Heard of the PA to MD/DO bridge

[ERPAC]

---

Members do not see this ad.

Hello, I heard of something recently about a PA to MD/DO bridge, has anyone heard anything about this and what schools might be doing this very soon??

PA-C

 

[jjmad1201]

Hello, I heard of something recently about a PA to MD/DO bridge, has anyone heard anything about this and what schools might be doing this very soon??

PA-C

i heard they were trying to make a bridge, but i havent heard anything about it recently

 

[BOBBIO2]

I heard the discussion about a year ago but haven't seen anything aside from the army PA doctoral program. I hate to be the one saying it but if someone wants to become an MD/DO then they should just go to med school and take the boards - really no shortcut around it.

 

[Old_Mil]

Hello, I heard of something recently about a PA to MD/DO bridge, has anyone heard anything about this and what schools might be doing this very soon??

PA-C

If such a thing is ever created - and I don't believe it should be - every graduate of an American medical school should be fully entitled to take a job as a PA upon graduation without a single day of residency.

 

[Cp22kjer]

I heard the discussion about a year ago but haven't seen anything aside from the army PA doctoral program. I hate to be the one saying it but if someone wants to become an MD/DO then they should just go to med school and take the boards - really no shortcut around it.

I'm not sure what a bridge implies but I assure you they would have to take and pass the boards (step 1, 2 and 3).

 

[bnp07]

No PA to MD bridge yet. It's been discussed for years and is a hot topic of controversy even within the PA profession itself.

However, before we all get so quick to judge, you'd be surprised at what a PA with ten years of experience knows and can do clinically. Many PAs take practice boards for fun and pass with flying colors. Don't be knocking down PAs or the profession without fully understanding their capabilities🙂

However, PA school is a very expensive stepping stone to become a doctor. I agree that if you want to be a doctor, go to med school and don't take a spot from someone who really wants to be a PA.

 

[ERPAC]

Well, that statement about PA's taking the boards is very True, a lot of us, including me, practice and take those tests and smoke them, so remember medicine is medicine. If you can work up cases, figure them out, know the labs, read the CT, order the meds, do the discharge summary, do the surgeries, then it is about a residency and a piece of paper showing you passed step 1 and 2 of the COMLEX or USMLE. Surely, quite a few experienced PA's can pass step 1 and 2 with no problem, and a lot of PA programs have the same Prof teaching the same course, except for a few here and there. I know, because I went to one, you rotate with the M3's etc..The attendings don't care who you are, they want you to speak and know the medicine cold turkey PERIOD! The last time I went to the ER and was sick, I didn't give a hoot owl about what the name badge said, I wanted some Zofran and an IV, and maybe some protonix for dessert. 🙂😎

 

[deleted6669]

There are currently a few doctorate level pa residencies out there done through the army and baylor(ortho/em/surgery) and a new pa/phd program is starting at wake forest in NC next yr.
as far as a bridge program, we are probably 5-10 yrs away from seeing one but they are in the planning stages and likely will be 2-3 yrs long with eaither 1 yr of didactic and 1 yr of clinical or 18 months of each.. the first one will probably be at a DO school that also has a PA program.
basically a bridge program would need to include almost all of ms1, some of ms 2, and at least 1 yr of rotations.
consider that the typical pa program is 100 weeks in 2 years vs the typical md program which is 150 weeks in 4 years. there is a lot of overlap including a full yr of rotations.
most of what pa school misses which an md/do program includes is hard core basic medical sciences taught in ms1 and to some extent ms2.
pa school covers most of ms2 and all of ms3.
I also studied for the pa boards and my required recerts every 6 years by using md level board prep materials including practice fp md board exams.

 

[Just Joshin]

Where are you getting that the average MD program is 150 weeks in four years? The average MD program is typically 200 weeks in four years.

 

[deleted6669]

Where are you getting that the average MD program is 150 weeks in four years? The average MD program is typically 200 weeks in four years.

I have seen this # quoted many times. when you remove " residency interview time" and "vacation blocks" from the schedule and include only didactic and rotation time it shortens most programs to around 3 years of actual work.
how many students do you know who took off months during 4th yr to do trips to nepal, etc to "explore other health care systems"...that's a vacation posing as school.
4th yr is cush for most folks....
in fact the DO program at lake erie offers a 3 yr option that cuts out excess vacation time and interview time and loses no content. you are tracked from the start to a primary care residency affiliated with the program.

How The Primary Care Scholars Curriculum Works

LECOM uses its experience with innovative teaching pathways to ensure that Primary Care Scholars receive the equivalent of four years of academic and clinical education in three years to prepare for post-graduate training.
Following unique courses and learning modules, students complete the first two years of basic science and preclinical education in under 20 months.
They begin clinical training in March of Year 2. Students must complete core competency-based clinical rotations that meet all the educational requirements necessary for primary care medicine. LECOM has introduced new core rotations to continue OMM training and other essential medical skills. A sub-internship introduces students to the hospitals where they will continue their clinical training after graduation

 

[Just Joshin]

Actually, the schools I'm looking at only allow a month off during fourth year. Maybe two if you don't take vacation time third year. Keep in mind that after 1st year, they go to school year-round too. It's much closer to 200 weeks. The reason LECOM can offer what they do in the three year track is that they get rid of classes/rotations their students don't need for FM.

 

[deleted6669]

The reason LECOM can offer what they do in the three year track is that they get rid of classes/rotations their students don't need for FM.

but yet they meet all requirements for the DO degree. if someone completing this program wanted to be a jerk they could apply for any residency they wanted; surg, derm, em, etc

 

[womp]

Well, that statement about PA's taking the boards is very True, a lot of us, including me, practice and take those tests and smoke them, so remember medicine is medicine. If you can work up cases, figure them out, know the labs, read the CT, order the meds, do the discharge summary, do the surgeries, then it is about a residency and a piece of paper showing you passed step 1 and 2 of the COMLEX or USMLE. Surely, quite a few experienced PA's can pass step 1 and 2 with no problem, and a lot of PA programs have the same Prof teaching the same course, except for a few here and there. I know, because I went to one, you rotate with the M3's etc..The attendings don't care who you are, they want you to speak and know the medicine cold turkey PERIOD! The last time I went to the ER and was sick, I didn't give a hoot owl about what the name badge said, I wanted some Zofran and an IV, and maybe some protonix for dessert. 🙂😎

This is one of those things where a few experienced PAs from a different era could do it, but not necessarily the entire PA profession or even a third of the profession. It's the same with DNPs: might be a good idea for the few very motivated NP's at Columbia (old female NP's who went to school when doctors were still mostly male), but is potentially a horrible idea if expanded to apply to every NP or RN in the country graduating from today's standards. Even still, 50% of those DNP students at Columbia failed the watered-down Step 3 they had to take. The worst medical school in the US would still have a 90% pass rate. I don't want to imagine what an online DNP program would be like, or an online PA to MD bridge seminar either.

