141 From Struggling to Passing the PANCE

Hello and welcome to episode 141 of the Physician Assistant Exam Review Podcast. We’re going to continue this week with our interviews of students who were struggling and turned things around. Heather is a student who worked with me for a long time, was very skeptical about my methods, honestly, because she had a lot riding on it. And I totally understand that. And we went back and forth a lot before she decided to work with me. But you can see from her interview just some of the things she tried to change, some of the things, places where she was a super confident, really good student, great person, and found herself just in this position that she thought she needed some help. And I’m not saying that everyone needs help.

Certainly, that’s not the point. But the point is that some minor changes can make some big differences. I think there’s a lot you can take away from this, whether you’re struggling, whether you’re doing well. There’s a lot she has to say that’s going to be really, really helpful. On top of that, I know some students have been saying recently that they’re having a little bit tougher time finding jobs upon graduation.

Now, I do think that that’s possible, and I think it may be true that the market’s tightening a little bit. I do also think that we’ve been spoiled for a very long time. So I think that doing some minor, again, just some minor tweaks, some minor things, adjustments in the way that you do things can have a huge, huge difference. So we’re going to get to our interview in just a second. Oh, wait, before we get started, this week for PA, hey, happy PA week. For PA week, I am hosting a tremendous giveaway. You can find it at physicianassistantexamreview.com/giveaway.

And what you’ll find there is over $2,500 in PANCE prep materials, including access a one completely free scholarship to the November cohort of 33 Days to Pass the PANCE.

Now, whether you’re in didactic year, whether you’re in clinicals, no matter where you are, This course is incredibly valuable for building skills and creating some new ideas for ways of going about things. It also includes a copy of The Final Step. It includes one-on-one training with me covering any topic that you like. It’s something I don’t normally do at this stage, so the only way to get it would be to win this giveaway. But here’s the cool part. Not only do you get it if you win, there’s a system where you can refer people into the giveaway. And when you do, you get three more entries into the random drawing.

But here’s the better part. If someone you refer wins, you win too. So I’m giving away free two packages, but one goes to the random drawing and the other goes to the person who referred the person who won. So it’s going to be a ton of fun for PA week. Really, really excited about it. Excited about the new November cohort coming out and registration for that starting next week. There’s so much going on here.

Talking with a lot of PA programs recently about some changes, some things we’re doing, trying to help more and more students. Anyway, without further ado, let’s get into Heather’s interview. I didn’t mean that to rhyme. So I have Heather here with me today, who recently graduated from PA school and passed her PANCE. And I want to bring her on to basically walk you through her journey through PA school to see if we can gather some insights and get some information that might be helpful. So Heather, welcome aboard. Thank you so much for coming on.

Thanks for having me, Brian. I think we’ll sit and reflect together. You’re starting to, you’re cutting out a little bit on me. Oh, no. Can you hear me now? I can hear you. Yeah.

Okay. I just said thank you for having me and I’m excited to sit and reflect together. Awesome. So can you tell me a little bit about when you first were accepted to PA school? I just did a session for the pre-PA clinic where we talked about the interview for PA school. Can you talk a little bit about that interview for you and how that process went and how you decided what school to go to? Sure.

So I am a student that is from New Jersey, but I had applied to schools in California because I’d studied public health undergrad and ended up going to the only joint curriculum PA and pH program in the nation. And so I was very excited about the interview process. Our program director at the time was an incredible leader and our school prides itself on producing providers who will eventually work in primary care. And so I felt that, you know, their mission was very in line with what I wanted to do in the future. I have a background in the military. As you know, in 1965, when our career field was birthed, it was a birth that it was birthed out of a necessity for primary care providers. There was just a burden on the US healthcare system.

And so physicians had decided to enroll four Navy corpsmen in the first ever PA class at Duke University. And my background as a flight medic in the medical corps for the Air Force is very similar to these corpsmen. We have very similar training. And so, yeah, that was kind of the next, the appropriate next step for me. And so yeah, the interview process, I flew out to California. I got to meet the program director and the faculty. All of them have, their master’s in public health as well.

It was, yeah, it was quite a long interview process, but I was so excited. It was my dream school. That’s great. So, you chose that based off of that offering in particular. So, you were excited for that particular school and had a good reason. One of the things I was just talking with these prospective students about was was coming you know was not just applying to any school because you want to get in somewhere, but to bring to that interview process that you want to be at that school, right? And then what that particular program brings.

And you, I guess, had that easily a way to handled and show that you wanted to be there in particular. So that’s fantastic.

All right. So you obviously got accepted there and then moved your whole life from one side of the country to the other and started PA school. I know that that transition can be tough for a lot of people. Can you talk a little bit about doing it with that big of a move? And again, I know a lot of, I speak with a lot of students who are in a very similar situation, who are either married, moving away from their spouse for some of the time, or in your situation, moving across the country for the first time ever? Oh, this is really fun to reflect on. So yeah, like you said, I packed up my life and moved across the country.

