If you haven't heard yet....

[68W2PA]

A year of core sciences and more in-depth pathophysiology. This is what I've been told and read. Med school students also get more time in rotations. Whereas PA students usually rotate 4-weeks in each area, med school students can spend 4, 6, 8 (and I've seen 12) weeks in a clinical concentration. Are you sure 101 isn't your program credit total? I admit, it is a lot. The NP programs are no where near PA credit totals. I cannot think of another graduate school program that requires this many credits (100+) and does not award a doctorate. If anything, this should be a big point of "hey, don't dismiss my education" in a "you're just a PA" scenario.

 

I am in IPAP, the military's PA program. It is officially 101 semester credits just for Phase I, which is our 4 terms of classroom didactic learning. We have class from 8-5ish M-F with exams every Monday and Friday morning at 0700 (they don't want exams to crowd into our lecture time.)

http://www.cs.amedd.army.mil/ipap/

 

Phase 2 is our clinical rotations. We do 57 weeks of rotations in 13 areas. I admit we get comparably less time, but we were told to expect to work 12 hours a day, 6 days a week, and to take call in the ED and some of the clinics.

 

The reason I made the comparison to the UNMC med school is that they are the ones who oversee our program. It just seems weird that as PAs, we take 20% more semester hours in 16 months than the med school students from the same school do in their first two years.

 

Our textbooks are similar if not identical to the ones used in the med school world. Many of us use USMLE prep books to help study for our exams. I know we don't get the same education, but at this point, I am genuinely curious as to what more information they are getting that we aren't.

[PACdan]

we didn't have any electives but had several selectives. peds em for peds, trauma surgery for surgery, etc.

our preceptorships required 1 block of 12 weeks of fp. 2nd block could be fp or em. guess which I did.....:)

Haha. No doubt.

 

I just need to figure out what I want to do, I'm sure school will help do that.

[PACdan]

I am in IPAP, the military's PA program. It is officially 101 semester credits just for Phase I, which is our 4 terms of classroom didactic learning. We have class from 8-5ish M-F with exams every Monday and Friday morning at 0700 (they don't want exams to crowd into our lecture time.)

http://www.cs.amedd.army.mil/ipap/

 

Phase 2 is our clinical rotations. We do 57 weeks of rotations in 13 areas. I admit we get comparably less time, but we were told to expect to work 12 hours a day, 6 days a week, and to take call in the ED and some of the clinics.

 

The reason I made the comparison to the UNMC med school is that they are the ones who oversee our program. It just seems weird that as PAs, we take 20% more semester hours in 16 months than the med school students from the same school do in their first two years.

 

Our textbooks are similar if not identical to the ones used in the med school world. Many of us use USMLE prep books to help study for our exams. I know we don't get the same education, but at this point, I am genuinely curious as to what more information they are getting that we aren't.

I agree brother. From what you describe, I cannot tell you.

 

They keep cramming more in, PA programs get longer, cover more. The lines might begin to blur and so might the utility.

[Guest JMPA]

how much time in med school is spent on business administration, medicolegal, small business training, and non-clinical classes. What are the fluff classes that the PA is diverted from that is not necessary to pure clinical practice? I would be interested in an honest comparison. I have yet to see a true breakdown comparison. I for one can attest to 24 hr rotations and select primary care, ER, surgical rotations that were 6wks plus.

[Boatswain2PA]

how much time in med school is spent on business administration, medicolegal, small business training, and non-clinical classes. What are the fluff classes that the PA is diverted from that is not necessary to pure clinical practice? I would be interested in an honest comparison. I have yet to see a true breakdown comparison. I for one can attest to 24 hr rotations and select primary care, ER, surgical rotations that were 6wks plus.

Fluff class I had in PA school - - - - - - "Medical Spanish".  They only put it in at my program because they got a big a$$ed diversity grant for it. 

 

The only thing I learned was "Dolor?"

[Guest Paula]

il e morte?  Oh, wait, that's French and a bad rendition of it. 

[Joelseff]

how much time in med school is spent on business administration, medicolegal, small business training, and non-clinical classes. What are the fluff classes that the PA is diverted from that is not necessary to pure clinical practice? I would be interested in an honest comparison. I have yet to see a true breakdown comparison. I for one can attest to 24 hr rotations and select primary care, ER, surgical rotations that were 6wks plus.

We had a "fluff" class. It was Behavioral something or other. It was separate from our psych unit courses. It was a workshop like class that ran all through clinical year where we shared our feelings for an hour... I thought that hour would've been better spent cramming for the next unit exam.

[DissentingVoice]

and 3x the salary for 2/3 the hours....

docs I work with make around 375k...I make around 125....I work 180+ hrs/mo, they work 120 or less.

Average salary is around $150k after seven years of schooling. How much did you make in that extra 5 years? They will have to pay back about $350k. How much does a PA have to repay, $150k? What do you start making? $70k?

 

(350 - 150) + (75 * 5) * 1000 = $575,000+ opportunity cost and an extra 5 years of your life gone for less than $75k pay difference

How many years does it take to make up that difference? Don't forget that physicians are in a higher tax bracket.

