Failed As A Physician Assistant Student?

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Why I Failed Out of my Physician Assistant Didactic Class

First off, let me clarify.  By “failed out” I mean got moved down from the class of 2016 to the class of 2017.  Now here is the big question… why? Well, it essentially comes down to 0.15 points but I’ll get into that later.  First, let me give you some background info.  My name is Rachael Nasca, a Physician Assistant student at D’Youville College (DYC) in Buffalo, N.Y.  I am a traditional student which means that I got into DYC’s P.A. program right out of high school.  I choose DYC because I lived around the area, which made commuting to school an option, which has saved me a lot of money so far.  As a traditional student I had to complete certain undergraduate courses before I was able to start the 3rd year of the P.A. program, the didactic year which consists of all P.A. classes such as Clinical Medicine, Pharmacology, Physical Diagnosis, and more.  I did not have any college credits coming into DYC so I had to start from scratch and take all of the core undergraduate classes, electives, and certain classes that the P.A. program required.

Needless to say that was a lot to get done within two years but that is what I wanted to do.  This meant that I had to take the maximum amount of credits that I was able to fit in each semester in addition to taking summer classes.  I didn’t want my resume to be all about studying so I decided to start joining clubs and volunteering more.  One of those clubs that I had joined was the Alpha Lambda chapter of Lambda Sigma, DYC’s chapter of a national sophomore honor’s society.  I really enjoyed this club and I even ended up becoming president of the chapter.  I was loving life, loving the volunteering, the club, and all of the classes that I was taking.  Then didactic year started.  I knew it was going to be hard, I had heard the horror stories about students staying up all night studying most of the nights.  With this is mind I decided to prepare, I took time off from my job as a lifeguard so I would only be working during school’s breaks and would not have to work during the semester at all.  It would be pretty hard to work while being in the didactic year anyways seeing as we had class scheduled from 8 AM to 5 PM every day which didn’t leave much wiggle room in terms of free time considering we still had to study from 5 PM until whatever time you fell asleep.  I heard that only a few managed to work during the didactic year but I didn’t even want to take the risk seeing as I usually had to spend more time studying for things than other students did.  Entering into the didactic year I had a cumulative GPA of about a 3.7 which I didn’t think was too shabby so I thought I was in pretty good standing.

Physician Assistant Student

The first day of classes I arrived about 40 minutes early and already a ton of the seats were taken.  I was very surprised and came to find out all of the early birds had a good reason for doing so, the seat that you sat in that day would be the seat that you were expected to sit in every day, for every class, for the rest of the semester.  I am more of a second row person but seeing as many of those were already taken I opted for the very first row.  That was my first mistake.  Yes, it was nice not to have to try and break your neck every time that tall person in front of you shifted in front of the PowerPoint but the front row was just very stressful.  I was so close to the professor for each two-hour class and I felt like I had to look extra attentive all of the time.  I also wasn’t able to whisper to my neighbor “Hey… do you have any idea what the professor just said about this slide? What drug is the drug of choice for this disease?” as much as I could have further back in the room.

What also took a lot of time was adjusting my study habits to the time constraints that I now had with my days.  I was always a big fan of rewriting things a certain way or using different colors to help me memorize things but as I found out there just wasn’t enough time to do this for everything.  Looking back I really shouldn’t have wasted as much time as I did rewriting things, I should have just highlighted in different colors or something.  A friend (who also liked to rewrite things) and I thought we could solve this issue by splitting up the work half and half but then there came the issue of scanning the handwritten documents into the computer to email it to each other when we were done and that just became too much of a hassle so we decided to type the documents.  That was my second mistake.  I was able to learn so much more from rewriting the slides by hand instead of just typing them and I knew this yet I continued to keep typing the documents, which was really a waste of time and didn’t help as much as the writing did.  Not to mention the added distraction of having the internet to help “take a quick break” as compared to taking a productive, and much shorter break, of getting up, stretching, and maybe grabbing a light snack.

From the start of the semester, I had always struggled with pharmacology.  Why? Probably a variety of things ranging from the fact that it seemed like a foreign language and that I had trouble remembering all of the different types of one class of drug and which situation they were best in. I would often mix up the drugs and which was best when.  Since the first couple weeks of exams I knew that Pharm was going to be the one that I would always have to study extra for and spend more time on.  That was my third mistake.  I was focusing too much and worrying about pharm too much that I started to forget about how important the other classes were as well even though I was doing much better in those classes.

By the end of the semester I was able to pull my Pharm grade back up where it needed to be, not by much but I was safe.  But by the time I was able to get my pharm grade up, my Clinical Medicine grade began to slip.  I was hovering around 80 which was the grade that was needed to pass the class.  After taking the cumulative final exam I found out that I did not do well enough on my final and my grade for clinical medicine was a 79.85 and that was not good enough seeing as an 80 was needed for passing.  Yes, 0.15 points, so many things were running through my mind…. should I have fought harder for that one question on that one exam that I thought I got right due to the wording but my professor disagreed? Should I have stayed up that extra hour the night before the exam to study more? Should I have spent the night in after that Pharm exam and study for the Clinical Medicine exam next week instead of taking a break for a night? I couldn’t believe that my progression in the P.A. program would boil down to 0.15 points.  But… there was hope.  My P.A. advisor told me that since I was so close the board had decided to allow me to take a remediation exam which was a cumulative exam, just like the final was but I would have to score a minimum 85%.  I had already planned to go on a cruise with my boyfriend and family so I had to take the remediation exam about a week earlier than planned.

For the days up until the exam I studied a lot, and became very, very nervous.  After taking the exam I didn’t think it was completely horrible but I was unsure on how I did. I was not able to find out my grade until about 5 days into my cruise.  So I payed the ridiculous amount of money it is for the few minutes of internet I did use to open up my email and find out that I did not score well enough on the exam to continue on in my class of 2016.  But I was not kicked out of the P.A. program, thankfully I was allowed to move down into the next class but that meant that I had to take a leave of absence from school for the spring and summer semesters until I returned in the fall to retake that one class.  The paperwork for all of this was very obnoxious and lead to a lot of running around and office employees saying things like “Are you sure that you want to do this? You are so close to finishing!” and I then had to rant on about my situation and how I really didn’t have a choice in the matter unless I just wanted to take classes for fun (Ha… not with a private school’s tuition, no thank you).  I printed out the email whilst crying in the cruise ship’s internet cafe…. yeah I looked and felt like a mess.  I was very thankful for my boyfriend who was able to collect the mess (me) and my belongings and bring me back to our rooms where I told my family of the bad news.  Overpriced cocktails followed very shortly after.

Keep an eye out for my next blog about how I got back on track and prepared for retaking Clinical Medicine!

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John Bielinski, Jr., MS PAC is a practicing emergency medicine clinician, and has been lecturing nationally for more than ten years, teaching the tactics that have proven invaluable in his career as a medical professional.
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