Although we had started school online because of COVID, by the time we were to enroll in our ClinAps courses. They required us to be in person for those hands-on skills. And so it was February of 2021 that I ended up moving to California. I didn’t even have housing actually. And so my program director had set me up with a good friend of hers who vacated their home regularly and they allowed students to stay for very cheap. Wow. As long as we watched their pets.

And so that was my first home in California. It was around the neighborhood that my school was in. And I watched this family’s dogs and cats while attending school. And then from there, I ended up moving on to our campus and living with a couple of other students. Yeah, but it was quite a transition. And being in the military, I’m very used to being transient and having to kind of pick up and move places. But, you know, that’s a really, that’s a stressful event for anybody.

It wasn’t the easiest thing I’ve ever done, I’ll tell you that. But I was just so excited to be there. And it felt like my dreams were coming through. That’s amazing. And two of the things I just want to point out and take away from that. One is we were talking briefly about you’re now searching for a job and how to do things differently. I love that you didn’t just say, oh, I don’t have a place to live.

Oh, I can’t afford this. Oh, I don’t know how to do it. You found a different way to go about it. And whether that opportunity presented itself to you or not doesn’t even matter. It’s just that when you get started with anything, there are challenges that you can’t know how to overcome, right? But you have to be a little flexible and move with those. And I absolutely love that you’re able to do that, right, and to get to where you want to go.

The other thing I wanted to point out is you talked about how stressful it can be on both ends, right, both when you are entering school and when you’re leaving school. I constantly talk with students who are taking their PANCE, moving back across the country, doing all these sorts of things all at once. So, yes, school is very stressful. But then you add in these bookending events of moving into an apartment, moving out of an apartment. A lot of people are getting married right around this time too, because of the age, you know, that most students are. So there’s just like a lot tends to be going on and it’s a lot, you know, it’s a lot to manage and it’s always impressive that people can handle it better than I can. You know, I was always like, let me just do this one thing at a time.

Yeah, I was going to say, I think stress is such a funny thing because in hindsight, right, I can say, oh, it wasn’t that bad. You know, I have such fond memories of PA school. But in the moment, you know, I mean, it was probably the most stressful thing. I love how quickly that changes too, because only a few months ago, you’re pulling your hair out. And now just barely on the other side. Oh, it was great. I had a great time.

It was like… The grass is greener. The sky is bluer. So as you entered into school, how was that process for you in the first couple of weeks, the first couple of months, that transition to essentially the volume and the pressures is despite what people kind of warn you about, it still is almost surprising. Can you talk about that a little bit? Oh, man, what an interesting transition. I think this is like the metamorphosis of Heather going from this young spry chicken, super motivated to, you know, then this just burnt out.

But disciplined, Heather, that really had to just lean into, yeah, the discipline that I know in order to make it through. So I think, like you said, you know, I mean, no one can really prepare you for PA school, right? Like until you actually go through it yourself and have the experience yourself of this, just the never ending study. You can’t really, I really try to wrap my mind around what school would be like for me. People would say that it’s hard. And so I convinced myself that it’s something that I could handle. But really, until you go through it, it’s hard to say how you yourself will adapt and overcome the situation just to survive and make it to the end.

Well, let’s do it this way. Were there things you had done in undergrad or previously that you brought with you that didn’t work and then you had to change your approach? If I’m to be completely honest with you, comparatively, I did not study in undergrad. That was not studying. I I didn’t think that I… what I was doing, I don’t I don’t think that I needed to in order to, you know, get the grades that I did to get into a graduate program. Especially doing a double master’s degree with, you know, just shy of about three years.

It was a level of intensity that I had never experienced before. So, I think the first couple of weeks was really just figuring out my learning style. Unfortunately for me, I think I learned through every style. And so, really, a lot of my initial learning was just inundating myself with the material in and through all ways. Right? So, doing study groups, studying alone, doing charts, you know, creating tables with classmates, doing active recall, writing things out. Yeah.

And what’s what’s interesting is your story isn’t all that different from a lot of people. In fact, from myself, right? Most people who get to this level have been, for lack of better word, smart, right? Have been able to get through with brains, right? And have, you know, some people are type A and do really, really well. But a lot of us are people who just, you know, were good enough to get through an undergrad. And then all of a sudden, you kind of hit this brick wall when you get to PA school of holy crap, I’m smart, but I’m not, I can’t handle all of this information, right?

I’ve got to come up with something new. I remember for me, my, my living room just filled with index cards. You couldn’t even walk across it. I never even took a note in college. It wasn’t a thing for me. So it was a huge transition. And like you said, a big part of that was discovering the way that you learn, the way that you remember.

And as much as you can rely on classmates and other people to see what they’re doing, figuring that out on your own is really important and does take some time, right? Because you have to test a lot of different models. And unfortunately, that also takes time. But it’s realizing that you’re going to have to make a transition. But usually what got you into PA school isn’t going to be enough to keep you going. And you’re going to have to just sort of suck it up and say, OK, what do I have to do differently now? Right.

