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Everything posted by dfw6er

  1. The class above me had like 1 drop....she left because she got pregnant and her spouse (also an APAP) took a 1 year LOA to help with the baby then joined our class. Another student took a LOA for personal reasons but joined our class. My class had one drop after needing emergent surgery during gross anatomy. We had one take a LOA when she got pregnant and I believe she joined the class behind mine last month. So yeah...it varies from year to year. My understanding is the attrition isn't usually due to an academic inability, rather life altering issues that come up. The toughest part of school is the didactics, especially the basic sciences. Once you're through that, it's actually much easier. The clinical portion is typically a breeze for the APAPs and their clerkship performance outshines the traditional 4-year students.
  2. I got that same question as well. I laughed and told them I worked exclusively nights, 55+ hours a week in my PA days because it paid better, less providers so I got my pick of more interesting cases, and lastly, no nosey admin folks around telling me I couldn't have a drink at my work station. That made them laugh.
  3. During a few of my residency interviews, I was asked how I thought residents would relate to me or how I'd get along with them and the faculty due to my age. It was kind of annoying to be honest....and felt a little like age discrimination.
  4. Bingo. There's a nurse behind this most likely. This is why it's important for PAs to get into admin roles so they can fight this kind of thing. Folks who are looking to get out of clinical practice in a few years ought to look into getting a master's of health care administration or an MBA degree and make some really money in admin.
  5. COCA seems to be tolerating it for now, but from what I've heard through the grapevine, they're not crazy about it because the lack of safeguards leave students in a bad position if a preceptor backs out at the last minute....where if the student were at a big teaching hospital another attending can step in if a preceptor leaves or backs out.
  6. Correct. And yes...COCA has apparently mentioned to LECOM they don't like APAP students setting up their own rotations, but they haven't forbid it yet either.....probably because APAP students have greatly outperformed traditional students on board exams, but that's just a guess. APAP students also tend to have prior work connections and often set up their rotations at sites they've worked at in their past lives as PAs. The preceptors still have to sign all the paperwork and be vetted by LECOM well in advance of the rotation beginning. I get the feeling that LECOM will probably do away with letting APAP students set up their own rotations in the future...but that's just my gut feeling. I could be totally wrong. Ultimately it'll be up to Drs. Feretti and Thomas.
  7. In the past APAP students were supposed to set up their own rotations. COCA seems to have had a problem with that so it appears that LECOM started encouraging APAP students to set up core rotation sites like regular 4-year students do. I honestly don't know what the official policy is now for the students who are in the last semester of their preclinical training. Dr. Kevin Thomas (at the Seton Hill campus) is the APAP director. If you're really interested, you can reach out to his office to see what he has to say.
  8. This is true. There is a stigma. Allopathic students do feel superior to osteopathic students....and part of that is due to the fact that it IS harder to get into MD school than DO school. No doubt about it. MCAT and GPA requirements are consistently less for DO programs. Then there's the whole USMLE vs. COMLEX issue. DO schools need to mandate taking USMLE steps 1 and 2 so all students can be equally stratified. A step in the right direction was the dissolution of separate graduate medical education programs in 2020...now all residencies are accredited by a single body, the AGME. But many of the programs that were formerly DO programs still allow osteopathic applicants to apply with COMLEX scores and allow allopathic students to apply with USMLE scores. It's just not equal. The COMLEX is an easier test with less precision and a wider confidence interval on scores than the USMLE. I scored in the 98% on my COMLEX Level 2 and 85% on my USMLE step 2. It's apples to oranges. With the 2020 combined match, DO match rates were around 90% while MD match rates were like 94%...so there is still a mild disadvantage to matching as a DO. The problem is the old guard DOs in charge of the DO schools, COCA, and NBOME...they won't go quietly into the night...they're going to fight tooth and nail until the end to preserve the DO distinctiveness.
  9. That's actually a really good idea. I'm stealing that.
  10. We'd withdraw 0.6mg/kg of decadron from the vial into a syringe, then mix with apple juice and have kids drink if for croup exacerbations in our ER. Worked great and admin never gave us a hard time about it either.
  11. Yup... data shows the therapeutic ceiling for IV toradol is 10mg.
  12. Because RNs don't report to SBMEs....they report to nursing boards.....and you know those nursing boards are all about expanding practice/financial opportunities and they have no doctors to tell them "No".
  13. Care to share the article? I'm kind of curious about how the PA profession is faring in other countries.
  14. My wife and I woke up with a bat in our bedroom 2 years ago so we both got vaccinated. Vaccine wasn't too bad, but the HRIG was.
  15. I voted based off what I was getting prior to starting school. Our night shift differential was and extra 10%. Plus we got OT (1.5x) base wage after 8 hours.....and we worked 10-hour shifts. So working nights exclusively wound up being a really nice chunk of change by the end of the year.
  16. All I've had since Adacel was initially released was the Tdap. I figured I'd rather have some protection against pertussis for my own comfort and, since I'm around neonates regularly, to potentially protect them too. I think I've had 3 of them....the third was because I had to have documentation of current tetanus vaccination and couldn't find documentation from my second Adacel.
  17. So the goal isn't to eventually get the patient off Suboxone, but to keep them on it permanently? Sounds no different from all the methadone clinics I've seen over the years.
