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About ProSpectre

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    Physician Assistant Student

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  1. ProSpectre

    More bridge programs?

    Overall, I agree with you, and I think we are pretty close on our ideas about this. As far as the 3 year medical schools, you're right that most require selection of a primary care specialty, but at least two that I know of allow you to apply to non-primary care specialties (NYU and the University of Wisconsin, if I remember correctly). Besides, I'm not quite sure how other programs would prevent a graduate from later specializing through a fellowship if they chose to (like a family med doc doing a 1-year EM fellowship and working as an EM doc in a Level II-III trauma center, though that would negate the benefit of the shortened program). And yes, I agree that some of the ideas you are referencing on this thread are simply untenable. I don't think shortening a bridge program to two years is feasible, or possible -- I've read that there is a stipulation, possibly through AAMC, that medical school education must be at least 134 weeks long to meet international criteria; incidentally, this is exactly how long the University of Wisconsin 3-year program lasts. I also don't think residency should be shortened. But if you convert 134 weeks to years (without taking breaks), it works out to just over 2.5 years. You mention that no shortcuts should be taken to make things "unfair" for current or future medical students -- are the current 3 year programs unfair to them? If not, then how is shortening the curriculum slightly for practicing medical professionals who already have pretty extensive training unfair if all standards are otherwise met (especially in the case of keeping any future bridge programs at 3 years)? As to your question about rotations, I would assume that only the medical school rotations would be used for residency applications, just like the 3 year medical school programs currently do (NYU's 3 year program has an early match process for residencies within their system, but still allows students to apply to residencies outside their system if they like, and don't limit students to only primary care). Which schools would open bridge programs would likely be dependent on who has experience with current PA education and sees that bright PAs could add further value to the system as physicians; unfortunately, it's not financially prudent for schools to do so since they can currently charge for 4 full years of tuition without any problem filling seats. The current bridge at LECOM does nothing differently than any of the other 3 year medical schools except allow for certain students to not take the MCAT if they meet other criteria (they have to meet GPA requirements and I think PANCE scores may be taken into account too). The MCAT is a barrier to medical school, but so is getting into and completing PA school for those who decide to go to bridge programs (there are schools with BS-MD programs that waive the MCAT requirement for students in those programs; the MCAT is a selection criteria for medical school just like being a certified PA is a selection criteria for a bridge program -- the MCAT itself has no bearing on residency, licensure or board certification). I doubt much of this will ever come to fruition though, it's just interesting to think about; I think the best that PAs can hope for is the continuation of the current bridge program and maybe 1-2 more eventually opening.
  2. ProSpectre

    More bridge programs?

    There are currently a dozen traditional medical schools with 3 year programs (most are designed for primary care specialties, but not all of them). So technically, the PA-DO bridge doesn't even shorten medical training any more than what schools already allow students like yourself to currently do. Do you resent people in those programs since they allow students to scrap a full year of medical school? Besides, I didn't argue for shortening a bridge to two years; I have said in the past that I thought a bridge program that lasted 2.5 years straight through could work, which would allow 1.5 years for the preclinical curriculum (some medical schools already do this, by the way) and 1 year of rotations, taking into account that PAs already do 12-15 months of rotations in PA school. This would still be a longer path to becoming a physician than simply going to medical school (27 months average for PA school plus 30 months for medical school = 4.75 years); so aside from planning for failing out and continuing to work as a PA as you mentioned, it wouldn't really benefit anyone to take that path, it would simply allow for those who realized they desired to increase their knowledge and practice independently as a physician the ability to do so by taking their prior training into account. Or keep the bridge at three years, and just implement a few more of them. Either way, I don't advocate for cutting corners on taking the Step exams or completing a full residency, which are the measures of competency that demonstrate adequate training to practice as a physician, not the length of medical school.
  3. ProSpectre

    More bridge programs?

    I disagree with the part about shortening residency. Shortening medical school makes sense as long as the Step exams are still taken and passed, but I don't think residency should be shortened, with or without a CAQ. Practicing as a PA for a year and passing a CAQ is not the same as a year of physician residency (and definitely wouldn't work for specialties like orthopedic or CT surgery where PA practice is not equivalent to physician practice). The preclinical curriculum would be important for filling in the gaps in basic sciences curriculum that PAs don't cover in PA school (and for preparation for Step 1), but it's also important for matching into residency to be eligible for board certification as a physician. Shortening residency would 1) lead to resentment among physicians and allow for arguments of inferior training, and 2) could potentially be an avenue for denying the ability to become board certified in a given specialty.
  4. ProSpectre

