Everything You Need to Know to Thrive in Your First Rotation


After spending your didactic year in sitting in lectures and buried in textbooks, your first clinical rotation can come as a welcome change of pace. The clinical year offers you the opportunity to put what you've learned into practice and to see some new humans. 


As a preceptor for over a decade (and as a former PA student), I've got some simple steps to make your first clinical rotation a success. 


Some of these I learned along the way, and some are ways that PA students have endeared themselves to me, but all are quick and easy ways to improve your first rotation experience. 



1. Contact your preceptor about a week in advance of your rotation

Contacting your preceptor not only reminds them that you are coming (they are busy, sometimes they forget), but it also gives you an opportunity to get some inside information on what to expect.


Ask about where to meet or how best to contact them on your first day so you know what do to when you arrive. Some of us work in areas that have employee-only access or are at different locations depending on the day of the week, so you need to have a plan for how you'll connect before you get there.


You should also ask about any particular resources you should bring with you (especially if it's an away rotation so you can pack accordingly).


I once bought a 30-pound, $250 textbook as suggested by the PA office of a hospital coordinating an away rotation. I then hauled it with me on a flight, forgoing other items to stay under the baggage weight limit, but I didn't really need it when I got there. Your preceptor will know best what you will need. 


2. Come ready for the environment

During my first surgery rotation, I thought my legs were going to fall off by the end of the second day. Granted, I studied late into the night most nights, had more dinners comprised of chips and salsa than I care to remember, and perhaps was not in the best shape of my life.


However, I didn't expect that my skin on my legs would hurt to touch after standing through a long surgery. Thankfully, a resident told me to get knee-high compression stockings, and they worked like a dream. 


Checking in with your preceptor before your rotation will help you know what to expect in the environment.


If you're going to be working on an inpatient floor all day, you probably want to avoid high heels. If you are in the OR, you'll be changing out of what you wear into scrubs, so you probably don't want to wear something with 87 buttons or a complicated pulley system.

How to Thrive in Your First PA School Clinical Rotation lBe a Physician Assistant


You should always dress professionally, but understanding the environment you will be in will allow you to adapt accordingly. 


3. Ask up front how your preceptor prefers to field questions

For many practices, asking questions as you go is routine. But, some practices are fast paced and more conducive to fielding groups of questions every few hours or at the end of the day. 


You want to ask as many questions as you can while on a rotation. Preceptors are gold mines for clinical pearls, career advice, and patient care strategies, and you don't want to miss out on their insight. 


So rather than feeling like you are interrupting, find out when is best to ask questions and you will be more comfortable with doing so. 


4. Ask about presentation preference

You'll surely be practicing your patient presentation skills before your first rotation. However, what a preceptor wants from a presentation will vary based on specialty and patient status. 


If someone is an established patient coming in for a specific complaint, a problem-focused presentation is appropriate. For a brand new patient, you'll want to cover a full history and highlight any items relevant to their presenting complaint. But, without asking, it's hard to know what you preceptor prefers. 


In my practice within a specialty, what is most important to me as a preceptor is that students can determine what is relevant to a patient. I don't want to sit through an entire medical history on someone who I have known for three years who is coming in for a check-up.


I prefer to see that students have the ability to triage the information they gain from a history and physical and tell me the essentials for a patient with a certain diagnosis or under a particular treatment. But, not preceptor wants what I want, so you need to ask. 


5. Ask about resources

You should have some reliable resources you use for referencing general medical information, whether in paper or electronic form. Be sure you have access to these during your rotation. 


You should also ask your preceptor about resources they recommend. The practice or hospital may have access to resources you haven't used before. 


Your preceptor may recommend books, apps, or websites particular to their specialty. Ask about these early. Using the same resources that your instructor considers the standard will help you to keep up and to ask better questions during the rotation. 


6. Pack a lunch (and a few extra snacks)

You never know what a new rotation may hold in terms of available food or lunch hours. Until you get a lay of the land, bring food with you. 


Even if there are places to eat nearby, some practices are too busy to break for lunch. Going on a new rotation is like starting a new job every 5-6 weeks and can be mentally exhausting. Do not assume you can make it through without some calories. 


If you're like me, you'll need to have some extra snacks on hand. Sometimes just knowing you have some backups, even if you don't use them, can help you survive the day. 


7. Honor your role with patients

One of the most difficult things as a PA student or as a new PA graduate is not answering a question. 


It's in our nature to be helpful. We want to fill in the blank for patients when they have questions, or sometimes provide a positive spin to something when we probably shouldn't. 


You might be 80% sure of something, but if you are not solid on an answer or feel like you are providing false hope, leave the question for your preceptor. 


Clinical rotations are an excellent way to observe how providers handle difficult patient questions. You don't have to worry about doing this yet, so maintain your role as a student and just learn how you MIGHT handle difficult issues in the future. 


8. Show up early, stay through the end

We understand you have a lot to do in PA school, but arriving a few minutes early and staying until the work is done (without incessantly checking your phone) will go a long way. 


You may not be interested in a particular field of medicine, but there's always something to learn. Preceptors are almost always volunteers, so even if you think you would never want to work in their specialty, respect that they are using their time to help you. 


Every preceptor is a potential future reference and a connection for job hunting in the future. Even if your bored, slightly woozy from the sights and smells of surgery, or would rather be somewhere else, it's in your best interest to stay engaged. 

There's much more to clinical rotations, but these steps will get you started on the right foot.


Remember to always to contact your preceptors in advance. Your first day of any rotation should include asking about presentation preferences, recommended resources, and the best timing for your questions. 


A little work up front can make any rotation, from the first one to the last, much smoother and more enjoyable.