Transitioning

Hello readers!

Today I'm feeling wistful about the coming year and especially about seeing my first round of out-patients as an intern so I've decided to touch on clinic requirements and the experience of the Palmer Clinics.

Mentors
As an intern at the Palmer Clinics, I have a mentor. My mentor, Dr. Beres, is the primary instructive person for me and about 10 other interns. We come in on rotating shifts, though, to get the largest portion of her time possible. This system actually makes everything much easier. In the past, interns would have to chase down doctors who floated from place to place within the clinic. Now, the only person who ever needs to sign my papers or approve my work is my specific mentor. In 8th quarter, students have a meet-and-greet with these clinic mentors and are able to choose one based on that doctor's specific practice model and philosophy. There are a wide variety of doctors available, so choose wisely!

So many numbers!
At the Palmer clinics, a spreadsheet of requirements for graduation will become your best friend. While this has changed slightly over the last couple of years, the idea has remained the same: 25o patient encounters and 1025 hours of clinic time to graduate. Beyond this, though, there are a myriad of other numbers that are sometimes not discussed on tours or on the website because they are specific and complicated enough to cause a lot of nervousness. Let me break these down for you and give you a sense of how your time in clinic will be spent.

• 250 patient encounters (200 must be non-students, 75 must be observed and assessed, 200 must contain a spinal manipulative technique, 30 must include a non-adjustive therapeutic such as ultrasound or rehabilitation exercise)
• 25 Case Management Reviews (completed on new patients with your specific mentor)
• 15 different case types (according to diagnosis and management)
• 30 assessed radiology encounters (up to 13 of these may be assists, meaning the intern will be the assistant to another intern who ordered the films)
• 1025 hours in the clinic minimum
• 10 cases of high complexity (live)
• 20 cases of high complexity (simulated)
• 55 clinical labs/diagnostic studies (25 urinalysis, 20 hematological, 10 chemical cultures)

So those are the numbers... now before your head starts spinning off, remember that while seeing 250 patients, most of these things will just happen naturally. In a population of 250 people, at least 10 of them will be complex... in fact, most of them will probably be "complex" it's just up to you to write up the paperwork. If, however, you find yourself in a position where one of these requirements is not filled, there are a few other options to consider.

Outreach Clinic
Palmer has set up three clinics outside of our two normal outpatient clinics meant to provide a valuable service to struggling members of our community. These clinics offer no-cost service to a variety of people from different socioeconomic levels. It's fantastic for them, but it's also fantastic for us because these clinics are BUSY. At any time during 10th to 13th quarters, interns can go out to one of these clinics, portable table in hand, and start lending a hand. These patients tend to have more complex problems, which makes them ideal candidates for "case of higher complexity" and "radiography candidate" titles.

Clinic Abroad
One of the fantastic opportunities Palmer students have is the ability to go into developing countries and deliver care. Between quarters 10 and 13, students from all three campuses come together for several weeks and have a chance to hone their skills. Not only do students develop better manipulative skills on these trips, but they have a chance to practice a myriad of primary care procedures since many of the patients have never seen a doctor before. Because our care is so rare and valuable to these people, students who elect to attend clinic abroad typically finish the remainder of their 250 encounters during the trip. In my opinion, this is a side bonus to the fantastic work of assisting those who are in desperate need of medical attention.

Once you've finished up these numbers...
You're ready to graduate....or go on preceptor. The preceptor program is available to students in 13th quarter who have finished all their clinic requirements by the middle of 12th quarter. On preceptor, the student can choose from dozens of doctors located all over the country and globe, and practice in that doctor's office for the last three months of their Palmer career. These internships are invaluable since many students find their jobs this way. It's also a great way to see what practicing in a different type of office is like. While the Palmer Clinics are a great educational tool, seeing a private practice in action is a totally different experience, and one that I think is incredibly valuable.

Day to Day of Clinic Life
The first time I went to visit the clinic during 9th quarter, I was completely overwhelmed. There were interns all over the place, papers almost flying through the halls, and door after door of patient rooms, treatment bays, and complex machinery. I could barely believe that I would ever adjust to its layout and intensity. Soon, though, the hallways became familiar, the people recognizable, and the machines operable. So the bottom line is to spend as much time as possible in the clinic before it is required. With the right attitude, and a little work, the experience of an intern should be a lovely journey of discovery: every day, taking one step forward toward becoming someone who can be trusted with patients' health.

