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Just curious if this is a common arrangement at FM residency programs. I've seen it once.
PAs as Preceptors...
- Thread starter Old_Mil
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Hmm... not really. Some programs hire NP/PA/midwives to offload residents because of work hour issues. But because they contribute to teaching or administration, they get faculty status which is attractive for the midlevels who have professional aspirations in academics.
I've worked with midlevels before. On the primary care level, they taught me a lot when I was a med student and intern. But going into 2nd and 3rd year, I felt like I learned pretty much all that they could teach me. For me, 2nd and 3rd year coincided with when I was starting to want to make independent decisions, something they by law are not allowed to do.
I continue to learn from midlevels in specialties, though. I always make sure I verify the medical knowledge their teaching me. But midlevels in EM and surgical specialties are good people to know if you're interested in gaining minor procedures experience.
I also continue to learn from midlevels with a lot of experience, regardless of specialties. I'm always very critical when I listen to their experience, because although there may be a pearl of wisdom hidden in their anecdotes, they are, after all, anecdotal.
Midlevels are like residents in my mind, except it's forever.
Bottom line, for me, is that there's something to be learned from everyone you work with. What's cool about family medicine is that we train with different disciplines.
I've worked with midlevels before. On the primary care level, they taught me a lot when I was a med student and intern. But going into 2nd and 3rd year, I felt like I learned pretty much all that they could teach me. For me, 2nd and 3rd year coincided with when I was starting to want to make independent decisions, something they by law are not allowed to do.
I continue to learn from midlevels in specialties, though. I always make sure I verify the medical knowledge their teaching me. But midlevels in EM and surgical specialties are good people to know if you're interested in gaining minor procedures experience.
I also continue to learn from midlevels with a lot of experience, regardless of specialties. I'm always very critical when I listen to their experience, because although there may be a pearl of wisdom hidden in their anecdotes, they are, after all, anecdotal.
Midlevels are like residents in my mind, except it's forever.
Bottom line, for me, is that there's something to be learned from everyone you work with. What's cool about family medicine is that we train with different disciplines.
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I have PAs and NPs as preceptors during my ER rotations- if the ER physician is overloaded and wants to get me out of his hair for a patient or two.
I find I end up teaching the NP a lot. The NP doesn't attempt to read an Xray, just waits for the radiologist to do his work. And the NP doesn't know a lot of finer details. The PAs know a lot more than the NP does, they are about at a PGY-2 level or so, but have pretty vertical knowledge, not horizontal.
I find I end up teaching the NP a lot. The NP doesn't attempt to read an Xray, just waits for the radiologist to do his work. And the NP doesn't know a lot of finer details. The PAs know a lot more than the NP does, they are about at a PGY-2 level or so, but have pretty vertical knowledge, not horizontal.
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deleted87716
I've never heard of mid-levels acting as preceptors in any residency program, family medicine or otherwise. That's not to say that it hasn't happened somewhere, but if I were a resident, I'd raise holy hell.
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I'm a resident (PiGgY 2 in FM) and frankly I couldn't give a steamy stool at this point. My opinion means nothing. All I want to do is pass graduate some day.
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deleted6669
FWIW- I have worked as the preceptor of record for residents(mostly interns) at 2 prior em jobs affiliated with well regarded family medicine programs. it's actually fairly common on the west coast, maybe elsewhere it's different.
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deleted87716
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deleted6669
for the most part we were precpting fast track pts which are generally pretty straight forward. one place had all the interns do a one month minor procedures rotation with us to go over commonly performed ed procedures like fb removal from the eye with slit lamp, i+d abscess, suturing, fb removal from ears/nose, anoscopy, fish hook removal. tx of epistaxis, etc
for the most part by the time they hit pgy-2 most fm residents are pretty confident in these areas.
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deleted87716
I'm not suggesting that you have nothing to teach them, but "precepting" (meaning oversight and competency evaluation) of physicians-in-training should only be done by physicians-in-practice.
