Misconception about a PA Doctorate

[EMEDPA]

The first step in solving a problem is defining the cause of the problem.  This very well could be it.

 

With all the doom and gloom about more programs and more PA's...there might be a silver lining.  There is strength in numbers.  Numbers = membership = money = influence.  Now just get the right folks in.  Just a thought...I profess no expertise in medical politics.

the problem is that the avg admitted applicant today is not the right type of person to represent our profession. they are folks with minimal experience who want an easy check and want to raise a family as their primary goal in life. it's a fine goal but if your focus is "kids by 25" > be a quality medical provider you end up with a bunch of folks who say things like " getting a B- in clinical medicine is good enough".

[Will352ns]

the problem is that the avg admitted applicant today is not the right type of person to represent our profession. they are folks with minimal experience who want an easy check and want to raise a family as their primary goal in life. it's a fine goal but if your focus is "kids by 25" > be a quality medical provider you end up with a bunch of folks who say things like " getting a B- in clinical medicine is good enough".

"Now just get the right folks in", meaning leadership in the AAPA...not students. 

 

That said, if you want to influence the ARC-PA and PAEA, the AAPA are most likely the best folks to do it.  Put the pressure on them to enforce minimum HCE requirements and definitions.  Although this would undoubtedly be met with resistance, it is more realistic than overhauling the entire PA educational curriculum. 

 

You just have to get the right folks in...leadership and students.

 

This is just me spouting off the top of my head on this fine day of procrastinating before a final.  I do not profess to be an expert in medical politics or education.

[Guest Paula]

AAPA meets everything with resistance ....at least it seems so....and I'm a  little worried about the marketing campaign coming up........will they pass by everything they develop to the AAPA membership and non-members to see if we agree with the marketing plan?  They should. 

 

If they present us as assistants then we are sunk and we may as well all quit being PAs and go to med school.  I believe students today with little HCE really believe they are getting a PA degree to be a highly paid assistant and they are ok with it.   

[blueridge]

Interesting to see the tide churning on this one -- by the same reasoning, perhaps the general public is ready to accept a path for PA (having a master's already) to physician via a one year tailored residency.  

 

Recent NYT article - Should Medical School Last Just 3 Years:

 

"Four more medical schools are nonetheless currently considering adding a three-year M.D. option to their traditional programs. And while all of these shorter programs still remain an option and not the norm, the debate they have incited has brought greater attention to other exciting initiatives, like anovel assessment method that is based on a student’s actual skill rather than the number of years completed. This “competency-based” assessment would mean that students would be allowed to graduate when they demonstrated the skills and not just when they fulfilled the four-year requirements of a 100-year-old standard."

 

http://well.blogs.nytimes.com/2013/10/24/should-medical-school-last-just-3-years/

[primadonna22274]

Competency-based medical education...hmmm...that sounds familiar.... ;)

[bobuddy]

And this leads to the gradual end of the PA profession.  An unpopular opinion on this forum...but there it is. 

 

Extending program lengths, mandatory residencies, and decreased lateral movement (CAQ) take away the very aspects that many were attracted to PA in the first place. 

 

Overhauling PA education as a "continuum" towards medical school negates the profession as a whole.  This is a great plan for someone who wants to be a MD/DO...but what about the folks who actually want to be a PA?  It will do absolutely nothing for them.  The same problems that PAs currently have will still be there.  If anything, I can see the PAs being looked down on if they didn't continue.  So why be a PA at all?  This solution doesn't address the current problems that have led to the question being asked in the first place. 

 

Before the flames, do know that I personally have zero problems with PA's going on to become a MD/DO and I am all for educational institutions giving PAs credit towards MD/DO...I just don't think it should be an expected career progression.

 

There has to be a happy medium.

 

Interesting to see the tide churning on this one -- by the same reasoning, perhaps the general public is ready to accept a path for PA (having a master's already) to physician via a one year tailored residency.  

