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ProSpectre

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ProSpectre last won the day on October 28

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About ProSpectre

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  1. ProSpectre

    AOA Warning on PA "Independence"

    I don't think anyone would say that it's your responsibility to teach an employee in that situation; it may just be an question of enjoying teaching or not. I worked for a time with a fantastic physician and an Army-trained PA who both took the time to teach and let me do more as a medical assistant than any of their full-time MAs, simply because they knew I'd soon be starting PA school. Of course when the practice was busy things sped up and we just had to get patients in and out, but they both very much enjoyed teaching and went out of their way to provide lessons for me wherever they could; my guess is that they saw it not only as investing in my future, but as investing in the education of a future colleague. I wasn't a paramedic, but I have had to start an IV on a dude with a displaced femoral shaft fracture in the back of a pickup truck driven by Afghan soldiers going 120km/hr (with a windchill of like 10 degrees at that speed), just hoping the route was clear of IEDs. I was having as much of an issue getting the stick due to shaking from the cold as I was from their terrible driving.
  2. ProSpectre

    AOA Warning on PA "Independence"

    I attend one of the oldest programs in the country, which is well respected and highly ranked (for what that's worth), and yet they accept applicants from all kinds of backgrounds with no firm requirement for PCE hours. Military medics, scribes, pharmacy techs, CNAs, MAs, athletic trainers, RNs, paramedics, RTs, and others are commonly accepted. When I first started PA school, I looked up to the military medics, paramedics and RNs as having "the best" prior experience (partly from opinions I saw on this forum), but I've consistently performed better than the ones in my class, despite my background. Out of the 2 paramedics and 1 respiratory therapist in my class, the RT and one of the medics were actually recycled from a previous year for failing, and are the only ones in my class that are there for that reason. The other paramedic has also struggled academically each semester, just not to the point of failing. I'm sure they will make fine PAs, but their background hasn't seemed to make much difference for them. To me, this solidifies that it is the individual, not the specific medical background, that determines success. Everyone has their strengths, but I can't seem to find congruence between past medical experience and the ability to perform strongly (academically or clinically), and there is currently no data to support it either. You can be taught medicine, but there are inherent characteristics that simply cannot be taught.
  3. ProSpectre

    AOA Warning on PA "Independence"

    A lot of this discussion is still not much more than an interesting but rather meaningless thought-experiment that provides no real evidence of what type of applicant makes for a better or worse clinician. There seems to be mild disdain from some on this board for students that don’t follow the traditional pathway to becoming a PA, despite being academically gifted enough to pursue any other career (and often foregoing medical school to join our profession instead). In my mind, we should embrace that there are multiple valid pathways to becoming a PA -- unless and until there is valid evidence that the current methods of selecting applicants are producing an inferior clinician. Maybe the 24 year old student that learns quickly, studies hard and does well academically will make just as strong of a PA as the 28 year old paramedic with years of experience. Maybe intrinsic characteristics such as compassion, perseverance, humility and resilience are just as important to becoming a great PA as whether you were an EMT or an RT. Maybe there is no one-size-fits all applicant that is guaranteed to make a strong PA. Regardless of the prevailing dogma that is pervasive on this board, the PA profession continues to grow in both size and reputation, despite the shifting trend in admissions over the last decade or two. I have full confidence that the generation of PAs currently in the making will carry the torch just as well during the next 30 years as many on this board have over the previous 30, despite these changes.
  4. ProSpectre

    AOA Warning on PA "Independence"

    Asking if there is data to support that assertion is valid in this case though, as it would have implications for our profession as a whole. It's no different than asking for data when physician groups state that PAs provide inferior care than physicians (I'm sure many of them would argue that they have that belief based on experience). If prior patient care experience is the main determinant of the quality of a PA (even if just for the first five years of practice), then the current PA school admissions practices should be diluting the profession with substandard PAs since the trend over the last 10+ years has been less PCE and higher GPAs (the annual PAEA reports show this). I've heard anecdotal accounts from experienced members of this forum that argue both ways -- some say that they have worked with early career PAs with very little prior experience that are rock stars, and others state that those with prior experience are always the best out of the gate. We can't change policy based on anecdotal experience though. There was this study (https://www.ncbi.nlm.nih.gov/pubmed/27228045) that looked at prior experience and clinical year outcomes, and the study "did not support the hypothesis that healthcare experience is associated with improved clinical year outcomes." It would be interesting to see a similar study that looked at first few years of practice rather than just the clinical year.
  5. ProSpectre

    AOA Warning on PA "Independence"

