PA School: One Semester Done



I'm currently in physician assistant school. I chose a 24-month, 6-semester program, and I just finished semester #1. Back at home for winter break, here's my update on how things are going.


We were several weeks into fall semester when I got an email to my student account asking for volunteers to sign up to have lunch with current applicants on one or two interview days. I remember this when I was interviewing last year. The program provided hoagie sandwiches, and I sat with the five or so other candidates interviewing that day around the conference room table with two students from the current class who chatted happily about their experiences. After, I sat at the back of the classroom for a few minutes and watched a lecture about standard precautions.


It being 2020, this year's interview days were all virtual, and so were the lunches. Even without the actual free lunch, signing up to chat with candidates and answer their questions is the kind of thing I usually volunteer for. When I opened the email asking for students to sign up, I felt like it was something I should do.


But then I realized: I didn't have one good thing to say about the PA program.


I feel like that experience basically sums up how my first semester of PA school went.


I started the semester in August, full of confidence. My parents and husband had helped me move to Idaho. I had tried to find a roommate or roommates who were also in the program, but wasn't successful. Still, I found a basement apartment for a reasonable price in a decent area that allowed dogs. I got it set up with my house plants and a cheery rug and my treadmill. I started working on establishing a routine of keeping the apartment neat, exercising regularly, and studying hard.


I had just read the book Lean In by Sheryl Sandberg, and on my first official day of the program, I went to campus determined to raise my hand, speak up, say yes to every opportunity, and really participate. Within the first few days, I had applied to be an AHEC Scholar (and got accepted) and had nominated myself to be the outreach officer in the program's student government (which I became). It felt like PA school would be an excellent setting for making good friends and forming a future professional network, and despite social anxiety, I had done things like form a Facebook group for the 2022 class, offered to help people move in, and invited people to lunch.


But within the first few weeks of the program, things started to deteriorate. We were required to register for an insane 30 credit hours, and the workload immediately piled up. I studied, but couldn't really fathom how--I didn't know how to study for Anatomy, for example, when the instructor had assigned some 150 pages of reading for the first lecture alone. I was still diligently making flashcards from the first lecture of histological slides and the first days of embryo development when the first test on the back was coming up. There was so much information, and I couldn't figure out how to possibly cover it all.


And then there was the struggle to connect with people. We practiced our first set of physical exam skills with professors early in the semester. Unlike most of my classmates, I fumbled with the blood pressure cuff and my new stethoscope. I knew it would be best to practice exam skills with others. The class had set up a GroupMe board for communicating with each other, chatting and asking questions, and I posted on there hoping to find people to practice with. My program is spread across three campuses in different cities, and after that post, someone added me to the message board for my city...as in, that's the place to arrange in-person study groups. It was already well-established. Just...no one had thought to add me before. I posted again, this time to the city board, already feeling dejected that I had just been forgotten...and no one responded. I tried emailing the people I had gone to lunch with directly, and nothing came together. Not long after that, I tried posting that I needed a partner for a group assignment, and the only person who responded had already done it, but just had pity on me.


By that point, I felt like all the confidence I had started with was completely gone. The material was overwhelming. I was lonely in my basement apartment. My efforts to put myself out there and try to connect with people had been a disaster. I believed I had things to offer the profession from my background as a teacher, I felt so behind with so many classmates having worked in clinics and hospitals and on ambulances.


And with all of that, symptoms of depression came rushing back.


Our class was split into two groups because of COVID, with just one group on campus alternating weeks, though we always had the option to attend class virtually from home. And that's what I did. I left my apartment as little as possible, and only went to campus for required labs. As the semester went on, things kept getting worse. It was hard to study. It was hard to get out of bed in the morning--so hard that it often felt easier to just not go to bed, which I did at least once a week. I wasn't exercising anymore. Then things like showering and eating started becoming more difficult. The coursework kept piling up. I would try to sit down at my desk and study, and it would feel like I was physically paralyzed and unable to move: Me sitting on the desk chair, hunched over, staring at the floor, yelling at myself inside my head to do something.


I was taking my meds and talking to a therapist through student services. I had had amazing results from TMS just a few months before, and found someone in the area that offered the therapy. I did treatments five days a week, over my lunch hour...but this time, they didn't work. Since the semester has ended, I've had to meet with the Academic Affairs Committee because of poor performance, and I'm still waiting to hear whether they decide I can continue the program.


I came home for the break with questions: Can I do this? If not, what do I do? If yes, how can I do it? Would I be happier in a $15/hour but low-stress job like the data entry job I had in the months before starting school--even if it isn't great financially or doesn't impress people? And do those things even matter if I'm happy? And, the biggest question: I can't survive another semester like that, so what on earth is left for me to do for depression? After trying more than a dozen medications, hospitalizations, meditation and mindfulness, cognitive behavioral therapy, dialectical behavioral therapy, eye movement desensitization and reprocessing, electroconvulsive therapy, transcranial magnetic stimulation...what is even left for me to try?


I could only think of one more thing: psychedelics.


I had thought about this before, after reading How to Change Your Mind. I found a clinic in California that used marijuana for its psychedelic effects, but when they heard my mental health history, they said treatment would have to take place over several months (not something I physically do). I was seriously considering a program in Peru when the first round of TMS started to work. But coming home from fall semester, I needed something that would fit during my break (if I was going to be able to survive another semester of PA school, things had to change). I was amazed when I found a clinic right near me that does ketamine injections for its psychedelic effects...and I signed up.


Will it work? Will I be going back to school? I'm still wondering all of that, and more.


So...stay tuned.

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