Education burden ridiculous

[rcdavis]

Hey knappy, lesh, and all you academs...

 

PA schools characteristically have a small core faculty.

 

They usually exist in previously built buildings.

 

They usually do not have student housing.

 

Most the books and equipment are a burden of the student ( and the hardware that is not paid for by the student usually is reusable for a 5-10 years cycle.

 

They do not pay for rotation sites.

 

The class size is creeping upward.

 

Why is it the cost of a PA degree is so gosh darn expensive???

 

Seems to me that is one of the most influential factors students have to consider when making practice decisions.. Geography and specialty be damned.. Where can I go, and what can I do to break this burden of my student debt.

 

If the government wants to increase practitioners in a certain field,,maybe they ought to make education to do that field... I dunno... Free?

 

Just thought before turning in after a loooong night.

[SocialMedicine]

I do not think the government needs to do anything to increase practitioner numbers by decreasing cost ... PA schools have people breaking down doors to get in. I believe Stony Brook had over 2,000 applications for a single class in recent years. Many PA schools report similar numbers. I feel many providers are going into general medicine ... even if they have a specialty aspect to their career many MD and PA see general medicine patients. I agree with Gordon PA and other members of this forum that the shortage of primary care is a bit of a myth and the actual shortage is limited to underserved and sadly often undesirable locations. The over saturation of medical providers will be correcting these issues ... people will have to accept less salary. It will not be a good situation for medicine in my opinion. The stress of medicine if practice correctly is high ... a lot of liability and dealing with personal situations most would be uneasy around. If the money is not there the qualified people with reasonable expectations will switch to other fields. I could walk into a health care consulting position at 100+ easy.

[SHU-CH]

A University functions a bit like a hospital. There are a few departments that are cash cows and many that struggle. Right now in education PA is red hot. The revenues raised by the PA department go to help support things like music, philosophy and English which might not be especially lucrative for the University but hopefully they help make a better society and are worthy of support.

 

I guess an analogy would be a hospital where the open heart program and the Ortho program raise the revenue that supports the clinic for indigent HIV patients...

[Boatswain2PA]

Yeah....and those revenues go to the ever increasing number of "administrator's" and tenure'd professor's salaries.

 

I have lost most faith in American academia. Perfect example of this is the educational encroachment of the PA profession. It used to be a certificate program, morphed into an AA program, then bachelor, and now master's....yet it teaches exactly the same thing.

 

Why isn't it a certificate program? Is there any evidence that AA, or BS, or MS trained PAs are better than the certificate trained PAs? Nope, none. But the universities can sure charge a LOT more money for the graduate education.

[LESH]

A University functions a bit like a hospital. There are a few departments that are cash cows and many that struggle. Right now in education PA is red hot. The revenues raised by the PA department go to help support things like music, philosophy and English which might not be especially lucrative for the University but hopefully they help make a better society and are worthy of support.

 

I guess an analogy would be a hospital where the open heart program and the Ortho program raise the revenue that supports the clinic for indigent HIV patients...

 

Well said. Completely agree Director Hanifin.

LesH

[LESH]

Yeah....and those revenues go to the ever increasing number of "administrator's" and tenured professor's salaries. I have lost most faith in American academia. Perfect example of this is the educational encroachment of the PA profession. It used to be a certificate program, morphed into an AA program, then bachelor, and now master's....yet it teaches exactly the same thing. Why isn't it a certificate program? Is there any evidence that AA, or BS, or MS trained PAs are better than the certificate trained PAs? Nope, none. But the universities can sure charge a LOT more money for the graduate education.

If you don't mind me asking, where did you go to PA school? Just curious. Thank you for your service.

LesH

[Boatswain2PA]

I went to a small, relatively cheap state university. But I have a pretty lengthy education history before PA school, including attending 8 other colleges/universities (plus dozens of military classes) and achieving a masters degree before Pa school as well.