    If we had stayed with that then the profession probably wouldn't be growing at the speed it is either though (whether that growth is seen as a positive or a negative is another question). Although GPA has become more important in admissions, I'd wager that it's not just an issue of those types of applicants being passed over in favor of medical assistants and CNAs with high GPAs, but rather that there simply aren't the numbers applicants with that kind of experience to fill classes (doubly so with all of the new programs opening).
  6. Curious to hear thoughts on this. The American Osteopathic Association has put out a statement warning of the "dangers" of non-physicians (i.e. PAs and NPs) gaining increased independent-practice rights. They mention the AAPA directly (as well as the AANP), and bring up one of the tenets of OTP without fully explaining what it means, the implications, or how it's different than true independent practice (no surprise there). They also cherry pick a few studies to back up their claims, while ignoring many others that don't support their statement. https://www.prnewswire.com/news-releases/expanding-independent-practice-rights-for-non-physicians-means-not-all-patients-can-see-doctors-300740501.html
  7. I worked for a time in a dermatology practice before PA school, and the PAs were treated the same as the physician practice owner. Each provider had their own MAs assigned each day to help with scribing (which dramatically cut down on charting time), assisting with procedures, and assisting in surgeries on OR days (each PA performed their own surgeries just as the physician did, with the exception of Mohs surgery). There was also a full time MA whose job was to take care of prior authorizations and associated paper work. In sum, the PAs were given the same resources as the physician to ensure efficiency, which allowed them to spend more time seeing patients and less time doing paperwork. One PA was only a few years out of school and didn't see nearly as many patients as the physician or more experienced PA, and yet she was still provided with the same resources as the other two -- there was no "paying her dues". It appears you are underappreciated at this practice, and that isn't likely to change.
  8. ProSpectre

    New DMS Program at ATSU

    From the research I've done on the LMU program, the format is largely online like the other DMS programs are, and is designed so that you continue to work your normal job while you take classes. It does, however, require two 1-week periods on campus during the 17 month curriculum for medical seminars and hands-on training in subjects like ultrasound and radiology. I believe this is similar to the on-campus requirements by some other doctorates like the DHSc from Nova Southeastern. I completely agree about the DScPAS though -- not only does the curriculum seem weaker than the other options, the name is just terrible and shows a complete lack of foresight by those who created the program.
  9. ProSpectre

    New DMS Program at ATSU

    I honestly don't get the push-back on this forum that people have for the LMU DMS program. Out of the available DMS programs (Lynchburg, ATSU, or the MCPHS program with the terrible name), it has the most robust clinically-oriented curriculum by far. Yes it is longer at 2 years, but it seems to be the only one so far that could actually add substantially to the clinical knowledge base of PAs; the others all seem to be focused on teaching or administration, which is kind of funny to me for a degree called "Doctorate of Medical Science". I understand the other programs may be preferable for later career PAs who have been working in their field for many years and are ready to move into administration/academia and simply need a doctorate for those purposes. For early career PAs who are still developing their skills and knowledge though, the LMU program seems to be the only one that actually takes the "medical science" aspect of the degree title seriously. One caveat to my statements is that Lynchburg's program is beginning to allow PA residencies/fellowships to fulfill part of the degree requirement, which I think is the best of both worlds, and may be the best model overall for a PA doctorate; however, it will likely be a minority of students utilizing this option for the foreseeable future until more residencies are approved and more are created.
  10. Ideally, you should get as many hours as you can with the best quality patient care experience that you can (note that PCE and HCE are different). Not only will this make you more competitive, but there is value in learning the ins and outs of medical terminology, talking to patients and other healthcare professionals, performing basic procedures, etc that you simply cannot get without being immersed in it. The assessment of just how much is enough comes down to how competitive you are otherwise, and the opportunity cost of putting off applications for another year to get more experience. Schools that say they "recommend" or "prefer" PCE mean just that: they reserve the right to accept otherwise excellent applicants with little or no experience (or experience that falls outside of the traditional PCE formats), but for most individuals to be competitive, they will still need a good amount. Having said all that, I applied to schools with well under 500 hours of PCE, and ended up getting multiple interviews and acceptances. This was at schools like UTMB, Augusta University (formerly Medical College of Georgia), UAB, multiple Nova campuses, PCOM, etc. I had a pretty solid application otherwise though, which likely helped "make up" for me being weak on PCE. I also ended up getting quite a bit more patient care experience before starting my program since I had like 7 months to kill, and that experience has definitely come in handy.
  11. The AAPA finally confirmed their choice for the research firm to conduct the title-change investigation, the results of which are due to be presented in 6 months to the HOD in May 2019. The chosen firm is WPP, "a world-renowned research, branding, and communications company". Another step in the right direction. If you don't believe the AAPA is finally making progress for PAs, then you just aren't paying attention. Hopefully this convinces PAs to join the AAPA so we can keep this recent momentum going. https://www.aapa.org/news-central/2018/10/expert-research-branding-firm-selected-conduct-pa-title-change-investigation/
  12. ProSpectre

    Supervision vs Collaboration

    What state was this in? I definitely feel like the profession is making progress, but seeing things like this make me wonder if it's one step forward and two steps back.
  13. ProSpectre