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Interesting...do you know if it is only FM residencies that make such arrangements, or are they present in other fields as well?
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deleted6669
I know critical care pa's who precept em residents in the icu as well.
From an earlier thread on the subject:
"Acutely off my final ICU rotation in EM residency and looking downstream to the light at the end of the tunnel. I recently gained a new respect for PA's in my ICU. My ICU is truly PA run, especially at night. I have no pride issue in stating that the PA's on this service taught me more about critical care medicine in a tertiary receiving center than the physicians. There are at least 6 full time PA's that rotate 3/3 nights/days where 3 always are on together and cover about 25-30 patients. Residents work under them and gain valuable thought processes. having been both a PA and a physician I was proud to see these autunomous PA's working in settings the way they were meant to perform. They kept continuity on the service and patient's gained because of it. Academic programs across all specialties should and must use PA's to keep continuity at a priority. PA's can also be involved in the residency teaching process, and rightly should be. I find this PA niche to be a new wave of the future. I hope to be involved with helping to develop it wherever I end up next year."
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Who "preceps" in an ICU? What kind of ICU is this?
I have a special place in my heart/brain for critical care and have frequently enjoyed discussing the finer nuances of pathophys that occurs in this setting. I've worked with a fair number of fine midlevels but I've yet to work with one that can offer the same understanding as an attending/fellow/sometimes upper level resident in this setting. Reading the ICU Book does not an intensivist make.
I wouldn't precept with anyone who couldn't explain to me "from the atoms up" what's going on, and I've yet to meet the midlevel who can do this across the spectrum of medicine. On the other hand, if you want to know that the PA's supervising specialist "does/orders Y when they see X" then a midlevel is a quick reference.
In my current practice setting, where the local specialty physicians tend to shotgun everything on consult (to save time in the workup and stay in the cath lab/endo lab/OR), the midlevels are relatively weak on pathophys/history/workup/treatment nuances that are important to teach the physician in training.
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Nuh-uh... no sir. I don't want to be anywhere near that chart when you're trying to explain to Bimbo and Billy-Bob ******, a.k.a. "a jury of my peers", about how you, Dr. Resident, took orders from a PA/NP on which knob to turn on that ventilator. And don't you put my name down as the attending either.
I don't care if the PA/NP *invented* the damn ventilator. It just looks bad.
I don't care if the PA/NP *invented* the damn ventilator. It just looks bad.
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deleted6669
how does it look when the r.t. tells you how to work the vent....after all they spend 2 yrs learning how to work the vent....how about the r.t. who becomes a critical care pa(which most of the rt to pa folks do by the way.....)
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So why bother? Why don't RT's worldwide run the vent and why aren't ICU's worldwide run by PA's s/p RT school?
Again, like Blue Dog said, I don't contest the fact that midlevels possess skill or knowledge. But when something goes bad, real bad, someone will ask who's in charge? Who's idea was it to jack with the ventilator? What are you going to say?
And how are you going to convince lay people who have no clue what goes on in the trenchs that what happened seemed like a good idea at the time?
Again, like Blue Dog said, I don't contest the fact that midlevels possess skill or knowledge. But when something goes bad, real bad, someone will ask who's in charge? Who's idea was it to jack with the ventilator? What are you going to say?
And how are you going to convince lay people who have no clue what goes on in the trenchs that what happened seemed like a good idea at the time?
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deleted6669
FWIW many large medical centers are adding pa teams to icu coverage with some depts almost entirely pa staffed. the # of pa critical care felllowships has increased significantly just in the last 2 yrs. hopkins has 1, umass, ohsu, etc
I'm not saying that pa's do it best, just that they are capable of doing it and doing it well. are we board certified critical care intensivists? of course not. but we work closely with them and with appropriate training can manage most icu pts most of the time with minimal input and we know when to get that input on the tough cases.
