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24. Surviving the Emergency Department A First-Hand Account
169 Plays2 years ago
In this episode, I talk with a fellow PA about our time in our ER rotation. We talk about the ins and outs to help you prepare a little better for this special rotation.
For more information on Locumstory, go to https://zen.ai/thepaexperience.
Check out this episode on Youtube: https://www.youtube.com/watch?v=XCc5NRIXLU4&t=1653s
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Transcript
Introduction to the PA Experience Podcast
00:00:15
Speaker
Welcome to the PA Experience Podcast. I'm your host, Sebring Sands, and as a PA, I take you behind the scenes to see what it takes to become a PA in all steps of the journey.
Exploring locum tenens for flexibility and income
00:00:33
Speaker
Are you a provider, whether it be a PA, physician, or NP, looking for a change? Consider locum tenens. Whether you're burnt out, need a change of pace, or looking to supplement your income, locum tenens might be the solution for you. You might ask, what is locum tenens? The story of locum
00:00:51
Speaker
began in 1979 as a way to provide physician coverage for facilities supporting underserved populations. Locum's has remained true to its roots and has become a way of life for physicians, NPs, and PAs who work with Locum's for diverse reasons. Finding the perfect work-life balance, a way to make extra money, explore the country and the world, learn new skills, and have more autonomy,
00:01:13
Speaker
and as a transition into retirement, and even to rediscover a new level of medicine. There are many different specialties offered ranging from primary care to shift work, specialties like emergency medicine, hospital medicine, psychiatry, OBGYN, and surgeons. Pay is often $32 more an hour than the average permit positions for physicians, and $17 more an hour
00:01:37
Speaker
than the average permit positions for PAs and NPs. If you're interested, please visit LocumStory.com today to learn more about Locum Tenants and see if it's right for you. Also, when you're ready to pull the trigger, please use my link in the description to start the process.
Guest Introduction: David Lewis, Emergency Medicine PA
00:01:54
Speaker
Welcome everyone to another episode of the podcast. I have an exciting new host or a new guest for you today. We're gonna be talking everything about emergency medicine and that rotation and things to think about if you wanna go into that specialty and everything in between. So we're gonna have, we're gonna talk to David and do you wanna introduce yourself, David?
David's transition to his first PA position
00:02:18
Speaker
My name is David Lewis. I'm from Southern California, and I'm about to start my first position as an emergency medicine PA. Excited to be with you, Sebring. Awesome. I'm glad that you're able to come before you start. I know. Yeah, it's coming up quick, and now I'm getting nervous. I've been trying to get people before they start, so they have a little bit of time, but I miss a couple of people. I'll be talking to Sawyer next time, and he already started, so I have to plan around his schedule now.
00:02:47
Speaker
Oh, yeah. Yeah, I'll start until it might be it would be cool to kind of get some the perspective before and after starting. Hmm. That's true. That's true. Yeah, I'll have to ask him questions about that. So that's a good plan. So what have you been doing since graduation? It's almost been six months. Yeah, yeah, it has been a long time already and it really flew by quickly. I think
00:03:13
Speaker
A big part of it was, you know, in December, studying for the pants, taking the pants. Um, my wife and I moved from Connecticut back to California. Um, and then, you know, spending a lot of time with family, catching up with old hobbies and, um, just kind of waiting in limbo to start my first job. So it's been a, it's been a long haul, but, um, it's, it's good to be starting pretty soon. When did you start looking like interviewing and applying for jobs?
00:03:43
Speaker
So I think I started looking maybe a month or so before. I wasn't super serious about it, but I had thrown in like a couple applications here and there.
00:03:54
Speaker
And then you know, I really wanted to focus on the pants before taking it very seriously I was kind of noticing that a lot of I would get kind of ghosted with a lot of places if I didn't have my license yet it seemed like at least that was my perspective and
00:04:13
Speaker
So I was waiting a lot of time to do that.
Navigating licensing and job search challenges
00:04:17
Speaker
And so I probably started interviewing maybe like late December, early January. And then really, I only took one or two
00:04:29
Speaker
interviews because the job that I had first got interviewed was the one that I really wanted to get into and the one that I ultimately ended up accepting. So after I accepted that job, I kind of put it on hold, but I was still getting, you know, after I got the license, then I started getting all the recruiters emailing me and, you know, you know how that goes.