And just because you passed the Steps after years of studying and 10 years of working experience, doesn't exactly put you on equal footing (at least in potential) with med students who had 1.5 months to study for them.

 

[Just Joshin]

but yet they meet all requirements for the DO degree. if someone completing this program wanted to be a jerk they could apply for any residency they wanted; surg, derm, em, etc

No, that isn't true. The program is tailored to primary care and cuts out the stuff that isn't necessary for primary care. That's how they get it done in three years and why these students won't be able to do a specialty outside of primary care when they're finished. From your own post:

Following unique courses and learning modules, students complete the first two years of basic science and preclinical education in under 20 months.

Students must complete core competency-based clinical rotations that meet all the educational requirements necessary for primary care medicine.

 

[Buckeye4life]

but yet they meet all requirements for the DO degree. if someone completing this program wanted to be a jerk they could apply for any residency they wanted; surg, derm, em, etc

It would be an extremely expensive decision considering the PCSP students have to sign a contract saying they must pay LECOM equivalent to one year's tuition if they don't go into primary care. Also, almost all of these residencies u mention, with the exception of EM, require the student to do an elective rotation at the program they want which is elimated by doing the accelerated pathway.

 

[J1515]

Ah, great. People looking for yet ANOTHER shortcut to the MD/DO degree. First it's NPs, then RNs, now PAs. Here's an idea, and try your best to follow me on this one:

If you want to become a doctor, go to medical school.

If there was a way to become a physician via the NP or PA route, then nobody would bother taking the MCAT anymore.

 

[brucecanbeatyou]

And just because you passed the Steps after years of studying and 10 years of working experience, doesn't exactly put you on equal footing (at least in potential) with med students who had 1.5 months to study for them.

This is a very good point, I actually laughed out loud when I read it.

I worked with a great ex-military PA. THAT is what the PA degree was intended for - medics returning to civilian life who knew their ish but didn't want all the hassle of medical school. I personally thought about PA school, because of the influence of this mentor, but eventually decided that I wouldn't feel comfortable practicing as a PA after only two years of school and a quasi-residency.

I think that a bridge program would be great, but would hope that there be a requirement of 5 or 10 years experience as a PA. There are no shortcuts in medicine.

 

[dilated]

Surely, quite a few experienced PA's can pass step 1 and 2 with no problem, and a lot of PA programs have the same Prof teaching the same course, except for a few here and there.

I've seen this coming from the DNPs too. The purpose of steps is not to prove that if you can pass them then you're ready to go out there and practice medicine. The pass rate on step 3 is 98% for US interns with extremely minimal studying, I'd certainly hope most experienced PAs could pass it.

The only point of the steps is that to show in ADDITION to being able to meet all the educational requirements of a LCME-accredited medical school one is able to pass a very, very minimum standardized threshold.

 

[deleted6669]

"I don't want to imagine what an online DNP program would be like, or an online PA to MD bridge seminar either. "

The proposal for pa to do/md bridge students is that they take required courses at a medschool alonmgside medstudents and be held to the same standards.

"No, that isn't true. The program is tailored to primary care and cuts out the stuff that isn't necessary for primary care. That's how they get it done in three years "

IF they finish this program and IF they are willing to pay the penalty for opting out of primary care they could apply to whatever specialty they want. they still have a DO degree. it doesn't have a little * next to it.
there are many do residencies in specialties that do not fill every yr that they could apply to as well as many of the md residencies which are less competitive(transitional yr, preventative med, etc).

 

[badasshairday]

I don't think it is a bad idea, they take the same classes as us. Although, I do think that after 3rd year of medical schoo, if one feels they do not want to do a 4th year, internship, and residency, they should be able to leave med school and be a PA.

Honestly, PA's learn medicine, just like MD/DO students. We medical students will be getting a doctorate in medicine and the PA students will be getting a masters in medicine. At least this is the way I see it. It is much more legit than the DNP crap and advanced nursing, lol.

 

[MedStudentWanna]

"No, that isn't true. The program is tailored to primary care and cuts out the stuff that isn't necessary for primary care. That's how they get it done in three years "

IF they finish this program and IF they are willing to pay the penalty for opting out of primary care they could apply to whatever specialty they want. they still have a DO degree. it doesn't have a little * next to it.
there are many do residencies in specialties that do not fill every yr that they could apply to as well as many of the md residencies which are less competitive(transitional yr, preventative med, etc).

You're 100% wrong. A requirement for residency is that you complete a rotation in that specialty. You can't get a derm residency if you've never rotated on derm before. The LECOM fast-track students will have never done rotations outside of primary care, therefore they won't qualify for residencies outside of primary care.

And by the way, transitional year MD residencies are very highly competitive. I don't know why you think they're not. Those are the ones that go to the derm residents who need a year before their residency starts and don't want to do a typical internship. And even if they did apply to it, then what? It's only one year. It's not a residency.

 

[TexasPhysician]

I have seen this # quoted many times. when you remove " residency interview time" and "vacation blocks" from the schedule and include only didactic and rotation time it shortens most programs to around 3 years of actual work.
how many students do you know who took off months during 4th yr to do trips to nepal, etc to "explore other health care systems"...that's a vacation posing as school.
4th yr is cush for most folks....
in fact the DO program at lake erie offers a 3 yr option that cuts out excess vacation time and interview time and loses no content. you are tracked from the start to a primary care residency affiliated with the program.

