Yale launching an online PA program

[joker2400]

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In case you guys wanted comments. I saw this on yahoo this morning

https://www.yahoo.com/finance/news/...ster-of-medical-science-degree-134718343.html

 

[Mad Jack]

I unfortunately don't have time today to address this at length. I think at its core is the fact that medicine is tough and you go through a lot of dehumanizing crap and see horrible stuff. Now I know some people don't share this view and plan on minimizing their interaction with the tough side of medicine until they can get to their concierge derm practice or whatever. But for most of us we will be going through a lot that is hard to process emotionally and intellectually.

People talk a lot about how the hidden curriculum as a negative in that it dehumanizes you. But that's only one part of what happens. Another part of it is that it teaches you to survive, to maintain clinical reason in the face of the grotesque and the tragic. It teaches you how to rely on each other (and how to identify those you can and cannot rely on).

I just don't think you get much of the positive aspects of the hidden curriculum in MS-1 and MS-2. I mean, I've been stressed a great deal by block weeks and a few of the other borderline insane stressors of med school, but it doesn't really hold a candle to the times when I was the only RT available on the ICU, dealing with 3 patients that were trying to code at once, trying to split my time and hope that none of them would up and die because I chose to spend my time with the wrong one. Or the pain of dealing with the withdrawal of care of a patient I'd grown quite attached to over the months and years. Or having a young parent die of the swine flu in less than a day despite all our efforts to stop it. Nor will it teach you how to deal with irate family that hate you and your team for what "you" did to their loved one, despite the fact that you didn't give them their disease, you just tried to stop it. Nothing, and I really mean nothing, in preclinical can do a damn thing to prepare you for that sort of ****.

But I agree there are certain aspects of it that you probably get in the clinical years and on into residency that are beneficial. Still, I question how much of the bad is coming with the good.

 

[Lawgiver]

can a pa specialize in medical genetics? also at Yale its called 'Physician Associate'

 

[Mad Jack]

can a pa specialize in medical genetics? also at Yale its called 'Physician Associate'

Technically they can do almost whatever an attending physician is willing to allow them to do, barring a few limits on things like surgery and anesthesiology. Legally, it would probably not be in their best interest to do so without some background and additional training in genetic counseling and testing.

 

[aiviphung]

Yale got denied: http://yaledailynews.com/blog/2015/04/09/online-pa-program-proposal-rejected/

 

[Wordead]

Yale got denied: http://yaledailynews.com/blog/2015/04/09/online-pa-program-proposal-rejected/

Well, hopefully the PAs dont go the way of NPs....good for them.

 

[jthedestroyr]

Well, hopefully the PAs dont go the way of NPs....good for them.

Their oversight is via the medical boards, therefore as long as our own medical boards don't sell us out they're stuck under us unlike the NP which their nursing boards determine their scope of practice.

 

[DoctwoB]

I think @Psai

A lot of PA schools they basically just have to go find a PA preceptor somewhere and that's it. The PA agrees to take them on for a 6 week rotation or whatever.

This is the terrifying thing to me about the push for independence for midlevels. While we've all seen the NP or PA with 20 years experience in a specific field who could function more or less independently (within the institutional protocols they have learned), allowing for independent practice allows people who have a 6 week "medicine" rotation with a random PA in the middle of nowehere that same right. The bar is just too low

Now back on topic. I certainly believe that a high quality online pre-clinical curriculum could replace much of the first two years of medical school, while also acknowledging the loss of learning that simply comes from being in the medical environment and learning through osmosis/experience. What could work would be to have a 1 year online pre-clinical curriculum taken wherever, followed by 6 months of intensive "in person" experience, including courses like physical exam, medical interviewing, and small groups or PBL in various specialties/organ systems. This would also allow time for shadowing, starting research experiences, etc. prior to clinical years. Some time for step 1, and then the rest of clinical years proceed as usual.

 

[charmiedermie]

I just don't think you get much of the positive aspects of the hidden curriculum in MS-1 and MS-2. I mean, I've been stressed a great deal by block weeks and a few of the other borderline insane stressors of med school, but it doesn't really hold a candle to the times when I was the only RT available on the ICU, dealing with 3 patients that were trying to code at once, trying to split my time and hope that none of them would up and die because I chose to spend my time with the wrong one. Or the pain of dealing with the withdrawal of care of a patient I'd grown quite attached to over the months and years. Or having a young parent die of the swine flu in less than a day despite all our efforts to stop it. Nor will it teach you how to deal with irate family that hate you and your team for what "you" did to their loved one, despite the fact that you didn't give them their disease, you just tried to stop it. Nothing, and I really mean nothing, in preclinical can do a damn thing to prepare you for that sort of ****.

