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Even more important, are there any studies evaluating the effect of prior experience on success as a practicing PA? Not sure who would be interested, because that's not how schools grade themselves. I can tell how much my prior experience as a firefighter/paramedic has helped me as an EM PA. However, 25% my graduating class from PA school went into EM. None of the rest of them had EMS experience. I also have no data on how well they're doing, what accuities they see, etc.

My experience is that PA schools don't care about what degree you have, but do have specific requirements for pre-requisite courses, usually pretty much the same as the pre-requisites for medical school. For example, my undergrad degree is in computer science (yes, back in the days of punched cards), but all that mattered was my GPA, whether I had taken all the pre-reqs within the 5 years preceding my PA school application, and what those grades were. A quick check of multiple PA schools' web sites should give you a good feel for how to proceed.

I was trained in Ohio. The PA practice laws there specifically forbid a PA from performing or assisting in abortion and also from prescribing any medication for the purposes of inducing an abortion. I spent a large portion of my life in corporate American before becoming a PA. In the 1980's we had lots of diversity training. In those days the focus was on gender and race issues. I saw one "world" in my colleagues in corporate American and an an entirely different "world" in many of the the people I encountered who needed the services of the fire departments I belonged to. My take was that I had much more in common with my corporate co-workers in terms of lifestyle, goals, aspirations for our children, etc. even if we were of different race, gender, religion, sexual orientation, etc, that with many of the folks I made runs on even if they were of the same race, gender, sexual orientation, etc. It seemed to me that similarities in economic situation dwarf other differences, probably because of education, goals, etc. Many of our trainers weren't interested in that perspective.

I don't do peds EM, I do general EM, which includes a fair bit of peds. The peds EM sites I've researched had a pretty limited scope of practice for their PA's: low acuity and lots of simple procedures. By comparison, I've handled much sicker kids and more complicated procedures on kids: joint and fracture reductions and complicated repairs in a general ED.

Slight sinus arrhythmia? That's the only thing I can see.

Another point, not all program directors value paramedics as good candidates for PA. If I recall correctly, one program director who posts on these forums stated that he felt paramedics tended to narrow their differential diagnosis too quickly and consequently he felt that they were more difficult to teach. Whether or not that belief is true globally, I believe his statements represent what he's come to believe based on his personal experiences. Therefore, that figures into his decision making.

Please remember the golden rule: them that has the gold makes the rules. Because of the position they hold, the program director gets to make the final decisions on who is accepted into their program. Different directors have different ideas about what sort of students they want in their program. Since people with all levels of healthcare experience and varying levels of GPA, GRE scores, and interview performance all manage to get into PA school and pass PANCE, there's no good data to support or reject any particular set of thresholds. More importantly, there's no data at all measuring who becomes a "good" PA. For example, my PA school class of 40 ranged from 21 year olds with minimal health care experience doing a combined 3+2 BS and MPAS program to a 53 year old with 30+ years experience in EMS with many years as a paramedic. 39 finished the program, 100% of these passed PANCE on the 1st attempt. School patted themselves on the back. I believe 38 of the 39 are still practicing. Again, no data rating these folks after X years of working. If the same school had picked a different set of 40 from their pool of applicants for that year would they have had the same results - probably but unknowable. I can't speak to the decisions made by the people and program you're concerned about. In particular, I don't know what if any sort of interview process was held and how these applicants performed there. So, you could be right - or not. Most likely, all of the applicants were good enough to do well in PA school and pass PANCE if they were above some basic thresholds, so in a way, the school is OK no matter who they pick as long as they avoid those applicants who just aren't ready.

Are you raising a question that there will be a selection bias in this study, because the principal investigator is using students in whose selection he had a major influence? Are you asking if there is a bias because the research is being funded by a company who profits by selling tests, so they have a vested interest in an outcome that would tend to support a product they ultimately market? From reading your attachment, it sounds like there is very little out there which shows much correlation between various quantitative measures, such as test scores, and performance on PANCE. That's the real goal here: PA schools are graded on 1st time pass rates for students taking the PANCE, so they want to only admit students that will do that. I didn't see anything in your attachment which spoke to any rating system for prior healthcare experience, only to grades and test scores. There is a wide variety of practice in how PA school admission processes value prior healthcare experience as well as how they do their interviewing or other assessment of the applicant's interpersonal skills. There's no data that I'm aware of that correlates any of this to success as a practicing PA.

There are web sites that will help you convert IDC9 to IDC10 codes - would that help?

A quick internet search did show jobs, including primary care, in Michigan that said they would take a new grad. Don't know if any of these were ones you have contacted or are in areas you've looked. Some other suggestions: - check with the state PA society, often they have job postings - check with Michigan PA schools - see what jobs they have posted for their grads - those will be new grad friendly jobs - consider other fields, e.g. urgent care

@SteakPA: what was the dosing of the NAC? Were you recommending the OTC dietary supplement? How long before the patient began to notice a difference if it was going to work for them? Thanks!

Evaluate for superinfection. One way to tell that it is really neurotic excoriation is to make sure the lesions are only in places easily accessible to the patient's hands.

What happens when something unexpected happens and the procedure has to be converted to an open one immediately? With a DaVinci robot at least the surgeon is in the room, albeit not at bedside. Who will take over in that setting?

One of the most important things in dealing with patients is sincerity. Once you learn to fake that, you've got it made. I mean this only partially tongue in cheek. Here are some techniques I use: - I acknowledge their worries and try to calibrate them by saying which s/s are probably not concerning, which ones might be, and which if any are. - I share my thought processes with the patients, family, and staff by talking through them out loud while in the room: "we're going to do X testing, Y imaging, and Z initial meds for S/S management." That gets everyone on the same page, and implicitly shows that I have a plan, including contingencies. - As I do my H&P I share the significance of what I'm seeing, feeling, and hearing: helps the patient know how things look, and also implicitly shows them that there's a thought process running. - I set expectations about what we'll rule in, rule out, and leave unanswered. I do EM, so an answer of the form that we're not sure of the diagnosis, but it's not immediately critical and further workup in the outpatient setting is sufficient. Tone of voice is very helpful. Think of what tone you'd use to console a scared 4 year old - use that with patients.

Fortunately, I'm in the grandparenting stage of life. In my prior FT job I worked 15:30-01:30 and seldom got out before 03:00. While I did get home before my wife left for work I left before she got home. We had lots of days when we were in the same house only for a few sleeping hours. We're actually seeing each other more when we are simultaneously awake with my new job than my old one. I do lose most of the day I travel home, because I get off work, shower, and then drive home. I pretty much hit the recliner until bedtime, but the next day I'm pretty much back on daytime schedule.