UC Davis midlevels over students?

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Aside from all of the latest discussion, to the original post, UC Davis is a great school and produces great physicians.

There is absolutely no way that the school is handing away clerkship/rotation spots willingly. I refuse to believe it. The screenshots do not imply that the school is willingly giving the spots away and the person who wote that probably does not know the full story.

There is nothing about how the school is or is not addressing the situation so we cannot say anything either way about the situation. We do not know if there was a dialogue before or after the screenshot explaining it more. It is too vague and too much we don't know.
 
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realitysickness said:
Hi I was recently accepted to UCD and am thrilled at the prospect of attending but this news is giving me serious second thoughts... what can I do to hold the administration accountable? Should I email Admissions about this through our applicant portal? Call Admissions?
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You must consider ALL the factors that affect a student when choosing a school to attend. It is a great school, has supportive staff, inclusive environment, supports wellness and mental health, financial aid constantly sends us scholarship postings, our advisors have our back, free psychiatry and psychology sessions to all students, so much free food, games/events, the list goes on.

Medical school in general is very difficult on many levels and takes its toll. Having a supportive environment at school is more important than what you can imagine as an applicant. Think about these factors when choosing your school. I cannot see myself as happy at another school and chose UCDSOM for the reasons listed.

From the MS2's comment on here, it seems that admin is working on getting back clerkships. Everyone so angry at UCD might be angry at a tiny, misrepresented sliver of the puzzle they saw and might change their mind if they saw the whole picture.
 
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heartofadoctor said:
You must consider ALL the factors that affect a student when choosing a school to attend. It is a great school, has supportive staff, inclusive environment, supports wellness and mental health, financial aid constantly sends us scholarship postings, our advisors have our back, free psychiatry and psychology sessions to all students, so much free food, games/events, the list goes on.

Medical school im general is very difficult on many levels and takes its toll. Having a supportive environment at school is more important than what you can imagine as an applicant. Think about these factors when choosing your school. I cannot see myself as happy at another school and chose UCDSOM for the reasons listed.

From the MS2's comment on here, it seems that admin is working on getting back clerkships. Everyone so angry at UCD might be angry at a tiny, misrepresented sliver of the puzzle they saw and might change their mind if they saw the whole picture.
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Would love for this to be true. Please keep us updated.
 
"Recommendations made in a new Trump Administration report would allow pharmacists and other health care providers to practice at the top of their professions and be paid directly for their patient care services. Pharmacists and other highly trained professionals can safely and effectively provide some of the same patient care services as physicians, the report acknowledges.

The report was authored by U.S. Department of Health and Human Services Secretary Alex Azar, U.S. Department of the Treasury Secretary Steven T. Mnuchin, and U.S. Department of Labor Secretary Alexander Acosta. It identifies actions that could develop a better functioning health care market while ensuring better access to patient care services.

Recommendations call for states to consider changes to their scope-of-practice statutes to allow all health care providers to practice at the top of their licenses, utilizing their full skill sets and training. In addition, the report says that the federal government and states should consider accompanying legislative and administrative proposals to allow non-physician providers to be paid directly for their services."
-Thomas E. Menighan B.S. Pharm., M.B.A., Sc.D., F.A.Ph.A.

https://www.hhs.gov/sites/default/f...are-System-Through-Choice-and-Competition.pdf
 
nimbus said:
But many pharmacists do complete residencies.
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-You'd be surprised. These days it's almost impossible for new pharmacy graduates to get an inpatient hospital position without doing a residency. the American Society of Health-System Pharmacists Strategic Plan includes: "Meet the year 2020 goal for all new college of pharmacy graduates providing direct patient care to have completed a postgraduate-year-one residency."

They have PGY1 residencies for community pharmacy and ambulatory care. And PGY2 residencies include HEMONC, ID, Critical Care, Cardiology, Internal Medicine, Pharmacy Informatics, Health-System Administration, Psychiatry, and others. There's even been talks of starting PGY3 pharmacy residencies. There are also fellowships available for pharmacists.