Good luck to all of us! :)

Negatives

During my tours, people are constantly asking me, "what is the down-side of going here?" I guess this is because I seem so positive. People want to test my sincerity, I suppose. Well, I've compiled a list of negatives about Palmer for all the nay-sayers... but I have to warn you, I am full of optimism and wistfulness... Here we go!

Newer isn't always better
We boast one of the newest chiropractic college campuses in the country. As far as architecture and space functionality, being new is fantastic. In other respects, however, it is more challenging. A new school means new curriculum, new professors, and lots of challenges. In my time at school the curriculum and various policies have changed more times than I can count. This can be confusing and, at times, frustrating. However, most of these changes benefit the students in the long run. Occasionally, it is not soon enough to benefit me specifically, but remember, anything that benefits the students of tomorrow eventually benefits the profession as a whole.

Chiropractic is full of questions
This is both a positive and a negative. Because our profession was founded only a little over 100 years ago, we are still children on the healthcare continuum. This leads to all sorts of questioning, arguing, and debating about where our profession should be heading in the coming years. While debate is the spark of innovation, it can also be disconcerting for a student about to graduate and embark on his/her own journey. As a student it is important to remember that once you go out into the world, your decisions are your own. This is as true clinically as it is philosophically and in business. Luckily, to combat this potential problem, we have a diverse group of faculty who have a wide range of opinions on the development of our profession. From these, any student should be able to create a personal practice paradigm.

Paperwork, Paperwork, and more Paperwork...
Entering Palmer College means signing your name 1000+ times before even entering the clinic. It also means learning an entire system of record keeping that--in all likelihood--will not even be close to the records you will keep in your practice. I recently saw my first student patient in the clinic and I was overwhelmed with the tedious nature of the forms/files/folders I had to complete. The overwhelm sets in when one realizes that he/she has not been properly informed on how to complete all this paperwork... He/she may have even seen all these forms before, but knowing exactly how one's overseeing doctor wants them done is another topic. This can be frustrating, since our clinical skills are highly developed by the time we enter our last year... I would like to believe that our record keeping skills are just as well-developed... but they are not. (You can see, I'm rather impassioned about this...) Anyway... it is very frustrating to feel like I am swimming in papers... but I also know that no matter how detailed the notes I will be required to take after graduation, there is no way they will be as detailed as this. Therefore, I'm learning the worst-case scenario to be better prepared for the real world. That's something I can feel good about. :)

I think that's it.
Knowing that these are the worst thing about my education, I feel pretty good. There is nothing that I cannot overcome or make an excuse for, so I know I made the right decision. If any of you have any questions, please feel free to email me any time. I love getting emails from my readers!

In Health,
Christabella
ccherub@gmail.com

Finances

I received a letter from one of my readers this evening. First of all, I was very pleased to see that people are reading my blog! (To anyone else who is reading, I really appreciate the feedback and I would be happy to answer any of other questions in my blog!) Second, I thought his concern was a big enough deal that I should address it in here so others can also benefit.

The question was about financial aid, tuition, and debt. Scary subjects for any student, but especially one who has already completed a four-year degree, pre-requisites, and now a doctorate.... Let's try to address these topics one at a time...

Tuition
In the time I have been at school, tuition has risen twice--once for each fiscal year. Unfortunately, these changes did not come with loan amount increases, so the amount of money given for living expenses has decreased proportionately to the tuition increase. This being said, the tuition has risen less than a thousand dollars per quarter since I started... so compared to the overall amount I am spending on my education, this increase seems nearly statistically insignificant.

Loans
Luckily, loans are easy to come by in graduate school and especially at Palmer. Palmer has an unprecedented default rate of less than 1% so loan approval is a cinch. Our loans come in three forms: Federal Stafford Subsidized (no interest accrued while in school) Federal Stafford Unsubsidized (interest accrued while in school) and Grad Plus (interest at a slightly higher rate accrued while in school). Most people take at least the Federal Subsidized, and many take all three. This money completely covers tuition for all 13 quarters and covers around $6,000 of living expenses per quarter (assuming you took the full package of all three loans.) Additionally, special loans can be taken to cover the cost of taking National Board Exams, Electives, and Clinic Abroad Trips.