    Another Doctorate program

    It boggles my mind that any school creating a doctorate for PAs thinks "Doctorate of Physician Assistant Studies" is somehow a good name; doubly so if PAs helped create the program and curriculum, which I'm sure some did. It makes even less sense than a Master's of Physician Assistant Studies (we've never gone to school to study "Physician Assisting"), and it doesn't accommodate growth or change of the profession. Anyone who has been paying attention for the last 10 years knows that the current professional title is on rocky ground (confirmed with the vote at the HOD this year and the initiative from the AAPA in 2016 to "just say PA"). Creating a new degree with that title is shortsighted and foolish.
  5. ProSpectre

    Job Outlook

    I agree with the residency comment, as I think that's the most surefire way to set yourself apart from other early career PAs (and NPs in general). A doctorate is also a good idea, but you can always work on that while you're employed and after completing a residency; the Lynchburg Doctorate of Medical Science program is already allowing certain residencies to fulfill some of their degree requirements too, and hopefully other doctorate programs will follow suit. As a side note, the ARC-PA has recently decided to reinstate formal accreditation of PA residencies, which should help weed out those programs that aren't up to standard or just use PAs for cheap labor, so that's a positive development as well. Overall though, I think the most important thing you can do is continue to educate yourself about the issues affecting the PA profession, and once you graduate, make sure you are active in the AAPA and your state organisation. Contributing time and money to those organizations is what will allow us to continue passing PA-positive legislation and hopefully close the gap between NPs and PAs nationwide. The AAPA seems to have woken up over the last few years with OTP, and issues like the name change are (finally) being examined formally as well, so hopefully over the next couple years more and more positive changes will develop. There are definitely issues affecting our profession, but I don't think it is all doom and gloom. The key will be ensuring that new grads and currently practicing PAs that haven't been active in advocating for the profession come out and stand together to make the positive changes that we need. For too long it's been a small minority of PAs that have carried the burden, and we need all hands on deck to make sure we stay relevant in the 21st century.
  6. ProSpectre

    Bombed my GRE

    Schools can only see the scores that you send to their CASPA GRE code directly from ETS. If I remember correctly, there is also an optional place to self-report your score in CASPA, but I just wouldn't put it there, as it isn't a requirement (if you could self-report without sending scores through ETS, people could simply make up whatever scores they wanted). As long as you send your score through ETS only to the couple schools who require it, then no other schools will have access to it.
  7. ProSpectre

    Why did I get rejected?

    Sure, just meeting the requirements doesn't make someone competitive, but my point is that there is no hard requirement for a minimum number of PCE hours for Rutgers, so who knows what's competitive and what's not for their specific program; both applicants are well above just meeting the requirements for GPA too (OP is well above the minimum cutoff -- although she had an "average GPA" for matriculates, the average simply shows where the middle of the distribution of matriculate GPAs are, it says nothing about how they are distributed). Red flags elsewhere in their applications are a possibility (likely with the other applicant due to her high numbers), but it's not a guarantee. So claiming the OP wasn't accepted based on being "light on hours" or average on GPA is pure speculation. It may be correct, but considering that others with higher hours and higher GPA were also rejected, there is also a very real possibility that there is simply some other quality that Rutgers adcoms look for that these applicants didn't have (for instance, Rutgers claims one of their core values is service to the community, and that they "seek students who demonstrate an ongoing commitment to their community by volunteering"). It's also possible that other things Rutgers mentions like completing several higher level sciences besides prerequisites screened them out. Besides, in regards to the OP's hours, her post said "over 2,500 health care hours combined of volunteer, 400 shadow and the rest direct patient contact", which I read to mean that at least 2000 of those was PCE as a derm MA doing direct patient care. The OP can correct me if I'm wrong, but a quick check of her post history seems to confirm that this is what she meant. I understand you're trying to be realistic with applicants and not sugarcoat things, but you come across as a bit negative when you critique people's stats without providing any actual advice. Some schools (like Rutgers) seem to have a very specific idea of what they want in an applicant, and high PCE hours or high GPA may not always be their first or only priority.
  8. ProSpectre

    Why did I get rejected?

