When Monday comes around, I will officially be in my second year of PT school. I looked over the curriculum for the next year, and it's amazing how the focus is shifting to a much more in-depth and complex view of physical therapy. The first year obviously included some basic core classes: gross anatomy, kinesiology, human disease, and neuroscience. This time around, we'll be applying that information to courses like differential diagnosis, growth and development, and health and wellness. We even have a "Leadership and Professional Development" course at some point. Without realizing it, I'm finding myself pretty far down the path toward becoming an actual physical therapist.

Even our clinical education is about to take a much more "serious" turn. Our first two part-time rotations were very much focused on things like patient safety and professional communication. In the next year, we'll complete our first full-time affiliation and prepare to interview for our final year-long affiliation. In each of these, we'll progress to taking on our own caseload and gradually be responsible for every aspect of patient care -- obviously a much more intimidating task than patient safety and professional communication.

I don't yet feel like I could treat a patient on my own, but it's exciting to know that within the next year that can be a realistic goal. With this advanced curriculum comes a lot more responsibility, but it's exciting to be able to see the end product. I expect the tone of this blog will eventually shift toward real "PT" issues rather than the funny quirks that come along with PT school.

A big group of people from my class is going on a camping and rafting trip this week before we start back to class next Monday. I find it very hard to believe that one year ago, I didn't know any of these people. I know I have blogged about my classmates in the past, but as time goes on, I feel more and more lucky that I am surrounded by such amazing people.

A lot of my friends are in graduate school pursuing a bunch of different degrees, and none of them seem to be having the same success with their classmates. I'm not sure if "PT people" tend to be like-minded, but there are definite differences between their experiences and mine. My younger sister is in pharmacy school and she's always surprised when I tell her about the different outings or events that my class has planned. From what I understand, the people in her program are very competitive and unfortunately that type of atmosphere doesn't foster friendships. The same is true for other friends in medical and law school -- none of them seem to have the class-wide connections that I have experienced.

PT schools are definitely doing something right. The experience that I've had is definitely a great way to affirm that I chose the correct profession. Like I have said before, the relationships that you form with your classmates are one of the most important aspects of your experience in PT school. It has made such a difference for me, and I consider myself very lucky to be in such a supportive and positive environment.

As of last Friday, I officially completed my first year of PT school. A few people have asked if, given the opportunity, I would go back and change anything that happened throughout the whole process, or if I have any advice for those of you entering your first year. I have to say that overall I'm happy with how things have gone in the past 12 months.

A year ago at this time, I was getting ready to move back to Pittsburgh. Before settling in, I took a trip to Europe as a "last hurrah" before school started. That's definitely something I would do again. No matter how you're preparing before you start, I recommend taking some time to relax. You can only do so much to prepare, and if you take it all in stride you'll be much better off. I also decided not to live with classmates. I could not love my classmates more, but I personally enjoyed having a break from the PT world that I was constantly submerged in.

When school started, even though I was completely overwhelmed, I decided to keep playing rugby as often as I could. There were definitely weeks when I couldn't go, but overall I think it was a great way to distract myself from PT school. Whatever your hobbies are, keep up with them. I think the key to keeping yourself sane is having balance, and while sometimes school tips the scales in one direction, you have to find a way to bring yourself back. If not, you'll go crazy. Whatever you like to do, there's definitely room for it if you learn how to manage your time.

As far as academics are concerned, I can't believe how much I have learned and subsequently forgotten in the past year. I was organizing my notes and read through a few pages and realized that I need to come up with a better way to commit some of this information to memory. I think I'm going to try to make a short and concise summary of different modules that we cover as an easy guide to refer back to when I'm trying to review. Who knows if it will work, but if you have a way to organize the information into a simpler summary, let me know! It's disappointing to realize that all of the work I have done has not ingrained the information forever in my mind.

This year has been amazing and I wouldn't trade the experience for anything. However, there are a few things that I could have done better. Of course, if you're wondering about anything else, let me know and I'll try to give you the best advice possible. Good luck to everyone who is preparing for their first year!

Sometimes, no matter how focused and dedicated you are to being successful in school, you just can't say "no" to playoff hockey tickets even when you know it might be the worst academic decision of your life. That's exactly what happened to me on Friday night when a friend offered me a spare ticket to game 5 of the Penguins vs. Flyers series. Despite facing six finals this week, three of them on Monday, I couldn't turn the opportunity down.