Absolutely. So another thing that people talk about is the, you know, not just the relentless amount of information being thrown at you, But also, most programs have a pretty tough schedule as far as quizzes, tests, and moving right along through the material and keeping up. I know a lot of people struggle with test taking. For me, I was fortunate because it wasn’t something that really bothered me to sit down and take a test. But I know a lot of people suffer from testing anxiety and get very concerned about their grades and how they’re going to do. And I know that that’s a very limiting issue for a lot of students. Was that something that affected you throughout your program?

Yeah, I would say that I definitely struggled with test taking anxiety, so much so that I requested accommodations through my program for test taking. So there is an official way to do it. This is nothing that I requested in undergrad. Grad. It wasn’t anything that I felt I needed for my public health exams, but I had requested extra time on my exams on the PA side of the house. And so for PA exams, whether it was didactic or the clinical EORs, I had 1.5 extra time on my exams. And you had that throughout PA school, not just for the PANCE.

I know some students have talked told me recently about having that accommodation for the PANCE. I didn’t realize that even for your PA program, that was an option. Yeah, I recognized early on that it wasn’t, while I was taking the exams, it wasn’t that I didn’t know the material. It was simply that I felt pressed for time and I didn’t want that to be kind of the limiting factor. And so I had just communicated this with my academic advisor and it was something that she recommended that I get. And I knew at that point that I could also request an accommodation for the PANCE as well. So yeah, it ended up being one of the best decisions I made through PA school.

And so I just want to encourage anybody that might be listening to this, that test taking anxiety is completely normal. You’re not alone. And I mean, if anybody has questions about the process about, you know, going about getting an accommodation, they’re going to reach out. Yeah. And their advisors and schools should be able to help them with that as well. That’s really great. Yeah.

I guess I didn’t realize that that was part of it within the PA program as well. So that’s really nice to hear because again, one of the things I tell people a lot is when it comes to taking your tests, for most people, I feel like if they can get out of their head onto the page, what’s in their head, they’ll do just fine. But a lot of people get tangled up in the whole mess of that and can’t get the information out and say, oh, I studied, I really know this, and I still didn’t do well. To me, it has a lot to do with that self-management. And whether or not just having that extra time made you feel more comfortable and that was helpful enough, whether it was that extra time was what you needed. There’s a lot of different layers to that. But I like that you got that suggestion from your faculty member and took it and didn’t just say, oh, no, no, no, I’m good, I’m good, I’m good.

Because I find people run into that a lot where they kind of shut down because they think it’s either an attack or they’re not doing good enough. I know we battle with my 14-year-old with this. When we try to give him strategies, he assumes we think he’s an idiot. And he shuts down and won’t listen to those strategies. And I can see how, you know, he’s 14, but I can still see myself doing things like that today as well. So it’s really impressive that you were able to take that suggestion and run with it. It certainly wasn’t easy, right?

I think I’m able to say all of this with confidence that that was a great decision in hindsight. Well, like we said now, months later, it’s like, oh, of course I did. That was a great idea. Why wouldn’t I have taken it? Versus in the moment. Oh, in the moment, there were tears. I was like, oh, no, I’m so different from my peers.

And then, you know, and then you find yourself in this in this separate room with students that also have accommodations and you realize, oh, you’re not even just one of two students, but many. And so I think that’s really where the confidence comes from. Like you said, I didn’t actually use all the time that I was allotted, but it was just this mental shift of, hey, this is going to be good for me. This can only be good for me. I’m going to try this out. And if it doesn’t work, we’ll adjust and figure something else out. But I think it was a great decision.

I don’t want to go down this road just yet, but that’s one of the things I found with the 33 Days to Pass the PANCE program is how many people come into that program feeling lonely, alone, like they’re the only one struggling. They’re the only one who hasn’t passed. They’re the only one who is struggling on an end of rotation, whatever the case may be, but they feel very alone. And they come into that program and look around and are like, holy cow, there’s 30 other people here who are just like me, that everybody is struggling. Everyone’s trying to figure this out, and finding those connections. And, and even if they don’t wind up, you know, if you don’t wind up studying with those people, this or that, it’s just nice to know that they’re out there. And that you’re not, you know, a standout.

You’re not, you’re, you’re not the only one in that position. Right. Absolutely. I mean, that was one of my favorite things about the 33 Days program. I joined the February cohort my first time around. And the second time around was in June, but we can talk about that later. Yeah, in February, I was probably about six months out from taking the PANCE at that point, but I’m someone who really likes to wrap my mind around game day, right?

Like what game day is going to look like, what to anticipate. I’m going to try to gather as much information as I can to make sure that I’m successful on the first shot. And so it was with that intent that I joined. But it’s exactly that. It’s the camaraderie that I gained, kind of being in a cohort with other students that were in a similar boat as me that suffered from an immense imposter syndrome and felt like we were so undeserving to even you know sit for the PANCE and there were also folks in that cohort who were clinicians and they had already you know passed or they had already graduated and they were either retaking the PANCE or sitting for the PANRE I think and that was just really that cohort, that 33 day program for me was pivotal because, I realized that, you know, oh yeah, this exam is just a game, right? These people are already practicing as clinicians and yet they’re, you know, they still struggle in the way that I do. And, yeah, I think, after that cohort, I just sensed in myself such a shift in my test-taking approach.

