Can I work as a PA?

[peepadoo]

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Having completed 4 years of medical school, can I atleast work as a PA?

Or have I not acquired enough 'skills' yet?

Seems that 160K in tuition doesn't buy as much as it used to these days.

Med school sucks. Screw residency.

 

[IFNgamma]

Umm...no, you have to have gone to PA school to work as a PA.

technically you are qualified to perform the job of a PA, but you don't have the degree, and they also have a board exam they have to pass.

 

[sophiejane]

Having completed 4 years of medical school, can I atleast work as a PA?

Or have I not acquired enough 'skills' yet?

Seems that 160K in tuition doesn't buy as much as it used to these days.

Med school sucks. Screw residency.

Med school is very different from residency. You may find once you have some autonomy, that you enjoy your job more.

If what you are unhappy with is medicine in general, you might want to sit down and have an honest look at what you want in life and how to get there from here.

Nothing is un-doable. Just because you have a lot of loans doesn't mean that the only way to ever make enough to pay them off is to be a physician.

 

[djavid]

Having completed 4 years of medical school, can I atleast work as a PA?

Or have I not acquired enough 'skills' yet?

Seems that 160K in tuition doesn't buy as much as it used to these days.

Med school sucks. Screw residency.

I don't want to bring bad news but you stuck dude. do a residency so you can pay of the loans. they will be with you forever if you don't.

Do a light residency.

 

[billydoc]

I don't want to bring bad news but you stuck dude. do a residency so you can pay of the loans. they will be with you forever if you don't.

Do a light residency.

What do you consider a "light" residency?

 

[IFNgamma]

What do you consider a "light" residency?

psych, FP, IM, PM&R.

 

[sophiejane]

psych, FP, IM, PM&R.

You know, I beg to differ that IM and FP are "light". I wouldn't call q2-q4 call for the majority of 1st and 2nd year particularly "light".

Pathology, derm, radiology, anaesthesia are the ones that usually come up when discussing "lifestyle" residencies.

 

[sirus_virus]

Having completed 4 years of medical school, can I atleast work as a PA?

Or have I not acquired enough 'skills' yet?

Seems that 160K in tuition doesn't buy as much as it used to these days.

Med school sucks. Screw residency.

The real question should be: after completing 4 years of medschool, why am I not getting paid at least as much as a PA, or a nurse for that matter?

 

[billydoc]

The real question should be: after completing 4 years of medschool, why am I not getting paid at least as much as a PA, or a nurse for that matter?

because you are not a PA or a nurse (RN, NP, CNS, CRNA, CNM) to be more specific. But you probably are getting paid more than most LPNs out there . But seriously lol, all of the above are the professional degrees as well. They are not at the doctoral level. But it doesn't make them any more or any less professional than your MD or D.O. Their professions are regulated by the boards which have to follow standards. Their sallries are dictated by many factors, not least of each is the supply and demand rule. You are not getting paid what you think you should be worth, b/c you are still a physician in training, and not a full-fledged doc yet.

Hope it helps.

 

[Faebinder]

You know, I beg to differ that IM and FP are "light". I wouldn't call q2-q4 call for the majority of 1st and 2nd year particularly "light".

Pathology, derm, radiology, anaesthesia are the ones that usually come up when discussing "lifestyle" residencies.

Sophie... if the guy/gal can get into derm or radiology, I am sure he would have already.

I don't know about anesthesia being light... they arent surgery but they arent psychiatry either.

To the OP.... You are stuck... welcome aboard.

 

[deleted87716]

You know, I beg to differ that IM and FP are "light". I wouldn't call q2-q4 call for the majority of 1st and 2nd year particularly "light".

Pathology, derm, radiology, anaesthesia are the ones that usually come up when discussing "lifestyle" residencies.

Nothing is going to seem "light" if you don't enjoy what you're doing. The ROAD fields are not known for their "light" residencies, either, but rather their "light" lifestyles (typically) once you're out in practice.