 

Just one example of the failure of academia. I had to retake chemistry to apply to PA school because it had been so long since I originally took it, so I took a biochemistry class at a community college. Absolutely fantastic class because it was taught by a chemist who was working at a pharmaceutical lab, and teaching biochem at the CC at night. She was a great teacher because she knew her stuff...and she WANTED to TEACH.

 

Few years later I've retired and applying to PA schools....some require biochem but won't accept the biochem I took at the CC because it wasn't upper level. Okay, I'll retake biochem at the small state school (where I eventually do go to PA school at). The class was horrible! The professor had very little teaching ability and didn't give a rats a$$ about whether the student's learned anything or not. Worse yet, the teaching assistants didn't seem to care either, PLUS they could barely speak English. So why would this state "University" have this tenured professor who didn't care about teaching? Why did this tenured professor hire these horrible teaching assistants? Because in bigger "Universities" the tenured professors are not there to teach, they are there to do research which brings in grant money. That also explains why he chose these teaching assistants---they were not there to teach but to do their graduate research, which again brings in grant money. To give you an idea of how bad this class was, the first day of class there were about 150 students. Probably 125 students took the first test which was so ridiculously hard, and had virtually no correlation with what the professor covered or what was in the assigned chapters, that the next day of class only probably 50 people showed up. The rest dropped the class. Of course, the date was after the first "drop" date so these students could only get half of their tuition reimbursed. In the ENTIRE CLASS there was ONE "A" given, and it was given to a buddy of mine who is now in med school. I was only able to pull of a "B" because I had recently taken that great organic chem class from a CC in another state.

 

Then I took biochemistry at this same university and had a very similar experience with a different professor and teaching assistants.

 

I really think academia in this country is broken. Beyond the incredibly liberal political influence, it is growing increasingly expensive and often providing decreasing returns. Just look at the "CNA" classes. When I took my CNA almost 30 years ago it was a weekend class given at a nursing home. A local CC had just decided to give 3 college credits for the class. Now many colleges require a full semester load of classes before someone can become a CNA. They're teaching the same thing...why a full semester? Because they get more money.

 

It was my honor to serve my country, thanks!

[SHU-CH]

Boatswain -

 

I can't disagree with a lot of what you have said, but the move to the MS we mostly brought upon ourselves. I was in the AAPA House of Delegates when they were discussing the policy that the MS be considered the degree for our profession. I went to an MS program myself and I teach in an MS program now, but I never thought this was a great idea and rose to speak against it in the HOD. With the ARC-PA backing the MS, everyone is headed there. Educational institutions can see which way the wind is blowing and develop their programs accordingly.

 

As to the structure of American higher ed, most places are following a much more "business" model (as are many healthcare institutions). As more and more regulations get handed down, more and more administrators are brought on board to deal with them. I am a bit of a libertarian by nature, so where regulations are concerned I might be content to get rid of everything except the Constitution and start from scratch.

 

I'm not sure how I feel about tenure. I am not on the track myself and the best part of my job is being in the classroom working with the next generation of PAs. So unfortunately I don't have many answers for you. Just know that many faculty members share your concerns.

[rcdavis]

sooooo...

 

what would the cost of a PA education be, really, if the only fees associated with it were faculty salary, some equipage, rent, building maintainece, etc.. and it were able to divorce itself from being the "cash cow" which supports the fine arts department?

 

perhaps we should be thinking about that as we graduate students with 50-125k of debt.

 

and we should remember what happened in the 80s at MUSC, when the funding for the PA school decreased.. did they siphon off some funding from other graduate schools to help subsidize continuation of the MUSC PA school?

nope.

 

they closed it.

 

seems like the cash cow philosophy only works when WE are feeding THEM.

