Med school vs. PA school...

[W19]

Interesting...j/c do you think the work ethic required to become a solid PA (top PA school into a competitive position like derm) is also sufficient to just pass (30th percentile ish) med school? Or is even just passing med school much harder?

There is no such stuff as PA derm in the true sense of derm like it is in the medical world... After getting your PA degree from any school, if you can find a derm practice to hire you, then you are a derm PA... I don't think doing a derm PA residency is a requirement to get a derm job; you just have to find a derm practice or physician that is willing to hire you. However, doing a PA derm residency will put you in better a position to get a derm job.

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[W19]

So you're saying PAs are closer to MDs than they are to NPs (pre-residency)? I thought PAs and NPs were suppose to be pretty interchangeable in the hospital?

@primadonna22274 is right about PA curriculum is closer to medicine. My cousin never had to take college chemistry/biology to become a NP. She just did an AS in nursing at a CC where they accepted her high school chemistry. Then she went on to do a 3-year BSN to NP...

 

[DermViser]

There is no such stuff as PA derm in the true sense of derm like it is in the medical world... After getting your PA degree from any school, if you can find a derm practice to hire you, then you are a derm PA... I don't think doing a derm PA residency is a requirement to get a derm job; you just have to find a derm practice or physician that is willing to hire you. However, doing a PA derm residency will put you in better a position to get a derm job.

You are correct. PAs do not do residencies and don't have their own Derm specialty boards to become board certified. If a PA wants to practice Derm, all they need to do is find a Derm practice that's willing to take them in.

 

[jsmith1]

You are correct. PAs do not do residencies and don't have their own Derm specialty boards to become board certified. If a PA wants to practice Derm, all they need to do is find a Derm practice that's willing to take them in.

Actually there are residencies for PAs available although they are not required as with MD/DO.

 

[Kahreek]

A well trained physician assistant is better than an attending physician, because the later just attends the situation while the former actually assists the patient.

 

[DermViser]

Actually there are residencies for PAs available although they are not required as with MD/DO.

Yes, I should say residencies are not required for PAs to practice, and I don't know of any PA Derm residencies that exist.

 

[MedWonk]

A well trained physician assistant is better than an attending physician, because the later just attends the situation while the former actually assists the patient.

 

[Priapism4tooLong]

NPs have much easier program compared to PAs/MDs. The hours aren't even close. Due to their degrees yes their jobs are interchangeable.

~50% of NPs failed step 3 when they were given a try.

I bet a lot more PAs would be able to pass step 3.

What? They don't take the steps

 

[DermViser]

What? They don't take the steps

The NPs took their own certification exam made by the NBME which was a modified USMLE Step 3. 50% failed it.

 

[Jabbed]

The NPs took their own certification exam made by the NBME which was a modified USMLE Step 3. 50% failed it.

How did that happen? I thought NPs were doctors too?

 

[boogaloo]

How did that happen? I thought NPs were doctors too?

Look, buddy. They don't want to be doctors. They just want to be called doctors. Know the difference, geez.

 

[jsmith1]

The NPs took their own certification exam made by the NBME which was a modified USMLE Step 3. 50% failed it.

Was this a recent event? What happened to the ones that passed? Did they get paid more or something? 50% isn't that terrible especially considering they never took Step 1/Step 2 which certainly would have helped.

 

[DermViser]

How did that happen? I thought NPs were doctors too?

Yes doctors (since they have a "doctorate") who can't even pass their own certification exam. Ironically enough after that disaster, they put out a statement saying that requiring a certification exam is an unneeded barrier to their practice. Meanwhile the medical profession is trying to put the screws in even further on doctors - where no amount of hoops we jump thru is enough.

 

[DermViser]

Was this a recent event? What happened to the ones that passed? Did they get paid more or something? 50% isn't that terrible especially considering they never took Step 1/Step 2 which certainly would have helped.

Step 1 and 2 have nothing to do with Step 3 though. It was a watered down version of Step 3 - http://www.nbme.org/pdf/nbme-development-of-dnp-cert-exam.pdf

No, it was more a testing out of things as the DNP people were interested (initially) in coming up with a DNP certification exam.

