hospitalistpac said:
I think about going to med school. The biggest deterrent is repeating rotations. I see the med students at my hospitals rounding on gyn pts at 5am, writing notes that no one will read. I did that already. I also did psych, fp, im, er, etc, etc. And yes we had tests at the end of every rotation that were stressful.
If a med school was to shave any time off, it should be from rotations.
My ideal med school: 20 months straight through didactic
12 months of fourth year type clerkships
Take step I, II along the way, then residency
I know it will never happen because of money. People pay to do third yeard rotatation, so why would they let someone not pay/not do it?
What is slowly happening, at least at my school, is that the Dean and President who are big PA proponents are seeing how well the PA's are doing in med school. Unfortunately its not all that impressive. I think I can say with 99% certainty that of the PA's that graduated ahead of me, and those behind me, none other than myself have bothered to try real hard and thus I am the only one near the top of my class. That does not help the profession, but helps the individual PA. I have had a great deal of pride in med school...wanting to make sure that no young whipper snapper was able to blow me away when I had a ton of clinical and academic experience coming in. I mean lets face it, there is no better preparation on earth for med school than being a full time primary care PA for several years. Though it sucked, I was able with about 50% effort to keep myself in the 95-99%ile range for rank, boards, and evaluations. Most of the PA's I know in med school rarely if ever worry about doing well. They just want to get through. They probably put forth considerably less effort than myself and still pass.
As for your ideal med school...I think it is feasible but unfortunately unrealistic. I do believe that if you could custom build a curriculum for PA's to go through med school as efficiently as possible, it would be like this:
First semester: Histo completely, Pathophys...first half of Robbins Text
Second Semester: Histo Part II, 2nd half of Robbins + rapid A&P review
Then, take USMLE Step I
Now for the clinical year (this is where it gets tricky) The student should be required to take the USMLE I by the end of June after the first year. Then, electives aimed at obtaining residencies should be allowed for July, August, and September. Now between October and May, each student would need to repeat each core rotation for only 1 month and serve as an MSIII, not an MSIV (because everyone knows MS4's don't do squat!!). Interviews would need to be done during either a December or a January vacation month, the only vacation month of the entire 2 years. The PA's would then take Step II of the USMLE in Spring after their interviews and graduate with the respective class, thus shaving a total of 2 years off the curriculum.
You simply need a progressive Dean to be convinced that signing off on the education was equivilant. Because as long as you have a Dean who signs the form for NBME, you can test and graduate. Its the state medical boards that might give you a problem if they were to look into the curriculum and see that there was not a total of 4 years in the med student capacity. They probably would not even look though if you had a diploma.
As for USMLE...I just think the main hurdle is passing Step I. I believe once a PA has studied for and passed Step I, it would only take minimal studying to pass Step II. Step II for me was much easier than Step I and I have no doubt I could have passed it as a PA having never been to med school. I would not likely have passed Step I though without additional education.
Another hurdle would be PD's seeing your strange looking med school transcript and not understanding it come application time for residency. I think being a PA helped me 85% of the time in my applications for residency but I am quite certain my being a PA turned off some of the more prestigious programs. I think they felt I might know too much and those power hungry academics in places like that want to have all the cards of the deck in their hands.
Quicksilver...you are correct...not a dozen Shelf exams.
Basic Science Shelf
Medicine
Surgery
Psych
OBGYN
Peds
Family Medicine
Some schools I think take an NBME EM and neuro shelf as well.
I too found the Shelf exams rather easy but it was because I studied for them. I knew from studies that a 95-99% on the Shelfs would get in excess of 250-260 on Step II. And I wanted to do that well.
In the end, if you went straight through, in a program that had the resources to devote to this type of curriculum, I believe it could all be done in 4 semesters....so less than 21 months total.
The problem is that most major med schools now also have PA schools, and it serves no greater good to encourage these grads to want to go back and become physicians. I also believe a curriculum like this should require a PA to have 3-4 years of full time work under their belts prior to entering.
BTW...I believe that a program like this should require an entrance exam and waive the MCAT. The entrance exam should be something like 200 questions comprised of all aspects of basic anatomy, physiology, pharm, etc....and as the program becomes more competitive it moves from simply a passing score to one where the highest 10 grades for instance are admitted.
Maybe when I am Dean!!!
😉
im in the same boat only im a 24 year old guy and finished my pre-reqs