It's interesting that I was talking with a classmate the other day who also works at the hospital that I work at about how I couldn't get a job as a pharmacist there unless I did a residency - which is actually a true statement. And my thinking pattern behind that statement was that as a pharmacy resident I would still be pharmacist, but with my own belief that new graduates cannot work as full-fledged hospital pharmacists unless they complete residencies. Also in pharmacy it's important to understand the pathophysiology of disease states to truly understand the pharmacology and pharmacotherapy.
 
I called an NP a midlevel once and they made me (a lowly scribe at the time) watch this video.



They are playing tennis without the net, correct others when they are called midlevels or told they don't provide equal care, then turn around and say "hello I'm xyz, I'll be taking care of you today". Then when a patient tries to clarify and asks if they are a doctor, they lie and say yes or tapdance around the question by saying "I'm a provider".

Words matter.
 
brownsfan999 said:
I called an NP a midlevel once and they made me (a lowly scribe at the time) watch this video.



They are playing tennis without the net, correct others when they are called midlevels or told they don't provide equal care, then turn around and say "hello I'm xyz, I'll be taking care of you today". Then when a patient tries to clarify and asks if they are a doctor, they lie and say yes or tapdance around the question by saying "I'm a provider".

Words matter.
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They got away with doing this to you because you were below them as a scribe. Which funny because in the video he talks about laterality. If they tried to make a physician watch this they would be laughed at.
 
NecFasc92 said:
On my last rotation I got pulled aside on the first day by the head of the department to tell me that the np students will get first crack at seeing the better cases and any procedures that come our way.

Good times.

This is where we are at, folks.

How do we change this?
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lol what???
 
Penguin Fan said:
"Recommendations made in a new Trump Administration report would allow pharmacists and other health care providers to practice at the top of their professions and be paid directly for their patient care services. Pharmacists and other highly trained professionals can safely and effectively provide some of the same patient care services as physicians, the report acknowledges.

The report was authored by U.S. Department of Health and Human Services Secretary Alex Azar, U.S. Department of the Treasury Secretary Steven T. Mnuchin, and U.S. Department of Labor Secretary Alexander Acosta. It identifies actions that could develop a better functioning health care market while ensuring better access to patient care services.

Recommendations call for states to consider changes to their scope-of-practice statutes to allow all health care providers to practice at the top of their licenses, utilizing their full skill sets and training. In addition, the report says that the federal government and states should consider accompanying legislative and administrative proposals to allow non-physician providers to be paid directly for their services."
-Thomas E. Menighan B.S. Pharm., M.B.A., Sc.D., F.A.Ph.A.

https://www.hhs.gov/sites/default/f...are-System-Through-Choice-and-Competition.pdf
Click to expand...

Obviously have to see where this ends up when details are added, but broadly speaking this is something I’ve felt we should have had years ago. When I worked around Europe I never once saw a physician but rather just went to the pharmacy and talked to the pharmacist and they were able to prescribe me whatever I needed. Seems to have worked pretty well over there for at least 20 years!

I’ve always thought it made no sense to have all these minute clinics where you tell an NP about your sniffles so they can rubber stamp you a script for the drugs of your choice. All the while there’s a pharmD standing ten feet away who could just as easily do the same thing.
 
operaman said:
Obviously have to see where this ends up when details are added, but broadly speaking this is something I’ve felt we should have had years ago. When I worked around Europe I never once saw a physician but rather just went to the pharmacy and talked to the pharmacist and they were able to prescribe me whatever I needed. Seems to have worked pretty well over there for at least 20 years!

I’ve always thought it made no sense to have all these minute clinics where you tell an NP about your sniffles so they can rubber stamp you a script for the drugs of your choice. All the while there’s a pharmD standing ten feet away who could just as easily do the same thing.
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You are right, if you just have the sniffles you don't need to go to a doctor to get what you need. You also don't need a pharmacist. You just need google. Until you do need a medical professional, then you need a doctor. NP/PAs just add to wasted healthcare because people don't know how to interact with our healthcare system. If you aren't sick enough where you need to see a doctor, then you don't need to see a NP/PA/Pharmacist either.
 