 

[hallowmann]

NPs have much easier program compared to PAs/MDs. The hours aren't even close. Due to their degrees yes their jobs are interchangeable.

~50% of NPs failed step 3 when they were given a try.

I bet a lot more PAs would be able to pass step 3.

To be fair it was a shortened and easier version of Step 3... wait...

Yes doctors (since they have a "doctorate") who can't even pass their own certification exam. Ironically enough after that disaster, they put out a statement saying that requiring a certification exam is an unneeded barrier to their practice. Meanwhile the medical profession is trying to put the screws in even further on doctors - where no amount of hoops we jump thru is enough.

I think its hilarious that it started as a way for NPs to show how equivalent they are to physicians by taking a watered down Step 3, and turned into a "plot" by physicians to discredit NPs.

 

[DermViser]

I think its hilarious that it started as a way for NPs to show how equivalent they are to physicians by taking a watered down Step 3, and turned into a "plot" by physicians to discredit NPs.

Yes, funny how their tune changed when 50% failed. I guess actual accountability is too much to ask. I can't wait till their malpractice shoots thru the roof once they can't rely on physicians to take the rap.

 

[IlDestriero]

And don't forget that step 3 is the one that nobody even studies for. (2 months, 2 weeks, #2 pencil)
The only studying I did was the 15 min tutorial for the computer based test.

 

[AnonymousD.O.]

I remember a PA told me that PA school is med school in 2 years minus residency. After being in med school right now for 2+ months (still a premed ), I have more respect for PA than I ever had... We covered biochem in depth (pathways, enzymes, and diseases etc..) in 1 month and Genetics in a little over a week... Many of my classmates could not not wait for that block to end since most of us were exhausted because we were on study/exams mode constantly... If the didactic portion of PA school is only a year, how can they cover so much materials (biochem, genetics, histology, physiology, gross anatomy, neuroanatomy, behavioral science, pharm, pathology, etc...) in such a short time frame? Even if they might water down some of these classes a little bit, I just can't imagine what PA students go thru....

Do PA's get a Pathology class? If not that's pretty sad

 

[W19]

Do PA's get a Pathology class? If not that's pretty sad

I think they do...

 

[AnonymousD.O.]

I think they do...

So I googled a random one http://www.pennstatehershey.org/web/educationalaffairs/paprogram/curriculum and it looks like they do. I would love to know though how involved it is. Don't know if it really matters as far as practice but it's a big difference I would think

 

[W19]

So I googled a random one http://www.pennstatehershey.org/web/educationalaffairs/paprogram/curriculum and it looks like they do. I would love to know though how involved it is. My gripe with PAs is that they just don't get quite the extensive overview of the diseases that one gets in Med School, so they aren't even on their differential. I'm just a little 2nd year pion but from my knowledge a lot of times the PAs are the ones taking the history etc. in offices, and would be missing the tough diagnosis. But what do I know

That is why they are PA--not MD/DO... If you have a grip with PA, google a NP curriculum and compare it with PA. It's scary! As I said before (post #52), my cousin graduated NP without taking gen chem, biology ect... The system is what it is now and physicians have to navigate thru it...

 

[jsmith1]

And don't forget that step 3 is the one that nobody even studies for. (2 months, 2 weeks, #2 pencil)
The only studying I did was the 15 min tutorial for the computer based test.

Is the 2 mos. referring to Step 1 and 2 weeks referring to Step 2? Do people really only need 2 weeks for Step 2?

I was talking to someone in a more "chill" residency (i.e psych, pmr, EM) and they suggested that Step 1/COMLEX 1 was the hardest part of their career. For someone shooting for one of these slightly more laid back residencies, is Step 1 the greatest and most stressful barrier to becoming a doctor?

 

[IlDestriero]

Yes. 2 weeks for step 2.
No. Step 1 just covers a ton of detail that requires dedicated review.
The biggest barrier to medical school is probably the MCAT.