00:04:50
Speaker
Yeah. Okay. So spend about the same timeframe. Yeah. I guess getting privileges and getting licensing and then the DEA takes time. Oh yeah. So it usually takes May, June or so. Yeah. Even if we started in December. I was expecting to be working like a, you know, a couple of months ago, but you know, it really does take a, it is a long process.
Choosing emergency medicine: Influences and experiences
00:05:11
Speaker
Like the DEA took, you know, six weeks, I think the license took another four weeks and you can't get the DEA until you have a license. So.
00:05:21
Speaker
Yeah, there's a lot of like little ins and outs that needs to be tied together before you actually start.
00:05:27
Speaker
Yeah, and I was telling Stephanie this, I'm definitely gonna do an episode detailing the order of doing things and the timeframe you can expect to do things. And it even differs from state to state, because I only took, after everything was in for my license, it took a day. And then after everything was in for the DA, it took like a week, but it took a long time for them to get everything from like my transcript, my other things, they kept losing things, had to resend them. So that's kind of annoying.
00:05:57
Speaker
Yeah, yeah. No, that would be a really good episode because I think it would set realistic expectations for people because I definitely did not have realistic expectations. Yeah. And no one really told me all about a lot of things I kind of had to like figure out and I didn't like that as much. So yeah, definitely going to talk about that. So emergency medicine. So what made you want to apply and ultimately take a job in the ER?
00:06:23
Speaker
So first off, before PA school, I was an emergency medical technician in Riverside County in Southern California for three years.
00:06:33
Speaker
Um, and I really, really enjoyed that experience, you know, in my head, going into peace school, I was kind of thinking, Oh, this is what I want to do. But I don't necessarily think that someone should go in with that perspective. And when I got to peaceful, I said, okay, I'm not going to think about, this is the only thing I'm not going to get tunnel vision into emergency medicine. Like I want to make sure that it's something that, you know, I, I want to do as a PA and just not as a before job thing. Um, so.
00:07:03
Speaker
With that in mind, when I did my emergency medicine notation, I really enjoyed it. I loved working with the variety in the demographics that you work with. You know, you see all ages, young, old, you see the super sick, the not super sick, and then you see various socioeconomic backgrounds, and I really enjoyed working with the variety of people that you get to work with.
00:07:28
Speaker
The other thing is I really enjoyed managing patients' acute problems more so than their chronic ones I was finding during rotations. So that was an aspect that I was kind of focusing on.
Gaining diverse acute care experience through rotations
00:07:43
Speaker
And then I really liked the fast-paced environment as well as the people that work in the emergency department. There's a lot of characters and good chromatography in the emergency department. So that's what ultimately brought me to wanting to choose that as my first job.
00:07:58
Speaker
Okay, that's very interesting. How many emergency rotations that you have? Just one? So I did one emergency medicine rotation, but in total I did three acute care specialties. So I did emergency medicine, I did urgent care, and then I also did an elective rotation in critical care just to get the whole breadth of acute care.
00:08:26
Speaker
Yeah, that's pretty much the whole thing is those three different settings is usually what it is. So that's cool to see all aspects outpatient, inpatient, like really inpatient with the critical care.
Life in the emergency department: A day in the life
00:08:41
Speaker
So that's great. And I think this became, I think a focus for lots of people in our cohort where I think I took it to heart when our program director said,
00:08:53
Speaker
I did another elective in what I wanted to do ultimately, and that's what I did too, is I really liked something so I got an elective in it rather than, like sometimes if you really don't know and you want to explore, then doing one of those one-off electives probably would really help, like cardiology or dermatology or whatever you want to go into.
00:09:14
Speaker
But if it's just a boring, doing the same like ER rotation or another one that will help you get a little more experience, that's definitely worth it because as a new grad, that's the only thing you have is that a little bit more experience and to kind of leverage in order to potentially get a job with the interview. So that's really cool that they got that experience.
