New Doctor of Physician Assistant Medicine Program

[primadonna22274]

I'm guessing the primary care MD/DO folks out there might have a problem with PAs taking over primary care....what makes more sense as mentioned above is an increase in the # of programs following the army/baylor method. PAs are interested in specialties outside of primary care.

I have spoken with Maj. Gruppo in person about his program and last time we spoke there were no plans to allow civilians entry into any doctoral programs overseen by the army.

 

I would rather a PA trained in the medical model, proven through the fires of PA training, take over PC than a DNP who may have worked as an RN for a year or two then done an online DNP with much less clinical time.

As far as the Army/Baylor method, I just think it serves as a great model for how to advance a rigorous residency into a doctoral degree appropriate to PAs.

[EMEDPA]

Prima- no argument from me on your preferences....

[cinntsp]

... 

 

[AREID]

I agree with KMD a bridge program will reveal PA to be a stepping stone/inferior position. It will make it more difficult for PAs with heavy experience and skill to advance autonomy. It is much like the name title ... Physician Assistant ... it suggests things about the profession that are untrue.

No, it is what it is. A new grad PA is inferior to a new grad MD/DO. If you don't believe this you are naive. This is not because MD/DOs are smarter, but because of the extra 5 years minimum they have spent practicing medicine. That's not to say that a PA after 10 years of practice is incompetent. Physicians have an extra two years to retain the information and learn the many details glossed over PA school. They also have a structured residency to perfect the craft. So yes a PA is inferior to a physician when comparing new graduates. What these clinicians do after graduation will vary considerably...

 

 

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[KMD16]

^ It appears you missed the point.

[ventana]

KMD16

 

I don't think a bridge program will make the PA profession a stepping stone for one big reason

 

 

it should be a lot longer and harder to get to MD through this pathway then through regular med school

 

Med school 3-4 years - + 3 for residency - could be as short as 6 years

 

 

PA school 3 years

then a requirement to have > 5-10 years of work as a PA to even be able to apply to a bridge program

then a 1-2 year bridge program - academic

then a 1-2 year residency

 

shortest route to MD through PA - something like 10+ years

 

and more reasonably 12 years

 

 

so an 18 yr old is not going to pick PA and sign up for an additional 5-7 years of stuff if he/she can get it done in 6........

 

 

A concern would be skimming the cream of the crop from the PAs ranks - BUT as I have said before - who better to advocate for PAs from WITHIN the medical profession then an PA that is now a Doc.......

 

 

This is NOT creating a shortcut to MD/DO instead it is taking into consideration the considerable similarities in training and job that a PCP PA has to an MD/DO.  I am unable to speak to the specialties (seems like if you wanted to do neuro surgery you are into the who 10+ years of residency)

[KMD16]

Ventana. I do not advocate for a bridge program. Rather, what I would like to see happen and in support is an optional pathway for a PA doctorate just like our NP colleague had done and a better scope of practice be it independent practice or whatever you may call it. I have said this time and again on this forum. If we as a profession don't catch-on, it would appears as if DNP > PA. We've got to fight for generation of PAs to come whether it being a shorter bridge program that requires only 1-2yrs to complete all in the name of advancing the profession.

[ventana]

Ventana. I do not advocate for a bridge program. Rather, what I would like to see happen and in support is an optional pathway for a PA doctorate just like our NP colleague had done and a better scope of practice be it independent practice or whatever you may call it. I have said this time and again on this forum. If we as a profession don't catch-on, it would appears as if DNP > PA. We've got to fight for generation of PAs to come whether it being a shorter bridge program that requires only 1-2yrs to complete all in the name of advancing the profession.

BINGO

 

could not agree more!!!

[RetNavyPAC]

...or it opens doors for more PAs to take greater roles in education, administration, research, and government.

 

There are DHSc programs or PhD programs out there that can prepare PAs for education, admin, research and legistlative roles.  I don't think any PA should be going into any of those arenas right out of school.

[Guest Paula]

If there is going to be a doctoral degree for the PA profession the Army program should be a model for developing future clinical doctoral degrees for PAs. I was on the Academy's Board of Directors in 2006 when Maj. Gruppo gave us an overview of the history and development of this program. Most importantly, to be eligible for  this program you have to be an Army PA with more than 2 years experience. The purpose of the program was not only to fill the need for highly trained emergency medicine and orthopedic PAs but also to help those individuals who had aspirations to make the Army a career to have the opportunity to gain an advantage for further promotions. It is also an 18 month program with both didactic and rigorous clinical training and not 9 months added after completing a masters program.

 

I agree with someone who said how can you develop a doctoral program in PA program which has not even been established to date. I think the Lynchburg program needs to get established first before trying to attempt to create a doctoral program.With that said, if this type of program is the next level of PA education, it may be the first steps in addressing medical education reform in total. I've always said that I believe our profession has proven that it doesn't take 4 years of undergraduate, 4 years of medical school and a 3 year residency to provide high-quality, cost-effective primary care medical services. If all PA education were to convert to the Lynchburg model, we could change the title to Doctor of Primary Care Medicine (DPCM), eliminate the PA profession and title completely, and take over the delivery primary care. I could go into more detail it is not appropriate for this forum.

