Jump to content


Photo
- - - - -

CAQ's from a PA-S viewpoint

CAQ PA-S PA-C EMPA

  • Please log in to reply
42 replies to this topic

#21 EMEDPA

EMEDPA

    Moderator

  • Moderators
  • PipPipPip
  • 20,166 posts

Posted 10 August 2014 - 11:33 PM

Fully online DNPs? Online NPs... I understand a lot can be done thru distance education these days, but that's another whopping training disparity in my book.

I can't recall coming across any online PA programs. But I also was not looking...

you still have to do (limited) clinicals that you arrange yourself at your convenience in your home town.

we had a student from one of these programs recently that we failed her last day or her last clinical. she was awful all along, but the last straw was when she couldn't recognize strep throat in a kid with a fever, ST, big nodes, white exudates, and lack of cough as the source of fever. she didn't even look at the throat, just told him it was viral. I was one of her 2 preceptors. the other( a really excellent NP with yrs as an icu nurse, etc) was the one who insisted we fail her. I agreed. she is still a floor nurse today.


Moderator, Emergency Medicine Forum
Emergency Medicine PA, EMT-P
Doctor of Health Science & Global Health
30 years in Emergency Medicine


#22 EMEDPA

EMEDPA

    Moderator

  • Moderators
  • PipPipPip
  • 20,166 posts

Posted 10 August 2014 - 11:39 PM


I can't recall coming across any online PA programs. But I also was not looking...

that's because there are no fully online PA programs....


Moderator, Emergency Medicine Forum
Emergency Medicine PA, EMT-P
Doctor of Health Science & Global Health
30 years in Emergency Medicine


#23 PACdan

PACdan

    PA-C

  • Validating
  • PipPipPip
  • 868 posts

Posted 10 August 2014 - 11:41 PM



we had a student from one of these programs recently that we failed her last day or her last clinical. she was awful all along, but the last straw was when she couldn't recognize strep throat in a kid with a fever, ST, big nodes, white exudates, and lack of cough as the source of fever. she didn't even look at the throat, just told him it was viral. I was one of her 2 preceptors. the other( a really excellent NP with yrs as an icu nurse, etc) was the one who insisted we fail her. I agreed. she is still a floor nurse today.


Just wow. I think that a good chunk of non-medical people, parents, etc. would have guessed Strep at that point. Also, not even looking in the throat...death of the physical exam.



#24 FfIghter23

FfIghter23

    Registered

  • Members
  • PipPipPip
  • 302 posts

Posted 10 August 2014 - 11:56 PM

3 yrs full time you could be a doc.....you know, if you had a supportive spouse with a good income in a state with 3 yr med schools and cheap in state tuition.....:)
the problem with becoming an NP is you have to become a nurse first....


For residents of Texas (like myself) they have a new three year Family Medicine Accelerated Track (F-MAT) at Texas Tech school of medicine. As a bonus, they give you free tuition your first year in the form of a scholarship. In-state tuition is $14,400. So for $28,800, plus costs of living... and you are a med school graduate in three years and can start a family med residency. If I was a student set on doing FM I would do it in a heartbeat...
  • EMEDPA likes this

#25 True Anomaly

True Anomaly

    Emergency Medicine PA

  • Moderators
  • PipPipPip
  • 2,124 posts

Posted 11 August 2014 - 01:08 AM

3 yrs full time you could be a doc.....you know, if you had a supportive spouse with a good income in a state with 3 yr med schools and cheap in state tuition.....:)

the problem with becoming an NP is you have to become a nurse first....

 

Yeah, my wife already keeps pushing me towards med school- she doesn't need any more ammunition, thank you very much :)


Emergency Medicine PA
Gig 'Em Aggies

#26 EMEDPA

EMEDPA

    Moderator

  • Moderators
  • PipPipPip
  • 20,166 posts

Posted 11 August 2014 - 02:41 AM

Yeah, my wife already keeps pushing me towards med school- she doesn't need any more ammunition, thank you very much :)

you are young and smart. you should seriously consider it.


