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The rise of PA and Professional School as the University Declines. A way for professors and presidents to make salary?


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The economist ran a fascinating piece about changing higher education throughout the world, especially in the United States. Several ideas were brought up including many traditional university degrees will not have a clear job in the future as 40% of our current work force will be replaced by technology in the next 1-2 decades *accounting, sales, etc*. Also, especially with the disruptive innovation of online learning, many universities will head towards closure. I believe they predicted almost half of low ranked universities in the United States will close within the next decade or so. I saw this right alongside a local newspaper identifying THREE universities within my state as facing major financial trouble. Sure enough 1 of them is opening a PA school and another just doubled the PA school size. I would be happy to provide serious parties a copy of these reports. When I look at the schools opening PA departments I do not see major universities and medical schools ... I see Universities that are perhaps in need of finances and not necessarily equipped to develop future clinicians.  Thoughts ?  Hopefully the accreditation standards are rigorous enough to weed out the troubled programs. And of course I need to state some of the best PA schools and PAs did not attend a program at a medical school. 

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I saw that piece it was well written. Part of the problem when you start talking about productivity gains, which is what they were alluding to, is that there is a disruptive part, followed by an increase in other jobs.

 

For example: technological productivity gains have changed the landscape, and let's say you have a factory that is able to devise a new to automate a task previously done by the labor force. This would be a productivity gain, and would displace those workers out of the workforce. But, the counter to that is, that now you have a new piece of automated machinery that will need maintenance, updates, repairs, etc.

 

I do agree with online learning displacing much of traditional university learning. This is Clayton Christensen's device in full display.

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What are there, 80 some new PA programs in the works right now? Even as a new student, that is a bit troublesome.

 

I agree with the sentiment that PA schools should be attached to a medical school or part of a university/college health science school that is integrated with a hospital system.

 

It seems worrisome when these small schools, unaffiliated with a hospital system or med school pop up a new program. And at 60k+ tuition...

 

I don't think the market will ever truly be saturated with providers, but we don't want to besmirch the PA moniker and hurt patients with PA "mills". Especially when current generation PAs are expanding the abilities of practice. That puts even more of an onus to perform on those of us to follow.

 

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The ARC-PA is very concerned about the increase in PA programs, and new programs (as well as existing programs!) are having to jump through a lot of hoops to ensure they have adequate resources in place to provide quality education to their students. It will all settle out ok in the end.

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I would disagree that all programs have to be associated with a medical school or with a health science college. These itself would/could foster other problems. For example, when I was in PA school (attached to a medical college) we had lecturers that visited us that had never worked with a PA. They also lectured using their specific specialty focus rather than a PA centric mode. When I did clinical rotations at the medical center, ortho, surgery, inpt medicine, I was the only PA student they had had in years, prior classes had found the environment so unfriendly they had gone elsewhere.

 

There are rigorous standards in place through the ARC-PA. One can find a copy on their website. I actually got to sit with ARC-PA site visit team and get interviewed by them at the local PA program when they were accredited. I found these two individuals, one a PA, another an MD/surgeon to be very cognizant about the need to ensure quality and I never got the sense that there was rubber stamping going on. The mood of the program was do or die and sphincters were clenched.

 

When I was in Boston at the AAPA conference, the PAEA put on a series of good to excellent lectures. Much of it was focused on improving both the didactic and clinical education for this generation's PAs. Flipping the classroom and online instruction were definite topics of note. I already see changes at our local program to further improve didactic and clinical education.

 

As for institutions of higher learning latching on to the PA profession to bolster tuition, that likely is occurring to some effect or a welcome secondary effect. If these programs are meeting the standard then what right does one have to block that based upon affiliation, nonaffiliation, current financial status, declining enrollment, etc. It could be the bolster that a failing institution needs reversing its fortunes or providing a new direction. Companies remake and rebrand themselves repeatedly, there is no reason a university or college cant either.

 

G Brothers PA-C

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What are there, 80 some new PA programs in the works right now? Even as a new student, that is a bit troublesome. I agree with the sentiment that PA schools should be attached to a medical school or part of a university/college health science school that is integrated with a hospital system. It seems worrisome when these small schools, unaffiliated with a hospital system or med school pop up a new program. And at 60k+ tuition... I don't think the market will ever truly be saturated with providers, but we don't want to besmirch the PA moniker and hurt patients with PA "mills". Especially when current generation PAs are expanding the abilities of practice. That puts even more of an onus to perform on those of us to follow.

 

I have always had the idea that clinical training is the limiting factor in training healthcare students. Nurses, radiology techs, PAs and Physicians, all need some sort of clerkship training as part of their degree. Even if 80+ programs are in the works, where are the students going for rotations? A particular local can only support so many trainee's at one time. This had been an institution's concern when I went through nursing school and again in PA school (we have a new program in the city.) I am not confident that we can open as many programs as we project. 

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I have always had the idea that clinical training is the limiting factor in training healthcare students...

 

It does remain a significant issue, and it is probably worse for PAs than for other healthcare profession because we often find ourselves in the position of "competing" for placements against MD and DO students. A couple of things could quickly help:

 

1. More PA preceptors are needed. Every setting, every specialty all across the country. If you are able to take even just one student a year and you can provide a good experience, please contact your local program. We need to look out for our profession. If you are waiting for the perfect time to get involved, there will never be a perfect time.

 

2. Instead of clinical placements being an either/or proposition, we need to get our med school colleagues to see value in pairing physician/PA students together. 

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I guess I have to echo an objection that PA schools should always be associated with a university with a medical school. I was accepted at one such place and found out that there was virtually no integration between the programs other than being on the same campus and using the same hospital. Fortunately I went elsewhere.

 

I also felt that doing your clinicals in a facility with a large number of med students was not a great experience. My peds rotation was at such a place. There were probably 50 med students, 10 pharmacy students, and me. I loved the noontime lectures and meeting the other students, but it felt like Gray's Anatomy, the pontificating attending included. My other rotations were mostly one-on-one -- me and the doc or me and the PA -- and I learned quite a lot more.

 

I do echo concerns over the sudden spurt in the number of PA programs, but then again there are a large number of NP programs as well. As supply increases, people will probably have to go farther to get jobs and perhaps salaries will go down. That said, the political muscle of PAs may also increase with the increasing numbers and, with that, perhaps improved opportunities and scope of practice as well.

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Let me just say I do not think a PA school has to be affiliated with a medical school in order to be a top program. I teach at one such program and it is an excellent place. Although an affiliation helps in a number of ways. 

 

Not all preceptors are created equal. I know a local practice which precepts NP students from a top 20 nursing school in the states. These students get an experience which I would find unacceptable. The preceptor is not given training in medical education and is not offered any reimbursement for time and space. If I was running a preceptor program I would offer my preceptors a small stipend,  faculty appointment with use of library and other minimal cost perks, and dinners every 2-3 months where dedication to the program could be fostered alongside an education moment about being a preceptor. It amazes me that some medical schools have entire departments dedicated to coming up with new ways to teach medicine in clinic and classroom yet a PA and nursing program , which may require more of this kind of work given our lack of residency up bringing, often has no such entity.  

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