But I agree there are certain aspects of it that you probably get in the clinical years and on into residency that are beneficial. Still, I question how much of the bad is coming with the good.

I saw this was posted awhile back, but thought I'd respond to what you said. No one, who is normal, describes the hidden curriculum as a good thing. It's an unintended consequence or a side effect. This is confirmed by the actual definition, papers and articles. I think this article captures the essence: www.medscape.com/viewarticle/540890

You can find some good ones by Googling "hidden curriculum medical school"

 

[Mad Jack]

I saw this was posted awhile back, but thought I'd respond. No one who is normal describes the hidden curriculum as a good thing. It's an unintended consequence or a side effect. This is confirmed by the actual definition, papers and articles. I think this article captures the essence: www.medscape.com/viewarticle/540890

I'd originally said there were no positives, but SS pointed out some potential things he views as positive about it. I'd direct your comments more at him than myself. I think the hidden curriculum is BS all around, myself. I don't do well with socialization, because I'm MJ first and a (student) doctor second. I think the hidden curriculum beats the living hell out of students and crushes both their uniqueness and their ability to question authority, both of which I believe have made medicine a weaker profession overall. I think most of our lack of political will and our general apathy toward certain leadership organizations (but a complete lack of a widespread, organized effort to oppose such organizations) is an unintended consequence of the hidden curriculum, and I fear that, while it previously defined our profession, it also stands to possibly ultimately destroy it.

I don't view things like how to deal with death and the like as a true part of the hidden curriculum- I view the HC as those aspects of medical training that teach one to cede to authority and to give up all things to please your superiors, lest you draw their ire.

 

[charmiedermie]

I'd originally said there were no positives, but SS pointed out some potential things he views as positive about it. I'd direct your comments more at him than myself. I think the hidden curriculum is BS all around, myself. I don't do well with socialization, because I'm MJ first and a (student) doctor second. I think the hidden curriculum beats the living hell out of students and crushes both their uniqueness and their ability to question authority, both of which I believe have made medicine a weaker profession overall. I think most of our lack of political will and our general apathy toward certain leadership organizations (but a complete lack of a widespread, organized effort to oppose such organizations) is an unintended consequence of the hidden curriculum, and I fear that, while it previously defined our profession, it also stands to possibly ultimately destroy it.

I don't view things like how to deal with death and the like as a true part of the hidden curriculum- I view the HC as those aspects of medical training that teach one to cede to authority and to give up all things to please your superiors, lest you draw their ire.

The "positives" he mentions would, by the very definition, not be part of the hidden curriculum, because that's not what it is. Unless up is now down and left is now right, they are all inherently negative. I have yet to see any usage, articles, anything at all for that matter, on the "positives".

It's not just a term applied only to medicine either but in all professions.

 

[shibby1111]

eh I don't think thats implied. It's just a rationalization coping method( to quote FA). they know they're not a physician, regardless of what they outwardly say.

The NP/PA knows he isn't a physician but likes the attention he gets from people who do think he is a physician.

We all do similar things all the time: One guy may drive his mom's nice car around knowing that he is broke but he like the attention of people who think he is an unusually successful and wealthy 26 year old. I like going on dates with my girl friend and her 2 hot friends knowing I'm only going to bang one of them, but I love the attention I get from people who think I'm banging all 3.

 

[KnuxNole]

Like some mentioned, honestly, I felt as if if the pre-clinicals were online, there would be no change in what I would have received in education. The only exception is 1st year anatomy.

 

[KnuxNole]

I really don't think you're missing a lot of the hidden curriculum if it's only in the preclinical phase. I am hardly ever on campus, and rarely interact with my professors or fellow students, aside from on required projects. You can basically completely avoid the BS of MS-1 in most schools if you want to. I'm more worried about the effects of having clinical rotations that are overseen by people that aren't exactly the cream of the crop in regard to teaching, which will be what really hurts these students.

I do agree, I study with friends, but that is true in a hypothetical online curriculum. In the traditional model, I NEVER stepped foot in class, so the only times I ever saw my friends in an academic setting were studying at a public place, or on exam day. If classes were all online, I would be doing the same I did in med school: study on my own, then meet for a few study session to review stuff with friends. I still get the positive collab effort. I guess I don't see a difference in the pre-clinical setting...except for clinical skills workshops and anatomy lab. I refused to go to class physically since there were ZERO positives. Like mentioned above, I probably did better when I went to independent study compared to depending heavily on audio lectures(powerpoints were detailed w/ detailed typed notes, so didn't need to listen to drawn out **** most of the time.)

There were people who did interact with professors after hours, which is different compared to emailing someone. Although, I would always fast forward student questions during lecture, those are kinda annoying...which I guess would be replaced by a comment section...