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acozadd last won the day on May 24 2010

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  1. My last NP student wasn't able to even accurately identify which bone was the tibia vs. fibula at the end of the rotation, let alone identify the fracture, discuss treatment options, etc. She is a few months away from graduating... She was the only NP student I've had so maybe my experience has been skewed by 1 bad example, but it was scary. I have more confidence in the scribes at my office compared to her. I'm sure her "years of high quality prior HCE" will help her at some point, but it wont be in an orthopedic office...
  2. I agree with the read, read and read some more comments. If you enter a specialty, read the biggest books around for those specialties. Once you've read all the texts, stay up to date on recent research. In ortho, I've found no single text has all of the information that I want. Instead of having 10 texts nearby, I've created an easy to reference word document on my work computer that has a basic overview of all conditions I've researched thus far (now >250 pages after 3 years). It takes the best of all sources, along with clinical pearls I've picked up, and it's an invaluable resource. I started with the most common diagnoses in the first year, and now I have expanded it to everything. If I were to work in ED, I'd pick the top 25 diagnoses and learn EVERYTHING ever written about them. Once you have these mastered, move on to other diagnoses.
  3. I see equally "well thought out" referrals from MDs, PAs, and NPs. "Well though out" is a general term meaning sometimes they get the body part right...
  4. EMED- worst student I ever had was an RN. The scribes in my office ran circles around her... Only further cementing the fact that prior HCE is a great foundation, but does not necessarily make you a better student or better provider.
  5. Work in Ortho. Here are the most common complaints... 1) I don't want to work 2) I'm allergic to all NSAIDs and weak pain meds. Only oxycodone/dilaudid works for my vague, chronic, subjective symptoms 3) Did I mention this is work related? Here's my work comp paperwork Mix in a smattering of legit injuries and complaints.
  6. I work in general ortho, but our group did have an ortho spine surgeon for a period of time that I scrubbed a few cases with. My general observations were that the cases were long, tedious, boring. The patient population is unvaried and often unpleasant. With that said, some people love it and I believe that it is a very well compensated specialty that that may translate into better PA salaries. Perhaps my opinion is a bit jaded because I REALLY enjoy general ortho, so take my comments with a grain of salt.
  7. Re: PA's taking med school validates PA school. I'm not sure how you can claim otherwise, but I am willing to hear your opinion. A common knock on "midlevel" education is that it doesn't cover topics in the same "depth" and that a "midlevel" could not survive medical school courses. If you do not take courses with med students, it becomes an opinion vs. opinion debate. But if you have taken courses with med students, you can say - as a PA I took courses alongside med students at the same depth of detail and not only did I survive but my average was significantly higher than the med student average. If you can speak on a topic with first hand experience, your opinion is now backed with substance.
  8. db_pavnp: Subjecting PAs to med student coursework legitimizes the PA education, and taking the coursework alongside med students encourages collaboration and discussion, which is ultimately the goal in practice. By no means is it abusive. In general, the coursework (again, we took pharm, renal, pulm, etc. with the med students) was not significantly different than any other of the other coursework experienced during PA school. It probably amounted to a few additional lectures per system, spaced out over a longer duration of time. My average on those exams was probably a few points higher compared to the PA coursework exams.
  9. Boatswain2pa- I completely agree with your post. In ortho, I read 100% of my own films, and 100% of films that have been previously read by a radiologist and referred to me. I've had way too many incorrect reads come my way to blindly trust a radiologist report. Was this taught in PA school? superficially, as it was to my med student counterparts. Now I look at musculoskeletal imaging daily, and I have the benefit of knowing the mechanism of injury and anticipated injury patterns. Most trauma reads by radiologists are too generic to be useful for treatment purposes regardless.
  10. Fact: Those courses were part of my schools curriculum. In those courses (The basic sciences), we generally had the same lectures given by the same lecturers as the med students at my school. Some were abbreviated from their original form. We did not cover all topics in the depth that they did, as mentioned above. If those aren't facts, what would you call them? I have no reason to lie about it... At the end of the day it is about being a competent and well rounded provider, regardless of what is ultimately tested on the certification exam. Your point sheds light on the fact that perhaps the PANCE needs to be revamped, as opposed to schools cutting important coursework. How do you find a PA taking mirco, immuno, etc. implausible? I find this whole conversation ridiculous. "We took these courses." ... "No you didn't."... ok?
  11. db_pavnp: Your question has changed, so which is it? First you claim PAs are avoiding those courses. Then when presented with facts claiming otherwise, your post is defensive stating that PAs are "claiming equivalent training." I did not make that claim. I merely stated that my program did not "avoid" these courses. In fact, we had dedicated courses for each listed aside from biochemistry, which was incorporated into a pathophysiology course, along with being a required pre-req course to enter the program. I never claimed equivalent training, but I did state that we had the majority of the same lectures presented by the same lecturer as the med students. There were certain instances where they would breeze through a slide and say "don't worry about this, but it's there for completion sake." AKA here is the kreb cycle. If you were a med student, I'd make you memorize and then shortly forget every step like you already have in undergrad. However, in PA school we were tested not on specific steps, but general input-->output. We did not fully cover the minutiae needed for step I.
  12. All of those topics were covered in PA school as dedicated courses. I cannot compare the level/depth they were taught at compared to the med students, because we took these during the summer while the MS1s were on summer break, but as I mentioned before, we had the same professors and often same powerpoints. There was probably consideration as to what information was vital/clinically relevant, and the information that was trivial but necessary for STEP 1, but that's an assumption. FWIW, in ortho none of those topics are clinically relevant ;)
  13. db_pavnp-- in response to your quote (for some reason I am not able to use the quote function lately)... My program also took a significant portion of our coursework with the med students, particularly second year students (pharm, surgical skills, renal, pulm, etc.). Our general science lectures were generally by the same professors that taught the med students, with the same powerpoints. That includes anatomy, etc. Like the poster above, we had 4 hours of extra lecture per day compared to the med students, and our expectations for "passing" was an 80% vs. their 70%. Since anatomy, physiology, and pathophysiology are an integral part of medicine, it only makes sense that our standards should be no less.
  14. EMEDPA- Your patient is a 27 year old male with an acute onset of hand/wrist pain with subjective instability following trauma. The respiratory therapist has stabilized the airway, and the medic found a tree branch to splint it for comfort... now what?
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