New idea for NP/PA to MD

[Siggy]

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Actually, I would disagree with this statement. Have you ever tried to explain what med school is like to someone not in it? They rarely truly understand.

Seconded.

Heck, every time I visit my parents I have to explain the entire 2 years lecture, 2 years rotations, combined called medical school, followed by 3-4 years (I currently want EM) of residency, the first of which is called "internship."

Every. Single. Time.

 

[Siggy]

To work independently, that's one thing. But to operate independently without access to the full scope of knowledge that Doctors possess is nothing short of driving blindsighted, imo.

Why?

They can practice their "advanced nursing care" on patients, and when it doesn't work they can bear the lawsuit for nursing malpractice. Let's see how quickly they're costs stay low and quality high with out the safety net.

 

[Therapist4Chnge]

Pool=Pole. I notoriously have typos I usually apologize for them in advance.

I preferred "pool", as it made me chuckle. 😀

 

[PSYCHNP]

If you can provide proof about my education and my training being subpar please let me know. I truly doubt you know much about the PA education at all. If NP's training is so much better than PA's, tell me why we had several RN's in my PA class and I have worked with numerous other ones that went the PA route when the NP route was available to them?

Furthermore, my first job was in a pretty large ER and the ER director blatantly admitted he preferred PA's because we practiced medicine and didn't do everything based on an algorithm and if it didn't fit come running to him confused over the simplest of cases due us actually being able to think outside of these algorithms.

Also there is a reason why PA's can see patients from the cradle to the grave while some NP's cannot.(I was hired due to this reason-> a NP could not see the full spectrum of patients so she was let go)

Since we are just basing our thoughts on personal experience I figured I would share mine.

As usual apologize for typos,
E.

Let me guess was your ER director an MD?

I believe Family NPs can see children and adults. Furthermore, CRNAs can also serve children and adults (I wouldn't want one to work in peds unless they specialize in peds unlike PAs who seem to want to do it all).

PAs are generalists and take on the scope of practice of their supervising MD.

As I mentioned in my previous posts who jumps from subspecialty to subspecialty without additional training and certifications? Even MDs can't do this. How can a clinician who jumps around like this claim to be an expert at something and want be taken seriously? Now PAs are even being supervised by PODS, what's next?

 

[deleted6669]

With that being said, in the grand scheme of things the 2,000 clinical hours of training the PA receives is in reality futile.
.

During my 3000 hrs of "futile" clinical training as a pa( following 10 yrs in ems as an er tech, paramedic, and paramedic instructor) I was treated as an ms3/ms4 on all of my rotations and was scheduled interchangeably with them. no filing and doing scut work. I was first assisting c-sections, putting in chest tubes and central lines, doing home visits on elderly folks with multisystem dz who were too ill to make it to the office, working a peds er with peds em residents, etc
you keep talking about inexperienced new grad pa's. what about the typical new np in 2011, you know the direct entry np who was a history major 3 yrs ago and just decided 1 day that healthcare would be fun? then they went through a 3 yr part time np program while working at starbucks? now they are "independent providers?"
independent to make me a latte maybe....
are you aware that the state of oregon recently changed supervision ratios for pa's specifically so they could be utilized more in retail medicine? know who was behind this? docs who own retail medicine clinics because they would rather spend thousands on passing a new law than hire an np.....

 

[Makati2008]

Let me guess was your ER director an MD?

I believe Family NPs can see children and adults. Furthermore, CRNAs can also serve children and adults (I wouldn't want one to work in peds unless they specialize in peds unlike PAs who seem to want to do it all).

PAs are generalists and take on the scope of practice of their supervising MD.

As I mentioned in my previous posts who jumps from sunspecialty to subspecialty without additional training and certifications? Even MDs can't do this. How can a clinician who jumps around like this claim to be an expert at something and want be taken seriously? Now PAs are even being supervised by PODS, what's next?

Yes he was a MD. Unlike primary care and gas, he doesn't have a horse in the battle with you gaining independence. I foresee a cold day in hell before you get the ER unsupervised personally. Please do not get upset that the BOM deems PA's clinically able to do this(switch specialities without restriction in many instances) as long as we have SP's that are willing ot train us.

Also there is a reason why Docs/PAs worry about you-> its because you want to practice unrestricted medicine with a restricted education. Also we PA's know our limitations and won't do anything that we are not comfortable with. An unsupervised NP with her/his own clinic can I truly say the same???

And to your point about speciality switching- your actually wrong to an extent about MD's being unable to do this. Think about the ER for example-You have EM/IM/FM docs that all cover the ER due to their training.

I should stop responding to someone who is still trying to gain her NP and yet to take her board(isn't it true you only take your NP board ONCE and do not have to recertify-I am asking this about FNP's. If true isn't that a little dangerous for patient care?)

As usual I apologize for typos and the like in virology,
E.

PS-Good thing that we are taken seriously by Attending and NP's have no say. Also with time and good training by our supervising M.D.'s we would become authorities in our respective fields.

 

[Makati2008]

During my 3000 hrs of "futile" clinical training as a pa( following 10 yrs in ems as an er tech, paramedic, and paramedic instructor) I was treated as an ms3/ms4 on all of my rotations and was scheduled interchangeably with them. no filing and doing scut work. I was first assisting c-sections, putting in chest tubes and central lines, doing home visits on elderly folks with multisystem dz who were too ill to make it to the office, working a peds er with peds em residents, etc
you keep talking about inexperienced new grad pa's. what about the typical new np in 2011, you know the direct entry np who was a history major 3 yrs ago and just decided 1 day that healthcare would be fun? then they went through a 3 yr part time np program while working at starbucks? now they are "independent providers?"
independent to make me a latte maybe....
are you aware that the state of oregon recently changed supervision ratios for pa's specifically so they could be utilized more in retail medicine? know who was behind this? docs who own retail medicine clinics because they would rather spend thousands on passing a new law than hire an np.....

I am actually friends with a girl that had this occur. She was political science major that couldn't get into law school and then said well I will do this instead I was like WTFH? Last time I talked to her she did support NP's having broader scope. She wasn't working at a starbucks though...we don't have them in that certain area....

