Sorry. It still doesn't make sense to me. A PA has to practice in two years. So what? A PA doesn't have a residency. So what? I just don't think having 2000 hours experience as a CNA will prepare me to be a PA. It may prepare me to communicate with patients, but that's about it since the job responsibilities/duties of a CNA and a PA vary quite a bit.
Also, I'm not sold on the idea that 2000 hours will make one a better PA. My cousin is a PA. He volunteered in a hospital and got about around 300 hours before he went to PA school. He hit the ground running just fine.
If PA schools are worried about patient interaction, then maybe the rotations should be two years instead of one or maybe there should be a year post-grad internship or something.
It's not to polish their clinical skills. It's to enhance their knowledge of their specialty. You can't really say that the reason they don't require nearly as much clinical exposure is because they have residency. It's a totally separate issue. They don't require as much clinical exposure because they know that no other job in the hospital is going to tell them what it's like to be a doctor, so what's the point?
It sounds to me like you have already made up your mind.
However, I will try and answer your questions again and in some semblance to the order you posted them.
First off, there are quite a few PA residencies for those who feel they would benefit.
In addition, there are a number of reasons why some schools may require that amount of time. I will list a few:
1. There are a ton of people applying to PA school and making people have this kind of experience weeds out quite a few who are not really all that dedicated.
2. In addition, a lot of people who apply and quite a few that I went to school with (where they have no such requirement) have absolutely no idea of what they are getting into. We actually had people who were surprised that their patients would burp, fart, have stinky feet and could be rude. If you have a certain amount of patient care experience then you are better prepared for the human condition. They also have no concept of a PAs place in the healthcare system.
3. There is a ton of information that is thrown at you in PA school. The quote most often used is "drinking from a firehose" and I think this illustrates it very well. With some patient care experience, you have some sort of a background on which to base things and a framework in which to put new ideas and concepts. For instance, there are a lot of our students who did not even know what an enema was. So, while the teacher has gone past that and is explaining something else they are trying to look up enema in their medical dictionary. Now granted, you will still not know what everything is, but at least there are some things that you will already know and won't have to struggle with every single name and concept.
4. Patient interaction is a huge part of your clinical rotations and those hours would help an incredible amount. They could make PA school two years of clinicals, but then why not just go to med school for an extra year of work and be a doctor.
As far as the hours making you a better PA. You and your cousin may be just fine without the hours. However, it helps most folks. Ask most PA preceptors and they can tell a huge difference in-between those with prior experience and those starting from scratch. If you have to teach a student what color an oxygen tank is and how to turn it on, then you are wasting valuable time where you could be teaching them higher-order skills.
I beg to differ about honing and polishing their clinical skills. Ask most folks who have been around in the medical field for more than a few years and who have seen where the residents start out and how they finish up, then there is little doubt that it happens.
I also think you're missing the entire point about the number of years. Doctors have a longer period to train and PA's have a shorter period. So, in order to bring the two closer together (keep in mind, they are still very far apart), they want the PA student to have some clinical hours. It just helps to even things out a little.
Actually, I can say (and am saying exactly) that the reason they don't require as much clinical exposure is because they have a residency.
I also get from your post that any training that is not in the field your going into is wasted. I disagree, you derive benefit from all experience in your life. I was a scrub tech, EMT and MT before going into PA school (as well as many other non-medical jobs) and I had a huge benefit over a lot of my classmates. My best friend was a CNA and taught me a lot about floor care that he participated in or witnessed.
I did not keep my mind and ears shut all the years that I worked in healthcare and I learned a tremendous amount. While I was in PA school I learned the reasons for a lot of the things that I had seen done over the years and was able to gain a deeper understanding than a lot of classmates.
In the end it does not matter if you learn from a doctor, PA, nurse or janitor, as long as you learn.
If all of this does not change your mind a bit, then keep in mind that whatever you think, if you want to get into PA school, then you have to jump through their hoops. There were several courses and countless papers that I thought were totally unneccesary in PA school. It mattered not one bit what I thought. I had to do them (and well) if I wanted to graduate, so I did them.
-Mike
