Studying: ER Rotation

Studying for this rotation was a lot harder than I expected it to be.  Between working night shifts and working 8 days straight, no weekends, and a questionable sleep schedule, it was hard to find time and a way to fit study time for the most difficult EOR. Slowly, it became harder and harder to bounce back after each night shift and find the energy/time to study. It’s really weird when you “days” start around 9pm and end the next morning. Then, you sleep for ~2-3 hours in the dark and the sun begins to peak through and your body fights to sleep through the light. Eventually you wake up at a weird time and try your best to squeeze study time in before you shift but try not to study too hard because you might end up with a tension headache for your night shift (LITERAL. TRUE. STORY.)

The hospital I rotated at didn’t have a residency program. However, it did have residents from another residency come to do procedures only. This was good in the sense that I wouldn’t have to compete with any residents to see patients. If there were cool procedures, it would typically go to the residents who were there to solely do procedures. But honestly, it was okay! The residents who came were really nice and taught me a lot too! I’d try to help out with difficult lacerations or crush injury suturing and every resident was so nice and let me help them. They would talk shop with me and were so kind to answer my questions.


The good thing about working at night is that it was less likely that there would residents there. So that meant I almost got to do almost all the procedures there – under the supervision of my ER doc of course. I got to intubate, reduce joints, drain abscess, remove nails, and do sutures. If it was a super deep laceration that would require the periosteum to be sutured up first, the ER doc would do it and I would finish up with the skin layer. The ER doc stood by my side as I intubated. He would hand me the scope and the tube once I visualized the vocal cords. It’s such a exhilarating feeling. I would seriously come back from rotations at between 2am-5am and try to sleep but couldn’t because it was so incredibly cool to use my hands and my brain to help someone!

My preceptor also worked a lot of night shifts. He was a night owl. On day one of my ER rotation, we had to choose a grading doc. Everyone was shouting out names so I randomly chose a name on a sheet of paper that didn’t require me to be there at 4-7AM, because it was more likely for me to sleep through a morning shift and be late than night shift. I wanted to set myself up for success okay. I didn’t do a really good job of looking through all the shifts before I signed up because turns out…my preceptor was a night owl lol. Hence, all of my night shifts. So worth it though! Plus, I loved my preceptor. I was only there for a month, and my mind set is that I can do anything for a month!

ANYWAYS. All of this fun left me waking up at weird times and napping at weird times lol. I tried my best to stay on top of my study schedule. Sometimes, it’s nice to shoot for the moon…because sometimes (most of the times) you miss the moon and fall on the grass. But it’s okay because you know you tried.

  • Make a study schedule. Do PRACTICE QUESTIONS.
    • With the weird schedule, I knew if I didn’t plan ahead then there would be some serious stress tears streaming down my face near the end of the rotation. I could definitely envision myself crying from the stress and feeling behind (because it’s happened before), so I really did NOT want that to happen. I’ve been told that surgery and ER are the hardest rotation exams simply because it is difficult to find time and energy to study for the tests after working long hours. But it’s okay! So many PA students have done it before you, and you can do it too (this was my mindset because I needed some encouragement and proof that things would be ok lol).
      • I looked at the topic breakdown list and the percent of each system. Cardio, pulm, MS, and GI were the biggest  components so I studied those first. I read the PANCE Prep Pearls on the diseases that were listed. Then I would do practice questions.
      • After doing the questions, I could definitely tell where my weak areas were. I’d make a mental note of what these areas were and made it my goal to read over them again if time allowed at the end and try to answer more practice questions on the topic.
    • I looked at the other systems and topic list and could kind of gauge on whether I should read the pearls or just do questions – I’ve heard from numerous people that doing practice questions was better than reading a bunch of diseases and trying to memorize it. If a it was a organ system that I didn’t feel so hot about, I would read the diseases. If it was something I felt that I could gather and remember from being in class, I just did the practice questions.
    • I tried to go through all the systems by the 3rd week. Key word: TRIED.
      • Basically, it didn’t happen lol. By the 4th week aka the last week of my rotation, I just did a BUNCH of practice questions and read their explanations. I tried my best to understand it and hoped it was enough.
  • Show yourself grace.
    • By week 2, I could kind of see how I was NOT going to be able to read all the diseases and do all the practice questions. Honestly, I just had to be okay with that. I began to feel frustrated because I felt that I wasn’t utilizing my time properly or efficiently.
    • Also..I would miss a lot of practice questions lol. YIKES. I was kinda scared. But then I had to remind myself that I’m in the studying part still, and that it’s okay that I didn’t know everything. I just had to get it down by the time of the exam.
    • Finally, let us remember and recognize that we’re all transitioning from sitting at a desk in lecture for at least 6 hours Monday-Friday and then more hours at night studying, to being on our feet and interacting with patients for 9 hours. It’s hard making that change, especially if that’s all you’ve done for the past 12+ months!


  • Based on what I did noted above, I ended up doing decent on my rotation exam and I’m pretty pleased with my grade! Whatever grade you get, I think you should be proud! My classmates and I essentially worked 17 ER shifts in ~22-23 days. You might think, “oh that’s 5-6 days to rest up and for the weekends, it’s not that bad..” but are you sure? Because on my days off, all I could do was sleep. I didn’t have the energy to hang out with my friends or talk to anyone because I was so exhausted all the time. Just going from a horizontal to a vertical position was challenging and I forced myself to sit at a nearby coffee shop a few hours before my shift started to just study.
  • I worked every weekend, missed Mother’s Day, and community group. It kinda stinked, but it was only a month and these things I missed fell under the umbrella of “sacrifices you make in PA school.” At the end of it, I was okay with it because the hard work paid off and it was a wonderful experience.


  • Personally, I would have done a better job of planning my shifts. I would have stacked my shifts more heavy at the beginning and planned my breaks better so I wouldn’t have to work 8 nights straight zzzz. That would have given me more time at the end to fix my sleeping schedule and have more time to prepare for my rotation exam.
  • I also would have liked to plan my grocery trips and meal prep better. I never wanted to go grocery shopping after I woke up because I was tired and felt like I needed to study before my shift. So grocery shopping got pushed back..which meant I didn’t have any food lol…which meant I ate a lot of Chick-fil-a and Chipotle.
  • Buy more scrubs. I hated doing laundry every 3-4 days because that’s the number of scrubs I own.




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