New idea for NP/PA to MD

[FutureDoc4]

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Thanks for your response. If I did not respect MD education, it would also mean I didn't respect PA education since PA programs are based on MD programs. My saying that PA programs are great does not mean I do not think the same of MD programs.

By the way, I also noticed that you had bolded my statement about PAs having as many classroom hours as MD students. During the 16 continuous months of the PA didactic curriculum, PA students accumulate as many classroom/lab hours as the MD students in their 20 non-continuous months didactic curriculum. But maybe it's just my school that does this. Do any other PA programs go to class from 8-5 everyday and have an association with a MD/DO program that is in class from 8-3 everyday?



You mean other issues such as drugs (isotretinoin), infections, immune-responses, sun-exposure, dehydration, B12 deficiency and iron deficiency.

PA students are also expected to come up with a DDx laundry list for each case.



MD/DO program graduates who do not enter a residency likely won't have a license to practice medicine. Thus, they are not permitted to work as a mid-levels. You'll either have to hire a PA, NP or a licensed physician.


Yes, if you're referring to cozying-up with PAs. Whenever NP organizations lobby for a bill giving them greater practice rights, PA organizations are right there to lobby against it. PA organizations spend a large amount of time and effort blocking NPs from expending their scope of practice.

Your "compliment" of medical education is a backhanded attempt at showing that the MD/PA years are equivalent.... which they are not (anyone familiar with both curriculum can see that--both in the basic science/clinical years)

The fact that you cannot just make the statement:

"I respect MDs education is more in-depth than my own, and I respect our different levels of care and responsibility. We both have important but distinct roles"

speaks volumes to your to viewpoint.

As evidenced above in your post #201

QUOTE "PAs are medical professionals and they are expected to practice medicine at the same level of safety and quality as physicians. Therefore, they are taught at the same level"

If they are taught at the same level, why do we have have two different degrees? Aren't they the same thing than?

Before, you try and "point put" my ignorance on PA education.... we have a PA school at my medical school as well... and I have a pretty good understanding of PA education.

 

[Dr Oops]

Whoa! This isn't about giving MD students a PANCE review. Where did I say that? I didn't. So I don't know where you pulled that statement from. Here's what I said...



First of all, most PAs don't want to take the USMLE. They don't want to do a residency, and they don't want to be physicians. PAs want to be PAs. And the ONLY way to be a PA is to go to PA school. That's why they go to PA school. So there's really no reason to be hostile and defensive towards PAs.

Secondly, regarding this little gem...



Maybe you didn't pay attention to my previous posts. I'm in a school with both MD and PA programs. PAs are in some of the very same classes with the MD students. So yes, I do know a few things about the education of both professionals. And despite being in different programs, PA students do occasionally study with MD students and compare knowledge--it suffices to say that PAs know their medicine.

I review the USMLE books (Step 1 and Step 2). All the PAs at my school do. And nothing in those books have caught us off-guard. So you can sit at your computer and tell me how much I'm making a fool of myself and the PA profession by claiming to be learning things such as "medicine" (*gasp*), but that doesn't change the fact that PAs are medical professionals and they are expected to practice medicine at the same level of safety and quality as physicians. Therefore, they are taught at the same level.

if you were really so intimately involved w/ the education the medical students are undergoing you would know there s no way to shorten it and still know everything we need to be responsible for.

we also have a P.A. program at my School, they do not take the same classes as us

 

[Dwindlin]

but that doesn't change the fact that PAs are medical professionals and they are expected to practice medicine at the same level of safety and quality as physicians. Therefore, they are taught at the same level.

I am sorry but the bolded portions are just wrong. PA's are expected to practice at the level of a PA and are thus educated at that level. No matter how much you say otherwise MD education in both preclinical and clinical far out weigh that of PA's, though at this point I would imagine no one will convince you otherwise...

 

[core0]

I am sorry but the bolded portions are just wrong. PA's are expected to practice at the level of a PA and are thus educated at that level. No matter how much you say otherwise MD education in both preclinical and clinical far out weigh that of PA's, though at this point I would imagine no one will convince you otherwise...

Actually if you do any expert witness testimony, the first bolded part is correct, the second point is a matter of opinion, but wrong for a number of reasons in my opinion.

Physicians and PAs operate under different types of licenses, but essentially the same standards. The scope of a physician is technically all of medicine and surgery in most states. In reality the scope and practice parameters are defined by a physicians training. A cardiologist would be judged by the standards of care by cardiologists in the community. They would not be judged by the standard of care of an orthopedist unless they did something silly like tried to manage a fracture.

On the other hand if there is overlap in scope of practice then the standard of care of the physicians specialty trumps everything else in theory. For example if the treatment of minor fractures is considered within the training and scope of an EM physician, then the standard of care would be that of EM not ortho. You see this in missed fractures for example, where the expert witness for the plaintiff would be an EM physician not a radiologist or an orthopod. YMMV here depending on the local court.

For a PA the dependent part of the license in most states refers to the scope of practice. In most states the scope of practice is determined by what the supervising physician is willing to do and what is within the scope of practice of the physician. For example if I know how to put in central lines, but work for a physician who does not put in central lines and is not credentialed to put in central lines then it would be outside my scope of practice to put them in since its outside the supervisory capabilities of the supervising physician. Since my scope of practice is determined by the supervising physician, the standard of care is the same as would be applied to the supervising physician if they had done the care.

The key here is how the parties are supposed to get to the standard of care. The physician is supposed to achieve the standard of care through mostly through the training they receive in residency. Ie residency is supposed to produce a physician capable of practicing at the minimum community standard of care. PAs are trained in general medicine. They achieve the standard of care by a combination of general medical training, post graduate training (if any), on the job training, and input from their supervising physician.

For example, older studies showed that a PA could autonomously handle approximately 85% of the cases which presented to a family practice office. Their training as PAs would allow them to identify and treat 85% of the presentations, for the other 15% they were supposed to identify and seek additional input from their supervising physician. Either way the standard of care was that of a family practice physician (in this case).

There is some additional recent case law that discussed PA practice and was quoted to show that a PA does not practice at the same standard of care as a physician. However, close examination of the rulings, showed that the decision stated that a physician could not testify about the standard of care of PA practices unless they were familiar with PA practice.

This is probably the principle reason that attempts to use FMGs to practice as PAs. While physicians are taught independent practice in a graduated manner, PAs are taught PA practice and the use of a collaborative environment to achieve the standard of care.

 

[ARAI]

The fact that you cannot just make the statement:

"I respect MDs education is more in-depth than my own, and I respect our different levels of care and responsibility. We both have important but distinct roles"

I respect that the full-MD education, inclusive of a residency, is much more in-depth than that of a PA's. I understand and respect our different levels of responsibility. We both have important roles and our goal of quality patient care is a shared endeavor.

If they are taught at the same level, why do we have have two different degrees? Aren't they the same thing than?

Have you ever taken a class during your undergrad days where there were also graduate students taking the same class, but receiving graduate credit. Same level, different degree. This happened to me in my Genetics class during undergrad. It happens in PA/MD shared classes too.

if you were really so intimately involved w/ the education the medical students are undergoing you would know there s no way to shorten it and still know everything we need to be responsible for.

