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Does your PA program operate this way?


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*Wall of text - be prepared*

 

I'm in my late 30's and spent the first 12 years of my career after undergrad in a healthcare management role. I have an MHA that was required for that role and my undergrad degree was business focused. I took the leap and applied and was accepted to a PA program in the state that I live in. I tell you all of that so that you know I have had quite a bit of experience working in a very demanding position in healthcare, alongside physicians and mid-level providers, at every step from contract negotiations, to daily operational management to discipline of those providers... ie, I'm not some kid crying about how tough schoolwork is. I cannot wrap my head around the fact that all programs work the way this one does, or that it is allowed to continue year to year. I MUST know, for my own sanity that there are better solutions out there for training our future PAs. I would LOVE to hear some feedback from the readers of this forum about how their programs operate.

 

Our faculty refers to what we do daily as "PA School". (Example, "You're going to have to learn to adjust your priorities, this is PA school".) This I think sets the tone for everything that is wrong with this program. It's a graduate medical education program, not kindergarten. I agree it's not medical school, but I WILL NOT agree that it's not as difficult, at just about any given time as med school is, considering the amount of material we are asked to cram and dump consistently for exams that are never ending for 27 months. We are spoken down to and patronized with condescending tones daily by faculty. We are made to feel inept and childlike on a daily basis. One of the recent classes was made up of more than the usual amount of "non traditional" students... meaning they were not 22 years old and JUST graduating undergrads. They had at least 10 that were seasoned healthcare providers, administrators, some with MHA/MBAs etc. On our first week of didactic classes we heard on multiple occasions from the faculty how much "trouble" this class had given them and how some of the changes in their program were due to this class. (For example we do not have exam reviews... more on that later). Since that class, the chosen student makeup is 95% or more newly graduated undergrads with no real world experience whatsoever. There have however been 1 or 2 token “nontraditional” students per class since. Now, this may be because the nontraditional candidates were not that great, or it might be because our faculty doesn't want to have to answer questions about their lack of preparation, planning or communication. I personally believe it’s the latter.  I think they prefer these younger kids with no experience because they tend to not ask questions. They just accept that things are the way they are and they have no say in it regardless. Like POWs in a warcamp...

 

I’m just going to dump a few of the recent things that are floating around in my head:

 

  • We have every lecture podcasted, however we are required to attend every lecture. In fact, if you are 1 minute late, they lock the doors and dock you professionalism points regardless of the excuse. Ignore the fact that at least 4-5 times EVERY week they forget to post their objectives or power points for printing UNTIL THE CLASS STARTS or AFTER. Other times they just show up later after lunch or even better, change the schedule 2 hours prior without any heads up or warning (but then stack those changes on top of whatever the schedule was... so we'll be in class until 5 or after). PS - when a classmate asked to miss class on a Friday because her first cousin passed away she was told that she really needed to be in class for the lecture and that it wasn't a first degree relative and that it would count against her if she missed (she was in class on Friday... she is 22 and doesn't know better than to say EFF YOU).

 

  • Faculty tells us that the ARC-PA states that PA programs must have PhD's or MDs deliver lecture material to us. So we sit in class, in lectures 8-4 or 4:30pm EVERY DAY. Then when the lecturers leave our faculty tells us, forget what they just said... that is not what we are going to test you on. So they schedule their OWN 1-2 hour lectures to cover the same material which I will add that almost ALWAYS contradicts the MDs and are told "learn this for the exam".  So yes… instead of spending 2 hours preparing for the exam, we are forced to sit through a “remediation” of material that we were just given… most often contradictory to what we learned.

 

  • We were told that it was disruptive to the learning of the class when one of our classmates excused himself to visit the restroom during a lecture, so we were told that in the future we were not allowed to use the restroom during lectures. The faculty member stated specifically, "I have 3 cups of coffee and can hold my bladder through these lectures in the morning so you need to train your bladders to hold it for 2-3 hours... and then added "you will have to do this during your clinical rotations". Again, I have worked in healthcare for over 12 years and not ONCE, aside from standing in the operating room, can I think of a time that an adult would not be able to empty his/her bladder in a 3 hour span.