I'm usually pretty careful when it comes to decisions like this, particularly around the time of finals, so I can't quite figure out what made me throw caution to the wind and go to the game. At some point in a semester like this, you eventually have to let some of the stress go and "live" (I know that sounds dramatic). Even if I hadn't gone to the game, I still would feel like there's not enough time to study all of this material, and I would still be in a state of mild panic. This is just another reinforcement that the key to doing well is time management, and despite some less-than-optimal decisions, I still have that going for me.

I may change my tune Monday after the exams. If I don't do well, I'll probably be eating my words. For the time being, I'm going to take this as a lesson in time management and balancing life with school. I'm also going to pray that if they make it to game 7, it's not the night before any of my other exams.

I'll be the first to admit that I've recently put on a solo effort when it comes to studying. I'm not sure if it's old habits dying hard or if I function better on my own, but after anatomy ended last summer, I gradually started to avoid group studying. Part of it was time constraints, but a bigger part was feeling completely unprepared to get into discussions about the information we were covering. I don't know when I started to feel insecure about being confused because I didn't realize it was happening, but for the past three months it's been the driving force behind my avoidance of studying with classmates.

Maybe I'm getting over my hang-ups, or maybe I'm just bored with sitting in a silent library cubicle for hours on end, but for the past week I've reverted back to my old ways and I've been studying with my friends. Total game-changer. The academic conversations that sprout during study sessions not only help to clarify concepts, but they also make it much easier to remember the wealth of information that we need to cover for our finals. To everyone's benefit, the majority of my classmates are genuinely invested in understanding (not memorizing) the information we're exposed to in class. The greatest benefit is that more often than not, we're trying to connect the information with clinical scenarios, even if we're making them up as we go along.

If I could re-do the last three months, I definitely would let go of my insecurities and study in a group. I feel so much more confident with the information this time around and much less overwhelmed. Not to mention that it's nice to have people to laugh with from time to time rather than stressing out alone in the far reaches of the library. This might just be the way I keep myself sane in the next two weeks.

Since I started school last June, my fitness levels have been steadily declining. I can confidently say that at this point, I'm at an all-time low. Prior to starting school, I worked a normal full-time job and for the most part, work was over when I walked out of the building. This meant that I had a lot more time to devote to fitness and hobbies, and while I didn't always do the best job, it was much easier to stay in shape.

Fast forward nine months, and I find myself in the worst shape I have been in within the past 10 years. Never in my life did I think I would consider walking my dogs a form of exercise. And yes, of course, there is time to do more than study in PT school. However, by starting a job and getting involved in as many opportunities as possible, I think I ate up a lot of that time. Exercise has become secondary to a lot of other things, and I'm not proud of it.

I find it ironic that by pursuing a profession that promotes fitness and well-being, I have lost touch with my personal drive for each of those things. I sometimes feel like a hypocrite when I'm educating a patient about the importance of exercise. I hear myself say the words, and when I have time to reflect on them later, I realize that I need to take my own advice. Unfortunately, it's just not that easy. (And who's to say patients don't feel the same way. Maybe this is a useful life lesson). Either way, I can't help but feel slightly embarrassed about my current physical state knowing that I am supposed to represent a profession that encourages a healthy lifestyle.

I'm confident that I will have more time to devote to getting back in shape once this semester ends. And to be honest, there really isn't anywhere to go but up at this point. So my new goal is not to feel this way four months from now.

My first two clinical experiences could not have been more different. Fortunately or unfortunately, it made me realize that the quality of a student's clinical instructor can make a measurable difference in her experience. To an even greater extent, it's the clinical instructor's ability to recognize learning opportunities that makes the greatest difference.

Just so that you have some background, my first rotation was not a very positive educational experience. My CI was not a natural "teacher," and therefore did not challenge me to apply the information or skills that I was learning in class to even the most obvious and appropriate clinical situations. He didn't like manual therapy, either. On my midterm evaluation, he told me that I asked too many questions. I had been in school for three months and hadn't even covered the upper extremity yet. Of course I had a lot of questions.

Contrast that with my current experience where my CI has had a profound effect on the development of my clinical skills. Every day I'm there, she not only expects me to learn something, but also expects to teach me something (and doesn't tell me that I ask too many questions). Her instruction spans the continuum of clinical practice. When we have a patient with a unique medical history, she makes sure I understand the possible implications, and what else I'll need to find out. Any time someone comes in with an atypical presentation, she makes sure I work with that person to "get a feel" for things like hyperreflexia, clonus, excessive joint mobility etc. She seems genuinely interested in my learning, which is encouraging.

