| Course | PA 628 Clinical Clerkship: Elective II |
|---|---|
| Week | 2 |
| Paper type | Elective justification memo |
| Length | About 400 words, 4 pages |
| Format | Memo with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 628 Week 2
Memorandum
To: Clinical year director
From: PA student
Date: November 2, 2026
Re: Elective II: endocrinology clinic, justified by what the nephrology block exposed
Name the Block Before the Wish
Elective I: outpatient nephrology, four weeks, completed October 30, 2026. About 190 encounters; objectives 1 to 3 met, objective 4 not met for reasons of clinic design.
The Hole, With Evidence Attached
Nephrology showed me where kidney decline comes from but not how glucose is managed to prevent it. Of 14 patients with diabetic kidney disease I staged, 9 arrived with an A1C above 8 percent. I could adjust a kidney dose but could not have changed an insulin plan; I have never titrated basal insulin for a patient I would see again. Coordinated diabetes care in kidney disease is a central recommendation of the current guideline (Rossing et al., 2022), and I have seen only the kidney half.
The Service in an Ordinary Week
The endocrinology clinic sees about 14 patients a day over four days. Most visits are type 2 diabetes on insulin or injectable agents; about one in five has chronic kidney disease. A diabetes educator runs insulin starts on Tuesdays. I expect to see continuous glucose monitor downloads at most visits.
The clinic also takes referrals from the nephrology clinic I just left, so I expect to meet some of the same patients from the other side. That overlap is part of why this clinic, rather than an endocrinology service at another site, fits the gap. A different site would teach insulin but would not let me follow the same patients across the two plans.
A Commitment Somebody Can Hold Me To
By the end of the block I will have reviewed 20 glucose monitor downloads and proposed a basal insulin adjustment for each before the attending's review, with the agreement rate recorded. The preceptor will sign the log weekly.
The Form My Section Supplies
The program's elective request form is attached, with this memo as the rationale section.
Why Not Another Specialty
Cardiology and palliative care were considered. Neither addresses the specific gap the nephrology block exposed, which is glucose management in patients whose kidneys are already declining.
Cardiology would add heart failure management, which matters to many of the same patients, but it would leave insulin untouched. Palliative care would teach conversations I value but would not build the prescribing skill I am missing.
References
Rossing, P., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., Sadusky, T., Tandon, N., Tuttle, K. R., Wanner, C., Wilkens, K. G., Zoungas, S., & de Boer, I. H. (2022). KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney International, 102(5S), S1-S127. https://doi.org/10.1016/j.kint.2022.06.008
Reading the PA 628 Week 2 instructions
This week's task is a request of about a page, with a case attached. Open by naming the block just completed and its results, before stating what you want. Show the hole that block exposed, with evidence. Describe the requested service in an ordinary week: patients per day, what kind and what you would do. Make a commitment someone can hold you to, with a number and a person who will check it. If your section supplies a form, attach the memo to it. If two services could fill the same hole, say why you chose one. If the first elective was allocated rather than chosen, say so and justify the second anyway. Naming a preceptor is optional. Cite guidance that defines the hole.
Inside the PA 628 Week 2 example
The memo goes to the clinical year director on November 2, 2026. The first section names outpatient nephrology, about 190 encounters, three objectives met and one unmet by design. The hole section reports 9 of 14 diabetic kidney patients arriving with an A1C above 8 percent, no basal insulin ever titrated and the guideline's call for coordinated care (Rossing et al., 2022). The service section gives about 14 patients a day, mostly type 2 diabetes on insulin or injectables, one in five with kidney disease, a Tuesday educator session and glucose monitor downloads. The commitment is 20 downloads with proposed basal changes, signed weekly. The form is attached, and a section sets aside cardiology and palliative care.
PA 628 Week 2 rubric: what full points look like
The memo stands or falls on its opening: naming the completed block, with results, before the request shows the case is built on evidence. The hole must be specific and supported by numbers. Describing the requested service in an ordinary week, rather than in promotional terms, earns credit. The commitment is weighed for its number and its checker; a commitment no one can verify carries little. Explaining the choice among alternatives shows judgment. Memo format with the section's form attached is expected. Cite guidance in APA form where it defines the gap. A commitment the director can check at the end of the block is weighed as heavily as the evidence for the gap.
PA 628 Week 2 help from the desk
Second elective requests commonly lead with enthusiasm for the new specialty and mention the first block only in passing. Another frequent gap is a commitment with no number or signer. Some requests also skip why other services would not fill the same hole. If your situation differs, such as an allocated first elective or a different gap, send the first block's results and the service you want; we would open with the completed block, show the hole with evidence, describe the new service plainly, add a checkable commitment and explain the choice. If your section supplies a form, the memo would be fitted to it.
Get a PA-628 Week 2 example written to your instructions
Send the request wording, any form your section supplies and the rubric rows, and a custom justification written to them arrives inside 24-48h, the first one free. Tell the desk which service you are asking for and what your completed block covered, and the argument gets built around your record instead of around a template.
More PA 628 papers and MPAS samples
- PA 628 Week 1: Settled Point From Elective I Post
- PA 628 Week 3: Revised Objective Set
- PA 628 Week 4: Prior Rotation Comparison
- PA 628 Week 5: Feedback Carryover Memo
- PA 628 Week 6: Specialty Interest Statement
- PA 628 Week 7: Elective Pair Synthesis
- PA 628 Week 8: Rotation Order Rationale
- PA 648 Week 2: Remediation Contract
- PA 626 Week 2: Elective Rationale Memo
- PA 650 Week 2: Question Narrowing Exercise
- PA 624 Week 2: Next Best Option Memo
PA 628 Week 2 questions, answered
What if the first elective was allocated rather than chosen?
It changes the opening paragraph and nothing else. Say the block was allocated, then treat it exactly as evidence, because allocated or not, those weeks show what the writer has already seen and what they have not. A document arguing from an allocated block is often stronger, since nothing in it has to defend an earlier preference that a reader might not share.
Does the justification have to name a preceptor?
Almost never. The rubric rows reward the match between a service and a documented hole, and a named individual adds nothing to either one. Describe the service by what it does weekly and by how closely a student there works under supervision. If your section's form has a field for a named clinician, fill the field and keep the argument itself about the service.
Two services would fill the same hole. How does one get chosen?
Choose on which ordinary week puts the writer closer to doing the work rather than watching it, then say in one line why the other was set aside. A justification showing that a second option was considered and rejected on a stated basis reads as a decision, where naming one service alone reads as availability dressed up as reasoning.
Where can I find a free PA 628 Week 2 sample paper?
A complete PA 628 Week 2 memo justifying an endocrinology elective from what a nephrology block exposed is on this page.
What commitment does the PA 628 Week 2 sample make?
To review 20 continuous glucose monitor downloads and propose a basal insulin change for each before the attending, with the log signed weekly.