Being a Med Student or PA?

[redjack2k]

Why do we do it? In a debate with a PA friend (she got accepted, hasn't started yet) she was getting aggravated at how med students had to study for the USMLE and memorize all this crap. She even got to the point of saying that this will be the "downfall of medicine."

Three questions:
1) Why DO we memorize all this stuff? Why do we have to know about disease mechanisms and granulomas and stuff when we want to go on to be, say, Radiologists? Is it useless to memorize Osler-Weber-Rendu syndrome and its presentation? Or memorize what disease states Henoch-Schonlein purpura appear in?

2) Don't PA students also have to also study like we do for their licensing exams? I think she needs to get off her high horse as she is going to be part of this "downfall"?

3) Is it more advantageous to be a PA? I wonder about this sometimes...

I'm a med student studying for Boards, obviously, but I can't explain it to even my own cohort. I personally feel that there is value in learning diseases and the pathology/pathophysiology relevant to the practice of medicine. What do you guys think?

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[Northerner]

Why do we do it? In a debate with a PA friend (she got accepted, hasn't started yet) she was getting aggravated at how med students had to study for the USMLE and memorize all this crap. She even got to the point of saying that this will be the "downfall of medicine."

Three questions:
1) Why DO we memorize all this stuff? Why do we have to know about disease mechanisms and granulomas and stuff when we want to go on to be, say, Radiologists? Is it useless to memorize Osler-Weber-Rendu syndrome and its presentation? Or memorize what disease states Henoch-Schonlein purpura appear in?

2) Don't PA students also have to also study like we do for their licensing exams? I think she needs to get off her high horse as she is going to be part of this "downfall"?

3) Is it more advantageous to be a PA? I wonder about this sometimes...

I'm a med student studying for Boards, obviously, but I can't explain it to even my own cohort. I personally feel that there is value in learning diseases and the pathology/pathophysiology relevant to the practice of medicine. What do you guys think?

THE SKY IS FALLING! A PRE-PA STUDENT HAS FORETOLD THE COLLAPSE OF MEDICINE! THIS IS NOT A ****ING DRILL, HAZMAT SUITS EVERYONE!

Honestly, what kind of question is that - "why do we have to learn all this crap if we're not all going to be radiologists?" If you're expecting a different M1/M2 curriculum for each student based on his pre-M1 declared specialty of choice, with accompanying personalized licensing exams, you're out of your mind, my friend. If I had a nickel for every person who changed their mind about specialties year to year....I'd have a ****load of nickels.

Complaining about "having" to learn minutiae of pathology is the hubris of the prematurely bitter. Keep on truckin', brother - you're doin' fine.

 

[Bitsy3221]

I went to PA school, worked as a PA for a few years, and went on to medical school. I am graduating in a few weeks, so take my view FWIW....

The major difference between a PA and an MD is the basic science knowledge, and this is not the downfall of medicine, it is the basis for being a competent physician. I think I was a pretty good PA, but there were still significant gaps in my knowledge that could only be filled by going to medical school. Often, such as in the ICU, I knew what to do but I did not always know why I was doing it. Now that I have had the extensive (at least when compared to PA school) education in anatomy, physiology, path, micro, etc. it makes taking care of critically ill patients so much more interesting, and I feel much better prepared to handle myself and sick patients. Did PA school teach some things better, such as physical diagnosis? Yes, hands down.

As far as memorizing all these diseases, you can't diagnose something if you don't know it exists. If you had no idea that HSP exists, you will never think about it in your differential when some kid comes in with a wierd rash and achy joints. You don't necessarily need to commit the entire disease process to memory forever, but remember that when you see this presentation you won't just write it off as rash and growing pains. I've heard a doc say "when all you have is a hammer, everything is a nail" Knowing the breadth of all these disease just gives you more tools in your toolbox, so you can at least think about them as you approach a patient.

Yes, PAs have to study for their licensing exam, which they take right before their graduation after two full years of schooling. Having taken Step 1, Step 2 CK and CS and the PA boards, I can confidently say that the PA boards and Step 2 are pretty similar in terms of clinical knowledge and difficulty. I used USMLE prep books to study for my PA boards. In addition, PAs have to retake and pass this exam every six years as long as they work, regardless of specialty. (Can you imagine having to take Step 2 every six years? ) Your friend is going to have to put a decent amount of studying in on this. PAs do not get adequate training to prepare for and pass Step 1, which is the knowledge base that you and your friend seem to be debating about.

I think the PA profession is great, and if a PA student is motivated and finds themself in a great relationship with a supervising physician willing to invest in their training, they can become very highly functioning in the clinical arena. However I do think that your friend, just like the pre-allos running around here making declarations about all-things-medicine, is probably out of line to decide what is the downfall of medicine (really--that just doesn't make any sense!) and, frankly, I do not see why she should bother getting aggravated b/c med students are studying. PA is good, physician is good, but both have serious downsides as well.

And congrats for starting another PA vs. MD flame war. Hopefully it will keep up until Thursday--I need something to keep my mind off the match.

 

[The Buff]

Love the avatar, bitsy. Nice post as well.

Hmm, I guess I should contribute something to the thread... Ill go with the classic pre-allo on PAs response: AHHHHHHHHHHHHHHHHHHHHHHHH! PA's are evil! Run to the hills!

 

[Critical Mass]

PA--2.5 years of schooling, a quarter of the tuition cost, multiple specialties to choose from, good lifestyle, low liability (all relative to med school)

The PA students at my school get better clinical experience early on and are better at physical exam skills after the first year and a half.

Bitsy seems to be right on with my view.

We'll wait until the thread sees page 2 before emedpa shows up.

And congrats for starting another PA vs. MD flame war. Hopefully it will keep up until Thursday--I need something to keep my mind off the match.

I just noticed that the OP has only one post.

 

[Bitsy3221]

I just noticed that the OP has only one post.

Fair enough Seriously, OP, I did not mean anything derogatory by that statement. It just that--how shall I say this--the "us vs. them" (MD/DO, PA/NP, PA & NP/MD & DO, etc) threads has a tendency to propagate and degrade....hopefully this one will stay constructive and civil.

 

[redjack2k]

Thanks for the encouragement...sorta. I do feel that I understand a disease process better by learning the minutiae (and like I always joke, physicians get paid better because we use the 50 cent words instead of your average nickel words...yea I sound like a fogey) of a pathologic lesion. The knowledge is there and I guess our patients would not feel comfortable if we did not know everything there was to know about their disease. But isn't that what residency is for? Preclinical curriculum, from my POV is to 1) give us sufficient knowledge to take the boards exam (getting your foot in the door; meeting the requirements of the different specialty boards and your school's requirements) and 2) allowing us to be somewhat competent about disease when we go on the wards which will then be another step in the development of a doctor. Then Steps 2 and 3 test us on our clinical abilities (H/P and eventually management of a pt). There probably exist a perfect system, but it's what we got.

It's just the grunt work of taking the Step 1 that's getting to all of us and my wannabe radiologist friend wants more to get specialized early on, as in "Radiology School" which is totally delusional. Plus I get so much crap from the PA-student cohort (PA's are another folk I think but I've never really run into a PA, just the students).

But I digress. Do you guys agree with the Step 1's goals? Are those goals just "part of the deal" and don't really correlate with a good future clinician? We learn diseases to learn about them for the sake of just learning, I feel but what other opinions are there about this? In a sense this delves into the psychology of the USMLE and I'm sorry for that!