I'm thankful to have had both a positive and negative experience so that in the future, if I ever take on a student, I'll know what to do and what not to do. Most obviously, if someone is not willing to teach, he should not become a clinical instructor.

I posted a long time ago about getting involved during school and whether or not it was a good idea from a time-management standpoint. Now that I have settled into the program and the grad school "way of life," I'm glad I decided to challenge myself and take advantage of as many volunteer, employment and networking opportunities as possible. That's not to say that I don't feel like I have a little bit too much on my plate at times, but I prefer a hectic schedule to one in which I don't have any variation.

The reason I'm happy with my decision is because of the personal and professional opportunities that have come about as a result of being involved beyond simply studying for class. Without reaching outside my comfort zone, I would not be on a path to do some very interesting SCI therapy here in Pittsburgh. I also would not be preparing to complete my summer clinical in England, which is actually a result of this blog.

I can't stress enough the benefits of getting involved to anyone who is in PT school. Whether you're in your first semester or your last year, nothing but opportunities can arise from taking the time to participate in as many different events as possible.

Ever since we started the musculoskeletal series, we've been taught the many mobility and special tests that we can implement in the clinic to rule in and out pathologic conditions. The catch, as always, is that we practice these techniques on our healthy classmates, so it's hard to get a feel for what a "positive" test would be. For example, how much is too much translation with the Lachman Test? I think we all just used to hope that it would be fairly obvious to determine a positive test if a patient presented with the corresponding condition. Now that we've entered the cervical spine, I'm less than comfortable with "hoping" that I'll be able to recognize when someone is, for example, unstable at AO or AA.

As luck would have it, we recently had a few patients with cervical dysfunction in the clinic. (I'm also lucky that my CI recognizes excellent learning opportunities). Just a few weeks ago, we covered the Sharp-Purser and C2 Spinous Kick Tests. As always, it was impossible to do anything but imagine the positive presentation of these tests when we were practicing in class. To my surprise and relief, it was actually pretty obvious that those two tests were positive for the patient I evaluated. The beauty of being a student is that you can have your CI confirm your findings and suspicions. It marked the first time that I performed a special test in the clinic and got a positive result.

These are the little victories that get you through PT school and keep you excited. While there are still a lot of other tests that I don't have a "feel" for, it was reassuring to be able to recognize dysfunction based on the tests that we spend so much time learning. I'm glad they actually work!

As my first year is coming to an end (which is hard to believe), I'm starting to think about potential specialty areas for next fall's affiliation. The first clinicals were assigned to us, and the only requirement was that we each experience both an outpatient and inpatient setting. Aside from that, we didn't have much say in our placements. This coming fall, however, we can choose to specialize in a number of areas. Some are very specific: dance, aquatics and hand therapy. Other "specialties" are setting-dependent. I seem to be having a harder time with the latter. I can confidently say that I'm not going to specialize in dance therapy, but I can't decide what to do when it comes to acute, subacute or neuro rehabilitation.

The majority of my clinical rotations have thus far been outpatient, which is why I am leaning toward some sort of inpatient setting in the fall. I just can't decide between the different options that are available to us. I want to be in the setting where I will acquire the widest range of skills, but I honestly don't know what that would be. My gut tells me that subacute rehab will be best, however I'm not familiar enough with the different settings to know if that's correct.

Life was so simple when the rotations were assigned to us. Now that we can choose, I'm starting to realize I'm inching closer and closer to a career in physical therapy. I still have a long way to go, but these types of decisions make the end seem much more tangible.

Spring break started this past weekend, which officially marks the halfway point of the semester. It's relieving to know that I've made it this far, but at the same time I can't believe we still have the hardest part of the semester to get through. As much as I would love a traditional spring break devoid of studying, I'm looking forward to being able to catch up with school work.

As each semester progresses, I can't believe how quickly all of it is flying by. When you're in the thick of things, it feels like these exams and this semester will never end. But when you get the rare chance to pick your head up, breathe and look at the bigger picture, you realize that school will be over before you know it. I was reflecting on this first year the other day, and the amount of knowledge that I have acquired is beyond anything I could have imagined, and there's so much more to come. It's exciting and scary all at the same time as we start to progress toward being clinicians instead of students.