 

[Therapist4Chnge]

I am actually friends with a girl that had this occur. She was political science major that couldn't get into law school and then said well I will do this instead I was like WTFH? Last time I talked to her she did support NP's having broader scope. She wasn't working at a starbucks though...we don't have them in that certain area....

I'm more surprised that you don't have a Starbucks in that area....and not at the jump into nursing (no offense to nursing, it just seems like a popular 2nd career choice for many).

 

[Makati2008]

I'm more surprised that you don't have a Starbucks in that area....and not at the jump into nursing (no offense to nursing, it just seems like a popular 2nd career choice for many).

Yes it was truly the middle of nowhere(well not really but I am used to cities with a million+ folks in them.). I tell you the BEST starbucks I ever had was in southeast Asia. They used pure sugar cane I do believe to sweeten things instead of the corn syrup they use here.

 

[vivalavie]

1. Assuming the training is tightly controlled.
2. Assuming the numbers are limited and the floodgates are not opened to the masses of applicants.
3. Assuming the people don't try and push the boundaries into other specialities. Once in the door of a house, it is quite hard to keep people to just one room...

Why re-invent the wheel? There are thousands of spots each year for medical school.

You make excellent points, points I thought I had addressed adequately but let me try again.

1) I proposed a program that is essentially the same as 3 year MD programs that currently exist, they'll have to take the USMLE's and apply for the same residencies. The curriculum could be tailored slightly to omit redundancies between nursing school and med school but, frankly, I agree that these would be minimal. The level of education of some of the nurses I've met terrifies me.

2/3) Look at the PA bridge, no floodgates are gonna open if you have a few bridge programs with a very limited number of spots. The competition will be crazy because so many of them want more responsibility. Have the PA transitions pushed boundaries?

Why reinvent the wheel? Well, I'd say, we're not. This IS essentially med school, just tailored slightly for nurses. But even so, why is it necessary?

True, these nurses COULD apply to med school, but med schools don't really like applicants from other branches of healthcare. If they want to actually get into med school it might require a post-bac (which might mean taking out loans before you're even accepted to med school, no guarantee that you'll be able to pay them off), independent research and all that ridiculous stuff we had to go through, even though they've already proven their commitment to medicine. This nurse specific path gives them a viable path to becoming physicians.

In addition, nurses hit a wall after they become NPs, and the ambitious ones are GOING to push to do more. Knowing their level of education, this scares me. Give them an alternative path, though it is a difficult one, and they will take it. The ambitious nurses will pursue medicine instead of lobbying for more rights out of nursing school and when they graduate from medical school they'll become our greatest allies. They'll tell nurses not to push their boundaries, they'll tell them to leave medicine to the doctors, and nurses will have to listen.

 

[Makati2008]

You make excellent points, points I thought I had addressed adequately but let me try again.

1) I proposed a program that is essentially the same as 3 year MD programs that currently exist, they'll have to take the USMLE's and apply for the same residencies. The curriculum could be tailored slightly to omit redundancies between nursing school and med school but, frankly, I agree that these would be minimal. The level of education of some of the nurses I've met terrifies me.

2/3) Look at the PA bridge, no floodgates are gonna open if you have a few bridge programs with a very limited number of spots. The competition will be crazy because so many of them want more responsibility. Have the PA transitions pushed boundaries?

Why reinvent the wheel? Well, I'd say, we're not. This IS essentially med school, just tailored slightly for nurses. But even so, why is it necessary?

True, these nurses COULD apply to med school, but med schools don't really like applicants from other branches of healthcare. If they want to actually get into med school it might require a post-bac (which might mean taking out loans before you're even accepted to med school, no guarantee that you'll be able to pay them off), independent research and all that ridiculous stuff we had to go through, even though they've already proven their commitment to medicine. This nurse specific path gives them a viable path to becoming physicians.

In addition, nurses hit a wall after they become NPs, and the ambitious ones are GOING to push to do more. Knowing their level of education, this scares me. Give them an alternative path, though it is a difficult one, and they will take it. The ambitious nurses will pursue medicine instead of lobbying for more rights out of nursing school and when they graduate from medical school they'll become our greatest allies. They'll tell nurses not to push their boundaries, they'll tell them to leave medicine to the doctors, and nurses will have to listen.

1.)I call BS on this. If you want to be a Physician(in the case of a nurse) go to medical school. The reason the PA Bridge was invented is because we are trained in the medical model already and the transition will not be nearly as hard for a PA vs. a RN. Also with certain NP's screaming for more practice rights this won't happen for RN/NP's anytime soon.

2.)Medical schools LOVE applicants from other fields. There are several RN's in my class, Medical technologist, and myself(PA) in my class. It shows them that we are committed to the healthcare field already.

SMH,
E.

 

[vivalavie]

1.)I call BS on this. If you want to be a Physician(in the case of a nurse) go to medical school. The reason the PA Bridge was invented is because we are trained in the medical model already and the transition will not be nearly as hard for a PA vs. a RN. Also with certain NP's screaming for more practice rights this won't happen for RN/NP's anytime soon.

2.)Medical schools LOVE applicants from other fields. There are several RN's in my class, Medical technologist, and myself(PA) in my class. It shows them that we are committed to the healthcare field already.

SMH,
E.

In med school you meet the ones who have succeeded. I've known a few who have not. One close friend of mine had a doctorate in physical therapy, good gpa and mcat. He did not receive a single interview.

I applied with a bachelor of arts and barely any clinical experience to all the same schools and got in. I'm embarrassed for all the medical schools that did not accept him because he's many times smarter than I am and is going to be a hell of a physician.

 

[Charles_Carmichael]

In med school you meet the ones who have succeeded. I've known a few who have not. One close friend of mine had a doctorate in physical therapy, good gpa and mcat. He did not receive a single interview.

Then something else was wrong with his application or he didn't apply smartly to schools. A good GPA/MCAT is not enough to "guarantee" a med school acceptance. Hang around in pre-allo and you'll see many threads littered with people who didn't get accepted at all even with 3.8+/39+ stats.