AnatomyGrey12 said:
Anecdotally I know far more NPs who are on the "I'm just as good" train than PAs. Most PAs/students I know will straight up tell you they went PA because they didn't want the responsibility and are choosing to work under the doctor because the lifestyle is better and they can still practice medicine but with a huge safety net. This isn't even getting into the fact that their education pathway is very standardized and ran under the medical model.
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Also, the PAs I've worked with were definitely smart enough to go to medical school but simply did not want to go to 8+ years of schooling as they had kids and wanted to secure a decent paying job in a reasonable amount of time. I totally respect that.

These same people have also told me to just go all in for medical school if you have no other obligations because the lifestyle and safety net is nice at first but as the years go on, you'll start clamoring for autonomy. I wouldn't go as far as to say they regret being PAs, but I can tell they get bothered from always having to run things by the doctor.


Anyways, just wanted to point out my experiences with PAs. They've certainly been positive and I would have no qualms hiring them in the future if I go into private practice.
 
PickleRickelus said:
Also, the PAs I've worked with were definitely smart enough to go to medical school but simply did not want to go to 8+ years of schooling as they had kids and wanted to secure a decent paying job in a reasonable amount of time. I totally respect that.

These same people have also told me to just go all in for medical school if you have no other obligations because the lifestyle and safety net is nice at first but as the years go on, you'll start clamoring for autonomy. I wouldn't go as far as to say they regret being PAs, but I can tell they get bothered from always having to run things by the doctor.


Anyways, just wanted to point out my experiences with PAs. They've certainly been positive and I would have no qualms hiring them in the future if I go into private practice.
Click to expand...

Yeah just like how I was smart enough to do investment banking but simply did not want to go to the office for 18+ hour days. I could totally be making bank right now though, just didn't feel like it.
 
NicMouse64 said:
You are right, if you just have the sniffles you don't need to go to a doctor to get what you need. You also don't need a pharmacist. You just need google. Until you do need a medical professional, then you need a doctor. NP/PAs just add to wasted healthcare because people don't know how to interact with our healthcare system. If you aren't sick enough where you need to see a doctor, then you don't need to see a NP/PA/Pharmacist either.
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Bingo. Google/home remedies take care of everything a midlevel would too. Seriously. And I mentioned in another thread that for a personal/family complaint of higher complexity, I'd be farrrrr more confident in my own diagnostic skills than a midlevels.
PickleRickelus said:
Also, the PAs I've worked with were definitely smart enough to go to medical school but simply did not want to go to 8+ years of schooling as they had kids and wanted to secure a decent paying job in a reasonable amount of time. I totally respect that.

These same people have also told me to just go all in for medical school if you have no other obligations because the lifestyle and safety net is nice at first but as the years go on, you'll start clamoring for autonomy. I wouldn't go as far as to say they regret being PAs, but I can tell they get bothered from always having to run things by the doctor.


Anyways, just wanted to point out my experiences with PAs. They've certainly been positive and I would have no qualms hiring them in the future if I go into private practice.
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brb going to take the back door in and demand changes.
 
Psai said:
Yeah just like how I was smart enough to do investment banking but simply did not want to go to the office for 18+ hour days. I could totally be making bank right now though, just didn't feel like it.
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I mean sure but there are DO schools so they really wanted to do medicine they could.
 
Psai said:
Yeah just like how I was smart enough to do investment banking but simply did not want to go to the office for 18+ hour days. I could totally be making bank right now though, just didn't feel like it.
Click to expand...
Priorities are different. That's all I'm going to say.
 
MedicineZ0Z said:
Bingo. Google/home remedies take care of everything a midlevel would too. Seriously. And I mentioned in another thread that for a personal/family complaint of higher complexity, I'd be farrrrr more confident in my own diagnostic skills than a midlevels.

brb going to take the back door in and demand changes.
Click to expand...
Lol never said they are actively pushing for autonomy, just that the ones I've come across (small sample size) who truly felt like they could've gone to med school given a different set of circumstances become disillusioned by the lack of autonomy. The majority are probably totally cool seeing sniffles and patients with low acuity under a physician.

Anyway jump to whatever conclusions you see fit. I'm out.
 
