'I’ve got this’: Physician assistant student reflects on growth during clinical rotations
Q&A with Cole Kitzman, second-year physician assistant (PA) student
What was the first day of clinical rotations like for you? Were there any surprises?
On my very first solo patient, I thought I totally blew it when I mispronounced the patient’s name. Then, she asked me a question about birth control, and unfortunately, I had no idea what the answer was. Luckily, she was nice about all of this and didn’t immediately demand to see my preceptor. By the end of the rotation, I could confidently answer 95% of questions about different forms of birth control. I feel like I really grew as a future clinician and realized, “I got this.”
What’s been your favorite hands-on learning experience so far, and why?
As part of my internal medicine rotation, I followed patients in the adult medicine clinic and in the hospital when they were admitted. One patient I met was hospitalized for cholangitis secondary to choledocholithiasis. I got to care for her every morning for a few days in the hospital and then got the opportunity to watch her ERCP [endoscopic retrograde cholangiopancreatography] procedure to remove the stone. The ERCP procedure was extremely interesting, and the doctor performing it explained to me what he was doing as he removed the stone. A week later, I got to see the patient in the post-op clinic, and she was doing much better. It was very rewarding to be able to follow a patient from the inpatient setting, to the surgical suite, and then follow up with her in the outpatient clinic.
Was there a specific moment when you felt, “Wow, I’m really becoming a PA?”
In didactics, I struggled with auscultating heart murmurs and thought that there was no way I would ever be able to hear one of those things on a real person. Early in my internal medicine rotation, I was doing a quick physical exam on a patient and then caught a real heart murmur. It wasn’t a new finding, and the patient already knew about it, but I was proud of myself for proving that I could catch one all by myself in the field.
Have you had a tough day where you questioned yourself? How did you push through?
We were running late one day on my internal medicine rotation, and the days were already about 10 hours long. We had a patient who had a very complicated concern about whole-body numbness/tingling, fatigue, and weakness. She already had multiple ER trips and seen multiple clinicians and had now come to the clinic for a second opinion. I wrote what seemed like a novel of a note trying to get the various aspects of her story down, but when I went to present the case to my preceptor, it just kind of all came out of my mouth in a confusing mess. I stopped in the middle of my presentation and apologized to my preceptor for being so disorganized in that moment. I was really down on myself. But then, my preceptor encouraged me not to overthink things. That advice still helps me today and reminds me to trust myself more.
What’s a skill or procedure you were initially nervous about but eventually mastered?
I was very nervous to do joint injections on my ortho rotation, mostly because I was afraid of hurting my patients and because I have never been a big fan of large needles. However, I got pretty good at them on my rotation and feel a lot more confident now. More importantly, I’ve built skills in strengthening rapport with my patients in those moments, which really helps patients to relax, trust me, and improve their health outcomes.
Credit to Marc Doobay, MPAS, PA-C, DFAAPA, for authoring the original story.