Misconception about a PA Doctorate

[wjm7]

...but residency is definitely not the corner I would cut!

 

 

I agree completely.  I really think residency is the most pivotal part of the educational process.

[LT_Oneal_PAC]

I agree completely. I really think residency is the most pivotal part of the educational process.

agreed. I, personally, wouldn't want to skip residency. Though I think it would be plenty fair to make med school 2 years, with no summer off, for a bridge. Could even be shorter. From my understanding duke basically does a brutal 1-2nd year together so that way you can spend 3rd year doing research. Not that I would do 1st and 2nd together ::shudder::

[skyblu]

Oh, I completely understand it will never happen.

 

But why is it such a crazy idea?

 

I hear what you're saying about intern year, but does busy equal more learning? I see our interns doing a lot of scut. Meanwhile, our PAs teach, research, write, and put on semi-monthly conferences.

 

I've obviously never been a resident, but I did attend medical school (didn't finish), and have worked along side residents for years. I get that different PA jobs have different responsibilities, and it would be impossible to regulate them to ensure the work experience compares to a residency.

 

Some EM PAs only do urgent care, so it would be unrealistic to confer them the title of EM physician if they've never intubate someone or ran a code or a case of chest pain.

 

But someone like, say, EMEDPA, who has a ton of experience, works solo, and functions essentially as an attending physician? Having him do an EM residency would be a joke!

 

Again, I get that in practice, it would be impossible to create guidelines since this would vary case to case.

[wjm7]

But someone like, say, EMEDPA, who has a ton of experience, works solo, and functions essentially as an attending physician? Having him do an EM residency would be a joke!

 

 

I'm not sure that I agree.  Even for an experienced PA like EMDPA, further formal training would go a long way toward eliminating any weak spots in his skill set.  Also, this is really the kind of statement that MUST piss off physicians.  For physicians that have slaved through a residency (although I know it gets easier through the years as a resident), I can only imagine that they would be sensitive to hearing a PA say that it would be a joke to go through the residency.  And I doubt it would be a joke for a PA.  A HUGE heads up?  I would imagine so.  Easy and smoothing sailing? Doubtful, in my mind.

 

Again, it seems to me that residency is the most important part of the process.  An overwhelming majority of physicians will forget the stuff they learn in med school, especially material from the first two years.  Physician friends have attested to this fact.  What you learn in residency, though, sticks, because it has to.

[wjm7]

I should say that I would be interested to hear EMDPA's take on the matter.

[LT_Oneal_PAC]

Even emed has said that he would a PA EM residency to improve his skills, if it wouldn't require uprooting his family. So I would assume the same would go for a full fledged MD residency.

[wjm7]

Makes sense to me.  Thanks for the clarification.

[EMEDPA]

I would still welcome the opportunity to do a formal residency. everyone has gaps in their knowledge and skills base and I am not immune from that. a formal program where you MUST be exposed to a set curriculum is a benefit to any provider at any stage of their education and practice.

[cinntsp]

I would still welcome the opportunity to do a formal residency. everyone has gaps in their knowledge and skills base and I am not immune from that. a formal program where you MUST be exposed to a set curriculum is a benefit to any provider at any stage of their education and practice.

 

Totally agree.  I think people tend to undervalue the benefits of a structured curriculum and an environment designed to force learning upon one's self.

[True Anomaly]

I kinda like residencies :)

[skyblu]

That makes sense. Hadn't thought of the structure part of it.

 

Still think EMEDPA would sail through it though! ;)

 

(And don't worry, prima, I would never say that to an MD. I agree it would piss them off.)

[primadonna22274]

That makes sense. Hadn't thought of the structure part of it.

 

Still think EMEDPA would sail through it though! ;)

 

(And don't worry, prima, I would never say that to an MD. I agree it would piss them off.)

I think it would piss off any DO too.

There is something to be said for highly structured learning, progressive independence and in-service exams to prove competence. One PD told me like this: say you're an awesome doctor in cards, pulm, neuro, Nephro, heme, the whole shebang--but you're weak in GI. Do you want to graduate residency still weak in GI? Better to identify your weaknesses and work on those to be awesome all around.

