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med school grad interested in being a PA...

Discussion in 'Clinicians [ RN / NP / PA ]' started by joshmir, Mar 26, 2004.

  1. joshmir

    joshmir Senior Member
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    Anyone know how a licensed (but not board certified) physician could get hired as a PA in an ED?

    Allow me to explain... :)

    It seems like this may be the only way for medical students who don't look good on paper and didn't match into EM residencies to show off their skill to EM departments, in the hopes of convincing people to give them a residency spot...we don't get covered for audition rotations after we graduate.

    Could the MD just take an exam? At my med school, it seems the PAs take the same classes we took, just abbreviated...
     
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  3. emedpa

    emedpa GlobalDoc
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    you would have to go to pa school, complete the program and take the national boards. there are no shortcuts. it works the other way around too. pa's who go to med school have to do all 4 yrs.
     
  4. MacGyver

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    What the hell? EM is NOT hard to match into, as long as you cast a wide net.

    If you are willing to go to rural ERs, you can graduate at the bottom of your class with subpar USMLEs and still easily land a spot.
     
  5. emedpa

    emedpa GlobalDoc
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    EM was actually a tough match this year. see appropriate threads on em forum. they filled most spots and people were trying to scramble to fill the few left over.
     
  6. 12R34Y

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    MacGyver,

    what do you mean if you are willing to go to a rural ER?

    he's talking about matching into a residency not working as a EM doc.

    There are no rural EM residencies and if there were they still wouldn't be "easy" to match into.

    MacGyver........are you in medicine or what?

    never mind...........i just remembered you are still a pre-med. can't expect you to know that kind of stuff.

    later
     
  7. niko327

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    OOPS!:eek: CAUGHT!!! :eek:
     
  8. papilloma

    papilloma Member
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    Why are you bagging on someone when you have no clue what he or you are talking about?

    Doing residency and working as an EM doc are identical. One who is doing EM residency is a MD working in the ER, thus a EM doc. What MG meant was that landing a residency spot in rural areas (thus doing rural ER during residency) is very much achievable.

    A bunch of people in the EM forum matched into their #1 choice, even IMGs matched into big cities. I have no clue what you are talking about emedpa.

     
  9. 12R34Y

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    papilloma you have also demonstrated your ignorance.

    look on saem.org

    click on residency catalog.


    go find me a rural residency program in EM............you can't. because there aren't any.

    if you reply to this you are just a glutton for punishment.
     
  10. PACtoDOC

    PACtoDOC 1K Member
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    There are no rural EM programs. An EM resident is not the same as an EM physician. An EM resident rotates through all services just as every intern, and they do electives in other fields like all residents. An EM physician and an EM resident are not one in the same. You guys are idiots once again and show your real bright side when you open your mouth on a topic you understand only minimally. Too bad that the ignore feature doesn't work when someone quotes an idiots comments and pastes them onto their own thread. Oh well, I am happy to call an idiot an idiot.
     
  11. papilloma

    papilloma Member
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    You must be posting straight from a trailer home. I am from a big modern city, and where I'm from I'd consider U of Nebraska at Lincoln, St Paul MN, even Kern medical and UCSF fresno all rural boontowns. Kern is supposively an allopathic institution but no MDs even want to compete with DOs for these residency spots because it's too rural for californians. I guess rural is relative, and so is competitiveness of residency, but I'd have to say Kern or St Paul are not competitive for most American allopathic medical students. These are just examples of a few "rural" residencies.

    pactodoc, in hospitals, medical students are not referred to as Dr. Blah. However, residents are referred to as Dr. Blah, plus the fact that they have earned doctorates. That means, a em resident is a Dr or Doc, but definitely not an attending. I don't know whether there is a system of when one can be referred to as a "physician,'' but a resident is a "doc," that cannot be denied, and that's the word both Macgyver and I used in our previous posts. I hope you can return to mature civil discussions rather than name calling stemming from personal rage.


     
  12. PACtoDOC

    PACtoDOC 1K Member
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    Pappy, unless someone quotes you I will not be seeing your reply. Thank God!!
     
  13. MacGyver

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    "Rural" is a relative term.

    perhaps you should take a visit to Temple, Texas where Scott & White medical center is located. They have an EM residency program.

    And EM is NOT hard to get into unless you only apply to top programs. Whoever said EM was tough to match into is a fool. Its one of the easiest specialties to match into.
     
  14. PACtoDOC

    PACtoDOC 1K Member
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    Temple, Tx is part of the great central Texas metroplex, and Temple the city has over 50,000 people. Waco, Temple, and Killeen together have over 500,000 people and include a military base with the Army's largest cavalry and infantry units. Scott and White has a 500 bed hospital system with over 500 doctors. This is hardly rural my friend.
     
