specialized PA programs

Discussion in 'Clinicians [ RN / NP / PA ]' started by TexasRose, Oct 21, 2002.

  1. TexasRose

    TexasRose Gotta run
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    I noticed while surfing somewhat randomly that Colorado has a PA program that specializes in pediatrics. Anyone know of other specialized programs like that?

    Also, can PA's get further specialized training beyond that of the Master's program? Or is it all done in school? I haven't found any references to further "residency" type training for cardiology or neonatology.

    (FYI, I'm a nontraditional premed discovering the plusses of PA over MD)

    Theresa
     
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  3. emedpa

    emedpa GlobalDoc
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    Theresa-welcome
    it is possible to do a residency as a pa in almost any field. most are 1-2 years in length and grant a certificate and/or masters degree. most also provide a salary around 40k/yr. it is also possible to design an emphasis while in pa school by taking your electives all in a certain field.
    for general info about the pa profession check out www.aapa.org
    for info on postgrad programs check www.appap.org
     
  4. TexasRose

    TexasRose Gotta run
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    Emedpa, likely you've answered this elsewhere, but I'll ask anyway. Why the premed when you're already a PA? I ask because I'm a premed considering PA and I'd like to know what the drawbacks are. ( I have a husband and 3 kids to factor into this decision, so it ain't easy)
    Thanks,
    Theresa
     
  5. emedpa

    emedpa GlobalDoc
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    Theresa-
    I too am married with kids and mortgage.
    I do 90% of what the er docs do on a day to day basis. most people would be happy with this but I have found that I am not. I miss doing some of the types of cases I worked on as a paramedic and would like to not have any real or imagined limitations placed on me by policy or the whims of whichever doc I am working with on a given day. some docs are ok with me running the most difficult cases while some want to hear about every cold. some docs treat me with respect while others think of me as a glorified medical assistant. I run circles around some of the docs in the dept(do procedures that they can't, intubate their patients, etc) and yet at the end of the day they still have to sign my charts(even when I have to explain a dx to them). I probably sound a little bitter, and I am. obtaining my md/do at this point is the only way to have the freedom I need in my practice.if you can accept some oversight in your practice you will enjoy being a pa. just pick the right job and md/do supervisor.
     
  6. TexasRose

    TexasRose Gotta run
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    Funny, my BA is in Anthro! We're the same age, too. My experience has been primarily in casework and speech pathology, however.

    Your dissatisfaction with the limitations of being a PA is the very thing I'm concerned about. I like being the one with the knowledge-base and the skills. I worry about how I will respond to having an MD looking over my shoulder.

    On the other hand, my kids will be in high school while I'm doing a medical residency and I'm afraid of being an absentee parent if I go the MD route.

    Does all your experience count for anything with regards to medical school? Still have to take the Orgo classes and MCAT? Do the PA courses transfer at all? How are you received by admin folks at med schools?(I wonder if they look down on PAs)

    Again, I appreciate your replies. They are very helpful in the decision process. I'm sure I'm not the only one reading them, either!
    Theresa
     
  7. emedpa

    emedpa GlobalDoc
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    T-
    some md/do programs grant limited credit to pa's for prior coursework but on a case by case basis, so I'm not counting on it.
    I still have to fulfill all prereqs and take the mcat.med school for former pa's tends to be much easier than for the avg applicant because a lot of the didactic material and the entire 3rd year is review. the pa's I know who have gone back to school end up at the top of their class
    part of my dissatisfaction with being a pa comes from the fact that I work with a group of over 50 different physicians. if you work in primary care you will probably have a better relationship with 1-2 physicians and they will know your skills better and help you to grow as a clinician. DO programs tend to love PA applicants due to prior healthcare and life experience while MD programs really don't care.I will probably apply to 2 do programs and my state md program as backup.
     
  8. cminchew

    cminchew Junior Member
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    So do you recommend the route you've taken? Meaning, PA to MD. I am choosing the PA route because I have 2 infants at home and I can't make the sacrifice for the next 5-8 years of their lives. I am willing to make the sacrifice to go MD later in my life, when they are much older. I don't mind becoming a PA with the intent of going to medical school later, maybe 10 years down the road. I feel like at some point I will be unsatisfied with being "just" a PA, when what I truely want is to be an MD. I was wait-listed 6 or 7 years ago for med school and I didn't get in. I then started research and had a kid or two, so now med school is a whole different ball game for me. So now I wonder if I should do some soul searching and go for my MD now or try being a PA first and see how I feel. Maybe I'll be totally satisfied with that?!!?!! I guess it really depends on what kind of person I am, and what my ultimate goals are..........just thinking out loud!!! Any advice would be appreciated.
     