 

[sirus_virus]

because you are not a PA or a nurse (RN, NP, CNS, CRNA, CNM) to be more specific. But you probably are getting paid more than most LPNs out there . But seriously lol, all of the above are the professional degrees as well. They are not at the doctoral level. But it doesn't make them any more or any less professional than your MD or D.O. Their professions are regulated by the boards which have to follow standards. Their sallries are dictated by many factors, not least of each is the supply and demand rule. You are not getting paid what you think you should be worth, b/c you are still a physician in training, and not a full-fledged doc yet.

Hope it helps.

Of course the economics is tilted heavily against residents. Demand and supply? Lets not even go there. Residency programs have more supply than what they demand, and med students applying for residency have absolutely ZERO negotiating power when it comes to pay. In theory, residency programs could refuse to pay residents a dime, and there will still be an ample supply of residents. Why? Well, because the other alternative will be abject poverty. The only thing residents can count on to help improve their work conditions are their employers having some conscience, which apparently they don’t.

So if you are that surgery resident busting your tail in the OR, making 6.50/hr, while watching out of the corner of your eyes as the salaries of your attendings continue to dip while the salaries of PAs and Nurses continue to rise, you might get confused.

 

[LADoc00]

The real question should be: after completing 4 years of medschool, why am I not getting paid at least as much as a PA, or a nurse for that matter?

Because med school in this country is a basically a huge scam. Regardless of the tuition, schools know they will have limitless applicants. Even at $50K/year, they could fill seats in a win-win for schools and big bank lenders.

Imagine taking out a home loan for $200,000 on a government HEAL loan program which has NO LIMIT for the interest rate which rises with the prime AND you get no tax deduction if your gross income is more than 76K, who would do that? No one, it wouldnt make sense.

And the kicker? You cant discharge student loans in bankruptcy. There is no greater screw job in American lending than student lending. It is only one step up from payday lending and loansharking/usary.

Government backed student lending is by far the greatest conspiracy that has been hoisted upon America's middle and lower classes in history. Under the banner of greated access to education, politicians have doomed a generation of students to massive unsecured inescapable debt while failing to ensure the quality of the product they are getting. In essence, they have given greedy universities already rife with mid six figure adminstrators that make more as a university chancellor than they would on Wall Street carte blanche to raise tuition with NO LIMIT because they know they students can simply borrow more and lack the economic sense to know they are screwed.

To the OP, you are screwed and you have Washington DC, the massive Ivory Tower complex and big banking to blame.

People rant about the military industrial complex, but the Ivory tower equivalent is FAR MORE insidious and potentially disastrous for the average American.

 

[billydoc]

Of course the economics is tilted heavily against residents. Demand and supply? Lets not even go there.

I think you misread what I was saying. The supply and demand comment was in relation to the PA and nursing sallaries. Hope it helps.

 

[Miami_med]

Because med school in this country is a basically a huge scam. Regardless of the tuition, schools know they will have limitless applicants. Even at $50K/year, they could fill seats in a win-win for schools and big bank lenders.

Imagine taking out a home loan for $200,000 on a government HEAL loan program which has NO LIMIT for the interest rate which rises with the prime AND you get no tax deduction if your gross income is more than 76K, who would do that? No one, it wouldnt make sense.

And the kicker? You cant discharge student loans in bankruptcy. There is no greater screw job in American lending than student lending. It is only one step up from payday lending and loansharking/usary.

Government backed student lending is by far the greatest conspiracy that has been hoisted upon America's middle and lower classes in history. Under the banner of greated access to education, politicians have doomed a generation of students to massive unsecured inescapable debt while failing to ensure the quality of the product they are getting. In essence, they have given greedy universities already rife with mid six figure adminstrators that make more as a university chancellor than they would on Wall Street carte blanche to raise tuition with NO LIMIT because they know they students can simply borrow more and lack the economic sense to know they are screwed.

To the OP, you are screwed and you have Washington DC, the massive Ivory Tower complex and big banking to blame.

People rant about the military industrial complex, but the Ivory tower equivalent is FAR MORE insidious and potentially disastrous for the average American.

I beg to differ. Atleast the loan sharks are honest.

 

[edmadison]

The real question should be: after completing 4 years of medschool, why am I not getting paid at least as much as a PA, or a nurse for that matter?

