Pre-med-No required medical experience; Pre-PA-need medical experience

[wisconsindoctor]

Why is it that the majority of PA programs require clinical experience (CNA, EMT, MA) but medical schools don't require clinical experience (please, shadowing a doctor is not the same as working as a CNA, MA, or EMT)?

Discuss!

I think EVERY medical schools should require applicants to have clinical experience. Meaning, actually work in the hospital as an employee and not just doing shadowing work.

---

Members don't see this ad.

 

[sunny1]

Why is it that the majority of PA programs require clinical experience (CNA, EMT, MA) but medical schools don't require clinical experience (please, shadowing a doctor is not the same as working as a CNA, MA, or EMT)?

Discuss!

I think EVERY medical schools should require applicants to have clinical experience. Meaning, actually work in the hospital as an employee and not just doing shadowing work.

Physician assistant programs are on average about two years long. I suppose they want to build in some of the clinical experience or at least exposure upfront prior to students entering their programs.

Compared to physician education where you have 4 years of med school plus 3-4 or more years of residency and possible fellowships on the back end.

Granted, PAs can do a 1 year fellowship, so something of the sort exists. But it's still a shorter education timeframe. So I guess they try to build in some mandated clinical exposure on the front end.

 

[Law2Doc]

Why is it that the majority of PA programs require clinical experience (CNA, EMT, MA) but medical schools don't require clinical experience (please, shadowing a doctor is not the same as working as a CNA, MA, or EMT)?

Discuss!

I think EVERY medical schools should require applicants to have clinical experience. Meaning, actually work in the hospital as an employee and not just doing shadowing work.

You will not get into a US allopathic med school without some decent clinical experience to talk about. A quick day of shadowing is unlikely to do it. But I think schools are cognizant of the fact that when they expect top grades, top MCAT, unique and interesting experiences, and often volunteerism and research, there are limits to what kinds of clinical experience folks will actually be able to get on top of all this. So they won't require the longterm job, but will likely expect some lengthy stint of volunteering and shadowing, so that you have an idea what medicine is all about and know what you are getting yourself into. But FWIW, you will find a lot of med students who have gone above and beyond, and held down healthcare jobs, which have contributed substantially to their admission.

 

[nevercold]

Physician assistant programs are on average about two years long. I suppose they want to build in some of the clinical experience or at least exposure upfront prior to students entering their programs.

Compared to physician education where you have 4 years of med school plus 3-4 or more years of residency and possible fellowships on the back end.

Granted, PAs can do a 1 year fellowship, so something of the sort exists. But it's still a shorter education timeframe. So I guess they try to build in some mandated clinical exposure on the front end.

This is exactly right. Because the PA program is shorter, they require a basic level of clinical practice first.

You do *not* need that experience to be successful in medical school and well prepared for residency, although I wouldn't say it hurts.

 

[Anka]

It also has to do with the difference in roles on the tail end. As an MD, there is a lot of investment in building you up cognitively, and therefore it is accepted that you're doing a lot to build cognitively, especially early in the course. For example, you have your stringent premed requirements, MCATs, then two years of preclinical work. Even once you are a clinical med student, you're going to take SHELF exams, the Steps, etc. You're still going to have very frequent lectures. You need to know a lot, develop good independent judgement, to be 'safe'. If you manage to graduate medical school having never put in a foley, people expect that you're smart enough to figure that out or learn from someone else very quickly.

PAs are not expected to perform as cognitive a role, and far less investment is placed in them on that end. They actually learn to do practical things far earlier in their education, and this is reflected in their admission requirements. And it's completely appropriate given their role at the end of the day, which is not independent.

There is also a historical aspect to this, and I'm not going to presume to go into all the details of the history of the PA, but historically they tended to be more experienced people 'going back' to get an extra degree. Given the brief nature of their degree, and the lack of an requirement for postgraduate training, it is entirely appropriate that they seek to continue this tradition.

Anka

 

[ufgrad00]

Long answer: Has been stated above already.

Short Answer: It is much easier to get into PA school than Med school. No MCAT, no O-chem nor Physics (at least in many programs in this state), and PA schools are willing to accept many students that are in the 2.0-3.0 GPA range. Thus the time requirement for many of the hospital employment activites would compromise the GPA's and test scores of many students wanting to go to med school.

Usually PA schools are looking for people who want to change their current careers or who have become interested in PA school later in life, thus many people who become interested already have years of experience in another health-related field.