CRITICAL CARE
The UMass Memorial Medical Center Physician Assistant Residency Program in Critical Care
Oregon Health and Sciences University
Johns Hopkins
TRAUMA/CRITICAL CARE
Bridgeport Hospital PA Trauma, Surgical Critical Care, and Burn Fellowship
Pacific University - Rural Trauma and Hospital Care
St. Luke's Hospital Trauma and Surgical Critical Care
an rt to pa who has done a fellowship in critical care is certainly more prepared for this work than an avg fm residency grad.....and many of them cover their own icu pts....are you implying that ONLY fellowship trained md intensivists should set foot in the icu? maybe in a perfect world. last time I checked there aren't enough to go around. my facility( a major medical ctr and trauma receiving hospital) has 2.
the only person who knows more about a specialty than a specialty pa is an md IN THAT SPECIALTY.
Midlevels are a fact of life in medicine now. many of your consultants will use them. many inpatient services use them.
yesterday I called md specialists for consults in surgery, ortho, psych, and cardiology. they all sent their pa's or np's(psych) to do the eval of the pt in the e.d. and follow up with them by phone.
I just did a job search on 1 pa job site. 19 critical care/intensivist jobs on just the 1 site. here's one of them.
a current job offering:
Physician Assistant- Pulmonary Critical Care
Lahey Clinic
Burlington, Massachusetts
JOB DETAILS
Located 17 miles northwest of Boston in suburban Burlington, MA, Lahey Clinic
Medical Center is a 317-bed academic medical center and tertiary care facility serving more than 3,000 patients daily.
TITLE: Physician Assistant- Pulmonary Critical Care JOB #: 825197
LOCATION: Burlington, Massachusetts FULL TIME/PART TIME: Full Time
CLIENT: Lahey Clinic PERMANENT/TEMPORARY: Regular
POSTED: 07/10/2008 EMPLOYMENT/CONTRACT WORK: Employment
REPLY SENT: NO VISA WAIVER AVAILABLE: Not specified
DESCRIPTION:
Physician Assistant – Pulmonary Critical Care -- #17662
Full-time, Days/Rotation, 7am-3:30pm, 11am-7pm, 24-hour weekend shift
Under the supervision of the attending physician, the Critical Care Medicine Allied Health Provider (AHP) will provide direct care for patients in Pulmonary/CCM. The successful candidate will be responsible for admissions, management of arterial and vascular access, history and physicals, obtaining patient consents, providing daily care, and transferring and responding to patients and families. The AHP is also the primary provider of the Procedure Service. This service provides arterial or vascular access as well as thoracentesis, chest tube thoracostomy, and parcentesis for patients on any service in an inpatient area of the hospital. The Procedure Service acts as guidance for house staff requiring supervision to perform these invasive procedures. The Procedure Service conducts a thorough chart review and gathers the necessary data on each patient prior to the beginning of the procedure. This information is documented in the patient's medical record along with the Universal Protocol.
I'm not saying that pa's do it best, just that they are capable of doing it and doing it well. are we board certified critical care intensivists? of course not. but we work closely with them and with appropriate training can manage most icu pts most of the time with minimal input and we know when to get that input on the tough cases.
CRITICAL CARE
The UMass Memorial Medical Center Physician Assistant Residency Program in Critical Care
Oregon Health and Sciences University
Johns Hopkins
TRAUMA/CRITICAL CARE
Bridgeport Hospital PA Trauma, Surgical Critical Care, and Burn Fellowship
Pacific University - Rural Trauma and Hospital Care
St. Luke's Hospital Trauma and Surgical Critical Care
an rt to pa who has done a fellowship in critical care is certainly more prepared for this work than an avg fm residency grad.....and many of them cover their own icu pts....are you implying that ONLY fellowship trained md intensivists should set foot in the icu? maybe in a perfect world. last time I checked there aren't enough to go around. my facility( a major medical ctr and trauma receiving hospital) has 2.
the only person who knows more about a specialty than a specialty pa is an md IN THAT SPECIALTY.
