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Anesthesiologist Assistant (AA) questions

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jamoles

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There are some nice write-ups for a lot of different professions on SDN, but there is not one geared toward AAs. Now, I have read a good deal of info about AAs (from schools that offer the programs), but there are still some questions I have not found answers to. Here are those questions (and, of course, not all questions can be answered with specifics, but any attempt is appreciated):

NOTE: I sent this as a private message to another member, but I figured the answers to these questions might be beneficial to others...

1. Will AAs ever be able to practice in all 50 states? If so, then within 10 years? Twenty years? Possibly anytime soon?

2. Do AAs take out malpractice insurance?

3. What is a typical day/week like (i.e., hours, number of cases, on-call hours, etc.)?

4. Now that you have been practicing, would you still take the AA road or would you do something different?

5. Not specifically yours, but what did some of your graduating classmates' job offers look like, and, similarly, do you feel there is a good deal of job security associated with being an AA?

6. Do you do a lot of moonlighting or are you employed by one group/hospital?

7. Did you shadow an anesthesiologist before applying to AA programs? If so, then how'd you go about doing so?

8. What were some of the deciding factors which made being an AA more desirable to you than being a doctor, or any other profession?

9. Are there any AA-geared forums or Web sites where I can read more about the profession?
 

RT2MD

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I would also be interested in seeing answers to these questions. I am also considering AA after looking at MD school for a while - don't think that I want to spend that much time away from my daughter... :)

Thanks!
 

RT2MD

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Thanks for posting all of that information. I have done a lot of research in the field and already knew pretty much all of above, but I think that it is great to have a thread going on here for others to look at.

They are starting a new message board, as well. It can be found at:
http://www.anesthesiologistassistant.com/forum/

They also are starting a 'prettier' version of an informational website. You do have to pay a one time fee of $27 to be able to post your CV, etc. This is the same site that the forum is on:
http://www.anesthesiologistassistant.com/default.asp

Don't forget that the website is just starting up, I think, so there are no job postings on it yet.

Here is a site that lists the practice locations. It is part of Case Western's website:
http://www.anesthesiaprogram.com/licensure.htm

Another thing that I would like to add would be the school locations:

Nova Southeastern University
Emory University
Case Western Reserve University
South University
University of Missouri, Kansas City

There are also several threads that are available on SDN if you search for either "AA" or "anesthesia assistant". I know the member JWK is an AA down in Georgia, and he seems to have a lot of knowledge on the subject.

Here is a link to the ASA newsletter in 2003 discussing AA's:
http://www.asahq.org/Newsletters/2003/03_03/TOC_0303.html

I think that is all that I have found, I hope that it helps... it sounds like you probably already have all this information, but I thought that I would post it.

-RT2MD (not anymore... maybe RT2AA?)
 

RT2MD

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I can't really think of any off the top of my head. I honestly believe that the AA will be licensed throughout the 50 states in the somewhat near future. I have heard that there are a couple of other areas that are thinking of starting schools too... although I don't know where.
 

Taurus

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Visit the anesthesiology forum. Btw, there's strong support by anesthesiologists for AA's.
 
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RT2MD

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Hrmm... I would love to work in Washington St. Just about at the top of my list of places I want to live! :D

Taurus - I have been lurking on the Anesthesiologist forum as well. Found this thread after doing a search on SDN for AA. I wonder if we should have it moved? The nice thing about having it over here is that it won't degrade into a yelling match as quickly (of course the downside is that nobody will see it:laugh:)
 

jamoles

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Not the best, but at least you don't have to write it down or have multiple windows open to see it all.