00:09:37
Speaker
I had initially put a second emergency medicine rotation and at the beginning I was kind of a little salty about not being able to do it a second time, but I realized now that it was a good thing for me to kind of branch out a little bit and see critical care and seeing
00:09:57
Speaker
like the management of these really, really sick patients. Um, and I think that was good for me. So I would say like, if you're, if you're really 100% sure of what you want, you, you should do the second rotation. If you have that option in that specialty, but if you're not 100%, kind of keep your eyes open. And if you like do something a little bit different, if you want to go into the acute care versus, you know, outpatient, um,
00:10:27
Speaker
kind of, you can go more towards one or the other, but you can keep it the same too. Okay. So what was like kind of for you a typical day in the rotation in the ER? Sure. So they kind of had me, I did a mix of day shifts and night shifts. So, um, it was either be like a set and they were 10 hour shifts. So they weren't like 12 or anything. Um, and they were three or four days a week, um, usually four.
00:10:57
Speaker
Um, so I would, you know, get to, um, the hospital and the emergency department and either my preceptor would be assigned to the fast track area, which is like the quote unquote lower acuity patients, which, you know, come to find out is not always the case in the fast track. Or we'd be in the main ED, um, handling, um,
Advice for students on emergency medicine rotations
00:11:20
Speaker
those patients as well. So usually what I would do is my preceptor was pretty hands off and my emergency medicine rotation, I think was second or third out of 10. So he would just have me check the board. If there's a patient that I was interested in seeing, I'd go see that patient independently and then we would go see the patient together. After I saw the patient, I'd give report to him.
00:11:49
Speaker
or whoever else was preceptoring me. And we kind of discussed the patient a little bit, what my plan would be, you know, what interventions I would do. And then, you know, we kind of discussed a little bit, go see the patient, come back, and he would kind of let me know, you know, whether or not this was the right kind of track for managing the patient.
00:12:13
Speaker
OK, so a little bit more academic in that approach. Yeah. How many how many patients did you usually see during one of your shifts? Oh, man. That's a good question, I think. Honestly, I feel like when you keep track, you.
00:12:31
Speaker
you get in your head a little bit about, Oh man, I've seen like 20, 30, 40 patients today. And I don't know, to be honest, I have no idea. I wouldn't keep track because, you know, it can get kind of grueling in there. Um, you know, as a student, it's exciting, but you know, if you've been doing it for awhile, it's kind of like, Oh, I've seen this many patients and I'm so exhausted. But, um, I mean, it was, it was a good amount. We were definitely, we did not have downtime to, Oh, really? Yeah. No downtime.
00:13:02
Speaker
okay yeah so busy i think the hardest oh sorry what did we say oh just saying it was busy okay yeah and where was this at um in stanford okay oh you did it at stanford okay yeah really interesting because i feel like i had a completely different at staver too so i'll go into this yes it was your experience
00:13:26
Speaker
I thought there was a lot of downtime, but basically the PA would just tell me to go to patients. I would go to patients and tell them the quick spiel about them. But the problem I had in my ER rotation was they didn't really let me do any medical decision-making and planning because
Managing anxiety and expectations in the ER
00:13:51
Speaker
all the stuff that I was thinking about potentially doing, they already ordered.
00:13:54
Speaker
that's the thing with the ER I felt like especially at that location was they ordered almost like everything pan scanning and like labs just before they even see the patient a lot of times so I felt like how do you how am I supposed to really practice
00:14:12
Speaker
like knowing which tests to do based on a differential that I can come up with the history and all that. So that felt like that was a little bit more tricky. I never really got that in that rotation. But I don't know. It seems like the one thing someone should be prepared for is if they're working on a busy ER is you might not get the full explanation and you should take note of what question you have.
00:14:40
Speaker
So you can either ask them when there is downtime or you're taking a quick lunch or you can go look it up when you get home because sometimes there's just not enough time to get that full explanation. And I kind of found that out quickly during my rotation. So for someone who's a little hesitant about
00:15:00
Speaker
potentially diagnosing some serious issues and maybe having to hospitalize them. How did you kind of deal with that if you had any of that anxiety or still have that anxiety going into the ER position? I think there's a good amount of anxiety with it. I think it's healthy though because you know you want to do right by the people that come into the ER and you don't want them to have to come back.
00:15:29
Speaker
because you miss something or they get worse. So that's definitely anxiety inducing. But when I was a student, I had some very interesting critical patients that came in, not even just critical.
