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FMG w/ passed USMLE wants to go PA route.

Discussion in 'Clinicians [ RN / NP / PA ]' started by billydoc, 03.25.12.

  1. billydoc

    billydoc Senior Member

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    Hello dear folks of SDN! Haven't been here in a while but recently found a good reason to pop up here again. I really need informed advise from those of you in PA profession. Here's the situation. My family friend ( I don't mean me) is a surgeon from Eastern Europe. He was quite established in this field in the old country. Now he has all 3 steps of USMLE passed (perhaps w/ not so hot scores). He is also pushing big 50 next year. So.... the time is of the essence. So far he has ben unable to land any meaningful residency opportunities that interest him i.e surgical field. Quite frankly, as an FMG in this age group w/ less than stelar USMLE scores (could be a laguage thing too) it's not likely that he will ever be a practicing sergeon in U.S. My question to you is could someone w/ his education and passed USMLE have some kind of shorter pathway to becoming a PA? Please pardon my ignarance, I've never researced such route for my needs, but may be you've heard or know of such transition. The reason he wants to go PA route is it will him to be in the field that he loves. He is not hung up on status (being an MD), he just wants to get going w/ doing the things he is really good at.

    I really appreciate any advise, or just pointing in the right direction.


    Thank You all in advance.
  2. GeneValgene

    GeneValgene

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    at the school i graduated from, there were a small number of FMGs that came through. they made an exception for some - the usual program length is 2.5 years, but some FMGs that were able to pass a written exam and a clinical skills exam could bypass 1 year of didactic coursework, and only had to finish 1.5 years of clerkship.

    with that said, if your friend is a surgeon, he could be very limited in what he can do as a PA, and he really needs to be sure he is OK with that.
  3. billydoc

    billydoc Senior Member

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    Thank You GeneValgene. Yes, understood. He is coming to grips w/ his limitations of being an FMG w/ passed USMLE, but rather low for surgical residency scores, and also getting close to being 50 next year. He probably can scramble into residency that will allow him to do primary care as an MD, but that's not where his heart is. He won't be a surgeon, but PA in a surgical field, depending on set up of the place, indeed could do many things he is used to doing. Sometimes reality bites but being sober about it also helps.

    So from what I understand, it's an individual thing and he should contact PA programs on his own.

    Just to remind everyone who is replying. We are talking about someone who is certified by ECFMG w/ all 3 steps of USMLE passed, not just someone who has a foreign medical diploma.

    Thank You again.
  4. Makati2008

    Makati2008 Moderator

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    I would do that. Also some pa programs frown on applicants like this(moreso due to attitudes and will that person fit the role of mlp instead of doc.)

    I can also promise you that no program will care if he passed his steps as well due to our certifying not being the steps.

    Also his story doesn't make sense to me? Why not do a 3yr fm residency (and be paid)and go somewhere rural where he can practice medicine at its full scope for more money instead of having to pay for pa school
  5. billydoc

    billydoc Senior Member

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    Thanks for replying Makati. Well, the best I can tell is the guy is hellbent on being in the surgical field. My advise to him was as well since you've put so much effort in passing boards you might as well go for it. Not sure why such rigidity? Anyway, I'll pass it along and hope that he will still go MD route, but....not my call.

    Thank you folks.
  6. emedpa

    emedpa GlobalDoc2B2015

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    also some states say specifically that any med school grad can not be licensed as a pa even if they go to pa school.
    he should do a full scope fm program and then go rural and he could do c-sections, trauma, etc
  7. billydoc

    billydoc Senior Member

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    Well, that's the whiole trouble, he won't move out of NJ b/c of family commitment. Obviously if he had residency spot landed anywhere in U.S he'll go there for the time of training, but the idea is to stay in NY/NJ. I agree he should do FM or IM if he can get it and may be try EM where there iss plenty of trauma and things for surgery to do. I've tried to get some info since the guy is really down on his luck trying to get surgry residency. The thing is it will take him 3 yrs to become full-fledged doc if he goes IM/FP route vs may be 2 + at best to become a PA. I guess what I was trying to figure out here is if there was any way or some kind of shortcut for him to becoming a PA since he is already certified by ECFMG, and got his USMLE (though low scores). It seems like none of it will make any difference or even worse, could hinder his chances to become a PA. Judging by all of these replies I think it's best he goes MD route. Though it's his and his family call.