How The Primary Care Scholars Curriculum Works

LECOM uses its experience with innovative teaching pathways to ensure that Primary Care Scholars receive the equivalent of four years of academic and clinical education in three years to prepare for post-graduate training.
Following unique courses and learning modules, students complete the first two years of basic science and preclinical education in under 20 months.
They begin clinical training in March of Year 2. Students must complete core competency-based clinical rotations that meet all the educational requirements necessary for primary care medicine. LECOM has introduced new core rotations to continue OMM training and other essential medical skills. A sub-internship introduces students to the hospitals where they will continue their clinical training after graduation

Different medical schools have different requirements. The MD schools in my state are pretty strict on even the 4th year. 1 month is traditionally set aside for interviews. My school only allows up to 3 months at another institution. There are 4 mandatory courses + electives in the 4th year. All mandatory courses must be done at OUR program. Tests are still taken in courses and attendance is required. Many of my classmates will be in clinic up until the day they graduate. Only TRUE 4 year programs here.

My friend is graduating from a DO school. His 3rd year is actually only 8 months long. The remainder of the 4 months and all of 4th year can be completed in mostly electives anywhere in the country. This is fact. I will not divulge where or who I am talking about.

This isn't a MD v DO fight......just the one school I know of with a vastly different clinical curriculum. I believe someone graduating from this DO program could make the most of this situation with tough electives at talented academic centers......or they can easily "squeek" by through laid back community programs. I certainly hope these students DO take advantage of this.

On the topic of PA to MD/DO. I think it is a HORRIBLY bad idea. Without structuring every medical school and PA school to be EXACTLY the same (curriculum, clinicals, electives, everything), there is no way to adequately regulate that everyone is getting the required education. Transferring PA "hours" to MD/DO "hours" would be a nightmare. No way there is the man-power to regulate this.

Certainly there are PA's with a knowledge base greater than some physicians. I'm glad we have them around. I however am not willing to help them easily transfer their degree to a MD/DO when certainly less qualified individuals would jump through those cracks.

For regulation reasons, I certainly doubt any respectable PA to MD/DO program will ever exist.

 

[DO2Be2013]

I have seen this # quoted many times. when you remove " residency interview time" and "vacation blocks" from the schedule and include only didactic and rotation time it shortens most programs to around 3 years of actual work.
how many students do you know who took off months during 4th yr to do trips to nepal, etc to "explore other health care systems"...that's a vacation posing as school.
4th yr is cush for most folks....
in fact the DO program at lake erie offers a 3 yr option that cuts out excess vacation time and interview time and loses no content. you are tracked from the start to a primary care residency affiliated with the program.

This is NOT TRUE and I've seen you post this more than once around here even though you've been corrected. The PCSP at LECOM-Erie does indeed cut content. Traditional students complete 24 clinical clerkships (with only 4 weeks of vacation/interview time per year, not several months); the PCSP students complete only 16 clinical clerkships (with no vacation). They are cutting out 8 months' worth of clinical content. They aren't just cutting vacation (which they do in the preclinical phase), they are cutting out a full eight clinical rotations with is a full third of a regular student's clinical education. Further, they are absolutely not tracked into or guaranteed an affiliated residency program from the start. I don't know where you heard this, but I interviewed at LECOM and spoke with actual PSCP students personally, and they had to enter the match just like everybody else and hope they'd get a spot where they wanted. One specific guy I talked to was aiming to go back home in the midwest for residency. No where on their website do they even suggest that you're guaranteed a residency match.

Instead of taking the LECOM website's word on the fact that they offer the "equivalent" of a four-year degree (which technically they can claim since for some crazy reason the AOA accredited this)... look at the actual preclinical and clinical curriculums. They credits do not come close to matching up one-for-one, especially not on the clinical end. But even in years one/two there are a few missing classes. This info is readily available on the same page you quoted.

As for med school amounting to three years of work if you exclude vacations... wrong again. Between M1 and M2 my school (which is typical of most) offers eight weeks of vacation. There is no vacation between M2/M3. During M3, there is no vacation block (we just get a week at Christmas) and during M4 there is one four-week vacation block during which time we are expected to interview. There is no separate "interview" block. That's 12 weeks of scheduled vacation during a four-year curriculum, not 52.

Finally, my school also offers a PA program and I took the following, regarding the clinical phase of the progam, directly from their website:

CLINICAL CURRICULUM
Clinical Phase Course Descriptions
The Clinical Phase courses primarily involve supervised practice experience in a variety of settings and specialties. It is expected that these experiences involve an average of 35-40 hours of practice experience each week. In many of these preceptorships, one night per week and one weekend per month of on-call experience is also appropriate and expected.

I'm not going to accept a weeks-to-weeks comparison across programs when a clinical "week" for PA students is 35 hours and one night of call, and a clinical "week" for medical students is easily double that or more!

 

[DO2Be2013]

but yet they meet all requirements for the DO degree. if someone completing this program wanted to be a jerk they could apply for any residency they wanted; surg, derm, em, etc

Of course they could "apply" but there's not a damn program in the country that would accept them. Even LECOM's officials were up front about this at my interview. The school would be incredibly unsupportive (no LORs or good dean's letter) and no program director would want them anyway. Who would accept a med student who didn't even do a clerkship in your specialty in for a residency? These people (and, by the way, we're talking about 5-8 people per year in this program out of LECOM's total annual enrollment of around 500) better be certain they want primary care b/c they are locking themselves in. Actually, the first batch of PCSP grads should have graduated last spring and I'm curious as to how many of them matched and where. I believe there were five of them; I know three wanted IM, one wanted Peds and one wanted FP.

 

[windjammer]

No matter how you look at it there is only ONE legitimate way to become an MD/DO. The good thing is that anyone motivated enough can do it, such as a high schooler to MD/DO, janitor to MD/DO, CNA to MD/DO, RN to MD/DO, and even more novel......PA to MD/DO. This is done by actually going through premed, being accepted into an accreditated medical school and finishing a residency. Easy as pie. There are no shortcuts.....PERIOD end of story! Why does everyone want to take the easy road??? I get frustrated when threads like this appear because as a premed who is a registered nurse and registered respiratory therapist with 17 years of healthcare experience I have been working my butt off trying to obtain my goal of physician and there is just no way around the system. Just do your time!!!

 

[ERPAC]

Different medical schools have different requirements. The MD schools in my state are pretty strict on even the 4th year. 1 month is traditionally set aside for interviews. My school only allows up to 3 months at another institution. There are 4 mandatory courses + electives in the 4th year. All mandatory courses must be done at OUR program. Tests are still taken in courses and attendance is required. Many of my classmates will be in clinic up until the day they graduate. Only TRUE 4 year programs here.

My friend is graduating from a DO school. His 3rd year is actually only 8 months long. The remainder of the 4 months and all of 4th year can be completed in mostly electives anywhere in the country. This is fact. I will not divulge where or who I am talking about.