 

  • We had a MD lecturer a few weeks back that started his lecture by stating that he was a clinical year preceptor for PAs and that he had never seen anything like our program in his life. He said they seem to like to "kick people out", and compared that to medical school where they will graduate bad doctors before they would kick them out and that they would go out of their way to ensure they had all the help a struggling med student needed. He followed that by saying he just wanted to let us know that this PA program was no joke and he knew the stress we were under and  felt bad for us (he teaches at the Med School also...) (PS - yes, they told us to ignore his lecture and "re taught" it the next day also)

 

  • All exams are cumulative, that is to say all 15-18 hours of lecture topics are fair game for the following exams. Ok, I can deal with that, however there are no Exam Reviews. So we never know what we missed unless you schedule a one on one meeting with a faculty member to go over your exam. Still, not unreasonable but here is the kicker... every exam, I am not exaggerating, EVERY exam has 2-4 questions that are blatantly wrong. We show them in the book and in the lecture where exact wording proves them incorrect and we are told either "We'll fix that for next year, but we aren't giving credit back this year OR my favorite... the faculty member, when shown that the book, which we are told is our "definitive resource", proves the question ABSOLUTELY wrong takes a red pen and marks on his exam scratching out the question and adding the correct verbiage and answer as she looks at the students and says thanks for teaching me something today... No points were returned on the exam. If it's wrong, isn't it wrong? Why not give credit back.. this is completely absurd and blows my mind. They claim that they stopped giving credit back  and having exam reviews because the class of more non traditional students held them accountable for every misworded, blatantly proven wrong answer or question. So they just stopped having the reviews all together. The faculty tells us they don't want this to turn into a session of arguing over "points back"... I agree with this, however if that's the case, spend 30 minutes looking over each question you have on an exam and ensure that you are not misleading or flat out using incorrect information (heck, have the other faculty review your questions... wait our faculty does not speak to one another so this isn't going to happen... more on this below)

 

  • When a PA faculty member calls an emergency lecture, the day before an exam and spends 2 hours teaching you how to do draw a pedigree (a family tree) and a student asks "are we really expected to do this with our patients?" to which the faculty responds, yes you should do this with every one of your patients, it's very important. Then a major part of that exam is testing you on pedigree situations/scenarios. The MD from the med school in the back of the room, waiting for his lecture, as soon as the PA faculty leaves he says, "psst... you're NEVER going to do that... ever, ever, ever"... my head wants to explode.

 

  • Faculty should be on the same page, right? How about if they hate one another? ... recipe for disaster right? So just like in grade school, there are clicks among our faculty. One group that seems progressive and eager to have the students do well, one group that seems to want to haze the students, because they were hazed, and one that answers every question with "it's good for your patients to go ahead an know everything on this topic" - This again, goes back to the root of what's wrong with the program. If faculty doesn't know (or care) what they other faculty is expecting of us (ie. 15 hours worth of lecture to be tested tomorrow... how can they be aware of how best to gauge our ability to focus or prioritize their objectives/goals/material? Example: 3rd week of our second semester we have 6 exams, each about 20% of our grades in 8 days. I know of at least 25% of the class that didn't sleep at all for at least 3 days. I personally slept 5 hours in an 80 hour period while camping out in the library with other classmates studying for those exams.... It doesn't HAVE to be that way. We'll have weeks that we don't have a single exam, we have 3 Friday's with 5 hours of mandatory lecture (yes, 15 hours IN THE CLASSROOM) about "how to work well with other allied health professionals, because a survey one of our faculty members read showed that PAs tended to feel like they were above PT's and OTs in the hospital. Then they give us 3 30 page reading assignments with questions to answer for a grade, as well as written assignments and a 15 minute presentation in front of all of the allied health staff and classes... all of this for 2% of our smallest 3 hour course... this happens the same week (and the week prior to and after) that we have those 6 exams in 8 days... each of those exams cover 15 hours of lecture and counted for 20% of our classes (7,5,4,3 hour classes).