    I thank you all again for the info.
  8. emedpa

    emedpa GlobalDoc2B2015

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    I don't know of a single pa program which would give him adv. standing. it just isn't done, even for docs.
    I know several docs who have done the pa school route and all did 100% of the prereqs and coursework.
  9. GeneValgene

    GeneValgene

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    yes, i would contact the programs directly. also reading through this thread, it really does seem like doing a family practice or medicine residency would make much more sense. good luck to your friend!
  10. Poetic Silence

    Poetic Silence

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    Hello Billydoc,

    I hope you don't mind me throwing in my two cents. I'm a pre medical student, but well read on the medicine in the U.S.A..

    It is my understanding that family medicine doctors can first assist in surgery at a higher level than a PA could. An FM or IM could also medically manage pre and post op patients and inpatients. With a fellowship, an FM can even become an obstetrician. Not the most popular surgical specialty, but surgery all the same.

    I gotta go with the majority vote and say that an FM residency makes much more sense than PA school.

    I wish your friend luck with whichever route he chooses.
  11. Marry2Pod

    Marry2Pod

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    Hi

    Doctor of Podiatric Medicine and Surgery (DPM) is also another option. Podiatry schools can take FMGs as advanced standing in their second year if they passed Step 1. So they would complete three years of formal school, followed by a 3 year surgical residency. New York College of Podiatric Medicine (NYCPM) in NYC is the closest one.

    Hope that helps.
  12. Poetic Silence

    Poetic Silence

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    I considered suggesting podiatry as well, but even with advance standing, that's six years of training. That's a lot for someone close to retirement age, plus, more med school style debt than makes sense.

    Also, Billydoc, don't forget that by passing USMLE step 3 you are licensed to practice medicine and surgery. If your friend feels confident in his surgical ability, he could, in theory, practice surgery with just an internship and a license. Board certification is just that, certification, not licensure.

    Just a thought.
  13. emedpa

    emedpa GlobalDoc2B2015

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    no hospital would credential him and let him in their o.r.
    I suppose he could set up an outpt surgical ctr but getting pts would also be tough when all the competition is residency trained and board certified...also malpractice would be very difficult to get for this...
  14. Poetic Silence

    Poetic Silence

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    I won't refute the points you made. As true as they are, this is a foreign surgeon wanting to practice surgery in the U.S.. He's already having difficulty with that, I'm sure he'd be grateful for any chance to pursue his passion in our country, even if it means competition. If he's truly passionate, he'll find a way and patients will come.
  15. Medstudentquest

    Medstudentquest Removed

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    I second this. PA school is definitely not cheap, and while it's not as competitive as med school, it's still competitive to get in. I think FM would be a good route. It offers a decent income with decent work hours and most people are able to get in. I think it makes a lot more sense than going through extra training. And like you point out, OP's friend would get paid for it too.
  16. Medstudentquest

    Medstudentquest Removed

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    Why would someone at 50 start extra training like that in a completely different field?
  17. Marry2Pod

    Marry2Pod

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    People go back to school at any age! It's up to them.
  18. Poetic Silence

    Poetic Silence

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    The OP made it pretty clear that his friend does not wish to redo medical school. He wants to find the quickest route to pursuing his passion in the U.S..

    FM + OB makes much more sense.
  19. Marry2Pod

    Marry2Pod

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    I was just putting it out there in case he wasn't aware. Isn't that the point of this forum! Was trying to help that's all.
  20. Socrates25

    Socrates25

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    So let me get this straight. Medical school grads cant get any credit for 4 years of school to go to a PA program, yet PAs with 2 years of school should be able to get 2-3 years shaved off of a 4 year MD program? What kind of crock of **** is this? :rolleyes:
  21. Poetic Silence

    Poetic Silence

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    There is only one PA to DO program and no PA to MD programs. I know of no case where a PA was given advanced standing in an MD or DO program other than the one at Lake Eerie College of Osteopathic Medicine. Even then, it appears only to be one year of clinicals that are shaved off.

    Nice try, though.
  22. emedpa

    emedpa GlobalDoc2B2015

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    PA'S who go to medschool are the cream of the crop...docs who go to pa school are bottom of the barrel failure rejects who couldn't match. big difference.
    also Lecom gives 1 yr of credit not "2-3".
    (also isn't about time you changed your sig....I was talking about pa residencies and you know it.....)
  23. Poetic Silence

    Poetic Silence

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    Speak it, homie!
  24. msctc2013

    msctc2013

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    Which program is PA to DO?
  25. MedPsy82

    MedPsy82 Just a Thought

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  26. primadonna22274

    primadonna22274 Senior Member

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    Correct.
    5 weeks away from end of M1. 12 yr in PA practice EM & FM. Hardest part? Learning how to be a student again. And sitting all day. My neck and back are a hot mess of perennial somatic dysfunction. My brain hurts...just finished basic neuro LOL (tell me again why they call it "basic"?!)
    I'll post an update later on...time to head back to class ;(