  9. TexasRose

    TexasRose Gotta run
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    The biggest problem I see with that plan, and I'm considering it myself, is that you would be spending the money and time on PA school only to turn around and spend more money and time on Med school. Why not do it "right" the first time?

    Also, I don't know about your age, but I'm 32 and waiting another 10 years for med school seems like I might just age myself out of being a good candidate. I could be wrong, of course!

    Those are my concerns, not my entire feeling on the choice!
    Theresa
     
  10. emedpa

    emedpa GlobalDoc
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    if you know already that you want the md, do it now. i didn't figure that out until 3 yrs out of pa school-e
     
  11. crawgator

    crawgator Junior Member
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    Emedpa,

    Hi! I really enjoy all of your posts and valuable insights that you bring into the forum. Have a couple of questions for you:
    1. I have been accepted to a Primary Care PA school and chose that school over a Surgically based program after corresponding with several practicing PAs. Anyway, I have an interest in Emergency Medicine-- after completion of my coursework, do I then have to specialize in emer med? Are there states that are PA friendly vs. non pa friendly? I'm just trying to figure out what states may choose to hire a PA over an NP.
    2. I thought that I would have to attend an SPA program to see your type of income, but I guess that I was wrong. Do you see any advantage of choosing a SPA program over Primary Care? How should I get involved in Emergency medicine? Do I beef up on my electives? Any further insights would be greatly appreciated!
     
  12. emedpa

    emedpa GlobalDoc
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    if you have some freedom in your selection of rotations you can specialize to some extent while in pa school. at my program they had over 50 sites for each rotation so there was a lot of flexibility. my rotations were as follows
    required rotation completed
    surgery trauma surgery
    medicine inpatient int. med
    ob high risk ob
    EM trauma center EM
    peds peds ER
    psych crisis psch( em psych)

    elective 1 community EM(3 mo)
    elective 2 family med(3 mo)

    also take acls, atls, pals as soon as possible.you can do an em residency if you want(the best 1 is at university of georgia, you can check it at www.appap.org ), but that is not a requirement. most folks who do em have some em background(I am a paramedic) but that is not required. to get your foot in the door you may need to start with a fast-track/urgent care position for a few years to show you have good basic skills. look for a state to practice in that allows dea schedule 2 prescribing. this is a good indication of a states attitude about pa's. north carolina, washington, vermont, and maine are especially good. also keep in my that my salary is based on 7 years at the same place as well as night and weekend differentials. a good starting salary for a new grad in em is 65-70k or so. also join sempa, the society of emergency med pa's. there site is www.sempa.org
    good luck-e
     
  13. PACtoDOC

    PACtoDOC 1K Member
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    Hey all, to throw a bit of similarity into the conversation, I will tell my story (quickly since emedpa already knows it). I am 31, and have been in medicine since 18. Navy Corpsman age 18, EMT age 20, paramedic age 22, PA age 27, and now first year medical student at the ripe old age of 31. Emedpa must have been my twin brother and we must have been separated at birth. I am starting to like this guy more and more as I read on. Like he, I have taught ACLS for years, have been told that my clinical skills exceed many of my previous supervisors, and I simply was not happy being less than what I felt I was. I think most people who are PA's are happy, but there are always the few who just honestly did not know they wanted to be a physician at that time in their life. I am glad I did it this way. I made a ton of cash over my 4 years as a PA, have a family, am well grounded, and now find myself mostly reviewing in med school. I have been embraced by the school faculty (some at least) and given leadership and even teaching opportunities, and I still work Saturday's to feel human and wear the long white coat. To emedpa, go to it boy!! You will not regret it one bit. It will suck at times when you have to do be graded for instance by a PA as a PA in practicals, but you just have to get over it. I have realized that the world is soon to be at my fingertips. I am in the top 2% of my class, will undoubtedly blow the boards away, thus should be able to get any residency I choose. So is the roundabout way really that bad? Not in my opinion, because now I know I am here because I want to be, and I will be better off financially and career wise because of it. Age wise, yes I will be about 8 years older when I am done than the average young doc, but in reality, most docs work until they die anyway. At least I know I will, because I love it. So no matter how it plays out, I will be able to say I practiced medicine all my life, but the last 30 will have been as a physician. Bottom line, do what makes you happiest, and realize that you can always go back and change your dream to suit your needs!!

