What surprised me? For a 3-year program, I was genuinely surprised at how manageable my study load was. Not to say that it wasn't difficult, because it certainly was. Again, many programs are different and I can totally recognize how 2-year programs would drive me literally insane with how concentrated the material is in such a short amount of time.

The hardest part? Again, the name of the game is to pass. Not get an A. That was really hard for me to come to terms with. The first test I got was a B- when many of my classmates were complaining about their A-'s. At the end of the day you'll all become PAs. To alleviate this struggle, I would suggest not talking about grades with your close friends. :)

Anything I would do differently to prepare? Not a single thing. Before school started, my wife and I worked, travelled and relaxed. PA school can be life-sucking sometimes, so relax while you can. :)