PickleRickelus said:
Lol never said they are actively pushing for autonomy, just that the ones I've come across (small sample size) who truly felt like they could've gone to med school given a different set of circumstances become disillusioned by the lack of autonomy. The majority are probably totally cool seeing sniffles and patients with low acuity under a physician.

Anyway jump to whatever conclusions you see fit. I'm out.
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Getting through the extreme workload of medical school and residency is a test of its own. Not just having a high gpa/mcat with lots of extracurricular work.
 
MedicineZ0Z said:
Getting through the extreme workload of medical school and residency is a test of its own. Not just having a high gpa/mcat with lots of extracurricular work.
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Right, I agree. I'm simply pointing out that this is enough on it's own to deter people with other priorities from medical school and instead become midlevel providers.
 
PickleRickelus said:
Right, I agree. I'm simply pointing out that this is enough on it's own to deter people with other priorities from medical school and instead become midlevel providers.
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Everyone in the "new" generation of doctors has peers who have said something along the lines of "I wanted to be a doctor but I didn't want to go through 7 years of education so I decided to become a PA/NP/Pharmacist/chiropractor etc. etc. instead."

They start out with the assumption it will be very similar. When it's not they advocate for the professions being the same because they are pretty awesome and we are pretty stupid for wanting that much education.
 
NicMouse64 said:
Everyone in the "new" generation of doctors has peers who have said something along the lines of "I wanted to be a doctor but I didn't want to go through 7 years of education so I decided to become a PA/NP/Pharmacist/chiropractor etc. etc. instead."

They start out with the assumption it will be very similar. When it's not they advocate for the professions being the same because they are pretty awesome and we are pretty stupid for wanting that much education.
Click to expand...
The worst part are the (thankfully a minority) med students/residents/attendings who praise these midlevels in some form. Like I don't get it, hurray for wanting to replace us with 1/20th of the training?
 
The fallout will come....look at the VA.

No respect for the NPs they see as their assigned PCP. They know it. The ones who can go elsewhere and see a Physician.

The veterans don’t call the NPs doctor. They call them what they are.

We need young motivated physician to join our movement.
 
Indebt4Life said:
The fallout will come....look at the VA.

No respect for the NPs they see as their assigned PCP. They know it. The ones who can go elsewhere and see a Physician.

The veterans don’t call the NPs doctor. They call them what they are.

We need young motivated physician to join our movement.
Click to expand...
Can you explain what happens at the VA? Completely unaware here.
 
NicMouse64 said:
Everyone in the "new" generation of doctors has peers who have said something along the lines of "I wanted to be a doctor but I didn't want to go through 7 years of education so I decided to become a PA/NP/Pharmacist/chiropractor etc. etc. instead."

They start out with the assumption it will be very similar. When it's not they advocate for the professions being the same because they are pretty awesome and we are pretty stupid for wanting that much education.
Click to expand...

As a soon-to-be-PharmD, I have been in school for 8 years. 4 years of undergrad and 4 years of pharm school. By the end will I have earned the right to be called "Doctor"? ....I don't care.
 
Penguin Fan said:
As a soon-to-be-PharmD, I have been in school for 8 years. 4 years of undergrad and 4 years of pharm school. By the end will I have earned the right to be called "Doctor"? ....I don't care.
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No? I'm confused, why would you think so? Are you being sarcastic?
 
On top of this midlevel issue, we have nurse supporters who think nurses know more/are smarter than doctors.

Common denominator is jealousy. I think we can slowly begin to admit that. People are jealous of a 275k job with authority. Simple as that.
 
Penguin Fan said:
As a soon-to-be-PharmD, I have been in school for 8 years. 4 years of undergrad and 4 years of pharm school. By the end will I have earned the right to be called "Doctor"? ....I don't care.
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In an educational or professional setting, I would argue that yes, you do have the right to be called doctor. In front of patients? No. It's just confusing for the patients. Lawyers aren't allowed to be called doctor, and they aren't even working in a hospital setting.
 
fldoctorgirl said:
In an educational or professional setting, I would argue that yes, you do have the right to be called doctor. In front of patients? No. It's just confusing for the patients. Lawyers aren't allowed to be called doctor, and they aren't even working in a hospital setting.
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Physicians should start going be esquire
 
fldoctorgirl said:
In an educational or professional setting, I would argue that yes, you do have the right to be called doctor. In front of patients? No. It's just confusing for the patients. Lawyers aren't allowed to be called doctor, and they aren't even working in a hospital setting.
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Or supreme emperor
 
MedicineZ0Z said:
On top of this midlevel issue, we have nurse supporters who think nurses know more/are smarter than doctors.