This isn't a MD v DO fight......just the one school I know of with a vastly different clinical curriculum. I believe someone graduating from this DO program could make the most of this situation with tough electives at talented academic centers......or they can easily "squeek" by through laid back community programs. I certainly hope these students DO take advantage of this.

On the topic of PA to MD/DO. I think it is a HORRIBLY bad idea. Without structuring every medical school and PA school to be EXACTLY the same (curriculum, clinicals, electives, everything), there is no way to adequately regulate that everyone is getting the required education. Transferring PA "hours" to MD/DO "hours" would be a nightmare. No way there is the man-power to regulate this.

Certainly there are PA's with a knowledge base greater than some physicians. I'm glad we have them around. I however am not willing to help them easily transfer their degree to a MD/DO when certainly less qualified individuals would jump through those cracks.

For regulation reasons, I certainly doubt any respectable PA to MD/DO program will ever exist.

So, guess what, I went to a PA program with a MD program and guess what else. PA students in the clinical phase, do the SAME HOURS as the M3, M4, interns, and residents, at least that is expected because it is a TEACHING HOSPITAL. Don't get yourself twisted when you think that the PA students don't do the same. I went in at 4am and left at 8pm+ on my surgery rotation and took call Q3, so check your statistics. Furthermore, for your edification, you might want to do your homework and you will find that a lot of attendings at teaching hospitals who GRILL PA's for breakfast find themselves writing a stellar letter and commenting at times to the M3 that the PA was sharper than they were and vice versa to respect the M3, I have seen them sharper than some PA's. I will apply to med school next year as a PA and GUESS WHAT ELSE....I was told by a surgery attending something that is very true....He said that, "The only thing separating you from ANYONE else in medicine is your ability to read and keep your face glued in a book." For all of the haters, keep this in mind....you will be short docs from now on...we will be short nurses....the PA's are increasing, but physicians can only supervise a certain amount from state to state....and by the way...what do you tell someone who lives in an area of the country that there is no medical care..."why don't you go find a PA about 100 miles away at the clinic...how about, maybe put a physician in that area that brings a PA. My point is that the health provider numbers will be short until we flood the market with PA's and NP's then WHAT? You will always need docs no matter what, and the same for nurses. KEEP HOPE ALIVE AND DO GOOD MEDICINE, ALWAYS

Signed: PA going toward the MD/DO, but really going for the patients

 

[TexasPhysician]

So, guess what, I went to a PA program with a MD program and guess what else. PA students in the clinical phase, do the SAME HOURS as the M3, M4, interns, and residents, at least that is expected because it is a TEACHING HOSPITAL. Don't get yourself twisted when you think that the PA students don't do the same. I went in at 4am and left at 8pm+ on my surgery rotation and took call Q3, so check your statistics. Furthermore, for your edification, you might want to do your homework and you will find that a lot of attendings at teaching hospitals who GRILL PA's for breakfast find themselves writing a stellar letter and commenting at times to the M3 that the PA was sharper than they were and vice versa to respect the M3, I have seen them sharper than some PA's. I will apply to med school next year as a PA and GUESS WHAT ELSE....I was told by a surgery attending something that is very true....He said that, "The only thing separating you from ANYONE else in medicine is your ability to read and keep your face glued in a book." For all of the haters, keep this in mind....you will be short docs from now on...we will be short nurses....the PA's are increasing, but physicians can only supervise a certain amount from state to state....and by the way...what do you tell someone who lives in an area of the country that there is no medical care..."why don't you go find a PA about 100 miles away at the clinic...how about, maybe put a physician in that area that brings a PA. My point is that the health provider numbers will be short until we flood the market with PA's and NP's then WHAT? You will always need docs no matter what, and the same for nurses. KEEP HOPE ALIVE AND DO GOOD MEDICINE, ALWAYS

Signed: PA going toward the MD/DO, but really going for the patients

You actually read nothing I wrote did you? Pay attention. They obviously don't teach reading comprehension at your PA school. I was trying to be polite, but since you are taking offense to absolutely nothing.....

Do PA's do 2 full years of clinicals after 2 full years of basic sciences? No. You can't argue this. If it WERE the same program, you would get an MD/DO degree at the end. Quit complaining and do the years.

All I was originally saying is that curriculums at every med school are already different. Transferring between medical schools is already difficult to do. A PA trained at UT will have a different curriculum than a PA at Texas Tech. A Texas Tech PA trying to get accepted into a hypothetical UT PA->MD program would have a nightmare with "transferring credit". Secondly, not all PA clinical programs are the same at different programs. The PA's here have different hours, months, and clinical designations than do med students.

Are many of the clinical experiences similar between PA and MD/DO - sure. Will a short-cut ever be built into the system - No. PA's have a regulatory board and MD/DO's have a regulatory board. All curriculums give classes different names. Absolutely too much work to make this happen.

 

[DeadCactus]

I don't see the problem with a 3 year PA to MD/DO program. Put them through the same basic science courses and a year of clinicals and let them try to match. Trading a two year degree and relevant work experience is enough reason to let them skip 1 of the more inconsequential years out of 7 to 11 years of training. It's not like they're trying to cut a year or two of residency out...

Edit:
Though if I had a vote in it, I'd probably vote no just out of spite for the PA community not keeping the more obnoxious members of their community from becoming the most outspoken representatives.

 

[windjammer]

Do PA's do 2 full years of clinicals after 2 full years of basic sciences? No. You can't argue this. If it WERE the same program, you would get an MD/DO degree at the end. Quit complaining and do the years.

So what you are saying is that there are NO shortcuts in obtaining a licence to practice medicine???😱 I think I will give-up on the galactically supid!!

 

[TexasPhysician]

So what you are saying is that there are NO shortcuts in obtaining a licence to practice medicine???😱 I think I will give-up on the galactically supid!!

haha Exactly. There are 0 current programs, and I doubt there will EVER be such a program.

I'm not debating whether there should or shouldn't be a program......I'm just saying it is too much work to ever happen.

 

[DO2Be2013]

I don't see the problem with a 3 year PA to MD/DO program. Put them through the same basic science courses and a year of clinicals and let them try to match. Trading a two year degree and relevant work experience is enough reason to let them skip 1 of the more inconsequential years out of 7 to 11 years of training. It's not like they're trying to cut a year or two of residency out...