  27. amaprez

    amaprez

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    How interesting. Obviously it's been a while since you were in PA school, but how does the course material difficulty compare?
  28. Makati2008

    Makati2008 Moderator

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    I can answer this one as I am in the same boat as well. The level of difficulty is like night and day when it comes to the Physiology, biochemistry, pathology, embroyology etc.... due to us not being exposed to it in such depth or not at all in PA school. I would venture to guess that 90% of PA's could Pass Steps 2/3 with ease but the 1st(and most important step) would probably mop the floor with greater than 90% of PA's if they decided to take it without going through a structured medical cirriculum. I do think that if I was younger like my classmates it wouldn't be nearly as hard due to burning out easier, family committments,etc....

    For example-In PA school I learned how to treat MSRA, while in medical school I learned the microbiology of why I have to pick a certain drug to kill/inhibit the organism. I do feel that my Pharmacology was much harder in PA school than Medical school though.
  29. whatbout2morrow

    whatbout2morrow Is there anything you would not do for your family Bronze Donor

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  30. Skinceutical

    Skinceutical

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    I sincerely doubt that.

    The first attempt pass rate on Step 2/3 for IMGs is around 70%. DOs have around a 90% first attempt pass rate on Step II. I have a very hard time believing that PAs will significantly outperform IMGs, and match DOs on any portion of the USMLE.
  31. Makati2008

    Makati2008 Moderator

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    IMGs-I disagree with you. I would think that more than 70% of PAs would pass that exam since they are trained in the American Medical model. Heck some IMg's were even allowed to function as PAs and they couldn't do that at an appropriate level and they got that right snatched(FL I think?)

    D.O./M.D.'s-You could be right or I could be right on this one. It would be interesting to see what the outcomes would be if the PAs were given the same exam as MD/DOs and sat took a board review course like so many medical students do(I am including myself in that one since I am currently doing Board review.).

    PS- I have also noted your anti-PA stance on previous post. I am not here for that if you are here to start a flame war/argument I won't get into that with you fyi.
    If typos present sorry typing on the go.
  32. Skinceutical

    Skinceutical

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    Considering the fact that you have yet to take Step 1, I think its a little strange that you're willing to make sweeping statements about the contents of Step 2 and 3, and how well your PA colleagues would do on those exams. The NPs also love to claim that the only difference between them and physicians is the basic science curriculum, and yet when they were offered a watered down version of Step 3 (the most 'clinical' of all the USMLE steps), the results were abysmal.

    Also, for what its worth, American medical graduates don't take prep courses for Step 2 and 3. I studied for about an hour or two for Step 3 (mostly spent familiarizing myself with the clinical case simulations). Most people I know didn't prepare any more than that either.

    I'm not the one trying to claim that PAs would do as well as DOs on the USMLEs. Feel free to share that opinion with the senior med students & residents at your school and see how they react.
  33. Makati2008

    Makati2008 Moderator

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    Do me a favor and go back to the derm board :)
    The PANCE and USMLE are somewhat similar. I helped a friend study for her Step 2 and I could answer the majority of the questions without studying but its only my personal experience I guess.

    Again, give some constructive advice on the board about NP/PA and Physician relations or otherwise why not just go back to your derm board.

    As for Step 2 prep courses-http://www.passprogram.net/USMLE-Step-2-Preparation.aspx
    Email them and ask if they have any AMGs and get back to me.
    Also, I tend to share my opinion with med. students/Physicians both. Mostly to med. students that have some negative things to say about PAs and try to educate them on what we are and aren't.

    And to repeat it once more, please either have something to say to help MLP Physician relations or go back to the derm board and spew your useless hatred.

    Thanks.
  34. emedpa

    emedpa GlobalDoc2B2015

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    as Makati mentioned, many pa's study for the pance and panre(recert) using step2/3 materials as they cover essentially the same material. I know several pa's turned physician who said step 1 was tough but 2/3 were a cakewalk that they could have passed without attending medschool. I used family med board books as well and this was also mostly review.
  35. Skinceutical

    Skinceutical

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    Who is "spewing hatred" here? I simply disagreed with a baseless statement you made. You're the only one who's getting all riled up here.

    Doesn't that chip on your shoulder get heavy sometimes?
    Last edited: 04.29.12
  36. Makati2008

    Makati2008 Moderator

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    Lol. Your post in the derm forum speak for themselves (which I happened to see prior to you commenting to my post) No chip here i just dislike people that know nothing about PAs making as you say baseless statements lol.