Midlevels are a fact of life in medicine now. many of your consultants will use them. many inpatient services use them.
yesterday I called md specialists for consults in surgery, ortho, psych, and cardiology. they all sent their pa's or np's(psych) to do the eval of the pt in the e.d. and follow up with them by phone.
I just did a job search on 1 pa job site. 19 critical care/intensivist jobs on just the 1 site. here's one of them.
a current job offering:
Physician Assistant- Pulmonary Critical Care
Lahey Clinic
Burlington, Massachusetts
JOB DETAILS
Located 17 miles northwest of Boston in suburban Burlington, MA, Lahey Clinic
Medical Center is a 317-bed academic medical center and tertiary care facility serving more than 3,000 patients daily.
TITLE: Physician Assistant- Pulmonary Critical Care JOB #: 825197
LOCATION: Burlington, Massachusetts FULL TIME/PART TIME: Full Time
CLIENT: Lahey Clinic PERMANENT/TEMPORARY: Regular
POSTED: 07/10/2008 EMPLOYMENT/CONTRACT WORK: Employment
REPLY SENT: NO VISA WAIVER AVAILABLE: Not specified
DESCRIPTION:
Physician Assistant – Pulmonary Critical Care -- #17662
Full-time, Days/Rotation, 7am-3:30pm, 11am-7pm, 24-hour weekend shift
Under the supervision of the attending physician, the Critical Care Medicine Allied Health Provider (AHP) will provide direct care for patients in Pulmonary/CCM. The successful candidate will be responsible for admissions, management of arterial and vascular access, history and physicals, obtaining patient consents, providing daily care, and transferring and responding to patients and families. The AHP is also the primary provider of the Procedure Service. This service provides arterial or vascular access as well as thoracentesis, chest tube thoracostomy, and parcentesis for patients on any service in an inpatient area of the hospital. The Procedure Service acts as guidance for house staff requiring supervision to perform these invasive procedures. The Procedure Service conducts a thorough chart review and gathers the necessary data on each patient prior to the beginning of the procedure. This information is documented in the patient's medical record along with the Universal Protocol.
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Interesting. Out of curiousity, what role do PAs play in other 1st world medical systems around the world (Canada, Australia, New Zealand, Europe)?
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deleted6669
canada uses pa's in manitoba and ontario provinces.
australia just started their first 2 pa programs last yr using american pa's as faculty(I considered 1 of these positions).
new zealand is due to start their first pa program within the next 1-2 yrs.
the uk uses american pa's in england and scotland(I will probably do this for a 2 yr assignment within the next decade)
and have just started a few programs of their own using american pa's as instructors.
holland has 2 pa programs that just graduated their 1st classes.
spain and japan are investigating starting pa programs. singapore and taiwan have pa programs.
for your consideration this study done on american pa's in england:
Role of Physician Assistants in the accident and emergency departments in the UK
Ansari U, Ansari M, Gipson K. Accident and Emergency Department; Warwick Hospital, UK
Published in 11th International Conference on Emergency Medicine, Halifax, Nova SCotia, Canada, June 3-7 2006 and Journal of Canadian Emergency Medicine, May 2006, Vol 8 No 3 (Suppl) P583
Introduction: The Accident and Emergency departments in the UK are under severe pressure to expand their staffing levels in a bid to try and comply with the 98% target for 4-hour waiting times set by the government. Increasing staffing levels is proving to be very difficult when a majority of Staff Grades have already left or are leaving to become General Practitioners for financial gains and better working hours. This combined with a limited number of FY2 doctors being allowed to work in Accident and Emergency departments poses new challenges to staffing within Accident and Emergency. The objective of this study was to evaluate the training requirements, GMC regulations and supervision required to perform a suitable role in Accident and EMergency following the appointment of two Physician Assistants at City Hospital, Birmingham. Methods: The activities of two Physician Assistants at City Hospital were monitored for two months. All case records were reviewed and the number and type of patients seen by the assistants recorded. These were then compared with the records of those patients seen by Senior House Officers. Monitored information included number of patients seen, type of patients seen as well as the quality of the notes. Results: On average, Physician Assistants at City Hospital treated 3-5 patients/hour compared to 1.5-2.5/hour seen by Senior House Officers. Physician Assistants were able to deal with most medical, surgical, orthopaedic and gynaecological problems with minimal supervision. The medical records revealed that documentation was better by Physician Assistants. Conclusion: Senior Physician Assistants from the USA are an effective way to improve staffing within Accident and Emergency Departments with the UK. Physician Assistants saw more patients and required less supervision than Senior House Officers. Physician Assistants proved to be a cost effective method of supporting Accident and Emergency doctors at City Hospital, Birmingham.