00:15:47
Speaker
you know, I don't know if I'm like a black flag for it, but I actually had a couple serious cancer diagnosis that ended up coming to our fast track. And you know, it, it's kind of a weird thing. It's some of these patients just, they get sent home with that big diagnosis and you kind of go, wow, like there's nothing, I mean, there's nothing acutely
00:16:09
Speaker
going on, they just need to set up some outpatient stuff, which, you know, we set up for them, but it kind of feels like something that they should have been hospitalized for, but that's not how it goes. And then you have some very serious patients where, you know, I had a patient that had a lot with blood wigs in China,
00:16:29
Speaker
And so it was very quick, serious. We got to make sure this patient's going to the OR to get intubated because his airway is compromised and he's going to be hospitalized for sure for antibiotics and monitoring. So I think going in with this perspective that
00:16:52
Speaker
you have to kind of keep an open mind with these patients that come in and whether or not you're going to hospitalize them or not. And yeah.
00:17:03
Speaker
Okay. Yeah. And also the ER isn't as exciting as TV. Usually nothing in medicine is as exciting as if it's on TV. And that's because they have to make it exciting for you to watch it. A lot of it is just, it's the same
Efficiency and mental health in emergency medicine
00:17:22
Speaker
thing. You're going to a patient, you're getting a history. You can't talk until you're going back, formulating the plan, and then you can go hop back and forth.
00:17:31
Speaker
to kind of update them sometimes if things are taking forever. And a lot of times they're just sitting there for hours waiting for one test or another or labs. So it's a lot of that, a lot of sitting, and also a lot of note writing too. The providers are writing notes, a bunch of notes for a bunch of patients on all their downtime. That's what stresses me I think the most with outpatient. Hopefully it's not so bad where I'm gonna be going where
00:18:00
Speaker
You're seeing a bunch of patients, you have to write notes for them. And you're trying to get everything done within your shift and you don't want to have to stay late or potentially come back and do it. Oh yeah, absolutely. I think taking work home is very stressful. So I think getting it done before leaving is a big portion. But I also have the opinion that you shouldn't be staying longer than your shift. If you have a couple notes to finish up, just finish them tomorrow.
00:18:30
Speaker
I think staying too late is bad for mental health. Oh, yeah. Oh, for sure. For sure. Let's see here. What are some of the procedures that you did a lot and wish you knew kind of how to do before you got into the rotation?
00:18:49
Speaker
Um, so before I went to my rotation, I kind of looked up, you know, what are the common procedures and, um, you're going to do a lot of suturing. You're going to do a lot of incision and drainage. Um, you might have like nail trepanations here and there for a nail hematoma. Um, so just kind of knowing like those sorts of basics.
00:19:10
Speaker
Um, just like the setup, I think something that is of note. So as a student is making a list of the equipment that you need for each procedure. Um, and getting all of those before starting, because, um, when I first started in the ED and doing a suture independently, um, you know, with supervision, but like, you know, just doing it, um,
00:19:36
Speaker
I wouldn't grab all the supplies I needed or I would forget a thing or two and it's obnoxious for you and it's obnoxious, I'm sure, for the patient to see you go in and out, in and out, in and out. So I think for procedures, making sure that you have all of the equipment that you need before you even start will get rid of a lot of headaches for you.
Building confidence and clinical skills through practice
00:19:59
Speaker
That's a good point to plan, prepare. A lot of the times there are kits which basically just bring the whole thing in that has everything in there. A lot of times you need to get lidocaine and stuff like that, which takes time sometimes because the nurses usually have to either get it from the pixus or something or you have to track it down someplace.
00:20:20
Speaker
So that's important. Yeah, I think that's one thing students might not realize in the EDs or even in rotations is if you have a good attending, hopefully people are having good attendings or providers or PAs that are supervising them,
00:20:36
Speaker
They see you do it a couple times, especially the ER. They're so busy, they'll let you do it by yourself. And they'll just come in and check on it after it's done. So that's really empowering. I think for me, I was I most I did. There's one day I was at the
00:20:52
Speaker
like the urgent care for Stanford. Yeah, I remember what it was called. Fast tractor, green zone. At the other location, not at the hospital. Oh, yeah. And there were so many sutures, probably like 10, 15 that day.