 

  • The complete lack of empathy at all on any situation is appalling. I realize this is medicine, and that patient care is of the utmost importance. However, given that there is only so much time available in any given day and the amount of material they continue to shove down our throats is endless I would think that focusing on the more common pathologies or etiologies rather than having 4 questions (of 50) about pheochromocytoma (.5% occurrence) on an exam that counts as 20% of your grade and you are given  2 slides out of over 260 on an exam that covers material lectured over 5 days. If you ask why this is deemed more important that say a DM, HTN or CAD the answer is “it’s important to your patients”... same for the 20 hours we spent on learning how OT's are concerned with the quality of life of their patients and how they all think the medical model is bad and that PTs/OTs do it better... when asked if in hindsight if that was a well spent block of 20 hours when the class was already so completely burdened with exam material to deal with the 6 exams in 8 days we were told "it's important for your patients". When we're told to learn how to do pedigrees and assess tactile fremitus and then tested heavily on it while the MD's are shaking their heads saying "no one does that" and we're told just learn it.. it's important for your patients.

 

  • When I run into a PA in a hospital in the town that I attend school in I am always so excited to talk to them and get any advice they might have about how to “survive or thrive” in the PA program I always get the same response “if you’re going here in town, good luck. I have nothing to say about that place”. Doctors are negative about the product as well as the personalities of the PA faculty. Hell, just under 15% of the graduates in the last class this summer opted to completely skip their white coat ceremony. When I asked why, I was told “I want nothing to do with those people (referring to the faculty)”. Wow… 2 years of blood sweat and tears and you are so sick of the faculty that you opt out of your own celebration. How does this go on? How do the Dean and his administrative staff continue to allow it? Head in the sand, or is this the type of program they want. I can’t imagine this is the reputation they want for their program, but then again.. it’s the only program in the state so maybe they just don’t care.

I am really just dumping anger and confusion out of my brain right now and I realize this might not even make sense to you guys but I have been debating for quite some time and finally decided to just put this out here and see what responses I get. I want to know if your school operates this way? I understand that our PA faculty is made up of PAs... not teachers. However the majority of ours seem to fancy themselves as educators when in reality they have no training at all in the nuances of education and boy does it show.

 

 

 

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You're not alone. Our program operated similarly to yours for about a decade. PAs I've met who matriculated then still shudder at the thought of what they went through. I'm coming through during a transition in leadership, and changes are being made. But the old elements still rear their arbitrary, mean heads. I keep my distance from those faculty members. I don't even want them to know my name. The new hires, and those who didn't agree with the former regime, are all truly interested in being fair and teaching us what we need to know. This is not to say they're easy -- they will criticize, but in a constructive, not patronizing way. Yes, I'm a nontraditional and have taught at the college level. I have no patience for blowhards who can never admit they're wrong then act out arbitrarily to show their power. People like this exist in all walks of life, and I do my best to not engage them.

 

My advise to you is keep your head down, get your receipt (degree), and don't look back. This behavior will eventually get them snagged in some accreditation tangle. Programs must prove they take into consideration student feedback, and I bet yours is deaf to the screaming course reviews.

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Wow. I really feel for you. It actually kind of sounds like a program in the mountain west that I considered going to, UNTIL I met the faculty. Ever considered documenting this and anonymously reporting it to ARC-PA? Is there even a process for that to happen, kind of like the Joint Comission?

