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ProSpectre last won the day on October 28 2018

ProSpectre had the most liked content!

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About ProSpectre

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    Physician Assistant Student

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  1. ProSpectre


    I'm a little surprised where this thread has ended up, and I must say the personal attacks are a bit disheartening. I believe pretty strongly in patient autonomy and the freedom of patients to make their own medical decisions, even if those decisions aren't what is recommended by their health-care provider or what is best for their health. However, when that decision-making may result in inadvertent harm to other patients or other members of society, I think it changes the issue. JMPA, you keep mentioning "Immunology 101" -- I'll do you one better, and include a quote from the text used in my upper-level immunology course (which is also the same text used by my university's medical school to teach immunology). The text is Janeway's Immunobiology, 8th Ed. This quote comes from Chapter 16: Manipulation of the Immune Response (specifically section 16-21 on page 700): "A successful vaccine must possess several features in addition to its ability to provoke a protective immune response (Fig 16.23). First, it must be safe. Vaccines must be given to a huge number of people, relatively few of whom are likely to die of, or sometimes even catch, the disease that the vaccine is designed to prevent. This means that even a low level of toxicity is unacceptable. Second, the vaccine must be able to produce protective immunity in a very high proportion of the people to whom it is given. Third, particularly in poorer countries where it is impractical to give regular 'booster' vaccinations to dispersed rural populations, a successful vaccine must generate long-lived immunological memory. This means that the vaccine must prime both B and T lymphocytes. Fourth, vaccines must be very cheap if they are to be administered to large populations. Vaccines are one of the most cost-effective measures in health care, but this benefit is eroded as the cost per dose rises. Another benefit of an effective vaccination program is the 'herd immunity' that it confers on the general population. By lowering the number of susceptible members of the population, vaccination decreases the natural reservoir of infected individuals in that population and so reduces the probability of transmission of infection. Thus, even unvaccinated members will be protected because their individual chance of encountering the pathogen is decreased. However, the herd immunity effect is only seen at relatively high levels of vaccination within a population; for mumps it is estimated to be around 80%, and below this level sporadic epidemics can occur. This is illustrated by a marked increase in mumps in the United Kingdom in 2004-2005 in young adults as a result of the variable use in the mid-1990s of a measles/rubella vaccine, rather than the combined MMR, which was in short supply at that time." I apologize for the length of this post, but I figured I'd provide the entire passage since a good overview seemed important, rather than cherry-picking a single sentence.
  2. This probably isn't exactly what you're looking for, but Radiology Masterclass (https://www.radiologymasterclass.co.uk/) would be a great adjunct to the UVA tutorials. It's a UK website, but there are solid tutorials, practice films with various pathologies, and some quizzes too. They also have courses you can pay for, but the free content is pretty solid for self-study.
  3. I understand why NPs have progressed so far in the healthcare field. What I don't understand is why PAs aren't using the success NPs have achieved to our advantage. Obviously we have limitations they don't (namely, that we're regulated by the medical board and they aren't), but it still seems that we could slowly chip away at some of the useless legislative red-tape that is holding PAs back if we simply focused our lobbying efforts on gaining parity with NPs by highlighting our better (or more standardized) training. Functionally, NPs and PAs do the same things in many settings, and yet we are restricted in areas where they aren't -- this seems like a relatively easy case for lobbyists to make to legislators. A good start would be to focus on the VA, which is the largest single employer of PAs and yet has granted full-practice to NPs while PAs are still required to work under a supervising physician.
  4. The specific degree name doesn't matter at all as long as the program confers a master's degree and is accredited by ARC-PA. Any residencies/fellowships out there will only care that you graduated from an accredited program and could sit for (and pass) the PANCE. I wish PAEA would just standardize the PA degree with a single name (like Emory & Mercer's MMSc, Master's of Medical Science), but that may not ever happen.
  5. ProSpectre

    General Chemistry requirement!! HELP!!

    Your best bet is always to contact specific programs you'd like to apply to for questions like these. Having said that, PA programs generally require all prerequisite science courses to be those designed for science majors (rather than nursing or allied health), meaning the courses you took likely won't work for many (if not most) programs. You'll probably have to take General Chemistry I & II at least, and most schools require at least 1 semester of Organic Chemistry as well, with some requiring Biochemistry (though this isn't universal). On the plus side, you've had some exposure to chemistry already, so you'll be ahead of the game and should be able to rock those classes, which will look good when it comes time to apply.
  6. ProSpectre