Because when you graduate from medical school, you have no marketable skills.

Ed

 

[Faebinder]

I beg to differ. Atleast the loan sharks are honest.

And their product is garaunteed... pure cash.

 

[Mman]

You know, I beg to differ that IM and FP are "light". I wouldn't call q2-q4 call for the majority of 1st and 2nd year particularly "light".

Pathology, derm, radiology, anaesthesia are the ones that usually come up when discussing "lifestyle" residencies.

Q2? Q2 in house call is currently against ACGME rules when averaged over 4 weeks.

I'll say I worked far harder my first year as an anesthesia resident than I did as an intern on any medicine service. Sitting around writing notes and writing orders and writing H/Ps and following up on labs and studies didn't exactly tax me too much, although the 3-8 hour rounds were painful.

When people talk about "lifestyle" specialties, they aren't referring to residency. They are referring to the real world after residency.

 

[MacGyver]

PAs are basically hypocrites just like every other midlevel. They want to do everything that doctors do, and yet make the argument that med school grads "arent qualified" to work as PAs.

Their claim is that 4 years of med school, passing of USMLE Step I and II as well as the CS exam is "insufficient" to work as a PA.

Years ago there used to be a program where FMGs who failed to match in US residencies could come to the states and work as PAs. The PAs found out about this "loophole" and were outraged. They quickly added new regulations which stipulated that only those who graduated PA school and passed the PANCE exam could be licensed as PAs.

For the record, a US med school grad who passes the steps is EVERY BIT AS QUALIFIED to work as a PA (if not moreso) than a PA school graduate who passes the PANCE. I'm going to love hearing the PAs come on this thread nad tell me that I'm somehow wrong, that PA school is "extra special training" that med school doesnt give you.

 

[sophiejane]

Q2? Q2 in house call is currently against ACGME rules when averaged over 4 weeks.

Well, I don't know what to tell you. It's a reality for some friends of mine who are at a residency that I fortunately decided against. I'm sure they have ways of making it work out when averaged.

 

[dilated]

Because when you graduate from medical school, you have no marketable skills.

Ed

Freshly graduated MDs have no marketable skills, but freshly graduated PAs and nurses from 2 year programs do?

 

[docB]

Freshly graduated MDs have no marketable skills, but freshly graduated PAs and nurses from 2 year programs do?

Yes. As a fresh out MD/DO you can't be licensed with out at least 1 year of additional training (more in many states, eg. NV requires at least 3 years of residency for licensure). Therefore you can't work practicing medicine.

 

[MacGyver]

Yes. As a fresh out MD/DO you can't be licensed with out at least 1 year of additional training (more in many states, eg. NV requires at least 3 years of residency for licensure). Therefore you can't work practicing medicine.

Irrelevant. The question at hand is whether a US medical grad is qualified to do the work of a PA. The answer to that is a resounding YES. The rest is just irrelevant regulatory BS.

 

[billydoc]

Irrelevant. The question at hand is whether a US medical grad is qualified to do the work of a PA. The answer to that is a resounding YES. The rest is just irrelevant regulatory BS.

Yeah MacGyver! I see you have it all figured out. So why don't some of the newly minted med school graduates get a job as a PA or a nurse, if they won't do a residency? You are discussing irrelevant, theoretical, hypothetical utopia. Your training as a physician does not stop with graduation from the med school. So you probably would be overqualified in your basic training, but grossly underqualified in your practical skills. Even with year 3 and 4 of clinical rotations under the belt. PA education is structured in such way, that for the most part, one doesn't need a postgraduate training. MD/DO are expected to do residency to be a full-fledged docs. It just comes with a territory of being a physician vs non-physician provider. BTW I'm not a PA, so some of you in the know please correct me if I'm wrong.

 

[core0]

Yeah MacGyver! I see you have it all figured out. So why don't some of the newly minted med school graduates get a job as a PA or a nurse, if they won't do a residency? You are discussing irrelevant, theoretical, hypothetical utopia. Your training as a physician does not stop with graduation from the med school. So you probably would be overqualified in your basic training, but grossly underqualified in your practical skills. Even with year 3 and 4 of clinical rotations under the belt. PA education is structured in such way, that for the most part, one doesn't need a postgraduate training. MD/DO are expected to do residency to be a full-fledged docs. It just comes with a territory of being a physician vs non-physician provider. BTW I'm not a PA, so some of you in the know please correct me if I'm wrong.