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Interesting.. where are these 2 Australian PA programs located?
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deleted6669
One is at james cook university in queensland(that's the one I was looking at).
I don't remember offhand where the other is.
here it is:
University of Adelaide Department of Surgery
> The Queen Elizabeth Hospital
> Woodville, South Australia 5011
I asked around-apparently there are others in the works as well.
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I've worked with plenty of PAs during residency who were my preceptors who signed my evals at away/community specialty rotations i.e. psych, ortho, sports med. They've been great and I enjoyed working with them.
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deleted6669
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Woowee...
In some countries, even MIDLEVELS are being replaced... check this out... "high school education"...
http://www.nytimes.com/2008/07/15/arts/television/15surg.html?fta=y
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There is very little midlevel care provided in Canada except for midwives. PAs are much rarer than NPs (advance practice nurses). Team model is obligatory.
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deleted6669
it's a new concept there but they are hiring pa's as fast as they can. I get something from healthforce ontario almost weekly with a list of new job openings in emergency medicine.
I'm probably going to do a 2 yr stint in ottawa in a few years.
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Interesting, as I am quite sure there are absolutely 0 PA schools in Canada, nor is there legislature that allows them to work in health care. I heard from someone that they do exist in the military setting, but that is it. Do you have any sources I can read on this? I don't doubt you, but I would like to read into it for the sake of curiosity.
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I don't know about the rest of you but I am going to consciously try to isolate myself from PA's and NP's and the like. I don't want to be around them and don't agree with the idea that they are beneficial. I will refuse to teach them and interact with them as little as possible in terms of doing anything that adds legitmacy to the what I feel what amounts to a bad and dangerous joke. I have found that in the clinic most patients don't even know what the hell they are and refer to them as "my doctor". I have found that they are mostly used by specialists to rubber stamp lucrative procedures with questionable indications. For example, I had a patient that got scoped from above and below for anemia with kidney failure with mutiple negative hemoccults and NO laboratory work up for anemia. They did the freaking iron studies after this woman got both an EGD and colonoscopy by a general surgeon which were of course negative. Complete BS. Of course the surgeons love them.
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deleted6669
province of ontario pa recruitment:
http://www.healthforceontario.ca/Wo...ario/OntarioPhysicianAssistantInitiative.aspx
province of manitoba pa recruitment:
http://www.wrha.mb.ca/careers/physicianassistant/licensure.php
pa program at u. of manitoba:
http://www.umanitoba.ca/student/counselling/spotlights/physicianasst.html
pa program at mcmaster:
http://fhs.mcmaster.ca/physicianassistant/about.html
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That just sounds bizarre. How could I do anything else but agree, with such an example. Too, I've seen Doctors make their share of bad choices. There was the time I had to help the PA I was shadowing to deal with the stack of files for patients whose Doctors had prescribed the wrong medications. *sigh* Those were such embarrassing phone calls to make! If I have a choice as a PA, I will distance myself from such shoddy Physicians in a heartbeat. No way would I ever want to work with such a 'Doctor'. In fact, when applying for my MD preceptor for one school, I met with one Doctor who couldn't even fill out the paperwork correctly (spelling errors, skipping whole sections, etc)...I actually had to ask them to fill out a new copy! And this is the person who's supposed to be in charge of me? Thanks, but no thanks!