 

[Charles_Carmichael]

1) I proposed a program that is essentially the same as 3 year MD programs that currently exist, they'll have to take the USMLE's and apply for the same residencies. The curriculum could be tailored slightly to omit redundancies between nursing school and med school but, frankly, I agree that these would be minimal. The level of education of some of the nurses I've met terrifies me.

If it's going to be essentially the same program, why do we need a separate pathway for them? They can go through the premed prereqs, MCAT, etc, just like everyone applying med school (emedpa or someone correct me but I believe even the PA-to-DO bridge require this). There's absolutely no need to make a nursing-to-MD/DO bridge. Why should nursing midlevels get an easier path just because they're "frustrated?" That's not a good enough reason.

Also, what redundancies are you talking about omitting? There's practically no redundancy between NP/DNP school and med school. Again, this reinforces the idea that a bridge program is useless for NPs/DNPs who want to be physicians.

2/3) Look at the PA bridge, no floodgates are gonna open if you have a few bridge programs with a very limited number of spots. The competition will be crazy because so many of them want more responsibility. Have the PA transitions pushed boundaries?

Why reinvent the wheel? Well, I'd say, we're not. This IS essentially med school, just tailored slightly for nurses. But even so, why is it necessary?

There's no need to "tailor" med schools for nurses. NP/DNP schools already claim to do that.

True, these nurses COULD apply to med school, but med schools don't really like applicants from other branches of healthcare. If they want to actually get into med school it might require a post-bac (which might mean taking out loans before you're even accepted to med school, no guarantee that you'll be able to pay them off), independent research and all that ridiculous stuff we had to go through, even though they've already proven their commitment to medicine. This nurse specific path gives them a viable path to becoming physicians.

In addition, nurses hit a wall after they become NPs, and the ambitious ones are GOING to push to do more. Knowing their level of education, this scares me. Give them an alternative path, though it is a difficult one, and they will take it. The ambitious nurses will pursue medicine instead of lobbying for more rights out of nursing school and when they graduate from medical school they'll become our greatest allies. They'll tell nurses not to push their boundaries, they'll tell them to leave medicine to the doctors, and nurses will have to listen.

I think you're wrong regarding the bolded. You even answered, in your own paragraph, why you're probably wrong. Also, what independent research are you talking about? No medical school in the US requires research as a prereq.

There is no need to have a special path for nursing midlevels to become physicians. And you have no evidence to say that "ambitious" nurses will pursue medicine instead of pushing for more independence. These ambitious nurses have always had the choice of pursuing med school if they wanted to increase their knowledge/responsibility further. They have repeatedly shown that they don't care to put in the time/effort to become physicians and would prefer to use their political clout to gain independence. This is unlikely to change even if an NP/DNP-to-MD/DO bridge opens up.

A viable path already exists for nurses to become physicians. It's called med school and residency.

 

[vivalavie]

If it's going to be essentially the same program, why do we need a separate pathway for them? They can go through the premed prereqs, MCAT, etc, just like everyone applying med school (emedpa or someone correct me but I believe even the PA-to-DO bridge require this). There's absolutely no need to make a nursing-to-MD/DO bridge. Why should nursing midlevels get an easier path just because they're "frustrated?" That's not a good enough reason.

Also, what redundancies are you talking about omitting? There's practically no redundancy between NP/DNP school and med school. Again, this reinforces the idea that a bridge program is useless for NPs/DNPs who want to be physicians.



There's no need to "tailor" med schools for nurses. NP/DNP schools already claim to do that.


I think you're wrong regarding the bolded. You even answered, in your own paragraph, why you're probably wrong. Also, what independent research are you talking about? No medical school in the US requires research as a prereq.

There is no need to have a special path for nursing midlevels to become physicians. And you have no evidence to say that "ambitious" nurses will pursue medicine instead of pushing for more independence. These ambitious nurses have always had the choice of pursuing med school if they wanted to increase their knowledge/responsibility further. They have repeatedly shown that they don't care to put in the time/effort to become physicians and would prefer to use their political clout to gain independence. This is unlikely to change even if an NP/DNP-to-MD/DO bridge opens up.

A viable path already exists for nurses to become physicians. It's called med school and residency.

Almost every question you asked I've addressed... most of them within the very post you're quoting. If you find my answers insufficient we'll have to agree to disagree, but please stop posting the same exact things.

As for the bold statement, I'm surprised to see a pre-med make this claim. It might not be a formal requirement, much like clinical experience and volunteering isn't a formal requirement, but it is rare to find a successful applicant with no research.

And about your statement regarding applicants with 4.0s and 39s getting rejected, how many of them had doctorates in a related field? It is beyond my comprehension how a responsible adcom could deem fit to reject my friend without so much as an interview. If they had interviewed him they would realize the magnitude of their mistake.

 

[vivalavie]

And about your statement regarding applicants with 4.0s and 39s getting rejected, how many of them had doctorates in a related field?

I didn't mean to imply that my friend had perfect numbers, but they were above average for most of the schools to which he applied. Maybe they didn't actively exclude him for being part of a related field, but it sure didn't do him any favors.

 

[Makati2008]

Almost every question you asked I've addressed... most of them within the very post you're quoting. If you find my answers insufficient we'll have to agree to disagree, but please stop posting the same exact things.

As for the bold statement, I'm surprised to see a pre-med make this claim. It might not be a formal requirement, much like clinical experience and volunteering isn't a formal requirement, but it is rare to find a successful applicant with no research.

And about your statement regarding applicants with 4.0s and 39s getting rejected, how many of them had doctorates in a related field? It is beyond my comprehension how a responsible adcom could deem fit to reject my friend without so much as an interview. If they had interviewed him they would realize the magnitude of their mistake.

1.)I call BS on this again. Most medical students do not have research. A lot of them do but the majority do not.
2.)DPT is not medical school in any shape or form sorry. Also you can't make such a blanket statement about this type of thing. When he sent in his application there could have been some red flags about his past or maybe his science GPA wasn't up to snuff. Also he could have taken his mcat multiple times. There are many things that he may not choose to share with you and instead only gave you enough to make himself seem like a very good applicant.
3.)Adcoms could care less about your friend,sorry to sound like a jerk, there are MANY MANY MANY more qualified applicants than him or both us and there are sometimes people that get left out and he appears to be one of those if he is half as good as you make him out to be.

