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This is extremely misleading. NPs specialize; PAs do not. In other words, sure a PA student works 40 or 50 hours a week in each specialty for 5 or 6 weeks, but they only get a few hundred hours of formal clinical training in each specialty. At graduation, a PA might have 200-300 hours of pediatric training, but a pediatric NP graduates with 500-600 in just pediatrics. Same is true of FP, EM, Psych, etc. I'm actually much more fond of the PA educational and practice model and plan to enroll in a PA program (rather than an accelerated BS->NP program) in May. But this notion that NPs somehow have diminished clinical training is completely erroneous because of the fact that they specialize while PAs do not.

Saying a NP specializes simply because they do their few hours in one area is disingenuous. A better way to say it is they are LIMITED to only one area.

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I don't see how more training time in varied specialties could ever be considered 'extraneous'.

Unless one did not have it and was simply looking for a way to diminish its value for self-interest.

 

Strong likelihood that there is a student in your class who feels a rotation or two is extraneous compared to the specialty they are dead set on entering.  We have seen a thread entitled something like, "Derm or nothing!"  It has been said to expect two great rotations, two terrible rotations, and a bunch in the middle of any PA program.  But yes, the entire construction of NP programs is dismissive of the extra rotation time, partially due to self interest, in the same way PAs wear it as a badge of honor, partially due to self interest.

 

I find it interesting that we are willing to malign an RN as not terribly cognizant of what they are actually doing and why are they are doing it, yet we extol the virtues of working as a care tech largely performing bathroom care with no formal education of the human condition.  I don't know what to consider it beyond a curious bias, especially given that nearly everyone drifts from the science of their education to the reality of clinical practice in every profession, providers included.

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- Strong likelihood that there is a student in your class who feels a rotation or two is extraneous compared to the specialty they are dead set on entering.  We have seen a thread entitled something like, "Derm or nothing!"  It has been said to expect two great rotations, two terrible rotations, and a bunch in the middle of any PA program. -

 

There may be that student, but at least I know they are being exposed to the other fields and specialities (whether they want it or not), incase:

 

1. They never get a derm job, so they go into another field.

2. If they ever switch out of derm, at least they have some previous foundation to build on.

3. While in their derm practice, they catch something outside of the derm sphere in a pt., because of their other exposure/training.

 

 

- But yes, the entire construction of NP programs is dismissive of the extra rotation time, partially due to self interest, in the same way PAs wear it as a badge of honor, partially due to self interest. -

 

I don't think it's so much a badge of honor as it is a measure of training. You wouldn't call MS3/MS4 a badge of honor? It's more training in medicine. That physician isn't going to do each one of those specialities in his or her life, but it's a necessary foundation and exposure for the practice of medicine as a whole.

 

 

I find it interesting that we are willing to malign an RN as not terribly cognizant of what they are actually doing and why are they are doing it, yet we extol the virtues of working as a care tech largely performing bathroom care with no formal education of the human condition.  I don't know what to consider it beyond a curious bias, especially given that nearly everyone drifts from the science of their education to the reality of clinical practice in every profession, providers included.

 

I think that an RN is fantastic pre-PA experience. And the process of going through PA school would produce a great provider.

 

The original concept of the profession was to use nurses to make PAs, but Dr. Stead got that idea axed by a nursing group. So his secretary, I believe, thought of using Navy Corpsman instead.

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Strong likelihood that there is a student in your class who feels a rotation or two is extraneous compared to the specialty they are dead set on entering. We have seen a thread entitled something like, "Derm or nothing!" It has been said to expect two great rotations, two terrible rotations, and a bunch in the middle of any PA program. But yes, the entire construction of NP programs is dismissive of the extra rotation time, partially due to self interest, in the same way PAs wear it as a badge of honor, partially due to self interest.

 

I find it interesting that we are willing to malign an RN as not terribly cognizant of what they are actually doing and why are they are doing it, yet we extol the virtues of working as a care tech largely performing bathroom care with no formal education of the human condition. I don't know what to consider it beyond a curious bias, especially given that nearly everyone drifts from the science of their education to the reality of clinical practice in every profession, providers included.

No one who cares about HCE is extolling care techs. You're just grasping at straws now. Let the thread die instead of, perhaps unintentional, further driving a wedge between PAs and NPs. Each has its merits and we should just work together to progress all advance practice clinicians.

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I've been a preceptor for both NP and PA students. I've had great and not so great students. But with the NP students, evaluations were done by the MD or NP, not me. However, the evals were collaborative effort on the performance of the students and my input was used. Sometimes the NP students would chose to follow me over the NP.

 

Funny thing though, one NP student stopped coming in on my schedule because she said I was "too hard with questioning her clinical skills". When I would ask her to present a patient, she'd say "I think he has a cold". Um no! I asked her if she had learned how to present patients, develop differentials, assessment and plans, etc. She was about to cry.

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This is a large forum with a great diversity of opinion.  You are challenging me to find one example that extols patient care tech experience?