I don't know how I feel actually. It doesn't really seem like a "shortcut" to remove a year of medical education if the prerequisite to doing so is spending two years in a master's program and then a certain number of years in practice as a PA. But at the same time, in a world where every other health profession is seemingly lowering their standards with accelerated, direct-entry, online, etc. kinds of programs and crazy degree inflation (even PA programs are guilty... they used to require extensive healthcare work expereince as a medic, RN, etc., but more and more programs are accepting new college grads and others without significant experience)... there's a comfort, to me, in knowing that medical education adheres to the strictest possible standardization in education. They're like the last bastion in that area. There's some integrity. That's part of what bugs me about LECOM's 3-year pathway, actually, but that's another topic.

No shortcuts, no online BS, no part-time accelerated stuff, no programs filled with fluff courses, etc. You want to be a doctor, well, everyone from Harvard and Hopkins down through the Caribs (well, the respectable ones anyway) has to do it exactly the same- from the pre-med requisites, to the MCAT, to the same two years of preclinical content and boards, same two years of rotations, same residencies, etc. Standardization is the key to ensuring quality. I don't like the idea of offering a shortcut to anyone. Even though, of all the health professionals, PAs probably have the most legit claim in arguing for one.

I wonder how receptive the PA community would be to allowing third or fourth year med students to sit for PANCE boards and get PA licensure? It might be an attractive option for some. Maybe during third year a med student realizes the grueling lifestyle isn't for them and the thought of four-plus more miserable years with residency scares them, but they're too far in debt to be a med school dropout with no other career options. Or, as a woman I almost hate to say it, but a lot of women might be considering marriage and motherhood at that time and regret the lifestyle they committed themselves to. If they could exit between M3/M4 and earn $100k as a PA, they could pay their loans eventually and enjoy an easier lifestyle. Just a thought.

 

[deleted6669]

Actually, the first batch of PCSP grads should have graduated last spring and I'm curious as to how many of them matched and where. I believe there were five of them; I know three wanted IM, one wanted Peds and one wanted FP.

what's to stop any of these folks from working in primary care for a yr or 2 then applying for a fellowship?
especially the IM folks...couldn't they start In IM, have a big panel and manage their own inpts, find they enjoy the hospitalist aspects more than outpt practice, get a hospitalist job, do that for a few yrs then apply for a critical care fellowship or something similar....?

 

[DaveinDallas]

Ah, great. People looking for yet ANOTHER shortcut to the MD/DO degree. First it's NPs, then RNs, now PAs. Here's an idea, and try your best to follow me on this one:
If you want to become a doctor, go to medical school.

If there was a way to become a physician via the NP or PA route, then nobody would bother taking the MCAT anymore.

I get so tired of people who want to be physicians but don't want to put in the ball-busting, mind-numbing years of study and work to do it. I hear it from PA's who tell me that they don't see why they have to take the MCAT since it has no relevance to clinical medicine and they've been practicing for 10 years and no one can tell them they don't know what they're doing, etc., etc. ad nauseum, ad infinitum.....

I hear it from NPs who don't know what to do with a symptomatic MI and a STEMI EKG staring them in the face.....(yeah, that did happen. They called a PA and then sent the patient home with the advice of going to the ER if it recurred or got worse.....glad I was a 3rd year student)....

I hear it from chiropractors who are determined that they're well trained enough to be PCPs and should have portal of entry rights.....

I've met some PAs who I had no problem with and some NPs...but the bottom line is.....if you want to be a physician, go to medical school, complete it, and then go to a residency program. If you're already skilled as an NP/PA/M.O.U.S.E you should be tops of the class and be able to match freakin' derm or whatever and your studies shouldn't take you more than 1 hour a night.......


Sorry if I've offended anyone but I run into this with amazing regularity....especially with the new healthcare overhaul.....

 

[ERPAC]

I would like to thank the negative thinkers here today, bravo, bravo...clap, clap and bow. First of all, as a PA we all should take the MCAT, I will be no exception to that, next year. Secondly, we should have all of the prerequisite courses, no problems there....Now, with respect to PA's not wanting to do the YEARS..that is not all of it..keep in mind that the last 2 years of M3, M4, a lot of practicing PA's can smoke...and get A's on the EOR tests and from their preceptors. Hey I know you MD/DO's reading this have precepted and thanks for the positive comments about some excellent PA's that you have come across. DON'T FORGET THIS...while you say negative things about PA supposed slackness, A LOT of medical schools take students in the 2nd or 3rd year of undergrad, just because they have a "B average" and have a recommendation from a pre-med committee AND ARE NOT REQUIRED TO EVEN TAKE AN MCAT, MUCH LESS STUDY FOR ONE... Lets keep it real, if you want to talk, I have my statistics. PA'S applying to medical schools should be given credit for a course, if the medical school professor teaches the same course to the PA's as the MD's/DO's. This BRIDGE could only happen in the beginning at Medical schools with PA programs together. I mean the curriculum, tests, quizzes, objectives, should be the same. The same rule should be applied to the M3, M4 ONLY IF the PA can pass an oral and written exam, and be observed for while doing clinical skills...how to work this..would have to be figured out. Finally, no doubt if my creator sees fit to allow me to humbly get admitted to a med school next year, I would have arrived there via hard work. How do you think med students and PA students view a student who had automatic admission to medical schools in the sophomore/junior year of college?...and you mean to tell me that you are opposed to a PA having a slightly shorter route....give me a break....no doubt if I am blessed, I am going to SMOKE clinicals. BY THE WAY, how about you check with your alma mater and some of your colleagues alma maters and FIND OUT WHO WERE the top students at the med school graduation. Finally, yes all PA programs should require 2000hrs of healthcare experience AND MEDICAL SCHOOLS! There are a few medical providers(PA, MD, DO) who are spineless jellyfish and don't have any bedside manner or patient sensitivity. Really, thank you for the dialogue, I'm not mad at any of you, this is a discussion, but please bring some stats.

 

[Just Joshin]

I would like to thank the negative thinkers here today, bravo, bravo...clap, clap and bow. First of all, as a PA we all should take the MCAT, I will be no exception to that, next year. Secondly, we should have all of the prerequisite courses, no problems there....Now, with respect to PA's not wanting to do the YEARS..that is not all of it..keep in mind that the last 2 years of M3, M4, a lot of practicing PA's can smoke...and get A's on the EOR tests and from their preceptors.