 

[vivalavie]

[/B]

1.)I call BS on this again. Most medical students do not have research. A lot of them do but the majority do not.
2.)DPT is not medical school in any shape or form sorry. Also you can't make such a blanket statement about this type of thing. When he sent in his application there could have been some red flags about his past or maybe his science GPA wasn't up to snuff. Also he could have taken his mcat multiple times. There are many things that he may not choose to share with you and instead only gave you enough to make himself seem like a very good applicant.
3.)Adcoms could care less about your friend,sorry to sound like a jerk, there are MANY MANY MANY more qualified applicants than him or both us and there are sometimes people that get left out and he appears to be one of those if he is half as good as you make him out to be.

1- I can't say for sure, but I would suggest that your experience at a DO school may not be typical, since they tend to focus much more on primary care and applicants tend to be a bit weaker (I don't mean to offend here, I have a lot of respect for DOs and plan to be a primary care provider-pediatrician-myself). Anyway, this is way off topic, and I'll concede that I may have overestimated the number of applicants with research based on my own experiences.

For your other points... I'm not arguing that the DPT=MD (how could you even think I was implying anything remotely like that from what I posted?), I'm simply saying that having a doctorate in a related health field should be a huge indicator of commitment and aptitude and he didn't even receive one interview... which strikes me as strange, especially if you're claiming that applicants from related health fields have an advantage. Would you disagree?

Edit: Also, cut us some slack! If there were that many many MANY better applicants than us we wouldn't have been accepted! 🙂

 

[Makati2008]

1- I can't say for sure, but I would suggest that your experience at a DO school may not be typical, since they tend to focus much more on primary care and applicants tend to be a bit weaker (I don't mean to offend here, I have a lot of respect for DOs and plan to be a primary care provider-pediatrician-myself). Anyway, this is way off topic, and I'll concede that I may have overestimated the number of applicants with research based on my own experiences.

For your other points... I'm not arguing that the DPT=MD (how could you even think I was implying anything remotely like that from what I posted?), I'm simply saying that having a doctorate in a related health field should be a huge indicator of commitment and aptitude and he didn't even receive one interview... which strikes me as strange, especially if you're claiming that applicants from related health fields have an advantage. Would you disagree?

Edit: Also, cut us some slack! If there were that many many MANY better applicants than us we wouldn't have been accepted! 🙂

1.)Yep your right about D.O.'s tend to take riskier applicants at times(so do MD but at a lesser rate I would bet) but speaking from personal experience it seems to be the same at BOTH MD/DO-research wise. (I was accepted at both MD/DO schools I picked D.O. due to the school I applied to having some of the best technology in the US)

2.)I stated that due to it appearing as though you thought that him having a DPT would make it much easier for him to get into med. school. maybe I inferred wrong. Sorry if I did.

PS-Getting into med. school is a crapshoot is why I made that statement. I know guys that went to Carribbean with MUCH better stats and grades than me and I know people with MUCH worse stats/grades than me that are in top tier programs.

 

[Charles_Carmichael]

Almost every question you asked I've addressed... most of them within the very post you're quoting. If you find my answers insufficient we'll have to agree to disagree, but please stop posting the same exact things.

As for the bold statement, I'm surprised to see a pre-med make this claim. It might not be a formal requirement, much like clinical experience and volunteering isn't a formal requirement, but it is rare to find a successful applicant with no research.

And about your statement regarding applicants with 4.0s and 39s getting rejected, how many of them had doctorates in a related field? It is beyond my comprehension how a responsible adcom could deem fit to reject my friend without so much as an interview. If they had interviewed him they would realize the magnitude of their mistake.

I'll stop repeating myself if you stop asking for a nursing midlevel-to-physician pathway because nurses are frustrated. You haven't provided any valid reason so far as to why such a path needs to exist. There's practically no overlap between medical and nursing education. If the PA-to-DO bridge only reduces med school length by one year (essentially removing 4th year, I think...and PAs have a heck of a lot more basic science/clinical training than NPs/DNPs), how will a bridge program for NPs/DNPs work? What, it'll reduce med school for them by about a month? Definitely not worth pursuing.

And no, research is not required for med school. I would say that the majority of matriculants to most med schools don't have research. And even if they did conduct some, it's likely nowhere near the level that would have much of a sway on the adcoms (ie. publications, presentations at national conferences, etc).

1- I can't say for sure, but I would suggest that your experience at a DO school may not be typical, since they tend to focus much more on primary care and applicants tend to be a bit weaker (I don't mean to offend here, I have a lot of respect for DOs and plan to be a primary care provider-pediatrician-myself). Anyway, this is way off topic, and I'll concede that I may have overestimated the number of applicants with research based on my own experiences.

For your other points... I'm not arguing that the DPT=MD (how could you even think I was implying anything remotely like that from what I posted?), I'm simply saying that having a doctorate in a related health field should be a huge indicator of commitment and aptitude and he didn't even receive one interview... which strikes me as strange, especially if you're claiming that applicants from related health fields have an advantage. Would you disagree?

Edit: Also, cut us some slack! If there were that many many MANY better applicants than us we wouldn't have been accepted! 🙂

I think you're wrong about a doctorate helping so much. A doctorate doesn't necessarily say you're committed to medicine. If you were committed to medicine, you wouldn't have gotten a doctorate in another field. 😉 A doctorate in nursing, chiropractry, podiatry, whatever, says that you were committed to that particular field; hence why you pursued a doctorate in it.

Don't get me wrong. I think a doctorate helps in med school admissions. I just think you're vastly overestimating how much it helps.

 

[Charles_Carmichael]

Besides, after the past several years of the nursing leadership and vocal NPs/DNPs claiming that they're not only equivalent, but superior to physicians, that physician training is inefficient and that they've figured out how to optimize it, and general bashing of medical education and physicians in general...do you really think that the medical community is going to welcome an NP/DNP-to-MD/DO bridge? Highly unlikely.

Let the nursing midlevels stick with their "superior" education.

