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About ProSpectre

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    Physician Assistant Student

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  1. I think you and CoastalPalm may be getting caught up on debating the articles, but there is evidence that replacement of clinical hours with simulation is at least allowed, if not actually happening. I posted earlier in the thread language directly from CCNE (with sources) that supports replacing some clinical patient contact hours with clinical simulation hours. The specific percentage the OP quoted was called into question, but the fact is that the accreditation standards do allow replacement of clinical rotation hours with simulation hours. Clinical simulation is a great tool and should definitely be used in medical education, but I think it is a tool that should supplement, rather than replace, actual clinical experiences. As I noted in my other post, I am not here to denigrate NPs or their education, and I don't support those (like the OP) who seem to raise topics like this simply to bash NPs. However, facts are facts. I think this topic elucidates the fact that the quality of NP education is quite variable, and that stated hour requirements posted by schools may not always be what they seem; some NP programs likely use clinical simulation appropriately to supplement clinical patient contact experiences, but there are other programs that may not be so judicious in its use.
  2. I don't think the article posted above is addressing what's being claimed by the OP. I also couldn't find any evidence that 50% of clinical hours can now be replaced by simulation, at least not as it's worded. However, according to the Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2016), it is allowed for NP programs to use clinical simulation to replace some clinical hour above the minimum required for accreditation. Basically, NP programs are required to have a minimum of 500 hours to be accredited, and clinical simulation can't replace any of that baseline 500 hours. But simulation can replace clinical hours above that 500 hour baseline requirement -- for instance, if a school says they require 750 clinical hours for their program, technically up to 250 of those hours could be completed in simulation. "Simulation is recommended to augment the clinical learning experiences, particularly to address the high-risk low-frequency incidents; however, simulation experiences may only be counted as clinical hours over and above the minimum 500 direct patient care clinical hours." From the Criteria for Evaluation of Nurse Practitioner Programs: see Page 12 http://www.acenursing.net/resources/NTF_EvalCriteria2016Final.pdf So it is possible for clinical simulation hours to replace clinical hours, but the percentage of clinical hours that could be replaced would depend on the specific school's clinical hour requirement. I'm fine with highlighting areas where PA education is stronger than NP education, which I think in general, it is. But we should be careful not to spread unsubstantiated claims about NPs or their education. Facts are our friends, rumors and hearsay are not. (The above site was found by looking at the 2018 Standards for Accreditation of Baccalaureate and Graduate Nursing Programs, which outlines on page 13 that all Master's NP programs must incorporate the Criteria for Evaluation of Nurse Practitioner Programs. Link here: https://www.aacnnursing.org/Portals/42/CCNE/PDF/Standards-Amended-2018.pdf) Post edited for formatting & clarity.
  3. Just saw this announcement from the AAPA. It looks like they are making progress on the title-change investigation by appointing a dozen PAs to an advisory council to serve as a resource for the firm that will be doing the investigation. The language makes it unclear if the specific firm has been chosen yet, but progress is progress, and results are expected at the 2019 HOD meeting so I'm sure they are making moves toward selecting a specific firm if they haven't already. It would be nice to know the specific thoughts of each of the PAs chosen to sit on the Title Change Investigation Advisory Council though. Either way, it's just nice to see steady movement on this topic. https://www.aapa.org/news-central/2018/09/pa-title-change-investigation-advances-selection-advisory-council-members/
  4. I just saw that as well. It appears to be written by a non-healthcare provider who doesn't really have a handle on the differences in training between a pharmacist and a medical practitioner. Not only do they take a jab at PAs and NPs with the line you quoted, they erroneously claim that pharmacists train for 5 years, failing to mention that 4 years (8 semesters) is pretty standard and that there are quite a few 3 year programs as well. Furthermore, the focus of what they learn is much different, and they get no training in conducting thorough H&Ps, forming differentials, making diagnoses, reading EKGs or imaging, etc. I have a lot of respect for clinical pharmacists as they are a great resource, but the role simply isn't the same. But hey, what do we know, we're just well-meaning PAs "playing doctor".
  5. The occasional B is not a big deal and is in no way a deal breaker; odds are good that you'll never be asked about them (if you don't have many, you won't likely be asked about the occasional C either). Your goal should just be to get A's as often as possible going forward (especially in any remaining prerequisite courses). Just keep in mind that while GPA is important, there are other things adcoms will be looking at more closely than a B in micro, like your patient care experience or the quality of your personal statement and LORs.
  6. Just received an email from the new AAPA president (a mass email, we aren't exactly buddies) outlining the important actions taken at the most recent Board of Directors meeting. They've "approved a preliminary project plan and funding to support an independent investigation of the physician assistant title and potential alternatives." They've designated an initial investment of up to $1 million dollars for the title change investigation, but are still in the process of identifying the specific firm they will hire to do the study. In the same email, they noted that "The Board also approved funding to support state chapters’ lobbying and communications efforts associated with the implementation of Optimal Team Practice (OTP), as well as The Six Key Elements of a Modern PA Practice Act..." and have budgeted over a half-million dollars for state chapter lobbying, advertising, and communications efforts. This is obviously paraphrased, and the email contains a little more detail. Looks like the new Board of Directors is already getting to work.
  7. ProSpectre

