The first few months working as a physician assistant

Before I get started I want to announce that all my classmates, class of 2014 from the University of Manitoba, passed the national exam!!! We can now call ourselves Canadian Certified Physician Assistants (CCPA). CONGRATS!! 

The Transition from PA-S to PA what to think about 

1. Finding a job which I have :) I have wrote about my experience earlier.

2. Writing the certification exam (which I hope to get started on for review tips next year)

3. DEBT – I now constantly feel broke and my student loans are haunting me. If anyone has any advice on how to get a handle on that that would be welcomed! 

AND now the long awaited question. 

HOW IS IT LIKE TO OFFICIALLY WORK AS A PHYSICIAN ASSISTANT?

The First Month 

At first it seems like any medical rotation as a student but there are BIG DIFFERENCES

1.       You are now asked for orders
2.       You are now WRITING orders with no co-signature  
3.       Not writing/saying physician assistant student
4.       Your supervising doctor does not need to see all your patients

At times I felt...

1. more of a burden than a help
2. that I did not know anything

I realized that it will take time to learn (lifetime learning). You need to take it day by day. I would also find myself comparing my knowledge/work to the doc and be dissapointed in myself. But you have to realize that you can't compare yourself, the doctor has 6+ years experience where I was fresh out of 2 years of school.

The first month I was also studying for my certification exam so it felt like a lot of new things were happening at once. 

**The most important transition was learning how to work with your supervising physician. Trust and communication is the most important part of the PA – physician relationship. It is also important to know your own limitations and to ask for help when you need. 

3-4 Months as a physician assistant 

1. I’m more confident in my assessments and orders
2. I’ve started to feel that I am now actually helping the doctor (Of course there are days where I would ask my doc millions of questions) 
3. The staff is starting to know and feel more comfortable with my role 

MY TYPICAL DAY 

- 9 AM – I look at the new admissions on the medicine and surgical floor (Ranges from 0 –8  patients, average is 2-4. I try to do the most I can and the doctor and I split the load if there are a lot)

- Review new admissions with the doctor

- See patients I’m following. Currently I am responsible for the surgical floor which are normally patients who have one issue ex. pancreatitis, ulcerative colitis exacerbation, febrile neutropenia etc.

- I’m also responsible for any reassessments that come in for outpatient IV antibiotics. This includes assessing their need for IV antibiotics and if I can transition them to oral medications or end treatment.

What I’ve seen/managed/done 

NSTEMI

CHF
Pneumonia
Asthma exacerbation

Peds – (asthma, pneumonia, UTI, hyperbilliubinemia, etc)
Cellulitis
Ulcerative colitis exacerbation
AKI
Diabetes
HTN
Consults – cardio, neuro, GI, ortho, peds etc
Fractures
Electrolyte abnormalities
Palliative care
Dictate discharge summaries
AFIB
Bedside ultrasound
And you know how it is in medicine (most patients have more than one problem plus co-morbidities)

I’ve learned a lot and I have a lot to review and improve on. One advice I received on one my clinical rotations was to learn one thing a day. If you do that you would learn about 365 topics in one year. (I might be doing that every second day :P ) 

What I miss 

My classmates and having the support of the PA program. You don't realize how great having their support is until it's gone. Of course we keep in touch but we are not all at the same place anymore.

(Christmas/certification celebration with the ladies. We are now working in different specialties and don't see each other as often - nephrology, emergency, pediatrics and medicine)

 

I ALSO WANT TO SAY… CONGRATS to the first year PA students for completing their first semester of PA education.