 

[ventana]

there is NOTHING that a PA does that approaches the MD/DO residency

 

I think the intern year could be drastically shortened, and likely 1 year off the residency so a 3 yr IM would be two years or something along those lines

 

BUT it is a gross miss statement in my mind to say any part of PA education equates to residency 

 

see tagline.....

[skyblu]

there is NOTHING that a PA does that approaches the MD/DO residency

.....

I disagree that the working life of a PA is NOTHING like what a resident does. The daily role of a PA is very much like what a resident does, although as mentioned above the structure and specific competencies may be different.

 

Interviewing for a PA position at MGH a few years back, the exact quote from the Chair of Emergency Medicine was "we expect PAs to function on par with 3rd year residents".

 

So while, okay, maybe not the exact same, I wouldn't go as far as saying it is NOTHING alike...

[TraumaGirl]

Hi All. Sorry to hash up this old post but, I have a question... I am fairly new to this forum (recently accepted to a PA program and start in June), so forgive me if I have missed the boat on this topic. But, I am wondering why universities/hospitals couldn't implement doctorate programs similar to the DSc's offered in the Army? From what I have read, it looks as if the Doctor of Science in Physician Assistant Studies is awarded after an 18 month residency in a specific specialty (i.e. EM, ortho, general surgery). This would essentially be a doctorate awarded for those who specialize, right? Couldn't we (those outside of the armed forces) advocate for something similar? What are your thoughts on this type of program/intervention?

 

http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/60863

 

http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/US-Army-Pleased-With-PA-Doctorate-Programs.aspx

 

 

[True Anomaly]

Hi All. Sorry to hash up this old post but, I have a question... I am fairly new to this forum (recently accepted to a PA program and start in June), so forgive me if I have missed the boat on this topic. But, I am wondering why universities/hospitals couldn't implement doctorate programs similar to the DSc's offered in the Army? From what I have read, it looks as if the Doctor of Science in Physician Assistant Studies is awarded after an 18 month residency in a specific specialty (i.e. EM, ortho, general surgery). This would essentially be a doctorate awarded for those who specialize, right? Couldn't we (those outside of the armed forces) advocate for something similar? What are your thoughts on this type of program/intervention?

 

http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/60863

 

http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/US-Army-Pleased-With-PA-Doctorate-Programs.aspx

 

While I am a big supporter of residencies (optional), I am not in favor of slapping a doctorate on the civilian programs.  It adds little but ego and potentially confusing for a patient.  I'll refrain from offering an opinion on the military adopting a clinical doctorate for their programs, but the fact is that one of the main reasons they (or at least, the major who instituted it) chose to make it a "doctorate" program was to allow for upward mobility in the ranks for military PA's.  Plus, he felt that people who did those programs deserved something other than a certificate.  I believe with the civilian programs that a clinical doctorate is not necessary- and this is coming from someone who does have a certificate from just such a program.

[TraumaGirl]

Aahhh I see. I was thinking that it could be reasonable if it were only offered to those who take the time to "specialize". Much like some DNPs who are specifically trained in family medicine, women's health, peds, etc. 

[primadonna22274]

^^^specifically but poorly trained....

[skyblu]

I'm so confused about the DNPs. An RN I work with just finished her BSN and is now going into the NP program,

which is totally online, is two years, and awards her a DNP! What? From bachelor to doctorate in two years?

 

I thought I had misunderstood her but another nurse at my other job just told me the exact same thing, from a totally different online program.

 

Are they really just replacing a master's with a doctorate with no further education?

 

That can't be right, can it?

[MICURN]

I'm so confused about the DNPs. An RN I work with just finished her BSN and is now going into the NP program, which is totally online, is two years, and awards her a DNP! What? From bachelor to doctorate in two years?I thought I had misunderstood her but another nurse at my other job just told me the exact same thing, from a totally different online program. Are they really just replacing a master's with a doctorate with no further education?That can't be right, can it?