 

Recent NYT article - Should Medical School Last Just 3 Years:

 

"Four more medical schools are nonetheless currently considering adding a three-year M.D. option to their traditional programs. And while all of these shorter programs still remain an option and not the norm, the debate they have incited has brought greater attention to other exciting initiatives, like anovel assessment method that is based on a student’s actual skill rather than the number of years completed. This “competency-based” assessment would mean that students would be allowed to graduate when they demonstrated the skills and not just when they fulfilled the four-year requirements of a 100-year-old standard."

 

http://well.blogs.nytimes.com/2013/10/24/should-medical-school-last-just-3-years/

 

 

  These two posts continue to muddy the water for current and future PA's.   If the medical schools gradually offer a three year degree - then this presents even more evidence of the end of the PA profession.  

 

  As I see it, the NP's get their 4 year undergraduate degree for the BSN, then spend approximately 3 years getting their APRN/DNP  (even obtaining the degrees online, working full time) with the end result of an independent provider equal to the MD's in primary care and other some fields.  

 

Most PA's that I know of (correct me if I am wrong) do not get into PA school during their undergraduate years - they have -  more than likely - already completed their 4 years of undergraduate work.   So, the PA's then go to school for another 2 years 8 months (our UKMC program in KY) for the masters (equal time to the NP's and ALMOST equal to the 3 year MD program) and we end up as the "assistant dependent practitioner".  

 

I fall back to my original thought of the existing PA's joining forces somehow with the NP's.  Yes, our profession goes away if we do this - but the way things are going - we are already headed down that road.

[GetMeOuttaThisMess]

I was accepted to my program prior to obtaining my BS, and thus was awarded a BS (talking early 80's).

[bobuddy]

At the University of KY - applicants must have completed a Bachelor's Degree before applying for PA school.   I have only kept up with the requirements of a few programs - UK in KY and Colorado Denver program (also must have bachelors degree before applying). 

 

Does anyone have a grasp on the current schools that do not require a bachelors degree before applying? 

[LT_Oneal_PAC]

There is a requirement by ARC-PA for all schools to move to a Masters soon, so it is really a moot point, for arguing the current premise, if a bachelors is given by programs now. There are several though.

[LT_Oneal_PAC]

I see this is pretty simple. A bridge for a PA to physician should be to do an M1 year so that we can get the research and basic sciences. As prima has said, if you can pass PANCE you can pass step 2, so skip it or shorten to 6 months covering mostly the real zebras. A PA has done rotations in all the core medical area, so skip it or shorten to 6 months. 4th year is for auditions and vacation, also it's already cut out by 3 year programs, so skip it. Apply for residency, which is where the real learning happens.

 

So I see no reason, other than current MD accreditation standards which can be changed to allow for bridges, that a bridge should be more than 2 years. It's not a shortcut since most PA programs are longer than 2 years, thus no one should be mad about making a back door. MCAT could be required if school preferred. Since it's only to show ability to pass med school, I'm sure LECOM, who dropped the req, could do a study to show that a PA is just as likely to finish med school as someone who made a 30 or whatever MCAT.

 

Easy. Now PA profession exists and there is clear way for PAs to progress if desired. Heck, the LCME could even place extra stipulations on top of arc-pa standard allowing dual accreditation (like there are regional and national accreditation standards for universities), that way med schools could be assured of uniformity, while still leaving schools that just want to deal with ARC-PA alone.

 

As for the DMS, I think that it should just be awarded with a residency. DMS with board certification in Internal Medicine, or whatever.

[Guest Paula]

I would do O'Neals plan even at my age!!!!

[rcreek]

I would do O'Neals plan even at my age!!!!

 

Yeah that sounds really fair and reasonable - for all parties involved. But I still think most of the MD/DO community would be against it.

[LT_Oneal_PAC]

Yeah that sounds really fair and reasonable - for all parties involved. But I still think most of the MD/DO community would be against it.

The MD community is going to be against any change. No ifs, ands, or buts. So will AAPA. Best chance is to have residencies that give a DMS with added autonomy in your specialty, IMO.