I'm sure you can shorten MD programs and still squeeze a lot of the same information out of them. Try cutting out summer breaks, spend more time in lecture each day, and drop the 4th year. Voila! That's PA school in a nutshell.

we also have a P.A. program at my School, they do not take the same classes as us

Perhaps you're in a DO program. PA don't study osteopathic medicine. They study allopathic medicine. I only know of one PA program that puts their students in classes with DO students.

I am sorry but the bolded portions are just wrong. PA's are expected to practice at the level of a PA and are thus educated at that level. No matter how much you say otherwise MD education in both preclinical and clinical far out weigh that of PA's, though at this point I would imagine no one will convince you otherwise...

PAs graduate with a comparable knowledge. PAs coming straight out of school go into PA residencies. PA residency = the first year of an MD residency. Do you really think Residency Directors would let a PA enter the first year of a residency alongside MD graduates if his/her education was "far outweighed" by that of an MD grad. No, they wouldn't.

And by the way, PAs are ultimately EXPECTED to deliver medical care (within their scope of practice) at the same level of quality and safety as a physician.

 

[Dr Oops]

Have you ever taken a class during your undergrad days where there were also graduate students taking the same class, but receiving graduate credit. Same level, different degree. This happened to me in my Genetics class during undergrad. It happens in PA/MD shared classes too.

Cant say that I have, but usually in those cases the grad student is required to know the subject much more in depth.

In college I learned how the kidney worked, but in med school I learned things about the specifics that you could leave out and still understand the big picture and how they pertain to the function of the body.

I'm sure you can shorten MD programs and still squeeze a lot of the same information out of them. Try cutting out summer breaks, spend more time in lecture each day, and drop the 4th year. Voila! That's PA school in a nutshell.

bullsh*t.

Perhaps you're in a DO program. PA don't study osteopathic medicine. They study allopathic medicine. I only know of one PA program that puts their students in classes with DO students.

I was wondering why i never saw any PAs in my voodoo classes.

PAs graduate with a comparable knowledge. PAs coming straight out of school go into PA residencies. PA residency = the first year of an MD residency. Do you really think Residency Directors would let a PA enter the first year of a residency alongside MD graduates if his/her education was "far outweighed" by that of an MD grad. No, they wouldn't.

Yes, because thats the whole point. The Physician assitant degree is meant to be an ancillary practitioner to help increase the amount of patients seen. They do not need to be trained to the level of a physician, thats part of the appeal of being a PA, you dont have to spend several years training.

As far as I know PAs who do residencies arent all that common.

I must be pretty stupid if i takes me 4 years to learn a comparable amount of information to your 2 years.

And by the way, PAs are ultimately EXPECTED to deliver medical care (within their scope of practice) at the same level of quality and safety as a physician.

Your statments seem to negate the bolded as if PAs are just doctor-lite.

While I think PA education is much better than NP education it is still geared toward a mid level provider. Its not just a faster version of medical school sans residency.

 

[Starpower]

Arai, remember that medicine is a group effort. Keep your eyes on the patient.

 

[Dwindlin]

Actually if you do any expert witness testimony, the first bolded part is correct, the second point is a matter of opinion, but wrong for a number of reasons in my opinion.

I disagree. A PA's scope can be very limited, and I think that qualifies as not the same level of practice of that of a physician. And no matter how broad the scope, PA's DO NOT have an unrestricted license. Your point is well taken, but that is why I did not bold the safe/competent part of his post. I agree that both provider are expected to be safe/competent is absolutely true, but I think it is false to say they practice at the same level.

 

[ARAI]

bullsh*t.

If I told you that PAs learn how to hold use a stethoscope in PA school, would you call BS then too?

I was wondering why i never saw any PAs in my voodoo classes.

If a PA student is at a university that has a college of osteopathic medicine and wants to learn osteopathic manipulations, he or she can probably find someone to teach them, but it's not part of the PA-training.

And PAs do not look down on DO students as practicing some lesser form of medicine than MDs. The reason they don't share classes has to do with the PA programs being housed in a separate college from the college of osteopathic medicine.

Yes, because thats the whole point. The Physician assitant degree is meant to be an ancillary practitioner to help increase the amount of patients seen. They do not need to be trained to the level of a physician, thats part of the appeal of being a PA, you dont have to spend several years training.

Maybe PAs don't need to be trained at the same level, but due to our sue-happy nation and the demand of better medical education, PA programs have become more rigorous and more competitive. So while PAs probably don't need to be trained at the same level, that doesn't mean they aren't.

As far as I know PAs who do residencies arent all that common.

They aren't that common. There are probably only 200 or so PA residency slots available per year.

I must be pretty stupid if i takes me 4 years to learn a comparable amount of information to your 2 years.

No, you're not stupid. PAs are just incredibly smart and diligent. 😛

But it's true that medical school could be shortened. Cutting out the 4th year drops MD program length down to 32 months. A PA program is 27 months by comparison. Take your first year of medical school and make it 7 months instead of 9 or 10 months. On top of current pre-reqs, require past health care experience and also require that students take Anatomy, Physiology, Microbiology and Genetics before coming to school so that they come into accelerated basic medical science courses with some background knowledge. Finally, go to class 8-5, every single day. Attendance required. There! I've just condensed the heart of medical school into 30 months.

Now, in some of the basic science classes, MD/DOs are required to know more minutia than PAs. But any MD/DO will tell you that they forget that stuff right after they finish Step 1. I've recently asked some practicing docs regarding all that minutia. The answer is almost always along the lines of "you don't really need that stuff unless it's required for a specialty. And even then, you probably don't need it."

Your statments seem to negate the bolded as if PAs are just doctor-lite.

Doctor-lite? Interestingly, I've heard PAs casually referred to as "junior doctors." I'm not sure how I feel about that term, although both this and the term "physician associate" convey a similar meaning.

Regardless, adding "within their scope of practice" to the statement is relevant to PAs and Physicians. A emergency medicine physician will not be expected to treat pituitary gland disorders as well as a PA who specializes in endocrinology.

PA education...is still geared toward a mid level provider. Its not just a faster version of medical school sans residency.

I completely agree. And I'm not arguing with you. So don't get mad at PAs if their programs provide them with a comparable knowledge. It's not the PA students' fault that the standards have been set so high. PAs just want to add as much benefit to the care team as possible. If that means studying one's butt off to learn as much as possible, so be it.

 

[Dwindlin]

PAs graduate with a comparable knowledge. PAs coming straight out of school go into PA residencies. PA residency = the first year of an MD residency. Do you really think Residency Directors would let a PA enter the first year of a residency alongside MD graduates if his/her education was "far outweighed" by that of an MD grad. No, they wouldn't.

And by the way, PAs are ultimately EXPECTED to deliver medical care (within their scope of practice) at the same level of quality and safety as a physician.

Comparable. Not the same level. And I am afraid that PA residency = internship, this is again just wrong. And as above I won't argue that you're expected to provide safe, competent care, but its care at your scope, not the physicians.