  15. medic8m

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    I'm from Fresno, it has half a million people.. Also one of the best trauma and burn centers in Cali.
     
  16. emedpa

    emedpa GlobalDoc
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    I did my paramedic preceptorship in fresno with american ambulance. downtown fresno is far from rural. the county has rural portions, but the city might as well be l.a.
     
  17. medic8m

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    Fresno is a pretty crazy place eh? What years did you work with American, we may know some of the same people.
     
  18. papilloma

    papilloma Member
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    WHAT???? That's similar to saying the city of Davis (even with sacramento right next to it!!) might as well be NY. That is a ludicrous statement. I have friends who live in LA and SF who would never live in Davis because they think it's too "rural," and it's known to most metropolitan californians (SF, LA, SD) that Davis is a cow town. Now, notice I never mentioned Davis as being rural, because at least it has Sacramento right next to it. Fresno = LA???? You've GOT to be kidding.

    In the following post from EM forum, Quimby2 wrote:
    "If King-Drew is not to much of a gamble for you, they do take DO's; though again, not too sure if you need USMLE's for them. Also, I know that Kern County takes DO's (But it's Bakersfield --ouch!!!). It might not be a bad idea to simply shoot off an email to the program directors."
    http://forums.studentdoctor.net/showthread.php?s=&threadid=111395

    Again, you might consider Bakersfield a big city. It's relative. I and probably most metropolitan residents would consider Bakersfield and Fresno to be rural, likely Davis as well. My friends and Quimby2 sure consider these places rural, even when Bakersfield is only 1 hr drive from LA. I'm sorry, but I am not convinced Fresno = Beverly Hills + Santa Monica beach + Hollywood + Alhambra + K town + Pasadena. No friggin way.




     
  19. PACtoDOC

    PACtoDOC 1K Member
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    Anyone hear something? Guess not, just the wind.
     
  20. MacGyver

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    Have you ever been there? Waco is 30 miles away from Temple. There is no "great central texas metroplex" there is Killeen, Temple, and Waco and they are nowhere close to comprising a "metroplex"

    what a joke.

    Like I said, unless you are trying to match into an academic program in a big city, EM is easy to match into.
     
  21. emedpa

    emedpa GlobalDoc
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    MEDIC8AM-
    I was there in 1992. mike kent and ray renard were my preceptors.
     
  22. medic8m

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    Hmm, dont think I know them, did you know Paul Hoffman? He was a paramedic with AA.
     
  23. emedpa

    emedpa GlobalDoc
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    mike kent was the head of the star rescue team at the time.
    nope, didn't know hoffman. did you know joe morris, emt-p? he was there then
     
  24. medic8m

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    no, I moved to Fresno in 2000 and worked in a CICU. I only know a few people that were there in the 90's. Oh well..

    Fresno sure had/has an abundance of trauma though. University Medical Center is a great training ground.
     
  25. papilloma

    papilloma Member
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    Anyway, I think you might want to consider taking a year off to do research or transitiona year.

     
  26. joshmir

    joshmir Senior Member
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    I am set to do a TY now.

    My worry is after a TY, if I apply into EM, I will only have 2.5 years of funding, for a 1-2-3 program or a 2-3-4 program.

    I have gotten the sense that research doesn't help TOO much- average clinically on paper is average clinically on paper. That can't be changed.

    The only thing I can think of is to get a PA license (apparently Iowa, Maine, Colorado ? allow you to take a test and get licensed if you have "equivalent experience" maybe EMEDPA can clarify. Then, I can throw my weight around an ED, giving the attendings a chance to like me, and take me into their residency program.

    For a person that's average on paper, that seems like the only thing to do if you don't match; after you leave med school, you're not covered by malpractice insurance, so you can't do audition rotations.

    ANyone have thoughts on this logic?

    Thanks!
     
  27. papilloma

    papilloma Member
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    I think it's more beneficial to do transitional yr than PA. If you want to impress those attendings, you're better off impressing them as a transitional resident than PA, since they will get to see the work you do as a resident for them to better evaluate you as a candidate for their residency program.
     
  28. CVPA

    CVPA Senior Member
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    I can't believe I am actually saying this, but I agree with Papilloma.

    If you want to impress the attendings, you should do so while functioning in the capacity of a resident because after all, you are a resident, not a PA. Furthermore, I have never heard of a medical graduate being allowed to take an exam without going through an accredited program. I don't know of a state in this country that allows a non-NCCPA certified person to practice as a PA and I know for a fact that you can't sit for the NCCPA exam without attending a certified PA program.

