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Am I competitive for PA school??
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Why not medical school first?
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Agreed.
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deleted6669
agree with agreed.
dude, you are the poster child for medschool. young, bright with research experience and minimal direct hce.
there are PA programs that you could get into. narrow your list to 5 or so and if you chose wisely you will get into one. applying to 22 + programs would not be cheap...not to mention interview expenses...
but seriously...medschool.
Thanks for the responses guys
-But most of all PA programs require 1000+ hrs of clinical exp. I only have volunteer/shadowing exp and they don't count those as clinical exp - Because of this I was thinking of getting my Master's while holding a medical scribe job and apply next year?
I was interested in med school, I just don't like the direction of how healthcare is going and I rather not spend that many years in school personally. I find PA relatively fit and even salary-wise can be on par to some primary care physicians, and also in regards to autonomy in private practice alongside a doc
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deleted6669
if you are going to take the time to get experience get good experience which is hands on and direct like emt, cna, medical asst., lpn, etc.
don't do medical scribe. lots of quality programs don't consider this hce at all.
don't do medical scribe. lots of quality programs don't consider this hce at all.
Alright, thank you
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All good points made. If you don't want to do med school don't do it. Follow your plan. Some schools such as UNMC (a top 15 pa school) require no HCE. I've known quite a few people accepted there with no HCE. Either way its good to have because your clinical time is a year shorter than med school.
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Totally agree. Med scribe is not a good source for HCE.
University of Colorado Denver proudly states that they don't require Health care experience. Ohsu requires 2000 hours, and has a liberal list of examples of accepted HCE, and includes scribe. To say that most programs require 1000 hours is a stretch. It's not hard to find programs that would be fine with your good grades and lack of HCE. There's absolutely no reason to waste time getting a masters. I wouldn't even spend time getting hce. The gates open in late April I think, so get ready to apply.
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deleted6669
OK, most quality and reputable programs require experience...ohsu is an ok program, nowhere near the quality of u.wa for example....the entire concept of PA education is to build on prior experience.
can you get in without it? sure.
should you? not if you want to be the best PA you can be...
I am involved in hiring new grad PAs at my job(and have at my last several jobs as well). I won't even interview someone without prior experience. there are enough folks who take the time to do it right. those folks get the interviews.
the only 2 actual PAs on this thread( Makati and myself) say don't do scribe and do get real experience. keep that in mind.
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The problem with no HCE is that a new grad will make more mistakes IMHO. I have seen new grads(both pas/nps) miss peritonsillar abscesses as well as other stuff like mastoiditis and atypical appendicitis. More exposure could possibly decrease these mistakes and give you a better foundation.
Also some of the higher paying jobs are locked out to new grads as well....(for example at my last job I made 15$/hr more than the PA that had a year more experience then myself because I did it the right way and my SP was off site due to my competency)
If the person does go with no HCE, then a 1 year residency would be advisable IMHO.
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This is very true. The one way to get good at assessments is to do them in the field. Mock assessments don't do much because "made up" situations do not help you when the real thing hits, trust me. Sometimes a patient won't shut up with a ton of information that has nothing to do with why you are seeing them, some are cryptic and leave you little to work with. If you don't know how to handle those situations it makes you feel out of control and hinders the decision making process. I improved my skills in this area because I have great colleagues that challenged me in the field in assessments and helped me see what is really going on vs. what you are being told "may" be going on. As an EMT I've also learned how to communicate with other health care professionals (e.g. ER nurses, docs, etc) which goes A LONG way in establishing a professional presence and the confidence to relay information to people with a much higher level of education than you have. The first time I had to give a report to a ER room full of nurses and a physician I about pissed my pants, it was far more nerve racking than treating any patients..I've been trained to do that. All these things come with HCE and I think its the most important thing for an individual aspiring to be a PA...for themselves in the work force as a future PA that is, not for an application to a specific school.
Medex is indeed a top program. It also requires 4000 hours of top quality hce. The op isn't going to go out and get 4000 hours of top quality hce (which would involve going back to school to become a nurse, RT, paramedic, lab scientist, rad tech, or an ER tech with considerable experience. So the question is, should the op take the time to do entry level work for a year to get the flavor of healthcare? I'm sure it would be helpful, but how helpful? Makati makes 15 dollars more an hour than the guy who got out of school a year earlier with 90k more in his pocket from that year out in practice. It will take 3 years before your 15 dollars more an hour breaks even to his or her 90k that they have from entering the workforce a year earlier instead of working the cna floor (or getting a EMT degree and then working for, what, 3 months before applying next year?)
I know what you guys are saying. In my nursing class, the folks with hce were much better overall than the folks without. But many of those folks with out are out working and making money just like all of us who had hce. They aren't regretting getting through school ASAP and learnig how to be a good NURSE rather than honing skills as a nurses aid.