  • primadonna22274 likes this

Moderator, Emergency Medicine Forum
Emergency Medicine PA, EMT-P
Doctor of Health Science & Global Health
30 years in Emergency Medicine


#27 G. Davenport

G. Davenport

    Registered

  • Members
  • PipPipPip
  • 220 posts

Posted 12 August 2014 - 07:32 PM

Hi friends. I helped evaluate the ER CAQ test but haven't taken it and most likely won't. I think the CAQ was a bad idea but there is no turning back. the ER residency led to only ER board certified docs in urban ERs, given time, the CAQ will lead to only PAs with an ER CAQ working in the urban ER. the FP DO or MD were pushed to rural high exposure ERs. The same future awaits the young non CAQ PA. It's either that or a residency after graduating (showing competency by passing the NCCPA PANCE exam won't be enough to get your foot in the door). I could ramble on this and I have lots to add. But to be honest, there is no turning back. So buckle up and prepare to go that extra mile -- to work in anything but primary care. The days of past are gone. EMEDPA knows as we worked in ERs that WOULD NOT hire an FP Doc (yet the director was an FP grandfathered into the ER specialty).
  • AMS_ER likes this

Gregory Davenport, D.H.Sc., PA-C
Dean, Graduate School of Health Sciences


#28 True Anomaly

True Anomaly

    Emergency Medicine PA

  • Moderators
  • PipPipPip
  • 2,124 posts

Posted 12 August 2014 - 08:32 PM

you are young and smart. you should seriously consider it.

 

I have considered it, but I think I told you before that I was likely gonna go for a JD before an MD, to help carve out a non-clinical niche once I got older. 

 

And thanks :)


Emergency Medicine PA
Gig 'Em Aggies

#29 EMEDPA

EMEDPA

    Moderator

  • Moderators
  • PipPipPip
  • 20,166 posts

Posted 12 August 2014 - 08:50 PM

I have considered it, but I think I told you before that I was likely gonna go for a JD before an MD, to help carve out a non-clinical niche once I got older. 

 

And thanks :)

if you do JD do a quality program. there are lots of online poorly accredited JD programs out there that turn out tons of lawyers who either can't pass the bar or once they do they can't find jobs because they went to a less than reputable program.


Moderator, Emergency Medicine Forum
Emergency Medicine PA, EMT-P
Doctor of Health Science & Global Health
30 years in Emergency Medicine


#30 EMEDPA

EMEDPA

    Moderator

  • Moderators
  • PipPipPip
  • 20,166 posts

Posted 12 August 2014 - 08:54 PM

. The days of past are gone. EMEDPA knows as we worked in ERs that WOULD NOT hire an FP Doc (yet the director was an FP grandfathered into the ER specialty).

yup. and what ends up happening is that these FP docs end up working rural and getting really good at em because they have less support than their EM colleagues at urban and academic centers and do everything that normally is done by specialists and teams in the big city by themselves. some of the best ER docs I know are rural fp docs working in the e.d. These guys can throw in a blind central line, chest tube, etc in less than a minute. Most of the urban EM docs I work with do maybe 1-2 central lines with u/s guidance per year and no chest tubes because the trauma team always jumps on those.

The funny thing is that working rural em is much more challenging than working urban em and yet as Dr Davenport points out above it will be the urban places that want the CAQ first when it really should be the rural places. 2 of the rural places I work at now are preferentially hiring folks with the em caq, although it is not yet a requirement.