    Waiting

    Honestly, I think the best thing you can do to alleviate the pain of waiting is to just start thinking of how you can improve your application for next year in the event that you aren't accepted this cycle. If you have a 4.0 GPA and a couple thousand hours of PCE but you know that you are weak on interviewing, then start looking up how to improve your interview skills. The same thing goes for a low GPA, poor GRE score, or only having a small amount of PCE hours -- practice a little self-reflection, find out where your application needs improvement, and start making plans about how you will improve those weak points. I had a relatively strong application in most areas, but by August of my application cycle (before I had any interviews or rejections) I was already thinking through what I would do if I didn't get in and how I would improve my application. I think this was beneficial in that it helped get me in the mindset that it was entirely possible that I wouldn't get in, but it also reaffirmed that if I wasn't accepted anywhere my first cycle that it wouldn't be the end of the world. Additionally, it gave me something concrete to focus on and goals to work towards that helped me feel like I still had some control over the process and that I was actively working to improve my chances of eventual success as much as possible. Finally, it helped me answer the inevitable interview question "What will you do if you aren't accepted this cycle?", which I had a ready-made answer for since I was already making plans for that contingency. There's no doubt about it, the waiting game sucks. But it's all part of the process, and the best thing you can do about it is to be proactive in working to make yourself a better applicant, even if it just means continuing to work at the patient-care job you already have or ensuring you do well in any prereqs you still have in progress.
  14. I agree, being a good PA student doesn't necessarily translate to being a good PA. However, you are more likely to succeed in PA school if you are a good student, and are arguably more likely to be a good PA if you understand the medicine you learn in PA school. But a mediocre or poor student with lots of prior experience that can't pass PA school or the PANCE isn't going to be a PA, period. I also agree with EMED that life experience after college and the maturity it brings with it is extremely valuable; and all the better if that time was in the medical field. PA school admissions have changed over the last decade or two, for better or worse, and have been trending toward students with higher GPAs and less PCE; has the end product gotten worse in general? I'd like to think not, but only time will tell. I guess my main point is that there is so much variability in PCE that it is hard to say that PCE in general makes a better PA. I would say that all other things being equal academically, strong PCE probably does help, especially as a new grad; but working as a CNA or MA for 6 months or a year (as many applicants do these days) isn't likely to make a huge difference in learning to think like a clinician. It absolutely makes a difference in learning to talk to patients, and probably makes a difference in knowing whether you like the medical field (though I would argue it doesn't tell you whether you would like working as a PA specifically, since the role and stress involved is so different). You learn to think like and perform as a clinician in PA school. There has been at least one study done by NPs (go figure) that found that prior experience as an RN doesn't necessarily correlate to better clinical skills as an NP (tried to find the link, but could only find abstracts -- I have the PDF if anyone is interested. The title is "Does RN Experience Relate to NP Clinical Skills?" by Ellen R. Rich, PhD, RN, FNP). From the study: "An unexpected finding was that there was a significant negative correlation between years of experience as a RN and NP clinical practice skills as assessed by the NPs’ collaborating physicians.Longer experience as a RN was associated with lower rankings of NP skills competency by the physicians." Another study showed that it is a structured orientation period, rather than prior RN experience, that correlates to a successful transition to practice as an NP (I did find that one -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323084/). It would be interesting to see similar studies done on PAs in the same manner, looking at prior experience (type and duration) and success in both PA school and as a PA.
  15. I was accepted into PA school with only shadowing and volunteer PCE as a medical assistant. I did go on to get a decent number of paid hours before I started the program, but I had already been accepted to a few schools by that point (and had turned down quite a few interviews). While I think the PCE I got has helped some, I know I could have done well academically without it. Where prior health care experience really shines is when you start working with actual patients. I do have a military background, and got a small amount of experience as my squad's Combat Lifesaver (and was able to use those skills a number of times on seriously wounded patients overseas), but they don't really count that as PCE like they would if I were a medic (my primary job was as a shooter, not a healer). I also worked for a few years in another field, so I think my background outside of medicine (along with my solid academics) helped prepare me to succeed. I know this isn't a popular opinion on this site, but I don't think prior patient care experience always translates to a stronger PA student, or necessarily to a stronger PA. I go to a pretty highly ranked program, and there are everything from former medical assistants, pharm techs, paramedics, EMTs, military medics, respiratory therapists, nurses, athletic trainers, scribes, etc. I haven't seen any correlation between a specific health care background and the ability to excel (academically or clinically); in fact, some of the students that struggled the most in the first couple semesters had some of the "best" prior experience (notably a paramedic and an RT, both with years of experience). Other students with "weak" prior experience have been rock stars. Obviously this is all anecdotal, but my point is that while prior experience can be helpful, being prepared academically can be just as important. To the OP: You mentioned that you have years left before you apply. Do yourself a favor and get some PCE; you have the time, it definitely won't hurt, and it will make you a more well rounded applicant. Just don't neglect your academics, as that foundation is just as important.
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