PA to MD

[IDFTIGER]

Sup, any PA's planning on going to med school? Any advice you guys willing to share? How did being a PA factor into acceptances etc.?

 

[eralza]

Why would someone want to go from PA to MD?! Every physician I spoke to before applying to med school told me to apply to PA school instead. The PA students at our school are happy and healthy, while we - the dwellers of the eternal library- look like zombies.

 

[Tori's dad]

Why would someone want to go from PA to MD?! Every physician I spoke to before applying to med school told me to apply to PA school instead. The PA students at our school are happy and healthy, while we - the dwellers of the eternal library- look like zombies.

Good Question... if you are already involved heavily in patient care, why the switch?

(one of my interviewers asked me "why not PA school") I'd be interested what you would say as a PA

 

[dara678]

i feel like going from PA to MD would be incredibly repetitious in terms of the classes, and even the school work ... i mean most PAs are the primary health care providers of their patients, and physician oversight is usually minimal or superficial at the least (because the PAs know what they're doing). wouldn't you want to be working, making a good income, and starting a family in those 4 years rather than of slaving away in the library?

 

[velo]

maybe s/he doesn't want to do primary care anymore (or the ER or assisting a surgeon/specialist or whatever else s/he's doing)?

There are no PA surgeons, cardiologists, gastros, etc...

 

[njbmd]

Sup, any PA's planning on going to med school? Any advice you guys willing to share? How did being a PA factor into acceptances etc.?

Hi there,
I had a couple of former PAs in my medical school class. I also had a couple of former RTs, pharmacists and nurses. I don't know if being a PA helped in terms of their admissions but it turned out to be pretty useful for third year. They were willing to help us "greenies" when it came to physical diagnosis.

njbmd

 

[nev]

maybe s/he doesn't want to do primary care anymore (or the ER or assisting a surgeon/specialist or whatever else s/he's doing)?

There are no PA surgeons, cardiologists, gastros, etc...

Well...there are PAs who work in cardiology, gastros, etc as clinicians just like they do in primary care....

 

[Tori's dad]

Well...there are PAs who work in cardiology, gastros, etc as clinicians just like they do in primary care....

Exactly...I'm just wondering WHY. I honestly don't understand the reasoning behind making the switch, though I would really like to know.

 

[ilovestewie]

well, there are many reasons.

1) the misunderstanding of what PAs are and do even within the medical community. It becomes very frustrating explaining it to EVERYONE you see.

2) doing the same job, as many of you have pointed out, for approximately 1/2 the money.

3) although PAs can be and many are great clinicians and MD degree awards you many more opportunities outside of the clinic and tenure in academia.

4) As a PA you are a dependent practitioner, if your supervising physician croaks, moves, divorces his/her office manager wife then YOU are left on the street or dealing with the reprocusions.

5) You're title has the word ASSISTANT in it. Its kind of demeaning for the hard work we put into school and work.

6) Nurses sometimes dont want to follow out your treatment plan for your patient. (the fact that these treatment plans are also called ORDERS also doesnt help, not many ASSISTANTS give ORDERS)

7) Everyone gets bored a little with their job, it never hurts to broaden your horizon and learn a little more.

8) Many PAs in specialties get the cold shoulder from referring docs when they refer the patient to see a SPECIALIST and the patient sees an ASSISTANT.

9) Surgeons are mean, PAs are their assistants no matter how much of the surgery they do or whether or not they are just as involved as an MD 1st assist would have been.

10) PAs have TONS of silly hoops to jump through in their practice and many resrictive laws that make practice more cumbersome than safe for the patient. Sometimes you have to be more worried about whether a drug is on your formulary that was submitted to the medical board and signed by your doc that takes 200 dollars and 2 months to change before you write an Rx.

chris

 

[Tori's dad]

I was under the impression that PA's knew these things before applying to PA school. So are you saying that the PA's going to med school did not know this before working in a clinical setting?

 

[Mr. McDuck]

I do believe people make a decision and realize it is not exactly what they thought it would be. Perhaps they didn't think those things would get to them as much as they did once faced with them. Or, it could be a variety of other reasons besides not knowing.

 

[velo]

Well...there are PAs who work in cardiology, gastros, etc as clinicians just like they do in primary care....

yeah but always with a cardiologist, surgeon, gastro....and being a PA with a doctor in one of those fields is not, by any stretch of the imagination, the same as being a surgeon or medical specialist.

PAs in primary care are (nowadays) similar to PCPs...but that's about the only area where this is really the case.

 

[dara678]

well, there are many reasons.

1) the misunderstanding of what PAs are and do even within the medical community. It becomes very frustrating explaining it to EVERYONE you see.

2) doing the same job, as many of you have pointed out, for approximately 1/2 the money.

3) although PAs can be and many are great clinicians and MD degree awards you many more opportunities outside of the clinic and tenure in academia.

4) As a PA you are a dependent practitioner, if your supervising physician croaks, moves, divorces his/her office manager wife then YOU are left on the street or dealing with the reprocusions.

5) You're title has the word ASSISTANT in it. Its kind of demeaning for the hard work we put into school and work.

6) Nurses sometimes dont want to follow out your treatment plan for your patient. (the fact that these treatment plans are also called ORDERS also doesnt help, not many ASSISTANTS give ORDERS)

7) Everyone gets bored a little with their job, it never hurts to broaden your horizon and learn a little more.

8) Many PAs in specialties get the cold shoulder from referring docs when they refer the patient to see a SPECIALIST and the patient sees an ASSISTANT.