00:21:07
Speaker
And he was so busy and he knew that I know how to suture. So we're just double, we're just double teaming it. And you just come in at the very end like that looks really great and really talk you up. And it helps for the patient to that you're talked about, like, I really trust this student, like he's really amazing. So they're a little more at ease. But that's really cool, too. You can do a lot of things independently once you become comfortable and they see you do it well. So that's very exciting.
00:21:36
Speaker
in your piece. It feels nice to you get like the nerves shaking off a little bit. And I don't know when people watch me very closely, I kind of get a little bit more shaky, which I don't like it at all. Yeah, when the patient see you shake a little bit, it's kind of like, Oh, what am I getting myself into? Even though I know what I'm doing, you know, it's just like a natural like, you know, you're being observed. So you get nervous. So yeah, I never liked being micromanaged.
00:22:02
Speaker
Even like I'd much rather go and take the history by myself and just learn from like, oh yeah, mental notes of things I forgot when the provider went in there and talked to them too. That's, I best learn from that rather than sweating. And I just, I just, that's when I get, every time I got pimped, I wouldn't do very well. I would just freeze. I couldn't think. I'm like, oh no. And they're, I feel like I'm failing at that very moment.
00:22:31
Speaker
It's like, it's just sometimes hard to synthesize when you're on the spot. It's like, oh, I know this, but I just, you know, you need a second or the nerves need to go away for you to remember it. But yeah. How was your experience with pimping there? Was it? No, no one really ever did it. The thing with the PAs I was with, we just worked together and we got, saw the patients and that was it. That's, I love that style of rotation where
00:23:00
Speaker
That's the best learning I do is sure like asking questions about like, oh, what do you think about when you see these symptoms? What do you think about? Or how do you differentiate this from this diagnosis? And how is this different from like, how do you synthesize this differential? Those types of things are important. But I think when you're actually working and doing the job,
00:23:27
Speaker
however limited it is as a student, that's how I learned best. I really enjoyed those rotations where I only did that. It's nice to feel like you're an asset to the team too. You're contributing instead of being a little bit of a hindrance, which you shouldn't feel that way as a student regardless, but it is nice to feel like, I'm actually speeding things up, I'm not slowing things down, I'm working pretty independently.
00:23:55
Speaker
So, you know, it is nice to feel that way. Mm hmm. And note on suturing. So for those that haven't had like a general surgery rotation or another surgery rotation, the suturing is very simple.
Memorable cases and learning moments in ER rotations
00:24:13
Speaker
It's just simple and erupted. You don't have to do anything fancy. You might get some providers that are super fancy on their suturing, but it's all the same. Just simple and erupted is the best because they
00:24:24
Speaker
have to be taken out anyways. So focus on that. Those are easy to practice. I'm going to be starting a surgery specialty and some of those things, some of those searches, I can't practice at home because nothing's good enough. Skin, human skin is the only thing I can practice on, but simple interrupted so you can do all day long. So you're going to be doing that. And I would say for if you're practicing suturing at home, make sure that you're
00:24:52
Speaker
you practice doing them well before you do them fast because you don't wanna mess up that and have your preceptor come back in and say, oh, this is too tight. I'm gonna cut it and then redo it. It's a little embarrassing. So yeah, I work on doing them well instead of doing them fast. So what's something that was very interesting that you were able to participate in or diagnose or see during your rotation?
00:25:20
Speaker
So I had those cancer diagnosis patients that I was talking about. I think like a little bit of emergency medicine is like stuff that's surprising you. You know, I don't want to like divulge too much into the patients, but it was
00:25:37
Speaker
a diabetic patient that ended up having a necrotic foot. I pulled taser barbs out of a patient. You definitely get the variety if you're looking for variety. There was stuff that I did that I wasn't expecting. It's good if you're looking for that kind of field.
00:25:59
Speaker
I think the coolest thing I did, or I saw, I definitely was able to diagnose it. It's pretty obvious. It was a pharyngeal abscess. Yeah, so it was pretty distinct. It was like, yeah, it looks exactly like you learn in PA school, but there was this hotshot new physician that wanted to do everything. So she went in and aspirated it.
