NCCPA CAQ in IM

[ventana]

So since the very start of the CAQ exams I have been getting emails to take a CAQ.  With every email I have replied to NCCPA is what they really need is an IM CAQ as this is the #1 field for PA's by their own Data with 20.5% of PAs in this field  

 

see http://www.nccpa.net/Upload/PDFs/2013StatisticalProfileofCertifiedPhysicianAssistants-AnAnnualReportoftheNCCPA.pdf

See page 13

 

They always offer the same polite reply that they will look into it, and that in the past they have felt PA school prepares you for IM. 

 

 

I have provided these same arguments each time:

 

1) IM is the single biggest  SPECIALTY for PAs to work in and we need an CAQ

2) We are being left behind by the NP profession as the move towards independence and we should be doing everything possible to demonstrate that we too are exceptional clinicians

3) PA school prepares you to enter medicine as provider but I have never heard of or seen a new grad capable of functioning as a PCP right out of school

4) it is absurd to think that 2 years of PA school makes us ready to be PCP when it takes doc's 6 years at a bare min to get to the point they can be PCP

4) The legislatures need to see that IM is taken just as seriously as the other specialties (Psych, renal, EM and all the other CAQ fields) so that we can advance out own profession - they likely don't truly understand the bills they pass, but they rely on their staff and first impressions - if we have a specialty exam we must be competent!)

 

I always get back a very polite and professional email that they will consider it.......

 

I would like to see what other PAs feel about this as I seem to be getting no where and we need to act.  

 

Specifically I would suggest a CAQ for IM with the issues of 18+ years old, obviously with a fair amount of Geriatrics - but modeled after the IM boards for Doc's (no need for anything Peds as that is covered by the Peds test - sorry FP folks)

 

What do you think?

[Guest Paula]

Yes, I would like to see an IM CAQ.  I would take it.  I would also take a FP CAQ as well but I am in the processes of transitioning to IM.  The next time I get an email notice to take a CAQ I will respond in like manner as Ventana.

[LKPAC]

I would have thought that FP was the biggest specialty for PAs.  However, I voted yes for the IM CAQ.

[cinntsp]

Have you considered trying the hospital medicine CAQ or do you not meet the hour requirement?

 

Sent from my Nexus 5 using Tapatalk

 

[ventana]

Have you considered trying the hospital medicine CAQ or do you not meet the hour requirement? Sent from my Nexus 5 using Tapatalk

 

Have you considered trying the hospital medicine CAQ or do you not meet the hour requirement? Sent from my Nexus 5 using TapatalkI don't 

 

 

I don't see the connection - hospital medicine is it's own specialty, and one that I don't know much about, nor would I have the hours..

[cinntsp]

I don't see the connection - hospital medicine is it's own specialty, and one that I don't know much about, nor would I have the hours..

 

It is, but someone with a strong IM background could probably do well on it with some additional studying, which is why I asked.  It doesn't solve the problem but could offer a temporary alternative.  Not having the experience makes the point moot, though.

[primadonna22274]

There are interesting changes brewing in the inpatient vs outpatient IM world.

I think in the very near future we are likely to see the development of a totally new specialty for physicians in Hospital Medicine. There is already argument from many ACGME folks in the know that IM and FM are much more similar than they are different--but what is very different is inpatient vs outpatient training and education needs.

Some have argued for revamping the pathways to Hospital Medicine (what we think of as IM now) from which the various IM sub specialties branch off (cards, renal, pulm/CC, hem-onc etc). These folks would continue to do the vast majority of their training in the hospital and spend very little time in outpatient clinics. Then Ambulatory Medicine would train primarily outpatient with much less inpatient training but very strong community medicine exposure. Now I recognize this is difficult for FM where we really do it ALL--but in reality most family practitioners after training will fine-tune their practice to their particular interests/talents/niches. I have zero plans of doing OB after graduating from my FM program--but I still have what equates to 3.5 mos of it during 3 yr, plus outpatient GYN and continuity deliveries. This cuts into my time that I would rather spend in the ICU or hospice/palliative med etc...of course there is room for that too but less than I would like (yes I know I chose FM over IM, just a mild rant). However, I have the opportunity to pursue more electives in geriatrics and a CAQ later in geriatrics and/or palliative medicine from FM (I could have done either/both of these from FM or IM so I chose location and "fit" over specialty per se). Similar opportunities for PAs should exist...what about pursuing a CAQ in Geriatric Medicine for PAs, Ventana? Maybe that's what we should be working toward. Truth be told, IM is just so vast that I don't think it could be a very well-focused CAQ as you are seeking.

We could very easily do this with Geriatrics and Hospice/Palliative Medicine--as you know there is a very significant overlap between the two.

Kinda fits in with my other pet project ????

[ventana]

There are interesting changes brewing in the inpatient vs outpatient IM world.

I think in the very near future we are likely to see the development of a totally new specialty for physicians in Hospital Medicine. There is already argument from many ACGME folks in the know that IM and FM are much more similar than they are different--but what is very different is inpatient vs outpatient training and education needs.