I felt extremely calm. I almost couldn’t recognize myself for our summative exams. I just remember before the exam, even during the exam, if we had multiple a day, and then after the exam, I remember this common cucumber. I remember bringing, bringing Spot It. It’s like a little game. Oh, I know. I’ve got kids.

I’m very familiar. And trying to convince classmates to play with me in between versus, you know, cramming and great idea. That’s really, I’m actually going to write that down. That’s a good one. But you, but you know, you know, prior to February 33 day cohort, Heather, I was a mess. I was the one, you know, that was cramming every last bit of information I could in between exams. I, you know, was relentless about kind of recalling what I had gotten wrong and looking up the answers and all of that for myself.

But it was just different. And so I knew that I had to join the cohort prior to take right before taking my PANCE as kind of a final boost. Yeah, to be with a great community with the same goal, with the same schedule. Nice. Well, let’s back up for a minute before we start, before we finish up and talk about your PANCE and where you are now.

Let’s back up to rotations for a minute. So you moved from the classroom out into the world a little bit. How did that go for you? Oh, well, I would say that, you know, again, at this point, I’m very fond of my clinical rotations and clinical year. But if I’m to try to remember how I felt in the moment, I think it was very challenging. My first rotation was in Dallas, Texas, which I drove to myself. Wow.

Our rotations were six weeks at a time. Yep. After that, I went to Southern California.

Now, did they set you up with a place to live in each of those? Or did you have to figure that out? Or how does that work? Nope. I had to figure it out myself. They set us up with a couple of alumni who had similar rotations, or just the class before us, if they had rotations in that location, so we could reach out on our own and see you know what housing accommodations they were able to.

Okay. You know Yeah. So, that was helpful. If you had someone who was there before you, I had a couple of rotations where I was the first student And at that clinical site. I was also in the Bronx for my emergency medicine rotation. So I flew around and drove around quite a bit. Wow.

And as you remember, right, or I don’t know if it’s the same for other programs, but say we finished a rotation on a Friday and I was in one city across the country, the expectation was for me to be at my next rotation on Monday. And you had an EOR in there too, right? Yes. Yep. Yep. We had our EORs during our callback rotation. So every, or callback week, sorry.

After every two rotations. So every 12 weeks we would come back to campus. So mandatory that would be in Northern California. And then we would take two EORs back to back. If you had an elective rotation, of course you would just have one EOR. That’s great. It’s nice to hear too, because like I said, on that conversation I just had with a bunch of pre-PAs looking at school, they had questions about some of the way different programs are set up and some of the ways that rotations are set up.

And I have some knowledge of it, but not a lot, right? I know what I did. I know what some other students I’ve spoken with did, but obviously a lot of schools handle this very differently. One student asked if during the interview, they could ask about the distances of their rotations. And I said, yeah, I think that’s not unreasonable to ask how the rotations are set up, but you can’t say, hey, are they all going to be within 10 miles of my house? That sounds a little bit like you’re, you know, that’s not really going to be reasonable. Fortunately for me, mine were all I could drive to from where I lived, the way our program was set up.

But I know a lot of programs are like yours where they’re all over the place. And I was one of, I want to say four out-of-state students in a cohort of about 48 students. I think that was our final number. And I don’t know if it was because we were out of state, but there was this kind of assumption that we’re okay with being a little bit more transient. So I know the clinical rotations, it was able to work out for students that were from California, especially Southern California, attending school, you know, at our Northern California school, because they were able to commute from their homes, their family homes. So it’s easier for some people, harder for others. But at the end of the day, I think it all kind of evened out.

What was your favorite rotation? Oh, I would say my favorite, one of my favorite rotations was a family medicine rotation in the Central Valley. I’ll keep it kind of vague. Where exactly it was, but this preceptor was excellent. The clinic was a FQHC, so federally qualified health center. We served a lot of patients who were under, you know, underinsured or yeah, didn’t have insurance at all. And it was a very underserved population.

I got to see everything from a four day old to like a 96 year old patient, often in the same day. So it was a very humbling experience. The preceptor was so fun and engaging and trusting, excellent teacher. And yeah, I I really appreciate the kind of… I’m at a loss for words right now. That’s all right. I just really appreciate that she allowed me to jump in and just serve like right alongside her.

That’s great. And obviously, it sounds like you had a lot of good teaching there, a lot of good experience there, got to see a lot of different things, and had someone who was happy to show you and willing to show you. Can you tell me a little about maybe a rotation that didn’t go as well and how you handled that situation? Oh, goodness. Can I say this on air? So we don’t have to use names or locations, but I know that’s something that people are nervous about, right? Is what if I go somewhere and I hate it?

What if my, you know, there’s so many what ifs, so many things to be concerned about. So yeah, do most of the time they go great? Absolutely. Are a lot of them mediocre? Sure. A lot of them can be mediocre. Are one or two not going to be great?