NOTE: No survey courses may be taken for credit


*Preferred but not required
**No lab required
***Either two semesters of calculus, or one semester of calculus and one semester of statistics

Nova Southeastern University
One semester of english
Two semesters of general biology
Two semesters of general chemistry
Two semester of organic chemistry
One semester of biochemistry**
Two semester of general physics
One semester of calculus

Tuition : $25,000
MCAT or GRE

Emory University
One semester of english
Two semesters of general biology
Two semesters of general chemistry
One semester of organic chemistry
One semester of biochemistry**
Two semester of general physics
One semester of calculus
One semester of cell and molecular biology*
Second semester of organic chemistry*

Tuition : $26,400
MCAT or GRE

Case Western Reserve University
Two semester of english
Two semesters of general biology
Two semesters of general chemistry
Two semester of organic chemistry
One semester of biochemistry**
Two semester of general physics
One semester of calculus***
One semester of statistics***
Two semesters of anatomy
Two semesters of physiology**

Tuition : $35,000

MCAT

South University
One semester of english
Two semesters of general biology
Two semesters of general chemistry
One semester of organic chemistry
One semester of biochemistry**
Two semester of general physics
One semester of calculus
One semester of statistics
One semester of cell and molecular biology*
Second semester of organic chemistry*

MCAT or GRE

University of Missouri, Kansas City
Two semester of english
Two semesters of general biology
Two semesters of general chemistry
One semester of organic chemistry
One semester of biochemistry**
Two semester of general physics
One semester of calculus
One semester of statistics
Second semester of organic chemistry*
Two semesters of anatomy and physiology*

MCAT

 

RT2MD

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University of Missouri, Kansas City
Two semester of english
Two semesters of general biology
Two semesters of general chemistry
One semester of organic chemistry
One semester of biochemistry**
Two semester of general physics
One semester of calculus
One semester of statistics
Second semester of organic chemistry*
Two semesters of anatomy and physiology

MCAT


Good list, I know that there are always people asking what are the requirements for different schools.

One note, though... the Two semesters of anatomy and physiology are preferred for UMKC's program.

Thanks for doing all that work!
 

jacketwrestler

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Recently, I have heard of Washington state as being the next site of an AA program. Hopefully that gets worked out soon.

Really? Are you sure it's not Washington, D.C. as they're already approved to work there? I haven't heard of AA lobbyists in the state of WA at all. But would be great news if true.



http://members.boardhost.com/Anesthesia/index.html

And the posts of Dave J are like gold on that forum. He's actually a CRNA in favor of AA's. Has a ton of knowledge on the role of anesthetists, salaries, etc.
 

RAMPA

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question

if one wants to be a trail blazer, wouldnt AAs find most anesthesiology departments at academic centers welcoming to their presence?

for example: i become an AA, yet want to work in washington state where currently AAs are not licensed, wouldnt going somewhere like here
be a good place to start looking for employment?

seeing as how they already employ CRNAs in the ACT model, an AA should fit right in... correct?

what else would be an obstacle to practicing there or any other state? correct me if im wrong, but isnt there only 1 state were AA practice is specifically prohibited?
 

foreverLaur

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I know nothing about the AA profession. What do they do? What purpose do they serve in addition to the Anesthesiologist and CRNA?
 
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deleted6669

I really hope you aren't saying that AA is to CRNA as PA is to NP because that would be very very false...
actually it's true. do a little research.
AA is a 2 yr grad degree with more science prereqs than medschool and also requires mcats. the programs train a non-rn in the same scope of practice as a crna. many AA's are former resp. therapists or paramedics.places that use both schedule them interchangeably and pay them the same. there are AA's who supervise crna's in mixed groups(JWK, a forum member here, is the head anesthetist in such a group in georgia).
the only difference between aa's and crna's is that all crna's are former nurses and a few states allow crna's to practice independently of an md.
all AA's work as members of an anesthesia team and have a supervising anesthesiologist available for consults who are not required to be present in the o.r. during cases.