    Matt
     
  14. cminchew

    cminchew Junior Member
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    I love what you said in your post. I was thinking along the same lines, but its nice to hear someone who has actually experienced it. I was thinking that I may be happy as a PA and it is a sacrifice I am willing and able to make right now to become one. I will make good money doing what I want to do, practice medicine. I am thinking that if I get to that point, and then feel like its not enough, I can go to med school. At least at that point I'll be in a better position financially, family wise, and with a much better knowledge base. I don't know if I'll be one of those people who would be totally satisfied with being a PA, but I think I should give it a try first and save what money, time and family life I can during school.

    Thanks to ALL of you that are PAs and med students for your advice. It is so important to hear several points of view really see the big picture.
     
  15. Ponyboy

    Ponyboy Senior Member
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    Holy ego, Batman! I'm surprised you can get into class with a head that big. While you set about bending the world to your almighty medical abilities, you might want to remember that residency directors also look for something called personality. Included in this little factor might be something called humility. Just a thought. But, hey, your skills are probably better than mine and I'm definitely not in the top 2% of my class, nor did I blow the boards away, so I could be wrong.
     
  16. Ponyboy

    Ponyboy Senior Member
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    cminchew,
    I might be a little biased but I would reccommend just going to med school. If you look at it this way, there are only two additional years of med school beyond PA school. There's an additional year of classes (which would afford you plenty of time for your family) as well as an extra year of clinical electives (most of which are 9-5 schedules). So, the two extra years are two years where there's be time to spend with your kids.
    the real time crunch comes during residency where call is more hectic but that's four years away. In addition, there are shared residencies as well as part-time residencies.
    the advantage to simply going to med school is that you save yourself time, money and deliberation. if you become a PA and then decide to become a doctor, you may have spent several years practicing in a capacity below your abilities and desires. in addition, you will have spent money on both PA and med school. finally, you would never have to wonder if you could have gone to med school, if you could have been a good subspecialist or if you would have been happier as an MD.
     
  17. TexasRose

    TexasRose Gotta run
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    Candace, let the boys say what they will, us moms often have a different perspective. While residency may be 4+ years away, I have to consider the age of my children during those years when I will be largely unavailable to them. My daughter will be between 13-17 for those years (in my MD plan.) I don't want to be an absentee parent for that perilous age. Not to mention my twins, who will be 11-15 years old.

    I believe I can practice the level of medicine I want as a pediatric PA and have time to be a mother as well. That's nothing to sniff at! I think my goals are well met by the PA route.

    For me, it's better to wonder if I could have been a full physician than to wonder if I should have been a full parent.

    That, of course, is a personal opinion about my own abilities and not a judgement of anyone else!

    Theresa
     
  18. PACtoDOC

    PACtoDOC 1K Member
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    Ponyboy,
    This is my last and only comment to you. You should be in the media instead of medicine. Your ability to cut and past sentences together out of context, and your ability to make judgmental generalizations makes you the next Jerry Springer. My comments were meant to sway someone into believing that it could be highly advantageous to be a PA before going to medical school. You don't know anything about my personality. But everyone else has now seen yours haven't they? I do have humility, display empathy, and am kind to my patients, and I guess I should have mentioned that in my posting. The posting wasn't about that though was it? It was about supporting an argument for why a PA could be highly qualified to be a physician. But keep telling yourself that residency directors are looking for someone with a personality, but honestly that sounds like a lame self help tape that you probably already purchased after your lame USMLE score report came back. Good luck with your humility on your match, you judgemental little wimp. Oh, and I guess I am not that much like emedpa, because he would have calmly and tactfully dealt with you. I speak my mind. Why are you on a PA forum anyway, so that you can tell everyone how much better it is to be a medical student than a PA student? What the hell would you know about it anyway?
     
  19. cminchew

    cminchew Junior Member
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    "For me, it's better to wonder if I could have been a full physician than to wonder if I should have been a full parent."