Of course. And you have to learn how to deal with that too. You know, I work in an operating room setting where I work with 60 different surgeons in a year. Are all of them my best friends? Absolutely not. Are there a handful I’d rather not work with? They’re not?

Absolutely. I like most of them. We have an amazing staff, but working with the people who, let’s just say, are not my favorite and making that relationship work and making the team work on those days is a big part of my job, right? That’s a huge part of what I do is still make good outcomes on those bad days. So I think it’s important to share that as well. Absolutely. And I think that’s exactly the takeaway from a bad rotation.

So again, loved most of my rotations. There was one, it was my second rotation. And it was an internal medicine rotation where we, our patients, so we largely worked with 65 plus adults. And yeah, I would say that the owner of the practice, this provider and I had very different ethical views. And it was to the point where I felt like what we were being asked to do may have been a little bit illegal. And so I had, I had reached out to my clinical director just to communicate what I was seeing, what I thought, what I felt uncomfortable with. And luckily that was one of the rotations where I wasn’t the only student.

There were students from other programs who were there with me as well from three other States. And they kind of shared a similar view of what was going on. And so, yeah, I communicated this with my director and she ended up pulling me from that rotation and finding a new rotation for me to go just maybe two days later. And that was incredible. I mean, that rotation that I ended up at, the preceptor was amazing and it was such an overall great experience. And I think the takeaway is that firstly, I think getting to know your faculty very well. And, you know, on the other hand, having them get to know who you are as a person is very important so that when you communicate, hey, you know, I’m uncomfortable with this because I think it’s an ethical issue.

Like they really have your back and they really trust your character and that you are someone that can, you know, otherwise stick things out and you have good judgment. I think all of those things really contributed to this going, in my favor and being pulled from this rotation. I talk with my kids about, about, you know, you go to the nurse when you need to, because if you’re there every day, no one’s going to, no one’s going to come pick you up if you’re in the nurse’s office every day. Right. But if you’re there once in five years, I’m going to leave my job and come get you. It’s really, really simple. And they’re going to be on board with that and they’ll figure it out.

But if you’re there every day, got to be different. Yeah, exactly that. I think presenting yourself also professionally in a way that, right, you’re not just crying wolf, right? Because there are going to be many rotations where it might not be 100% what you were dreaming of, right? But again, you make the best out of our situation. I think you can learn from any provider that you meet, even if they’re not your best friend and you’re not a fan, you learn how you don’t want to be to patients. Yeah.

And learning what not to do is just as important as learning what to do, right? They’re not separate. We like to think of it as separate, but they’re really not. You need to experience both sides of that. And one of the things I know I kind of missed out on on my rotations and I try to push on people now is to realize it’s not just about the medicine, right? You’re there to experiment and learn about medicine, of course, but there’s so much more going on than the medicine. There’s all of these relationships.

There’s figuring out how offices work. There’s figuring out how operating rooms work. There’s standing up for yourself in a situation that you’re uncomfortable in. There’s so much to learn. This is going to sound odd, but it’s a relatively safe place to do all of that, right? Because you have the backup of your program, provided you’ve shown the character and been a person to deserve that, you can kind of, I don’t want to say play, but almost experiment a little bit with some different ideas and some different ways of seeing and doing things and pay attention to how other people do them. Because again, it is a, you know, it’s a safe place.

That’s why you’re practicing medicine there. Someone’s looking over your shoulder. You’re not on your own yet. So you have an opportunity to make mistakes, whether that’s just in relationships, even if you don’t get along with an attending, great. That’s better than figuring out how to do it there than it is on a job site where you kind of need the money and you’re in a bad spot, right? So even if something bad happens, so there’s a lot of other things besides medicine that rotations are built for you to learn and experience. Right.

Absolutely. Yep. Can you share, if you can think of one off the top of your head, an interesting case or something that happened in particular on rotations? An interesting case? I feel like I’ve had many. Gosh oh Gosh. I don’t know if this is appropriate.

But I I feel you can maybe relate. This is just kind of a funny moment. And I would say, Brian, can I preface this with me? You may have to cut this out. I just marked down the time. I already marked it down so I could cut it.

Okay. So I think when I reflect on my clinical experience, what brings me so much joy is that there are many situations I feel like I found myself in that I wouldn’t even be privy to if it weren’t for the fact that I was a student, right? Even as a certified PA and clinician, there’s no way that I could kind of relive these little moments. And so, yeah, I was on a plastic surgery rotation in Beverly Hills and the provider and I got along great. They actually gave me a job offer. But it was just so different from anything that I had experienced before. They had specialized in explants and deep plane facelifts.