9) Surgeons are mean, PAs are their assistants no matter how much of the surgery they do or whether or not they are just as involved as an MD 1st assist would have been.

10) PAs have TONS of silly hoops to jump through in their practice and many resrictive laws that make practice more cumbersome than safe for the patient. Sometimes you have to be more worried about whether a drug is on your formulary that was submitted to the medical board and signed by your doc that takes 200 dollars and 2 months to change before you write an Rx.

chris

i see ... good post! thanks for enlightening me

 

[ilovestewie]

I was under the impression that PA's knew these things before applying to PA school. So are you saying that the PA's going to med school did not know this before working in a clinical setting?

yes, you hear them one at a time usually. and each one seperated is not that big of a deal. Rarely do you hear someone make a list and the ten I gave is just a drop in the bucket. it is not possible to get the whole scoop from someone, not to mention most PAs are happy with their jobs so asking them makes it seem like a fairytail. Then all of the public misinformation, check out the "money magazine" version of PA hood and compair it to what I said.

What really happens is, more exists. Some people will always desire more and until more doesnt exist anymore they will not be happy. The only point in medicine that is an END POINT is as a board certified physician. It is very easy to convince yourself (well, this is enough) especially at 21-25 when 80-100k a year while still in your 20s sounds mighty appealing.

The funny thing is, a lot of people think its about the money, but being a PA is a very financially sound decision. The real factors are everything else I have mentioned. It gets very very very old and FAST. I am actually considering staying a PA and being the strong person who promotes are profession but the real question is... promote it HOW? In what way can I promote our profession without pissing most doctors (our employers) off!? I cant quote the studies that show PAs give equal care, I cant do anything... WHY? BECAUSE I NEED A JOB! Think about it... Its a tough place to be in.

All in all, being a PA is a job.... being a physician is a calling. Some people need a job, some people develop that feeling, that they have that calling to be a physician.

 

[OrnotMajestic]

yeah but always with a cardiologist, surgeon, gastro....and being a PA with a doctor in one of those fields is not, by any stretch of the imagination, the same as being a surgeon or medical specialist.

PAs in primary care are (nowadays) similar to PCPs...but that's about the only area where this is really the case.

That's my thoughts as well. One of my best friends is graduating from PA school this August. I asked her how one gets a job as a PA specialist. "Is there a residency and a training to go to?" Her reply? "Not really. Usually you just apply and then get on-the-job training".

If this is true, then it is no wonder people get pissed off to see a PA instead of a cardiologist. I really doubt two years of PA school and and application can make up for four years of medical school and six years of residency. If it does, then I'm wasting a lot of time being in medical school.

 

[mjl1717]

well, there are many reasons.

1) the misunderstanding of what PAs are and do even within the medical community. It becomes very frustrating explaining it to EVERYONE you see.

2) doing the same job, as many of you have pointed out, for approximately 1/2 the money.

3) although PAs can be and many are great clinicians and MD degree awards you many more opportunities outside of the clinic and tenure in academia.

4) As a PA you are a dependent practitioner, if your supervising physician croaks, moves, divorces his/her office manager wife then YOU are left on the street or dealing with the reprocusions.

5) You're title has the word ASSISTANT in it. Its kind of demeaning for the hard work we put into school and work.

6) Nurses sometimes dont want to follow out your treatment plan for your patient. (the fact that these treatment plans are also called ORDERS also doesnt help, not many ASSISTANTS give ORDERS)

7) Everyone gets bored a little with their job, it never hurts to broaden your horizon and learn a little more.

8) Many PAs in specialties get the cold shoulder from referring docs when they refer the patient to see a SPECIALIST and the patient sees an ASSISTANT.

9) Surgeons are mean, PAs are their assistants no matter how much of the surgery they do or whether or not they are just as involved as an MD 1st assist would have been.

10) PAs have TONS of silly hoops to jump through in their practice and many resrictive laws that make practice more cumbersome than safe for the patient. Sometimes you have to be more worried about whether a drug is on your formulary that was submitted to the medical board and signed by your doc that takes 200 dollars and 2 months to change before you write an Rx.

chris

Good! There is a lot of truth to this post. And I speak from real life experience as a PA.. Id also say that what is read about in the books and classroom is on thing. But what actually occurs and is experienced on the job can be totally different entities.

 

[TexasRose]

yes, you hear them one at a time usually. and each one seperated is not that big of a deal. Rarely do you hear someone make a list and the ten I gave is just a drop in the bucket. it is not possible to get the whole scoop from someone, not to mention most PAs are happy with their jobs so asking them makes it seem like a fairytail. Then all of the public misinformation, check out the "money magazine" version of PA hood and compair it to what I said.

What really happens is, more exists. Some people will always desire more and until more doesnt exist anymore they will not be happy. The only point in medicine that is an END POINT is as a board certified physician. It is very easy to convince yourself (well, this is enough) especially at 21-25 when 80-100k a year while still in your 20s sounds mighty appealing.

The funny thing is, a lot of people think its about the money, but being a PA is a very financially sound decision. The real factors are everything else I have mentioned. It gets very very very old and FAST. I am actually considering staying a PA and being the strong person who promotes are profession but the real question is... promote it HOW? In what way can I promote our profession without pissing most doctors (our employers) off!? I cant quote the studies that show PAs give equal care, I cant do anything... WHY? BECAUSE I NEED A JOB! Think about it... Its a tough place to be in.

All in all, being a PA is a job.... being a physician is a calling. Some people need a job, some people develop that feeling, that they have that calling to be a physician.