 

[Dwindlin]

1- I can't say for sure, but I would suggest that your experience at a DO school may not be typical, since they tend to focus much more on primary care and applicants tend to be a bit weaker (I don't mean to offend here, I have a lot of respect for DOs and plan to be a primary care provider-pediatrician-myself). Anyway, this is way off topic, and I'll concede that I may have overestimated the number of applicants with research based on my own experiences.

For your other points... I'm not arguing that the DPT=MD (how could you even think I was implying anything remotely like that from what I posted?), I'm simply saying that having a doctorate in a related health field should be a huge indicator of commitment and aptitude and he didn't even receive one interview... which strikes me as strange, especially if you're claiming that applicants from related health fields have an advantage. Would you disagree?

Edit: Also, cut us some slack! If there were that many many MANY better applicants than us we wouldn't have been accepted! 🙂

I would also say that the majority do not have any significant research (I'm talking serious research that was an attempt at getting poster/publication...not little insignificant "projects" people did for honors classes).

Also no, healthcare experience isn't looked at nearly as favorable as people like to think it is (see every post about EMS experience and med school ever posted on this board). It all gets lumped in with "work" or "volunteer" experiences. Saying you volunteered as a nurse at a free clinic for such and such years is the same thing (at least in my experience) as *insert random number* of years working for habitat for humanity to adcoms.

 

[vivalavie]

Also no, healthcare experience isn't looked at nearly as favorable as people like to think it is (see every post about EMS experience and med school ever posted on this board). It all gets lumped in with "work" or "volunteer" experiences. Saying you volunteered as a nurse at a free clinic for such and such years is the same thing (at least in my experience) as *insert random number* of years working for habitat for humanity to adcoms.

I think you're wrong about a doctorate helping so much. A doctorate doesn't necessarily say you're committed to medicine. If you were committed to medicine, you wouldn't have gotten a doctorate in another field. 😉 A doctorate in nursing, chiropractry, podiatry, whatever, says that you were committed to that particular field; hence why you pursued a doctorate in it.

Yeah... look at the post history. I was responding to a post which said that having worked in a healthcare field outside of medicine helps you get into med school. I was making the opposite point. It's hard for these guys to get into med school, which is why, I think, they need an alternative path. Thanks for making my argument for me

 

[Charles_Carmichael]

Yeah... look at the post history. I was responding to a post which said that having worked in a healthcare field outside of medicine helps you get into med school. I was making the opposite point. It's hard for these guys to get into med school, which is why, I think, they need an alternative path. Thanks for making my argument for me

You're misreading things. I never said that having healthcare experience is not helpful. I said that having a doctorate in another field is not as helpful as you think it is. Big difference. I agree with Makati that having experience in another healthcare field does help. I disagree with you that it's as helpful as you think.

Again, and I'm getting tired of repeating myself for you, there is absolutely no evidence suggesting that an NP/DNP-to-MD/DO bridge should be pursued. Stop asking for an easier path because nurses are "frustrated." Like I said before, that's not a good reason. And a bridge program, if it ever occurs, will only shave off a month or two for the nursing midlevels since they have to pretty much learn everything a med student does anyways.

 

[vivalavie]

You're misreading things. I never said that having healthcare experience is not helpful. I said that having a doctorate in another field is not as helpful as you think it is. Big difference. I agree with Makati that having experience in another healthcare field does help. I disagree with you that it's as helpful as you think.

Again, and I'm getting tired of repeating myself for you, there is absolutely no evidence suggesting that an NP/DNP-to-MD/DO bridge should be pursued. Stop asking for an easier path because nurses are "frustrated." Like I said before, that's not a good reason. And a bridge program, if it ever occurs, will only shave off a month or two for the nursing midlevels since they have to pretty much learn everything a med student does anyways.

But I don't think it's helpful at all.
I think you're having an issue with wording, but I honestly can't discern your point.

I've asked you to stop repeating yourself, it's not adding anything to the argument, I've addressed all of these things many times in previous posts and I am moving on. If you do not do likewise I will add you to my ignore list, because it's getting annoying. We've discussed these issues, we came to different conclusions, read my previous posts if you want to hear my arguments again.

 

[drift]

But I don't think it's helpful at all.
I think you're having an issue with wording, but I honestly can't discern your point.

I've asked you to stop repeating yourself, it's not adding anything to the argument, I've addressed all of these things many times in previous posts and I am moving on. If you do not do likewise I will add you to my ignore list, because it's getting annoying. We've discussed these issues, we came to different conclusions, read my previous posts if you want to hear my arguments again.

Many NP programs don't even require gen chem as a prereq for their "clinical doctorate." They want credit towards medical school now?

..I'd sleep on it.

 

[Charles_Carmichael]

But I don't think it's helpful at all.
I think you're having an issue with wording, but I honestly can't discern your point.

I've asked you to stop repeating yourself, it's not adding anything to the argument, I've addressed all of these things many times in previous posts and I am moving on. If you do not do likewise I will add you to my ignore list, because it's getting annoying. We've discussed these issues, we came to different conclusions, read my previous posts if you want to hear my arguments again.

You didn't really address any of my issues. All you've kept repeating is that nurses are frustrated and that they want an easier path to med school without putting in the effort for prereqs, etc. That's really all you've said.

In fact, some of the things you've said support my argument. You yourself said, for example, that NP/DNP training has very little overlap to medical training and that you were scared at how low the knowledge of some of these nursing midlevels. Since this is the case, why is there a need for a bridge program? There is nothing to bridge in the first place if these nursing midlevels have to learn everything a med student and resident does. What part of med school would you cut off for this bridge program? You haven't given a single good reason as to why such a program needs to exist.

Feel free to add me to your ignore list if you'd like. Still doesn't change the fact that you haven't provided any convincing argument as to why such a bridge program needs to exist. It's hard to get into med school for anyone, not just nursing midlevels. Should we give everyone bridge programs now because they're frustrated at how difficult it is to get into med school?!

 

[vivalavie]

You didn't really address any of my issues. All you've kept repeating is that nurses are frustrated and that they want an easier path to med school without putting in the effort for prereqs, etc. That's really all you've said.