[primadonna22274]

I don't dislike your plan Oneal but there is a sneaky little rule that states the minimum number of weeks for any WHO-accredited medical school is 132. Very hard to get around that with a bridge less than 3 years. Reforming that would require an INTERNATIONAL rules change. Feeling optimistic and ready to take on the world--literally? :)

[EMEDPA]

I would do O'Neals plan even at my age!!!!

me too......

[EMEDPA]

I don't dislike your plan Oneal but there is a sneaky little rule that states the minimum number of weeks for any WHO-accredited medical school is 132. Very hard to get around that with a bridge less than 3 years. Reforming that would require an INTERNATIONAL rules change. Feeling optimistic and ready to take on the world--literally? :)

what if you have a school with both pa and md/do programs which counts pa courses that transfer(clinicals, history taking, ethics, etc) into the 132 weeks? actually dually accredit rotations and certain courses as pa2/ms3 or something? should be ok. at many programs rotations for pa2 and ms3 are already scheduled interchangeably. dual pa/mph and pa/pharmd programs already do this. the pa/pharmd folks count pa2 as their entire clinical year(the normal year 4 or 5).

a 2 yr bridge with no mcat and an affiliated family medicine residency? 5 yrs start to finish? I would start tomorrow. and as far as location I think the pacific northwest needs such a program.....:)

[LT_Oneal_PAC]

I don't dislike your plan Oneal but there is a sneaky little rule that states the minimum number of weeks for any WHO-accredited medical school is 132. Very hard to get around that with a bridge less than 3 years. Reforming that would require an INTERNATIONAL rules change. Feeling optimistic and ready to take on the world--literally? :)

I read there is an idea about integrating internship or some part of residency into med school. Don't think there are any who rules on residencies ;) just took off another year, keeping med school long enough, and not breaking any rules. It does, however, make the whole idea more complicated than it needs to be.

 

Also, if the LCME could do the dual accreditation thing, then maybe you could convince WHO that times counts towards an MD degree.

 

To answer the question:

 

Well, I think WHO really cares about access and the public health and would be more open to the idea than LCME. Oh, and I'll do no such thing. At least, not as a PA. For any change to allow different entry into physician-dom, it will have to come from within. This is what happened with your LECOM program. Wasn't it a former PA turned physician that got it all rolling? Anyways, I've become near completely disillusioned with PA/NP/physician politics. It feels like beating my head against a wall to talk about it with 80% of the people I meet in person. I'm supporting PAFT and will support them with my time, money, or whatever else they need. Other than that, I'm just trying to relax more. Being "politically" active has brought little except grief.

[EMEDPA]

in the late 80s/early 90s there were a few medschool programs and fp residencies that dually accredited ms4 as pgy1 so folks came out md's with fp board certification in 6 years. these folks scored BETTER than their peers across the board but the aafp stopped accrediting the programs after several years because they said it "cheapened the image of family medicine". what it actually did was make ms4 a useful training year instead of the extended vacation and interview time it is at most programs. I would love to see this model come back.

more info on those programs here:

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0CDoQFjAD&url=http%3A%2F%2Fmds.marshall.edu%2Fcgi%2Fviewcontent.cgi%3Farticle%3D1004%26context%3Dsm_fch&ei=gsyfUuSfGtjhoASL34KoBg&usg=AFQjCNHaq4WJz70RzwVspx-I0t5g9XRz2g&bvm=bv.57155469,d.cGU

[primadonna22274]

Yes Oneal, you are correct the LECOM "bridge" was championed by Mark Kauffman, DO, PA. He's my advisor--has been a great advocate for all of us.

Your idea of continuing PA/integrated med curriculum is sort of the idea of the stem cell model of medical education that some have proposed. I like this idea. It wouldn't work at my school because we don't have a PA program although there are now 2 feeder programs in the area and the college has just established linkage with Gannon for a 3+4 path for traditional college students. Would be interesting to see if they would consider extending the same to the PAs who are interested...I've taught in that program and the students are bright and YOUNG, most of them with zero prior HCE. A very, very different demographic than my PA class or the students I taught at MCG/GRU.