 

[Denatured]

Interestingly, I know of one school where the med students take the computer based gross anatomy and the PA students take the cadaver gross anatomy. Before they switched to this, the cadaver gross anatomy for the med students and the PA students was taught by a neurosurgical PA.

 

[silas2642]

If I told you that PAs learn how to hold use a stethoscope in PA school, would you call BS then too?


If a PA student is at a university that has a college of osteopathic medicine and wants to learn osteopathic manipulations, he or she can probably find someone to teach them, but it's not part of the PA-training.

And PAs do not look down on DO students as practicing some lesser form of medicine than MDs. The reason they don't share classes has to do with the PA programs being housed in a separate college from the college of osteopathic medicine.



Maybe PAs don't need to be trained at the same level, but due to our sue-happy nation and the demand of better medical education, PA programs have become more rigorous and more competitive. So while PAs probably don't need to be trained at the same level, that doesn't mean they aren't.



They aren't that common. There are probably only 200 or so PA residency slots available per year.

No, you're not stupid. PAs are just incredibly smart and diligent. 😛

But it's true that medical school could be shortened. Cutting out the 4th year drops MD program length down to 32 months. A PA program is 27 months by comparison. Take your first year of medical school and make it 7 months instead of 9 or 10 months. On top of current pre-reqs, require past health care experience and also require that students take Anatomy, Physiology, Microbiology and Genetics before coming to school so that they come into accelerated basic medical science courses with some background knowledge. Finally, go to class 8-5, every single day. Attendance required. There! I've just condensed the heart of medical school into 30 months.

Now, in some of the basic science classes, MD/DOs are required to know more minutia than PAs. But any MD/DO will tell you that they forget that stuff right after they finish Step 1. I've recently asked some practicing docs regarding all that minutia. The answer is almost always along the lines of "you don't really need that stuff unless it's required for a specialty. And even then, you probably don't need it."



Doctor-lite? Interestingly, I've heard PAs casually referred to as "junior doctors." I'm not sure how I feel about that term, although both this and the term "physician associate" convey a similar meaning.

Regardless, adding "within their scope of practice" to the statement is relevant to PAs and Physicians. A emergency medicine physician will not be expected to treat pituitary gland disorders as well as a PA who specializes in endocrinology.


I completely agree. And I'm not arguing with you. So don't get mad at PAs if their programs provide them with a comparable knowledge. It's not the PA students' fault that the standards have been set so high. PAs just want to add as much benefit to the care team as possible. If that means studying one's butt off to learn as much as possible, so be it.

Your Napoleon complex continues to fascinate me-- I don't see how an MD education could possibly be shortened from four years (I believe that Duke does have an abbreviated curriculum for the pre-clinical years, but those med students are kind of a different breed): medical knowledge doubles approximately every 8 years and continues to grow at an exponential rate.

While I will say that traditional med school curriculum is generally not the most efficient, I think that you'll also find that the vast majority of US allopathic schools have responded to this and adjusted their curriculums appropriately to "catch-up" with the 21st century.

The fact of the matter is you're going to be a PA who works under the supervision of an MD/DO, particularly when you're green. You'll be a crucial member of the team who will be able to deal with more complex cases as time goes on, but you'll also never function at the level of an attending. You just won't have the training. I've seen PA's with 30 years of experience who still say on rounds, "I'm not sure, we'll have to ask the attending." That's just the nature of the training for PA's vs. MD's-- you see more as an MD and the training is far more intense and intensive.

I don't understand why you feel like you have to get out the measuring stick everytime someone suggests that physician training is somehow more extensive than PA training-- no one is saying that you in particular "didn't have what it takes" to make it as an MD. They're two very different fields with different sets of responsibilities. Period.

 

[deleted6669]

LECOM now has a 3 yr pa to do bridge program.
there is also a texas med school going to a 3 yr curriculum next yr.
cut out a bunch of 4th yr fluff and 3 yrs is very doable. there is a current thread in clinical rotations about guys who have done very little except vacation all of 4th yr...
http://forums.studentdoctor.net/showthread.php?t=778460
one of my attendings spent 6 mo of 4th yr backpacking in the himalayas. he got credit for that as an "international medicine rotation" because he stopped at village clinics for a day or 2 here and there.

 

[Starpower]

You'll be a crucial member of the team who will be able to deal with more complex cases as time goes on, but you'll also never function at the level of an attending. You just won't have the training. I've seen PA's with 30 years of experience who still say on rounds, "I'm not sure, we'll have to ask the attending."

No. While I understand that you most likely did see such an occurrence, that doesn't make it rote. You obviously don't know as much about PAs as you think you do. There are PAs who operate independently (while still maintaining the review requirements). emedpa is one of them, he often flies solo ER. There are also a few PAs who own their own practices (again, while still maintaining review requirements). Further, your assumption that being a MD or DO automatically means that you know everything there is to know, is extremely misguided. I've seen attendings confer with one another, and that certainly has nothing to do with their training.

 

[deleted6669]

EVERYBODY gets consults as it is impossible to know all of medicine. hopefully a physician, pa, or np working in the same specialty for a long time will learn most of the intricacies of that specialty but that does not exempt them(regardless of level of training) from getting the opinions of others on occasion. as a new grad I asked my attendings LOTS of questions. now I ask them a lot fewer and the common response is :" I don't know that either, talk to the xyz specialist and let me know what they say". my em group has used pa's for over 20 yrs. we have a strong group of clinicians and it is not uncommon to see pa's being asked questions by physicians in our group(about as often as we ask them). our pa group makes the physician partners around 3 million dollars/yr even after we get all of our salary/benefits/production bonuses so they are very happy to have us around.
many of the subspecialty groups at my facility use pa's so often when you call for a consult a pa comes and does it and only calls their attending if it is really unusual. they are on the hospitalist, trauma/critical care, neuro, ortho, gen surg, cardiology and IR services.

 

[Denatured]

LECOM now has a 3 yr pa to do bridge program.
there is also a texas med school going to a 3 yr curriculum next yr.
cut out a bunch of 4th yr fluff and 3 yrs is very doable. there is a current thread in clinical rotations about guys who have done very little except vacation all of 4th yr...
http://forums.studentdoctor.net/showthread.php?t=778460
one of my attendings spent 6 mo of 4th yr backpacking in the himalayas. he got credit for that as an "international medicine rotation" because he stopped at village clinics for a day or 2 here and there.

Lecom has actually decreased the didatic time to 20 months in their 3 year primary care track, as a matter of fact. Less than the typical PA program. I'm sure they still learn more aboutthe basic sciences as I'm not arguing that, but it goes to show the inefficiency of medical education.

 

[FutureDoc4]

The following are often quoted:

Duke only has one year of preclinical work

Penn only has 1.5 years of preclinical work

LECOM has 3 year programs

Let me respond to all of them. Yes, Medical school takes 4 years.... why? Because it is not all as straight forward as "going through the motions" as you all seem to think.