info from the program at emory:
During the mid-1960s in response to a manpower shortage and concerns over the increasing complexity of anesthesia and surgery, Drs. Gravenstein, Steinhaus and Volpitto1 created the concept of anesthesiologist assistant. They designed an educational program whereby matriculants would build on an undergraduate premedical education then obtain a masters degree in anesthesiology. In their white paper, the authors wrote, "Responsibility and immediate care of the patient must remain within the province of the anesthesiologist; consequently, personnel could not work independently but only under the immediate direction of an anesthesiologist. An advantage in manpower for the anesthesiologist would result, as he could provide attention to several patients with the proper employment of the anesthesia team, described above."
Since its beginning, the Emory program sought to produce a new type of anesthetist, the anesthesiologist assistant, whose clinical and technological skills complement the traditional medical role of the anesthesiologist. This new type of anesthetist has advanced the quality and efficiency of care delivered by the anesthesia care team. The basic science education in anatomy, physiology, biochemistry, pharmacology, biophysics, and medical instrumentation, along with intensive clinical training, prepared the graduates to become knowledgeable skilled practitioners and participate as valuable members of the anesthesia care team.
The current program graduates approximately 30 anesthesiologist assistants each year. Approximately ten percent of the program's graduates have entered medical school, and of those, over ninety percent have completed residencies in anesthesiology. Approximately two percent of graduates have pursued graduate school in the basic sciences, dental school, or law school.
1. Gravenstein JS, Steinhaus JE, Volpitto PP. Analysis of manpower in anesthesiology. Anesthesiology 33(3): 350-7, 1970.
2. Steinhaus JE, Evans JA, Frazier WT. The physician assistant in anesthesiology. Anesthesia and Analgesia. 52(5): 7949, 1973.
MMSc Program in Anesthesiology, Emory University School of Medicine

AND FROM THE PROGRAM AT CASE WESTERN:
http://www.anesthesiaprogram.com/default.htm
 

fab4fan

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the only difference between aa's and crna's is that all crna's are former nurses and a few states allow crna's to practice independently of an md.


CRNAs are not "former nurses." They are nurses practicing in an advanced specialty. What did you think the "RN" in CRNA stood for?
 

jwk

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I really hope you aren't saying that AA is to CRNA as PA is to NP because that would be very very false...

emed has already given the explanation, but why would you assume, especially as a premed student, that it would be "very very false" when you say you "know nothing about the AA profession"?

Facts are your friend.
 

foreverLaur

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Seeing as how you need prior critical care experience and a BSN/RN to be a CRNA, how would all CRNAs not be former nurses??

All I know about the AA profession is that upon graduation, the job descriptions are usually about the same for an AA vs CRNA, but doesn't an AA have to practice under an anesthesiologist where CRNAs have to practice under a physician (legally speaking)?

So then, why do we have AAs when there are more than enough people applying to CRNA programs?? Is one supposed to take over the other or are they just going to forever compete against each other?
 

core0

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emed has already given the explanation, but why would you assume, especially as a premed student, that it would be "very very false" when you say you "know nothing about the AA profession"?

Facts are your friend.

Actually in my opinion she is correct. With deference to EMED the origins of the AA are in the PA profession, but the AA profession is the lone remnant of early PA experiments that have since been closed. In the original PA design one group pictured three types of PAs. The generalist PA which is what PAs are called now. The specialist PA examples of which would be the primary health PA and the AA. And technician PAs examples of which would be OPAs. The PA profession discarded this model soon after it was proposed. The AA remains the only portion of that experiment.

The basis of the PA profession is that the PA is trained in all aspects of medicine and then is trained further through either post graduate course work or by working closely with their supervising physician. The basis of the AA is to train in one aspect of medicine and then work in the ACT model with anesthesiologists. In essence the AA model is closer to all of the APN models including the NP which trains in only one aspect of advanced practice nursing. The AA lacks the true flexibility that is the hallmark of the PA profession.

David Carpenter, PA-C
 

core0

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Seeing as how you need prior critical care experience and a BSN/RN to be a CRNA, how would all CRNAs not be former nurses??

snip

What fabfourfan was saying is that they are still nurses not former nurses. One of the requirements to be licensed as a CRNA is to have an active RN license.

David Carpenter, PA-C
 

fab4fan

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Seeing as how you need prior critical care experience and a BSN/RN to be a CRNA, how would all CRNAs not be former nurses??