Its just not worth arguing with McGyver. I will submit this post by another med student who has actually been a PA. The original post was discussing a bridge from PA to MD. It is equally appropriate here:
"I have weighed in on this subject many times. As a LONG time ER PA now in med school I feel I have a unique perspective ---even if others without the experiences of either disagree.

I am against any bridge that would grant medical science credit. The material is presented differently in med school and from a different perspective. There is in fact deeper understanding of material--mostly due to the extra time allowed to learn.

I would support advanced credit to skip physical diagnosis/exam H&P, ethics and all that crap.

BUT--if anyone thinks the clinical aspect of the education is the same--they are simply wrong. Minimally--they are identical with the slight edge to the PA programs.

Medical school is designed to create a doctorate level acedemic in the field of medicine. Residency creates the clinician.

PA school is DESIGNED to create a clincian.

PA grads are simply better prepared (for the immediate) in a clinical setting. The education, examinations, boards and overriding philosophy is clinical medicine.

This quickly reverses itself when comparing a new grad PA with a post residency physician. There is simply no comparison then."



For what its worth there was a PA test given by the state of Florida in the 1990s for FMGs. From what I remember none of the applicants could pass the test and the costs of the lawsuits from those who couldn't pass the test ran well over $1 million. There is a very large FMG community in Florida who tries this pretty much every year. One natural consequence of allowing med school graduates to practice as PAs would be to allow the several hundred thousand FMGs to practice as PAs. I'm sure McGyver is in full support of this.

There are still a few FMGs practicing in Florida with temporary licenses after 6-7 years. The BOP also uses FMGs as PAs. Nice company I guess.

For what its worth there is an AAPA position paper on this. One of the salient points is that part of PA training is in the role of the PA and how to work under the supervision of a physician. I do not have much experience in working with medical students, but I do not think that there training encompasses this role.

Here is the AAPA paper:
http://www.aapa.org/policy/unlicensed-med-grads.html

David Carpenter, PA-C

 

[sarahs007]

Oh please. Interns are clinically useless. They can't place lines to save their lives...how many pneumothoraxes have i seen...how many interns have I seen in a code, sitting there dumbfounded...I also loved the night I had a patient in horrific ARDS. I started propofol, fentanyl, nimbex, insulin drip and levophed on her before the intern went in the room because the intern was disappeared, thereby rendered useless.....respiratory therapist and I all own our own with the patient, playing with the vent to try to get her o2 sat past 80%, who turned into the sickest person I've ever taken care of.......oh nevermind, no pointing fingers. Anyway, interns are clinically inept...the humble (usually smarter ones) know this, the smug ones don't know this and trip on their face at some point later in the year. Book knowledge YES...they are veritable medical dictionaries. That doesn't equate clinical knowledge. Be humble. It's a key to success whether it makes sense to you know or not.

 

[sarahs007]

Ok

 

[Faebinder]

Sorry I disagree with core0. MD fresh out of school can do the same thing as a PA fresh out of school. Maybe you are not seeing it till you finish your third and fourth year yet or maybe because it's been too long since you were fresh out of PA school that you don't remember them being clueless... either way, there is no way you are going to convince me that the two years clinicals for PA are better than the two years clinicals for MD.

Oh please. Interns are clinically useless. They can't place lines to save their lives...how many pneumothoraxes have i seen...how many interns have I seen in a code, sitting there dumbfounded...I also loved the night I had a patient in horrific ARDS. I started propofol, fentanyl, nimbex, insulin drip and levophed on her before the intern went in the room because the intern was disappeared, thereby rendered useless.....respiratory therapist and I all own our own with the patient, playing with the vent to try to get her o2 sat past 80%, who turned into the sickest person I've ever taken care of.......oh nevermind, no pointing fingers. Anyway, interns are clinically inept...the humble (usually smarter ones) know this, the smug ones don't know this and trip on their face at some point later in the year. Book knowledge YES...they are veritable medical dictionaries. That doesn't equate clinical knowledge. Be humble. It's a key to success whether it makes sense to you know or not.