Duke, requires one year of research so:
1 year basic science (full year no summer)
1 clinical year
1 year research
1 clinical year

Penn does it very similiar (over 50% of students take an area year off:
1.5 years of basic science
0.5 year research (over 50% do a full-year)
2 years clinical

LECOM
3 year programs but REQUIRE you to go into primary care... I don't agree with this program....but, people seem to think we need primary care physicians that bad


4th year is NOT complete fluff as everyone says... can you do international rotations? Yes, but you also have to do audition rotations (where you are killing yourself to make the best impression possible).... doing your sub-internships.. and may have some core rotation requirements left (e.g. neurology) and are trying to get exposed to other fields of medicine related to your field to make your knowledge base stronger (if your doing IM, doing a rotation in infectious disease, radiology etc are all helpful)

People are not sitting around drinking kool aid....get over yourselves if you think that


Finally, the point of me discussing PENN/Duke is that students who spend time doing research gain a hands on understanding of how basic science/translational medicine is related to disease and the practice of medicine FAR more in-depth than any classroom experience.!!

By cutting the "preclinical" classroom time short they are NOT decreasing the amount of knowledge we are required to know. In fact, they are making students become MORE involved in understanding basic medical science and research by becoming involved in it.


Anyone who has done research realizes how much more than know a subject by studying it in a lab than reading about it in a textbook.

Frankly, I am usually PRO-PA and anti-NP , but many of the comments I have been finding lately on this board are making me (and other medical students) question that stance.

 

[ARAI]

Interestingly, I know of one school where the med students take the computer based gross anatomy and the PA students take the cadaver gross anatomy. Before they switched to this, the cadaver gross anatomy for the med students and the PA students was taught by a neurosurgical PA.

I think I know which school you're speaking of. If I were a resident of that state, I would have gone there.

Your Napoleon complex continues to fascinate me

I've only been describing the differences between PA and MD programs based on my own experience. I've tried to remain unbiased. And I've tried not to post anything that was merely speculation. Saying that PAs graduate with a comparable knowledge to MD students is a statement that is published and sent to potential employers in the community by my college (of medicine) which houses both the MD and PA programs.

I didn't realize I had a Nepoleon complex, and I don't think I do. Maybe it is others who are suffering from illusions of grandeur.

 

[Denatured]

ARAI, I'll just tell you, UAB. I'll won't use his name but the PA is an excellent teacher from what I'm told. Heard he almost lost his job he was so against the med students not taking an actual cadaver course. But at least he got to keep it for the PAs. The surgical PA program is of high interest to me and, IMO, I like what I've seen of the program there as opposed to Cornell. Also interestingly, the CRNAs there take anatomy with the PA students. Nice to see surgery and anesthesia can actually play well together for once, hehe.

 

[Starpower]

This thread is ignoring the MOST important point ...

... who's going to see Tron Legacy, and which 3D format are you tending towards and why?
Posted via Mobile Device

 

[ARAI]

ARAI, I'll just tell you, UAB. I'll won't use his name but the PA is an excellent teacher from what I'm told. Heard he almost lost his job he was so against the med students not taking an actual cadaver course. But at least he got to keep it for the PAs. The surgical PA program is of high interest to me and, IMO, I like what I've seen of the program there as opposed to Cornell. Also interestingly, the CRNAs there take anatomy with the PA students. Nice to see surgery and anesthesia can actually play well together for once, hehe.

Oh, UAB! Obviously for a surgical focused program, cadaver work is very important. Actually, I was referring to UF. According to a couple of PA students there, PAs do more cadaver work than the MD students.

As for Cornell, the program seems to have done the bare minimum in an effort to modify their surgical assisting certificate program into a masters PA program. If I were choosing between Cornell and UAB, I'd definitely choose UAB.

This thread is ignoring the MOST important point ...

... who's going to see Tron Legacy, and which 3D format are you tending towards and why?

Me. 3D, because modern 3D cinema technology was developed specifically for movies like this.

 

[Charles_Carmichael]

I've only been describing the differences between PA and MD programs based on my own experience. I've tried to remain unbiased. And I've tried not to post anything that was merely speculation. Saying that PAs graduate with a comparable knowledge to MD students is a statement that is published and sent to potential employers in the community by my college (of medicine) which houses both the MD and PA programs.

I didn't realize I had a Nepoleon complex, and I don't think I do. Maybe it is others who are suffering from illusions of grandeur.

You can't be unbiased/not speculative if you're just basing things off of personal experience. You should realize by now that the plural of anecdote =/= data.

Even if we're to believe that PAs graduate with a comparable knowledge level of that of graduating med students, it still doesn't matter. The physician undergoes a rigorous residency. You don't. The attending physician is the highest authority in his/her respective clinical field. Every single graduating med student that goes through residency will reach that status eventually. Midlevels don't. It's as simple as that.

It's silly to compare graduating PAs (who are done with formal training) with those who're, at best, halfway through training.

 

[Dr Oops]

If I told you that PAs learn how to hold use a stethoscope in PA school, would you call BS then too?


If a PA student is at a university that has a college of osteopathic medicine and wants to learn osteopathic manipulations, he or she can probably find someone to teach them, but it's not part of the PA-training.

And PAs do not look down on DO students as practicing some lesser form of medicine than MDs. The reason they don't share classes has to do with the PA programs being housed in a separate college from the college of osteopathic medicine.



Maybe PAs don't need to be trained at the same level, but due to our sue-happy nation and the demand of better medical education, PA programs have become more rigorous and more competitive. So while PAs probably don't need to be trained at the same level, that doesn't mean they aren't.



They aren't that common. There are probably only 200 or so PA residency slots available per year.

No, you're not stupid. PAs are just incredibly smart and diligent. 😛

But it's true that medical school could be shortened. Cutting out the 4th year drops MD program length down to 32 months. A PA program is 27 months by comparison. Take your first year of medical school and make it 7 months instead of 9 or 10 months. On top of current pre-reqs, require past health care experience and also require that students take Anatomy, Physiology, Microbiology and Genetics before coming to school so that they come into accelerated basic medical science courses with some background knowledge. Finally, go to class 8-5, every single day. Attendance required. There! I've just condensed the heart of medical school into 30 months.

Now, in some of the basic science classes, MD/DOs are required to know more minutia than PAs. But any MD/DO will tell you that they forget that stuff right after they finish Step 1. I've recently asked some practicing docs regarding all that minutia. The answer is almost always along the lines of "you don't really need that stuff unless it's required for a specialty. And even then, you probably don't need it."



Doctor-lite? Interestingly, I've heard PAs casually referred to as "junior doctors." I'm not sure how I feel about that term, although both this and the term "physician associate" convey a similar meaning.

Regardless, adding "within their scope of practice" to the statement is relevant to PAs and Physicians. A emergency medicine physician will not be expected to treat pituitary gland disorders as well as a PA who specializes in endocrinology.


I completely agree. And I'm not arguing with you. So don't get mad at PAs if their programs provide them with a comparable knowledge. It's not the PA students' fault that the standards have been set so high. PAs just want to add as much benefit to the care team as possible. If that means studying one's butt off to learn as much as possible, so be it.

Well just talked to one of my classmates who used to be a PA. Very smart guy. He told me that the PA cirriuculm was not nrealy as much science as he is learning now and that while we dont have class from 8-5, he still has to do more work in medical school. I spent a semester learning about the kdney in college. Went over everything and more than I learned in about a week of med school.

