So what do I call me?

[quicksilver2]

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This post is meant semi-tongue-in-cheek, so don't take it too seriously. At the same time, I'm interested to hear what people think.

So I'm a PA-C. I'm also about to graduate from medical school in a few more months. Due to how timing worked out, there'll be a period of about 6 months where I have an MD degree (but no physician license since I won't have started residency yet), but my PA license will still be active. So what do I call myself?

Now, in reality, I really don't care all that much -- if I'm working as a PA (employed or volunteering), I'd simply do what I've always done and use my first name. There're no reason to confuse anyone further, and if the parameters I'm operating under are those of a PA, then, well, that's what I should be.

Still, it made me wonder -- what if I did care? I know the perennial argument over what to call PAs who have EdDs or PhDs has been out there forever, but in this case, I would hold an actual "clinical" doctorate. I suppose this is not all that dissimilar to the issue of IMGs who fail USMLE and then try to obtain PA licensure (in the states that allow it). Do they introduce themselves as "Doctor"?

The next twist on the situation would, of course, be once I'm in residency. As an intern, I'd generally only be licensed to do clinical activities within the scope of the program I'm in. If I were to volunteer to do something outside the residency as a PA... 🙂

(Same deal, probably -- when a PA, just do what you've always done as a PA. when a doc, do what you'd do as a doc.)

For that matter, do state laws protect the term "physician"? I.e. could a recent graduate of a medical school who hasn't entered residency yet identify themselves as "a doctor" but not as "a physician"? Do residents technically have to identify themselves as "resident physicians" (or "doctors") and not "physicians"?

As you can tell, this is more out of curiousity over names and signifiers than really an issue of practical value (to me personally.) I'd love to hear what people think...

 

[ockhamsRzr]

Funny situation!

Actually though I think once you've attained the MD degree you are legally held to the responsibilities of an MD. I don't know if legally you can work as an PA if you have an MD and maintain the same degree of liability protection that PAs enjoy.

Anyway, congrats on your two accomplishments--that's awesome!

Ock

This post is meant semi-tongue-in-cheek, so don't take it too seriously. At the same time, I'm interested to hear what people think.

So I'm a PA-C. I'm also about to graduate from medical school in a few more months. Due to how timing worked out, there'll be a period of about 6 months where I have an MD degree (but no physician license since I won't have started residency yet), but my PA license will still be active. So what do I call myself?

Now, in reality, I really don't care all that much -- if I'm working as a PA (employed or volunteering), I'd simply do what I've always done and use my first name. There're no reason to confuse anyone further, and if the parameters I'm operating under are those of a PA, then, well, that's what I should be.

Still, it made me wonder -- what if I did care? I know the perennial argument over what to call PAs who have EdDs or PhDs has been out there forever, but in this case, I would hold an actual "clinical" doctorate. I suppose this is not all that dissimilar to the issue of IMGs who fail USMLE and then try to obtain PA licensure (in the states that allow it). Do they introduce themselves as "Doctor"?

The next twist on the situation would, of course, be once I'm in residency. As an intern, I'd generally only be licensed to do clinical activities within the scope of the program I'm in. If I were to volunteer to do something outside the residency as a PA... 🙂

(Same deal, probably -- when a PA, just do what you've always done as a PA. when a doc, do what you'd do as a doc.)

For that matter, do state laws protect the term "physician"? I.e. could a recent graduate of a medical school who hasn't entered residency yet identify themselves as "a doctor" but not as "a physician"? Do residents technically have to identify themselves as "resident physicians" (or "doctors") and not "physicians"?

As you can tell, this is more out of curiousity over names and signifiers than really an issue of practical value (to me personally.) I'd love to hear what people think...

 

[quicksilver2]

Funny situation!
Actually though I think once you've attained the MD degree you are legally held to the responsibilities of an MD. I don't know if legally you can work as an PA if you have an MD and maintain the same degree of liability protection that PAs enjoy.

Thanks. I'm not so sure this is true for the situation I described -- having a degree as an MD _but no licensure as a full physician_ doesn't mean much. Having been through both PA and med school, I can also tell you that there's really no major difference between a graduating PA student and a graduating medical student. The residency is "what makes the physician".

Certainly I'd agree with you if I had both a full PA license and a full physician's license -- being in a situation as, say, a volunteer PA, screwing up, and then claiming that I was only working as a PA is dubious when I clearly have the knowledge base and training of an MD available. As a PGY-1, though, it's not as clear-cut...