Moderator, Emergency Medicine Forum
Emergency Medicine PA, EMT-P
Doctor of Health Science & Global Health
30 years in Emergency Medicine


#31 gbrothers98

gbrothers98

    Advanced Member

  • Members
  • PipPipPip
  • 647 posts

Posted 13 August 2014 - 02:12 AM

Hi friends. I helped evaluate the ER CAQ test but haven't taken it and most likely won't. I think the CAQ was a bad idea but there is no turning back. the ER residency led to only ER board certified docs in urban ERs, given time, the CAQ will lead to only PAs with an ER CAQ working in the urban ER. the FP DO or MD were pushed to rural high exposure ERs. The same future awaits the young non CAQ PA. It's either that or a residency after graduating (showing competency by passing the NCCPA PANCE exam won't be enough to get your foot in the door). I could ramble on this and I have lots to add. But to be honest, there is no turning back. So buckle up and prepare to go that extra mile -- to work in anything but primary care. The days of past are gone. EMEDPA knows as we worked in ERs that WOULD NOT hire an FP Doc (yet the director was an FP grandfathered into the ER specialty).

 

PAs straight out of a program will still get job offers for a variety of reasons, some are cannon fodder, some have prior HCE that will put them above the rest. Regardless, to obtain the CAQ, one has to get the ED hours requirement satisfied. That usually means a full time gig. Same goes for procedures. 

 

yup. and what ends up happening is that these FP docs end up working rural and getting really good at em because they have less support than their EM colleagues at urban and academic centers and do everything that normally is done by specialists and teams in the big city by themselves. some of the best ER docs I know are rural fp docs working in the e.d. These guys can throw in a blind central line, chest tube, etc in less than a minute. Most of the urban EM docs I work with do maybe 1-2 central lines with u/s guidance per year and no chest tubes because the trauma team always jumps on those.

The funny thing is that working rural em is much more challenging than working urban em and yet as Dr Davenport points out above it will be the urban places that want the CAQ first when it really should be the rural places. 2 of the rural places I work at now are preferentially hiring folks with the em caq, although it is not yet a requirement.

 

I agree that those FP and IM ED docs usually are a very self sufficient breed. I also think that group is not getting replaced for several reasons. So PAs and NPs are filling the void. PAs can set themselves apart with the CAQ and newer PAs with residency/fellowship. It is likely that more urban sites will require the CAQ due to resources available and a desire to ensure a standard. It will spread out into the hinterland over the next decade and what was once unusual and controversial will be the norm and expected. 

 

G Brothers PA-C



#32 whoRyou

whoRyou

    Wannabe PA

  • Members
  • PipPipPip
  • 1,196 posts

Posted 13 August 2014 - 02:41 AM

I have considered it, but I think I told you before that I was likely gonna go for a JD before an MD, to help carve out a non-clinical niche once I got older. 

 

And thanks :)

TA: What niche are you looking at if you do not mind me asking? Forensics?


Posted Image

#33 True Anomaly

True Anomaly

    Emergency Medicine PA

  • Moderators
  • PipPipPip
  • 2,124 posts

Posted 14 August 2014 - 03:05 AM

TA: What niche are you looking at if you do not mind me asking? Forensics?


Not sure, but it would involve my PA education/experience somehow. I thought med mal, but now not so sure- maybe legal with a physician group or hospital? My sister-in-law, who is an attorney, has talked up patent law to me due to it's technical aspects
Emergency Medicine PA
Gig 'Em Aggies

#34 whoRyou

whoRyou

    Wannabe PA

  • Members
  • PipPipPip
  • 1,196 posts

Posted 15 August 2014 - 02:05 AM

Not sure, but it would involve my PA education/experience somehow. I thought med mal, but now not so sure- maybe legal with a physician group or hospital? My sister-in-law, who is an attorney, has talked up patent law to me due to it's technical aspects

TA: Have you considered MedMal Consulting or Tort Law or would you consider being an expert witness? If you are in TX I 'might' know someone who can possibly talk to you. 


Posted Image

#35 True Anomaly

True Anomaly

    Emergency Medicine PA

  • Moderators
  • PipPipPip
  • 2,124 posts

Posted 15 August 2014 - 01:56 PM

TA: Have you considered MedMal Consulting or Tort Law or would you consider being an expert witness? If you are in TX I 'might' know someone who can possibly talk to you. 