Thanks for the thoughtful posts.

As you pointed out, not everyone realizes exactly what they want, or exactly what a particular career path will mean in the long run, when they are in their early 20's.

 

[Tori's dad]

yes, you hear them one at a time usually. and each one seperated is not that big of a deal. Rarely do you hear someone make a list and the ten I gave is just a drop in the bucket. it is not possible to get the whole scoop from someone, not to mention most PAs are happy with their jobs so asking them makes it seem like a fairytail. Then all of the public misinformation, check out the "money magazine" version of PA hood and compair it to what I said.

What really happens is, more exists. Some people will always desire more and until more doesnt exist anymore they will not be happy. The only point in medicine that is an END POINT is as a board certified physician. It is very easy to convince yourself (well, this is enough) especially at 21-25 when 80-100k a year while still in your 20s sounds mighty appealing.

The funny thing is, a lot of people think its about the money, but being a PA is a very financially sound decision. The real factors are everything else I have mentioned. It gets very very very old and FAST. I am actually considering staying a PA and being the strong person who promotes are profession but the real question is... promote it HOW? In what way can I promote our profession without pissing most doctors (our employers) off!? I cant quote the studies that show PAs give equal care, I cant do anything... WHY? BECAUSE I NEED A JOB! Think about it... Its a tough place to be in.

All in all, being a PA is a job.... being a physician is a calling. Some people need a job, some people develop that feeling, that they have that calling to be a physician.

So, a good follow up question would be, then, why do people choose PA school over medical school in the first place? From what I hear, PA school's are comparable in competitiveness for potential applicants (I could be wrong, that's just what I heard)

 

[supa]

So, a good follow up question would be, then, why do people choose PA school over medical school in the first place? From what I hear, PA school's are comparable in competitiveness for potential applicants (I could be wrong, that's just what I heard)

Well if you go to PA school, you can graduate and make $70,000 or more in a little over 2 years, as compared to med school where you have to wait at least 7 yrs b4 you start making good money. If you have a family to support, that's a major consideration.

Being a PA is great, but basically the perception is (among patients, med students, physicians, and other allied health/nursing staff) that no matter how long a PA works in a certain specialty, he can never be as knowledgeable as even a resident (ask Panda Bear about that).

I want everyone to stop and think about that for a second. That's pretty far from the truth if you objectively think about it. It's so simple that I'm not sure how to explain it to make it sink in. A PA is trained in such a way that upon graduation he can practice in his field up to the defined limits agreed upon by him and his physician/medical director. The program is DESIGNED in such a way that even though it is shorter, the knowledge base is sufficient for that purpose. Do we learn everything a doctor learns in school? No. But we learn enough to be able to practice relatively independently in many cases. In some practices/settings, PAs work alone, with a doctor showing up once a week or a phone call away. Without adequate training, that would be a recipe for disaster. The model works people, otherwise it wouldn't still be around (and flourishing).

Let me try to compare that to 2 med schools. One is full day schedule with classes from 8am to 5pm, 5 days/week. The other is 8am to 12pm, 5 days a week. The students at the 2nd school is in effect getting half of the formal education of the 1st school thru the 1st 2 yrs. But does that mean that they know half as much? Probably not. In reality, the curriculum at the 2nd school is DESIGNED so that the students there know everything they need to know to be successful on the boards, and as physicians.

Sure the PA education isn't as intense, and there is no MANDATORY residencies as of yet (even though you can do a residency in surgery, EM etc.). But I'm sorry, 1 to 2 more years of school, and 3 years of residency is not necessarily going to make a brand new attending in Internal Medicine (for eg.) more competent or knowledgeable than a PA working 20 years in IM. Experience trumps education at some point. Over a 20 year career, that PA would have handled hundreds of cases of a particular disease, and can manage and treat that patient just as well or better than the new attending who in many cases might even consult with a veteran PA (I've seen it happen).

In closing, a medical school education is longer, more rigorous, and more difficult to get into than a PA education, these things are obvious. Noone on this thread has argued that PAs are equal or should be equal to a doctor. I just want you guys to realize that a PA education is quite solid, and to think about how important actual real life patient contact is to the practice of medicine, and when you become physicians, not overlook how valuable an experienced NP/PA can be to your practice or group. There's so much more I can say on this topic but I fear I've overtyped my welcome already.

 

[Tori's dad]

I don't think the issue is whether PA's are more or less qualified than physicians. I don't even think anyone here is making that argument. The OP's question had to deal with PA's going to med school and a couple of people, like myself, wanted to know why someone would switch, and then why they would choose PA school over med school if they had the choice. I believe, thanks to you and others that those questions have been answered, however; I don't know why you made the comparison between the educations of the two professions. Perhaps that is a better topic of discussion for another thread?

 

[supa]

I don't think the issue is whether PA's are more or less qualified than physicians. I don't even think anyone here is making that argument. The OP's question had to deal with PA's going to med school and a couple of people, like myself, wanted to know why someone would switch, and then why they would choose PA school over med school if they had the choice. I believe, thanks to you and others that those questions have been answered, however; I don't know why you made the comparison between the educations of the two professions. Perhaps that is a better topic of discussion for another thread?

Sorry, there have been so many PA to MD topics on this board that I took a detour after the 1st paragraph, which dealt with one reason to make the switch. I've seen people make the comparisons between the 2 education models so I was also kinda responding to those people in this thread also.

But length and cost of education are 2 main reasons people opt for PA school. Others have no desire to be an MD, but still wish to manage and treat patients. And yes, some use PA school as a backup to med school.