OHSU and UC denver aren't Medex, but few other schools are. That's like pulling out Harvard and saying all other schools pound sand. Medex has an entirely different approach to PA education that other programs are straying from. For this op to want to go to Medex would probably take over 3 years or more. That's roughly 270k in forfeited PA income for that entry level hce thats so valuable. The question is whether the benefits you gain from being a back office MA are worth 270k. So yes... If they go the route you suggest, then it would be worth it to go to medical school instead of PA school. But that's not the only route.
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deleted6669
their pts are the ones regretting their decision.....
their pts are the ones regretting their decision.....
are patients who see a PA or NP in an emergency room regretting thier decision that both those folks didn't go to medical school, but instead chose an "easier" route? is the patient that see's a PA with 5 years of experience going to regret seeing that PA and not you? How do you fix that?
if you pass the PANCE, you are considered worthy to go on and be a PA... thats thier standard. if theres more to it than that, then they need to fix the PANCE. theres always more someone can do to provide better patient care. the fact that an applicant would be more informed going into PA school if they had HCE isnt lost on me.... i have plenty of it. but i know too many poor performing folks in every profession to hail the notion of automatically praising someone who shows up with HCE.
I didnt like going to talk to admissions folks at PA programs and having them care less about my prior health care experience vs their bubbly, fresh from undergrad matriculants who spent lots of time with the pre PA club at thier school doing a condom run at all the bars in their college town to raise awareness about STDs, or a produce a campaign to spay and neuter pets. Im not super happy about the state sponsored programs who take in these out of state students who promise they want to practice out in the sticks in the state, but then choose to hit the big city back where they are from once they graduate (but gotta make sure where you commute to practice in your new car is ghetto enough to qualify to government reimbursement as an underserved site!). "yay, then I work retail and make bank on my days off from my ghetto site until my two years is up and I can leave!" they squeal.
^ yeah, thats most of the young PAs that I know being churned out of the programs around me. so why bother with hce? The only PAs i would want to touch me were the ones i met at the medex interview, vs the other schools. But there isnt enough medex's out there.
consequently, medex also wasnt a place that basically said, "yeah, check the HCE box and we will look at you." they were basically like "yeah, you are awesome? prove it." when HCE is a box to check... like 2000 hours, a program isnt serious about you actually having it.
^ yeah, thats most of the young PAs that I know being churned out of the programs around me. so why bother with hce? The only PAs i would want to touch me were the ones i met at the medex interview, vs the other schools. But there isnt enough medex's out there.
consequently, medex also wasnt a place that basically said, "yeah, check the HCE box and we will look at you." they were basically like "yeah, you are awesome? prove it." when HCE is a box to check... like 2000 hours, a program isnt serious about you actually having it.
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deleted6669
totally agree with all of the above.
fortunately a few new programs are following the medex model like gardner-webb university in NC.
eventually we will have 2 kinds of PAs, call them type A and Type B.
type A will have prior experience and/or complete a residency and/or CAQ(specialty exam)
type B will be the folks you describe above.
Type A will get all the good jobs and type B will get all the crap jobs at quickie marts and wt loss clinics.
it's already happening to some extent. I just got a new job that REQUIRED that I have the CAQ in em to practice full scope EM and work solo. I have also seen job postings for great jobs that say "seeking em residency grad or 10 yrs experience or EM CAQ only."
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I wish residencies were more prevalent throughout the US. I would kill for one year to work under other docs and PAs and get a feel for the specialty I wanted to be in. It boosts pay and trust from hiring docs/groups, and instills confidence in the practitioner, not to mention opens the door for a job any where in the country. Its almost odd they aren't required or at least offered in every state/major city.
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deleted6669
there are plenty for em(19) and surgery(20+). if you apply to a few of those you will get a spot.
other specialties have just a few each.
www.appap.org
think about how that will play out for the profession. "physician associate"? nope... no name change possible, unless maybe the A crowd separates from the B's, and the folks with CAQ get to be "associates", and the ones that don't are "assistants". how do folks from the B crowd even be able to advocate for themselves and advance the profession.
PA's are the ones doing this to themselves. It was PAs that were showing me around telling me "we can make anyone into a PA".
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I don't think he was as concerned with a title as much as he was with properly trained PAs coming out of school vs coming out of a residency and taking a required specialty test in their field. I don't think this would be needed in things like FP or peds, but in say EM, IR, ENT, and other surgery sub specialties I think its a fantastic idea. Shows dedication to your field and decreases "jumping". It gives the PA more clout with their SPs, patients, and peers. Plus doing this would further cement the PA as a needed practitioner and increase their worth (which in turn gives more autonomy, more cash, all good things). I'm not saying PAs aren't needed but so many people have no idea what a PA is in the first place..it doesn't help the profession at all.
