So, I have officially finished my first week of Duke PA school. I've been working on this post for a few days, so it's going to be pretty long, but my overall impression is that this new gig is
fabulous. There are 76 of us in the class, and almost everyone is brilliant and funny and amazing. I've made a couple of close friends already (one running buddy, one carpool buddy, some lunchmates, some seatmates...) and am really having a fantastic time getting to know everyone. The building is newly renovated and awesome, with two floors, a large kitchen and lunch area (the 'bistro'), a 'quiet lounge' in case you want to study during lunch, mailboxes and full-size lockers for everyone, showers (for those of us who want to bike to class or go for a run during lunch), small 'breakout rooms' for our small-group sessions, and a large stadium-seating classroom (complete with ergonomic chairs, lumbar supports, and footrests) with a barrage of technology at every seat -- speakers, laptop plugs, and Ethernet outlets (for the super-secret secure connection we have to use to take our tests). Everything is electronic; we swipe our Duke Medical ID cards (which most of us wear around our necks, like in high school) to get into the building, to print documents at the e-print stations, etc.
Also, they are organized beyond belief. Everything they could possibly do for us ahead of time was done; we hit the ground running. On the first day, we got personalized packets of papers with things to review and sign, as well as ID badges, engraved nametags, and individually encrypted laptops and iPod Touches. Our various accounts were already set up and programmed; it was easy as could be. They've clearly done this a time or two. :)
Of course, it's not all sugar and spice. For example, there is zero predictability in terms of a schedule, which is stressful to my type-A, OCD personality; it isn't like undergrad courses, with neat and tidy MWF and TR schedules. We might have lectures in one course for three days in a row, then no more sessions for a week; another course might meet twice a week, but on different days and for different lengths of time. Instructors and guest lecturers are constantly rotating in and out; we never see the same face twice in a row. The only predictable day is Friday -- small-group work all day long, with three hours of cadaver lab in the morning and then three more hours of Physical Diagnosis practica in the afternoon (i.e. practicing procedures on one another).
The other problem I've noticed is that the 7-8 courses that we take at one time don't intersect very well in terms of a clear, comprehensive schedule of readings and assignments. To be fair, the problem probably lies more in the structure of Blackboard (which is our online 'brain' for keeping ourselves on schedule -- it's where we download the PowerPoints, check our exam dates, upload documents to our teachers, etc.). Namely, we have to delve into several layers of folders and documents just to find out what our reading assignment is for
one class; then wash, rinse, and repeat six more times to get the rest of the data for our other classes. It would be better if there were a 'central' area on Blackboard where we could see exactly what was required for each class for each day, all together. As it is, I have to keep a running 'sticky' on my desktop with the current assignments, and I'm sure I'm going to miss something sooner or later.
And I won't lie; the amount of work, especially the amount of reading we're supposed to do before each lecture, is overwhelming. I haven't gotten a full night's sleep all week, and it's only orientation! But in terms of content -- the actual facts and procedures that we're beginning to learn -- I'm not overwhelmed at all. We've been focusing on patient interaction, i.e. how to take a complete medical history, what constitutes 'good' and 'bad' questions and body language, how to clearly document what you learn from the patient (both verbally and from your exam), et cetera. And, although it truly surprised me, I'm realizing that I've already internalized a lot of this stuff via my previous job in direct patient care. I mean, I wouldn't want to turn around and try to complete a full 45-minute physical exam tomorrow (though that is precisely what our final course exam will be in November!), but I have a solid enough foundation in everything that goes into such an encounter that I surprisingly don't feel overwhelmed by the idea of having to do it alone in a couple of months. And that lack of fear makes me feel even more confident, because I recognize that the system is working. I can see that my prior health care experience -- no matter how difficult it was for me to obtain in the very beginning, and no matter how much I initially resented having to do it -- is absolutely a necessary prerequisite to any quality PA education program.
The other good news is that the instructors fully recognize and admit that the workload is insane. We're constantly being encouraged that we can do this, that it's going to be hard but not impossible, that the faculty are here for us in any way we need, that we are all fully qualified to be here, and that we shouldn't let ourselves feel too overwhelmed, despite the massively steep learning curve we're embarking on this week. It's nice to hear that verbal assurance once in a while. :) They actually brought a psychologist in to talk to us for 90 minutes on Wednesday afternoon about successful and unsuccessful mental strategies during times of stress. He was quite entertaining, and I've got to admit, I saw parts of myself in nearly everything he said, especially the parts about perfectionism and getting into 'cycles' of worry, where, for example, you're unable to just 'feel happy' because you're constantly 'checking in' with yourself about exactly why you
aren't happy. My classmates admitted afterwards that they all saw strong reflections of themselves, too. Prior to that, I might have scoffed at the idea of bringing in a psychologist, but I think it was really time well spent.
Bottom line: I feel like I can really see the 'process' they've structured for us -- and they've incorporated things I'd never even thought of: small-group projects with Duke MD and DPT students (so that we become accustomed to working in teams with people of different medical degrees/levels), lectures on professionalism, group discussions about ethics, and so forth. The amount of detail and planning that has clearly gone into creating this curriculum is truly staggering, and even though I can't see around the corner right now, I nonetheless feel like I can trust it. I still don't exactly feel qualified to wear that white coat (which was officially 'given' to me at this afternoon's ceremony!), but despite that, I'm pleasantly surprised to find that I truly believe this program is going to turn me into the best clinician I can be. Playing devil's advocate, I'm also sure that that's exactly how the faculty
want us all to be feeling right now -- prepared, excited, motivated -- but the fact that I actually
do genuinely feel the very emotions they're aiming for, well, to me, that speaks volumes in itself about the care that has gone into planning this program. Ask me again in a few months, but for the moment -- psychology aside -- I can't remember the last time I felt so strongly that I was in exactly the right place.