 

The short answer is, no, that is not how my program operates. I think what struck me most was the unsupportive faculty, their resistance to giving credit for wrong answers on tests, and the general negative mood. The difference here is between being tough and being abusive. My program is tough, we have to know a lot of information in a short period of time, but it's not a nightmare. It's fair, the faculty is not out to get us, and they really want us to become good PAs. The tests are still a shock for some because the grading scale actually means something, so you have to work for an A and truly master the material to get there (or memorize everything, which I find difficult to do). But were here to learn how to be a PA, not to learn how to pass the test. 

 

Around here, it's tough love. The faculty will do everything they can to help you, but at the end of the day aren't going to make things easier. They know what it takes to make you a good PA and aren't going to compromise that.

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Wow.  Our program was really hard and pretty painful at times.... but just because I don't enjoy spending 80-100 hours a week in class and studying.  PA school is an inherently painful and even unfair process I think, but our faculty always wanted us to succeed and would go out of their way to help us when possible.  They also listened very closely to our feedback and took it seriously.  

 

My opinion is keep your head low and graduate......

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"...it might be because our faculty doesn't want to have to answer questions about their lack of preparation, planning or communication. I personally believe it’s the latter.  I think they prefer these younger kids with no experience because they tend to not ask questions. They just accept that things are the way they are and they have no say in it regardless."

 

These comments nail it on the head for me.  

 

I am a non-traditional student who has gone to several interviews in the past two months.  I have been quite surprised by the reactions of most interviewers and admissions committees.  They appear intimidated by my health-care administrative experience and previous education.  

 

Rather than selecting the best P.A. candidates for serving the community, these schools want to have students who are naive, docile, and will not challenge poorly-performing, unprofessional staff.  

 

I have been very surprised by the abundance of poor quality staff with a sense of entitlement and defensiveness during my interviews.  During our exchanges, they very clearly did not want to be critiqued or analyzed in the same way they were doing so to me.  This was a major red flag for my school decision-making process.  

 

While I have been accepted to two of these schools, I will in no way give them my hard earned money or time.  I am waiting for the decisions of two schools where I felt there was an equal exchange of interest, professionalism, and frank dialogue.  Otherwise, I fear I would repeat the same experience as throw-away-PA.  

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I had a class with weekly graded quizzes, yet the teacher would never go over them with us afterwards.  Her position was that she didn't want us nitpicking everything and arguing for points back.  I didn't understand the point of a weekly quiz if we weren't able to use them to gauge our weak areas before an exam, especially when they counted for something like 10% of our final grade.  Stuff like that is unacceptable but thankfully that class was an exception rather than the rule in my program.

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My advice for interviewees: buttonhole some of the existing students (they often act as tour guides and such) and ask them what they don't like about their programs. Then stay away from those that don't meet your needs. You shouldn't expect the program to be easy, but you should expect a supportive faculty and being treated like an adult. It shouldn't be like basic training in the service (been there!).

 

 

Sent from my iPad using Tapatalk HD

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I am very appreciative of the feedback thus far. As I am currently a student I will not be providing the name of my program in fear of reprocution (hence the throw away account I'm using to post). I will tell you that UgoLong is exactly right. If you are a non traditional student, ask the program to provide you with the names of a few recently graduated nontraditional students to speak with them. Of course it's even better if you can find some contacts on your own so that you are not getting cherry picked participants. I have found that the programs issues will be visible and pervasive across almost ALL of the students so you don't have to be very picky with your choosing who to ask and who not to. I know that our current class is actively telling friends/family etc to NOT interview or accept invitations to our program. It's a shame that a school that you have so much pride in, can have it's name tarnished by individuals that are allowed to operate freely and unchecked in such a manner.

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Heh. I'm actually in the military's PA program and they don't treat us like this. They treat us with respect knowing that they are preparing us to be their peers and colleagues when we graduate.

The funny thing is that our faculty will say this too... then their next breath will be similar to what would be said to a child in grade school. It's all a dog and pony show. They take, take, take and never give and DARE you to question them on their agenda or through process only responding that it's in the best interest of your patients that you do what they say.