 

Yeah, specialists make a lot of money. I never would have done primary care simply because it is not financially wise. (even though I really like it)

[Steve]

Let's assume the payback figures are correct and further simplify things by saying the entire paycheck will be devoted to loan repayment. Forgetting about taxes, and only looking at earning potential:

 

 

End of 7th year:

 

PA - (4 x 75k).Loan paid off and 150k leftover

 

Dr - 200k left on loan(350k - 150k(3 residency years)). Now making 150k/year in FM

 

 

Not accounting for raises, fast forward 10 years:

 

Dr - 1.5 mil - 200k(remaining loan) = 1.3 mil

PA - 900k (750k + original 150k that was leftover)

 

 

 

20 year mark:

 

Dr - 2.8 mil

PA - 1.65 mil

 

 

 

Even 5 years out of medschool & residency, the Dr is slightly better off than the PA who's been at their fulltime job for 9 years.

 

 

Dr - 750k - 200k loan = 550k

PA - 525k

 

 

 

Obviously this is very simplified analysis, but the point remains that the Dr's earnings will quickly catch up. Quality of life down the road is also much better. 

[Acromion]

Excluding the obvious benefits and education that comes with a residency, I often wonder what it is that I am missing in terms of instruction. What part of that data pie are we not getting?

In my PA program, in the didactic phase (4 terms over 16 months) we earn 101 graduate semester hours.

I looked up UNMC's med school curricula and it is only 84 semester hours in the first two years.

 

Biochem, histo, embryology, ect . . . 

 

I took a graduate level histology course prior to PA school and though I can't recall much of the detail, I can look at histo slides and identify the stain and the type of tissue I'm looking at. Not sure how useful that has been in my everyday practice, but it was one of my favorite classes.

 

Most docs don't remember the details of that stuff but it does lay a good foundation for a more comprehensive understanding disease processes. It's the difference between knowing the cookbook vs knowing culinary theory, so to speak. 

That said, it is widely accepted that the best chefs were at one point line cooks and sous chefs.

 

I think the data that primma donna has shared with us is encouraging. It doesn't surprise me that PA's have performed so well in the bridge program. There's more than one way to skin a cat and it seems there's more than one path to becoming a good doctor. I think bridge programs will be a great way forward for PA's who wish to advance their careers. 

[EMEDPA]

Steve- now show the math at the doc making 350k/yr starting their first yr out of residency....this is what we hire new em docs at...and did I mention that is for 10-12 8-9 hr shifts/mo while the pas work 180 hrs+ for about 1/3 the salary...doing 90%-95% of the same things....

[Acromion]

I think an unmatched med school graduate could function easily as a PA, in theory. Whether it's a good idea to put people trained as doctors in a supportive role is another question altogether. I say, let them do it but we better get something out of it too and it better be good. I haven't decided what that would be yet but I like to play hardball. If the MD's want to fix their professional problems by sh*tting on our profession then tribute must be paid. 

 

Anecdote: There was an MD in my PA program who had dropped out of her residency to raise a family, only later to return to medicine unable to match into a residency (no surprise there). Anyway, she had a huge chip on her shoulder, was constantly disparaging the PA profession, and had an overall poor attitude. This probably says more about her than anything, but in general these MD trained "Assistant Physicians" would likely see themselves as a breed apart from "Physician Assistants" and this would sow a lot of professional discord. 

[EMEDPA]

the only way to make it fair would be to dually accredit overlapping coursework as md1/pa1. then an md student could take a few pa specific classes to become a pa and a pa could take a few md specific classes classes to become an md. the md would probably need 2-3 classes and the pa would probably need most of ms1 + another 1/2 year of rotations.

[EMEDPA]

I think an unmatched med school graduate could function easily as a PA, in theory. Whether it's a good idea to put people trained as doctors in a supportive role is another question altogether. I say, let them do it but we better get something out of it too and it better be good. I haven't decided what that would be yet but I like to play hardball. If the MD's want to fix their professional problems by sh*tting on our profession then tribute must be paid. 

 

Anecdote: There was an MD in my PA program who had dropped out of her residency to raise a family, only later to return to medicine unable to match into a residency (no surprise there). Anyway, she had a huge chip on her shoulder, was constantly disparaging the PA profession, and had an overall poor attitude. This probably says more about her than anything, but in general these MD trained "Assistant Physicians" would likely see themselves as a breed apart from "Physician Assistants" and this would sow a lot of professional discord. 

the issue no one has mentioned is the prior experience of the pa student which in most cases would be > than that of an md/do student. a former navy corpsman who is a pa school grad may be more competent than a new grad md student without the years of experience the pa had before starting school. granted, with the trend of pa programs to accept candy strippers as experience this will become less pronounced.

[blueridge]

the issue no one has mentioned is the prior experience of the pa student which in most cases would be > than that of an md/do student. 

Also, when comparing certain prerequisites for PA school vs. med school, generally, PA trumps med school.  Classes typical for entrance to PA school, such as anatomy, physiology, genetics, virology, and more are not required for entrance to med school.  