 

PCT is good experience if as a tech you get to take vitals, perform EKGs, draw blood, assist with wound care, assist nurses, doctors, and ACPs as needed, chart, perform ADLs with pts., while changing sheets, bedpans, and emptying ostomy bags.

 

If you made a poll here, I'm sure most members would agree that Medic, RN, or RT experience is near the top tier of pre-PA experience.

 

PCT can be very good experience, but I don't think anyone would go into raptures about/over, wax lyrical about, sing the praises of, praise to the skies, acclaim, exalt, eulogize, adulate, rhapsodize over, or rave about (extol) it as the end-all, be-all of experiences.

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Of course you are correct about the poll.  However, PCT exp is certainly "praised enthusiastically" which is the root of the definition you have quoted, electing the more flowery language to illustrate your point.

 

Why should solid PCT experience not be held in regard, along with the other avenues?

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Why should solid PCT experience not be held in regard, along with the other avenues?

 

I think it's fine.  Most importantly, adcoms think it's fine.  I am either expressing myself in a confusing way or a couple of you are jumping into the middle of the conversation without starting from the beginning.

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This is a large forum with a great diversity of opinion. You are challenging me to find one example that extols patient care tech experience?

 

Very funny. Have you been to this site before?
You were the one who made seem so common place as to imply I've not visited this site before to have missed it. Please find where it's "extolled." I win either way. Either you eat crow or I've successfully made you waste your time on an Internet argument or you don't look and can't substantiate your claim :) On holiday, bored, with nothing but time. I'm just in it for the enjoyment now.
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You were the one who made seem so common place as to imply I've not visited this site before to have missed it. Please find where it's "extolled" I win either way. Either you eat crow or I've successfully made you waste your time on an Internet argument :) On holiday, bored, with nothing but time. I'm just in it for the enjoyment now.

 

Can't speak for anyone but me, but the general tenor of the typical PA training > NP training post or thread ignores the background of an increasing number of PA students -- no HCE at all, or CNA/PCT for a few months prior to admission.  While perhaps that is not "extolling" such a background, taking the stand that all new grad PA's (including those with no HCE or only CNA/PCT experience) are inherently more prepared than all new grad NP's implies that CNA or PCT constitute acceptable levels of prior HCE for PA school.

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Can't speak for anyone but me, but the general tenor of the typical PA training > NP training post or thread ignores the background of an increasing number of PA students -- no HCE at all, or CNA/PCT for a few months prior to admission. While perhaps that is not "extolling" such a background, taking the stand that all new grad PA's (including those with no HCE or only CNA/PCT experience) are inherently more prepared than all new grad NP's implies that CNA or PCT constitute acceptable levels of prior HCE for PA school.

I'm not saying all new grad PAs are better than all new grad NPs. An impossible statement to make because we have to account for intelligence, length of experience, quality of that experience, quality of the programs, work ethic, drive, life obligations, and the list goes on. What I am saying is all things being equal, PA training produces a more knowledgable provider out the gate. I don't see this as an unreasonable statement. I saw first hand what was taught at UAB NP program, and it's pretty poor compared to what I was taught at my PA school.

 

ETA: again, things level out over years. NPs have hoards of data to show safe and effective care. I'm just trying to promote the fact that PAs have high quality training. I may get mixed up and accidentally say things that are demeaning when I'm simply trying to state facts and I apologize. I really do want to see NPs and PAs work together.

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Can't speak for anyone but me, but the general tenor of the typical PA training > NP training post or thread ignores the background of an increasing number of PA students -- no HCE at all, or CNA/PCT for a few months prior to admission.  While perhaps that is not "extolling" such a background, taking the stand that all new grad PA's (including those with no HCE or only CNA/PCT experience) are inherently more prepared than all new grad NP's implies that CNA or PCT constitute acceptable levels of prior HCE for PA school.

 

As some smart people on this forum have brought up before, we can't really go off what was done before PA or NP school, it's more or less irrelevant to how the two types of programs stack up against each other. For example, do we judge MDs by what their undergrad degree was? Or what their prior healthcare experience to medical school was? No, we accept that the general level of training in an MD program produces a typical result. Some docs were paramedics or RNs for years, some never set foot in a hospital before school. And we never bring that up as a comparison between docs, b/c they all receive the same standard training.

 

So we must judge PA and NP schooling on their standard training. On average, PA has 2-3x the credit hours and 4x the clinical hours. Those are meant to produce a typical result, regardless of what was done before.

 

 

I'm not saying all new grad PAs are better than all new grad NPs. An impossible statement to make because we have to account for intelligence, length of experience, quality of that experience, quality of the programs, work ethic, drive, life obligations, and the list goes on. What I am saying is all things being equal, PA training produces a more knowledgable provider out the gate. I don't see this as an unreasonable statement. I saw first hand what was taught at UAB NP program, and it's pretty poor compared to what I was taught at my PA school. ETA: again, things level out over years. NPs have hoards of data to show safe and effective care. I'm just trying to promote the fact that PAs have high quality training. I may get mixed up and accidentally say things that are demeaning when I'm simply trying to state facts and I apologize. I really do want to see NPs and PAs work together.