 

[ilovestewie]

So, a good follow up question would be, then, why do people choose PA school over medical school in the first place? From what I hear, PA school's are comparable in competitiveness for potential applicants (I could be wrong, that's just what I heard)

sure.. I will simply give my reasoning.

I didnt think I could do it.

Now I realize I can and I can do it well, as good as anyone else.

 

[ndspider]

Why would someone want to go from PA to MD?! Every physician I spoke to before applying to med school told me to apply to PA school instead. The PA students at our school are happy and healthy, while we - the dwellers of the eternal library- look like zombies.

Don't use superlatives...eg "EVERY" doctor.
That is simply not true.
I would not go to PA school simply because I like control.
I want to know why I am giving medication... how the medication works... and what the hell is going on rather than being told so. MedSchool is the way to go if you want to be in the matrix.. if not... be a PA- which is an excellent field. It is basically what you want.
Don't forget how much more schooling MD's go through than PA's..... those doctor's that tell you to not go MD are either disgruntled or something else......
.spider

 

[supa]

Don't use superlatives...eg "EVERY" doctor.
That is simply not true.
I would not go to PA school simply because I like control.
I want to know why I am giving medication... how the medication works... and what the hell is going on rather than being told so. MedSchool is the way to go if you want to be in the matrix.. if not... be a PA- which is an excellent field. It is basically what you want.
Don't forget how much more schooling MD's go through than PA's..... those doctor's that tell you to not go MD are either disgruntled or something else......
.spider

So are you trying to imply that PAs don't know why they're prescribing meds and how they work? So when we took pharmacology I assume you think they just gave us a long list of drugs and put the diseases or conditions those meds are commonly used for without detailing the pharmacokinetics, pharmacodynamics, indications/contraindications, side effects/adverse reactions?

This is exactly the problem. Most people have no idea what a PA education entails, and usually they have some weird (and erroneous) assumption that we have an extremely surface knowledge of medicine, with little understanding of the disease process we're treating. I'm not sure how or if the profession can remedy this perception, but as someone in this thread -or another one, I kinda forgot- said, until a person has experienced both educations, they shouldn't make comparisons. That's why I'm not trying to compare the two per se, I'm more trying to get you guys to understand that a PA education conveys a lot more medical knowledge than you think.

Edit: You know what? I hope this thread keeps going so I can erase some of the misconceptions that people may have about the profession, and also to answer any questions about my experience as an Internal Medicine PA.

 

[UCSBMed1]

So are you trying to imply that PAs don't know why they're prescribing meds and how they work? So when we took pharmacology I assume you think they just gave us a long list of drugs and put the diseases or conditions those meds are commonly used for without detailing the pharmacokinetics, pharmacodynamics, indications/contraindications, side effects/adverse reactions?

This is exactly the problem. Most people have no idea what a PA education entails, and usually they have some weird (and erroneous) assumption that we have an extremely surface knowledge of medicine, with little understanding of the disease process we're treating. I'm not sure how or if the profession can remedy this perception, but as someone in this thread -or another one, I kinda forgot- said, until a person has experienced both educations, they shouldn't make comparisons. That's why I'm not trying to compare the two per se, I'm more trying to get you guys to understand that a PA education conveys a lot more medical knowledge than you think.

Edit: You know what? I hope this thread keeps going so I can erase some of the misconceptions that people may have about the profession, and also to answer any questions about my experience as an Internal Medicine PA.

Good post.

 

[ilovestewie]

my PA pharmacology?

3 semesters long,

first 2 semesters consist of lecture tapes and powerpoints watched/listened to at home and an additional 8 hours of class time a week for dynamic dicussion of the material covered in lecture.

The third semester is entirely case based and teaches EBM strategies for decision making.

Who teaches these classes? The pharmacology professor from our affiliated med school and the head of the med school's family practice department. Are the drugs we prescribe any different then the one docs precribe? Are docs even the "end all" of pharmacologic knowledge in the first place? Does the federal government issue DEA numbers to people who "dont know why they are prescribing something?"

 

[Tori's dad]

So are you trying to imply that PAs don't know why they're prescribing meds and how they work? So when we took pharmacology I assume you think they just gave us a long list of drugs and put the diseases or conditions those meds are commonly used for without detailing the pharmacokinetics, pharmacodynamics, indications/contraindications, side effects/adverse reactions?

This is exactly the problem. Most people have no idea what a PA education entails, and usually they have some weird (and erroneous) assumption that we have an extremely surface knowledge of medicine, with little understanding of the disease process we're treating. I'm not sure how or if the profession can remedy this perception, but as someone in this thread -or another one, I kinda forgot- said, until a person has experienced both educations, they shouldn't make comparisons. That's why I'm not trying to compare the two per se, I'm more trying to get you guys to understand that a PA education conveys a lot more medical knowledge than you think.

Edit: You know what? I hope this thread keeps going so I can erase some of the misconceptions that people may have about the profession, and also to answer any questions about my experience as an Internal Medicine PA.

Well said. And that is coming from a med student. I appreciate your answers to my questions.

 

[ndspider]

I am not saying PA's don't know. Of course they do.
But I can't tell you how many times i the hospital we have came across nurses and PA's that don't f-ing think
Eg. Some guy with heart failure is on a diuretic. So he is supplemented with potassium. If the potassium is at 6 should the freaking PA still follow through and continue with supplement or tell a doctor? Well 8 out of 10 times they keep jacking the patient up with potassium not realizing what the hell they are doing or why.....