[EMEDPA]

Also, when comparing certain prerequisites for PA school vs. med school, generally, PA trumps med school.  Classes typical for entrance to PA school, such as anatomy, physiology, genetics, virology, and more are not required for entrance to med school.  

although all medschools require ochem while many pa schools do not. If I had to take ochem and biochem for pa school I would have just applied to medschool. As prereqs get closer and closer the reasons to attend pa school diminish rapidly.

[PACdan]

although all medschools require ochem while many pa schools do not. If I had to take ochem and biochem for pa school I would have just applied to medschool. As prereqs get closer and closer the reasons to attend pa school diminish rapidly.

UVA Medical School has no prerequisite courses now, to apply.

 

They just suggest you expose yourself to a wide variety of sciences.

 

MCAT still required though. : (

[Steve]

Steve- now show the math at the doc making 350k/yr starting their first yr out of residency....this is what we hire new em docs at...and did I mention that is for 10-12 8-9 hr shifts/mo while the pas work 180 hrs+ for about 1/3 the salary...doing 90%-95% of the same things....

 

That's where it gets ugly :)

 

5 years:

Dr - 1.55 mil (after theoretical loan repayment)

PA - 525k

 

10 years:

 

Dr - 3.3 mil

PA - 900k

 

20 years:

 

Dr - 6.8 mil

PA - 1.65  mil

[EMEDPA]

UVA Medical School has no prerequisite courses now, to apply.

 

They just suggest you expose yourself to a wide variety of sciences.

 

MCAT still required though. : (

to do well on the mcat you still need bio, chem, ochem, and physics. drop the mcat like LECOM and we're in business! If I was 10 yrs younger or my current age and single/without kids there would be nothing keeping me from applying to LECOM. Life is good though, and I am happy with my current situation.

[EMEDPA]

 

That's where it gets ugly :)

 

5 years:

Dr - 1.282 mil

PA - 525k

 

10 years:

 

Dr - 3.029 mil

PA - 900k

 

20 years:

 

Dr - 6.524 mil

PA - 1.65  mil

 

thanks. thought it would look like that. so the doc makes 4x as much by yr 20 working 2/3rd the hrs....remind me again, who has the better quality of life? spends more time with their families? vacations for a month in europe instead of a weekend at disneyland?

[Steve]

My numbers were a bit off, I just revised it and it looks better...for the doc lol

 

Pretty sick when you look at the total picture and the scope of your job.

[Acromion]

the only way to make it fair would be to dually accredit overlapping coursework as md1/pa1. then an md student could take a few pa specific classes to become a pa and a pa could take a few md specific classes classes to become an md. the md would probably need 2-3 classes and the pa would probably need most of ms1 + another 1/2 year of rotations.

 

With the internet, traditional classes just don't make much sense anymore. I know MD students who NEVER went to class because they just watched all their lectures online, which were streamed and archived daily. Now, with sites like Dr. Najeeb or Pathoma.com, it becomes even clearer that the traditional model of education is quickly becoming outmoded. Why have a separate biochem professor for every school when you can just pay to watch lectures from the best biochem professor? Despite this, the cost of tuition just keeps going up, up, up. I guess that's one of the downsides of professional guilds: the barriers to entry allow for steep entry tolls. 

 

Granted, certain classes and labs would need to be taken in person, and there is a benefit to having a cohort, syllabus, advisors and such.  As you've said before, it's the process, not the test. However, who is to say that the PA process to MD is not equally, if not more effective? Are we really to believe that a PA who takes additional classes, perhaps part time, could not be just as competent at subjects like embryology or neuroanatomy? I think the rigor of the USMLE exams should be sufficient in determining this.

 

As a PA, I would like the opportunity to fill in some of the gaps in my knowledge, not to be a doctor, but just to be a better PA. I would also, at some point, like to teach and/or do research. People think of us as grunt workers, but in actuality we are highly educated and intellectually curious people. Having a better educated PA workforce would make us more valuable and allow us to function at a higher level. (I think I actually just made an argument for a clinical doctorate, which I have opposed in the past LOL).

[EMEDPA]

on a slightly related note, very few physicians make 150k unless they work part time. the avg fp md now makes like 180-225k if I remember correctly....

[EMEDPA]

As a PA, I would like the opportunity to fill in some of the gaps in my knowledge, not to be a doctor, but just to be a better PA. I would also, at some point, like to teach and/or do research. People think of us as grunt workers, but in actuality we are highly educated and intellectually curious people. Having a better educated PA workforce would make us more valuable and allow us to function at a higher level. (I think I actually just made an argument for a clinical doctorate, which I have opposed in the past LOL).

at the very least you just made a case for a recognized masters level credential like an MPH or MMS, as opposed to the basically worthless MPAS or MHS. Hard to tell someone who has completed a legitimate DHSc or PhD that they are grunt level workers...

[Guest JMPA]

to do well on the mcat you still need bio, chem, ochem, and physics. drop the mcat like LECOM and we're in business! If I was 10 yrs younger or my current age and single/without kids there would be nothing keeping me from applying to LECOM. Life is good though, and I am happy with my current situation.

bio, chem, ochem, and physics were all required prerequirements for my program and they were not introductory courses. So what truly are the differences ? what is the fluff? and where are the missing links?