 

[jsmith1]

Yes. 2 weeks for step 2.
No. Step 1 just covers a ton of detail that requires dedicated review.
The biggest barrier to medical school is probably the MCAT.

Ya I totally agree that the biggest barrier to becoming a physician in general is the MCAT since you need to be in at least the 75th percentile to even have a decent shot at med school. Im talking more from the perspective of a 30 yr old attending fresh out of residency. When a new psychiatrist looks back at his rigorous training, would he see Step 1 as the most stressful time in his career?

Obvs. there is a lot of variability in psych and Im sure many work 80+ hrs a week + research but Im talking about someone working 45 hrs a week that is not married to their job.

 

[Psai]

Is the 2 mos. referring to Step 1 and 2 weeks referring to Step 2? Do people really only need 2 weeks for Step 2?

I was talking to someone in a more "chill" residency (i.e psych, pmr, EM) and they suggested that Step 1/COMLEX 1 was the hardest part of their career. For someone shooting for one of these slightly more laid back residencies, is Step 1 the greatest and most stressful barrier to becoming a doctor?

Well step 2 is becoming more important so I think that many people are taking around a month to study for it

 

[IlDestriero]

That's difficult to say. I went to a good school and did pretty well. I expected to do well on the steps and didn't view them as a barrier to my career options. I didn't study full time for 2 months though. I was doing other things over the summer. Much more fun things, and some not so fun things. LOL.
For someone at a DO school or a average to below averge MD student dreaming about matching in a competitive specialty, I imagine it is very stressful. The score can make or break your chances. It can be frightening to realize that doing poorly on this one time test could eliminate many potential career choices, or at least make them much more difficult to pursue.

 

[jsmith1]

That's difficult to say. I went to a good school and did pretty well. I expected to do well on the steps and didn't view them as a barrier to my career options. I didn't study full time for 2 months though. I was doing other things over the summer. Much more fun things, and some not so fun things. LOL.
For someone at a DO school or a average to below averge MD student dreaming about matching in a competitive specialty, I imagine it is very stressful. The score can make or break your chances. It can be frightening to realize that doing poorly on this one time test could eliminate many potential career choices, or at least make them much more difficult to pursue.

Interesting... so how about for someone at a DO school or a average to below average MD aiming for a noncompetitive specialty? How much easier would you say it is to score a 210 vs a 220+?

 

[Mass Effect]

Ya I totally agree that the biggest barrier to becoming a physician in general is the MCAT since you need to be in at least the 75th percentile to even have a decent shot at med school. Im talking more from the perspective of a 30 yr old attending fresh out of residency. When a new psychiatrist looks back at his rigorous training, would he see Step 1 as the most stressful time in his career?

Obvs. there is a lot of variability in psych and Im sure many work 80+ hrs a week + research but Im talking about someone working 45 hrs a week that is not married to their job.

I haven't taken Step 3 yet, but I would agree that Step 1 is the most stressful part of med school (and I wasn't gunning for anything competitive -- I had it narrowed down to psych, neuro, or IM at that point). Step 2 was much better because studying for the shelf exams all year made Step 2 review painless. I studied about 2 months for Step 1 and three weeks for Step 2.

 

[IlDestriero]

A higher score will still help you match at a better program or at a better location.
I'd pick Boston, DC and San Diego over Detroit, Kansas City and El Paso every day and twice on Sunday.
The best programs and locations in any field will be competitive.

 

[Yadster101]

I haven't taken Step 3 yet, but I would agree that Step 1 is the most stressful part of med school (and I wasn't gunning for anything competitive -- I had it narrowed down to psych, neuro, or IM at that point). Step 2 was much better because studying for the shelf exams all year made Step 2 review painless. I studied about 2 months for Step 1 and three weeks for Step 2.

Im really interested in psych and I would not mind living in slightly less desirable locations (like St. Louis). For someone below avg (still passing) that studies 8+ hrs a day, how much effort would be required to just pass Step 1 with like a 210? Could I study for 4 weeks and pass?

Also weren't you more stressed in 3rd year when you had to study for shelf exams along with doing your rotations? Especially in surgery? Is it less common to fail a rotation/shelf exam than it is to fail an exam in year 1/2?