 

[Tori's dad]

I am not saying PA's don't know. Of course they do.
But I can't tell you how many times i the hospital we have came across nurses and PA's that don't f-ing think
Eg. Some guy with heart failure is on a diuretic. So he is supplemented with potassium. If the potassium is at 6 should the freaking PA still follow through and continue with supplement or tell a doctor? Well 8 out of 10 times they keep jacking the patient up with potassium not realizing what the hell they are doing or why.....

You are making some pretty blanketing statements here...prepare to get flamed.

 

[ndspider]

I am trying to illicit a point. PA's are useful.. but they are not MD's
(I bet this has been beaten to death on SDN)
Flame me for what?
Stating the obvious.
I am sorry but I worry about the patient. And my experiences are my experiences. Not all PA's are the same just as they are quacks.. but we cannot expect a PA to think like an MD regardless of the 1 (or was it 1.5) years of pharmacology they had.
Duh

 

[ilovestewie]

what kind of pharmacology do you have sir? can we compair PA pharm to a duke MD grad who did all of their basic sciences in one year and had a 20 week long class on pharm? maybe "comparable."

anecdotal evidence is just that... anecdotal. I have plenty of anecdotal stories of doctors messing everything up. Your example also shows your small knowledge of medicine in the first place. potassium supplementation for a diuretic? please, couldnt you come up with something a little more involved? Are you actually passing judgment on a subject you don't even have training in? (I am guessing by your posts that you most definately are not in medical school yet)

p.s.-nobody has tried to say PAs are MDs... um, to quote you "duh" why did you feel the need to step in on this conversation?

 

[ndspider]

what kind of pharmacology do you have sir? can we compair PA pharm to a duke MD grad who did all of their basic sciences in one year and had a 20 week long class on pharm? maybe "comparable."

anecdotal evidence is just that... anecdotal. I have plenty of anecdotal stories of doctors messing everything up. Your example also shows your small knowledge of medicine in the first place. potassium supplementation for a diuretic? please, couldnt you come up with something a little more involved? Are you actually passing judgment on a subject you don't even have training in? (I am guessing by your posts that you most definately are not in medical school yet)

p.s.-nobody has tried to say PAs are MDs... um, to quote you "duh" why did you feel the need to step in on this conversation?

A bit defensive aren't we? Ha ha. The potassium example is a very simple example that happens all the time and it can have ill effects on the heart silly.
Maybe you need another semester of pharm. or would you perfer a more "involved" example. I have a bucket load of em'

Besides. I hope no patient would be stupid enough to have a person that had 3 freaking semesters of pharmacology to prescribe them drugs..... they don't know dick about pathophysiology, pathology, or microbiology.
Conceptually I bet you know your stuff.... but here is a very simple lesson. Humans aren't standardized. They are all flippin different so you can't take a standard text-book taught protocol and apply it to a real life patient. That is whre the ART in medicine is... which can't be found in your little "3 semester long course" taught by the Master pharmacologist.

Dummy

 

[supa]

I am not saying PA's don't know. Of course they do.
But I can't tell you how many times i the hospital we have came across nurses and PA's that don't f-ing think
Eg. Some guy with heart failure is on a diuretic. So he is supplemented with potassium. If the potassium is at 6 should the freaking PA still follow through and continue with supplement or tell a doctor? Well 8 out of 10 times they keep jacking the patient up with potassium not realizing what the hell they are doing or why.....

This is another problem with the PA profession. Usually people translate the actions of 1 or 2 PAs to indict the entire profession like this poster did. This is hardly ever done with doctors. You may hear of incompetent MDs, but it is rare for someone to then extrapolate and declare the MD profession as the problem. But I'm a little confused by your post sir/maam. Are you saying that the PAs at this hospital you speak are the ones who actually set up meds for infusion, or administer their own meds in general?

 

[ndspider]

. But I'm a little confused by your post sir/maam. Are you saying that the PAs at this hospital you speak are the ones who actually set up meds for infusion, or administer their own meds in general?

Yawn.

Firstly, Grady Memorial Hospital.
Biggest hospital inthe SE.
Nurses set up the infusion... PA's monitor. Among other things based on the directives given.
I am just starting a 3rd year but at our med school we go once a week for PE, Grand Rounds, and occasionally Morning Report. And if I already have stories.... then leave it at that....
PA's are great but that make mistakes too and the majority of them don't get reported. Why.....cause they aren't responsible!!!!!

To the guy that doesn't think I am in medical school.... you truely are a fool

 

[supa]

Yawn.

Firstly, Grady Memorial Hospital.
Biggest hospital inthe SE.
Nurses set up the infusion... PA's monitor. Among other things based on the directives given.
I am just starting a 3rd year but at our med school we go once a week for PE, Grand Rounds, and occasionally Morning Report. And if I already have stories.... then leave it at that....
PA's are great but that make mistakes too and the majority of them don't get reported. Why.....cause they aren't responsible!!!!!

To the guy that doesn't think I am in medical school.... you truely are a fool

I'm not sure if you are truly familiar with the role of a PA based on statements like PAs monitor infusions, or you go 1x/week to the hospital. Your vast hospital experience has no doubt allowed you to judge actions of PAs at this hospital as "mistakes". You haven't even started 3rd year yet?!? You have no credentials young man so maybe you should wait until you finish 3rd year before you jump into GROWN FOLKS conversation.

 

[Tori's dad]

Yawn.