    But again I will ask you nicely just don't respond to my comments and you can even put me on your ignore list :)

    Ps- if you think this is riled up I feel sorry for you. Maybe the Internet doesn't convey my personality well who knows.
  37. Skinceutical

    Skinceutical

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    .
    Last edited: 04.30.12
  38. Makati2008

    Makati2008 Moderator

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    Waves and says adios
  39. needassistplez

    needassistplez

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    Answering the original thread/question....

    To my knowledge (as a current pa student), there is not any way to receive advanced credits in pa school. A requirement of the Board of Accreditation for any pa teaching faculty is a pa degree. I have an M.D. professor who had to apply, attend, and graduate pa school before being able to teach at my school.

    While most people would not want to take this route, my guess is that he personally did so because he only had a foreign medical degree. Basically, I believe he needed to somehow further his education in order to work in the United States, but I am not sure why he chose teaching or pa school specifically.

    In addition, one of my classmates also has a foreign medical degree and while he does handle certain subjects quite well (i.e. lab results and othertopics we have not been taught yet), he pretty much has to study and work just as hard as the rest of us, although I am not sure how much can be contributed to his language barrier (English is his 2nd language).

    After several years of pre-pa classes (pre-reqs/undergrad/work experience), pa school is only 1 year in the classroom & 1 year in rotations (some schools also have extended requirements, for example 2 1/2 years). I'm sure the rotations are much easier for any individuals with prior experience.While I somewhat agree in the argument that M.D.'s/D.O.'s should be able to"test out" of certain subjects (not currently available)...what about the subjects that they have never been taught? There are different rules, classes, and skills that pas are taught, that is why there is a separate degree/schooling model. Does that mean that pas should be able to get a nursing degree automatically too? Probably not.

    I do not believe that pa school is as easy to get into as mentioned above.It will be especially difficult if the admissions board believes that the candidateis applying as a 2nd choice/needs a "quick fix" so that they can practice medicine. Many pa schools have 1000 applicants and only 20 seats available each year. Also, knowing why (pa vs. M.D. etc...) and the history of pa profession is essential at the admissions interview.

    Another problem with your friend's situation is that pa schools usually require many (for #'s check individual school), very specific and deadline oriented pre-reqs (for example: must have A or B in Biochemistry within the last 5 years). I'm sure your friend would not be thrilled about having to goback to undergrad and re-take all the science and math pre-reqs required.

    Hope this helped, if you like, you can PM me if you have further, important questions. Checking the individual school's websites is probably the best place to start.
    Last edited: 05.02.12
  40. emedpa

    emedpa GlobalDoc2B2015

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    The above is not correct. lots of pa programs have docs teach at them who are not pa's.
    what he probably meant was that to practice as a pa you must go to pa school. that is true.
  41. needassistplez

    needassistplez

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    In response to :"The above is not correct. lots of pa programs have docs teach at them who are not pa's.
    what he probably meant was that to practice as a pa you must go to pa school. that is true."


    I'm not on the Board, nor do I know the exact wording, but I JUST read this in the Guidelines...You must have a pa, M.D., or D.O. license to teach at an Accredited pa school.
    I will admit that I am not always right. Do you have a different understanding Emedpa? If my eyes weren't crossing from reading multiple, dry handbooks then I would look it up. Who am I kidding? It's going to bother me not to know (like when you can't remember the name of a movie)...I will be looking it up soon.
  42. emedpa

    emedpa GlobalDoc2B2015

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    This is correct. you must have a PA or MD or DO license to teach at an accredited program, not all of them. I have been on several admissions committees and taught at pa programs before. trust me on this.
    the number of folks who are both pa's and md/do's is very small. if this was a requirement there would only be around a dozen pa programs not 160+
    most lectures at my program were taught by physicians. not a single one of them was also a pa.
  43. Poetic Silence

    Poetic Silence

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    So, podiatrists can't teach at a PA program? What about PhD's?
  44. primadonna22274

    primadonna22274 Senior Member

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    Can teach, yes, but cannot be core faculty or medical director. ARC-PA rules.
  45. AlmostJesus

    AlmostJesus

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    If youve passed Step 3, why not look at doing an internship and seeing if a surgery group would be interested in taking you on to first assist in OR cases with no or limited independent practice. Theoretically that could lead to better reimbursement for the case and if you are a competent surgeon, it might be more advantageous to have a surgeon with experience assisting you on a procedure vs. a PA.
    Just a thought
  46. Makati2008

    Makati2008 Moderator

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    It wouldn't make a bit of difference on reimbursement in this case due to the fact he couldn't get a medical license with only a internship(since they last a year). Most FMG's need two years at least if not three years of training to get a license.

    If I am wrong please correct me.

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