All I know about the AA profession is that upon graduation, the job descriptions are usually about the same for an AA vs CRNA, but doesn't an AA have to practice under an anesthesiologist where CRNAs have to practice under a physician (legally speaking)?

So then, why do we have AAs when there are more than enough people applying to CRNA programs?? Is one supposed to take over the other or are they just going to forever compete against each other?

If you were formerly something, it indicates you left that behind. You don't leave nursing to be a CRNA--you are still a nurse.

This is where some people get into trouble. They see the fast track to CRNA because they don't want to see themselves as nurses. That speaks volumes about what they are thinking about their co-workers.

A CRNA is still licensed to practice as an RN. That never changes.

Thanks Dave, I just saw your post. ;)
 
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deleted6669

"A CRNA is still licensed to practice as an RN. That never changes."

agree- I didn't mean to offend there. I probably should have said all crna's have a nursing background.the fact is though that you don't see crna's picking up extra floor rn shifts, they are in a new role doing anesthesia. I am a former paramedic. I could pick up medic shifts at 1/3 my current payrate but am unlikely to do this anytime soon.
not all crna's have a bsn though as a few programs allow a bs in anything + rn experience as an ed or icu rn. I have a good friend going through the application process now and his bs is in anthropology and he is an er nurse without icu experience.
 

RAMPA

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Seeing as how you need prior critical care experience and a BSN/RN to be a CRNA, how would all CRNAs not be former nurses??

All I know about the AA profession is that upon graduation, the job descriptions are usually about the same for an AA vs CRNA, but doesn't an AA have to practice under an anesthesiologist where CRNAs have to practice under a physician (legally speaking)?

So then, why do we have AAs when there are more than enough people applying to CRNA programs?? Is one supposed to take over the other or are they just going to forever compete against each other?

you could take the above statement and replace AA with PA and CRNA with NP.

"So then, why do we have PAs when there are more than enough people applying to NP programs?? Is one supposed to take over the other or are they just going to forever compete against each other?"

im not tryin to argue with you, but i hope you see what im saying. plus competition is not necessarily a bad thing. :D

i believe nurses are not the only ones who are capable of being competent non-MD anesthesia providers. i know CRNAs have proven themselves, yet i dont think i should have to go to nursing school just to pass gas in the future. AA is thus an option for someone like me.

im still stuck between choosing PA or AA.
 
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deleted6669

you could take the above statement and replace AA with PA and CRNA with NP.

"So then, why do we have PAs when there are more than enough people applying to NP programs?? Is one supposed to take over the other or are they just going to forever compete against each other?"

im not tryin to argue with you, but i hope you see what im saying. plus competition is not necessarily a bad thing. :D

i believe nurses are not the only ones who are capable of being competent non-MD anesthesia providers. i know CRNAs have proven themselves, yet i dont think i should have to go to nursing school just to pass gas in the future. AA is thus an option for someone like me."

RT is a great background for AA or PA....also after getting your PA there is now a PA to AA bridge if you are feeling really motivated.....I know a few....also a few NP/CRNA folks....either way, a powerhouse combo as you can work outside the o.r. and cover pain clinic, icu, etc
 
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foreverLaur

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Are there benefits to one or the other or any reason to pick one over the other? What do employers think about the two when hiring?
 
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deleted6669

Depends on the state. AA's do not yet have practice rights in all 50 states and crna's do. new states are being added every few yrs as physician led anesthesia groups see the advantages of AA over crna.
there are only 3 or 4 AA programs at this point with several new ones planned.
 

foreverLaur

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Depends on the state. AA's do not yet have practice rights in all 50 states and crna's do. new states are being added every few yrs as physician led anesthesia groups see the advantages of AA over crna.
there are only 3 or 4 AA programs at this point with several new ones planned.


what are those advantages??
 
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deleted6669

what are those advantages??