In fact, some of the things you've said support my argument. You yourself said, for example, that NP/DNP training has very little overlap to medical training and that you were scared at how low the knowledge of some of these nursing midlevels. Since this is the case, why is there a need for a bridge program? There is nothing to bridge in the first place if these nursing midlevels have to learn everything a med student and resident does. What part of med school would you cut off for this bridge program? You haven't given a single good reason as to why such a program needs to exist.

Feel free to add me to your ignore list if you'd like. Still doesn't change the fact that you haven't provided any convincing argument as to why such a bridge program needs to exist. It's hard to get into med school for anyone, not just nursing midlevels. Should we give everyone bridge programs now because they're frustrated at how difficult it is to get into med school?!

I can deal with you when you're like this, it's just when you do that copy and pasted response thing that I get annoyed, sorry I got a little steamed, heated debate 🙂.

I never mentioned pre-reqs, but I don't see why they shouldn't be responsible for them or equivalent coursework that would prepare them for med school... whether or not such coursework exists within a nursing program I am not qualified to say. I'm also not qualified to say how much the program could be abbreviated, but I'd say neither are you. What we need is a nurse who has made the transition to point out where the programs overlap. Even then, I would say that the subjects of overlap must absolutely be taught and tested to the same level of any medical school, but it could be accelerated since the nurses had already seen the topic. Beyond that, as I have stated the school would follow the 3 year med school model, only it would be slightly abbreviated in the way I have outlined, and it would create primary care providers who are dedicated to their work.

Silencing whining nurses is not the main point, the point is created primary care providers for underserved communities. The fact that they stop whining is just a nice added bonus 🙂. Nurses have proven their commitment to providing care, and they could be valuable allies as doctors by filling those positions that other physicians will not take.

I'm going to tell you now that I understand that you disagree, but please don't ask me to repeat these points in the future.

 

[drift]

Nurses have proven their commitment to providing care, and they could be valuable allies as doctors by filling those positions that other physicians will not take.

Did you really just use the words nurses & ally in the same sentence?

 

[vivalavie]

Did you really just use the words nurses & ally in the same sentence?

haha, well, in fairness, they wouldn't be nurses any more at that point now would they?

 

[Paseo Del Norte]

Many NP programs don't even require gen chem as a prereq for their "clinical doctorate." They want credit towards medical school now?

..I'd sleep on it.

Meh, chemistry is rather overrated. Just the other day I had to explain to an EMT student the basics behind giving bicarb and the association with increased carbon dioxide. Clearly, understanding that has no bearing or implications relating to "clinical" practice. Other than being able to say cool things such as "Le chatelier," I fail to see how chemistry applies to somebody who has a "clinical" degree in health care.

 

[Charles_Carmichael]

Meh, chemistry is rather overrated. Just the other day I had to explain to an EMT student the basics behind giving bicarb and the association with increased carbon dioxide. Clearly, understanding that has no bearing or implications relating to "clinical" practice. Other than being able to say cool things such as "Le chatelier," I fail to see how chemistry applies to somebody who has a "clinical" degree in health care.

Eh, I don't know. I don't have any clinical experience (beyond volunteering, shadowing, etc) but I have a solid basic science background. With that in mind, I've found physics and gen chem to be very helpful in developing a strong foundation in physiology. Cardiovascular physio? Basic E&M and fluid dynamics. Renal physio? Acid/base chemistry was very helpful. Respiratory physio? Again, acid/base chem and gas laws as well as pressure gradients, etc. Biochem built upon the basics of organic chemistry. Etc.

But, like I said, I don't know how much of this basic science stuff translates over to being helpful in the clinic. Physics and chem were definitely helpful, at least for me, in understanding physiology. And I would imagine that having a solid foundation in physiology would help out in the clinic. Who knows? Maybe I'm completely wrong. 🙂

 

[Paseo Del Norte]

Eh, I don't know. I don't have any clinical experience (beyond volunteering, shadowing, etc) but I have a solid basic science background. With that in mind, I've found physics and gen chem to be very helpful in developing a strong foundation in physiology. Cardiovascular physio? Basic E&M and fluid dynamics. Renal physio? Acid/base chemistry was very helpful. Respiratory physio? Again, acid/base chem and gas laws as well as pressure gradients, etc. Biochem built upon the basics of organic chemistry. Etc.

But, like I said, I don't know how much of this basic science stuff translates over to being helpful in the clinic. Physics and chem were definitely helpful, at least for me, in understanding physiology. And I would imagine that having a solid foundation in physiology would help out in the clinic. Who knows? Maybe I'm completely wrong. 🙂

Who knew? After all these decades, basic science courses turn out to be essentially useless. It's not like I actually care if my doctor knows about the chemistry of the medications he prescribes... 😀

 

[Makati2008]

Eh, I don't know. I don't have any clinical experience (beyond volunteering, shadowing, etc) but I have a solid basic science background. With that in mind, I've found physics and gen chem to be very helpful in developing a strong foundation in physiology. Cardiovascular physio? Basic E&M and fluid dynamics. Renal physio? Acid/base chemistry was very helpful. Respiratory physio? Again, acid/base chem and gas laws as well as pressure gradients, etc. Biochem built upon the basics of organic chemistry. Etc.

But, like I said, I don't know how much of this basic science stuff translates over to being helpful in the clinic. Physics and chem were definitely helpful, at least for me, in understanding physiology. And I would imagine that having a solid foundation in physiology would help out in the clinic. Who knows? Maybe I'm completely wrong. 🙂

1.)I agree with you on this. The basic sciences are important-Biochemistry is the perfect course to use in this case. You can use this course to learn about many metabolic disorder(mainly diabetes). Also you need some Chemistry for acid/base d/o.
2.)Physio when I took it in PA school seemed to need at least a small amount of general chemistry to get by as well.(Ask me next August for med. school lol)
3.)Some medicines we give you again need to know the basic chemistry.
4.)OPP we use a very small amount of physics.(At least the TA's at my school do when explaining motion and mechanics)

Hope that helps,
E.

 

[Paseo Del Norte]

Yeah, it's not like knowing about the stability of certain bond angles will actually be helpful when trying to understand how certain antibiotics work. Yet, who really needs that science stuff to be called "doctor" anyway.