And I think just for me, like a silly moment that I reflect back on, which I’m pretty sure is your every day is is once we you know do the the breast explants for patients and we set them back up, and they’re still under anesthesia, we need to reattach the nipple, right? So I think just that process of like very seriously kind of standing next to the lead surgeon with our arms crossed, kind of analyzing what exactly we should place these nipples it’s very comical but fond memory that I have. Yeah, that’s about every other Friday for me for the past 10 years. Yep. And it’s just the most, you know, serious moment and it’s and it’s everything, right? So patients, once they’re awake and they’re able to see the work that we’ve done. So it has to be very, very precise, but it was just, that’s, that’s a moment that nobody could have prepared me for.

Right. It’s surreal. It’s something, but that’s also to my point about being a student, right? Is there’s so much there that you would never be in a position to see experience do. And it’s one reason on rotations why I really want people to go and experience and meet people and ingratiate yourself with your preceptors so that you can get experiences like that. You know, in my, in our, when I have students, I’m working hard to make sure that they get to put screws in and do everything that they could possibly do, because that’s, even if you’re not going into surgery, right, you’d have no plans of going to surgery. It sounds like it’s still an amazing experience and a whole world opened up to you that you’ve never would have gotten to see.

Yes, it isn’t going to be what you want to do. That’s okay. It doesn’t have to be right. Medicine isn’t what I wanted to do, but it was still great to be in the ER on my rotations. It was my peds ER was one of the most amazing times of my life, but it doesn’t something I wanted to do, but there’s no other way to get that experience. Right. So take something away from that is absolutely phenomenal.

And I get what you’re saying, but all of those experiences are valuable. Is that something that can be aired or? Oh yeah, no, I’m absolutely leaving that in. So throughout this whole process, it’s exhausting. It’s long. We’ve talked about that. You mentioned that it’s this relentless grind of day in, day out, studying the work, the traveling, all of this.

How do you stay on top of it? How do you stay motivated throughout? How are you able to keep pushing through? So, how do you stay motivated throughout? I think, to be honest, the motivation has to just turn into discipline at some point, right? You This is what you worked for, right? Once you’re in PA school, you set aside those two or three years to dedicate your days to studying and trying to get as much information under your belt.

And this is something that you said a lot to us in the 33 Days program, but you didn’t just become a PA student to stop at being a PA student, right? Or even stop at passing the PANCE. I think you just have to kind of keep that future goal in mind. I think being able to visualize yourself working with patients in the future, or really whatever yeah you imagined for yourself, right? Whatever visions you had of of yourself doing these amazing things, you got you have to kind of just hold on to that throughout your experience. And and also keep in mind that there’s a time for everything, and this is your dedicated time. You won’t get time like this again to be able to detach from the world and just focus on studying.

Yeah, I like that. For most students, they can kind of detach. And although it’s hard, that is your focus. Not everybody’s, but for most people, that’s kind of your focus. I laugh now when I have to study for my PANRE and I’ve got two kids, I’m running places, I’ve got a full-time job, I’ve got this business going on. And I’m like, man, I kind of wish I was not that it was easier then, but it was at least a very clear goal, right? It was very obvious.

I’m doing this and I can work on it. So to take advantage of that and realize that you’re in that situation as hard as it may be is a really good point. Is there anything you would share that you would have done differently throughout your journey through PA school? Well, I think I would have found your podcast sooner. And then subscribe to the newsletter sooner as well. Yeah, I think really finding mentors. I mean, I call you coach now, right?

Finding a mentor who has been in your shoes and understands exactly what you’re going through and kind of mentors who can encourage you to keep your head up and keep grinding until you’re finally where you imagined yourself to be. I think earlier on would be a recommendation that So again, it almost goes back to what we said about discovering your learning styles and things, but to the sense of, you know, not discovering that you’re not going to do this all yourself, right? That you’re going to need some help. You’re going to need, whether that’s the people in your cohort, whether that’s your faculty members, whether that’s someone like myself, you’re going to need ideas and plans and some structure outside of what you’ve done before. Cause you’re going to have to grow, right? That’s the whole point here is to, is to improve, get better, learn more and move on. Right.

So if you could do that with what you’ve already had, then there would be no point. You wouldn’t be growing and improving and getting better, right? So that’s a really good takeaway. Can you tell me a little bit, let’s transition a little bit to your PANCE without going into details, obviously about questions and whatnot, but just a little bit about how you prepared. I don’t want to take up too much more of your time, but I want to talk about that and a little bit about where you are now and where you’re heading. So a little bit about how you prepared, how the day went for you. Cause I know, like I said, that that’s, you would have said, you know, six months ago, you would have don’t want to know every piece you could about that day and how it was going to go.

So whatever you could share that might help somebody who is in that position of just dying to know a little bit more about how it went. Yeah. So like I said, when I joined the February cohort, 33 Days, I was about six months out. So I had registered for the PANCE on July 18th and the 20th. So like I said, I had accommodation for my PANCE of 1.5 extra time, which meant that my PANCE would be split between two days. When you go to apply for the NCCPA accommodations, you’re able to choose if you want to take day one of the exam of 150 questions. And then I think it’s like 10 days later, you can take the second half of 150 questions.