I'm taking a few days off, but then it's back to the grindstone. My mind is eager for a break from PT, but deep down, I realize that I need to get back to work as quickly as possible. I hope everyone else out there gets to enjoy break, too.

This week in our patient management course, we're learning about lower-extremity amputations and PT interventions. Inevitably, there were pictures of "amputations gone wrong" and surgical complications that we could potentially encounter if we decide to do any work with prosthetics or amputees in the future. When pictures popped up in the PowerPoint presentation, the gasps and screams from the class were hilarious, myself included.

I thought that after making it through the wound-care unit last semester, we would have been more prepared and less disturbed by the photos we saw. That wasn't the case. I even consider myself one of the less sensitive people in the class when it comes to graphic images, and I really thought I was making strides toward being completely desensitized. But the amputation lecture caught me off guard, and I think I'm regressing a little bit.

We need stronger stomachs. Yes, many of us may have chosen physical therapy because we didn't think we would have to deal with "blood and guts," but in reality we'll have to face it in some capacity. Until then, I'll dread studying that amputation lecture and constantly fear what I'll see every time I turn a page.

With the results of our recent exams back, there has inevitably been concern about our grades and the implications for those who did not do as well as they would have liked to. The question that always remains is to what degree written exams actually predict your success as a clinician in the future. I guess you can make the argument that this is where the practical portion of exams is useful, since they obviously reflect a more realistic application of the material. However, it doesn't change the fact that we all tend to stress about less-than-perfect exam grades.

I'm wondering what everyone thinks about this? It's so hard to let go of the ideas that have been ingrained in us throughout 16-plus years of schooling - that grades are of ultimate importance. Realistically, as we train to be future clinicians, what should matter is the application of our skills in clinical settings. However none of us, including myself, can let go of the feeling that our success is measured on a scale from A to F.

Some of the most talented people in my class, who will undoubtedly become incredible clinicians, are feeling the same way. And while I don't yet consider myself in their "class" as far as clinical skills are concerned, I can sympathize with how they are feeling. I hope that one day we will all stop basing our success on a grading scale and realize that what matters is how we perform in the clinic.

If you have read any of my recent posts, I'm sure you can figure out that I'm knee-deep in the middle of a pretty tough semester. So I'll preface this post by saying I recognize that I'm on edge, and probably have a pretty short fuse compared to normal. That being said, I have started to notice that different people handle stress in different ways, and some of them do so by complaining. To some degree, I can sympathize. (Realistically it's what I'm doing right now in this blog). But the more I hear people complain, the more I realize it's a useless coping mechanism.

Certain things are more complaint-worthy than others: like having our two hardest exams on the same day. I can understand that one, and if I'm being honest, I probably had a few things to say about it too. What bothers me is when classmates complain about the material we're covering in class, saying either that we'll never have to use it, or that they don't care about it. For whatever reason, it really gets under my skin.

Maybe it's because I'm partial to neuro, or maybe it's because I'm a huge nerd, but I feel like there's a certain amount of value to everything we learn. There were times when I felt the same way in the past. But as we move forward with our education and I realize the responsibilities that are going to be placed on us, I can't help but embrace a complete knowledge base. I sometimes feel like I'll never know enough.

In case I find myself on the other side of the fence in the future, I'm going to try to remember this post. I'm sure other people have their own pet peeves, but right now, this one seems to be the one that's sticking out the most.

It's official -- we're in "that semester." The one we've heard about since entering the program, and despite having some forewarning that it would be terrible, I don't think any of us realized how bad it was going to get. I know it's nothing new. Anyone who has ever been in PT school can relate to what we're dealing with right now. With 21 credits that include neuroscience and musculoskeletal, it's nearly impossible to keep up with the overwhelming amount of work. The worst part is that, as luck would have it, all of our exam schedules seem to be synchronized. I'll be the first to admit that I'm not very good at studying for more than one big exam at a time, which is really not helpful this semester.

The most disheartening thing is that in the midst of all the stress and confusion, I feel like I'm losing sight of the bigger picture. I find myself questioning why I even came to PT school. No matter what anyone tells you, it's hard to see past all of the late nights, unexpectedly difficult tests and phone calls from friends wondering where you've been. I resent that just two months ago, I was so certain that I was in the right place, and also was certain that I would be successful. Lately, I've started to question all of that.

I think one of the other problems is that I have always felt confident in my academic abilities. Even when challenging concepts have been presented in the past, I have always managed to find a way to learn and understand the information. Now, faced with neuro, I feel like I could finally be defeated.