PA education is good, but its not comparable to the level of med shchool.

 

[Starpower]

You don't. The attending physician is the highest authority in his/her respective clinical field. Every single graduating med student that goes through residency will reach that status eventually. Midlevels don't. It's as simple as that.

http://nurse-practitioners-and-phys...ceweb.com/Article/2007-FP-PA-of-the-Year.aspx

Kaushik, your immaturity is blinding.

I spent a semester learning about the kdney in college.

Wth are you talking about?

 

[Starpower]

Me. 3D, because modern 3D cinema technology was developed specifically for movies like this.

NO, that is NOT what I asked! 😡😉

WHICH format, IMAX3D, RealD, or Disney3D (which I've never seen anywhere)?

 

[Narnian]

[Startup Rant]

If you do want the extra knowledge that is lacking in P.A. school you would have to go bury yourself in a Library for one year... the first 2 months would be just figuring out the material that you are missing... then the next 10 months would be trying to learn and memorize it. On top of that you would not be tested on it, so you would not be constantly reveiwing it. Most my classmates have the attitude that if it is not on the test... they don't care. I try to go off on a long stimulating rant about why lack of calcium causes hyperpolarization of the neurons and how this causes muscle spasms and other strange symptoms and they stop me before I can even get rolling and say "Is this going to be on the test!" Well no ... "Then I don't care"

That whole meaning is... even if you were to obtain what is lacking, you are not tested or responsible for it. Therefore the gravity of your understanding and retention would be more fickle and prone to "leakage". I am not saying there are not exceptions... but on a whole... if it is not tested and reviewed it is lost.

[/Rant]

 

[ARAI]

Well just talked to one of my classmates who used to be a PA. Very smart guy. He told me that the PA cirriuculm was not nrealy as much science as he is learning now...

He's probably referring to basic medical sciences. For that, I have always stated that I believe MD/DO students do have to learn more.

PA education is good, but its not comparable to the level of med shchool.

PA education is great. It may not be equivalent to MD education, but it is still comparable. Consider that with the education PAs receive, they have the capacity and are required to perform at the same level as MD graduates in the first year of a residency.

WHICH format, IMAX3D, RealD, or Disney3D (which I've never seen anywhere)?

RealD, definitely! And what is the difference between those and Disney3D. I didn't even know there was a "Disney 3D."

That whole meaning is... even if you were to obtain what is lacking, you are not tested or responsible for it. Therefore the gravity of your understanding and retention would be more fickle and prone to "leakage". I am not saying there are not exceptions... but on a whole... if it is not tested and reviewed it is lost.

I understand your point and it's very valid. It's a good argument, but there are both PA students and MD/DO students who elect to supplement their education in order to understand the processes of varying pathologies. There are also students in each respective program who do the bare minimum to get by.

 

[MurphysLaww]

This seems like a very interesting concept that could help guide provide a solution for the shortage of primary care physicians. However, my concern is that while it will add to the number of primary care physicians that will already have experience in medicine, it will also drive up the cost of healthcare. Primary care already has a revenue problem causing more people to go into specialties this rise in cost by converting mid-levels to physicians my hurt financially if we loose too many experienced mid-level practitioners.

That being said, the people that worry about on-line courses need to look into some of the innovations of the times. The University Of Houston has started to use a lot of distance learning courses in their degree programs and have discovered many innovative ways to bring education into your living rooms. The University its self offers little in the way of housing and the neighbor around the school is not safe to live in so many student commute to classes, some driving up to two hours each way in heavy Houston traffic. Undergrad programs have a heard enough time getting students to walk from their dorms to classes, much less spend hours every week in traffic, thus the need for innovative solutions to increase graduation rates.

They have different professors who have varying levels of comfort with the utilization of "distance learning," some have live web-cam courses where students actually see the lecture live, and show up on a screen for the prof. to see. They can interact with the class by clicking to ask questions that are broadcast for everyone to hear, and answered by the professor. Its as close to being in class as you can get, the students just have to be mature enough to get rid of the distractions of home, thus it is not for everyone.

Most professors stipulate exams be taken at a testing center that you have to register with at the begging of the semester. The center will scan your State ID and take a picture of you along with a thumb print to verify ID. Then you have to schedule your exam with them in a short time window, so that they ensure there are ample spots open and enough proctors are present to ensure no academic dishonesty.

The infrastructure is available, but it would take quite a bit of time to sort out the logistics of such a program.

 

[Dr Oops]

This seems like a very interesting concept that could help guide provide a solution for the shortage of primary care physicians. However, my concern is that while it will add to the number of primary care physicians that will already have experience in medicine, it will also drive up the cost of healthcare. Primary care already has a revenue problem causing more people to go into specialties this rise in cost by converting mid-levels to physicians my hurt financially if we loose too many experienced mid-level practitioners.

That being said, the people that worry about on-line courses need to look into some of the innovations of the times. The University Of Houston has started to use a lot of distance learning courses in their degree programs and have discovered many innovative ways to bring education into your living rooms. The University its self offers little in the way of housing and the neighbor around the school is not safe to live in so many student commute to classes, some driving up to two hours each way in heavy Houston traffic. Undergrad programs have a heard enough time getting students to walk from their dorms to classes, much less spend hours every week in traffic, thus the need for innovative solutions to increase graduation rates.

They have different professors who have varying levels of comfort with the utilization of "distance learning," some have live web-cam courses where students actually see the lecture live, and show up on a screen for the prof. to see. They can interact with the class by clicking to ask questions that are broadcast for everyone to hear, and answered by the professor. Its as close to being in class as you can get, the students just have to be mature enough to get rid of the distractions of home, thus it is not for everyone.

Most professors stipulate exams be taken at a testing center that you have to register with at the begging of the semester. The center will scan your State ID and take a picture of you along with a thumb print to verify ID. Then you have to schedule your exam with them in a short time window, so that they ensure there are ample spots open and enough proctors are present to ensure no academic dishonesty.

The infrastructure is available, but it would take quite a bit of time to sort out the logistics of such a program.

Well online learning is the future. However, classes that are completely online are usually of lower quality than classes with actual, well, classes (at the present). Basically because the infrastructure is not there in most cases. The examples you talk about are big classes, in which the infrastructure is in place. But alot of these programs just spring up because they are cheap to implement with or without the proper testing structure etc.

Then theres the most important part of the curriculum which is the clinical aspect. NP programs have very little clinical hours compared to Medical programs. So which would you choose 500 or 10,000 +

 

[Makati2008]

You can't be unbiased/not speculative if you're just basing things off of personal experience. You should realize by now that the plural of anecdote =/= data.

Even if we're to believe that PAs graduate with a comparable knowledge level of that of graduating med students, it still doesn't matter. The physician undergoes a rigorous residency. You don't. The attending physician is the highest authority in his/her respective clinical field. Every single graduating med student that goes through residency will reach that status eventually. Midlevels don't. It's as simple as that.

It's silly to compare graduating PAs (who are done with formal training) with those who're, at best, halfway through training.