  18. Our school admin told us COCA (regulatory agency for DO schools) mandates that only a physician can precept us on clerkships. IDK if the same is true for allopathic students or if my school was lying and it's really just my school's policy. I do know that my physician preceptor may elicit feedback from anyone I had interactions with during my clerkship, but each and every clerkship evaluation must be completed by the physician preceptor....and the preceptors are identified ahead of time and are known to my school's clinical education department. We are told to notify school if we're not getting supervision from a physician on rotations so they can remove that site from their clerkship list. Yeah, I agree that a very experienced PA (15-20+ years) can deliver excellent care to the vast majority of ED patients, but that's the exception, not the rule. I think all but the very rural, hard-to-recruit-physician ERs, benefit from having boarded EM docs on staff. I don't think EM PAs will replace EM physicians in most ERs as one person posted in this thread....if anything you'll be seeing more and more BC docs in the future as more and more EM residencies are popping up all over the place (CMG-administered like Kaiser and HCA). And again, I'm a huge fan of the PA profession and will continue to advocate for PAs....this is just how I'm seeing things now having been through both PA school and now about to graduate med school in the spring.
  19. The truth is usually the best policy, but most employers don't care if you've failed an exam as long as you're eligible to work and thus eventually passed.....but I'd point out that the question seems to be aimed at physicians as they have oral and written boards for their specialty which are taken at the completion of their residency. Technically your PANCE is not a board exam....it's a national certification examination. As a PA, you're licensed to practice medicine by your state board of medical examiners or state board of PA examiners. That being said, the prospective employer will likely go to NCCPA's website to verify you passed the PANCE. IDK if NCCPA discloses PANCE failures to employers or not. I suppose you could call NCCPA and find out. If all the employer gets is a date of passed PANCE then you technically have nothing to disclose. I think folks who might care about past PANCE failures would include PA post-grad training programs or, if you wanted to go back to medical school, the ADCOM would likely care.
  20. This is why contracts are important. Time off is time off..... everyone both needs and deserves it. Many corporations have enacted policies stating employees are not to check email or use company smart phones after hours or on weekends. Don't let your employer strong-arm you into doing extra work on what little time off you have, especially if you're not reimbursed for it. Work-life balance is worth fighting for. You went to grad school for your degree and profession and you deserve better.
  21. You really can't replace BC EM physicians in high acuity ERs. Low volume rural places maybe as many of them transfer out complex cases anyway. By definition, Level 1 and Level 2 trauma centers can't be staffed solely by PAs....they must have BC/BE EM residency-trained physicians on staff working there. Heck Level 1 trauma center rules dictate that only BC/BE EM-trained physicians are allowed to run traumas....so FM docs who work EM can't see the traumas, let alone PAs. The amount of dedicated pediatric EM training EM physicians receive in residency is considerably more than any PA would receive in PA school and more than any EM PA would get on the job unless they worked in a dedicated pediatric EM....and most of those are constantly rotating in EM residents and have pedi EM fellows staffing them so the PAs & NPs don't get to do much of the high acuity care at those places. The amount of surgical critical care and intensive care training EM docs get in residency vastly outweighs what little EM PAs receive as well. I really don't think anyone but the top 1% of PAs could come close to treating complex, critically ill/injured patients as well as a BC/BE EM doctor. But there's too much complex stuff that regularly shows up in the majority of ERs to think that your average EM PA is as capable of evaluating and treating just as well as a EM physician. You might like to think otherwise, but you're deluding yourself. I was definitely a well-above-average EM PA, and my technical skills are on point, but after learning all I've learned in med school, I know now that I was woefully undereducated compared to the physicians I worked with in my shop.
  22. I'm not sure what medical students you've been "precepting" but at my school they'd never. in. a. million. years. allow anyone but a physician to precept medical students. Sure a NP/PA might be on the service the med student is clerking on that month and might help teach a med student, but credentialing bodies for med schools will not allow anyone but a physician to be the preceptor for med students. See there's a difference b/w PAs and NPs. PAs are following the medical model when it comes to CME and recertification. I don't think it's enough to just maintain CMEs...especially when it's so easy to accumulate low-quality category 1 CME. Having to recertify with periodic standardized exams makes sure the PA or physician has basic competency to practice safely. If NPs are just doing easy nursing contact hour CEs, then what safeguard is in place for the public?
  23. I took a rural health clinic gig several years back and applied/was awarded a NHSC loan repayment, allowing me to pay off my loans with one check. It felt amazing and helped bump my credit score as my debt:income ratio was improved. It also opened more opportunities for me professionally as I was able to focus on paying off CC debt and save more so I could move to the west coast and take a lucrative job for really big $$.
  24. Yeah, my understanding is, IIRC, ACEP/ACOEP and other EM interest groups have argued that the extensive trauma training and routine traumas EM residents receive is well above and beyond the scope of ATLS and therefore they shouldn't be required to repeat ATLS regularly like non-EM boarded physicians. And, I believe, ACS (who certifies trauma centers) agrees with that. I can tell you that virtually every EM residency I've looked at as I'm getting ready to apply this fall has their EM residents go through ATLS, PALS, ACLS, and some even add NRP, APLS at the beginning of their PGY-1 year. So at least the younger residents have had ATLS....they're just not required to keep up that cert....and honestly don't really need to keep it current if they continue to work in a shop that sees a decent amount of trauma.
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