 

[vivalavie]

Yeah, it's not like knowing about the stability of certain bond angles will actually be helpful when trying to understand how certain antibiotics work. Yet, who really needs that science stuff to be called "doctor" anyway.

I think this is where you run into trouble. If a nurse wants to become a doctor, fine, but he/she had better be willing to work just as hard (probably harder) and know just as much as any other doctor. If you start cutting corners such a program will never come to fruition.

That said, I think there's a lot to be said for understanding things at a fundamental level.

 

[drift]

Meh, chemistry is rather overrated. Just the other day I had to explain to an EMT student the basics behind giving bicarb and the association with increased carbon dioxide. Clearly, understanding that has no bearing or implications relating to "clinical" practice. Other than being able to say cool things such as "Le chatelier," I fail to see how chemistry applies to somebody who has a "clinical" degree in health care.

I wouldn't necessarily consider EMT training/working as "clinical" practice. Being an EMT-B once back in college, I can agree with you that working as an EMT, no such fundamental knowledge is required. Although for a physician/midlevel, it is absolutely essential. It builds up; need to know gen chem to understand orgo, need to know orgo to understand biochem, need biochem to understand, along with metabolic diseases, numerous other pathologies. Much of it may not be relevant, probably the majority, but there are certain concepts that need to be mastered. Imagine trying to treat a gout patient without knowing basic acid/base concepts.

 

[PSYCHNP]

I'll stop repeating myself if you stop asking for a nursing midlevel-to-physician pathway because nurses are frustrated. You haven't provided any valid reason so far as to why such a path needs to exist. There's practically no overlap between medical and nursing education. If the PA-to-DO bridge only reduces med school length by one year (essentially removing 4th year, I think...and PAs have a heck of a lot more basic science/clinical training than NPs/DNPs), how will a bridge program for NPs/DNPs work? What, it'll reduce med school for them by about a month? Definitely not worth pursuing.

And no, research is not required for med school. I would say that the majority of matriculants to most med schools don't have research. And even if they did conduct some, it's likely nowhere near the level that would have much of a sway on the adcoms (ie. publications, presentations at national conferences, etc).


I think you're wrong about a doctorate helping so much. A doctorate doesn't necessarily say you're committed to medicine. If you were committed to medicine, you wouldn't have gotten a doctorate in another field. 😉 A doctorate in nursing, chiropractry, podiatry, whatever, says that you were committed to that particular field; hence why you pursued a doctorate in it.

Don't get me wrong. I think a doctorate helps in med school admissions. I just think you're vastly overestimating how much it helps.

I thought podiatrists practice podiatric medicine?

I was also under the impression that NPs prescribe the same meds as MDs.

Then again, I may be wrong.

 

[OHNAILS]

delete

 

[Paseo Del Norte]

I wouldn't necessarily consider EMT training/working as "clinical" practice. Being an EMT-B once back in college, I can agree with you that working as an EMT, no such fundamental knowledge is required. Although for a physician/midlevel, it is absolutely essential. It builds up; need to know gen chem to understand orgo, need to know orgo to understand biochem, need biochem to understand, along with metabolic diseases, numerous other pathologies. Much of it may not be relevant, probably the majority, but there are certain concepts that need to be mastered. Imagine trying to treat a gout patient without knowing basic acid/base concepts.

It was an EMT intermediate student who asked the question after a renal patient with hyperkalaemia was given bicarb.

I hope my sarcasm was not misunderstood? I thought I had pretty clearly indicated this? My whole point being, a provider with less than 500 hours of training found chemistry relevant to clinical practice, yet we have some providers with "doctoral" degrees who have nothing more than survey couses under their belt. Not that survey courses are bad however.

 

[VA Hopeful Dr]

Nurses have proven their commitment to providing care, and they could be valuable allies as doctors by filling those positions that other physicians will not take.

This excuse is often used but I"ve yet to see any evidence that this happens. If this were the case, we wouldn't see any NPs outside of rural practice primary care. Derm is certainly not an area that physicians won't take, yet the NPs are after that one fairly hard.

 

[vivalavie]

This excuse is often used but I"ve yet to see any evidence that this happens. If this were the case, we wouldn't see any NPs outside of rural practice primary care. Derm is certainly not an area that physicians won't take, yet the NPs are after that one fairly hard.

You're coming into the discussion late, what I suggested was a bridge program based on the 3 year med school model. These schools have only one year of clinical rotations because they focus exclusively on primary care, and once the student graduates they are only eligible for primary care residencies. NPs graduating from such a program would have to go into primary care.

Edit: Futurama quote in your signature AND a TARDIS avatar? I approve so hard.

 

[zenman]

Imagine trying to treat a gout patient without knowing basic acid/base concepts.

Better know your veggies also...

 

[deleted6669]

Better know your veggies also...

and your selection criteria for antihypertensives....it's amazing how many folks put pts with bad gout on hctz....

 

[Maybeknot]

You're coming into the discussion late, what I suggested was a bridge program based on the 3 year med school model. These schools have only one year of clinical rotations because they focus exclusively on primary care, and once the student graduates they are only eligible for primary care residencies. NPs graduating from such a program would have to go into primary care.

And, as many have said, there is a bridge program based on the 3 year med school model. It's the 3 year med school model.

I do get what you're saying though. I wouldn't have a problem letting NP/DNP/PA's/anyone "pass out" of certain educational or clinical requirements if they aced a standardized set of exams; for instance, let the students take the biochem final from the previous year, and if they get an "A" (as weighted against that year's class) they don't have to take biochem. Hell, my med school wouldn't let people with PhD's in biochemistry pass out of biochem-- which was utterly ridiculous.

Clinical rotations are a little harder, though. Make them ace the shelf, and if they succeed in that, they can have, say, 1 month of medicine instead of 3 (where if they don't meet an extremely high evaluation standard, they must continue to the entire length of the rotation).

I don't think many NP/DNP/PA/anyone's are going to really want to do this. But it would be a way of making certain that, if you insist that you're already qualified based on your prior experience, that you really do pass a high standard to skip required coursework/clinic work.

 

[FutureDoc4]

And, as many have said, there is a bridge program based on the 3 year med school model. It's the 3 year med school model.