 

[paranoid_eyes]

umm....ive been shadowing doctors for months and it is probably a waaaay better experience than any kind of EMT/CNA crap. I guess if you are interested in emergency medicine type work then EMT is good. But I really am not interested in that kinda stuff.

your shadowing experience really depends on the doctor too. Some of the doctors allow me to take vitals and really get good patient interaction. some just let me observe them in surgery. but shadowing is the only real way you get to see what the job of a PHYSICIAN (not an EMT or nurse) is like. If you can see yourself doing what the doctor you are shadowing is doing, then medicine is probably for you. 👍 So i think shadowing is pretty much necessary if you are deciding a career in medicine, but the EMT/CNA stuff is not as important when you apply to medical school.

PA's on the other hand don't really have the same job as doctors. I would compare the type of work they do more to nurses than doctors. Also, as mentioned above, PA's aren't in school for too long and their schooling doesn't have a clinical aspect (it's nothing compared to 3rd/4th year medical school). So PA schools require this kind of experience because such experience is not provided in the PA schooling.

 

[SCHMITTIE120]

Long answer: Has been stated above already.

Short Answer: It is much easier to get into PA school than Med school. No MCAT, no O-chem nor Physics (at least in many programs in this state), and PA schools are willing to accept many students that are in the 2.0-3.0 GPA range. Thus the time requirement for many of the hospital employment activites would compromise the GPA's and test scores of many students wanting to go to med school.

Usually PA schools are looking for people who want to change their current careers or who have become interested in PA school later in life, thus many people who become interested already have years of experience in another health-related field.

while it may be true that PA is a little easier to get into than Med school, the average GPA's that have gained admission are rising dramatically....around here you cannot even get an interview invite without a GPA above a 3.0, and most of the schools (around me) require o-chem and physics....i just wanted to point out that most PA schools will not consider an applicant with a below 3.0 GPA

 

[SwampGator]

while it may be true that PA is a little easier to get into than Med school, the average GPA's that have gained admission are rising dramatically....around here you cannot even get an interview invite without a GPA above a 3.0, and most of the schools (around me) require o-chem and physics....i just wanted to point out that most PA schools will not consider an applicant with a below 3.0 GPA

Agreed, not the same pre-reqs required, but definitely higher, substantially, than a 3.0 GPA. Aren't there a lot fewer seats for PA school too. I know the class at UF is only ~60.

 

[ufgrad00]

while it may be true that PA is a little easier to get into than Med school, the average GPA's that have gained admission are rising dramatically....around here you cannot even get an interview invite without a GPA above a 3.0, and most of the schools (around me) require o-chem and physics....i just wanted to point out that most PA schools will not consider an applicant with a below 3.0 GPA

Really, they require o-chem and physics at more schools? The reason I understood many didn't is because of the background and experience of the people who apply. I worked with a few RN's with over ten years experience that got into PA school last and this year. They told me that in getting their BSN for nursing they did not need to take ochem or phys. Nor did their school require them to go back to school and take those courses. One in particular said that the admissions was more interested in her experience in the hospital and not so much in her academics. Maybe its a state by state or program by program thing. But I don't doubt that it is becoming more competitive to enter those programs. I think just about everything today as far as becoming a health care provider is getting more competitive.

 

[pinkblue]

I think requiring clinical experience is a good way to increase the quality of applicants applying without spending much money. THey don't want people to look at PA school as a back-up to med school. Creating an entrance exam for PA school would cost tons of money, but simply adding "you must do X amount of clinical work" to their website is basically free .

 

[primadonna22274]