[HMtoPA]

Having attended both community colleges and a public 4-year university, I can agree with you 100% about the myth of superior instruction at 4-year institutions (at least by virtue of their "university" status alone). I actually think it's getting worse. My wife recently took an Anatomy class at our local CC, and she found it to be rigorous and challenging. I forget the qualifications of the instructor, but I'm pretty sure he/she was a PhD, and in any case clearly possessed mastery of the material, per my wife's report. She then took a Physiology class at the local 4-year (SDSU), since the CC didn't offer a section over the summer. Her instructors for the lecture portion were not even TA grad students (they were teaching labs, I believe). No, the class was being TAUGHT BY UNDERGRADS! They had to go through some sort of application process, but the only real requirement was that they had to have passed the course previously with a B or higher. It's the blind leading the blind! My wife said they were constantly mispronouncing anatomical terms, and if someone asked a question they couldn't answer, they would either give bad information or sort of redirect the class with comments like, "Oh, you don't need to know that," etc. What a joke. What's really sad is most AdCom's will automatically assume the class from a 4-year university to be superior.

[eddoc]

I am at a private school located in an academic medical center and our tuition is in the middle of the pack. That said, my total budget is $2.1 million (after the university takes its 45% off the tuition generated) with full-time faculty and staff costing $1.65 million per annum (including benefits). We pay for our faculty licenses, CME and certification costs. All of my faculty could make much more in clinical practice than they do now. Old building? Yes, but it takes that much more to heat and cool it. Free clinical year? No, we pay for our clinical coordinators and their staff support. The didactic phase costs more than we charge per student for that year: lecturers, lab support, cadavers, standardized patients, software, hardware, biohazard disposal, the list goes on and on. On the other hand, we don't pay for maintenance, utilities, communications, network support, malpractice coverage, legal counsel, lab upkeep, student finance, a registrar, document storage (transcripts must be kept in perpetuity), etc. Is it expensive? Yes, and it is probably true that student loan repayment is driving more students to higher paying specialty positions BUT I also have new NHSC grads who had a hard time finding placements.

[jorgea]

I believe the burden in the education for this field is only to increase with time. Thanks for sharing your latest thoughts on this theme here at http://www.physicianassistantforum.com

[rcdavis]

I am at a private school located in an academic medical center and our tuition is in the middle of the pack. That said, my total budget is $2.1 million (after the university takes its 45% off the tuition generated) with full-time faculty and staff costing $1.65 million per annum (including benefits). We pay for our faculty licenses, CME and certification costs. All of my faculty could make much more in clinical practice than they do now. Old building? Yes, but it takes that much more to heat and cool it. Free clinical year? No, we pay for our clinical coordinators and their staff support. The didactic phase costs more than we charge per student for that year: lecturers, lab support, cadavers, standardized patients, software, hardware, biohazard disposal, the list goes on and on. On the other hand, we don't pay for maintenance, utilities, communications, network support, malpractice coverage, legal counsel, lab upkeep, student finance, a registrar, document storage (transcripts must be kept in perpetuity), etc. Is it expensive? Yes, and it is probably true that student loan repayment is driving more students to higher paying specialty positions BUT I also have new NHSC grads who had a hard time finding placements.

 

So, for the privilege of being a part of the university, you get to pay 1.7+ million. And are left with 2.1 million...

 

What does the university provide you for that money?

 

My question is that it all seems to be a scam.. And once the bucks fail... Sayonara PA school.

 

And, if my premise is true, then what's the exact purpose of the university affiliation? The name?

 

I am not naive enough to think that the university will "give it away"... But 45%!!!!! Is this industry standard?? Can it be negotiated to.. Say 15-20 percent (like a tax), since the university ain't contributing much...

 

And would give you almost another million to do your job.

 

Just askin

[eddoc]

It varies by university but is pretty much the industry standard. I grumble about the university's cut but there is economy of scale that I could not duplicate. One could argue the specifics but, for example, if we were charged for leasing our space, it would cost about $600,000 per year (and that doesn't include wet lab or cadaver lab spaces). In addition to the things I listed above (maintenance, utilities, communications, network support, malpractice coverage, legal counsel (I use them a lot), lab upkeep, student finance, a registrar, document storage) we have an excellent medical library (on campus and on-line), student health services, campus police, folks that spend a lot of time worrying about our regional accreditor, all underwritten by those tuition dollars. Those are just the things that spring to mind at the moment. Of course I would prefer to have more to spend! But not if all that stuff that the university now covers became the program's responsibility.