u/Significant-Action31

Hey guys, I hate to come on here and be negative. It seems like I always am negative, but I could use some advice. I am on my 3rd rotation and it is going extremely rough. This rotation is ambulatory care. We work up patients, present them and use guidelines and studies to explain why we are making the recommendation. I thought I was decent at this, but every time I present a patient it is nitpicked incredibly hard. When it is time to interview the patient, I was told I paused too much. I have received nothing but negative feedback and now I am at midpoint this week. It hurts because I care so much about improving but something is just not clicking. It is like walking on eggs shells around my preceptor who is a faculty member. I do not want to risk failing a rotation and potentially ruining my GPA and am really scared it will delay graduation. Should I reach out to the experiential programs office about this? I haven’t been able to sleep because of the feedback. I am really scared. Any help could be greatly appreciated.

Hey everyone I am a current P4 in the thick of rotations. Out of an abundance of caution or retaliation from University, I will leave that out.

I am drowned financially, and I know I am not alone.

The current APPE model is completely broken. We are required 40+ hours a week of skilled, vital clinical labor for healthcare systems and pharmacies. At the exact same time, we are paying full-time tuition to our universities- thousands of dollars for a year we aren’t on campus using resources.

Because of the exhausting schedule and rotation demands, it is virtually impossible to hold down a part time job. My credit is ruined to the point I can’t access Grad Plus loans. My family is suffering, we can barely afford to eat and I have children.

We aren’t just shadowing. We are giving vaccines, doing MTM calls, counseling, and keeping the pharmacy running. I know many of my APPEs, I was depended on because of pharmacists being on vacation. If we are providing essential labor, why is the system designed to starve us out?

I am full aware it has been like this for decades, but something has to give. In the current economic times, it is just not sustainable.

How do national organizations like ACPE and AACP expect to attract top-tier, diverse talent when the entry price is a year of forced financial crisis?

I want to advocate for change, but I am too terrified to speak up.

How can we, as a community, safely pressure ACPE/AACP to revise the rules?

Are any of your schools offering creative workarounds, stipends or tuition relief for P4 year?