AA's always work as part of a physician led anesthesia team and are subject to medical oversight, QA, and educational requirements so docs "trust the product". also AA's never become "the competitition" like crna's in some places may do by setting up their own practice in direct competition with local md anesthesia groups.
AA's like PA's must have an affiliation with an md and therefore at least some degree of medical oversight.
in something like 15 states crna's can set up there own shop independent of an anesthesiologist similar to the way that np's can do this with full independence in 12 states.
 

jaderok

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I do...it'a a little off topic but I had a question about the pre-requisites. It may be a stupid question but is microbiology and biochemistry the same thing? I may be over-thinking the issue, but I go over it in my head I run into a circular argument. Anyways, any clarification would be greatly appreciated.
 

jwk

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I do...it'a a little off topic but I had a question about the pre-requisites. It may be a stupid question but is microbiology and biochemistry the same thing? I may be over-thinking the issue, but I go over it in my head I run into a circular argument. Anyways, any clarification would be greatly appreciated.
A little off topic?

I'm not sure why you have difficulty separating the two.

Microbiology is the study of micro-organisms. Bacteria, viruses, etc.

Biochemistry (among other things) is the study of carbohydrates, proteins, lipids, and the other building blocks of life. Amino acids, the Kreb's cycle, fatty acids and triglycerides, all that fun stuff.
 

jaderok

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I guess it was just wishful thinking. Biochemistry is only offered at the University in town during the day. It is essentially out of the question since its a Monday through Thursday class in the middle of the morning and I work fulltime. :eek: I checked the CC in town, but they apparently don't offer the class. Or I can't find it. Microbiology, however, is offered at the CC in the evenings. Oh well.
 
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deleted6669

I guess it was just wishful thinking. Biochemistry is only offered at the University in town during the day. It is essentially out of the question since its a Monday through Thursday class in the middle of the morning and I work fulltime. :eek: I checked the CC in town, but they apparently don't offer the class. Or I can't find it. Microbiology, however, is offered at the CC in the evenings. Oh well.
university of new england and uc berkeley both offer fully online accredited biochem courses......
 

jwk

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Micro usually has a lab component and is frequently required in nursing programs, so lots of CC's will have it.

Biochem is usually just a lecture course, so online should work as emedpa noted.
 
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deleted6669

Micro usually has a lab component and is frequently required in nursing programs, so lots of CC's will have it.

Biochem is usually just a lecture course, so online should work as emedpa noted.

Clackamas community college has an online microbio course with lab. you pay a deposit, they send you materials, you do the labs at home, you return the materials(slides, etc) and get your deposit back.
http://dl.clackamas.edu/bi-234-30.htm
 
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RT2MD

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jaderok

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I appreciate all the information you guys have given me. An online course will definitely fit my schedule very nicely. I will take a look and let you know. Thank you.
 

jacketwrestler

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I wish I would've known about these online courses last year! I drove to 3 different uni's trying to add this class, and finally got one at UCR. But the teacher and class was very difficult and dis-organized (I hate Rastop! aka Rasmol). Enough ranting..


Anyone going to be applying to AA schools for entry in '09? I am.
 

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What is the job market like? I have seen little to no jobs advertised online, all anesthetist positions seem to be for CRNAs. I even called an anesthesia group here in Orlando and they said they don't employ AAs. Do groups communicate directly with the schools to hire graduates?
 

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Yes they do from what I understand. When you do your clinical work in AA school, you will very likely get job offers from some of those clinical sites. Many of the sites in Florida are in south Florida, but I know 100% that there are sites in Tampa and Orlando. I'm not sure where else exactly....yet.
 

jwk

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What is the job market like? I have seen little to no jobs advertised online, all anesthetist positions seem to be for CRNAs. I even called an anesthesia group here in Orlando and they said they don't employ AAs. Do groups communicate directly with the schools to hire graduates?

The groups in Florida that don't want to hire AA's are generally either:

1) caving to pressure from their CRNA employees that they'll all quit if they hire an AA (doesn't happen - idle threat), or,

2) use CRNA's to take call by themselves so they don't have to come in at night, thus being an "Anesthesia Care Team" practice on weekdays from 7-3 only.

