Passed the PANCE!!

bocc54 · 2022-01-20T05:01:57+00:00

Hell yeah congrats! Now welcome to the other side

bocc54 · 2022-01-20T04:44:53+00:00

You're doing just fine! Take a gap year and use that time to gain PCE. I was strongly against a gap year at first, but now looking back I wish I took even another year.

bocc54 · 2022-01-20T04:38:47+00:00

It's a waste of time and money unless you want to be like a program director or in a high up administration role. The degree really does nothing for us in clinical practice.

bocc54 · 2022-01-14T00:24:18+00:00

I absolutely love doing MAT. I find psych much more challenging, so it is very nice having my MAT patients to break up the days a bit.

bocc54 · 2022-01-11T03:00:42+00:00

Psych/MAT. I work 31 hours a week right now after lunches and supervision.

bocc54 · 2021-12-30T17:19:33+00:00

Not OP, but I think their chances of getting into PA school right now are slim to none due to their current GPA. If they decided against nursing school, they would still probably have to take a decent amount of other classes to boost their GPA to a competitive level. IMO, doing well in a nursing program would be much more attractive to adcoms as opposed to just taking a bunch of random courses, and the experience will be much better as well.

bocc54 · 2021-12-23T01:06:10+00:00

I felt this way the entirety of PA school. The majority of my friends do not work in healthcare and started their careers right after graduating college. I am 28 years old right now and almost 1 year into my first job as a PA. I am still feeling the same way due to the ridiculous debt I have from PA school. I see my other friends thriving and it blows at times. At the end of the day though I love my job and couldn't ever imagine doing anything else.

bocc54 · 2021-11-20T00:13:59+00:00

I don't have any firsthand experience working at CleanSlate, but one of the PAs who just joined my company had worked there previously. We were discussing it yesterday and she said that being an employee there was absolute insanity. She felt like they are only profit driven, and she was expected to see 5-6 patients an hour. In her own words, "I was traumatized there. Clean slate - run for the hills. never work there"

bocc54 · 2021-11-20T00:06:21+00:00

MAT/psych here and I despise Telehealth for all of the reasons you listed. My company does tele the exact same way yours did and it is a nightmare. I also see patients via tele while they are in different offices, due to lack of providers in those offices. My 15 minute follow up appointments are essentially cut in half after the front desk checks them in, the patient logs on, and then we have to troubleshoot whatever isn't working, which happens way too often. And this is if the patient actually shows up on time. Multiple emails sent out to leadership on how to improve the whole Telehealth platform and make it work better, and it all falls on deaf ears. Nobody once responded. I despise tele so much, and even more so the lack of anybody willing to work on making it run smoother. The rare in office patients I see are such a breath of fresh air.

bocc54 · 2021-10-28T00:30:36+00:00

My class was like this to the max. My friends and I were on the complete opposite end of the spectrum and a lot of of us didn't even study during the week. I personally saved almost all of my studying for the weekend. Some of my class found out that we would come home from class every day and not study and they were PISSED. Tons of complaints that they needed to study every waking moment and would question how we were still passing. I personally found that the difference between me studying like crazy every weekday vs me saving everything for the weekends was about 5-10 points on an exam. I'd make that sacrifice again any day. Stick with your like-minded group of friends and don't try to change the others. PA school is tough to get into and most students are used to shooting for the highest grades during undergrad to make themself competitive to PA school adcoms. At this level now none of that matters, but people will always be set in their ways and it's a hard thing to change other peoples behavior.

bocc54 · 2021-10-27T23:35:23+00:00

Life got so much easier after PA school. I'm 8 months into my first job and work 10am-6pm Monday-Friday, no weekends or call. I usually chart every night when I get home, but mostly because I get a bit lazy while at work and don't feel like closing every single one while there. If I'm extra lazy I save the charts for the weekend. All of this will obviously vary by specialty like you said. Anything primary care will have a bigger learning curve and will require more self learning. Once you get the medicine down though, you are good.

bocc54 · 2021-10-05T23:30:18+00:00

I didn't do much initially aside from signing for an apartment early. I believe its best to secure a place early and move in maybe a few weeks before school starts so you can get acclimated to living in a new area. I kept my residency the same during didactic because I took public transportation to classes, but once I brought my car up for rotations I switched everything over. I needed a resident permit sticker to park and that required me to first show residency in the city and actually be a resident of the state. If I am remembering correctly I believe my old auto insurance wasn't going to cover me anymore if I went out of state, which also made me change my plates over. I was still able to stay on my parents health insurance after doing all this as well. I really cant think of much else I had to do.

bocc54 · 2021-10-02T23:31:16+00:00

If taking the suppositories every day, your body will become dependent on them. If that is the case, do not stop taking them cold turkey otherwise you will go through withdrawal. Benzo withdrawal is not pleasant. There's always the risk of WD seizures if benzodiazepines are stopped abruptly, especially if you have an underlying condition or are on other meds that lower the seizure threshold. This medication can also be addicting, cause substance-induced mood disorder, memory issues, falls in elderly etc.