Last sentence^^^^^^   Is this in the works?????   This idea has been floated around before to have PAs take over primary care, or to provide a rigorous residency (12-18 mo) and then take a test that would allow us independence to act as PCPs.  I would like to hear more, too. 

[True Anomaly]

If there is going to be a doctoral degree for the PA profession the Army program should be a model for developing future clinical doctoral degrees for PAs. I was on the Academy's Board of Directors in 2006 when Maj. Gruppo gave us an overview of the history and development of this program. Most importantly, to be eligible for  this program you have to be an Army PA with more than 2 years experience. The purpose of the program was not only to fill the need for highly trained emergency medicine and orthopedic PAs but also to help those individuals who had aspirations to make the Army a career to have the opportunity to gain an advantage for further promotions. It is also an 18 month program with both didactic and rigorous clinical training and not 9 months added after completing a masters program.

Slight correction- the Army/Baylor program, when it first started, actually required 4 years, not 2, before an Army PA could transition into it. I don't know if that's changed, but at least then the minimum amount of experience was 4 years.

 

Your point still stands, though

[JohnnyM2]

I like this thread because it has everyone thinking about the PAs role, status and training vs mds and nps, especially dnps. While I am not a priori against the idea of doctorates for PAs, I have some questions and concerns. Is the purpose of the doctorate to allow PAs to be called doctor? In a patient setting that could be confusing and misleading, much as it is when dnps call themselves "doctor". Would the name tag read Jane Doe, PA-C, PhD or what? Once the mpas became the standard degree for PAs, it became more difficult for those with bachelor's degrees to compete for jobs. (I have seen job listings specifying masters degree only.) The result is that many experienced PAs have had to get into bridge programs to compete. Would the same thing eventually happen with doctorate degrees? Do PAs really need doctorates or is that just an (expensive) distraction? If the original role of the PA was to provide autonomous primary care with an md as sp, it seems that the current mpas degree should be sufficient.

On the other hand, since not all PAs want to limit themselves to primary care, there should be advanced training for those who want or need it. I like the idea of expanding access to fellowships for surgery, orthopedics, emergency medicine, dermatology and some other specialties. Fellowships are typically paid and the fellowship could be added to the name tag as it often is for mds. Thus the PA could demonstrate advanced training without (meaningless) degree creep.

I understand that nps started this competition by conferring doctorates and there may be no way out for the PA profession other than to follow suit. The shame of it is that the doctorate degree is unlikely to boost salaries to any great extent and could lead to escalating competition between the PA and nursing professions. I repeat that I am not saying there is no place for PA doctorates. But these are things to think about.

 

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[gleannfia]

Sure, if you guys want to pay for this bullshit, be my guess.  I ain't doing it.

[gleannfia]

Yeah, I would only agree to this if we got to be independent practitioners.  I favor the proposal that PAs pass Part I and II of USMLE and do one year residency and get an MD.  Otherwise, I am not interested in contributing to degree inflation.

[gleannfia]

I'd rather have the bridge program. I do not want a freaking "Dcotor" of PA.

[EMEDPA]

I'm not particularly personally interested in a "doctor of PA studies" although this program seems to contain additional clinical time which would certainly be of value. . I opted to go back for an academic doctorate that has nothing to do with the pa profession. my classmates come from a variety of health related fields but will not be tied to any of them when they complete their doctorates. an efficient bridge to md/do and/or a doctorate conferred after a residency make more sense to me than a generic entry level dr. of pa, although as I said the extra clinical time is certainly a plus. .

[Guest JMPA]

I'd rather have the bridge program. I do not want a freaking "Dcotor" of PA.

thank you, i think you speak for most

[KMD16]

An MD bridge program will not fly. Not under the watchful eyes of the LCME.

 

The closer we can get is the current bridge program at LECOM which still struggling to attract qualify candidate.

 

Someone suggested taking the both USMLE step 1 & 2 and be awarded an MD. Again, not gonna happen. Passing step 1 requires extensive basic science knowledge which are not thought in PA school. Maybe USMLE step 2.

 

I recently came across an article in clinician 1 title DNP are taking over primary care in Minnesota. This folk will continue to push there agenda through until until they becomes our new supervising DNP.

 

We've got DNP, DPT & DrOT. We've got to catch-on! DHSc is a viable option.

 

I would say this again. I strongly strongly advocate for an optional PA doctorate and independent practice or a better scope of practice whatever you choose to call it. For those of us older with family/other life commitment, an online DHSc is a viable option.

 

If you want to be an MD/DO, take the MCAT (score the minimum 23 or 25) and apply at LECOM PA to DO bridge program.

 

I rest my case.