 

Right on. But I wouldn't give up the fight. While it may be very true that PAs and NPs have the potential to level out after time in practice; so do PAs and physicians. In certain fields (ex. primary care), PAs probably level out with the docs after X number of years, but docs would never, ever concede this on the whole. Even if the PA and the doc are 100% interchangeable in the practice. So what incentive do PAs have to readily rollover and go "yeah, NPs are the same". We aren't doing ourselves any favors by giving up more ground to people that already have a lot more than we do. There are plenty of historical and cultural examples where this doesn't work out so well for the meek party.

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As some smart people on this forum have brought up before, we can't really go off what was done before PA or NP school, it's more or less irrelevant to how the two types of programs stack up against each other. For example, do we judge MDs by what their undergrad degree was? Or what their prior healthcare experience to medical school was? No, we accept that the general level of training in an MD program produces a typical result. Some docs were paramedics or RNs for years, some never set foot in a hospital before school. And we never bring that up as a comparison between docs, b/c they all receive the same standard training.

 

So we must judge PA and NP schooling on their standard training. On average, PA has 2-3x the credit hours and 4x the clinical hours. Those are meant to produce a typical result, regardless of what was done before.

 

 

 

Right on. But I wouldn't give up the fight. While it may be very true that PAs and NPs have the potential to level out after time in practice; so do PAs and physicians. In certain fields (ex. primary care), PAs probably level out with the docs after X number of years, but docs would never, ever concede this on the whole. Even if the PA and the doc are 100% interchangeable in the practice. So what incentive do PAs have to readily rollover and go "yeah, NPs are the same". We aren't doing ourselves any favors by giving up more ground to people that already have a lot more than we do. There are plenty of historical and cultural examples where this doesn't work out so well for the meek party.

Absolutely a PA catches up with the MD after so many years. Obviously the fresh attending is beyond a fresh grad PA, but things level out same as with NPs.

 

I'm not conceding any ground. I propose that PAs should have every benefit that NPs enjoy. Suggesting that we work together on legislation will only benefit us. Look at through the lens of the MD/DO debate of decades past. Do we want to be the hard ass MD standing up saying no one else can do what we do, looking like total a-holes, or do we want to be the DO extending the olive branch? Worked out pretty well for them.

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As some smart people on this forum have brought up before, we can't really go off what was done before PA or NP school, it's more or less irrelevant to how the two types of programs stack up against each other. For example, do we judge MDs by what their undergrad degree was? 

 

I have to politely disagree.  The entire foundation of NP and PA programs is based on what one has done before.  Both, at least historically (and correctly IMO), required prior HCE.  The NP programs were designed for experienced RN's, and PA programs were designed originally for Navy corpsman and until recently, have almost all universally required significant prior HCE.  Med school, and subsequent residency, is designed for those without prior experience and hence why there are much more clinical hours in the MD program and then residency.

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I'm not saying all new grad PAs are better than all new grad NPs. An impossible statement to make because we have to account for intelligence, length of experience, quality of that experience, quality of the programs, work ethic, drive, life obligations, and the list goes on. What I am saying is all things being equal, PA training produces a more knowledgable provider out the gate.

 

 

My post did make it sound as if I were saying that you believed that -- I did not mean to imply that.  I was trying to speak generally.  However, there are many who seem to suggest that PA > NP no matter what.  I 100% agree it is an individual thing.  I would also agree (somewhat) that all things being equal, a PA program has a greater chance of producing a more knowledgeable provider out of the gait.

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It would be extremely interesting to let seasoned PAs/NPs working in primary care to challenge the FP boards.  Then, and only then could we say our knowledge has leveled out to that of a physician or that the PA/NP have leveled out to each other.

 

Assuming, of course, that we pass the test.

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It would be extremely interesting to let seasoned PAs/NPs working in primary care to challenge the FP boards.  Then, and only then could we say our knowledge has leveled out to that of a physician or that the PA/NP have leveled out to each other.

 

Assuming, of course, that we pass the test.

 

I would wholeheartedly support this, though I doubt it will ever happen.  Only physicians are permitted to know what physicians know. :)  I think the next best thing is a national examination open to PA's and NP's that models FP boards in content and rigor.  NBME has their exam that is vaguely modeled after step III, but it is open only to NP's with a DNP, and of course, has been widely criticized by physicians groups.

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I have to politely disagree.  The entire foundation of NP and PA programs is based on what one has done before.  Both, at least historically (and correctly IMO), required prior HCE.  The NP programs were designed for experienced RN's, and PA programs were designed originally for Navy corpsman and until recently, have almost all universally required significant prior HCE.  Med school, and subsequent residency, is designed for those without prior experience and hence why there are much more clinical hours in the MD program and then residency.

 

Oddly enough, early MDs in the United States had to complete an medical apprenticeship (and have a valid certificate) before going to medical college. As EMED correctly says, our evolution is paralleling theirs not only in increased specialization/certification but also less prior HCE, longer programs. It'll be interesting if there is ever a full-time PA program longer than 3 years.

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