Debt... scared yet?
While thinking about a total sum of over $100,000, it's easy to start feeling nauseated. However, before you stroke out, let's talk about the facts. This debt is sizable, but it is given to us so freely because of our major earning potential. I went searching for some statistics on this "potential" and found the following on the U.S. Bureau of Labor Statistics Website: "In 2009, the mean salary for chiropractors was $94,454." This is quite encouraging, and personally, I know a lot of chiropractors who make much more than this. For chiropractors, as with many other small business owners, income is largely based on the number of years in practice. So at first, things will be more challenging and later, life will be easier.

After School Options
In order to pay down this enormous amount of debt, you'll have to work (obviously) but you have lots of options of how to do that. In the past, most chiropractic physicians went into solo practice right away. While this has definite advantages, it also comes with a huge price tag of rent, equipment, and staff. In order to avoid this, many new D.C.s are becoming Associates in other doctors' offices for a few years after graduation. This gives these new doctors a chance to start making money (usually on a salaried basis) and hone their clinical skills before they go out on their own. Another option is to become an independent contractor. In this situation, the doctor would pay a percentage of all earnings to the owner of the clinic to pay for overhead and use of staff/equipment. This situation is generally considered more advantageous since seeing more patients means more money, although the doctor is usually responsible for getting his/her own patients through marketing/advertising. Additionally, there is an increasing demand for chiropractors in all sorts of salaried positions including on military bases, as part of multidisciplinary practices, and as researchers in universities.

The Bottom Line
Despite the enormity of the debt we are incurring, I feel confident that I will be able to pay it back with the education I have been given. I also feel that this is a fantastic time to be a part of this exciting profession. The public interest in holistic health care has never been so high and changes to our scope are making our position in health care policy all the more important. When you graduate from Palmer Florida you can expect to be nervous about money--I think this is normal--but if you stick to what you're good at, I have no doubt that you will be able to pay back your debt and within a few years live the lifestyle you've dreamed of.

Cheers!

Today is the day!

One of the scariest days for any chiro student is the day board scores come out. Today is that day...

Six weeks ago all the 7th and 8th quarter students here at Palmer Florida emptied out our pockets, went through metal detection devices, defended our identities twice, and sat down for what is arguably the most important test we have taken in our lives to date. Part I boards are notoriously anxiety-inducing. The reason for this is their relative insignificance to the practice of chiropractic. The sections include Biochemistry, Microbiology, General Anatomy, Spinal Anatomy, Pathology, and Physiology. While these sections may seem to make sense for what we are doing, the actual questions asked are typically no more than useless trivia about exceptions to general rules and the most rare diseases that exist.

All of this being said, most students find ways to pass these on the first try. Palmer Florida students have been above the national average for passing Part I for the last several years. You can check out our pass scores here: http://www.palmer.edu/uploadedFiles/Pages/Academics/_pdf/pccf_nbce.pdf

Once we are passed these (both literally and figuratively), the next three sections of the boards make a lot more sense for practice. I'll have more to say about those in March!

Wish me luck!

Week 2

Hi Friends!

Week one... the week that seemed interminable... has finally ended. It actually ended very well. Let me recap this weekend's activities.

The Palmer Connection
This event was put on by my school's Admissions department in order to educate pre-health advisers about our program and admissions process. It was really neat giving them tours and sitting on a panel for questions. Their questions were different than that of typical prospective students.

I'm in nutrition right now and there is something I need to rant about. We are discussing an initiative to implement statin drugs in an over-the-counter capacity to those who eat in fast food restaurants. How ridiculous is this?! It all comes down to the idea that putting one chemical into the body can have a single effect on the body's chemistry. Readers, I'm assuming that most of you have at least some knowledge of basic physiology, but even if you don't, doesn't it stand to reason that a system as complicated as our body's chemical mediator system has enough variables to make any one chemical ineffective in impacting only one body system?! This fact, which is so obvious to many of us, sits in direct conflict with the allopathic paradigm of biochemistry as a primary healthcare intervention. I don't want to get too into this now... but later, we will be talking about paradigm a lot more, I think. :)