Frankly, the only reason I'd maintain a PA license/certification post-PGY-1 would be for "street cred" if I ended up doing any teaching in a PA program. And even then, it would probably only be worth it to hold on to certification (the "-C" part), not the state license.

One of the most interesting "challenges" will actually be finally referring to myself as "Doctor" -- after years of the PA role, it's almost automatic to issue a gentle correction when I'm termed "Doctor".

 

[deleted6669]

quick- did you go the md or do route?
what are you going to do your residency in?
as a do(the way I would go at this point) I think I would keep my pa-c and emt-p and list them on my cv or when I write article or teach but not on my daily nametags. that might get a little ridiculous:
emedpa, do, pa-c, mpa, emt-p

a curious pa still eyeing medschool......

 

[fuegorama]

as a do(the way I would go at this point) I think I would keep my pa-c and emt-p and list them on my cv or when I write article or teach but not on my daily nametags

Why?

 

[FoughtFyr]

Thanks. I'm not so sure this is true for the situation I described -- having a degree as an MD _but no licensure as a full physician_ doesn't mean much. Having been through both PA and med school, I can also tell you that there's really no major difference between a graduating PA student and a graduating medical student. The residency is "what makes the physician".

Certainly I'd agree with you if I had both a full PA license and a full physician's license -- being in a situation as, say, a volunteer PA, screwing up, and then claiming that I was only working as a PA is dubious when I clearly have the knowledge base and training of an MD available. As a PGY-1, though, it's not as clear-cut...

Frankly, the only reason I'd maintain a PA license/certification post-PGY-1 would be for "street cred" if I ended up doing any teaching in a PA program. And even then, it would probably only be worth it to hold on to certification (the "-C" part), not the state license.

One of the most interesting "challenges" will actually be finally referring to myself as "Doctor" -- after years of the PA role, it's almost automatic to issue a gentle correction when I'm termed "Doctor".

I was "somewhat" in the same boat as I was an active firefighter paramedic during medical school and went back on the ambulance after graduation but before residency. What I was told by my medical school's dean was simple. I was a doctor. He pointed out that this was an academic degree that was conferred. If I chose not to do residency, I would still legally be awarded the title of doctor. Having a license has nothing to do with it. Now, in the clinical setting, this does confuse the situation. People expect that a "doctor" is a licensed MD/DO. So, in the rare event that it would come up (I usually introduced myself by first name on the ambulance), I would explain that I was there in the capacity of a paramedic. The only "fun" part was getting grief from a new nurse who didn't agree with my management of a patient. She went on to lecture me about how she was "educated" and how, as a paramedic, I was only "trained". I think she was set-up by her colleagues because the howls of laughter that accompnied my long explanation about the pharmacokinetics of epinephrine (I nebulized in a refractory asthmatic) and then my partner's introduction of me as "Dr. Foughtfyr" where hilarious. Let's just say she does not get as "uppity" with EMS crews as she once did as a new grad.

I still list my EMT-P on formal presentations (street cred), but the liability thing was a little different for me as we had "field physician" protocols where I worked, so I was not the first to do it. I was formally changed on the EMS System's roster to a "field physician" from an "EMT-P" even though I did not have my license.

As for the title "physician", it is not protected. Lots of people call themselves "physicians" with little or highly suspect training (e.g., chiropractors, naturopaths, homeopaths, etc.). As a resident I will formally introduce myself as a "resident physician" only if I am including the location of where I am training (as to not be confused with hired medical staff). So, if I am talking to a group I am "Dr. Foughtfyr, a resident physician at Best Medical Center." To my patients I am "Dr. Foughtfyr" and have been since day one. Don't worry, you'll get used to it - I think. I still haven't after a year and a half (and I have my license), but that's just me.

Congrats!

- H

 

[deleted6669]

Why?

"street cred"
having pa-c, emt-p on my name tags helps me quite a bit now with the medics when they realize I am not just some ivory tower snob but a "been there done that" former street medic

 

[quicksilver2]

quick- did you go the md or do route?
what are you going to do your residency in?
as a do(the way I would go at this point) I think I would keep my pa-c and emt-p and list them on my cv or when I write article or teach but not on my daily nametags. that might get a little ridiculous:
emedpa, do, pa-c, mpa, emt-p

MD, although geographic considerations kept DO school from being an option. I'm glad I didn't do DO, only because I've gotten sick of years of explaining what a PA is, and I wasn't about to put up with that as a DO. (Before I get flamed, I've worked with many DOs who I respect, have friends who did PA school at osteopathic institutions, and I was even on the faculty of one of those institutions' PA programs for a while. 🙂 )

Residency: pediatrics.