Some have argued for revamping the pathways to Hospital Medicine (what we think of as IM now) from which the various IM sub specialties branch off (cards, renal, pulm/CC, hem-onc etc). These folks would continue to do the vast majority of their training in the hospital and spend very little time in outpatient clinics. Then Ambulatory Medicine would train primarily outpatient with much less inpatient training but very strong community medicine exposure. Now I recognize this is difficult for FM where we really do it ALL--but in reality most family practitioners after training will fine-tune their practice to their particular interests/talents/niches. I have zero plans of doing OB after graduating from my FM program--but I still have what equates to 3.5 mos of it during 3 yr, plus outpatient GYN and continuity deliveries. This cuts into my time that I would rather spend in the ICU or hospice/palliative med etc...of course there is room for that too but less than I would like (yes I know I chose FM over IM, just a mild rant). However, I have the opportunity to pursue more electives in geriatrics and a CAQ later in geriatrics and/or palliative medicine from FM (I could have done either/both of these from FM or IM so I chose location and "fit" over specialty per se). Similar opportunities for PAs should exist...what about pursuing a CAQ in Geriatric Medicine for PAs, Ventana? Maybe that's what we should be working toward. Truth be told, IM is just so vast that I don't think it could be a very well-focused CAQ as you are seeking.

We could very easily do this with Geriatrics and Hospice/Palliative Medicine--as you know there is a very significant overlap between the two.

Kinda fits in with my other pet project

 

Prima,

 

I would love Geir/Palliative but the #'s of PAs is so small am not sure the demand is there, however the demand for an IM is there with out question simply by the numbers.  

 

Also, I think it is possible (and desirable) to have this, as by your admission the amount of info is HUGE and certainly it is worth while for the PAs that do this to be able to have a CAQ.

 

 

 

But maybe the Geir/Palliative care track would be an easier track to get through..... any NCCPA folks reading this??

[primadonna22274]

I'm very early into working on an interdisciplinary curriculum for geriatrics. This will be a couple-year project. Happy to help if NCCPA is interested. I also know several movers and shakers in PA geriatrics/HPM world who would be very helpful in this regard.

[ventana]

I'm very early into working on an interdisciplinary curriculum for geriatrics. This will be a couple-year project. Happy to help if NCCPA is interested. I also know several movers and shakers in PA geriatrics/HPM world who would be very helpful in this regard.

hummm

 

interesting.....  would be interested in helping develop this......

[SocialMedicine]

you mention IM CAQ and PCP ..... but wouldn't an IM board include inpatient medicine as well ? I wonder how many PAs see their patients inpatient as well ? 

 

I am not sure I agree FP is the same as IM ..... a TRUE family medicine practitioner can do a number of ED procedures, basic OB GYN, mgmt of children/adults. I am not sure a significant % of PAs in primary care or pediatrics could cross over with ease. 

[EMEDPA]

you mention IM CAQ and PCP ..... but wouldn't an IM board include inpatient medicine as well ? I wonder how many PAs see their patients inpatient as well ? 

 

I am not sure I agree FP is the same as IM ..... a TRUE family medicine practitioner can do a number of ED procedures, basic OB GYN, mgmt of children/adults. I am not sure a significant % of PAs in primary care or pediatrics could cross over with ease. 

agree. an FP doc (a good one anyway) can see anyone in almost any setting to include inpt and ICU. Internists are limited to adults(although, granted they tend to manage a lot of the sick ones). From an ED perspective, I would much rather work with FP>IM docs because the IM docs tend to skip all the kids, all the OB, most of the procedures, and all the trauma, leaving those for the fp docs and PAs so they can see chest pain and dyspnea all day long. and if there isn't CP and sob they tend to slack and let everyone else carry the load...I was personally responsible at my second job for getting all the moonlighting IM residents fired and replacing them with PAs for around 1/3 the cost resulting in a significant increase in productivity and quality of work done.

[primadonna22274]

^^^all true and ultimately why I chose an FM residency. In my hospital the only place we (FM residents) don't go is NICU. Every other ICU, the stroke unit, cardiovascular, every medicine floor, the nursery, peds and women's services, the ED, the endoscopy suite-- we work on all of them.

Cool but on day 7 of a 12-day stretch, man am I tired....

 

[Guest Paula]

Yikes!  I'm moving into an IM position with some FP sprinkled in.  Hope it goes well for me.  I will miss the kiddos for sure, don't particularly like OB/GYN, and sure hope none of the docs I will be working with are slackers.  I'll be sure to highlight the procedures I do now and make sure my employers know I'm open to doing procedures.

 

I would like a CAQ in something but there is nothing for us generalists other than the PANCE/PANRE. 

 

I applied for the rights to do all the procedures I did in FP when I filled out my credentialing packet. 

[ventana]

I got an email from NCCPA letting me take a FREE CAQ practice test in one of the already established CAQ fields....

 

So now they are giving away FREE practice tests to drum up business, instead of doing an IM CAQ

 

 

PAFT  any thoughts???

[Guest Paula]

I got the email too and it confused me.  I understood it to be some type of study they are conducting to see if their practice tests are valid?  And if you pass no CAQ is conferred upon you so I deleted the message. Plus, wasn't it limited to a set number of PAs who could take part in the experiment?