Common denominator is jealousy. I think we can slowly begin to admit that. People are jealous of a 275k job with authority. Simple as that.
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:troll::troll::troll::troll::troll::troll::troll::troll::troll::troll::troll::troll:
 
Penguin Fan said:
As a soon-to-be-PharmD, I have been in school for 8 years. 4 years of undergrad and 4 years of pharm school. By the end will I have earned the right to be called "Doctor"? ....I don't care.
Click to expand...
In a clinical setting? Absolutely not.
 
As a PA who is now also a MD, I would say I didn't think I was smart enough (initially) to become a MD. There are PAs who couldn't become MDs due to intelligence, but most could qualify for DO programs with their experience. Most of us can't later on due to family obligations - my husband has been incredibly supportive. It was very hard for me to go PA to MD - I was a lot of years out of school, had to deal with a house I couldn't sell, borrow money in addition to school loans, and try to raise a bunch of kids as a medical student - all to get this MD degree. I really hope I still think it's worth it when I'm done. There are significant barriers for non-traditional students to go back to medical school. It isn't always a bunch of sour grapes - sometimes it's true regret.

During medical school I watched my husband complete his online NP while I was studying in the 1st and 2nd years of my program. The education was far inferior to what I received in PA school 10 years earlier. His NP school is a well respected brick-and-mortar program that added an online program, so this isn't a symptom of one lackluster online program. FOR A FACT, PA's get a far stronger STANDARDIZED education than NPs.

Also, there are grade requirements for PA school and a level of competitiveness and competency that aren't required to become a NP due to the number of NP programs out there. (And the amount of money online-only schools can make by providing a NP degree.)

Also, many NP programs no longer require their nursing applicants to have any patient care experience. PA programs ALL require many hours (the average successful PA applicant has 3 years of hands-on patient care experience).

So, your average PA will be a far stronger applicant coming out of school, than the average new NP grad. There are strong NPs out there, but they are more competitive than the average NP student and put significant effort into self study once on the job.
 
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Darth Doc said:
As a PA who is now also a MD, I would say I didn't think I was smart enough (initially) to become a MD. There are PAs who couldn't become MDs due to intelligence, but most could qualify for DO programs with their experience. Most of us can't later on due to family obligations - my husband has been incredibly supportive. It was very hard for me to go PA to MD - I was a lot of years out of school, had to deal with a house I couldn't sell, borrow money in addition to school loans, and try to raise a bunch of kids as a medical student - all to get this MD degree. I really hope I still think it's worth it when I'm done. There are significant barriers for non-traditional students to go back to medical school. It isn't always a bunch of sour grapes - sometimes it's true regret.

During medical school I watched my husband complete his online NP while I was studying in the 1st and 2nd years of my program. The education was far inferior to what I received in PA school 10 years earlier. His NP school is a well respected brick-and-mortar program that added an online program, so this isn't a symptom of one lackluster online program. FOR A FACT, PA's get a far stronger STANDARDIZED education than NPs.

Also, there are grade requirements for PA school and a level of competitiveness and competency that aren't required to become a NP due to the number of NP programs out there. (And the amount of money online-only schools can make by providing a NP degree.)

Also, many NP programs no longer require their nursing applicants to have any patient care experience. PA programs ALL require many hours (the average successful PA applicant has 3 years of hands-on patient care experience).

So, your average PA will be a far stronger applicant coming out of school, than the average new NP grad. There are strong NPs out there, but they are more competitive than the average NP student and put significant effort into self study once on the job.
Click to expand...

Just want to point out that this gets touted a lot, but isn't actually true. I know from experience since I was applying to PA programs many years ago, and I personally emailed admissions at many schools re patient care experience hours. Some programs were willing to work with me, i.e. I had zero patient care experience, but many hours in a clinical lab (not patient care).
 
