It has been almost two months since I started PA school at Penn State Hershey. If I have been a little silent on this blog, all credit is given to the rigor of this program. We have at least four or five tests every week. And a single test can have hundreds of slides of information. Not to mention material from our books and lecture notes. One of the PA students in the class before me calculated it and figured out that they had right around 190 tests in their didactic year.

The biggest challenge in PA school is just getting started.

When you first arrive on campus, there is a rush of anxiety and excitement. Here you are, squarely at the beginning of the rest of your life. You know that the path before you is some of the most difficult terrain you have ever encountered. But you know that because you have talked to other travelers down that path. You have never experienced it for yourself. And no matter how ready you think you are, there is always a nagging feeling of self-doubt. A suspicion that out of the thirty or so students chosen for your program, they made a mistake in choosing you.

Trust me, if I can do it, then so can you. Just be prepared for this: the first month and a half of PA school, you will be in a constant state of adjustment. You are right in feeling unprepared. Because every habit that you have is about to be challenged. And I’m not talking just about the habits that you use to procrastinate. But also the habits that you use to study. There wasn’t a single student in my class who wasn’t caught off guard by this. The first three weeks, in particular, everyone was scrambling to figure out what was expected of them and how to study the massive amount of material that was being presented to us. Some lectures felt like a hurricane that had swept us off our feet and tossed us out into the middle of the ocean. There was enough material to drown in.

The best advice I can give is to quote the director of our program who tells us over and over again to: “Trust the process.” PA school will reshape you in ways you never expected. Workloads which once seemed impossible will gradually become doable. And the longer you keep at it, the better you become at mastering the material.

My biggest fear in the first month of this program was that I was passing tests but not learning the material. There is so much to memorize that I often feel as though I’ve learned it well enough to eek by on an exam, recognizing answers only when I see them listed in multiple choice. No way, though, that I could ever recall that information without it staring me in the face. However, our program has purposefully built in repetition to its curriculum, and everything you learn builds off of what you previously learned.

We started with the heart, since it is at the center of everything we do. (That is not just a cheesy marketing line, it really does determine how you treat and circulate medication to every other organ system). As we have moved through each disease process of the heart, the same medications come up again and again. And the same physiologic processes and EKG manifestations. With each disease we study, I feel like I am mastering the previous disease that I only knew dubiously when I took the test. And in about a week we are moving onto pulmonary medicine. As you might imagine, everything we just learned will continue to be relevant. Next term we will be delving into the details of interpreting EKGs. And then we will be dissecting the heart and learning ACLS and Emergency Studies. In short, by the end of this program, I have little doubt that the heart will be ingrained in my memory (and soul) and that I will feel well prepared for boards.

I mentioned that your study habits would change. Probably the biggest change you will experience is that you will focus on learning concepts rather than memorizing. Route memorization doesn’t help you as much as you think it would in PA school. Frankly there is too much material, and trying to develop memory devices for everything will drive you insane. And it won’t help you answer questions. Your eventual job will be to think critically about body systems and navigate a disease process the way you would a maze or a puzzle. Memorizing every medication name and anatomical detail is helpful, but it is not nearly as useful as understanding the relationships between structures and drug interactions. Because it is the relationships that are ultimately going to lead you to a diagnosis or treatment regimen.

The professors here are incredibly supportive of us. Out of over 2,100 applicants, they selected 30 of us to be in their program (again, makes me wonder how I am here). The staff demonstrates a great deal of responsibility and integrity in regards to that selection process. They know that their program is challenging. But they challenge us because they know that we can handle it (we don’t know we can, but they do). And also they know that pushing us will make us better PAs.

Even though the program at Penn State is new, the professors have a proven track record at a previous university. They know how to get 100% of their students to pass the boards. Unlike other programs that may cut struggling students in the last semester in order to retain a high pass rate and save face, this program chooses to support its students, taking responsibility for our failures as well as our successes. I was told at the onset of this journey that it was the faculty’s mission to make sure that all thirty of us walk across the stage at graduation. As tough as the workload is, I do believe them. What’s more, I believe that the degree that they place in my hand on that day will be worth more than if I had gone to any other program. I am amazed at how far we have come in two months. And I am proud that the ultimate benefactors some day will be my patients.