us to observe and palpate the manifestations of each. In the glucometer/insulin lab, we learned how to utilize each so that we can educate our patients about them.

MPA 5216 Pharmacology II

This semester of pharmacology could not finish any faster. I am personally not a fan of pharmacology, although our professor does a fantastic job of conducting it. The same format as last semester - we had 4 exams and 3 correlates with an additional pain management assignment to replace a correlate grade. The first exam covered GI drugs and drugs of abuse, hepatitis drugs, and dietary supplements. The second exam covered CNS medications (anti-epileptics, headache meds), rheumatologic medications, pain management, and multiple sclerosis medications. The third exam covered poisons and toxicology, polypharmacy and geriatrics, and women’s health/contraception, and hormone replacement therapy. The final exam was over diabetes medications, thyroid/parathyroid medications, IV fluids, and urology medications. Overall, it wasn’t that bad of a semester, but I am overjoyed to never have to take a pharmacology test again! I don’t mind drugs, but some times I felt overwhelmed with the amount of information since it was all so new to me. As a PCT (my healthcare experience prior), I was never exposed to a lot of these drugs. Learning the names and what class was honestly the hardest part. As I said before, our class was so good about creating Quizlets and sharing tables with one another for these exams. It made it super easy to study for the exams and those Quizlets will be there for future PA classes to use now.

MPA 5103 Integration Skills II

Integration skills changed for the better this semester. We still had a few cases where we received information, we made a differential diagnosis and explained why we chose them, and we had to write about 4 SOAP notes in class after receiving additional information about the “patient.” Those SOAP notes were typed, but no template was provided. We had to write out a SOAP as if we had just interviewed the patient, forcing us to remember characteristics we had already obtained and integrating new information into the HPI. We had to then formulate a suspected diagnosis in an assessment and plan for the patient. For our oral presentation weeks, which alternated with the weeks we wrote SOAP notes, we would watch  recorded interview with a professor and a “patient.” After gathering pertinent information, we would present orally to our “attending physician” the day of in the proper format. We also had a few class days where we just had a pre-class assignment and then we discussed the information we were covering in clinical medicine in detail. A few examples included the LFT and hepatitis serology tables and a hypertension diagnosis and medication review. We also took a class day to “deliver bad news” to one another. We practiced scenarios where you would deliver bad news to a patient, including telling a patient they were diagnosed with type 1 diabetes and would be on insulin therapy for life. Not every patient will be a cancer patient and it was helpful to role play with each other and see how patients can react in different ways to bad news and to know how to respond. In Integration Skills we also practice our Review of Systems so that by the end we would take a comprehensive ROS quiz, helpful for interviewing our patients about their presenting complaint.

MPA 5204 Clinical Prevention & Population Health (CPPH)

CPPH was taught by professor Kindratt and Dr. Dekat (the former course director). This class is geared toward learning about disease prevention and population health. Classes included smoking cessation, health literacy, stress management, nutrition, domestic violence awareness, travel medicine and vaccinations, health department resources, cancer screening and prevention, oral health, clinical diabetes education, complementary & alternative medicine, social determinants of health, cultural issues in patient care, prevention and screening in the elderly, and exercise. Built into the class was a luncheon with the nutrition students where we had previously sent them a 2-day log of our food intake. They took the information and presented a plan for how we could change our diet to improve it. The luncheon was prepared by nutrition students and they also had a workshop with additional information for us to educate our patients about including weight loss. Later in the course we were “diabetes patients for a week” in an experiment where we received a letter and bag of “medication” similar to what a newly diagnosed patient would receive. We tried to see if we could understand how to use insulin as prescribed without any prior education, including taking our blood sugars with real glucometers. It was a great experience and I don’t know how real diabetics do it! They are truly dedicated. I learned a lot and afterward we had the diabetes educator teach us all about insulin use and glucometers in patient evaluation. It was a great intro to the diabetes/endocrine block. There were 2 exams in this course but both were open book/open note, so this class was more about learning than adding additional stress to our workload.

HCS 5106 Professional Development II (IDEAL)

This was the second semester of IDEAL. It had a lot more interaction with patients and the other health professions including medical students, nursing students from TWU, radiation therapists, clinical nutritionists, prosthetists and orthotists, rehabilitation counselors, physical therapists, and of course, physician assistants. One of the first activities of the semester was a Nursing Home or Assisted Living Facility visit with a medical student. For us, we were expected to interview the patient and perform a physical exam with the aide of the medical student. The next major activity was  a clinical skills session where we were put in groups with different professions and had to admit to a “medical error” and figure out how to approach the patient’s family about the error, etc. The course also had a lecture series about geriatrics in which they presented a case scenario and each profession talked about their role in the care of the patient from the scene of the accident to the post-op care. The Capra Research Symposium this year focused on Alzheimer’s disease diagnosis and treatment and featured many leading professionals in this topic. Convergence Day finally came where we converged with everyone and learned about the value of interprofessional teamwork - the basis of this course.

This semester I took on the “role” giving campus tours, which was a nice extra source of income. I came upon the job through the Dean’s office. They actually had me start during winter break and I continued into the semester and gave them times between classes to give one hour tours and only gave tours when people booked them. The nice part was that I still got paid even when people didn’t show up. Free money is always appreciated.

I don’t want readers to think that students don’t just have time for the program. This semester, many of us also participated in the Dallas ISD Divisional Science Fair, and a PA Suture Clinic as well as the largest health fair called United to Serve held at T.J. Rusk Middle School.