    Residency VS Doctorates

    I think for an early career PA, doing one of the established residencies/fellowships will pay off more in the short term than a doctorate since it will actually increase your exposure to managing sick patients while improving your clinical acumen. You can always work on a doctorate (like the DMSc or DHSc) over the next few years while you work and make money; Lynchburg's DMSc will actually take completion of some residencies into account as well, which is a win-win (here's hoping other programs take note of this model and expand on it). I don't think residencies will be an absolute requirement for PAs for the foreseeable future (there simply aren't nearly enough of them right now), but for the astute new grad, I definitely think it's the way to go. I plan on doing both eventually, but my focus will be on getting into a residency as a new grad, and the doctorate will be done when the time is right.
  7. ProSpectre

    New DMSc program in Oregon

    Honestly, I knew this would be happening sooner or later (and I was betting on sooner). I understand there are strong feelings on both sides of the fence, but I don't think it is anything that can be stopped. Regardless of your thoughts on degree inflation, doctorates add legitimacy in the eyes of the public and in the eyes of legislators, which is why so many health professions have been moving that way over the last couple decades. Pharmacy, Physical Therapy, Occupational Therapy, Audiology, Nurse Practitioners, etc have all made this transition to the doctorate as their standard in the last 20 years or so. There have been arguments for years that the current PA master's degrees already require enough credits to qualify for a doctorate; my program clocks in at 120 credits (which is average), and this is well over what is required for the DPT, DNP, DrPH, etc at my school. As far as it being the same length of time as medical school, it's 3 academic years (by number of semesters), not 3 calendar years; plus it still doesn't require a residency, so the pathway is still much shorter. The tuition is high, but unfortunately not any higher than many of the current master's programs, and those students won't have to worry about going back and getting a DMSc later like many current PA students across the country will likely end up doing.
  8. ProSpectre

    Statistics on PA residency advantages??

    Without more information, I don't think anyone can give you a solid answer. The fact that it's brand new shouldn't necessarily be a deal breaker (every program has to have a first class). A good residency should have protected academic time, off-service rotations (in specialties like optho, ortho, peds, ENT, neurology, critical care, etc), graduated responsibility (with the ability to see patients of all acuities, not just low acuity or fast-track patients), along with a well defined curriculum (ideally with courses like ACLS/PALS/ATLS/FCCS etc included). The Society of Emergency Medicine PAs (SEMPA) has good resources on what a post-graduate training program in emergency medicine should cover for PAs: https://www.sempa.org/professional-development/postgraduate-training--practice-guidelines/ If it is simply less pay to staff their ER with no off-service rotations, or no defined academic structure or competencies to meet, then I would probably pass.
  9. ProSpectre

    Service Academy Struggle!

    Like MT2PA mentioned, the first 3 years of a 5 year program is not PA school -- it is simply the undergrad portion required to get to PA school (so for colleges that have these programs, they can cut out the extra liberal arts portion of the degree and just have their students fulfill the degree requirements and prereqs for the grad portion). The reason these programs can exist is because the undergrad courses at their schools are a known entity, so they assume students who make it through the first 3 years of the undergrad portion of their program will be able to handle the last 2 of the professional portion; students in the undergrad portion of those programs don't get much say in their schedule or course load, and they usually must meet stringent grade requirements to move on to the professional portion. I'm not a huge fan of these programs, but they aren't exactly an easy away out. I do think that having gone to a service academy will absolutely be beneficial when you are applying to PA school though, since it will set you apart from most other applicants; military service is also valued by many schools as well considering the history of the profession and the strong record of military trained PAs. However, I say that with a strong caveat -- it will only be beneficial as long as you are an otherwise competitive applicant, meaning you have ALL the prereqs that are required, good grades and at least meet minimum PCE requirement for schools you apply to (and preferably more). If your grades are weak, it is going to be much harder for you regardless of where you completed your undergrad degree; plenty of people work full time or compete as division 1 athletes while completing STEM degrees too (with solid grades), and the ones that are able to do those things and still do well are the ones that have a leg up when applying. You may just have to take the extra time after you graduate to finish additional prereqs for PA school, and you'll probably have to find a way to get some PCE too (or just apply to IPAP). If you really want to be a PA it is definitely doable though, and you'll be stronger for having made it through your current situation on your path there.
  10. ProSpectre

    North Dakota Closer to OTP

    Kaepora, I think you are conflating the issue a bit here. The lack of a legal document tying a PA to a specific supervising physician is not the same as turning new grads loose unsupervised. New grads will still be working closely with the physicians (or experienced PAs and NPs) in their practice, just like they do now. I honestly doubt much will change in the way PAs practice, but it will be easier to hire PAs (less paperwork), and there won't be threat to a PA's livelihood if their supervising physician moves, retires, dies, or loses their license. I don't think anyone here is advocating for turning inexperienced clinicians loose to work unsupervised. Like mentioned above, the medical board (which still regulates PA practice) would still require PAs to work in established practices, so new grads won't be graduating one week and opening a new clinic all alone the next.
  11. ProSpectre

    Why did you choose PA?