    Good luck.
     
  29. PACtoDOC

    PACtoDOC 1K Member
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    I am still ignoring that guy because his frequency of worthwhile posts run the same %age as Kadafi's worthwhile worldly accomplishments!
     
  30. CVPA

    CVPA Senior Member
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    LOL!

    Not to deviate from the topic, but CNN was reporting that Kadafi is apparently joining the fight on terrorism. He kind of strikes me as the proverbial beaten dog that has become submissive to the will of his master.
     
  31. PACtoDOC

    PACtoDOC 1K Member
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    I call it the equivilant of a shotgun wedding!!
     
  32. joshmir

    joshmir Senior Member
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    CVPA-

    Papilloma-

    I agree with your advice. Unfortunately, where I am set to do my TY does not have an EM residency, NOR will they allow me to do away rotations. It's a community hospital in the middle of nowhere.

    If I re-apply after my TY year, and don't get in, re-apply with publications, and don't get in, you don't think the PA route would be the next best step? It's the only way I can think of to get the exposure that would mitigate my "average-on-paper" dilemma...

    WHat do you think?

    Thanks for your advice!
     
  33. PACtoDOC

    PACtoDOC 1K Member
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    I certainly don't mean to condescend, but I see you have 3 choices. None of them include anything to do with the PA profession. You can't imagine the paperwork involved with getting a PA license, and it would easily take the better part of a year to get that taken care of. Besides, if you aren't a primary care junkie, you might not pass the PA boards.

    1) Scrap your contract with your current TY slot and scramble into one in BFE wherever they have an EM residency.

    2) or, accept that you just might not have the credentials to get an EM slot, and do something else.

    3) do FP, and accessorize your experience to where you could easily get enough EM time to feel confident running an urgent care clinic or do rural EM after that.

    But stop considering the PA route because it will never work. Besides, you will never get hired as a PA in an ER even if you somehow got a license because these slots go to the best and brightest and experienced PA's with tons of paramedic, nursing, or critical care experience. You are SOL as a PA and judt forget that mess. You are a doctor for crying out loud, so work as one and take your lumps. Not everyone can match EM. There are about 30 people in my class who will be applying EM and about 10 might get it if the stars align perfectly. You can always do your TY now and reapply next year with stellar LOR's, but apply to MORE programs this time. Don't forget the 4 year programs if EM is really what you want to do.
     
  34. CVPA

    CVPA Senior Member
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    I really don't know enough about the logistics of a TY to know how feasible this is, so I will refrain from further comment.

    I do know that the PA route does not sound like a viable option, to me. First of all, I don't see how you will ever get licensed without going through a 2-year program. I just don't see that happening for you. Secondly and as PACtoDOC mentioned, even if you do somehow get a license as a PA, it doesn't mean that you are going to be able to just jump into an ED position somewhere that happens to have an EM residency program. PA EM positions are historically very competetive positions and almost exclusively are reserved for those with either EM experience or new graduates who have completed an EM PA residency.
     
  35. eddieberetta

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    Give us a break, please!
     
  36. PACtoDOC

    PACtoDOC 1K Member
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    Eddie,

    Are you saying that as a newly graduated physician (yesterday a 4th year!!!) that you could pass the PA boards? The PA boards are honestly much more like step III of the USMLE or even more like the FP boards scaled down. I doubt many interns could pass the PA boards because the exam is almost all primary care medicine but in greater detail than you learn in medical school. And considering most medical students despise the primary care material it makes for a challenge when it come to passing the exam. PA school is directed to making practitioners almost overnight, while medical school really doesn't make one ready for practice without residency. Its just a difference in the focus of the material. Relax Eddie, I am on your side here.....we're in the same boat.
     
  37. MacGyver

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    This coming from a fool who hasnt taken any of the Steps at all, much less the FP board exam. :laugh:
     
  38. emedpa

    emedpa GlobalDoc
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    florida had an option for a short time for md's(mostly fmg's) to take the pa boards but this no longer exists. the only way at the present time to become a pa is to go to pa school and pass the boards. as noted above, empa slots are very competitive. at my current job we have a stack of applications for folks wanting to work here and they all meet the minimum cut of at least 2 years as an empa plus acls/atls/pals. most have> 10 years experience. I had to work here per diem for 2 years before they offered me a spot. the last guy to leave(via retirement ) had been here for 18 years. there are plently of crap er fast track jobs out there for new grads but if one wants to do full scope em as a pa you have to put in the time and work your way up the food chain over years. have you thought about appling to a joint program em/peds or em/im? they have fewer applicants as they are longer programs, although they tend to want folks with some interest in doing academic em. good luck-e
     
  39. flighterdoc

    flighterdoc Rocket Scientist
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    LOL, with the traffic in the greater LA metroplex being as bad as it is (and will be worse in the future) I think I'd rather do a residency at Kern than Drew - it would take less travel time to see the family driving to Encino from Bakersfield than from Compton (during rush hour).

