PA & clinical rotations

[TMPH]

Hi everyone, I am really interested in the PA career and hopefully I will peruse it after I finish my MPH. I just have couple Q’s about the clinical years. During your OB/GY rotation do they actually allow you to deliver babies (like medical students), and what exactly PA’s does in the OR (do they perform minor surgery or just close the wounds after the surgery is done)??.

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[Monika]

Our program treated us no differently than med students on all rotations. The residents and attendings treat us equally and expect the same level of work from the PA students as they do for the med students.
As far as the OR goes, I was allowed to ASSIST during all the operations that I scrubbed in on. I was allowed to close as well. The discretion is left up to the upper level or attending at the surgery regarding how much they will let you do in the OR. Remember that the liability is HUGE in Ob/Gyn, so they are generally very careful about what they will alow any student to so.

This was just my single experience, I'm sure others will have other views to offer.

Mon =)

 

[deleted6669]

at my program pa students were treated just like medstudents, sent to the same facilities with the same preceptors and had the same responsibilities while there. as a clinical pa student I
delivered babies,
intubated pts,
put in chest tubes and central lines, performed open cardiac massage
1st assisted at c-sections and trauma surgical procedures,
performed tubal ligations as primary surgeon with the ob doc 1st assisting me(after I saw a few and 1st assisted him),
performed facial repairs on children using conscious sedation with ketamine,
performed lumbar punctures on sick kids at a childrens hospital
admited pts to the icu and followed them while there,
taught my intern on the im service how to dictate, suture, draw blood and start iv's( it was his 1st month out of school),
took q2 24 hr call at the busiest trauma center in washington dc for 5 weeks,
got certified/credentialed( or recertified in some cases) in acls, pals, nals, phtls, and atls
in addition to a variety of other tasks/procedures.

so yes, pa students get to do what md students do. the md students do it for 2 years though while we only do 1.

 

[Freeeedom!]

At my medical school and residency ( and I think this is a trend)...there is a hierarchy with the procedures going to the medical students first and then the PA students. Unfortunately there are ALOT of fights for the procedures and that may leave a unaggressive student behind. But as you may expect, there is a defined hierarchy.
I think emedpa is the exception to the rule. Personally I think the medical students don't even get enough procedures do to "liability concern"... It is a reality.

 

[Monika]

'Defined hierarchy' or not, a lot of it is left up to fate & who happens to be around when a procedure comes up. You are right about needing to be aggressive though, that helps. My experience has been that if you show interest & act confident most residents/attendings could care less if you are a medical or PA student.

So to the OP...I would not worry about not being able to get your hands in procedures. You will have plenty of opportunity at most places. Just jump in there!

M

 

[deleted6669]

'Defined hierarchy' or not, a lot of it is left up to fate & who happens to be around when a procedure comes up. You are right about needing to be aggressive though, that helps. My experience has been that if you show interest & act confident most residents/attendings could care less if you are a medical or PA student.

So to the OP...I would not worry about not being able to get your hands in procedures. You will have plenty of opportunity at most places. Just jump in there!

M

there is a lot to be said for being agrressive and also for choosing your rotations well. on many of my rotations I was the only student of any kind on the service at the time so procedures were by definition mine to do if I wanted them. on my surgery rotation we had 3 trauma teams switching off as primary call group/backup call group/day off. there were students from all over the world on other teams but my school had a special in for the only student spot on the navy surgical team for which I am forever grateful
on medicine there were lots of brand new 3rd years but they were all timid so I just pushed them out of the way when the attending asked for volunteers to do procedures.
many programs can tell you what kind of students rotate at a certain site and when. aim for the slots when no one else is there. my em rotation slot was nights at a busy trauma ctr and once again I was the only student there. lots during the day, but none on the night shift.similar deal with ob. I was the only student willing to go to an inner city hospital in the middle of the combat zone. something to think about.

 

[TMPH]

Thanks for your responds, As far as I know Medical students have 2yrs of clinical rotations (3rd& 4th yr) but they only have to wary about 3rd yr rotations (Surgery,Intern.med,OB/GY,Family or ER) because USMLE-II based on it and the 4th yrs is just electives (mainly concentrating on what type of residency they will peruse). My point is both PA& Med students do the essential clinical rotation in one YR and technically PA’s are able to take USMLE-II and passed with no Pb’s

 

[Ponyboy]

Med students have different rotations than PA students. Their rotations tend to be longer (12 weeks of Medicine and Surgery, 6-8 weeks of Peds, ObGYN and Psych) than PA students.
While Emed has done a lot as a student, if I recall correctly, he trained in an era before our time. In this day of med malpractice, the procedure hierarchy is definitely shifting so that higher trainees (residents and fellows) are doing what lower trainees used to do (students and residents). Unfortunately, this means that PA students are one below med students when the order comes for procedures.

That being said, if you're vocal and confident, you can get almost as many procedures as you want.

 

[Monika]

I'm sure that med students schedules are different overall. All I know is that when we are on the same service as med students, the residents/attendings require the same work from the PA students.

Just to give you an idea of a typical PA clinical year...here's my program rotation requirements:

Emergency Medicine: 4 wks
General surgery: 4 wks
Surgery elective: 4 wks
Community/underserved medicine: 4 wks
General Pediatrics: 6 wks
Obstetrics & Gynecology: 6 wks
Medicine: 8 wks
Primary Care: 12 wks

Research block: 4 wks

Take care,
M

 

[deleted6669]

mine was:
trauma surgery 5 wks
inpt medicine 5 weeks
obgyn 5 weeks
trauma ctr/ er 5 weeks
peds er 5 weeks
psych(inpt) 5 weeks
fp/im outpt 12 weeks
community em 12 weeks
total clinical yr = 54 weeks> 2200 hrs

 

[girlscallmepogi]

mine was:
trauma surgery 5 wks
inpt medicine 5 weeks
obgyn 5 weeks
trauma ctr/ er 5 weeks
peds er 5 weeks
psych(inpt) 5 weeks
fp/im outpt 12 weeks
community em 12 weeks
total clinical yr = 54 weeks> 2200 hrs

Do PA students have to do all these rotations like med students, or do they choose which ones they want?

 

[hospPA]

Do PA students have to do all these rotations like med students, or do they choose which ones they want?

I did

8 weeks ER
8 weeks IM (inpatient)
8 weeks FP with OB (outpatient)
4 weeks peds
8 weeks general surgery
4 weeks geriatrics

*all above required, the 2 below could be anything you want

4 weeks ortho (elective)
4 weeks cardiology (elective)

Pat