Beginning 9th Quarter

I noticed today that my blog has been officially added to the Palmer website. I'm quite pleased by this since this means there is a chance that someone will actually read my posts! :)

This is week one. At Palmer Florida, our life has been reduced into segments of 10-week decathlons. By this I mean that we struggle and push ourselves for 10 weeks (each of which holds different challenges) and then collapse during breaks. The particular push right now has to do with my clinic transition. Here at PCCF we begin seeing out-patients in 10th quarter. During 9th quarter, we see student patients and get acquainted with the clinic while still taking a full 30-hour course load. In addition to school and clinic responsibilities, I am the president of my class and, newly, the president of the Campus Guide Association... so I'm rather busy. During the last week I have probably done more than I did all last quarter--even with boards. Between arranging meetings, making schedules, introducing myself to tons of clinic staff, and honing my diagnostic skills, it has been crazy!

This morning I came in at 7:30 and I have not been home since. Soon I will head home to change and eat and then head off to a new event we are hosting this year called the Palmer Connection. Admissions representatives and career counselors from colleges around the country are coming to meet with our admissions department to better assist their students who are interested in coming here. It should be really fun. As I'm sure you've figured out, I love to talk about the school... this is a different way of getting to do it. I think this group will have very different questions and concerns than a typical prospective student would.

Anyway, if I can make it through this busy time everything will start to calm down. I'm excited to take on this new quarter and even more excited to fully move to the clinic next term. I think it's going to be a fantastic journey. More to come soon!

Welcome

If you are reading this blog, you must either be an interested student, a random blog-surfer, or my mom... Continuing as if you are the first, welcome! As a student at PCCF things are always changing, and I hope to give you a taste for that through my weekly blogs.

First things first...

Making the decision to come to chiropractic college is one of the hardest I think you'll ever have to make. There are days when I wake up and wonder, "Why on earth did I do this to myself?" and rightly so... our schedule is crazy, the classes are hard, and the impending clinical experience is daunting, to say the least. Through all this, though, the promise of seeing my own patients someday and helping them to actually improve their lives is what keeps all of us going. That's the key, really... to do this because you love it--because you have a passion for it. BJ Palmer said, "get the idea, all else follows," and I think that's the best advice. Choose something you love generally, and chances are, you will be able to love the details. All that being said, let's get down to how to choose to come, and how to choose to come to Palmer.

Visit

One of my various activities on the Palmer Florida campus is the Campus Guide Association. As a girl who took a tour and now a girl who gives them, let me tell you, it's the most valuable thing you can do at any school. This may seem obvious... and it is. What isn't obvious is what else you should do when you come for your tour. If time allows, spend some time in the area. Go to the local restaurants, walk around campus without your guide, sit in the library, people-watch as the students go by, listen to their conversations. I like to think of this part as reconnaissance... you are making a mental note of everything you see, hear, and feel, and reporting it back to yourself later on when it is time to choose. I visited a couple of schools before choosing PCCF... the clincher for me was the curriculum...

Compare

Knowing what is individually important is the key to all this choosing. Like I said, the curriculum was the final factor. Let me explain: I'm an incredibly varied learner. In order to know a subject, I like to see it from all angles. In undergrad, I majored in Behavioral Sciences... specifically Medical Anthropology: how healthcare has been and will be seen all over the world, by different groups of people. It was very holistic, actually--looking at large trends. Well, I knew that sitting in classroom for 30 hours a week without any hands-on opportunity would not cut it for me. When I came to the Florida campus, I learned about the "track system." Basically, instead of having a class called "embryology," we learn the embryology of each system as we go through it. Let me give you an example: when we studied the gastrointestinal system, we studied its anatomy, physiology, histology, and embryology all at the same time that we learned its related physical exams and thoracic/lumbar chiropractic set-ups. This completely sold me. While it's not always easy to change gears so quickly, I have found that I have a lot more clinical prowess than other chiro students at my same point in the program. Super pleased.

Feel it out

In a healing profession, we rely a lot on our tactile sense... but as we get more experienced we will also be relying on our intuition. Put that into practice now, where ever you feel at home, feel comfortable, feel relaxed, go there. My guess is, if you come to Palmer Florida, you will probably feel all those things. Come look me up on your visit and I'll show you exactly what I mean. :)

Until next time,
Christabella