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Just rough not having an option if you lived in a specific state, like I do (NE). Not a dream having to re-locate your family for a year then move back home. But I'm sure there are people working to make the residency more widespread which is great for the future.
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deleted6669
the type b's are the ones doing this as they are faculty now at many places..."I didn't need experience to get my job at the quikie mart doing retail medicine so no one else does...."
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The would be golden and well paid if they do a residency.
Also PAMAC in my example that other person had numerous patient complications and near misses....so my extra 30k and better patient safety are worth it to me.
Also PAMAC in my example that other person had numerous patient complications and near misses....so my extra 30k and better patient safety are worth it to me.
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deleted6669
NOPE, I would definitely hire someone who took the time to do a residency to improve themselves.
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deleted6669
to me it's about being fair to your pts your first year in practice.
the no experience folks will make a lot more mistakes that first yr and that means bad outcomes. they will also require a lot more handholding making all PAs look bad in the eyes of docs and others working with that PA. " I hired a PA once and had to babysit for a yr then they quit once they got a clue. not ever doing that again. I will just hire NPs from now on, at least they were nurses first....." don't laugh, it happens....
the no experience folks will make a lot more mistakes that first yr and that means bad outcomes. they will also require a lot more handholding making all PAs look bad in the eyes of docs and others working with that PA. " I hired a PA once and had to babysit for a yr then they quit once they got a clue. not ever doing that again. I will just hire NPs from now on, at least they were nurses first....." don't laugh, it happens....
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Thanks. A number of people have talked about the salary advantages of doing a residency as a new PA. Is the difference really that substantial? Also, would attending a PA program that accepts folks without HCE make someone uncompetitive for a residency?
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deleted6669
many places equate a residency with at least 5 yrs of experience in terms of seniority and pay.
doesn't really matter where you go to pa school for residency apps.
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emedpa would be able to answer the salary question better, but I would assume he would say its substantial. I think with a residency you can scrape the 100K mark starting vs. between 8-0-90K starting. That is actually a huge difference, and it is VERY well deserved IMHO. For the latter, not one bit. A PA grad is a PA grad. I know PA grads from a small, relatively unknown PA school in Nebraska that work at the top Neurosurgery clinic in the state.Your performance in PA school may dictate whether or not you get a position..and whether or not you're a good interview is probably weighted pretty heavily.
Residency is nice option, but it isn't realistic to assume most folks can just go to one. 19 EM residencies that take an average of 2-3 PA's per class. That's not a very good number if you consider the amount of new grads.
The whole idea of residencies is good.....but it isn't realistic simply due to the lack of them. New PAs need to be adequately precepted during their first couple of years, while working on the lower end of the pay scale. Whether someone has or hasn't had HCE shouldn't really be a deciding factor. The only way to know how someone will be as a PA is to evaluate them as a PA.
BTW, I have almost 20 years HCE, I don't think it will matter much when I look for my first job after graduation. If it does good, if not...I will pay my dues.
The whole idea of residencies is good.....but it isn't realistic simply due to the lack of them. New PAs need to be adequately precepted during their first couple of years, while working on the lower end of the pay scale. Whether someone has or hasn't had HCE shouldn't really be a deciding factor. The only way to know how someone will be as a PA is to evaluate them as a PA.
BTW, I have almost 20 years HCE, I don't think it will matter much when I look for my first job after graduation. If it does good, if not...I will pay my dues.
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deleted6669
Not many folks apply for those residency spots which is why if you apply to several you will likely get a spot in 1. I know most of the em residency directors and there are years when they can't even fill 2-3 spots. one program got zero applications last year.
having significant prior experience definitely helped me get my first job and got me more money at my first job as well. since then I have gotten jobs based on my prior medic experience because they know I am comfortable with critically ill folks, can intubate, etc
Hopefully I will be in a market that will value my past experience. Unfortunately, doing a residency isn't in the cards for me. I guess I will see.
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Do you know anything about Acute Care/Critical Care residencies and typical vacancies?
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I am actually currently in the first semester of a local university's RN program, but I have also been considering applying to PA programs. At this point, I'm debating as to whether I should become a PA, NP, or CRNA. I was leaning towards the CRNA route, but I'm also intrigued by the notion of becoming a surgical PA and working for a neurosurgery/spine group (I also have a Biology degree that I received in 2010).
I know this is going to sound like a crazy question, but do you know of any well-reputed PA programs in the southeast that are known for accepting individuals who have no HCE? I have a 3.65 GPA (graduated with a 3.59 on my Bio degree) and an 1170 GRE score. The reason I'm not really interested in taking more time off to attain HCE is because I will absolutely do a residency if I pursue the PA route.