AnatomyGrey12 said:
This. The local PA school students do their rotations with the MD students, the exact same 3rd year core rotations, and take the same shelf exams.

There is simply a much higher standard expectation that you can have with a PA.
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A lot of them have less responsibility on those same rotations though. Or do fewer weeks.. usually both of those actually. And of course drastically fewer total weeks/hours across the board.
 
MedicineZ0Z said:
A lot of them have less responsibility on those same rotations though. Or do fewer weeks.. usually both of those actually. And of course drastically fewer total weeks/hours across the board.
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These students do the exact same stuff and have the same time expectations. Like I said, they even take the same shelf exams. Obviously not all programs will be like that, but there isn’t a single NP program in the country that come close this. The point is that PA programs at least have some baseline level of competency that can be expected, and programs like the one I am talking about aren’t some great rarity. Not the rule, but not quite the exceptions either.
 
AnatomyGrey12 said:
These students do the exact same stuff and have the same time expectations. Like I said, they even take the same shelf exams. Obviously not all programs will be like that, but there isn’t a single NP program in the country that come close this. The point is that PA programs at least have some baseline level of competency that can be expected, and programs like the one I am talking about aren’t some great rarity. Not the rule, but not quite the exceptions either.
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Right I agree, but I just meant that only a minority of PA programs fit the criteria you explained. None of them nationwide are anywhere close to the total volume of med school rotations & some of them (like you explained) are on par with the rigor for some rotations.
 
MedicineZ0Z said:
Right I agree, but I just meant that only a minority of PA programs fit the criteria you explained. None of them nationwide are anywhere close to the total volume of med school rotations & some of them (like you explained) are on par with the rigor for some rotations.
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Well no... then they would be medical schools...

I’m comparing NP and PA, not PA and MD/DO.
 
AnatomyGrey12 said:
Well no... then they would be medical schools...

I’m comparing NP and PA, not PA and MD/DO.
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Currently you are right about PAs. I think though the profession is currently taking a dark turn, as unfortunately hospitals prefer NPs over PAs. So PAs are trying to become more like NPs instead of improve their partnership with the medical profession. I talked to a guy in the military that said he went to NP school instead of PA school because he didn't want to deal with the board of medicine. The board of nursing is "much less likely to get you in trouble for making a mistake" in his words.
 
Giovanotto said:
Just want to point out that this gets touted a lot, but isn't actually true. I know from experience since I was applying to PA programs many years ago, and I personally emailed admissions at many schools re patient care experience hours. Some programs were willing to work with me, i.e. I had zero patient care experience, but many hours in a clinical lab (not patient care).
Click to expand...

It's become significantly more competitive than when we applied. If you look at the CASPA website for centralized PA applications (new since we applied), the average applicant in 2016-17 had an average of 2,817 hours of direct patient care and "other" health care hours. In 2017-2018, the average increased to 8,274 hours.

Also, working in a lab is still better IMO than straight from BSN to NP.
 
Darth Doc said:
It's become significantly more competitive than when we applied. If you look at the CASPA website for centralized PA applications (new since we applied), the average applicant in 2016-17 had an average of 2,817 hours of direct patient care and "other" health care hours. In 2017-2018, the average increased to 8,274 hours.

Also, working in a lab is still better IMO than straight from BSN to NP.
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They will use the 8274 hours to signify clinical "training" in the future. Mark my words.
 
Penguin Fan said:
I agree, though in most clinical rotations that pharmacy students take in school (especially hospital) we almost always address their preceptors (PharmD) as Doctor...
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Right when it is a pharmacy student/pharmacist interaction. But no one is calling the rounding pharmacist on ED, ICU, floor rounds “Dr. Xxx.”
 
Penguin Fan said:
I agree, though in most clinical rotations that pharmacy students take in school (especially hospital) we almost always address their preceptors (PharmD) as Doctor...
Click to expand...
If it's not in front of patients that's fine. The only person who should be introducing themselves as Dr. So and So in a clinic is a MD/DO.
 
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