I have to agree with Starpower. That comment is a tad immature and could start a flame war.... I have seen the "highest authority in their clinical fields" miss something like septic shock and treating it like it was a SVT(HR not high enough to call it this as well as the patient had all the clinical findings of clinical shock due to sepsis) or how about another one who didn't want to CT Scan an AMS patient I had but luckily I had already had the scan finished(actually had two of these one had an intracranial hemorrhage and the other had a C-spine fx-unstable)

From someone who is in medical school and has practiced as a PA for several years, remember training is very important as well as clinical skills. I know residency makes the physician the most knowledgeable authority but it doesn't mean by any stance that they know ALL as it seems to imply from your statements.

It would do you well to shadow some P.A.'s prior to medical school if you want to better understand their roles. There would be many times I would prefer a PA like EMED over some of the attendings I have seen practicing...personally....

I hope the best of luck in med. school and whatever residency that you might choose.
E

 

[PSYCHNP]

I have to agree with Starpower. That comment is a tad immature and could start a flame war.... I have seen the "highest authority in their clinical fields" miss something like septic shock and treating it like it was a SVT(HR not high enough to call it this as well as the patient had all the clinical findings of clinical shock due to sepsis) or how about another one who didn't want to CT Scan an AMS patient I had but luckily I had already had the scan finished(actually had two of these one had an intracranial hemorrhage and the other had a C-spine fx-unstable)

From someone who is in medical school and has practiced as a PA for several years, remember training is very important as well as clinical skills. I know residency makes the physician the most knowledgeable authority but it doesn't mean by any stance that they know ALL as it seems to imply from your statements.

It would do you well to shadow some P.A.'s prior to medical school if you want to better understand their roles. There would be many times I would prefer a PA like EMED over some of the attendings I have seen practicing...personally....

I hope the best of luck in med. school and whatever residency that you might choose.
E

I agee with what you saying Makati. As I mentioned in some of my previous posts the literature shows that it takes 10-15 years to go from novice to expert. A fine PA like EMED is definitely an expert in his given field (being an EM PA).

As far as many of the attendings, I believe that they would be considered novice level physicians until they have practiced for 10-15 years in their respective specialty.

 

[danielmd06]

I agee with what you saying Makati. As I mentioned in some of my previous posts the literature shows that it takes 10-15 years to go from novice to expert. A fine PA like EMED is definitely an expert in his given field (being an EM PA).

As far as many of the attendings, I believe that they would be considered novice level physicians until they have practiced for 10-15 years in their respective specialty.

Is this argument really still going on?

Why is the public majority always so silent on such serious issues affecting our world?

Why are people continuing to seek the advice of less than qualified people on this thread for serious career advice?

(1) If you want to be a doctor and practice the full scope of medicine then you must go to medical school.

(2) If you wish to practice health care in a supervised capacity then become a physician's assistant or nurse practicioner and go to appropriate training schools.

(3) If you currently wish to expand your own clinical practice then seek out accredited and federally approved means of doing so.

Heaven forbid one should fear the length, cost, and intensity of training that would force you to become a better practicioner of medicine and thus a better servant to the community.

There are no shortcuts or easy paths to doing the right thing. Only shortcuts and easy paths to making more money.

 

[Charles_Carmichael]

I have to agree with Starpower. That comment is a tad immature and could start a flame war.... I have seen the "highest authority in their clinical fields" miss something like septic shock and treating it like it was a SVT(HR not high enough to call it this as well as the patient had all the clinical findings of clinical shock due to sepsis) or how about another one who didn't want to CT Scan an AMS patient I had but luckily I had already had the scan finished(actually had two of these one had an intracranial hemorrhage and the other had a C-spine fx-unstable)

From someone who is in medical school and has practiced as a PA for several years, remember training is very important as well as clinical skills. I know residency makes the physician the most knowledgeable authority but it doesn't mean by any stance that they know ALL as it seems to imply from your statements.

It would do you well to shadow some P.A.'s prior to medical school if you want to better understand their roles. There would be many times I would prefer a PA like EMED over some of the attendings I have seen practicing...personally....

I hope the best of luck in med. school and whatever residency that you might choose.
E

Eh, perhaps I could've worded my statement different. I was comparing the avg. attending physician vs. the avg. NP/PA/whatever. I also never stated nor implied that physicians know all. I have repeatedly stated that they have the lengthiest/most rigorous training (in clinical medicine) and are considered clinical experts in the medical field they practice in. I don't think that's an immature stance to take. And from what you've written (ie. "I know residency makes the physician the most knowledgeable authority..."), it seems like you share the same view that I do.

 

[Charles_Carmichael]

As far as many of the attendings, I believe that they would be considered novice level physicians until they have practiced for 10-15 years in their respective specialty.

Huh? 😕

 

[VA Hopeful Dr]

Huh? 😕

Yeah, that caught my attention was well. I'm fairly insulted by that notion. In 5 years when I've been an attending for 3 years, I certainly won't know everything but I sure as **** won't be a "novice physician". Quite frankly, I think residents are the ones who qualify as that.

 

[PSYCHNP]

Yeah, that caught my attention was well. I'm fairly insulted by that notion. In 5 years when I've been an attending for 3 years, I certainly won't know everything but I sure as **** won't be a "novice physician". Quite frankly, I think residents are the ones who qualify as that.

After thinking over what I posted earlier I agree that residents would probably be more considered a beginner/novice physician. I apologize if I came off wrong. I know how hard all physicians study/train and would never want to minimize that.

I also believe that someone in let's say a specialty like surgery, who has been out there practicing for 20 years, would be far more advanced than one who practiced for 2. Despite the fact that they both received similar training in school.

With that being said, is a PA with 20 years experience (EMED) better than a full fledge MD with let's say 1-2 years of professional/independent experience.

PA (20 years experience)>>>>MD (1-2 years experience).

 

[Coastie]

After thinking over what I posted earlier I agree that residents would probably be more considered a beginner/novice physician. I apologize if I came off wrong. I know how hard all physicians study/train and would never want to minimize that.

I also believe that someone in let's say a specialty like surgery, who has been out there practicing for 20 years, would be far more advanced than one who practiced for 2. Despite the fact that they both received similar training in school.

With that being said, is a PA with 20 years experience (EMED) better than a full fledge MD with let's say 1-2 years of professional/independent experience.

PA (20 years experience)>>>>MD (1-2 years experience).

ROFL, you're delusional.

Seriously, this troll is still around?

Well, at least we can all agree that NP < PA-student < PA....

 

[Makati2008]

Eh, perhaps I could've worded my statement different. I was comparing the avg. attending physician vs. the avg. NP/PA/whatever. I also never stated nor implied that physicians know all. I have repeatedly stated that they have the lengthiest/most rigorous training (in clinical medicine) and are considered clinical experts in the medical field they practice in. I don't think that's an immature stance to take. And from what you've written (ie. "I know residency makes the physician the most knowledgeable authority..."), it seems like you share the same view that I do.

I do agree with you to a limited extent and honestly maybe it was the wording that rubbed me the wrong way. Although they may be clinical experts in their respective fields they still can learn from the mid-level colleagues just as we learn so much from our MD/DO colleagues. I am a firm believer in saying that without you(MD/DO) there would be no us(PA/NP).