00:26:27
Speaker
It wasn't super crazy, but I thought it was pretty cool. Yeah, no, it's cool. And it's not something that, I mean, they're common, but it's not something that procedurally you're going to, you do that often. So were you able to observe it or? Yeah, I was, I was one of the patients I saw, I was able to see him see or do it and everything. So that's awesome. Pretty cool. Yeah.
00:26:50
Speaker
So the mundane can be very interesting you know at the beginning because it's just like it's all new to you so it's so cool. And also seeing it in practice I think really helps.
00:27:03
Speaker
with the learning and the memorizing of it, because sometimes some things are so abstract if you don't see it. Like sepsis, sepsis was so difficult for me to understand until we saw we're trying to make sure people don't have sepsis in the ED and like, oh, what does these things mean and this house compared to this and these things that we're looking for? And so that was very helpful.
Balancing clinical experience with study priorities
00:27:31
Speaker
Oh yeah, I think the best learning happens when you have a patient and you're managing them because you learn very quickly what you need to do, what things need to be ordered. And then for me, taking home a patient or two, not like literally, but kind of metaphorically and kind of brushing up on a diagnosis or two every night was something that
00:27:58
Speaker
was really important for me just to make sure that I understood the patho, the workup, the diagnosis and the treatment for a couple of patients that I personally had during the day was also good for my learning.
00:28:13
Speaker
OK, I've heard that a few times, focusing on a couple of those things, usually things you've seen during the day to help you solidify those things. How do you go about studying for the end of rotation during this rotation? So I think for every end of rotation, you should definitely be looking at the Blueprint.
00:28:40
Speaker
and kind of honing or studying towards looking at that aspect of what's on the topic list towards whatever rotation you're in. So if you're in emergency medicine, because you're going to have overlap between the things on the exam, right? So general surgery and emergency medicine might have things that overlap, but your focus should be more on, for emergency medicine, on the acute aspects of those topics. So
00:29:09
Speaker
Um, you know, if someone, um, if someone comes in with like a, you're going to diagnose the PE, um, instead of like the surgical aspects of it, um, focus more on like the acute management for emergency medicine, like how to manage it in an acute setting.
00:29:29
Speaker
you know, and there's probably some overlap between the surgical and the emergency medicine too. But I think when you're looking at the topic list, doing that will take you a long way. You know, for my studying, I did
00:29:43
Speaker
In the clinical year, you have been introduced to all the material that you're going to see on these EORs. So a lot of it is brushing up. So doing a lot of practice questions and reviewing flashcards, I think, was really important for my studying. I used Roche Review a lot in smarty pants. I think Roche Review is more challenging, in my opinion.
00:30:13
Speaker
But I think the thing with rosh review is it gives like the when you get a question wrong, it has like an in depth explanation of why you got it wrong or like why the correct answers correct or why the wrong answers are wrong.
00:30:27
Speaker
And I think it's the most similar to the EORs. The other thing is making sure for emergency medicine that you're brushing up on your EKGs because I think I had like, I don't know, I can't remember exactly, but it felt like 10 EKGs. The thing is with the
00:30:48
Speaker
the EKGs for testing purposes is they don't make them very subtle. So, you know, if you know the EKG, you're going to get the answer right. But if you don't know it, you're going to have a hard time. So, you know, you don't have to know, like, the very nuanced EKGs, but knowing, like, if it's a STEMI, like, it's going to be a Ripon STEMI and you're going to you're going to know, but you should know, like, oh, is it anterior or lateral, inferior?
00:31:15
Speaker
you know what vessels are being you know if it is one of those what vessels are being affected or you know most likely to be affected if it's acute pericarditis you should be looking for that diffuse st elevation because it's going to be there so just make sure that you know like the basics for the ekgs and then
00:31:36
Speaker
When you're studying, just know that common things are common in the ER, and they are also on the test. So the more nuanced diagnoses, you should be looking them up and knowing them, but the more common things should be your focus, really, because that's what's going to show up on the majority of exams.
00:31:58
Speaker
Awesome, yeah, so I think it definitely practice questions. You only really need one question bank. I think we can fall in the trap of thinking we need everything, but we just need one.
00:32:16
Speaker
And it's okay to realize that the end of rotation exams are hard. And if you didn't do as well as you hoped, it doesn't necessarily mean anything about you passing the pants. I think I heard this before I took the pants that someone said that the ewars were harder than the pants.