    I used to work in El Segundo - I left the office at 2:00 PM one day, and got home (to Santa Clarita) at 7:00 PM that night. No stops (except for gas), no road closures, just traffic. Lots, and lots, and lots of traffic. 55 miles, 5 hours.

    anyone wonder why I would prefer a "rural" program?
     
  40. flighterdoc

    flighterdoc Rocket Scientist
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    Not to mention everyone elses comments, but just how do you think you would get malpractice insurance? As a physician, you would ALWAYS be held to a higher standard of care than a PA, no matter what your "job title" said. This has been proven in court time and again with people "playing below their weight", nurses and paramedics as EMT's, for instance.
     
  41. eddieberetta

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    Medical school is very primary care/IM focussed. I would have score higher on the Step 3 if had taken it earlier (many states allow fresh docs to write it). Going out on a limb here... but I think most physicians could pass the PA boards (possibly with some prepatation, i.e. for the radiologists among us...) But I digress-- there is really no reason to do so.

    To the OP - a research year will be better from a match perspective. The other option of a TY will allow you to become (essentially) a GP after passing the S3 and getting a state licence -- no reason to be a PA.
     
  42. stoic

    stoic "Time you enjoy wasting, was not wasted"
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    I just looked on the scott and white medical center EM residency homepage (don't have the link, sorry). They see 66k patients a year in a 29 bed ER.

    I'm from Kansas. I've shadowed in a lot of ER's. The BIG ones here (major cities - Wichita, KC, and Topeka - aside) have 12 rooms and see about 25k per year. The small ER's are at hospitals where the ER has only on call physician coverage.

    Those who think S&W in Texas is rural need to do two things. The first is vist Kansas. The second is retake sociology 101.

    By the way, I'm a premed, this goes out to Mac and Pap. You guys need to stop making all of us premed's look like idiots. Opinionated, ignorant people like you two are the reason that so many people think all doc's are stuck up assholes.
     
  43. PACtoDOC

    PACtoDOC 1K Member
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    Davey, I am literally ready to give you the "best reply of the year" award for putting those guys in their place. Its great to hear the truth sometimes !!!
     
  44. PA_to_MD

    PA_to_MD Junior Member
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    I scored a 95 on Step II and an 85 on the PA recertification. The recert was a lot harder than Step II. Step I and the recert were nothing alike. I'm not sure what Step III will be like compared to the recert but I here it is pretty easy.

    My take on this discussion:
    1. A good student will keep trying to learn even after they finish school.
    2. Knowledge is not copyrighted by any profession.
    3. With increasing knowledge and experience, one becomes less concerned with differences in professions and more concerned with differences in individuals.

    As far as the original posters dilemma, it sounds as if he has already decided what to do.
     
  45. emedpa

    emedpa GlobalDoc
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    pa2md....it looks like i'm set then. I scored a 97 on the pa recert so I guess I only have to worry about that pesky mcat, getting into med school, and step 1.....
    in all seriousness, thanks for your post. I always figured the pa boards were basically step 2 and 3 combined. my class studied fp board books for the initial exam because we all figured if we could pass the fp boards we could pass the pa boards.....I guess we were right
     
  46. 12R34Y

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    just to clarify some facts for robswafford

    Kansas City....Truman (UMKC) sees 56,000/yr and is 29 beds and in 2 years will be 57 beds.

    KUMC.....sees 40,000/yr

    childrens in KC 50,000/yr

    12 beds and 25,000/yr is NOT what is seen in KC.

    suburbia (johnson county and northtown) all have at least 20 beds and see at least 25,000-30,000.

    i was a medic here for years and now am a student here also.

    just getting the numbers straight for robswafford.

    later
     
  47. stoic

    stoic "Time you enjoy wasting, was not wasted"
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    I know KC sees more than 25k a year in 12 beds. That's why I stated that KC, Wichita, and Topeka ASIDE a big ER in kansas sees those numbers.
     
  48. 12R34Y

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    gotcha. i must have just misread your post.

    no harm, no foul

    later
     

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