Monday, August 3, 2015

Fourth Semester at UT Southwestern

Fourth Semester at UT Southwestern
Updated: 08/03/2015
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Finishing didactic is probably one of the most bittersweet and alleviating feelings you have ever felt in your life; there really isn’t another comparison, unless passing the PANCE feels the same way or better. Although this semester may have had a less demanding class-schedule and less courses than previous semesters, there was definitely enough work to be done. Between SOAP write-ups, seeing patients in the hospital or in a controlled (OSCE) setting, or preparing for exams, there was never a dull moment. This semester felt like one of the most rewarding because we finished our didactic education - now it is time to review everything, hammering the material in, and ensuring we are competent providers when we graduate.

MPA 5511 Clinical Medicine III
Clinical medicine began with OB/GYN, continued with emergency medicine and surgery, and finished off with a nice review of all systems in pediatrics. 3 exams in this course were averaged for our final grades, but I believe next year our faculty are considering splitting OB/GYN and possibly pediatrics into 2 exams each since we spend about 4 weeks in each. Emergency medicine and surgery flew right on by in mere 2-week block. At the end of the clinical medicine course we took the PACKRAT (practice PANCE), which we used as a marker to determine how much knowledge we have retained thus far. Everyone in our class passed the PACKRAT (passing score is at least a 110/225).

MPA 5208 Clinical Skills I
Clinical skills was a really fun course that integrated lots of useful hands-on lectures, such as SAMA training, injections and IVs, knot tying and suturing, BCLS and ACLS certifications, and casting and splinting. We also had a short introduction to coding and billing. The basis of this course was to learn and interpret basic and advanced (12-lead) EKGs and radiographs, including CT scans and MRIs. The overall course was pass/fail (>70), but we had minimum grades to make on exams.

MPA 5307 Patient Evaluation III
Patient evaluation was not the same as previous semesters. Instead, we integrated our clinical skills we had practiced in the past and took full history and physicals on patients at Clements University Hospital or Parkland Memorial Hospital every other week. We would write-up full SOAP notes and present orally to our “attendings” the following Monday. We were broken up into small teams of about 6 and had an individual instructor (licensed PA) critique our oral presentations and write-ups. On weeks when we weren’t seeing patients, we had OSCEs (objective structured clinical examinations), which were history and physicals with simulated patients. In addition, on OSCE days, we had to complete a full hand-written SOAP note in 15 minutes and 15-minutes for a third station which was over review material from previous semesters. There were 5 minute breaks between each of the 3 stations: the interview, the write-up, and the “review” station. Our OSCEs were recorded and we were required to sign-up and view them within the next week to see how well we interacted with patients and to notice if we had any bad tics, shakes, or stuttering (umm). It allowed us to make changes every time we interviewed a new patient to work out the kinks in our own H&Ps. These OSCE stations were not meant to be difficult; they’re meant to serve as a review to gauge what we know and remember from other blocks. The diagnoses were common and were what you’d consider “bread and butter” medicine.

MPA 5231 Psychiatry
Psychiatry integrated clinical medicine and pharmacology and included a midterm and final over the entire course of 11 weeks. The exams were not difficult, but YouTube videos and the textbook definitely aided our understanding of the conditions we learned about. If you have never taken psychiatry before, you’ll soon realize just how difficult it is to differentiate many disorders from one another. My best advice in this course is to utilize online resources and create acronyms to help you remember the characteristics that are diagnostic.

This semester a group of students from our class, as well as the class above us, attended the AAPA conference in San Francisco. We all learned a lot from it and were able to bring back our experiences to encourage more students from our program to attend next years national or state conference. We also attended our little’s white coat ceremony where they took the PA oath and donned their white coats. This year we had current TAPA president Elias Villarreal, Jr. as a guest speaker. The Class of 2016 ended the semester with a boat party to celebrate completing didactic and it was a remarkable experience spent with significant others and ended with fireworks on the Lake Lewisville.

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