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deleted6669
nope, sorry
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deleted6669
nope, sorry. all the programs I recommend require experience.
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But just to be sure, completing a residency would "make up" for any discrepancies that would arise from completing one of those programs? Out of curiosity, are they considered to be bad programs specifically because they accepts applicants who have no HCE, or are there issues with the program/curriculum itself?
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If you're interest in the NE region you should apply to QU. Awesome facilities, they take classes with the new med students, and use a cooperative educational model where nurses, PAs and med students practice working together. They have a simulation center that actually looks like the wing of a hospital. I think it's a great school, ranked highly, and with the addition of a medical school the cooperative education model can only get better.
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deleted6669
yup, a residency would be the great equalizer.
I'm sure some of the no hce programs are fine but it's just a personal prejudice of mine that pa programs should require experience because when I was going through the process 20 yrs ago they all did.
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Sorry, I don't mean to sound oppositional or argumentative regarding not wanting to get HCE -- it's just that, at this point, with me being 25 years old, I'm really ready to get things moving. And if I plan on doing a residency anyways, I figure I might as well get the ball rolling. BTW, what's your opinion on becoming an NP and then doing a surgical residency? I did a quick Google search and saw that there are a number of surgical residencies for NP's as well as a few residency programs that accept both PA's and NP's, but I wasn't sure how common/accepted it was for NP's to work in surgery.
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deleted6669
if you want to do surgery do PA. no one hires np's for surgery. there are 20 + PA surgical residencies, many around for 30 + yrs.
norwalk and montefiore are the oldest and best known.
there are only a handful of np surg residencies, and as I said the surg np market is very small. np's own the outpt psych, women's health and peds markets +/- fp.
em and surg are firmly pa dominated fields.
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UAB (this is good for you since it is more surgically oriented), Mississippi College, Nova - Jackson, South College are all places I know I've seen people accepted with no HCE. There may be others that I can't remember.
Finishing RN and then applying would probably be better.
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Thanks. I think, however, that if I finish the RN program, I'll probably just apply to CRNA programs. I'm not sure if having it is helping CRNA's get jobs in this field, but I'm kind of interested in doing one of the new pain medicine certificate programs for CRNA's.
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You'll get little chronic pain management in most schools, so will need postgrad training in that arena. Either from someone already doing it, or structured education. It would be very beneficial.
You could always apply in nursing school. With your GPA and GRE, as well as some introduction to healthcare in a nursing program, I think you could get into one of the above schools. Emed is correct in saying that the best require HCE and I understand why he wouldn't stamp his approval on anything less. I'm not giving my stamp of approval on any of the above, except maybe UAB for those wanting to be in a surgical specialty, I know they are decent.
You could always apply in nursing school. With your GPA and GRE, as well as some introduction to healthcare in a nursing program, I think you could get into one of the above schools. Emed is correct in saying that the best require HCE and I understand why he wouldn't stamp his approval on anything less. I'm not giving my stamp of approval on any of the above, except maybe UAB for those wanting to be in a surgical specialty, I know they are decent.
For what it's worth, I don't know many PAs in ERs, and the market where I'm at has tons of ERs. To say they dominate is variable. I don't doubt that some places see them in large numbers. ER fast track is basically where I've seen them before they quit being utilized regularly. We just use NPs and doctors, as do most of the rest of the major systems here. A relative of mine saw a PA for a few minutes in a nearby facility, but got passed off to a physician when it looked to be a non fast track kind of case.
There aren't a ton of NPs in surgery, but it can be done. Surgery would drive me up the wall with boredom, but some folks love it. I would try out nursing for a bit and get a good look at the lay of the land. Your perspective may change. As a nurse, ER is an absolute blast. I don't see it as being as awesome if i were a provider. Better than most provider jobs, but certainly not epic... Especially if I were relegated to fast track.
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By me a large city hospital staffs the ED with almost all PA (I think one medical director to a few PAs) , it's pretty common to see triage push low acuity to PA around here and higher acuity to EM. It's also common to see a PA first then have the EM doc come in at another hospital nearby.
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The different Ed physician groups and hospitals crow about getting patients in to see doctors specifically. The facitities that didnt take this approach were at a public relations disadvantage, notwithstanding the potential efficiencies associated with that triage system. The ER group director at my hospital has told the nurses that they figure a physician can cut through to the heart of a patients problem sooner than a bunch of PAs, and get patients through to where they need to go quicker, so they invested in scribes to keep them moving.
I can't imagine most people being excited about taking their loved one to an ED that is staffed only by PAs, with a medical director as backup. That's not to say that folks wouldn't go to those places, but it wouldn't be something that would give them an edge with the public. Note that I'm not saying that PAs and NPs arent a good addition to an ED, just that it can be more tricky that just improving efficiency.