 

MedMal would be a big interest- not sure about tort law.  

 

But even if I do the JD, we're talking at least 5-10 years before I would pursue it


Emergency Medicine PA
Gig 'Em Aggies

#36 RichardLPeeA

RichardLPeeA

    Advanced Member

  • Members
  • PipPipPip
  • 50 posts

Posted 18 September 2014 - 11:54 AM

Your hypothetical is working as a hospitalist. Let them take the general med PANRE. That covers hospitalist and FP pretty well.

If people want to continue to take the generalist PANRE then so be it, to cover all their bases (as well as that exam can cover them).

 

I work in CT surgery. I get VERY little clinical yield out ofthe current PANRE. Instead of worrying about how to make specialty exams work for PAs who jump specialties, I ask what is NCCPA doing to serve the specialty PAs who are indedicated practice for many years. I should not need to take 2 exams (PANRE and CT Surg CAQ) when the first one is nearly meaningless.

I think having CAQ replace PANRE is a good idea so long as you stay within that specialty.  If you want to venture out into let's say FP, then you should also take PANRE or have FP CAQ.


  • EMEDPA and cinntsp like this

#37 Paula

Paula

    Registered

  • Members
  • PipPipPip
  • 2,175 posts

Posted 05 October 2014 - 02:22 PM

An emerging concept is something called Established Professional Activities (EPA).  It is an activity that has been objectively validated in both assessment, performance, and management of complication.   I do not know much about it but we at PAFT will be discussing it at our next board meeting. 

 

Once an EPA has been validated the "tether"  (to a physician) could be cut  or autonomously performed perhaps.

 

So our profession has to show a valid way to prove we are competent in our SOP and maybe at some point these EPAs will be the key? 

 

Since I just learned of this concept about 3 days ago I cannot answer any questions about it.  I need to find out more info myself. 



#38 Paula

Paula

    Registered

  • Members
  • PipPipPip
  • 2,175 posts

Posted 05 October 2014 - 02:53 PM

The correct term may be : Entrustable Professional Activities.  EPA.  At least that is what the Medical associations and education gurus call it.  It's been around for a couple of years now to establish competency for 1st year residents and what they should know before starting PGY1.

 

Let's just merge the PA and MD/DO professions.  



#39 primadonna22274

primadonna22274

    Physician and PA-C

  • Members
  • PipPipPip
  • 3,429 posts

Posted 05 October 2014 - 07:33 PM

I haven't heard the EPA term Paula but it does sound like our residency "milestones" that must be reached to demonstrate competency.
Here's something funny: I only have to do 2 I&Ds supervised at my program to reach the milestone for that procedure--but I can't do them unsupervised in my program until then (despite the fact I've done, oh, I don't know, several hundred or maybe a thousand in my 14-year PA career??).
I will look into the EPA concept.
"It is only with the heart that one can see rightly. What is essential is invisible to the eye."
--Antoine de Saint-Exupery

#40 primadonna22274

primadonna22274

    Physician and PA-C

  • Members
  • PipPipPip
  • 3,429 posts

Posted 05 October 2014 - 07:46 PM

Very new concept indeed. Gotta love the medical education ivory tower, always rebranding old ideas and calling them new ☺️
See the link below. Slides 21-22. Soooooo general. Certainly not anything "procedural". I suspect PAs would need to demonstrate meeting the "EPAs expected for any practicing physician" on the Venn diagram a few slides before--don't know yet what procedures are included there. Also note that these EPAs for any physician entering residency are no different than any PA program expects of its graduates. 😉
https://www.aamc.org...lactivities.pdf
"It is only with the heart that one can see rightly. What is essential is invisible to the eye."
--Antoine de Saint-Exupery





Also tagged with one or more of these keywords: CAQ, PA-S, PA-C, EMPA

0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users