    That's exactly how I feel! I just hadn't put it into words here on the boards. I'm not as worried about how much time or money I spend in school, or how much money I make afterward, but what quality of parenting I can give the WHOLE time. There aren't any years of my kids lives that I can be an absentee parent. Being a PA will limit the time away from them to a few years of stretching it both ways. Even then, it won't be much worse than having any other full time job.

    I think its important, for my kid's and husband's sake, for me to try to be a PA to fulfill my medical career desires. It's a sacrifice the whole family can live with. I'm not ruling out medical school for the future, but it would have to be way in the future. I don't think it's ever too late to start a career. I would go to medical school in my 50's, if the desire hits me. That would likely give me at least 20 years to practice medicine as an MD!!

    Glad to hear from someone in a similar position. Thanks.
     
  20. PACtoDOC

    PACtoDOC 1K Member
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    For you parents, I can understand completely your thoughts. I have two kids, 5 and 3, and I never even gave it a second thought to attend med school until they were approaching school age. Mostly this was because my wife really needed my help in parenting, and if I had started med school when my kids were born it would have been impossible. I am now to the stage with one kid in school and the other starting next year, that I can feel comfortable starting a second career. I know these years will be tough on them, but it will be over before they are in junior high, and the best years of their lives will be when I am living a normal life again. And don't take this wrong if you are female, but the PA field is simply changing rapidly toward a female dominated career path. It makes more sense for females to want to be PA's because of the flexibility in mothering, and it just works out better for most practices to have a female PA. I don't think there will be more than 20% males in the PA field in the next 20 years. When I went to PA school it was about 50/50, and now it is about 65/35, if not more unbalanced. The interaction that I have seen among male physicians and female PA's is the perfect mix, where often times the male/male interaction gets territorial and competitive. My last supervising physician married our other PA partner!!
     
  21. Ponyboy

    Ponyboy Senior Member
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    I should be in the media? I'm about to be the next Jerry Springer? I have lame USMLE's? I'm a judgemental little wimp? OK, now who is making judgements here?

    True, your post was about the advantages of being a PA before med school. But the tone reeked of arrogance and pride. You were boasting about being in the top 2% of your class, blowing away the boards (which you have not done yet) and getting the residency of your choice (which you have not done either). How else is one to interpret these statements? That you're somehow clairvoyant and can predict future events? Seriously, if you were conversing with a residency director about the advantages of being a PA, would you slip into the conversation that you were going to ace the boards, get the residency of your choice and that you had been told that you were better than your supervisors? Of course not. Why? Because it would sound arrogant. So why is it any different here?

    FYI, I did just fine on the USMLE's. I don't think that anyone would call my performance lame. That's kinda inferring a lot from someone's statement about personality, isn't it?
    FYI, I'm neither little nor a wimp. What was that about making judgements?
    FYI, I like to read about medical issues. That includes mid-level practioners. I have never said that being a med student was better than being a PA student, I've only offered my rationale regarding PA vs. med school in terms of life choices (what was that about judgements again?).
     
  22. TexasRose

    TexasRose Gotta run
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    Boys, take it outside. Seriously. Maybe you could start a slamming thread...

    PACtoDOC, I appreciate your input and point of view. I hope I didn't insult anyone with my position on my family's needs.

    Candace, glad we're talking! It's hard to make these sorts decisions and it's good to share ideas, info, and experiences.

    Where are you in the application process? I've got 3 Bio classes left to take so I'm going to apply next summer/fall. PM me if you like!

    Theresa
     
  23. AritonM

    AritonM Junior Member

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    I'm no PA and I don't play one on tv, but wouldn't becoming a PA be the perfect scenario for becoming an MD later? I mean how could a med school turn down someone who is already 90% an MD over some kid who read alot of books in college? Let me break it down. Two guys Jim and John:

    Jim: Graduates college B.S. Biology, goes to PA school graduates at 24. Works 6 years as a PA. Applies to Med School.

    John: Graduates college B.S. Biology, applys to Med School.

    Who would you take?

    I am in the midst of a career change to becoming a PA. I plan on working a few years as one and then attending Med school. What could they possibly teach me in med school? How to cash a 10,000 dollar pay check?
     
  24. AritonM

    AritonM Junior Member

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    Anything that has 65% women has to be good. Woo Hoo!!! I'm there!
     

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