Again, I ask you to shadow a PA/MD practice for a few days if you haven't already to see what both respective parties do. I noticed that your only premed and I don't know if you have been truly exposed to many healthcare fields prior to med. school. If you have I apologize for assuming you have not.

E OMS-1.5 PA-C

 

[Socrates25]

To drift and arai thank you for enlightening me. If there are checks and balances in the practice of PAs and that the BOM can rein in on any PA org anytime PAs deviate from their role (want equivalency and independence) and if the PA org. is in consonance with the med. orgs' stance against independent practice of NPs then it is well and good. But there is always the nagging question at the back of my mind: 50 years ago who would have thought that nurses would be practicing medicine independently? Would the propagation of midlevels eventually "destroy" medicine in this country? I do not know and nobody knows. Although PAs and NPs play important roles in healthcare, IMHO the utilization of midlevels (instead of physicians) in healthcare is not to the best interest of patients.

Dont believe their lies, altap. PAs are just as interested in independent practice as the NPs are; they are just a few years behind them and they have to find a way to extricate themselves from the "medical board" problem first. They are gradually doing that by watering down "supervision" requirements so that one doc can "supervise" 300 PAs on remote distant sites and bill for all of them simultaneously, all in the comfort of their own home with never actually seeing a patient or signing off on the treatment plan (here comes emedpa's story about how North Carolina only requires 1 chart review per 5000 patients every 50 years).

If you really want a glimpse at what the PAs are thinking, you need to go to their board (PAforums.net). See my signature quote below. They reveal their true feelings on that website. EMEDPA is just as interested in independent practice as everybody else is. I'm sure STARPOWER and some of the other PAs on this site also have logins on that forum, and its very enlightening to watch them change their tune. On SDN, its all "oh we would never ever want to work independently" but on PAforums.net its all about how "my SP is stupid and I should be able to work alone without his interference" or "PAs should be able to apply for MD residencies."

Make no mistake -- just because PAs are more limited in their ability to change their professionnal scope and independence due to medical board oversight does NOT limit their ambitions to become just like the NPs.

 

[drift]

Dont believe their lies, altap. PAs are just as interested in independent practice as the NPs are; they are just a few years behind them and they have to find a way to extricate themselves from the "medical board" problem first. They are gradually doing that by watering down "supervision" requirements so that one doc can "supervise" 300 PAs on remote distant sites and bill for all of them simultaneously, all in the comfort of their own home with never actually seeing a patient or signing off on the treatment plan (here comes emedpa's story about how North Carolina only requires 1 chart review per 5000 patients every 50 years).

If you really want a glimpse at what the PAs are thinking, you need to go to their board (PAforums.net). See my signature quote below. They reveal their true feelings on that website. EMEDPA is just as interested in independent practice as everybody else is. I'm sure STARPOWER and some of the other PAs on this site also have logins on that forum, and its very enlightening to watch them change their tune. On SDN, its all "oh we would never ever want to work independently" but on PAforums.net its all about how "my SP is stupid and I should be able to work alone without his interference" or "PAs should be able to apply for MD residencies."

Make no mistake -- just because PAs are more limited in their ability to change their professionnal scope and independence due to medical board oversight does NOT limit their ambitions to become just like the NPs.

Your accusations are bold, yet they are hollow. Show me proof. I read EMED's quote, it's perfectly fine. why misquote?

If you think PAs are "taking over", show me proof. I work alongside both the AMA and the AAPA, and if you have something that we are missing, I would gladly like to present it. The truth stands that PA leaders/organizations are overseen by the board of medicine and they have no desire to practice independently.

One man's desire doesn't superimpose on an entire profession. Politically speaking, PAs are (absolutely) no comparison to NPs. Sure, supervision requirements may loosen, but they will never (ever) be able to go independent. From education through practice, there are several mechanisms that ensure the physician-PA relationship lasts. Plus, PA residencies are a good thing. Whats your fuss with them anyways? They don't change their scope of practice at all. A residency trained PA is equivalent to a non-residency trained PA politically/legally/medically. What's your problem?

 

[deleted6669]

as mentioned in numerous other of my postings I am in favor of pa's working WITH PHYSICIANS IN A COLLABORATIVE MODEL. I don't believe pa's or np's should be completely independent. autonomous with a great scope of practice? sure. without physician oversight? nope. over the next decade more pa's will be completing specialty residencies and working as pcp's. residencies for pa's are not new. they have been around for decades and can be done in almost any specialty. there just aren't enough spots for every pa to do one yet, not by a longshot. see www.appap.org for info on available pa residencies.
pa's will again be called physician associates. that doesn't mean they will be independent providers. it means they will be well trained to work as part of a team doing many but not all of the same things their physician colleagues do everyday. I am in favor of pa's having the best education possible. I think we will see the avg program go to 3 yrs( as USC already has) and mandatory 1-2 yr pa residencies for new grads after a certain date come into being within the timespan of all of our careers. These residencies will likely follow the model of the programs at baylor and grant a DHSc( to keep up with the market pressure degree creep of the dnp). these new residency grads, despite having a doctorate, will only be called "dcotor" when they teach, lecture, or publish, just like current grads from the baylor program and other current pa's with phd's, etc.
there is already 1 pa to physician bridge program. there will be more. as the pa to docs(both bridge and traditional route) get into the workforce I think we will start to see a change in attitude towards pa education so that it gets the respect it deserves.
it isn't medschool but it's the closest thing out there.

 

[Socrates25]

Your accusations are bold, yet they are hollow. Show me proof. I read EMED's quote, it's perfectly fine. why misquote?

Misquote? The guy said he expects that PAs should be able to match into residency slots RESERVED FOR MD/DO.

What's your problem?

My problem is PAs like you pissing on my back and telling me its raining.

 

[bradt9881]

Dont believe their lies, altap. PAs are just as interested in independent practice as the NPs are; they are just a few years behind them and they have to find a way to extricate themselves from the "medical board" problem first.

We need to prep this guy STAT for an emergency rectal-cranialectomy!

 

[Dr Oops]

as mentioned in numerous other of my postings I am in favor of pa's working WITH PHYSICIANS IN A COLLABORATIVE MODEL. I don't believe pa's or np's should be completely independent. autonomous with a great scope of practice? sure. without physician oversight? nope. over the next decade more pa's will be completing specialty residencies and working as pcp's. residencies for pa's are not new. they have been around for decades and can be done in almost any specialty. there just aren't enough spots for every pa to do one yet, not by a longshot. see www.appap.org for info on available pa residencies.
pa's will again be called physician associates. that doesn't mean they will be independent providers. it means they will be well trained to work as part of a team doing many but not all of the same things their physician colleagues do everyday. I am in favor of pa's having the best education possible. I think we will see the avg program go to 3 yrs( as USC already has) and mandatory 1-2 yr pa residencies for new grads after a certain date come into being within the timespan of all of our careers. These residencies will likely follow the model of the programs at baylor and grant a DHSc( to keep up with the market pressure degree creep of the dnp). these new residency grads, despite having a doctorate, will only be called "dcotor" when they teach, lecture, or publish, just like current grads from the baylor program and other current pa's with phd's, etc.
there is already 1 pa to physician bridge program. there will be more. as the pa to docs(both bridge and traditional route) get into the workforce I think we will start to see a change in attitude towards pa education so that it gets the respect it deserves.
it isn't medschool but it's the closest thing out there.