 

[W19]

Yes. 2 weeks for step 2.
No. Step 1 just covers a ton of detail that requires dedicated review.
The biggest barrier to medical school is probably the MCAT.

I agree 100% with this statement... Once you get into US med school, you probably have a 95% chance of becoming a physician... For some reason they don't want students to fail; they make available to you all the resources you need to help you graduate.

 

[DermViser]

That's difficult to say. I went to a good school and did pretty well. I expected to do well on the steps and didn't view them as a barrier to my career options. I didn't study full time for 2 months though. I was doing other things over the summer. Much more fun things, and some not so fun things. LOL.
For someone at a DO school or a average to below averge MD student dreaming about matching in a competitive specialty, I imagine it is very stressful. The score can make or break your chances. It can be frightening to realize that doing poorly on this one time test could eliminate many potential career choices, or at least make them much more difficult to pursue.

THIS.

 

[DermViser]

I agree 100% with this statement... Once you get into US med school, you probably have a 95% chance of becoming a physician... For some reason they don't want students to fail; they make available to you all the resources you need to help you graduate.

The reason being they lose tuition dollars and you lose everything invested. Doesn't mean anything.

 

[W19]

The reason being they lose tuition dollars and you lose everything invested. Doesn't mean anything.

Actually it means something... We don't have to be too cynical here... A lot of things about med school can be changed, but in that aspect, they do a good job to make sure their students succeed.

 

[Yadster101]

The reason being they lose tuition dollars and you lose everything invested. Doesn't mean anything.

What are these crazy extra resources everyone talks about? All I know is that you can remediate and tutors are available...If you fail remediation then you are out

 

[Priapism4tooLong]

Somehow so many threads get diverted to discussing the boards lol.

They aren't all that bad.

 

[DermViser]

Actually it means something... We don't have to be too cynical here... A lot of things about med school can be changed, but in that aspect, they do a good job to make sure their students succeed.

Again, medical schools are invested in you to succeed the farther you progress in the curriculum. In fact an argument has been made by some that medical schools are reluctant to fail out students who really shouldn't be graduating to begin with. Your medical school can pass you all it wants, but it's utterly useless without a residency.

 

[DermViser]

What are these crazy extra resources everyone talks about? All I know is that you can remediate and tutors are available...If you fail remediation then you are out

Depends on the school, some that allow u several times to remediate.

 

[W19]

Again, medical schools are invested in you to succeed the farther you progress in the curriculum. In fact an argument has been made by some that medical schools are reluctant to fail out students who really shouldn't be graduating to begin with. Your medical school can pass you all it wants, but it's utterly useless without a residency.

Once you graduate from a US school and you pass the board(s), you will find something in FM/Psych/IM somewhere (maybe that somewhere might be in the middle of nowhere)...

 

[DermViser]

Once you graduate from a US school and you pass the board(s), you will find something in FM/Psych/IM somewhere (maybe that somewhere might be in the middle of nowhere)...

That's the case now. Not when the number of US med school graduates exceeds the number of residency positions.

 

[Mass Effect]

Im really interested in psych and I would not mind living in slightly less desirable locations (like St. Louis). For someone below avg (still passing) that studies 8+ hrs a day, how much effort would be required to just pass Step 1 with like a 210? Could I study for 4 weeks and pass?

Also weren't you more stressed in 3rd year when you had to study for shelf exams along with doing your rotations? Especially in surgery? Is it less common to fail a rotation/shelf exam than it is to fail an exam in year 1/2?

It all depends on how much information you retain, but if you're at a US MD school, passing all your classes, yes, you can easily study for 4 weeks and pass the boards if your goal is simply passing.

What are these crazy extra resources everyone talks about? All I know is that you can remediate and tutors are available...If you fail remediation then you are out

Some schools provide more than others. It's not standardized.

Once you graduate from a US school and you pass the board(s), you will find something in FM/Psych/IM somewhere (maybe that somewhere might be in the middle of nowhere)...