Agreed, but a PA fresh out of school is just as bad. or will we start claiming a PA out of school can put central lines perfectly now?

 

[yaah]

One way to look at it that people are overlooking is that for an MD in residency, part of your "compensation" is the education you are receiving. Obviously there are some places (maybe many places) for whom education is an afterthought or at the very least a low priority, but residency is training and education. It's a job and you get paid, but part of the reason you get less money is because it's an education. Obviously, many people aren't going to see that as relevant or significant, but it is the truth. This is also part of the reason that you as residents have to advocate for your own education more - if you're doing nothing but work and not getting an education that's inappropriate.

 

[dutchman]

Oh please. Interns are clinically useless. They can't place lines to save their lives...how many pneumothoraxes have i seen...how many interns have I seen in a code, sitting there dumbfounded...I also loved the night I had a patient in horrific ARDS. I started propofol, fentanyl, nimbex, insulin drip and levophed on her before the intern went in the room because the intern was disappeared, thereby rendered useless.....respiratory therapist and I all own our own with the patient, playing with the vent to try to get her o2 sat past 80%, who turned into the sickest person I've ever taken care of.......oh nevermind, no pointing fingers. Anyway, interns are clinically inept...the humble (usually smarter ones) know this, the smug ones don't know this and trip on their face at some point later in the year. Book knowledge YES...they are veritable medical dictionaries. That doesn't equate clinical knowledge. Be humble. It's a key to success whether it makes sense to you know or not.

Yet your post is filled with worthless arrogance.

 

[MacGyver]

BUT--if anyone thinks the clinical aspect of the education is the same--they are simply wrong. Minimally--they are identical with the slight edge to the PA programs.

I knew it wouldnt take long for teh PAs to come out and start making outrageous claims that their training is actually BETTER than MDs. I figured it would be emedpa, the "resident PA defender" who would chime in first, but alas he's missing in action.

So let me get this straight. For years I've read on the PA boards how the 1 year of PA clinicals is equivalent to the 2 years of MD clinicals. Now all of a sudden the goalpost is shifted and the 1 year that the PA gets is BETTER than the 2 years that the MD gets?

Is that the position of the PA community now? What a load of crap.

Please explain to me in detail how PA clinicals are "better" than MD clinicals.

Medical school is designed to create a doctorate level acedemic in the field of medicine. Residency creates the clinician.

So PAs are not "clinicians" then are they, since the vast majority do not complete any residency and the residencies that do exist for PAs are a paltry 12-18 months.

PA school is DESIGNED to create a clincian.

Oh bull****. How many times have I heard PAs brag that they are in the same classes that the med students take and they share the same clinical rotations. Now you're going to tell me there's some "secret training" in those shared classrooms and rotations that teh PAs got but somehow the MDs missed out on.

PA grads are simply better prepared (for the immediate) in a clinical setting. The education, examinations, boards and overriding philosophy is clinical medicine.

That might have been true 20 years ago when the average entering PA had at least 5 years of clinical experience doing somethign else. But those days are gone and in this day and age, the entering MD has the same level of experience as the entering PA.

For what its worth there was a PA test given by the state of Florida in the 1990s for FMGs. From what I remember none of the applicants could pass the test and the costs of the lawsuits from those who couldn't pass the test ran well over $1 million. There is a very large FMG community in Florida who tries this pretty much every year. One natural consequence of allowing med school graduates to practice as PAs would be to allow the several hundred thousand FMGs to practice as PAs. I'm sure McGyver is in full support of this.

I'll put up the USMLE Step I/II against PANCE any day of the week pal. I guess the next joke youre going to tell us is that the PANCE is harder than the steps.

For what its worth there is an AAPA position paper on this. One of the salient points is that part of PA training is in the role of the PA and how to work under the supervision of a physician. I do not have much experience in working with medical students, but I do not think that there training encompasses this role.

Oh please. Med students have plenty of experience working under a supervisor. Theres no magic training that PAs get that MDs dont get exposure to.