You guys have some of your facts straight and many are way off.
There probably are programs that don't require o-chem AND biochem but most require at LEAST one of them. Mine required both. Physics is generally NOT required because it seems to have the least practical application of any of the sciences. O-chem and biochem are both very important in order to understand pharmacology and physiology and how it all works together.
When I went to PA school a decade ago, my program required many more prerequisites than any of the medical schools I was looking at. I had to have a full year of bio, chem, A&P, 1 semester each of orgo and microbio, and of course the usual mumbo-jumbo of humanities and math/statistics. I was grateful that I didn't have to have calculus because I never wanted to take it. I also had several thousand hours of direct patient care experience at that time which put me on the low end compared to many of my classmates. I planned to apply to PA school the first go-round and if I didn't get in, to take MCAT and apply to med school the next year. But I got into PA school so I went.
At that time I had also taken cell bio, genetics, a whole year of biochem, and a full miserable year of organic knowing that I was meeting major requirements and fulfilling prereqs for PA school. Most of my pre-dent and pre-med classmates weren't taking many of the classes I was taking.
Health care experience is required by MOST programs (should be all) because PA has traditionally been a second career. It's designed to build on clinical skills the student gained in previous experience. It's really helpful in a PA class to have paramedics and RNs and RTs etc. helping each other understand how it all goes together. Also there is very little time from starting a PA program until going out on clinical rotations a year later and needing to show clinical acumen right up front. Practically speaking, it's much easier to guarantee your PA students can become clinicians when they have worked with patients significantly in the past.
As for no PA entrance exam, how would one go about designing one? In forty years of training PAs we haven't come up with one yet. Some programs look at GRE (not necessarily predictive) and a few programs will look at MCAT though none require it. Physician assistant training has traditionally been competency-based which means we don't work for a degree, but for a certificate of completion that says in essence we have met the minimum educational requirements to practice safely as a Physician Assistant. We all take the same national certification exam and cannot be licensed by any state board without passing this exam. We all have to maintain certification by taking a recertification exam every six years and completing a minimum of 100 hours of approved CME every 2 years. There have not been any convincing studies that show that PAs who complete an entrance exam to a PA program are more likely to succeed in a PA program and pass the licensing exam. Certain requirements have demonstrated some correlation with PA school success, like science GPA and previous healthcare experience. In fact I am not sure that MCAT has been demonstrated to be terribly predictive of medical student success either.... 🙄

 

[brianmartin]

In fact I am not sure that MCAT has been demonstrated to be terribly predictive of medical student success either....

Actually it has. It predicts USMLE scores very well, and does it better than ugrad GPA.

 

[TheRealMD]

Actually it has. It predicts USMLE scores very well, and does it better than ugrad GPA.

What's this? One standardized test correlates with yet ANOTHER standardized test?

However, what is the strength of such a correlation? And there are tons of variables. I'm not saying the MCAT is important, but let's not start using that for choosing residencies!

 

[primadonna22274]

Show me the studies. I've read conflicting data. I'd not venture to say there is no correlation but how strong is it?
My point is there is not a PA entrance exam because traditionally PAs have been admitted under mostly non-academic standards. Only in the last 15 years has there been a significant academic interest in training PAs (and one could argue universities have become interested because PA programs make money for the universities--a LOT of money).
Also no one has ever been particularly interested in creating a PA entrance exam since we have a 40-year track record of turning out PAs without such an exam. I will agree that the PAs of today look very different than those of a generation ago. Arguably there may be a need for such an entrance exam as we get further away from competency-based PA education and more towards degree-based.

Actually it has. It predicts USMLE scores very well, and does it better than ugrad GPA.

 

[HumidBeing]

In my state there are a grand total of 27 slots per year for PA school. The prereqs don't include physics, but do include bio, chem, ochem or biochem, anatomy, physiology, and microbio - each with lab. It also requires statistics, math, a batch of behavioral sciences, a batch of humanities, and at least 30 hours worth of liberal arts/sciences electives that are neither professional nor technical in nature. Clinical experience is not a prerequiste; however, they state that class selection preference will be given to those with direct patient care experience. In other words, with only 27 seats in the class, an applicant is very unlikely to get in with only shadowing and volunteer paper shuffling under his belt. The program is 27 months long and leads to an MS. Applicants are also required to take the GRE.

You can locate the requirements for just about any school at this website:
http://www.arc-pa.org/Acc_Programs/acc_programs.html

 

[AggieSean]

What's this? One standardized test correlates with yet ANOTHER standardized test?

However, what is the strength of such a correlation? And there are tons of variables. I'm not saying the MCAT is important, but let's not start using that for choosing residencies!

Studies do show that if you eat breakfast, you are in fact, 10 times cooler.

 

[primadonna22274]

Some states are saturated (NY, PA) with PA programs. PA graduates in these states are paid the least and have fierce competition for jobs. In states like Oregon (my home state), where there are 2 PA programs for a relatively large geographic area, it's harder to get into a program but easier to find rotation sites and jobs. Pay is better too. Before the first PA program started at OHSU in 95 though (first graduates in 97, Pacific first graduates in 99) Oregon did not train ANY of its own PAs. All practicing PAs before my day came from out of state. It took a lot of convincing the state legislature that there was a good reason to have homegrown PAs. (And look, I left, and am applying to med school to boot. Oops.)
The application requirements Humid mentioned are much more typical these days. And it is a rare applicant who gets a competitive seat without at minimum 500 hours of direct patient care experience.
I took the GRE in 97 but my program didn't look at it, and still doesn't. Some do, as I said before. I remember I did pretty well too but it was in the end just an expensive ego boost.