00:32:34
Speaker
was laughing in my head about that like you've got to be kidding me but no I feel like it's true I think it's because the PAEA goes into minutia that you just don't see it in with the pants
00:32:47
Speaker
Um, so it's okay to realize this is hard and you don't have a lot of time to study too. So just give yourself some grace and just, it's okay. As long as you can pass it, that's basically the best you can do. You know, just move on and you'll be able to pass your exams and pass the pans just fine.
00:33:07
Speaker
So I'd rather someone get more out of their clinical experience than spend a million hours studying for an EOR. Like if you're getting good experience at your rotation site, I would take that over doing like getting a perfect score on an EOR any day.
00:33:24
Speaker
says the guy who got almost a perfect scores on all of us. No, you're so humble. Yeah. I wanted before we, we, we finished, I forgot. I wanted to talk to you about this. So you were on the team, the sacred high university. Um, what is it called? The, um, challenge ball team. And we've got second place, right?
00:33:49
Speaker
Yeah. Yeah. It was like, do you want to tell us about that experience? Yeah, it was cool. Honestly, our team, we didn't do, I mean, we had a pretty good team. Not pretty good. We had a really good team and, you know, we didn't do any like, like group practice sessions or anything. I don't, I don't know if we kind of, we went in with the mindset that, you know, we're just going to have fun. It's not going to, you know, we're not trying to like,
00:34:16
Speaker
win the thing or, I mean, you know, obviously you're trying to, but we don't have that expectation.
David's experience in the Challenge Bowl
00:34:21
Speaker
Um, cause there's a lot of really good schools out there and there's a lot of really smart people. Um, and you know, we came in with a, you know, a bright attitude and we ended up doing really well and it was, it was a really fun experience actually. How are the questions formatted?
00:34:39
Speaker
Was it like a Jeopardy style or yeah so the, as I remember, the, so you can answer the question at any point during when they're reading the question, but the way that they had it is.
00:34:57
Speaker
If you answered a question wrong, you can't answer again, which is kind of Jeopardy style, right? And also you would lose points too. So you wanted to be sure that you're quick, but also accurate in your responses. Otherwise you can't answer again and you're also going to lose points.
00:35:14
Speaker
You know, I think we went in with the strategy of, you know, like, listen to the whole question. We don't want to be tricked with a not at the end of the question or isn't or, you know, like a negative inflection to the statement. And then.
00:35:29
Speaker
you know, not answering unless we absolutely are sure that we know the answer because, you know, we would see a lot of teams answer a question and it didn't seem like they were 100% confident and they would lose points. So, you know, there was a round or two where
00:35:48
Speaker
We won because we got one or two questions right, but we more won because other people lost points because they got questions wrong. So I think that's an important aspect. If you are doing the challenge, well, is making sure that you're confident in your answer and not just answering to answer. Okay. And were they like normal question stems or were they like pimp questions? I think there was a little bit of trivia in them, but there were
00:36:15
Speaker
they weren't like a traditional like you are or anything like they were pretty they were short because they were spoken out loud. It wasn't like we had like a teleprompter to look at the question. So they had to keep them kind of short so we could remember all the factual data within the question to answer it. So they didn't like make them crazy long or anything. Okay, some of it was some of it was like a question stem.
00:36:42
Speaker
That's super cool. And congratulations on doing our school proud. Before we go, any last advice or comments you want to make to whoever listens to this episode?
00:36:59
Speaker
Sure. So I think before you go to the ER, I think one of the most important things is to look up the 10 most common ED diagnoses or complaints and brush up on those things before you go into the ED because you're going to see those things all day, every day, you know, with sprinklings of other things. But I think that's a good way to approach before you go to the ED.
00:37:27
Speaker
Okay, that's awesome. Let's remember that people, PA students are going to the ER top 10. Okay.
Conclusion and farewell to guest David Lewis
00:37:36
Speaker
Awesome. Well, thanks so much for joining me, David. This has been fun. Thanks for having me, Sebring. I appreciate it. And congratulations. Thanks for catching up with you and chatting with you. Congratulations on your job and good luck. You're going to lose your freedom in like a couple of weeks, a couple of weeks or so. Congrats to you too, Sebring. Oh, thanks.