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I think everyone could find things about their program that they don't like, but your situation seems to be extreme.  Hang in there....like everybody else is saying, head down and grind it out.  

 

The goal is PA-C, do what you have to do.

Yes, I agree. Exactly what I've been doing for quite some time. Every day that passes is like a new test. All of the previous students leave us "words of wisdom" on a white board in the classroom and they almost all say, "pick your battles". Good advice, however there should never be 10 new bonafide battles EVERY week... at some point surely someone is looking over their shoulders and saying this has got to change.

 

One of the responders above mentioned the lack of the program to respond to course feedback as an action item - I personally have spoken to graduates and students that have left the program completely in the past 5 classes and the feedback is identical. They bash them in the post semester reviews and nothing changes, the bash them in the post graduate reviews... nothing changes. It's like no one is listening, or cares to.

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Sorry you have to deal with this.  I am in a similar situation, seems our program is hell bent on making our lives as difficult as possible, and when we ask for help they reply with a total sink or swim attitude.  I could go into it but suffice to say while the majority of programs may not be like this, there are many of them out here.  My school has a good reputation but it is a total facade.

 

My advise is such: stop fighting an uphill battle.  Say to yourself "I am here to hustle, to get my degree, and that is all that matters."  Stop searching for justice, you won't find it.  LEARN TO PLAY THE GAME.  And trust me, once you get to rotations, things get a lot better (but the school still does find ways to **** us over, but trust me, SO much less than before).  Keep your head up and your mouth shut and stick to the game plan.  Never lose sight of the big picture.

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All I can say is that I'm going to Jefferson College of Health Sciences in Roanoke, VA, and it's been the most wonderful experience.  It's by no means easy, but the faculty has been wonderfully supportive, always available, and flexible to change our schedule to fit our needs.

 

AND we have 100% PANCE pass rate. So there's no need for what you're experiencing.

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  • 2 weeks later...

I agree although our program has had several faculty members leave I am glad to say I have never felt like this. We were welcome to go in their office and discuss things. Our faculty are very open and supportive, especially to those that are non traditional. I would say just tough it out and keep going. I won't say the program I am in is perfect in any way, but I don't feel like they are out to get me either, thank goodness. School is hard enough especially in dealing with that kind of atmosphere.

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  • 2 weeks later...

My program was the opposite.  We would get a stack of objectives to know for an exam and suggested reading.  From there, we learned the material on our own.  We had lectures from the local community, not from the college.  Those lectures may or may not touch upon the objective being tested for that time period.  Our lectures were sometimes given by a PA, sometimes and MD/DO, a few times by an NP, and other times a various assortment of allied health workers talking about their various roles.  Most times we would tune out and work on our objectives during the lecture, as the lecture had NO direct bearing. The program I attended has multiple campuses where all students take the same test at the same time but each campus is left on their own of how to fill the lecture hours. As a result, a student attending one campus does not get the same lecture or material than someone on a different campus.

 

All of our students were non traditional.  One of the requirements to apply is 4000 hours with hands on patient care.  The average is around 6-7 years in the field though.

 

Though, like yours, our campus was a mandatory attendance to all lectures with deduction on professionalism for no shows.  The school believed that each lectureur could add "pearls of wisdom" that would benefit us in clinical practice...yeah, whatever.  We had our fair share of last minute schedule changes, adding hours to the day.  Test review was also only on a scheduled 1:1 basis.  Mandatory 80% or better.  If you failed a test, you could retest at the end of the term. Fail two tests and their re tests, you were dismissed.

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I can relate to Throw Away and gothope. I have had lots of mixed feelings about my program and their lack of respect for nontraditional students and what seems to be a disorganized curriculum. I wondered sometimes if all PA programs were like mine. Apparently, not all are. I highly recommend to stick with it. Study what you must to prepare for tests, get some prep materials for the PANCE, and graduate to move on. Hang in there until the end and don't look back. For all I know, gothope and I are in the same program.

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