That is simply not true. Physician education is more detailed and time-intensive because it is not just a matter of on-the-job-training. Consider this: Suppose you took a beginning fourth year medical student and said, "Hey, you know what, fourth year and residency is bogus, we'll just let you work in an Emergency Department for a few years under some close supervision and in ten years nobody will know the difference between you and a board-certified EM physician." Would you be as well-trained?
Of course not. You would automatically have missed out on four years of didactics, supervision in an academic environment, exposure to other specialties, and many, many important off-service rotations. I am, for example, finishing my sixth ICU month of my residency training which means that I have almost as much time learning just about critical patients as a typical PA gets for their entire clinical training.
Critical care is important to Emergency Medicine. At my department we are regularly forced to hold ICU patients until a bed becomes available and, not counting the initial decisions, we have full responsibility for them until they go upstairs. Where do PAs or our hypothetical fourth year medical student get their critical care training? How about OB/Gyn? ENT? Hand? Cardiology? Emergency Medicine is not just triage and referral. You do have to know something about a lot of things.
That's the criminality of it. That people can throw around ideas of equality and equivalence but at the same time have no idea what residency training involves. I can understand that because we see a lot of minor complaint many of you get confused and think there is nothing to the practice of Emergency Medicine (or any specialty for that matter) but that's only a lack of understanding on your part.
I am, as those of you who have read my now defunct blog know, not the biggest booster of medical training but that doesn't mean I think that two years of superficial training and a little OJT is equivalent to eight years of the real thing.
I see your points, and I understand where you're coming from. I still think you have a superiority complex, although I appreciate the more respectful tone in your writing today.
Look, I don't mean to infer that PAs and Docs are equal across the board, and I thought that my writing up to this point had succinctly expressed that. However, I'm not completely speaking out of my arse. One of our PA mods runs an ER. It's a small ER, but he runs it. I consider myself to be a scientist who goes on facts, and that's a fact. You could run on until the heavens rain down, but the fact would remain that that's his situation. I realize that it's not the norm, but I also realize that the PA path holds different things for different people. Is his training as thorough as someone else's might be? That's debatable. But I think that your indirectly belittling someone who holds 20 years of paramedic experience before his over 10 years of EM experience shows me that you're highly defensive of your own education and experience. To a point rightly so. And while I can see how the additional training would be highly important to working in EM, still...there he is. And he obviously knows what he's doing.
I'm not trying to 'top' you, brother. No one here is trying to discredit the wisdom that you have thus far acquired. No one's trying to kick you out of your seat that you've worked so hard to have the right to sit in. Without MDs and DOs there would be no PAs. In fact, MDs were the ones who started the PA program. My curriculum is almost as much taught by MDs as PAs! Doctors are the ones with the 4 years plus, and without them our medical model as we know it would crumble. But the facts are facts and they remain, that the PA model is a diversely intertwined entity which the MD/DO model must now and does work with. And in that combination there is overlap and there is oftentimes experience (and granted, sometimes there isn't...as can even be the case with doctors, some are better than others). So while I'm not trying to battle your status as a king of a mountain, I am trying to open your eyes a little to the realities and possibilities. Maybe you've forgotten Blalock and Thomas, but I haven't.
Would I ever want to work with you? Probably not. Your attempts to showcase the intense didactic and clinical model of PA education as "superficial" and often quite substantial medical experience of applicants as "little" are nothing short of paltry. I've not had any rotations yet, but I do have experience working with Alzhemier's, pediatric ICU, geriatrics, EM, hospice and AIDS hospice. My EMT training and experience may mean nothing to you, but it meant a lot to a few patients along my path, I can tell you that much.
Someone here suggested that I'm going into the PA profession because I couldn't hack getting into medical school. That couldn't be further from the truth. I actually was accepted into medical school and at that point realized that I didn't want to be a doctor, I wanted to be a PA. I'd be in my later 40s by the time I graduated from med school, and while some might want that, I don't. I want to get to work practicing medicine, to the best of my abilities. And to tell you the truth, I'm okay with being the assistant. I'm okay with taking the 4s and 5s (and maybe some 3s). There are PAs who take the 1s and the 2s, such as the friend I have mentioned. But myself, I'm okay with what I want. And I'll search until I find a Doc and a practice that treats me with respect, and that is able to gain a mutual understanding with me about what we want to accomplish together.
