It is hard to believe that didactic year of PA school has finally come to an end! Even though ‘time-wise’ I am only halfway through this journey, I know that in terms of stress and workload, I have made it to the top of the mountain. The remainder is downhill.

When I first started this program my roommate (a second year student) told me that by the time I finally figured out how to study for exams, didactic year would be over. To an extent, he was right. The past year has been a constant struggle. I have changed my habits and strategies more times than I can count, sometimes dramatically altering my approach to cope with the shifting curriculum and massive workload.

You want to hear a crazy statistic? In one year we have had exactly 200 exams! (Tell me that sentence doesn’t deserve an exclamation mark). Week-to-week ranged from anywhere between 2 exams (hallelujah-weeks) to 9 exams (affectionately referred to as ‘hell-weeks’).

Even with all of the changes I made to my study habits, I’m not sure I ever found a method that ‘worked’ to prepare me for all of these exams. The bitter fact is that there will always be more work than is humanly possible to handle. Of course, I am speaking for us mortals. There is always one or two students in every class who get near-perfect scores on every exam and never seem to break a sweat. But, when you ask them, even they feel overwhelmed.

The most stressful thing about first year is that there is ALWAYS something hanging over your head. You finish one ‘hell week’ of 7 exams and 2 all-nighters and feel exhausted and depleted. You know in your heart that you deserve a break (and a chance to catch up on sleep). But in the back of your mind you are already worrying about the 3 exams next week and that annoying essay you have to write for ethics class.

I always try to provide advice in my posts to give you a leg up in PA school, but honestly there is nothing I can say to prepare you for this. Everyone in my class had to figure things out for themselves since we are all unique in our strengths and weaknesses. Most of us wound up with very different routines.

That being said, I did my best to create a list of 10 general tips below. Some of this advice is my own, and some of it I have heard from my peers. I think all of it is extremely valuable and, if you manage to do all 10, you may find yourself thriving (as opposed to surviving) in PA school.

  1. Know that the first month of school will be the most difficult month of your life. Having never encountered this workload before you are going to struggle this entire month to adjust. You will slowly figure out what is expected of you and how to study for each of your classes. Since every professor is different, there is a lot of figuring out to do in this month. Prepare to cry. Prepare to cram. Prepare to fail. Prepare to question why you are in PA school.
  2. Remember that you were chosen for a reason. Out of thousands of applicants, they chose you. Yes, it is a little hard to believe sometimes, but the faculty knew what they were doing when they made that decision. They saw something unique in you that is going to make you a great clinician. Do your best to discover what that is and build on it. When you struggle and begin to doubt yourself, think about that strength and remember why you will be a great PA. The rest will come in time.
  3. Make friends with the upperclassmen. I mentioned earlier in the post that my roommate was a 2nd year student. That was a huge benefit going in. He gave me some direction on what to expect from different teachers and how to study for tests. He also let me borrow all of his books (thanks Doug!).
  4. Keep up with the material. This may seem obvious, but honestly it is one of the hardest things to do. The temptation is to put all of your energy into the next test (whatever that may be) and ignore the new material coming in. If you focus on the new stuff even for just an hour or two every night, your anxiety level will go down and you will retain more material than you would just cramming for tests.
  5. Make time for yourself. Again, it seems obvious but you will often forget to do it. Especially the first month of the program, I did nothing but stress over studying every single night. When I met with my academic advisor, he challenged me to create a new rule: never study on Friday night. Give myself that one night a week to relax and regain my strength. I also began reading from a novel every night before I went to bed. Even if I only had time for a single page, I forced myself to read at least something. I love literature and did not want to lose that connection. By the end of the year, I even found time to write a little fiction/poetry again.
  6. Don’t ignore your health. Admittedly, I did a terrible job of this didactic year. When I entered the program I was at the gym 3+ times per week lifting weights or doing cardio. I went out for runs around campus and was planning to join the Penn State Running Club. After a few months of school, my level of activity had slowly declined. I was doing my best to get to the gym once a week. I was stress eating and gaining weight. I also was not sleeping at night. By the start of 3rd semester I had all but given up. I was completely sedentary, either sitting at the desk in my apartment or in the library. I did at least change my diet 3rd semester and lost most of the weight I had put on. Don’t ignore your health like I did. It was not worth it. Some of my classmates would jump rope in their apartment, do pushups while studying, or go out for a 15 min jog every day. One annoyingly trained for, ran (and won) triathlons throughout the year and still did well in school.
  7. Make room for your relationships. I had the extra challenge of maintaining a long-distance relationship throughout PA school. We were both initially worried that the experience might drive us apart, but instead it brought us closer together (now engaged). I did my best to make time for her every night, whether it was a 30 minute phone call or studying on Skype while she did freelance work or watched TV. In the end, it was much more of a benefit than a challenge to have someone so understanding and supportive in my life. Also, pick up the phone and call your parents/siblings/friends every once in a while. It is easy to get wrapped up in the world of exams and forget. They are also your allies in this. Even if they are hundreds of miles away, you will not survive PA school without them.
  8. Work as a team with your peers. Each one of us in our program has a different background in medicine as well as different strengths and weaknesses as students. My classmates have been an invaluable resource over the last year. So if you are studying pulmonology, it may not be a bad idea to talk to the respiratory therapist in your class. When you study the musculoskeletal system, hit up the athletic trainer, etc. Also, create a Google Drive and share notes. I posted every set of flashcards I made, regardless of whether or not my classmates contributed. Remember that this is not a competition. If you have made a study guide, you might as well share it. It is worth it if it helps even one of your struggling classmates pass.
  9. Don’t be afraid to ask for help. As much as the faculty has pushed us, they have also been supportive. They want to see you succeed. In fact, they may take it as a personal failure if you do not. They understand that you are stressed out and depressed. Remember that the faculty has been through this gauntlet too. Also reach out to your peers, family members, significant others, mentors, and consult a therapist if needed. Whatever you do, do not try to face this challenge alone.
  10. Finally, don’t put all of your focus into your grades (easy enough to say, I know). The end goal is not to graduate with a 4.0 GPA; it is to be a good and compassionate clinician. Never forget that. If you memorize information solely to regurgitate it on a test, you are going to forget it in the long run. Learning and interacting with the concepts is what will give you the most benefit when you enter your clinical year (even if it doesn’t give you the best grades). Also, if you can find the time, go shadow people and volunteer at the free health clinic. Yes you may lose valuable study time, but it will get you closer to the actual goal of becoming a good clinician. And it may yield a little extra motivation by reminding you of why you are putting yourself through hell in PA school.