 

[Guest Paula]

Anyways, I've become near completely disillusioned with PA/NP/physician politics. It feels like beating my head against a wall to talk about it with 80% of the people I meet in person. I'm supporting PAFT and will support them with my time, money, or whatever else they need. Other than that, I'm just trying to relax more. Being "politically" active has brought little except grief.

Thanks for supporting PAFT.  We need every PA and PA student to support us and pay their dues.  Being politically active can be frustrating and there is a big hole on my wall  in my office where I bang my head almost daily..........and then I take a deep breath and say to myself " Paula, onward, soldier, onward". 

[Guest Paula]

I might die from wall thumping alzheimers. 

[primadonna22274]

in the late 80s/early 90s there were a few medschool programs and fp residencies that dually accredited ms4 as pgy1 so folks came out md's with fp board certification in 6 years. these folks scored BETTER than their peers across the board but the aafp stopped accrediting the programs after several years because they said it "cheapened the image of family medicine". what it actually did was make ms4 a useful training year instead of the extended vacation and interview time it is at most programs. I would love to see this model come back.

more info on those programs here:

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0CDoQFjAD&url=http%3A%2F%2Fmds.marshall.edu%2Fcgi%2Fviewcontent.cgi%3Farticle%3D1004%26context%3Dsm_fch&ei=gsyfUuSfGtjhoASL34KoBg&usg=AFQjCNHaq4WJz70RzwVspx-I0t5g9XRz2g&bvm=bv.57155469,d.cGU

Minor point E--by mistake (honestly) I took my step 2 about 3 mos earlier than I should have. The timing is confusing and I misunderstood when I could take it. I still had 2 cores and 2 shelf exams to take when I took step 2 and scored 98. It was not looked at too fondly by admin to say the least. My husband, a teacher, told me that it doesn't reflect positively on the school (hence their dissatisfaction with me--I very nearly got in trouble for this--yikes) but instead demonstrates the strengths of the individual student and schools don't like that.

Whatever... I'm just glad it's over!

[2234leej]

Still not sure the idea is there....

 

We all should be graduating with a Clinical Doctorate RIGHT NOW

 

We have enough credits, our job is important enough, we give orders to many of the other Clinical Doctorate level, we are not Allied Health(but instead providers), NPs are already doing it.....

 

No additional time needed - just give the doctorate

 

Think law school  2-3 years after BA/BA

DNP is an online

DPT is 5 years total

 

I am an orthopedic physical therapist who is potentially interested in becoming an orthopedic PA. A physical therapist is 3 - 3.5 years post graduate education (~7 to 7.5 years total). I am currently doing my orthopedic physical therapy residency at U of C which is an additional year. While I know that residencies aren't required in PT that would be 8 years in total. And I don't know any PT program that is 5 years total. 

[skyblu]

I say in regards to bridge, 18 months of school (if you have a Masters already), and, my big thing: years of clinical practice as a PA should count as years of residency.

 

If I, as an EM PA of 4 years, function in my daily duties far above the level of a resident, why can't I go do the remaining classroom work to pass Step 1, and then be considered as having fulfilled medical school AND an EM residency?

[primadonna22274]

I say in regards to bridge, 18 months of school (if you have a Masters already), and, my big thing: years of clinical practice as a PA should count as years of residency.

 

If I, as an EM PA of 4 years, function in my daily duties far above the level of a resident, why can't I go do the remaining classroom work to pass Step 1, and then be considered as having fulfilled medical school AND an EM residency?

You're gonna have to pass all 3 steps AND EM boards to be fully licensed and credentialed anywhere.

I don't think any entity is going to let you skip residency. I'm just preparing to begin residency in 6 months and I don't think there is anything about intern year that looks remotely like the busiest year of my PA work life.

Could the process be shorter? I hope so--but residency is definitely not the corner I would cut!