 

[docB]

Irrelevant. The question at hand is whether a US medical grad is qualified to do the work of a PA. The answer to that is a resounding YES. The rest is just irrelevant regulatory BS.

Try practicing without a license and see how relavent it is. I'll conceed that an untrained med school grad could probably do the work of a PA. Not a nurse.

 

[MacGyver]

Oh please. Interns are clinically useless. They can't place lines to save their lives...how many pneumothoraxes have i seen...how many interns have I seen in a code, sitting there dumbfounded...I also loved the night I had a patient in horrific ARDS. I started propofol, fentanyl, nimbex, insulin drip and levophed on her before the intern went in the room because the intern was disappeared, thereby rendered useless.....respiratory therapist and I all own our own with the patient, playing with the vent to try to get her o2 sat past 80%, who turned into the sickest person I've ever taken care of.......oh nevermind, no pointing fingers. Anyway, interns are clinically inept...the humble (usually smarter ones) know this, the smug ones don't know this and trip on their face at some point later in the year. Book knowledge YES...they are veritable medical dictionaries. That doesn't equate clinical knowledge. Be humble. It's a key to success whether it makes sense to you know or not.

All newly graduated PAs on the other hand can all place lines well and they are all experts in vent management. 🙄

What you think of interns is irrelevant, its the comparison that matters. And I'll take the average intern over the average new PA grad any day of the week. Note that I said AVERAGE because there are superstars and duds in every field. So spare me the irrelevant comparison of "I know this superstar PA who ran circles around every MD in the hospital and who was smarter than all of them" crap.

 

[sarahs007]

Yet your post is filled with worthless arrogance.

-------------------------------------------------------------------

How do you figure? I didn't "toot my own horn" once in my post. In fact, if you read it correctly, you would note that I am insinuating how potentially dangerous it is for an MD to leave a bad ARDS patient in the hands of a nurse and resp. therapist without coming in to check things out. Did I say I saved her life or something? No...I just said I was forced to do things without orders that I was uncomfortable doing (i.e. starting nimbex).

This is not an isolated incident, either. I think some residents trust certain nurses too much.

Would a PA be more functional than an intern at first start? Maybe - they have more intensive clinicals. I am not saying they could throw lines in and do all the ICU stuff, but they tend to have stronger clinicals at school than med students.

 

[primadonna22274]

OK Macgyver, you're missing the point here. A very important part of PA school is the socialization of a PA to work as a PA, hence, as a dependent practitioner. Now, I haven't been to med school (yet), but to my understanding it doesn't prepare the med student to function as a PA (including to "know one's place", etc.). And, we all know that the current US system of training physicians delays true clinical education and application until residency. So, without a residency, the physician has not yet become much of a clinician.
So the simple problem here is that the OP can't work as a PA because s/he IS NOT A PA. This is the question that Florida answered at least a decade ago (I was in school then, I remember something about it) when FMGs wanted to be licensed as PAs. (core0 alluded to this issue above)
Guess what? I don't have any shortcuts to become a physician either.
OP, I feel your pain, but just suck it up and do your residency. You will never make enough money as a PA to justify the cost of med school, unless somebody else paid for it and you have no debt.
L.

 

[ditch doctor]

Would a PA be more functional than an intern at first start? Maybe - they have more intensive clinicals. I am not saying they could throw lines in and do all the ICU stuff, but they tend to have stronger clinicals at school than med students.

I went to a caribbean school and ended up doing rotations at six different schools/hospitals. Four of them had PA programs. At those school PA students and med students rotated together. I asked some of them if this is the way most schools do it. They said yes when there is a medical school in town. Where I do my residency, PA students rotate with medical students. My wife is in NP school, she rotates with the medical students. I really don't see how their rotations could be any stronger, if they are the same. It doesn't make sense.

And for the record everyone sucks out of school. In that room, if you had an intern, a fresh PA graduate, a fresh nursing graduate and a fresh RT graduate, all four of you would be standing in a puddle of piss with a snot bubble coming out of your nose. That's just reality.