I do get what you're saying though. I wouldn't have a problem letting NP/DNP/PA's/anyone "pass out" of certain educational or clinical requirements if they aced a standardized set of exams; for instance, let the students take the biochem final from the previous year, and if they get an "A" (as weighted against that year's class) they don't have to take biochem. Hell, my med school wouldn't let people with PhD's in biochemistry pass out of biochem-- which was utterly ridiculous.

Clinical rotations are a little harder, though. Make them ace the shelf, and if they succeed in that, they can have, say, 1 month of medicine instead of 3 (where if they don't meet an extremely high evaluation standard, they must continue to the entire length of the rotation).

I don't think many NP/DNP/PA/anyone's are going to really want to do this. But it would be a way of making certain that, if you insist that you're already qualified based on your prior experience, that you really do pass a high standard to skip required coursework/clinic work.

This totally misses the point many people are making here.

For example, the person with a PhD took classes that focused on the molecular/cellular aspects of biochemistry, but likely did not learn about that effects physiology, pathology, and pharmacology choices (e.g. classical example: G6PD defiency and Dapsone).

The focus is COMPLETELY different---so how are you going to let someone "test out of" something they NEVER proofed they learned?

This same thing carries over for mid-levels---just because they took pathology (e.g. PAs, because DNPs really don't take traditionally pathology as far as I have seen in curriculum & and I have looked at a few of them)

It is has not at the same level and depth--so how can you let someone "test out of of" what they never proofed to have learned.

The same goes for rotations. PAs and DNPs have great medical experience but expectations for them on rotations and clinical exams are different (I'm sorry I dont mean to be harsh, but its the reality).

So, letting them have 1 month of medicine instead of medicine instead of 2 doesn't make sense because it is a different intensity/focus.

 

[deleted6669]

The same goes for rotations. PAs and DNPs have great medical experience but expectations for them on rotations and clinical exams are different (I'm sorry I dont mean to be harsh, but its the reality).

.

This is highly variable as you might expect. at my program pa-2 and ms3 were scheduled interchangeably on rotations and had exactly the same requirements in terms of pt load, presentations, call, etc
I know some programs treat pa students like second class citizens and have them do nothing. fortunately the better programs arrange real rotations for their students.

 

[Makati2008]

This totally misses the point many people are making here.

For example, the person with a PhD took classes that focused on the molecular/cellular aspects of biochemistry, but likely did not learn about that effects physiology, pathology, and pharmacology choices (e.g. classical example: G6PD defiency and Dapsone).

The focus is COMPLETELY different---so how are you going to let someone "test out of" something they NEVER proofed they learned?

This same thing carries over for mid-levels---just because they took pathology (e.g. PAs, because DNPs really don't take traditionally pathology as far as I have seen in curriculum & and I have looked at a few of them)

It is has not at the same level and depth--so how can you let someone "test out of of" what they never proofed to have learned.

The same goes for rotations. PAs and DNPs have great medical experience but expectations for them on rotations and clinical exams are different (I'm sorry I dont mean to be harsh, but its the reality).

So, letting them have 1 month of medicine instead of medicine instead of 2 doesn't make sense because it is a different intensity/focus.

Up until this point I agreed with you. When I rotated with medical students we were used interchangably. I was allowed to put in chest tubes/central lines/etc.. while on Gen surg. rotation for example. On Pysch the medical students seemed to be confused when they were pimped while the PA's students seemed to be more with it. I even had the medicine doctor shocked about what we had to know/ learn during our Medicine block.

I think that our(PA) education is more streamlined for clinical practice while that of the medical student is geared toward preparing for internship/residency due to the greater amount of clinical training they will recieve after graduation(This is the point where the medical student will overcome the pa by leaps and bounds). I will say this the physiology in medical school is much more indepth than what I had in PA school as well as the Neuroanatomy course.

Sorry if the syntax is screwed up been a LONG day.

 

[deleted6669]

agree about the clinicals. we had an award given out on medicine for the best student.
a PA got it despite the fact that we had several ms3's on the same service.
No arguement here about the didactic coursework. that is why the lecom bridge has the pa do 100% of ms1 and ms2 followed by a streamlined clinical yr including summers.

 

[Maybeknot]

This totally misses the point many people are making here.

Respectfully, I'm not missing anything. I understand your point. I understand the opposite point of view as well. I'm offering a middle ground. The NP/DNP's will insist that their background is equivalent enough-- rather than pout and deny, let's make them prove it.

For example, the person with a PhD took classes that focused on the molecular/cellular aspects of biochemistry, but likely did not learn about that effects physiology, pathology, and pharmacology choices (e.g. classical example: G6PD defiency and Dapsone).

The focus is COMPLETELY different---so how are you going to let someone "test out of" something they NEVER proofed they learned?

Do you really have such a complete grasp of the differences between ALL graduate level biochemistry programs and a medical school level biochemistry course? If someone who has "proofed" through completing their PhD coursework and committee-reviewed original research thesis that they understand biochemistry, I don't think there's any harm in letting them sit through an exam to prove that they don't need to sit through a biochemistry course. After all, in my med school, a substantial portion of classmates didn't show up to lecture and just read the syllabus on their own. Is that proofed enough that they learned anything?

This same thing carries over for mid-levels---just because they took pathology (e.g. PAs, because DNPs really don't take traditionally pathology as far as I have seen in curriculum & and I have looked at a few of them)

It is has not at the same level and depth--so how can you let someone "test out of of" what they never proofed to have learned.

That's why they have to take the test, and not only pass it (the med student requirement), but ace it. If they can do that, then who is anyone to say that they didn't master the material?

The same goes for rotations. PAs and DNPs have great medical experience but expectations for them on rotations and clinical exams are different (I'm sorry I dont mean to be harsh, but its the reality).

So, letting them have 1 month of medicine instead of medicine instead of 2 doesn't make sense because it is a different intensity/focus.

The NP/DNPs are claiming otherwise. I'm giving them a chance to prove that they are right. I personally believe that they are wrong, but rather than continue to argue to earless heads (let's face it, the politicians are in the hands on the nursing lobby far more than they are with ours), let's give them an opportunity to prove us wrong.