Still, I would never let a few select incidences create an overall bias (how immature would that be), since thankfully the majority of Physicians I've worked with have been stellar.
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Very interesting..so neither of those programs exist yet, but it looks like Manitoba's inaugural program will be this September.
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deleted6669
Both provinces are already hiring american pa's to fill clinical slots though.
I spoke personally with dr tepper, the ontario asst. minister of health, about this 2 yrs ago at a pa conference. they have more open slots now than pa's who want to fill them so they are starting their own formal (non-military) programs this yr but will continue to hire american pa's and recognize our board certification.
You know, I was cool with PAs because in primary care they can just do well exams and colds or what not. But when they started getting into surgery, radiology and the other specialites, PAs really oversteped they purpose. A doctor can do everything a PA does and more, so really if we had enough doctors in enough places, PAs would not be nessecary. Period.
I see more and more that doctors are using PAs for one thing, TO MAKE MORE MONEY.
So really doctors just see these PAs are ways to make more money while the paitents are hoodwinked into thinking they are seeing a doctor. The worst part is we are adding another profession to an already expensive health care system.
The root of all evil....
I see more and more that doctors are using PAs for one thing, TO MAKE MORE MONEY.
So really doctors just see these PAs are ways to make more money while the paitents are hoodwinked into thinking they are seeing a doctor. The worst part is we are adding another profession to an already expensive health care system.
The root of all evil....
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not to resurrect a year old thread but I'm baffled that of all people a pre-med has the audacity to attack medical professionals with substantially more training. I work with PAs everyday and they're some top knotch clinicians. obviously there are bad PAs but there are bad physicians too. and you seem to not understand primary care if you think it's easy and anyone with a white coat can do it. in my area you have to be knocking on deaths door to be admitted, many sick patients who would've been admitted in the past have to be treated by you guessed it PCPs and their lowly PAs. I'm not quite sure where your elitist attitude comes from as pre-meds are completely at the bottom of the barrel, but I hope you drop it by the time you start practicing.
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deleted87716
Why does that surprise you?
It happens here on SDN a hundred times a day. You don't have to dig up an ancient thread to see it.
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I'm anything but an elitist. Providing high quality health care to people requires an egalitarian team approach that values and integrates the contributions of everyone involved from the PCT to the attending physician.
That having been said, the issue separating MDs from PAs is one of (1) intellect and (2) duration of training. While there are exceptions to the rule, this is, in fact the rule, and PAs do not belong in a position where they precept MDs.
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Redleg, Redleg, Stone Hombre 6, Stone Hombre 6, drop 200 and FIRE FOR EFFECT!!!.....😀
Sorry, couldn't resist.....
You realize that you've just started a pissing match.....
One the one hand, I've got a good friend who's a former PA,
went back to med school, and is now an ED attending.....
on the other hand, I've seen PA/NPs who recommend
ASA for elderly patients because the PA/NPs Mom is taking
it......
It chaps me a bit that everyone wants to be a 'Doctor'
but no one wants to go to medical school.....During
Christmas I had a conversation with an NP who was working
for a DC running 'a medical clinic'. She was overseen by
an MD but the DC provided the cash and most of the
patients......
I really have to watch myself sometimes......
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Dude, you're pre-med. How do you know what a "top-knotch"
clinician is anyway? PAs should never, ever, ever be precepting residents. Ever. They shouldn't be precepting medical students, either. Physicians should.
They are valuable members of the team..believe me. I love PAs. Their role, however, isn't in graduate medical education.
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Interesting comment as your .sig file indicates that YOU are a pre-med.....