 

[ditch doctor]

Now, I haven't been to med school (yet), but to my understanding it doesn't prepare the med student to function as a PA (including to "know one's place", etc.).

HAHAHAA.... I'm going to follow your career and email this back to you during your surgery rotation in medical school.....

Jeez... I just spit my coffee all over the screen.....

 

[primadonna22274]

Heh, this is funny, since in our ED we have a Fililpino-trained physician who cannot get licensed in the US without first taking USMLE and completing a US residency.
So...he's an RN. A very good one, too, although unhappy. I finally asked him what's the scoop...he did NOT complete an RN program, but in the state of SC he was able to take the RN boards and become licensed.
I'm not sure you can do this in other states. I DO know you cannot become a licensed PA in any state this way, otherwise I'm sure he would have chosen that instead.
L.

Try practicing without a license and see how relavent it is. I'll conceed that an untrained med school grad could probably do the work of a PA. Not a nurse.

 

[ditch doctor]

And, we all know that the current US system of training physicians delays true clinical education and application until residency. So, without a residency, the physician has not yet become much of a clinician.

Not really that true... 3rd year maybe, but 4th year you're expected to make all the decisions and management and stuff. You're corrected if wrong, but you're still expected to make the decisions. At least that's the case where I was.

 

[primadonna22274]

Well, glad I could entertain you, but what I meant to say is that we as PAs will never be "independent practitioners", whereas you as a physician will eventually be just that.
And yes, while this was OK with me 9-10 years ago when I began my training, it's getting a little old, and when I finally get myself frustrated enough I'll get my butt back in med school (probably in the next 2-3 yr, hopefully before I have to do my second recert as a PA....)
😳

HAHAHAA.... I'm going to follow your career and email this back to you during your surgery rotation in medical school.....

Jeez... I just spit my coffee all over the screen.....

 

[toxic-megacolon]

Has anyone actually WORKED with a PA fresh out of PA school? I've worked with 4 so far. Not a huge sample size, but they are NO more clinically prepared than an intern fresh out of medschool. They are much more cocky though. 🙄

 

[8744]

Q2? Q2 in house call is currently against ACGME rules when averaged over 4 weeks.

I'll say I worked far harder my first year as an anesthesia resident than I did as an intern on any medicine service. Sitting around writing notes and writing orders and writing H/Ps and following up on labs and studies didn't exactly tax me too much, although the 3-8 hour rounds were painful.

When people talk about "lifestyle" specialties, they aren't referring to residency. They are referring to the real world after residency.

Nope. I worked with some general surgery interns who were working 24 on, 24 off which is Q2 call. Of course, this sounds good on paper and complies with all of the ACGME rules but what really happened is that their 24 hour work day strectched to 26 or 28 hours, they were completely deprived of sleep every other night, and were pretty worn out after two months of it.

I have done a couple of rotations this year where, because I had a week of night float with no call, for the rest of the three weeks in the block I was Q3+ call. (Eight call nights in 21 days.)

And it's not as if anything we do is that taxing. The sum total of 30 hours of being awake, repetative bureaucratic tasks, stress, fatigue, caffeine, and the lot will wear anybody out.

 

[southerndoc]

Yet your post is filled with worthless arrogance.

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How do you figure? I didn't "toot my own horn" once in my post. In fact, if you read it correctly, you would note that I am insinuating how potentially dangerous it is for an MD to leave a bad ARDS patient in the hands of a nurse and resp. therapist without coming in to check things out. Did I say I saved her life or something? No...I just said I was forced to do things without orders that I was uncomfortable doing (i.e. starting nimbex).

This is not an isolated incident, either. I think some residents trust certain nurses too much.

Would a PA be more functional than an intern at first start? Maybe - they have more intensive clinicals. I am not saying they could throw lines in and do all the ICU stuff, but they tend to have stronger clinicals at school than med students.

I'm not even following along the discussion (until now), and I thought your post was arrogant.

We do not allow PA's to place lines in our ED. Things can differ on the units though. Only residents and attendings can place central lines, chest tubes, arterial lines, etc. We have one PA who has been cleared to intubate, only because he is also a paramedic. (A great PA by the way, and a great guy overall.)