Firstly, Grady Memorial Hospital.
Biggest hospital inthe SE.
Nurses set up the infusion... PA's monitor. Among other things based on the directives given.
I am just starting a 3rd year but at our med school we go once a week for PE, Grand Rounds, and occasionally Morning Report. And if I already have stories.... then leave it at that....
PA's are great but that make mistakes too and the majority of them don't get reported. Why.....cause they aren't responsible!!!!!

To the guy that doesn't think I am in medical school.... you truely are a fool

Just a friendly reminder...physicians, attendings and deans all read this website. You have linked your personal information to your screen name. I wonder what your dean/ attending would say to you if he read your remarks about PA's?

 

[ilovestewie]

you didnt answer me, how much pharmacology do YOU have? and you do realize that pathophysiology, pathology, and microbiology are not pharmacology right!?

My point is, there is no need to point out the obvious if you are educated. WE ALL know that every person is different, we have all disected, we all learn medicine, patho, micro, pharm, etc. You are making it seem as if you have limited knowledge because you continually use as your argument the MOST BASIC concepts ever know to man.

And yes, I would love to hear you try to give me a more involved example because your potassium supplement example shows that you obviously didnt have all the facts.

p.s. PAs are responsible, do get sued, and have their own malpractice coverage because they are practicing medicine.

 

[IDFTIGER]

Sup guys, thx for your posts. This is my situation: I got into a very competitive PA program (36 spots for 500 apps) right out of highschool, so I'm still in college completing my B.S.(soon to be masters) in PA studies. I'll probably work for 2 or 3 years before trying for med school. I would go to med school right away, but...there are personal reasons for me having to go PA first. I was just wondering, what the transition from PA to MD is like later. However, with the profession growing so rapidly, both in terms of autonomy, and financially, I dont even know if i'll make the switch. However, my desire to become an doc has never ceased.

P.S. I wish they f***** changed the ASSISTANT in PA, because from what we're learning and from what I'm seeing, we don't assist or learn the art of assisting; we learn the art of medcine like docs, just a bit less. Also, I think the word assistant misleads many patients, and makes them think we are incomptenet becasue of our title. At least Physician Associate, or second tier physician, would be acceptable. Yes, we may not be equivalent to docs, however, PA's are EXTREMELY knowledgable and work independntly 95% of the time. Like supa said, EXPERIENCE tops education, after a while.

 

[OrnotMajestic]

Sup guys, thx for your posts. This is my situation: I got into a very competitive PA program (36 spots for 500 apps) right out of highschool, so I'm still in college completing my B.S.(soon to be masters) in PA studies. I'll probably work for 2 or 3 years before trying for med school. I would go to med school right away, but...there are personal reasons for me having to go PA first. I was just wondering, what the transition from PA to MD is like later. However, with the profession growing so rapidly, both in terms of autonomy, and financially, I dont even know if i'll make the switch. However, my desire to become an doc has never ceased.

P.S. I wish they f***** changed the ASSISTANT in PA, because from what we're learning and from what I'm seeing, we don't assist or learn the art of assisting; we learn the art of medcine like docs, just a bit less. Also, I think the word assistant misleads many patients, and makes them think we are incomptenet becasue of our title. At least Physician Associate, or second tier physician, would be acceptable. Yes, we may not be equivalent to docs, however, PA's are EXTREMELY knowledgable and work independntly 95% of the time. Like supa said, EXPERIENCE tops education, after a while.

The PA role was created as assistants to physicians, so therefore the name assistant. They still do assist physicians, and while are mostly autonomous, they are still under the auspice of a physician, especially when faced with things beyond their scope of care.

Yes, experience DOES top education, but education + experience tops just experience. No, I am not knocking the PA role. This has been discussed ad nauseum. Everyone has a specific role to fufill. Mid-level health providers are crucial to providing interim care and reducing patient load on physicians. As you said, you are NOT a physician. If this bothers you, if the name bothers you, etc etc, then find something else to do. This is starting to remind me of the whole "doctorate of nursing" thing. What next? X-ray techs complaining that they know just as much about radiology as radiologists and earn doctorates in it? Dental Hygenists fighting to be called third-tier dentists because they do most of the work? Look everyone! I can pee farther than you!!

Look, let's settle this. Physicians need to understand that PA's play an important role, and are well trained and know what they are doing and quit knocking them/putting them down/mistrusting them. Physicians need to understand that they aren't the end-all in patient care, and they aren't perfect and holy. PA's need to understand what they don't know (a major problem with mid-level providers...they don't know what they don't know) and be happy with the quality and level of care that they provide (which is very high). Everyone has a role, let's stick with it.

 

[IDFTIGER]

The PA role was created as assistants to physicians, so therefore the name assistant. They still do assist physicians, and while are mostly autonomous, they are still under the auspice of a physician, especially when faced with things beyond their scope of care.

Yes, experience DOES top education, but education + experience tops just experience. No, I am not knocking the PA role. This has been discussed ad nauseum. Everyone has a specific role to fufill. Mid-level health providers are crucial to providing interim care and reducing patient load on physicians. As you said, you are NOT a physician. If this bothers you, if the name bothers you, etc etc, then find something else to do. This is starting to remind me of the whole "doctorate of nursing" thing. What next? X-ray techs complaining that they know just as much about radiology as radiologists and earn doctorates in it? Dental Hygenists fighting to be called third-tier dentists because they do most of the work? Look everyone! I can pee farther than you!!