    I thought being a PA would be a good balance of what I liked about medicine (the science, diagnosing and treating patients) without some of the (in my view) negative aspects like the heavier focus on research. Another large factor for me was money, unfortunately; I'm using VA benefits to pay for PA school, and I didn't think they'd cover medical school (not sure if this was the right call, but it'll be nice graduating with very low student loan debt). I was also a little older when I began this journey (started PA school at 31), so age did play a part in my decision. I'm still a second year PA student, and while I don't regret my decision, I am also one of those who are on the fence about whether I should have went to medical school; I had the grades for it and completed all the med school prereqs (except physics) while preparing for PA school, so I do wonder sometimes if I made the right call. I haven't completely ruled out med school yet either, though it's not likely. I plan on doing a residency and giving this PA thing the best shot I can. Overall, I think being a PA is a great career, and I'm hopeful that I can find a niche that I'll be satisfied in.
  12. ProSpectre

    North Dakota Closer to OTP

    Just throwing this out there Boats, but according to the newest PAEA program report, the average age of a first year PA student is about 26, which means the average age of a newly practicing PA can't be any less than about 28. The average PCE hours is still around 2,900 (with a median of 2,300). There are of course younger students in some programs, but they are in the minority, so the "typical new PA grad" is in no way a 25 year old with no life experience. As an older student with a military background myself, I understand the value of life experience, and I can appreciate your desire to hold on to the "traditional" PA school admissions model; I also understand why you view the changes currently being pushed for in our profession with suspicion. But you shouldn't sell your future (and current) colleagues short by assuming that anyone without your specific background will be too immature to understand the gravity of their position, to ask for help when they need it, and to practice within the scope of their training and experience.
  13. ProSpectre

    North Dakota Closer to OTP

    Boatswain, I'm a bit confused about your statements in support of OTP. There are four tenets of OTP, and one of the four is the removal of a legally-mandated supervisory agreement with a specific physician. This is so that practice level decisions about the level of supervision can occur, rather than being state mandated; if the practice wants 100% chart review and every patient presented to an attending, then they can still do so. See the second bullet point from AAPA's OTP webpage: The new policy calls for laws and regulations that: Emphasize PAs’ commitment to team practice; Authorize PAs to practice without an agreement with a specific physician—enabling practice-level decisions about collaboration; Create separate majority-PA boards to regulate PAs, or give that authority to healing arts or medical boards that have as members both PAs and physicians who practice with PAs; and Authorize PAs to be directly reimbursed by all public and private insurers. PAs will remain employees subject to all of the practice-level rules put in place by their given employer. I think it is also important to note that this change in ND wouldn't allow PAs to just open their own clinics and practice independently of a physician; it was specifically mandated by the medical board that their support hinges on PAs working within established practices, meaning the team model would still be preserved. They just wouldn't be tied to one specific physician, but rather could collaborate with any physicians in their practice (eliminating any issues created when their legally mandated supervising physician moves, retires, dies or loses his license).
  14. ProSpectre

    Incoming Students, Be Advised, Be Aware!

    ARC-PA is the PA accrediting body (not PAEA), and it is indeed against the standards of accreditation to require students to solicit preceptors or set up their own rotations (at least for required rotations). Per the most recent Standards of Accreditation from ARC-PA: "A3.03 Students must not be required to provide or solicit clinical sites or preceptors. The program must coordinate clinical sites and preceptors for program required rotations. ANNOTATION: Coordinating clinical practice experiences involves identifying, contacting and evaluating sites and preceptors for suitability as a required or elective rotation experience. Students may make suggestions to principal faculty for sites and preceptors but are not required to do so. Student suggested sites and preceptors are to be reviewed, evaluated and approved for educational suitability by the program." - Source: Page 12-13 http://www.arc-pa.org/wp-content/uploads/2016/10/Standards-4th-Ed-March-2016.pdf If the program isn't meeting these standards, then they risk being placed on probation and subsequently having their accreditation pulled if the issues still aren't fixed. If these issues are resulting in students getting poor rotations or having graduation delayed, it may be worth it to bring this to the administrations attention; I can't imagine they are unaware of these standards, which is a huge part of running a program, but it may light a fire under them if they know students are aware and liable to contact ARC-PA, which could result in an audit of the program.
  15. 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.

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