There are plenty of practices in Florida that will hire AA's if they have the opportunity. Do NOT expect every anesthesia job to be listed on gaswork.com or monster.com or similar sites, because most practices don't advertise, and even fewer will use recruiters. You need to do the legwork, phone calls, and letters yourself, and take every advantage of being in a number of different clinical sites while you're in your program. Every graduating AA from the senior classes this year will have a job lined up before they graduate, and most will have multiple offers. That includes Nova Southeastern in Florida as well as the other three programs with students finishing this summer.

Those practices in Florida and elsewhere that are able to hire AA's and don't do so are missing out on a fine group of clinical providers. It's their loss.
 

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I wish I would've known about these online courses last year! I drove to 3 different uni's trying to add this class, and finally got one at UCR. But the teacher and class was very difficult and dis-organized (I hate Rastop! aka Rasmol). Enough ranting..


Anyone going to be applying to AA schools for entry in '09? I am.

I am applying for next year......:)
 

KNC

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thanks.....you also!
 

nampa1

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Is AA admissions all about test scores and grades? If so, what standard? What else are they looking for? Volunteering? OR time?
 

Josh L.Ac.

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I just met with one of the assistant instructors at the UMKC program and there are some updates on the program:

1. The only classes that need to be retaken if they are older than 5 years are now Biochem and A&P. But if you do well enough on the MCAT [>25], then they will waive the 5 year requirement.

2. The first class was 4 students and the next one will be 8-10, depending on how many AA's they can get for the 1:1 clinical work. I was told there are more applicants this year and the selection process is going to get more difficult.

3. They probably won't change the MCAT requirement over the GRE anytime soon, so get studying.

4. Kansas is probably going to open up in the next few years. Since there is such a shortage of AA's, they did have some difficulty staffing the program at UMKC. One of the ideas to shore up the staffing issues is to open a new program in the state when it gets licensed. Apparently many of the state medical schools are excited [about] this concept.



More to come.
 

nampa1

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I did my undergrad years ago, but I hope to be a graduated pharmacist in some years.
Would this help me be competitive to have that pharmd? I know they like former healthcare workers, but thought it was limited to Respiratory workers.
 

Endee

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I did my undergrad years ago, but I hope to be a graduated pharmacist in some years.
Would this help me be competitive to have that pharmd? I know they like former healthcare workers, but thought it was limited to Respiratory workers.

I think Pharmacy training would be irrelevant and unlike PA (physicians assistant), AA does not place the same kind of emphasis on prior healthcare experience. I had none and I was accepted.
 

nampa1

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I think Pharmacy training would be irrelevant and unlike PA (physicians assistant), AA does not place the same kind of emphasis on prior healthcare experience. I had none and I was accepted.


I have to disagree with this. Some programs definetly said they liked previous experience, but I only got Respiratiory therapist as an example. Since pharmacy deals with drugs, I was just wondering if that would be a second for their preference.

That's great you got in without any experience. I wish this program was around when I was undergrad. Pharmacy looks like it might be a wash. The surplus is ending and the powers in pharmacy trained to push the counseling role as primary, as opposed to opening up new venues, like a pharmacist version of anesthesiology, nurse practitioning etc.
 

bwbrown

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Hi, I am looking to apply to AA programs. However, my GPA (3.0) and GRE (1150) are a little below AVG. I realize that I must pursue a lot of volunteer work/shadowing; are there any suggestions as to who I can shadow (on top of an anesthesiologist) and how many hours will make me competitive? In the meantime I plan to retake the GRE and possibly the MCAT, but I need a goal of hours and locations to shadow before applying. Thanks!
 

facetguy

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Hi, I am looking to apply to AA programs. However, my GPA (3.0) and GRE (1150) are a little below AVG. I realize that I must pursue a lot of volunteer work/shadowing; are there any suggestions as to who I can shadow (on top of an anesthesiologist) and how many hours will make me competitive? In the meantime I plan to retake the GRE and possibly the MCAT, but I need a goal of hours and locations to shadow before applying. Thanks!

Are you confusing shadowing and shagging?:D
 
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