Look, let's settle this. Physicians need to understand that PA's play an important role, and are well trained and know what they are doing and quit knocking them/putting them down/mistrusting them. Physicians need to understand that they aren't the end-all in patient care, and they aren't perfect and holy. PA's need to understand what they don't know (a major problem with mid-level providers...they don't know what they don't know) and be happy with the quality and level of care that they provide (which is very high). Everyone has a role, let's stick with it.

The PA prfoession was created not to be assistants to doctors, but to fill the primary care void during the 60's and 70's in the U.S. PA schooling is based on the "fast track model that prepared doctors for deployment in World War II" (http://www.paworld.net/panews2003.htm). So the PA cirriculum is in part based on that of physicians. Maybe a new grad will "assist," the physician, but so do interns and residents. Soon enough the PA works practically independently. What about the small towns in the US where the only the health care provider is a PA? You think patients consider him an "assistant?" They consider him a health care provider who can treat them, and often patients don't even know the difference between a PA or doc, which shows the level of care they recieve is the same. If this was not the case, the PA profession would be long, yet it is flourishing, and is the third fastest growing according to the bureau of labor statisitics.

Finally, experience is extremely important. I've seen RN's correct diagnoses of residents, and I have seen, in my education so far, ATTENDINGS who were wrong, and PA's who were right. I'm not bashing any profession, but I still believe, that experience, can top "book knowledge, very often, because in the end, and in the real world, the patient couldn't care less about biochemistry, or pharmokinetics; they care if you can help them, and often clinical knowledge and experience, as well as hands-on ability, kicks in. Many MD's I've talked too have told me 70% of med school is basically b***, in terms of caring for the patient. It all comes with experience. That is not to say that book knowledge is not important, b/c it provides a foundation, but in terms of actually treating and diagnosing patient, that comes with experience. It has been estimated that PA's "are able to render up to 85 percent of their patients' primary care needs" (http://www.paloaltoonline.com/weekly/morgue/cover/1994_Jul_20.NURSE.html).The ability to treat the other 15%, I assure you, comes with experience.

 

[OrnotMajestic]

The PA prfoession was created not to be assistants to doctors, but to fill the primary care void during the 60's and 70's in the U.S. PA schooling is based on the "fast track model that prepared doctors for deployment in World War II" (http://www.paworld.net/panews2003.htm). So the PA cirriculum is in part based on that of physicians. Maybe a new grad will "assist," the physician, but so do interns and residents. Soon enough the PA works practically independently. What about the small towns in the US where the only the health care provider is a PA? You think patients consider him an "assistant?" They consider him a health care provider who can treat them, and often patients don't even know the difference between a PA or doc, which shows the level of care they recieve is the same. If this was not the case, the PA profession would be long, yet it is flourishing, and is the third fastest growing according to the bureau of labor statisitics.

Finally, experience is extremely important. I've seen RN's correct diagnoses of residents, and I have seen, in my education so far, ATTENDINGS who were wrong, and PA's who were right. I'm not bashing any profession, but I still believe, that experience, can top "book knowledge, very often, because in the end, and in the real world, the patient couldn't care less about biochemistry, or pharmokinetics; they care if you can help them, and often clinical knowledge and experience, as well as hands-on ability, kicks in. Many MD's I've talked too have told me 70% of med school is basically b***, in terms of caring for the patient. It all comes with experience. That is not to say that book knowledge is not important, b/c it provides a foundation, but in terms of actually treating and diagnosing patient, that comes with experience. It has been estimated that PA's "are able to render up to 85 percent of their patients' primary care needs" (http://www.paloaltoonline.com/weekly/morgue/cover/1994_Jul_20.NURSE.html).The ability to treat the other 15%, I assure you, comes with experience.[/QUOTE] My apologies for not elaborating. I know many PA's were Vietnam medics who were forced to practice autonomy in the field (I worked with several who were grandfathered in via this route, and their service, experience and knowledge were irreplaceable). I know that they were created as a "quick" doctor by schooling matters. When I say they "assist" physicians...I don't mean wiping their brows. As I said earlier, they assist by taking a bulk of patient load of cases that can be handled by a mid-level. That's the purpose. To take care of a growing population base, thereby leaving the tough and complicated things to the physicians. Hence why they care for 85% of the Primary Care needs. GOOD. That leaves the physicians to focus on the last 15%, which is what they are trained to do. You are right, most patients don't know or care who sees them. As long as they do it well. RN's correct residents and attendings, residents correct attendings, PA's and NP's correct attendings, RN's correct all them. Attendings also correct everyone. Hell, I've seen family members correct physicians. I still don't understand the point. You are correct that patients don't care about pharmacokinetics and microbiology...nor should they. That stuff should be learned and used behind the scenes. Experience IS very important...and physicians have this also. They also have the schooling. I'm going to do a bit of anecdotal evidence, but bear with me. A friend of mine is currently graduating from PA school (from a very good program). You know what? She's scared. Why? Because she is almost done with second year clinicals, and realizes that she will soon be practicing autonomously. I talked to her recently, and she used to make fun of me for taking "so long to finish in med school" when she was done faster. She told me she envies me. Why? She is scared to not have an interim time, like a residency, in which she learns a larger bulk of information under the auspice of closely watching physicians and other mid-levels. What I'm saying is...that after 15 years of working, I'm positive a PA is highly knowledgeable. Just as anyone working 15 years in something should be. Yet, me, when I'm fresh out of 4th year, will not be working as an independent. I'm glad to know that I'll be a closely watched intern until I gain the proper skills to practice independently. Question of curiousity. For a PA to be considered a "specialist" in a field (cardiology, derm, etc) do they have a residency? How do they gain such a title? I'm honestly curious.