If PA school is 3 yrs and 1-2yrs residency then y would people goto PA school when they can goto med school for another year or 2. Increasing the length of training for PAs (and NPs) makes them less desirable paths, unless the end goal is physician encroachment.

The whole "better training" argument doesnt work here because if you wanted more training that pathway exists = med school. PAs are supposed to be an mid way between a physician and an emt or whatnot. By continually lengthening training you disincentivize going to PA school.

 

[deleted6669]

If PA school is 3 yrs and 1-2yrs residency then y would people goto PA school when they can goto med school for another year or 2. Increasing the length of training for PAs (and NPs) makes them less desirable paths, unless the end goal is physician encroachment.

The whole "better training" argument doesnt work here because if you wanted more training that pathway exists = med school. PAs are supposed to be an mid way between a physician and an emt or whatnot. By continually lengthening training you disincentivize going to PA school.

bs( 4 yrs) + pa @ 3 yrs + mandatory 1 yr residency= 8 yrs.
practice any specialty, switch whenever you want. minimal debt.

md 11 yrs min
1 specialty
major debt

see the difference?
you may not like it but this is probably where the field is heading. when the pa concept began all the applicants had significant prior medical experience along the lines of medic, rn, rt. this is less true every yr now so as a result they will need to lengthen the training. it's been creeping up a month or so every few yrs as it is with most programs now 27-28 months or so instead of the traditional 2 yrs.
also consider that education is a business. if a school can charge for 3 yrs of tuition instead of 2 they will. the np's forced us to go to a masters degree ( for the most part- a few non-ms programs remain but they are under serious pressure to transition to the ms level) to remain competitive and when they fully embrace the dnp we will probably need to come up with a mechanism for having a doctorate as well, although I think ours will not be entry level but granted at the completion of residency like the current baylor em, ortho, and surgical residencies. hospitals and organizations like the joint commission have been cracking down on all types of medical providers moreso every yr to demonstrate ability and training to perform many procedures and the best way to show that ability is through formal training and procedure logs generated in a residency. I've been following trends in pa education for the better part of 3 decades and I think the writing is on the wall for all of this to happen.

and there is a path for "more training" now with the 3 yr pa to physician bridge program for those who want to be docs. I think once this takes off many more programs like this will open up, first at DO schools and then at MD programs as well.

 

[altap]

I agree with dr. oops, the status quo is fine as it is. PAs are midlevels so your education and training are adequate for the job that you perform. Unless, you would like PAs to practice independently.

 

[PSYCHNP]

I agree with dr. oops, the status quo is fine as it is. PAs are midlevels so your education and training are adequate for the job that you perform. Unless, you would like PAs to practice independently.

I agree with Dr. OOps and Altap, the status quo is fine when it comes to PAs. The three years of doctorate level education would only cause confusion and more money to be spent by the students. What would the PA be awarded a doctorate in physician assisting?

Like Kaushik said earlier if a PA wanted to become an MD 4 years of medical school training should be the requirement.

PTAs, COTAs, LPNs ect. use a lot of the same textbooks as professionals in their various fields, but the depth and scope of the training is far less. The same holds true in regards to PAs and MD/DOs.

 

[Charles_Carmichael]

I agree with Dr. OOps and Altap, the status quo is fine when it comes to PAs. The three years of doctorate level education would only cause confusion and more money to be spent by the students. What would the PA be awarded a doctorate in physician assisting?

Like Kaushik said earlier if a PA wanted to become an MD 4 years of medical school training should be the requirement.

PTAs, COTAs, LPNs ect. use a lot of the same textbooks as professionals in their various fields, but the depth and scope of the training is far less. The same holds true in regards to PAs and MD/DOs.

I actually don't think I said that (if I did, I was likely referring to NPs/DNPs needing to go through 4 yrs of med school). I'm cool with the 3yr PA-DO bridge because PAs get, IMO, a fairly strong basic science training.

I am, however, against NPs/DNPs bridging into the MD/DO. They definitely have to go through 4 yrs of med school, IMO, because they have a very weak basic science foundation. Nursing theory is not a replacement for a solid theoretical foundation in the basic sciences.

I've never been against PAs. I've always been against NPs/DNPs who want independence. I respect PAs and respect the training they get. Can't say the same about NPs/DNPs who are fighting for independence. Hope that clarifies things.

 

[PSYCHNP]

bs( 4 yrs) + pa @ 3 yrs + mandatory 1 yr residency= 8 yrs.
practice any specialty, switch whenever you want. minimal debt.

md 11 yrs min
1 specialty
major debt

see the difference?
you may not like it but this is probably where the field is heading. when the pa concept began all the applicants had significant prior medical experience along the lines of medic, rn, rt. this is less true every yr now so as a result they will need to lengthen the training. it's been creeping up a month or so every few yrs as it is with most programs now 27-28 months or so instead of the traditional 2 yrs.
also consider that education is a business. if a school can charge for 3 yrs of tuition instead of 2 they will. the np's forced us to go to a masters degree ( for the most part- a few non-ms programs remain but they are under serious pressure to transition to the ms level) to remain competitive and when they fully embrace the dnp we will probably need to come up with a mechanism for having a doctorate as well, although I think ours will not be entry level but granted at the completion of residency like the current baylor em, ortho, and surgical residencies. hospitals and organizations like the joint commission have been cracking down on all types of medical providers moreso every yr to demonstrate ability and training to perform many procedures and the best way to show that ability is through formal training and procedure logs generated in a residency. I've been following trends in pa education for the better part of 3 decades and I think the writing is on the wall for all of this to happen.

and there is a path for "more training" now with the 3 yr pa to physician bridge program for those who want to be docs. I think once this takes off many more programs like this will open up, first at DO schools and then at MD programs as well.

Another issue with doctorate in physician assisting is the graduating PAs would have more powers that the MDs who created the PA field. The doctorate in physician assisting grads would be able to practice in any subspeciatly without additional training.

These doctorate level PAs would soon start their own organizations, demand equal reimbursement, and the ability to practice independently.

 

[PSYCHNP]

I actually don't think I said that (if I did, I was likely referring to NPs/DNPs needing to go through 4 yrs of med school). I'm cool with the 3yr PA-DO bridge because PAs get, IMO, a fairly strong basic science training.

I am, however, against NPs/DNPs bridging into the MD/DO. They definitely have to go through 4 yrs of med school, IMO, because they have a very weak basic science foundation. Nursing theory is not a replacement for a solid theoretical foundation in the basic sciences.

I've never been against PAs. I've always been against NPs/DNPs who want independence. I respect PAs and respect the training they get. Can't say the same about NPs/DNPs who are fighting for independence. Hope that clarifies things.

I hope these PAs would be required to complete all of the pre-reqs that are required of traditional MDs, like physics I and II with labs and Organic Chemistry.