I don't know what the EOR tests are, but in med school, you have national Shelf exams after every rotation that expect you to know the material at the level of a med student. PAs should be required to take every single one, after completing every single rotation a typical med student would. This "let's excuse them from a year of rotations because of their experience" thing is crap. The fact is that every rotation is different a peds PA may not have a clue what happens in surgery. A surgical PA may be clueless when it comes to psych.

Hey I know you MD/DO's reading this have precepted and thanks for the positive comments about some excellent PA's that you have come across. DON'T FORGET THIS...while you say negative things about PA supposed slackness, A LOT of medical schools take students in the 2nd or 3rd year of undergrad, just because they have a "B average" and have a recommendation from a pre-med committee AND ARE NOT REQUIRED TO EVEN TAKE AN MCAT, MUCH LESS STUDY FOR ONE...

First off, there aren't "a lot" of med schools that do this. Second, the ones I know of still require the MCAT. You must get a minimum score to stay in the program. But aside from that, they still require the pre-reqs. The only thing they're cutting out is undergrad elective courses and upper level sciences. Every single person starting medical school has met certain pre-reqs. There's just no way around that.

Lets keep it real, if you want to talk, I have my statistics. PA'S applying to medical schools should be given credit for a course, if the medical school professor teaches the same course to the PA's as the MD's/DO's.

Are the standards the same? I know someone at a PA program like that and the PAs need a 60 to pass while the MD students need a 70. There's an obvious disparity there grade-wise.

This BRIDGE could only happen in the beginning at Medical schools with PA programs together. I mean the curriculum, tests, quizzes, objectives, should be the same. The same rule should be applied to the M3, M4 ONLY IF the PA can pass an oral and written exam, and be observed for while doing clinical skills...how to work this..would have to be figured out.

No rotations should be given credit for. Sorry, but the standards are just different. The national shelf exams that med students take aren't comparable to any old written or oral exam.

Finally, no doubt if my creator sees fit to allow me to humbly get admitted to a med school next year, I would have arrived there via hard work. How do you think med students and PA students view a student who had automatic admission to medical schools in the sophomore/junior year of college?

I don't have a problem with that. If they got all the pre-reqs done, I couldn't care less if they took Humanities 101 or Philosophy 320 in order to get a Bachelor's degree. And as I said the schools I know of that do that, do require the MCAT to be taken in order to stay in the program.

...and you mean to tell me that you are opposed to a PA having a slightly shorter route....give me a break....no doubt if I am blessed, I am going to SMOKE clinicals.

Fine, and when you do, you can rest assured that you'll get any residency you want. What's the problem?

 

[DO2Be2013]

what's to stop any of these folks from working in primary care for a yr or 2 then applying for a fellowship?
especially the IM folks...couldn't they start In IM, have a big panel and manage their own inpts, find they enjoy the hospitalist aspects more than outpt practice, get a hospitalist job, do that for a few yrs then apply for a critical care fellowship or something similar....?

What's to stop them from applying? Nothing. That doesn't mean they'll be accepted. The LECOM deal requires you to agree to five years I think (it might be ten) in primary care practice under financial penalty. In theory if one of these people wanted to break that agreement and just pay the penalty, I still don't think they'd be viewed positively by fellowship program directors. If you know any, ask them. I don't see them being too enthusiastic about a candidate who did a special shortened "primary care" program under which they made a commitment to be PCPs and skipped 1/3 of their clinical medical education in subspecialties. From a training standpoint, they're lacking some education. And from an ethical standpoint they're trying to get away with something that's pretty transparent and they're basically breaking a promise they made to their med school and the medical community to do it. Don't know what kind of supportive LORs they could get either. I think it's likely (at least I hope) they'd be essentially blackballed and rightfully so.

But keep it in perspective; this LECOM program only takes 5-8 students per year and it's still very new. Out of 800,000 practicing physicians in the US, in a few years, you'll be talking about a few dozen tops who went this route. It's not some kind of common, widespread trend in medical education (and I hope it stays this way) and for now, call me naive, but I have faith that the people who go for this program are being honest in their commitment to primary care. I guess time will tell in 5-10 years whether some dishonest people try to take advantage of this program as a shortcut to specialty practice.

 

[MSSM2013]

just a friendly reminder, the boards are a minimum competency test, every MD should be able to pass it and do much more beyond.

 

[ERPAC]

good point, I like this. It is so true,

 

[TexasPhysician]

I would like to thank the negative thinkers here today, bravo, bravo...clap, clap and bow. First of all, as a PA we all should take the MCAT, I will be no exception to that, next year. Secondly, we should have all of the prerequisite courses, no problems there....Now, with respect to PA's not wanting to do the YEARS..that is not all of it..keep in mind that the last 2 years of M3, M4, a lot of practicing PA's can smoke...and get A's on the EOR tests and from their preceptors. Hey I know you MD/DO's reading this have precepted and thanks for the positive comments about some excellent PA's that you have come across. DON'T FORGET THIS...while you say negative things about PA supposed slackness, A LOT of medical schools take students in the 2nd or 3rd year of undergrad, just because they have a "B average" and have a recommendation from a pre-med committee AND ARE NOT REQUIRED TO EVEN TAKE AN MCAT, MUCH LESS STUDY FOR ONE... Lets keep it real, if you want to talk, I have my statistics. PA'S applying to medical schools should be given credit for a course, if the medical school professor teaches the same course to the PA's as the MD's/DO's. This BRIDGE could only happen in the beginning at Medical schools with PA programs together. I mean the curriculum, tests, quizzes, objectives, should be the same. The same rule should be applied to the M3, M4 ONLY IF the PA can pass an oral and written exam, and be observed for while doing clinical skills...how to work this..would have to be figured out. Finally, no doubt if my creator sees fit to allow me to humbly get admitted to a med school next year, I would have arrived there via hard work. How do you think med students and PA students view a student who had automatic admission to medical schools in the sophomore/junior year of college?...and you mean to tell me that you are opposed to a PA having a slightly shorter route....give me a break....no doubt if I am blessed, I am going to SMOKE clinicals. BY THE WAY, how about you check with your alma mater and some of your colleagues alma maters and FIND OUT WHO WERE the top students at the med school graduation. Finally, yes all PA programs should require 2000hrs of healthcare experience AND MEDICAL SCHOOLS! There are a few medical providers(PA, MD, DO) who are spineless jellyfish and don't have any bedside manner or patient sensitivity. Really, thank you for the dialogue, I'm not mad at any of you, this is a discussion, but please bring some stats.