 

[MacGyver]

Would a PA be more functional than an intern at first start? Maybe - they have more intensive clinicals. I am not saying they could throw lines in and do all the ICU stuff, but they tend to have stronger clinicals at school than med students.

Thats a load of crap. Please explain to me how the PA clinicals are "stronger" than the MD counterparts.

 

[Coastie]

Many FP and IM programs are light.

Anesthesia and rads are not as light as you might think. Some choice Anesthesia programs are quite light.

Path, derm, psych. Path can be difficult in some programs, though...

You know, I beg to differ that IM and FP are "light". I wouldn't call q2-q4 call for the majority of 1st and 2nd year particularly "light".

Pathology, derm, radiology, anaesthesia are the ones that usually come up when discussing "lifestyle" residencies.

 

[Coastie]

Very true.

A new PA vs a new MD?

Take the MD everytime.

For the record, a US med school grad who passes the steps is EVERY BIT AS QUALIFIED to work as a PA (if not moreso) than a PA school graduate who passes the PANCE. I'm going to love hearing the PAs come on this thread nad tell me that I'm somehow wrong, that PA school is "extra special training" that med school doesnt give you.

 

[dilated]

Your training as a physician does not stop with graduation from the med school. So you probably would be overqualified in your basic training, but grossly underqualified in your practical skills. Even with year 3 and 4 of clinical rotations under the belt. PA education is structured in such way, that for the most part, one doesn't need a postgraduate training.

Obviously on graduation physicians are not prepared to do the full range of procedures... OF A PHYSICIAN. Nobody has explained what the mysterious knowledge is that PA students, in one year of less intense clinical experience (the PA students here: call? What is this call you speak of?), gain that a medical student does not in two years.

 

[RNtoMD2011]

This conversation is foolish. All three (RN,PA,MD/DO) have a different focus and goals of practice. Fresh out of school they all need direction and supervision. If you compare an experienced RN or PA to a new MD, of course they are more clinically prepared. Yet lets not forget that the objective of each is different (especially fresh out of school). The new MD is not training to be a nurse or PA.

As healthcare workers, it is our responsiblity to RESPECT the different parts of the healthcare team, instead of trying to make our own part more important than the other team members. As an experienced nurse (of many years), I have come to learn (in a hospital setting), that none of us can function one without the other.

 

[sarahs007]

Thats a load of crap. Please explain to me how the PA clinicals are "stronger" than the MD counterparts.

That's the word on the street. Upon graduating, they are fully prepared for their practice. Hey don't get me started. While I don't think interns are prepared upon med school graduation to function as PAs, I am not personally a huge fan of PA's - I think they are extremely cocky and I would ask an intern a question long before a PA. Same goes for NPs.

I didn't mean to be arrogant. I am just a little but bewildered at the general level of cockiness on these boards. Take you, for instance. Aren't you the one who started some thread about some PA referring to her education as med school (which I agree is stupid and unacceptable) but your intention of starting that thread (which was closed because of your tone) was to put down non-MDs essentially. I am sorry you have some apparent ax to grind with PAs and probably nurses, but I am not the one to discuss this with, as I am no fan of PAs myself - most of them are a perfect example of someone with a little knowledge turning into a monster. I'm happy being a BSN-ICU nurse. I completed a 6 month post graduate program in critical care that was classroom based...I try to learn something new everyday. I am not arrogant, but most posters on this board certainly are. It's bizarro. Oh well. I think it's actually insecurity but whatevs.

 

[billydoc]

This conversation is foolish. All three (RN,PA,MD/DO) have a different focus and goals of practice. Fresh out of school they all need direction and supervision. If you compare an experienced RN or PA to a new MD, of course they are more clinically prepared. Yet lets not forget that the objective of each is different (especially fresh out of school). The new MD is not training to be a nurse or PA.

As healthcare workers, it is our responsiblity to RESPECT the different parts of the healthcare team, instead of trying to make our own part more important than the other team members. As an experienced nurse (of many years), I have come to learn (in a hospital setting), that none of us can function one without the other.

As an RN of also many, many years in practice I've realized the same.
Amen to that.