[primadonna22274]

Yeah, I would only agree to this if we got to be independent practitioners. I favor the proposal that PAs pass Part I and II of USMLE and do one year residency and get an MD. Otherwise, I am not interested in contributing to degree inflation.

PA education would prepare you for steps 2 and 3 but most definitely NOT step 1. I've said before, the real difference in PA and MD/DO education is step 1 material. Pick up a copy of First Aid for USMLE step 1 and see how much of that material (and they absolutely DO test on the minutiae!) you've been exposed to as a PA. Not much. As someone who's done both PA and med school, I can say with confidence that most PAs could pass step 2 no problem, and probably step 3--but step 1 is an entirely different animal.

[primadonna22274]

An MD bridge program will not fly. Not under the watchful eyes of the LCME. The closer we can get is the current bridge program at LECOM which still struggling to attract qualify candidate. Someone suggested taking the both USMLE step 1 & 2 and be awarded an MD. Again, not gonna happen. Passing step 1 requires extensive basic science knowledge which are not thought in PA school. Maybe USMLE step 2. I recently came across an article in clinician 1 title DNP are taking over primary care in Minnesota. This folk will continue to push there agenda through until until they becomes our new supervising DNP. We've got DNP, DPT & DrOT. We've got to catch-on! DHSc is a viable option. I would say this again. I strongly strongly advocate for an optional PA doctorate and independent practice or a better scope of practice whatever you choose to call it. For those of us older with family/other life commitment, an online DHSc is a viable option. If you want to be an MD/DO, take the MCAT (score the minimum 23 or 25) and apply at LECOM PA to DO bridge program. I rest my case.

And just as of this weekend, MCAT scores are waived for qualified PAs who want to apply. I'm not sure if there is a minimum PANCE/PANRE score. (I suggested 550ish but don't know if my suggestion went anywhere.)

I don't see why MD programs won't get on board, if it is advantageous to them to do so. IMO a program where MD and PA programs are housed in the same building and the students learn together would be ripe for this experiment. There are several 3-year primary care MD programs now and I think eventually we will see a PA-MD bridge but can't say when.

[KMD16]

PA education would prepare you for steps 2 and 3 but most definitely NOT step 1. I've said before, the real difference in PA and MD/DO education is step 1 material. Pick up a copy of First Aid for USMLE step 1 and see how much of that material (and they absolutely DO test on the minutiae!) you've been exposed to as a PA. Not much. As someone who's done both PA and med school, I can say with confidence that most PAs could pass step 2 no problem, and probably step 3--but step 1 is an entirely different animal.

Yes. PA education only prepare you for step 2 & 3 (not that simple). However, one would still need to buckle-up. You would need to study in depth beyond what was thought in PA school & clinical acumen.

 

First Aid for USMLE step 1 is like studying Exam-cracker MCAT physics. If you lack the basic foundation on subject area, your score will suffer. I have copies of both books on my bookshelf.

 

 

[KMD16]

And just as of this weekend, MCAT scores are waived for qualified PAs who want to apply. I'm not sure if there is a minimum PANCE/PANRE score. (I suggested 550ish but don't know if my suggestion went anywhere.)

I don't see why MD programs won't get on board, if it is advantageous to them to do so. IMO a program where MD and PA programs are housed in the same building and the students learn together would be ripe for this experiment. There are several 3-year primary care MD programs now and I think eventually we will see a PA-MD bridge but can't say when.

The MCAT requirement was waived months ago. I had a conversation with the director/founding dean a while back. It is my understanding that with the MCAT waived, he/they still look beyond MCAT score like PANCE/PANCE score & SAT scores.

 

With respect to the newly 3-years MD program. This programs primarily target traditional students with above average MCAT scores or those that want to do primary care.

[Avalon]

Please explain more fully how you envision the doctorate of health sciences is a viable solution?  I understand the benefits of a distance learning model, especially given my prior post regarding the obstacles of attending a bridge program for mid-life PAs.  The curriculum of the DHSc is, however, not designed to refine clinical acumen by increasing exposure to pathology, or to broaden exposure to less common medical presentations, or to provide supervised acquisition of medically advanced skills.  It is designed to facilitate a more academic understanding of population based illness, illness prevention, evidence based medicine, and the process of scientific inquiry.  This option unquestionably enhances a PAs marketability in academic and administrative settings, but I fail to see how it answers the clinical dilemma we face regarding scope of practice and competition from other clinicians.

 

EMEDPA - your thoughts?  Will you be a better clinician upon completion of your DHSc?  Unless we can say that our doctoral training makes us more knowledgable and more skilled clinicians, and convince the public that this is in fact true, We're still in the same mess, even with DHSc after our name. 

[KMD16]

I categorically stated that a DHSc is a viable option. Never said it was a solution. Any doctorate degree put us at an equal footing with DNP in public eyes IMHO.

[EMEDPA]

 If you want to be an MD/DO, take the MCAT (score the minimum 23 or 25) and apply at LECOM PA to DO bridge program. I rest my case.

the lecom bridge has done away with the mcat requirement.