I'm sorry, but you just don't know what you are talking about. After you finish your MD/DO full-length program, come back and look at this. It is truly difficult finding any good points in your paragraph, and I really don't have time to argue every sentence.

 

[futIDdoc]

may have been stated earlier in the thread, but no way this happens with the current number of residencies. Accoring to nrmp there werer ~29k applicants for ~22k spots. Only 425 or 2% of total residencies went unfilled. With a couple of new allopathic schools on the way and seemingly 2 new DO schools opening per year, I just don't see the need to create a PA bridge.

 

[Jamers]

I would like to thank the negative thinkers here today, bravo, bravo...clap, clap and bow. First of all, as a PA we all should take the MCAT, I will be no exception to that, next year. Secondly, we should have all of the prerequisite courses, no problems there....Now, with respect to PA's not wanting to do the YEARS..that is not all of it..keep in mind that the last 2 years of M3, M4, a lot of practicing PA's can smoke...and get A's on the EOR tests and from their preceptors. Hey I know you MD/DO's reading this have precepted and thanks for the positive comments about some excellent PA's that you have come across. DON'T FORGET THIS...while you say negative things about PA supposed slackness, A LOT of medical schools take students in the 2nd or 3rd year of undergrad, just because they have a "B average" and have a recommendation from a pre-med committee AND ARE NOT REQUIRED TO EVEN TAKE AN MCAT, MUCH LESS STUDY FOR ONE... Lets keep it real, if you want to talk, I have my statistics. PA'S applying to medical schools should be given credit for a course, if the medical school professor teaches the same course to the PA's as the MD's/DO's. This BRIDGE could only happen in the beginning at Medical schools with PA programs together. I mean the curriculum, tests, quizzes, objectives, should be the same. The same rule should be applied to the M3, M4 ONLY IF the PA can pass an oral and written exam, and be observed for while doing clinical skills...how to work this..would have to be figured out. Finally, no doubt if my creator sees fit to allow me to humbly get admitted to a med school next year, I would have arrived there via hard work. How do you think med students and PA students view a student who had automatic admission to medical schools in the sophomore/junior year of college?...and you mean to tell me that you are opposed to a PA having a slightly shorter route....give me a break....no doubt if I am blessed, I am going to SMOKE clinicals. BY THE WAY, how about you check with your alma mater and some of your colleagues alma maters and FIND OUT WHO WERE the top students at the med school graduation. Finally, yes all PA programs should require 2000hrs of healthcare experience AND MEDICAL SCHOOLS! There are a few medical providers(PA, MD, DO) who are spineless jellyfish and don't have any bedside manner or patient sensitivity. Really, thank you for the dialogue, I'm not mad at any of you, this is a discussion, but please bring some stats.

The PA students I have worked with do not impress me. They are not "smoking" any of the rotations I have observed them on. At best, they have the knowledge level of a first or second year medical student. Now, the PA-Cs that have been in a given field for 10 to 15 years are great. That's what you get after that many years in a field: good at it. However, I do not think this should then allow them to skip years and obtain their doctorate.

 

[windjammer]

Just because they may get a "doctorate" doesn't mean that they will or can be called "doctor" so n so! This is the same argument that the DNP's are having. I have said it before, THERE IS NO SHORTCUT TO OBTAIN AN MD/DO AND THEREFORE A LICENSE TO PRACTICE MEDICINE!!!!! If you want it you need to do it like everyone else!

 

[bnp07]

My question is why we are all so territorial and ripping other health professionals down. What has happened to the "team approach" to health care? PAs weren't designed to take the places of doctors, they have been created to fill gaps. They're trained as generalists, so of course many aren't going to have the same clinical knowledge as experiences physicians in their field (although some can and do, based on experience).

What particularly baffles me is why this is happening on a DO board when DOs themselves have had to battle for years against antagonism from MDs. How many times throughout history do you think the phrase "DOs are not real docs" has been uttered?

I'm also puzzled because I'm going to take a guess (and I may be wrong) that many people either reading and/or posting have very little experience with PAs in which to base their judgment on. All they know is what is posted on the internet and not from real life interactions. It would be like saying "Oh look at the MCAT and GPA requirements of DO schools compared to allopathic, DO students are just those who couldn't hack it to get into MD schools" without ever talking to a DO student or seeing a DO physician in action. We all know that statements like that aren't true and many reading this would be prepared to fight anyone presenting an argument like that, because you can't judge people (or schools) from the surface or from what others say. You can't look superficially at a PAs education and immediately conclude that they are incapable of performing everyday roles in the health care system, it is unfair.

Health care is a serious business and we do need to do everything we can to keep our patients safe. Making sure that clinicians are properly trained and knowledgeable is crucial and it is great that we are concerned and advocating for our patients. But to immediately discredit skilled PAs and rib them for trying to "pretend" they are doctors is doing a disservice to you, your patients, and the people you work with. They are many great PAs out there, and there are not so great as well. There are also many, many great doctors and some boneheads. You're going to have good and bad clinicians no matter what field you work in. It ultimately comes down to one's work ethic, compassion, and willingness to learn. It would be a shame to dismiss the truly talented in the "lesser" health care careers as doctor wannabes. And please...don't be so quick to pass judgments! Get informed! 🙂

 

[DaveinDallas]

Just because they may get a "doctorate" doesn't mean that they will or can be called "doctor" so n so! This is the same argument that the DNP's are having. I have said it before, THERE IS NO SHORTCUT TO OBTAIN AN MD/DO AND THEREFORE A LICENSE TO PRACTICE MEDICINE!!!!! If you want it you need to do it like everyone else!

Oh, not so --- I've been in situations where a nurse had a Ph.D (in what, I don't know), was wearing a white 3/4 length lab coat and went into the patients room with us and was introduced as 'Dr. CatintheHat'.......and
never corrected the person doing the introducing....who was a physician by the way......

 

[DaveinDallas]

My question is why we are all so territorial and ripping other health professionals down. What has happened to the "team approach" to health care? PAs weren't designed to take the places of doctors, they have been created to fill gaps. They're trained as generalists, so of course many aren't going to have the same clinical knowledge as experiences physicians in their field (although some can and do, based on experience).

What particularly baffles me is why this is happening on a DO board when DOs themselves have had to battle for years against antagonism from MDs. How many times throughout history do you think the phrase "DOs are not real docs" has been uttered?