I didn’t want to do that. I think even having a day in between made me feel like I wanted to implode. But, you know, that was ultimately the best decision for me. So I put a day in between. As I was prepping for the PANCE, I joined the June 33 Days cohort. So I was on a really great schedule of covering specific content on specific days and also keeping up with kind of our daily disciplines, the dailies. I don’t know if you want me to speak to that.

I’m not right now. That’s okay.

Okay. So, yeah, there are these things called the dailies, and I personally felt that that was a good way to kind of have a goal every single day leading up to the PANCE where, you know, you’re finished clinical rotations at this point, you are some of the exams, and you’re kind of just antsy to take the PANCE. So, I felt that it was very helpful to have daily goals.

Now, setting up a plan for even, four weeks every single day can be kind of overwhelming. So a suggestion that I would have is the night before the next day, you plan out what you want to accomplish for that day and you do what you say you’re going to do. And you just keep in mind that this is a very short designated period of time that you’re preparing for this thing and you never hopefully have to do this again. And let that be your motivation, right? That you’re going to put all your cards on the table and just, you know, yeah, try your absolute best to get this thing on the first shot. The actual, so the first, oh, another tip that actually you gave us was to go and visit your testing site before game day. And I can remember posting a photo of exactly where my testing site was going to be.

I went about like three weeks before game day and I met the front desk guy. His name was Tim. And I knew that my exam was going to be on the 14th floor. I really tried to think through absolutely everything that I would need on that day so that, you know, come game day, I didn’t have to stress about those tiny details. I really encourage folks to, yeah, pack for the day of well in advance. I had, you know, my chocolate, my sugary drinks. I knew exactly what I was going to do on my scheduled breaks.

I knew exactly how I wanted to break up the 150 questions each day. So I did, you know, do you want me to go into this detail or? Yeah, sure. Absolutely. As long as you’re comfortable. Yeah. Sure.

Sure. So, so after I checked in and did the, you know, fingerprinting and all of that, it was time for me to take my test. So I did 30 questions. I did another, another section of 30 questions. And then, even though, you know, mentally I didn’t feel that I needed a break. I just wanted to honor the break that I said I was going to take. Right.

The plan. Make the plan and follow the plan. That’s the big deal. Exactly. Follow the plan. Follow the plan even if you don’t feel like it and you feel like you can just do everything all in one day or all in one short period of time. So I took my break.

I did a lap around the building that my test was in. I did some push-ups. I did some visualizations, right? This is the day that you prepped for. I came back into the building, knocked out another 60 questions. So two sections. I took a three minute bathroom break and then came back and finished up the last section.

And yeah, I just remember feeling great when I walked away from the exam, but everything went as planned. And then I just have that second day to, to tackle with really the same plan. You know, I know I mentioned it in that cohort as well, but I find so many times that students blast through their breaks and don’t take them because they’re feeling really good. And I always use sports analogies and this one just fits into my life right now because I’m training for a marathon, but I have these splits where I, I run hard for a certain amount of time. And then I back off either walk or kind of jog for a few minutes. And the first one of those that rolls around, it’s like, well, why the heck am I going to, you know, kind of take it easy now? I’m not even a mile in yet, but if I have 18 or 20 miles to go, by the time I get to the end, I’m going to wish that I had taken that break early on, even though I felt great for the you know, the first hour.

I don’t really need those breaks on my runs, but by hour two or three, it’s like, geez, you would have been an idiot not to have taken them. You can’t go by how you feel. That’s doesn’t really work, right? We have to be smarter than that. Right. And another thing I’ll say is definitely practice like you’re going to play. I think for me, I knew exactly where my stamina stood, I guess, with X number of questions.

So going into game day, I knew full well that doing two sections in a row was going to be no problem for me. And then you come up with a plan based off of your stuff you can handle and just being honest with yourself. Yeah. And that’s a big part. And we talked about it earlier with you, accepting the accommodations that I did to being honest with yourself, right. And seeing what you can do and then realizing what’s going to be better for you and not just banging your head against the wall to say, Nope, I’m good. Nope.

I’m fine. You know, figure it out, actually pay attention. And it all goes back again, all the way back to the beginning of this conversation, where we talked about figuring out your learning style and not just banging your head against the wall, doing it the way you did it before, but saying, no, can I reevaluate and actually be honest and see what works for me and see what doesn’t work for me? And that’s from day one of PA school all the way through preparing for the PANCE. You need to be honest with yourself and not see what other people do or other people are rather, what other people are pretending to do and follow along that and see that you don’t fit that mold. But give yourself a real, So it’s nice to have an outside coach, right? You don’t really have them for this.

That’s the point of a coach. Even top level tennis players, right? They have coaches, golfers have coaches because you can’t see yourself. The goal is to be as honest and see yourself as clearly as possible so you can evaluate and move forward. So you got your scores back. Tell me a little bit about what happened there. So, I would say, you know, even waiting for the scores was so hard.