    Someone on the Rutgers application page for this cycle was outright rejected with 4.0 sGPA, 3.96 cGPA and 8000+ hours of PCE (plus volunteering and shadowing). Many schools do in fact accept volunteer hours as PCE if those hours otherwise meet the requirements, and Rutgers doesn't specify anywhere that hours must be paid. They also have medical assistant first on their list of "types of experiences that are recommended"; despite the bias on this board for paramedic and EMT hours, working as a back-office MA is pretty widely accepted and can be good experience for PA school. I'm not sure what their average is for PCE hours since they don't have a minimum and don't list the average for matriculated students, but it doesn't seem like GPA or PCE hours alone will get you an interview there. My guess is that they are looking for a very specific type of applicant, and they can afford to carefully screen for them based on personal statements and the numerous supplemental application essays.
  9. Because despite PAs having a stronger training model, NPs are winning the marketing game by spending money on advertising and lobbying. https://www.forbes.com/sites/brucejapsen/2018/06/26/as-numbers-swell-nurse-practitioners-launch-national-campaign/#1c93b10193ae
  10. In case anyone missed these, here is a Forbes article written by a PhD economist that advocates for increased scope of practice for PAs & NPs. Forbes is one of the few publications that seems to consistently put out articles covering PAs and PA issues in a positive light, which is nice to see. The article is written in reference to a recent report from the Brooking's Institute ( a non-partisan Washington think-tank) that outlines how removing barriers to practice for PAs would improve the US healthcare system. This report outlines things that many on this site may already know, but it's nice to see a pretty extensive policy proposal done that examines some of the evidence on this issue and can be used to help sway lawmakers as PAs work to introduce OTP legislation. Link to the article: https://www.forbes.com/sites/adammillsap/2018/06/19/its-time-to-expand-scope-of-practice-laws/#6479dae72c64 Link to the abstract (the full report & policy brief are linked on the left side of the page): https://www.brookings.edu/research/improving-efficiency-in-the-health-care-system-removing-anticompetitive-barriers-for-advanced-practice-registered-nurses-and-physician-assistants/
  11. I hope it's not true. I hope it is as they said, that they simply allowed one of the two appointed PA members of the commission to write an opinion piece without denoting it as such. However, in the front page article of this month's newsletter, the commission chair describes the article Mr. Anderson wrote as "discussing current controversies swirling around the idea of physician assistants moving toward more independent practice". That's the issue, and is why there was such negative response to it among PAs -- it mischaracterized what OTP is about, and puts the idea that it is about independent practice in the heads of the commission members and the MD readership. The commission chair then goes on to state that they allowed it because it was seen as a "good exposition of current thought". Which begs the question, whose current thought?
  12. Another possibility is that the MDs that serve with Mr. Anderson know full well that his piece was a political advocacy piece against OTP, and that they simply support his actions and viewpoints against PA practice modernization. What better way to attempt to silence those who oppose his views on OTP than to take the approach they did in the latest issue and call them unprofessional bullies?
  13. I also switched careers from a non-healthcare job. I wasn't a cop, but I served as an infantryman in the Army and acted as my unit's primary Combat Lifesaver; I used my training during numerous incidents overseas, both combat-related and non-combat related. I didn't count any of that in my PCE hours when applying to schools, but being able to talk about those experiences in my personal statement and in interviews definitely helped me stand apart from most applicants. I'm sure your experiences will also serve you well in that regard. There are a number of schools (some very well respected) that don't have a hard requirement for patient-care experience hours, meaning that other aspects of your application may make up for less experience at those schools. I was able to use what few hours I had when I applied (basically a couple hundred hours of volunteer MA experience, since I didn't use my Army CLS experience) to get multiple acceptances, so I can point some of those schools out for you if you like; I did go on to get an additional 1000 hours of direct PCE before I started PA school, but I was already accepted at that point. It's not popular advice on here to apply without a lot of PCE hours, but depending on your GPA and other aspects of your application, you may have success in getting in without having a ton of hours. You may be able to get some hours using your EMT-B certification, either serving as an EMT or using your cert to get a job as an ER tech or something. If you are trying to apply this cycle, just keep in mind that timing matters, and admissions deadlines for some schools will be hitting soon; you generally want to apply as early in the cycle as possible (at least for schools with rolling admissions) to maximize your odds of acceptance. If you are looking to wait until next cycle to apply, then you should have time to get an amount of PCE as an EMT/ER tech that will meet the minimum for most schools.
  14. I'm still a student, but one of my professors recommended the Case Files series for thinking through clinical scenarios. I've been reading the internal medicine one, and they start with a case presentation so you can think through what you think the diagnosis is and next best steps. They then work through the diagnosis (including a bit of the pathophysiology), differentials to look out for, labs/imaging to order, and treatments. Each case/chapter is finished out with a few questions, and some clinical pearls to remember. Here is the EM version, it may be worth looking into: https://www.amazon.com/Case-Files-Emergency-Medicine-Fourth/dp/1259640825 A couple of others that have been recommended for EM: https://www.amazon.com/Avoiding-Common-Errors-Emergency-Department/dp/1496320743/ref=mt_paperback?_encoding=UTF8&me= https://www.amazon.com/Bouncebacks-Emergency-Department-Cases-Returns/dp/1890018619 https://www.amazon.com/Tintinallis-Emergency-Medicine-Comprehensive-Tintinalli/dp/0071484809
  15. ProSpectre

    Why is it so important to apply as early as possible?

    Keep in mind that you can selectively submit your application through CASPA to individual schools on your own timeline throughout the cycle. So if you meet all the requirements for a given school now, then you can submit your app to that specific school (or schools) early, and simply hold off on submitting for the schools that you don't meet the PCE requirements for yet. Since there are often supplemental applications and other hoops to jump through (which I know is the case for UAB), it is my advice to apply to those you meet the requirements for now rather than wait until later in the cycle near the deadline when you may get overwhelmed by last minute stuff to do.

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