I'm also puzzled because I'm going to take a guess (and I may be wrong) that many people either reading and/or posting have very little experience with PAs in which to base their judgment on. All they know is what is posted on the internet and not from real life interactions. It would be like saying "Oh look at the MCAT and GPA requirements of DO schools compared to allopathic, DO students are just those who couldn't hack it to get into MD schools" without ever talking to a DO student or seeing a DO physician in action. We all know that statements like that aren't true and many reading this would be prepared to fight anyone presenting an argument like that, because you can't judge people (or schools) from the surface or from what others say. You can't look superficially at a PAs education and immediately conclude that they are incapable of performing everyday roles in the health care system, it is unfair.

Health care is a serious business and we do need to do everything we can to keep our patients safe. Making sure that clinicians are properly trained and knowledgeable is crucial and it is great that we are concerned and advocating for our patients. But to immediately discredit skilled PAs and rib them for trying to "pretend" they are doctors is doing a disservice to you, your patients, and the people you work with. They are many great PAs out there, and there are not so great as well. There are also many, many great doctors and some boneheads. You're going to have good and bad clinicians no matter what field you work in. It ultimately comes down to one's work ethic, compassion, and willingness to learn. It would be a shame to dismiss the truly talented in the "lesser" health care careers as doctor wannabes. And please...don't be so quick to pass judgments! Get informed! 🙂

It's typically not the physicians that are causing the problem. It's the mid-levels who want to be able to practice with no physician oversight and then cop attitude saying they are just as well trained.......to which the people who have spent the time to get the education and skills to earn the full medical license call ....BULL*()&......

 

[womp]

It ultimately comes down to one's work ethic, compassion, and willingness to learn. It would be a shame to dismiss the truly talented in the "lesser" health care careers as doctor wannabes. And please...don't be so quick to pass judgments! Get informed! 🙂

What's so ethical about pretending to be a medical doctor in front of patients when one is not and when patients don't know better? Teamwork does not mean everyone in the team has the same responsibility, same decision-making and same liability. That would be called partnership. Don't blame the doctors when others on the team don't want to be team players simply because their egos are too big for their roles.

 

[Bacchus]

Oh, not so --- I've been in situations where a nurse had a Ph.D (in what, I don't know), was wearing a white 3/4 length lab coat and went into the patients room with us and was introduced as 'Dr. CatintheHat'.......and
never corrected the person doing the introducing....who was a physician by the way......

This is a huge liability issue that a hospital has to nip. I'm pretty sure a lot if not all state legislatures and licensing organizations clearly outline no one other than a physician should be called Dr. in the healthcare setting.

The physician probably in this case probably had a mutual respect. Patient X, this is Dr. SoandSo, our nurse practitioner.

 

[DaveinDallas]

This is a huge liability issue that a hospital has to nip. I'm pretty sure a lot if not all state legislatures and licensing organizations clearly outline no one other than a physician should be called Dr. in the healthcare setting.

The physician probably in this case probably had a mutual respect. Patient X, this is Dr. SoandSo, our nurse practitioner.

I agree it's a huge liability issue - but the physician introduced her as Dr.CatintheHat and no appendage of NP or whatever was made. As far
as the pt. knew, she was a physician. It may have been a case of mutual
respect as he was the only physician working the pediatric obs unit with three NPs. I don't know for sure....may have just been a slipup like when
people introduce me as 'Doctor DaveinDallas' but I make it a point to stress
that I am a student, period. And I know it annoys the hell out of the interns and attendings - but I address them as Dr.SoandSo and 'Sir' or 'Ma'am' as appropriate. They ARE physicians. I'll be one in less than 250 days so until then, I'm a student......and it's ok.....

 

[Jamers]

I have seen this # quoted many times. when you remove " residency interview time" and "vacation blocks" from the schedule and include only didactic and rotation time it shortens most programs to around 3 years of actual work.
how many students do you know who took off months during 4th yr to do trips to nepal, etc to "explore other health care systems"...that's a vacation posing as school.
4th yr is cush for most folks....
in fact the DO program at lake erie offers a 3 yr option that cuts out excess vacation time and interview time and loses no content. you are tracked from the start to a primary care residency affiliated with the program.

How The Primary Care Scholars Curriculum Works

LECOM uses its experience with innovative teaching pathways to ensure that Primary Care Scholars receive the equivalent of four years of academic and clinical education in three years to prepare for post-graduate training.
Following unique courses and learning modules, students complete the first two years of basic science and preclinical education in under 20 months.
They begin clinical training in March of Year 2. Students must complete core competency-based clinical rotations that meet all the educational requirements necessary for primary care medicine. LECOM has introduced new core rotations to continue OMM training and other essential medical skills. A sub-internship introduces students to the hospitals where they will continue their clinical training after graduation

**I was asked to comment on this posting by another student I know who doesn't have an account***


I don't know where you get your information that fourth year is "cush." We have a grand total of 8 weeks off between third and fourth year (two months total for our ENTIRE clinical phase...not a year). Also, when people go to Napal or elsewhere in the world, has it occurred to you that they might just be doing an international rotation?? Also, residency interview time? Are you serious? I have eight interviews...that means I get eight days off to attend these interviews. I don't get months off just because I have an interview.

My clinical years have not been "cush" by any means. My last rotation found me spending near to 90 hours a week in the hospital. I was not in Napal or the Caribbean or at home watching the game.

 

[DaveinDallas]

**I was asked to comment on this posting by another student I know who doesn't have an account***


I don't know where you get your information that fourth year is "cush." We have a grand total of 8 weeks off between third and fourth year (two months total for our ENTIRE clinical phase...not a year). Also, when people go to Napal or elsewhere in the world, has it occurred to you that they might just be doing an international rotation?? Also, residency interview time? Are you serious? I have eight interviews...that means I get eight days off to attend these interviews. I don't get months off just because I have an interview.

My clinical years have not been "cush" by any means. My last rotation found me spending near to 90 hours a week in the hospital. I was not in Napal or the Caribbean or at home watching the game.

I'll second that one....my 'cush' 4th year has started with my first month at the busiest trauma center in Texas (supposedly the nation) followed by 60 hour weeks on a medicine service disguised as FM. It's being followed by FM,Pulmonary and ICU.....I keep being told 4th year is a cruise....I keep thinking, 'In what dimension?'....