 

[Chronic Student]

There are "residencies" available in a number of fields, although they are a lot more like fellowships in that they are almost always a year in length.

However, the vast majority of PA's learn their particular field through OJT and it is really up to their SPs to determine when they are competent enough to be trusted to do their job under less rigorous supervision. This time is generally about a year although I would suspect that its closer to four or five years before they (the PAs) feel really at ease.

-Mike

 

[IDFTIGER]

My apologies for not elaborating. I know many PA's were Vietnam medics who were forced to practice autonomy in the field (I worked with several who were grandfathered in via this route, and their service, experience and knowledge were irreplaceable). I know that they were created as a "quick" doctor by schooling matters. When I say they "assist" physicians...I don't mean wiping their brows. As I said earlier, they assist by taking a bulk of patient load of cases that can be handled by a mid-level. That's the purpose. To take care of a growing population base, thereby leaving the tough and complicated things to the physicians. Hence why they care for 85% of the Primary Care needs. GOOD. That leaves the physicians to focus on the last 15%, which is what they are trained to do.

You are right, most patients don't know or care who sees them. As long as they do it well. RN's correct residents and attendings, residents correct attendings, PA's and NP's correct attendings, RN's correct all them. Attendings also correct everyone. Hell, I've seen family members correct physicians. I still don't understand the point. You are correct that patients don't care about pharmacokinetics and microbiology...nor should they. That stuff should be learned and used behind the scenes. Experience IS very important...and physicians have this also. They also have the schooling. I'm going to do a bit of anecdotal evidence, but bear with me.

A friend of mine is currently graduating from PA school (from a very good program). You know what? She's scared. Why? Because she is almost done with second year clinicals, and realizes that she will soon be practicing autonomously. I talked to her recently, and she used to make fun of me for taking "so long to finish in med school" when she was done faster. She told me she envies me. Why? She is scared to not have an interim time, like a residency, in which she learns a larger bulk of information under the auspice of closely watching physicians and other mid-levels. What I'm saying is...that after 15 years of working, I'm positive a PA is highly knowledgeable. Just as anyone working 15 years in something should be. Yet, me, when I'm fresh out of 4th year, will not be working as an independent. I'm glad to know that I'll be a closely watched intern until I gain the proper skills to practice independently.

Question of curiousity. For a PA to be considered a "specialist" in a field (cardiology, derm, etc) do they have a residency? How do they gain such a title? I'm honestly curious.[/QUOTE

I can assure you that any new PA grad will be supervised by his attending, or supervising physician until he/she gains the necessary skills to function autonomously. At least PA's I've spoken have told me that often they were treated like interns and residents, until physicians were comfortable with their level of performance, and until the PA's themselves, were comfortable, in delegating treatment. Good Luck to you.

 

[ilovestewie]

PA residencies, such as this one at mentefiore, often give the PA residents (18 month residency) the exact same responsibilities as an MD surgical intern.

http://prof.montefiore.org/prof/clinical/surg/residency/pa-residency.pdf

As far as the other "PA student" posting. I disagree with a lot of what they have to say and I'll leave it at that. There is a huge difference in being turned off by a profession andwanting to change it into something it is not.

 

[AngryBaby]

I just poked my head in here again and after reading all these posts I'm still not sure about something: are the PA's posting here saying the difference between themselves and docs is negligable?? (And I'm including all docs and their education in this question, not simply PCP's)

 

[velo]

I just poked my head in here again and after reading all these posts I'm still not sure about something: are the PA's posting here saying the difference between themselves and docs is negligable?? (And I'm including all docs and their education in this question, not simply PCP's)

I've seen people make that claim (NPs too). Some will even claim that there are studies that "show that the difference is NEGLIGABLE!!1!" but I've never seen them cite those studies.

I suppose people forget that while PAs/NPs can probably do just as good of a job as a doctor in handling the cases/issues that they're trained to handle, that doesn't mean that the "difference is negligable." They're only really qualified to manage a handful of the issues that an MD is trained to handle. They can't jump in and do an MDs job--they'd run into things they're not trained for--that's why they handle less complicated cases and have a supervising MD to consult when they are in over their heads.

 

[AngryBaby]

I've seen people make that claim (NPs too). Some will even claim that there are studies that "show that the difference is NEGLIGABLE!!1!" but I've never seen them cite those studies.

I suppose people forget that while PAs/NPs can probably do just as good of a job as a doctor in handling the cases/issues that they're trained to handle, that doesn't mean that the "difference is negligable." They're only really qualified to manage a handful of the issues that an MD is trained to handle. They can't jump in and do an MDs job--they'd run into things they're not trained for--that's why they handle less complicated cases and have a supervising MD to consult when they are in over their heads.

Hello there, Velo. Made your way over from the pee-pee thread, did you?? I think that's got to be the greatest SDN thread of all time.

 

[velo]

Hello there, Velo. Made your way over from the pee-pee thread, did you?? I think that's got to be the greatest SDN thread of all time.

hey, it happens, I'm not afraid to admit it!

 

[AngryBaby]

hey, it happens, I'm not afraid to admit it!

Yes it has happened to us all. I am currently working hard on this issue in advance of my scrub years.

 

[supa]

I just poked my head in here again and after reading all these posts I'm still not sure about something: are the PA's posting here saying the difference between themselves and docs is negligable?? (And I'm including all docs and their education in this question, not simply PCP's)

I think i missed that particular post where any PA said that the difference between MDs and PAs is negligible <-------- (note correct spelling). You care to enlighten me?