Tell that to those looking for off-cycle spots. Also, not everyone is aiming for FM/Psych/IM. If your goal is to go into anesthesia, you may not be satisfied with going into IM instead. Board scores are crucial.

 

[W19]

Tell that to those looking for off-cycle spots. Also, not everyone is aiming for FM/Psych/IM. If your goal is to go into anesthesia, you may not be satisfied with going into IM instead. Board scores are crucial.

We are not living in a perfect world here. At the end of the day some people have to be honest with themselves; If you had to remediate multiple times in med school and you got 200 in step1, you gotta be somewhat realistic that primary care and psych might be the only specialties available to you...

 

[W19]

That's the case now. Not when the number of US med school graduates exceeds the number of residency positions.

I agree... With the expansion of MD/DO, it might not take that long for med school graduates to surpass GME spots... That's why I think going to carib now is riskier than ever.

 

[DermViser]

I agree... With the expansion of MD/DO, it might not take that long for med school graduates to surpass GME spots... That's why I think going to carib now is riskier than ever.

It's ALWAYS been risky.

 

[W19]

It's ALWAYS been risky.

25 years ago it wasn't according to a SGU graduate who got in there with 2.6 GPA, failed step1 once and still got an IM spot and did an ID fellowship... Now once you fail step1 as a carib student, your chances of finding a residency spot is almost ZERO.

 

[DermViser]

25 years ago it wasn't according to a SGU graduate who got in there with 2.6 GPA, failed step1 once and still got an IM spot and did an ID fellowship... Now once you fail step1 as a carib student, you chances of finding a residency spot is almost ZERO.

25 years ago, fee-for-service was just getting rolling as a reimbursement mechanism. If it gives you any idea, 25 years ago, the average Step 1 score was 200.

 

[Yadster101]

25 years ago, fee-for-service was just getting rolling as a reimbursement mechanism. If it gives you any idea, 25 years ago, the average Step 1 score was 200.

@W19
You guys having this discussion makes me feel like the hardest part about becoming a doctor is just passing the first 2 years and passing Step 1. I mean if a guy with a 2.6 GPA could do it from SGU then the M1/M2 + Step 1 must be the greatest real hurdle for someone going into a noncompetitive specialty.

Obvs not saying that this is a good idea since we should all strive to be the best physicians we can be for our patients and also there are obvs many extremely hardworking ppl in psych, IM, FM, etc. I just kind of realized though that for many ppl that just want to be FM docs and have a life outside, Step 1 may be the worst of it. Right?

 

[W19]

@W19
You guys having this discussion makes me feel like the hardest part about becoming a doctor is just passing the first 2 years and passing Step 1. I mean if a guy with a 2.6 GPA could do it from SGU then the M1/M2 + Step 1 must be the greatest real hurdle for someone going into a noncompetitive specialty.

Obvs not saying that this is a good idea since we should all strive to be the best physicians we can be for our patients and also there are obvs many extremely hardworking ppl in psych, IM, FM, etc. I just kind of realized though that for many ppl that just want to be FM docs and have a life outside, Step 1 may be the worst of it. Right?

From talking a 2 third-year students, they said some of these rotations can be soul crushing... At the same time, these two are already looking forward to starting residency. Therefore, they know the chances for them of becoming physicians after passing step1 are 99.99%. You are right that the first 2 years and step1 might be biggest hurdle in that process.

 

[W19]

Yes, funny how their tune changed when 50% failed. I guess actual accountability is too much to ask. I can't wait till their malpractice shoots thru the roof once they can't rely on physicians to take the rap.

I still don't get why physicians have to take the rap... If it is so, there is no way I would hire a NP if /when I become a physician assuming that I got my own practice. They are working under their license, so why physicians have to take the fall when they screw up?

 

[Priapism4tooLong]

Derailing the thread for one sec, had to share

Patient x - 250 lbs, 5'8,

x - "doc do you think its a good idea driving down to DC next weekend with the family?"

me - "what do you mean?"

x - "with the ebola out break down there and everything?"

.....

he's one candy bar away from being diabetic and he's worried about ebola haha, oh man i love patients.