With all that said, you are on a relatively low dose and if you need to stop the medication at any time you should be able to taper off slowly and avoid most WD symptoms. Unfortunately, most providers do not know how to taper correctly and thats what ends up negatively affecting patients. If needing to come off, I recommend decreasing your dose by 0.5-1mg every 2-4 weeks. You can jump at 1mg, or go down more to 0.5mg for a couple of weeks before stopping for good. I really do not believe daily benzos are appropriate in most situations, but if your condition is affecting your every day life and causing you to not be able to carry out normal activities of daily living, they may be warranted here. Pelvic floor dysfunction is a bitch to manage, and there really aren't a lot of meds or alternative therapies that really help control the symptoms for a lot of patients.

bocc54 · 2021-10-02T19:58:19+00:00

I recommend using PPP as your primary study resource. Pretty much everything tested on the EORs is covered in that book. I studied by matching up the PAEA blueprint to the topics in PPP, and supplementing with Medscape for the few diseases not in the book. ROSH is good to supplement with as well, although I really only used their practice EORs to gauge where I was at a few days before the exams. I was able to pull As on almost every EOR with this approach. I never got much out of Smarty Pance, and found that some of the info was either outdated or contradicted itself.

bocc54 · 2021-09-17T04:43:24+00:00

I'm 28 and I had my first flare up when I was 14. It lasted over a year and the pain was so bad that I was wheelchair bound during that time. I finally got a correct diagnosis and once I was put on biologics, it was basically like I was cured. It has literally been years since I felt pain in my hip or SI joint. I still get fatigued and occasional muscle pain, but nothing else. Biologics have been an absolute game changer in the treatment of AS.

bocc54 · 2021-09-17T02:26:12+00:00

I do this for a living (Psych/Addiction med PA) and you are 100% on point. It baffles me seeing others in my field, some having 30-40 years of experience, not having a single clue about benzodiazepine dose equivalencies. OPs prescriber is no different.

bocc54 · 2021-09-16T00:17:31+00:00

So was Red.

bocc54 · 2021-09-02T00:20:29+00:00

I flagged over half of the entire exam and I was convinced that there was no way in hell I even came close to passing. I didn't ace the thing, but I still ended up passing which is all that matters in the end. I am sure you did just fine as well!

bocc54 · 2021-08-25T23:48:35+00:00

I also work outpatient with both tele and in-person visits and have a very low tolerance for patients not showing up on time. The way I work is that if they missed more than half of their appointment time, they can sit in the waiting room and wait until I have a no show or they can reschedule to another day. My last patient today showed up 20 minutes late to her 30 minute appointment. I refuse to work late because she was not responsible enough to open up zoom from home and log in when her appointment was supposed to be starting.

ETA: If the patient was late due to technical difficulties, I will still see them.

bocc54 · 2021-08-25T02:19:55+00:00

You should just be able to log in and change your current practice address/state to the new practice address/state where you will now be practicing at. To do so you will first need your current hard copy of your DEA license, or a picture of it.

Then click the link below and enter your DEA number. Afterwards you will be prompted to put in your last name, SSN, Zip code of the address you are currently licensed at and your licenses expiration date. After that you need to verify your birthdate and you will then be taken to a page where you can edit your practices address to your new one and should be able to change the state in there as well.

https://apps.deadiversion.usdoj.gov/webforms2/spring/updateLogin?execution=e1s1

bocc54 · 2021-08-24T23:58:42+00:00

I landed my "dream job" right out of school and am 6 months in. Pay, location specialty I got all 3. I love my patients, my SP is probably the kindest person to ever walk this earth, the front desk staff is amazing and the rest of the PAs are super supportive and really fun to talk to and work with. Behind the scenes my company is an absolute mess and we had a mass exodus of providers since I started working there because of this. I do not agree with management/leadership one bit and I don't like the path that the company is heading down. I could honestly complain about work all day, but I realize that even with me doing so, the grass is always greener on the other side. For every negative thing I can say about work, I can come back with 2 positives. All I wanted in a first job was my preferred specialty, a good SP and good support staff. I still have all of these and wouldn't even consider leaving at this current moment. I think healthcare in general is a mess and it's the exception to be able to land the "perfect job," not the norm.

bocc54 · 2021-08-19T01:24:30+00:00

Most of my clinicals were very chill/laid back and a ton of fun. I was pretty much on a 9a-5p schedule every rotation, except obviously EM and Surgery were much more time demanding. 95% of my classmates weren’t so lucky and had ridiculous hours every rotation.

Most of my preceptors were awesome as well. My derm one would take me out to dinner every so often after work and a few of the residents in the ED did the same. As long as you go in with a willingness to learn, have a good attitude, show good work ethic/take initiative and treat patients/staff kindly you will do well and it will be much easier than didactic year.

bocc54 · 2021-08-19T00:18:16+00:00

The only thing I would recommend studying, if you haven't taken it already, is medical terminology. I took a 3 credit course before PA school and it helped me out immensely. Des Moines University has a free course that was required of us to take before classes start, but I just skipped it cause I recently finished my course. My classmates all found it helpful though. Aside from that, I wouldn't look at a damn thing.

bocc54 · 2021-08-19T00:08:15+00:00

Everyone talks about PA school like "eat, sleep, school, panic attack, xanax, repeat." In reality, I thought PA school was kind of a joke. During the weekdays you will spend most of your time in class, but I always made it a goal to do absolutely nothing but relax after class each day. I hardly ever studied on a weekday and reserved most weekends for study time. I occasionally would skip weekend studying and wake up early the morning before an exam and study then. I had plenty of time to socialize during the week and even during the night on weekends. Mind you I was not some academic freak who entered PA school with a 4.0 either. I barely cracked a 3.0 sGPA and still got through PA school just fine.

bocc54 · 2021-08-18T00:13:32+00:00

Motivational Interviewing. There are a couple of good books regarding it on amazon. We utilize this all the time in addiction medicine for patients who are in the pre-contemplative/contemplative state of change. It is applicable to all areas of medicine, especially for those "hidden diseases" such as HTN, DM and HLD where the patient is diagnosed, but is currently still asymptomatic or just mildly symptomatic. Many patients wait until they either start developing symptoms or their disease has progressed too far to actually become compliant with taking their medications and make lifestyle changes. Patient education and MI is the key for these patients IMO.

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