I have to admit- starting clinical rotations as a PA student was a bit overwhelming at first (but also exciting)! Everything was new—the pace, the expectations, the amount of information, and the responsibility of working directly with patients. At first, it felt like there was so much to learn and so little time to absorb it all- especially when you get home from working all day and want to pass out from exhaustion. But as I settled in after the first few months and gained experience, things started to naturally click. The initial nerves faded, and what once felt daunting became second nature. I began to feel more comfortable with the clinical environment and confident in my ability to contribute to patient care.
For my rotations, I started with OBGYN, which was an incredible introduction to hands-on patient care. The electives I chose were in oncology, ENT, and cardiology, all of which were extremely beneficial. I can say that, overall, I had a wonderful clinical year, learned a lot about medicine and even more about myself, and made some amazing friends along the way.
However, here are 5 things I wish someone had told me before diving headfirst into the chaos:
1.Each Rotation Is a Whole New Universe:
Every rotation feels like stepping onto a new planet with its own language and rules. One week you’re memorizing antibiotics for family medicine, and the next you’re suturing in the OR.
What I Wish I Knew: Be ready to adapt—fast. Each rotation has a different vibe. ER? It’s all about speed and precision. Family medicine? Brush up on your people skills and time management. Don’t expect one size to fit all, and don’t beat yourself up if you feel like a complete beginner every time you switch. This will fade as you become more comfortable throughout your clinical year.
Pro Tip: Before each rotation, it’s a great idea to send your preceptor an email a few days ahead of time to confirm the details of your rotation. Ask about where you need to go, what to wear, what time to arrive, and any specific expectations they have for you during the rotation. And always make it a point to show up before your start time—being punctual not only reflects your professionalism, but also ensures you make the most of your learning experience from day one.
Also, being prepared on clinical rotations is key to making the most of your experience. Always carry the essentials: a pen, paper/pocket notebook, stethoscope, penlight, and your ID badge. Having snacks on hand can help keep your energy up during long shifts (because lunch breaks aren’t guaranteed), and bringing along any necessary resources like a pocket guide or a reference app can be a lifesaver when you need quick answers. Being organized and ready for anything shows your commitment to the rotation and ensures you’re ready to tackle any situation that comes your way.
2.You Can Study, But Not for Everything:
I thought I could prep for rotations the same way I prepped for exams, but it simply was not possible. Sure, reviewing medications and EKGs will help, but nothing prepares you for that first patient who has every symptom except the ones you studied.
Pro Tip: Do a quick review of the basics for each rotation beforehand. For family/internal medicine, dive into common conditions like diabetes, high blood pressure, and acid reflux. For OBGYN, know your STIs and APGAR scores. But also accept that half the learning happens on the job. When in doubt, ask questions (it shows you are paying attention and wanting to learn). And if you are “pimped” during a rotation (basically, asked a medical question by your supervising physician) and you don’t know the answer, simply reply with “I’m not sure but I will research the answer.” Then take the opportunity to look it up afterward and discuss it with your preceptor later. This shows initiative and a commitment to your learning.
Helpful Study Resources for Clinical Rotations:
3. Choose Rotations That Matter to You:
You won’t love every rotation, and that’s okay. Choose your electives wisely. Pick one or two based on what you think you want to do long-term. Don’t waste an elective on something you have zero interest in. If you’re unsure, pick something broad. Urgent care, ENT, dermatology and/or cardiology are all great foundations and will help you on your PANCE exam, as well.
Personally, I thought I’d love surgery (turns out, I did not- something about being cold, standing all day and being hungry just didn’t sit right with me….although I have a whole new respect and appreciation for surgeons!). However, many of my classmates loved their surgical rotations and ended up working in surgery, so it really is all about preferences and personalities!
4. Mistakes Are Inevitable, But They’re Also the Best Teachers:
Ah, the sting of embarrassing yourself and messing up! It happens! I’ll never forget my initial rotation- it was my first C-section, and I was told I didn’t have to scrub in and could just watch from a distance. During the procedure, one of the surgical techs tossed a sterile towel to me, and I panicked. After all, I was told earlier, “You can’t touch anything once you’re scrubbed in!” So, I quickly jumped (yes, jumped!) out of the way of the oncoming towel, convinced it was a test. The towel landed on the floor and I just stood there…with the entire team just staring at me. I blurted out, “I can’t touch it” and they all burst into laughter. I had forgotten the small detail that I wasn’t scrubbed in, and it turns out- it wasn’t a test! She simply wanted me to throw the towel away.
Lesson Learned: Own your mistakes, learn from them, and move on. Preceptors don’t expect perfection; they expect effort. Take the feedback they give you and use it to get better. I ended up loving my OBGYN rotation and did great, despite my humbling start!
5. The People You Work With Make All the Difference:
Your preceptor can either be your greatest mentor or your biggest nightmare. Your fellow students might become your best friends or your competition. The nurses? They can make or break your day.
What I Wish I Knew: Building relationships is just as important as building knowledge. Help out when you can, say thank you often, and remember that everyone’s there to help the patient. Also, if you’re kind and helpful, people are way more likely to share tips and tricks.
Pro Tip: On the last day of a rotation, it’s always a great idea to express gratitude to everyone who has contributed to your learning experience. A thoughtful way to do this is by writing thank you notes and/or bringing a snack for the team to enjoy. Taking the time to go around and personally say thank you and goodbye to each person shows appreciation for their guidance and support. It’s always a good practice to leave on a positive note, but also remember that many licensing boards require 1-2 physicians to speak on a student’s abilities and character. Having those strong, supportive connections can be invaluable in the future.
Final Thoughts:
Clinical rotations are exhausting, awkward, and sometimes downright terrifying. But they’re also exhilarating, rewarding, and the best way to learn what kind of PA you want to be. Embrace the chaos, laugh at your mistakes, and remember: everyone feels like an imposter at first. You’ve got this!
And as always, if you need us to help guide you through your clinical rotations, we are here for you! Feel free to reach out and send us a message!
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