I list _everything_ on my CV, because that's the point of a CV. I tend to drop my PA school master's degree (because it's kind of redundant with the PA-C) on name tags and the like, and I hold two other master's degrees as well already.

 

[quicksilver2]

I was "somewhat" in the same boat as I was an active firefighter paramedic during medical school and went back on the ambulance after graduation but before residency. What I was told by my medical school's dean was simple. I was a doctor. He pointed out that this was an academic degree that was conferred. If I chose not to do residency, I would still legally be awarded the title of doctor. Having a license has nothing to do with it.

Yeah, I know. The problem, as you point out, is that the degree entitles one to be called "Doctor", but the general public's use of the term implies "Physician".

The only "fun" part was getting grief from a new nurse who didn't agree with my management of a patient. She went on to lecture me about how she was "educated" and how, as a paramedic, I was only "trained". I think she was set-up by her colleagues because the howls of laughter that accompnied my long explanation about the pharmacokinetics of epinephrine (I nebulized in a refractory asthmatic) and then my partner's introduction of me as "Dr. Foughtfyr" where hilarious. Let's just say she does not get as "uppity" with EMS crews as she once did as a new grad.

🙂 Yeah, a couple of times I've run into know-it-all interns at our (fairly low-ranked) residency program, but, you know, it just wasn't worth it. I just did the math and figured out what I was doing clinically when they were trying to get into med school. 🙂

The tricky part was whether to "reveal myself" to my attendings or not. I didn't want to deal with the extremes (either being given more responsibility than I should "because you're a PA" or hostility (because they don't like PAs what whatever reason), so I ended up kind of doing half-and-half. If asked about my background, I'd always mention it. What was surprising was the number of times the preceptor never asked anything about prior experience, etc.

As for the title "physician", it is not protected. Lots of people call themselves "physicians" with little or highly suspect training (e.g., chiropractors, naturopaths, homeopaths, etc.).

Actually, in Illinois, the title does appear to be somewhat protected (225 ILCS 60/49):
=====
Sec. 49. If any person does any of the following and does not possess a valid license issued under this Act, that person shall be sentenced as provided in Section 59: (i) holds himself or herself out to the public as being engaged in the diagnosis or treatment of physical or mental ailments or conditions including, but not limited to, deformities, diseases, disorders, or injuries of human beings; (ii) suggests, recommends or prescribes any form of treatment for the palliation, relief or cure of any physical or mental ailment or condition of any person with the intention of receiving, either directly or indirectly, any fee, gift, or compensation whatever; (iii) diagnoses or attempts to diagnose, operates upon, professes to heal, prescribes for, or otherwise treats any ailment or condition, or supposed ailment or condition, of another; (iv) maintains an office for examination or treatment of persons afflicted, or alleged or supposed to be afflicted, by any ailment or condition; (v) manipulates or adjusts osseous or articular structures; or (vi) attaches the title Doctor, Physician, Surgeon, M.D., D.O. or D.C. or any other word or abbreviation to his or her name indicating that he or she is engaged in the treatment of human ailments or conditions as a business.
=====

I suspect you could term yourself a "homeopathic physician" or "chiropractic physician" or whatever without any problem. It may depend on what the Practice Act states for those areas, assuming that they're licensed professions.

As a resident I will formally introduce myself as a "resident physician" only if I am including the location of where I am training (as to not be confused with hired medical staff). So, if I am talking to a group I am "Dr. Foughtfyr, a resident physician at Best Medical Center."

Yeah, I meant it as a more formal introduction. The number of times I get asked "So, are you doing your residency?" by people _who work in hospitals_ is astounding.

To my patients I am "Dr. Foughtfyr" and have been since day one. Don't worry, you'll get used to it - I think. I still haven't after a year and a half (and I have my license), but that's just me.

Thanks. I think it's the knee-jerk response that one develops as a PA since we "look" like physicians to the average layperson, so you tend to get a little more attuned to immediately correcting it. There's also the fact that I _still_ associate "Mr Quicksilver" with my father, not me, so introducing myself as "Dr Quicksilver" would be even stranger...