    Direct Entry (BS/MS) Programs

    I agree with Darcy in that I don't think a dual-degree program is a good idea in your case. Many of those programs don't accept transfer students and are intended for new freshmen without a prior degree (there are likely exceptions though), and they are definitely still competitive programs. The one at the undergrad I attended didn't even guarantee you acceptance to the program, it simply guaranteed you an interview -- that's a lot to hedge your bets on. Even more importantly in my opinion though, is that it would likely be extremely expensive to do it this way; one of those 5 year programs costs a quarter-million dollars in tuition, which is simply insane (others are less, but still extremely expensive compared to your other options). Most of those schools do have a direct-entry pathway for people that already have bachelors, but I would stay away from the idea of going through the bachelor's portion again. I think your best bet is to keep working on getting quality PCE and search for schools that you know will take your experience as a PT-tech. Take the prerequisite classes you still need for those schools (a community college or inexpensive 4-year school is fine) and make sure you get A's in them; then you can focus on retaking any other prerequisites you did poorly in. You don't have to do a traditional post-bacc to increase your GPA to become competitive; there are lots of people that simply create their own "post-bacc" by taking CC classes and are able to get in that way, probably saving a lot of money along the way. Finally, I wouldn't worry about retaking your GRE unless you scored significantly below 50th percentile in one of the sections -- a 312 is a good score and doing significantly better on the GRE isn't going to offset your GPA anyway.
  8. While the vote on the resolution occurred at the AAPA conference in May, the new AAPA leadership just took office at the beginning of July. That, plus the large sum of money that will be spent to hire these firms and the general molasses-pace most bureaucracies work at, means that it is likely still in the works. However, I don't think that is reason to believe it won't happen. There is overwhelming support for change right now, and I think the AAPA has woken up to it. These things aren't going to happen quickly, and the changes we want to see are much more likely to occur if more PAs add their voice (and their dollars) into the mix by supporting the AAPA and state orgs.
  9. ProSpectre

    More bridge programs?

    This is disconcerting to me. We aren't NPs, we're trained as generalists to take care of all patient populations. Besides, aside from the issues with ARC-PA accreditation, couldn't that be construed as a discriminatory practice? They should find rotation sites that allow male students (even if they have to pay preceptors), or they should have their accreditation withdrawn. The ARC-PA is pretty clear on this. From the ARC-PA Standards, 4th Edition: "Supervised clinical practice experiences used for required rotations are expected to address the fundamental principles of the disciplines below as they relate to the clinical care of patients." -- (page 21 http://www.arc-pa.org/wp-content/uploads/2016/10/Standards-4th-Ed-March-2016.pdf) The words emphasized in italics are theirs. The required rotations they're addressing are: "a) family medicine, b) internal medicine, c) general surgery, d) pediatrics, e) ob/gyn and f) behavioral and mental health care." You can't simply exchange a required rotation for extra time in a different specialty.
  10. Thanks for taking the time to write your representatives about the bill, I think it was a really strong letter. For future reference, and for others who read this thread, the form letter can be accessed on the AAPA news-brief page about HR 5506 (posted below); there is a link at the bottom of the page that takes you to "AAPA's Advocacy Action Center" (you must be an AAPA member, and it will ask you to login). The form letter is the second one down in the legislative alerts, and it can be accessed by clicking the envelope icon, and be edited/personalized by clicking the "view" tab once the template letter is pulled up (or can be sent as is). Of course, writing a personalized and informed letter is just as good (or arguably better), so however we can encourage people to contact their legislators in support of this bill is a win. News-Brief: https://www.aapa.org/news-central/2018/04/legislation-introduced-authorize-direct-pay-pas-medicare/ Advocacy Action Center (login required): https://aapapac.aristotle.com/SitePages/Take-Action.aspx
  11. That bill (HR 5506) is a really big deal, and I sincerely hope PAs are writing their legislators about it and encouraging their colleagues to do the same. We can't afford to forget about it and let it die on house floor. I wrote mine around the time that it was announced, and may do so again (I got a canned and likely automated response back, but that's probably the best you can hope for). For those who are interested, AAPA has a form-letter that you can edit/personalize that automatically sends to your legislator. Here is more info: https://www.aapa.org/news-central/2018/04/legislation-introduced-authorize-direct-pay-pas-medicare/
  12. 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.
  13. 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.
  14. 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.
  15. 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.

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