These MSNs and DNPs are not nurse practitioners. There are many types of MSN/DNP degrees, many of which are non clinical, so yes, they are often online so these RNs can continue to work. There is absolutely NO nurse practitioner program that is online (or entirely online I should say. Many professional programs, including medical schools, are integrating online coursework).

[skyblu]

Both these nurses clearly stated they were getting doctorates in nurse practitioner. That's why I was so confused.

[MICURN]

Look, there are programs out there that have online didactic work but all programs require a clinical component which is obviously not online. I'm not saying I would attend one of these programs, haha (there is one close to me). There's also a PA program in my area I wouldn't attend known for graduating subpar providers.

 

I think any person deciding to attend either a PA or NP program needs to have a few years of high quality (as in RRT with ICU experience, RN with ICU or ER experience, or paramedic responding to a high volume of high acuity calls) and only consider programs with a good reputation for graduating competent providers! Not difficult.

[ventana]

These MSNs and DNPs are not nurse practitioners. There are many types of MSN/DNP degrees, many of which are non clinical, so yes, they are often online so these RNs can continue to work. There is absolutely NO nurse practitioner program that is online (or entirely online I should say. Many professional programs, including medical schools, are integrating online coursework).

 

 

not really true DNP is an NP with a doctorate...

 

problem is the doctorate is in nursing theory and has little to nothing to do with clinical skills 

 

ALL NP degrees are to be DNP by 2015

 

This is a political move for independence (non medical have an easier time accepting that DNP should get out of supervision - IMHO this is the motivating factor)

 

Problem is that the education is FAR FAR below med school, and FAR below PA training.  Remember this is not a clinical degree.

 

Strange, the NPs are doing great in the political arena, but I the new DNPs are fully aware of their limitations and short comings and are now starting to migrate towards residency programs because, low and behold, an online part time 2 year program does not prepare you to see patients.......   at all........

[MICURN]

not really true DNP is an NP with a doctorate...

 

problem is the doctorate is in nursing theory and has little to nothing to do with clinical skills 

 

ALL NP degrees are to be DNP by 2015

Not correct. DNP is a doctorate of nursing practice, not of nurse practitioner-ing. Haha. You can obtain your DNP in research, administration/leadership and for NPs.

 

The ivory towers of nursing are calling for all NP degrees to be DNPs by 2015 but we'll see what happens. Haha. They've been calling for the abolition of diploma and AA nursing programs for years.

 

It's absolutely a political move. But healthcare has become a political game. Reality. Essentially, PAs will be the only non-doctor ally trained providers in not too many years. It will be detrimental for them. Plain and simple. As is their title.

 

I'm an ICU RN. I have my choice of PA, NP or CRNA. I am leaning towards CRNA but if I were to choose an NP program it would be a reputable school and only an acute care NP program.

 

If PA programs had stricter entry requirements (I just can't relearn the basics all over again with kids that have no clue how to even take a BP) a better title and a more independent practice, I'd probably be all in.

[PACdan]

It's absolutely a political move. But healthcare has become a political game. Reality. Essentially, PAs will be the only non-doctor ally trained providers in not too many years. It will be detrimental for them. Plain and simple. As is their title.

 

DNPs passing themselves off as "doctors" in a clinical setting are a sham. They're only fooling themselves and less informed patients.

 

 

I'm an ICU RN. I have my choice of PA, NP or CRNA.

 

Cocky.

 

 

If PA programs had stricter entry requirements (I just can't relearn the basics all over again with kids that have no clue how to even take a BP) a better title and a more independent practice, I'd probably be all in.

 

I have worked with a physician who handed me their stethoscope and stepped back because they could not take a manual BP. PA programs are the last tier before MD/DO school in terms of medical training. Don't kid youself.

 

NP Master's programs average 1/2 the credit hours (with predominantly nursing courses) and 1/4 the clinical rotation hours of PA programs. There is no comparison. PA school has the same diversity of rotation services as medical school, albeit less weeks in them.