I mean we had visualized, right, how game day was going to go, but I didn’t visualize the in-between. The six days in-between, where you’re just in this purgatory waiting for NCCPA to email you that your scores are posted. And And So, you know, I really try to keep myself distracted during that time. My now fiance had asked me to go to Yosemite with a couple of friends. And so, yeah, I mean, I was in the middle of packing for that when I got the email that my scores were posted. He had asked if he could be with me when I opened up the score report. I said, absolutely not.

You weren’t a part of my visualization. This is just me. I imagined myself opening this for better, for worse. And so, yeah, I opened up the results and I was just in disbelief. But, you know, I was over the moon. I think by that point, some of that. Right.

Because even ramping up to taking the PANCE, you’re just so wound up, tightly wound up. And so, you know, even six days of kind of resting in between, seeing friends, talking to family, just hanging out and loving on people that I had largely put on the back burner for a couple of years was so good and refreshing. And I think I got to a place mentally where I was like, OK, Heather, you know, I put everything on the table. If it doesn’t, if the results are not what I am anticipating, then that’s OK, because I tried my best. And so I think I was in a great headspace when I got the results back. No, and that’s great. And honestly, that’s what I try to explain to people, right?

It’s putting everything you have into it and then taking it is a tremendous accomplishment. Of course, you want to have the results you want to have, right? But sometimes things don’t go the way that you want them to go. You can prepare, you can do everything right. And sometimes it doesn’t work out. It doesn’t ruin everything. It doesn’t mean you’re a terrible person.

It just means some days aren’t your day. So to me very much, that’s the, the winning attitude is I’ve done everything I can do. I’m going to go in and do my best and keep my fingers crossed. So I think that that’s, that’s really great.

All right. So now you’re in the position of looking for a job. You said your program was focused on family care. Is that where you’re headed? Is that what you’re thinking about? Yeah. So, I’m back on the East coast now and I’m looking for jobs in family medicine.

And internal medicine outpatient. I think I knew for a while that that’s what I wanted to do. So plastic surgery is completely out. I mean, it was a lovely offer. And if I stayed in California, if I didn’t need to be back with my family, it’s something I considered for a moment. Honestly, it was so fun. And I certainly love procedures and that’s something I want to continue to do.

I love working with my hands. And so, yeah, that’s what I’m looking for right now. I am learning that maybe because my network is in California, I’m finding that there are many opportunities for new grads to join, you know, family medicine, internal medicine. But on the East Coast, I’m finding that PAs are much more specialized. And so a lot of these clinics are asking for very specific things like, you know, spine and vascular surgery PA. I’m like, oh, not what I’m looking for right now. Yeah.

But maybe again, that’s maybe because my network is in California. So it just seems that way right now. Yeah. And that’s something I talk a lot with people about. And unfortunately, since your rotations are all over the place, one of your best networking abilities is obviously on your rotations, right? That’s where you’re going to meet the most people. So if you can create a network during that time, that’s definitely a nice way to do it, which sort of is more difficult, right?

If you are either doing PA school somewhere you’re not, or in general, if you’re doing PA school somewhere you’re not going to be living, you are going to have to build that up separately. And it is going to take a little bit more time where you have to be a little more creative and go a few different routes. But that tends to be one way that students do find work after or places that they would like to work after school. So, all right, great. Well, thank you so much for coming on. I really, really appreciate it. I think this is going to be incredibly valuable for pre-PA students, PA students, anybody getting ready for their PANCE and moving through their journeys to hear how you did your struggles and accomplishments along the way.

Like I said, I think everybody has them. So I like to kind of, as much as we’d like to gloss over them, I think it’s a good thing to bring out and demonstrate that you’re not alone. There are tons of other people who are in a very similar situation who has similar problems or close enough problems that it’s not just you. Everybody’s got the same things and quite frankly, have figured out ways to get through it. So, so can you, is really a major message I wanted you to take away from this. So anyway, thank you so much for coming on. Really appreciate your candor and your enthusiasm as you shared your journey.

Thanks for having me, Brian. Hey, that was fantastic. Again, such a good student, such a great story, really powerful. I hope that you were taking notes. I hope you were paying attention. I hope that you take a lot away from that. There’s, again, just some minor tweaks, some small things you can do to make adjustments in what you’re doing.

Don’t think that you’ve done everything you can do. That’s just not possible. I’m seeing that phrase more and more from students. I’m doing everything I think I can do. There are things you haven’t thought of yet. There are things you haven’t imagined yet. Look for those resources.

And there’s a segue. One way to find more of those resources is to join the PA Week giveaway that I’m hosting, physicianassistantexamreview.com/giveaway, all one word. And there you will find a ridiculous package of over $2,500 worth of PANCE Prep material, including one-on-one training from me, entrance into the 33 Days to Pass the PANCE November cohort, a copy of The Final Step, and so much more. So just go over there, register, check it out. I think you’ll be really pleased. Take something away from Heather’s interview today. Change something that you’re doing.

Use something that she talked about in order to make a difference in your life. Change a behavior. This isn’t just for entertainment purposes. This is for improvement purposes.

So let’s go ahead and get on that.

All right, until next week, take care, good luck, and let me know how you’re doing your exams. Thank you.