Personally, if I had wanted to be preceptored by PAs/NPs, I would have
gone to PA/NP school.....
I read a rather heated attack on physicians in a letter to the editor of a national NP magazine where the letter writer flatly stated that she became an NP so she wouldn't have to spend 'all those years' in school and yet she firmly asserted that she was 'just as qualified' to deliver healthcare as any physician and no physician 'was the boss' of her, in spite of what the public or anyone else thought......
And that's the problem.......she just doesn't know what she doesn't know....more than one NP on another premeds forum has stated that they had no idea what they didn't know but quickly got an inkling when they hit medical biochemistry which is usually one of your first classes in medical school.......
Again - if you want to be a doctor, go to medical school....otherwise, be content with being a mid-level and the responsibility and limitations that go with it......
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deleted6669
the em residency faculty at LA county/usc including the famous mel herbert would disagree with you.
click on the following link to observe em pa's teaching em residents a variety of procedural skills(this is common practice everywhere I work as well).
http://www.emrap.tv/?option=com_rd_sitemap&view=sitemap&id=3&Itemid=63
see episode 3(toenail removal) and 18(extensor tendon repair) among others
highly recommend this site by the way. lots of helpful stuff.
click on the following link to observe em pa's teaching em residents a variety of procedural skills(this is common practice everywhere I work as well).
http://www.emrap.tv/?option=com_rd_sitemap&view=sitemap&id=3&Itemid=63
see episode 3(toenail removal) and 18(extensor tendon repair) among others
highly recommend this site by the way. lots of helpful stuff.
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It's unfortunate if true. I don't care who the great so and so is, it doesn't make it appropriate for mid-levels to be involved in the education of residents.
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deleted87716
One more reason not to go into EM.
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Old edition of the magazine which I glanced through while waiting on my next interviewer to get freed up....Looked for a link and couldn't find one.....
I know BlueAvenue and I reckon he wasn't suggesting he wasnt a pre-med. Just that a pre-med shouldn't be insulting people when they aren't in a healthcare field.
Coastie pre-med does not always equal teenage undergrads like myself. BA is a baltimore city medic with some experience. I know people don't really value EMS around here but I think he's been around the block enough times to make a fair judgement on someones competency.
Im not sure if PAs should precept residents because I am neither. I do think the idea of PAs is really cool though!
Coastie pre-med does not always equal teenage undergrads like myself. BA is a baltimore city medic with some experience. I know people don't really value EMS around here but I think he's been around the block enough times to make a fair judgement on someones competency.
Im not sure if PAs should precept residents because I am neither. I do think the idea of PAs is really cool though!
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I am a 2nd year resident and I can't speak for all PA's, but the one's in my hospital should NOT (and do not) be in any capacity to precept any residents under any circumstances. LOL
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I will state for the record... my reading of this thread has pretty much only reached BD's statement above.
As per mid-levels, a good number have a great deal they can teach and I welcome it. However, that being said, resident or not you are the physician. This does not mean be abussive or "superior".... Rather it means you are liable. You will have a hard time telling a jury during malpractice case.... "the NP/PA told me to do it...."
So, with that in mind, you need to consider the exact roles folks are playing in your training and/or supervision. Learn what you can from everyone...
---------------- Listening to: Experimental Audio Research - Space Themes Part 1 & 2 (Tribute To John Cage In C,A,G,E) via FoxyTunes
I am IM residency trained. I can't speak for EM or FP programs but IM has no midlevels as preceptors. However, when I rotated on ortho for 2wks to learn joint injections, my preceptor was a PA. He knew how to inject most joints but forget about teaching me about any pathophysiology. He didn't pretend to be bothered.
I am IM residency trained. I can't speak for EM or FP programs but IM has no midlevels as preceptors. However, when I rotated on ortho for 2wks to learn joint injections, my preceptor was a PA. He knew how to inject most joints but forget about teaching me about any pathophysiology. He didn't pretend to be bothered.
