Clearly, neither do you. You're still in your didactic years.
I didn't understand at all what it was like to be a 3rd or 4th year medical student, or what clinical training was actually like, until I was there. It's funny to hear people run their mouths about how advanced or rigorous their "training" is when they haven't even gotten there yet. I am 2 rotations away from graduation, and will have more training in clinical medicine and surgery than someone graduating from PA school. And I am completely humbled by the training of my colleages in surgical residencies, and the abilities of my surgical attendings. There is a reason that surgical residency is as long and as grueling as it is. There are no shortcuts.
On my surgical rotations (cardiac, gen surg, colorectal, etc.), the role of the PA in the operating room was usually to carry out the highly repetitive tasks that the attending surgeon or fellow did not have the time nor the desire to do. They were there to increase efficiency, to limit the amount of time per patient in the OR, so that turnover was faster. They performed tasks that take a little while to learn, but once you've repeated it enough times, it's relatively straightforward and difficult to screw up or seriously hurt the patient. Occasionally the PA would function as first- or second-assist, but since I mostly rotated at academic centers, usually the fellow or senior resident served this capacity. At the community hospital where I rotated there was a PA who would occasionally assist in the OR, but he was usually upstairs doing floor work. Also, he worked 40 hours a week - not the 80+ that the residents and attendings did, so I rarely saw him in the OR.
In my experience with PAs in the operating room, they were all very competent at what they did, especially the cardiac surgery PAs. They sped up the efficiency of the procedure and certainly helped out the attending's bottom line ($$$). And I'm sure that the fellow didn't mind because that meant one less saphenous vein he had to harvest, and one less leg to close - he could then spend all his time in the chest. However, the cardiac surgery PAs were terrible at teaching residents and medical students, and carried themselves with a perpetual air of superiority - probably because having medical students performing tasks that were usually delegated to them slows down the efficiency of the process. I get it - it's annoying to have someone pick their way through something you could do in half the time. I guess it's easy to forget that we were all students once, and that you have to learn sometime. Especially when $$ is at stake. But at an academic center, it should be understood by the attending that cash flow need to take a backseat to education at times. Clearly, this is lost on some of the cardiac surgeons at my institution, as well as their PAs.
