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CAQ's from a PA-S viewpoint

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From the perspective of a PA-S who is on the cusp of completing the journey through the bowels of hell known as "Didactic Year" and going into the Clinical Phase, I've heard a lot of pros and cons on CAQ's. Basically, I started this topic with the motivation to find out if there are any major differences in benefits other than just sharpening your knowledge in a particular area, such as pay increases, responsibility/ duty increases, increase in the amount of procedures you can perform, hospital/ practice privileges, job availability, etc. Any and all input is greatly appreciated. Thanks. 

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I'm sure it was increase job availability as people can be assured if your experience and knowledge base. The rest depends on the location. Level 1 trauma center with residents and EM residency, doubtful. Smaller community hospital, probably.

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I know EMEDPA saw a increase in position and salary as a result of passing his CAQ, but he can speak better to that.  I'm not sure if my own CAQ helped me with getting my new job that I'm starting soon, but it sure didn't hurt- I've yet to see if it results in increased scope of practice.  I think having done a residency, along with being 5 years in, helped more with my new job.

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Residency>caq.

That being said, my caq cliniched a new solo coverage job for me last year and got me procedural sedation rights that others without it didn't get.

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I am a family medicine PA preparing to take the first ever Peds CAQ in September. I feel that the preparation (CMEs and studying) has helped improve on my knowledge base and feel that having this CAQ will increase my credibility as a provider of pediatric care.

 

I do not feel that I will receive any other benefit in my current job - I do not expect a raise or change in duties. It may, however, open doors for me elsewhere in the future.

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I am a family medicine PA preparing to take the first ever Peds CAQ in September. I feel that the preparation (CMEs and studying) has helped improve on my knowledge base and feel that having this CAQ will increase my credibility as a provider of pediatric care.

 

I do not feel that I will receive any other benefit in my current job - I do not expect a raise or change in duties. It may, however, open doors for me elsewhere in the future.

have not tested this assumption yet, but I think it will probably help get teaching jobs as well. as the recognized peds expert on staff you could teach all the peds lectures and they could say "our peds curriculum is taught by PAs with the highest levels of certification in the specialty".

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Actually, emed, I have suggested to my alma mater that I could be the guest coursemaster for Pediatrics beginning next spring - assuming I pass - which I do assume I will :-) .

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Read this article

http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1892195

 

To see how the CAQ is being endorsed (by NCCPA of course!) as a measure of competency to docs.

While I think there are some PAs whom think CAQs are just another NCCPA grab for $$, the reality is that there does need to be a confirmation of skills and experience in specialty practice. The CAQ helps address this. New grads may benefit from residency in the future but those of us whom have been toiling away in specific specialties for decades are under or may be under pressure to actually prove we know what we are doing regardless of our everyday performance. I actually know Greg from the NCCPA and have talked with him at length about the CAQ process. Not only is he a good guy, he makes a very necessar and coherent argument that the CAQ is a necessary step in a PA's career. This is driven in part by national physician specialist organizations wanting some sort of standard put in place due to the initial general training PAs undergo without any follow through residencies or fellowships but instead years to decades of OTJ training. It also helps those of us whom have a certificate (myself) or BS in physician assistant studies to differentiate from the masters level PA being made now and cements our professionalism.

 

The above quoted article is a great example of where PAs can make a difference in a specialty that is in dire need of help. At my community hospital we have a psychiatrist that visits once every several weeks, is booked solid for months out and does not take call nor contribute much to the care of the acute psychiatric patient either in the attached clinic or the ED. This tepid support and presence from the psychiatric community is a shame but could be alleviated by PAs trained in psychiatry and the psychiatry CAQ can serve as a benchmark to strive for to ensure quality of care.

 

Whether this designation gets you more money or prestige or closer parking space is moot. We live in a time where the public wants and demands credentialing. Anyone who naysays is in danger of being left behind sooner or later. Personally, when I got the CAQ in EM, there was a perceptible appreciation from the medical staff and the hospital that I chose to get a designation that no one forced me to but did because I thought it was the proper thing to do as the senior PA here. The bottom line is that many long practicing PAs in certain specialties have plenty of hours to qualify, have done the procedures listed and can likely pass the exam with a bit of self directed study. The issue is the cost, about $300. Have your employer pay it or use CME funds if that will break the bank, thats what you negotiated for.

 

G Brothers PA-C

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While I think there are some PAs whom think CAQs are just another NCCPA grab for $$, the reality is that there does need to be a confirmation of skills and experience in specialty practice. The CAQ helps address this. New grads may benefit from residency in the future but those of us whom have been toiling away in specific specialties for decades are under or may be under pressure to actually prove we know what we are doing regardless of our everyday performance. I actually know Greg from the NCCPA and have talked with him at length about the CAQ process. Not only is he a good guy, he makes a very necessar and coherent argument that the CAQ is a necessary step in a PA's career. This is driven in part by national physician specialist organizations wanting some sort of standard put in place due to the initial general training PAs undergo without any follow through residencies or fellowships but instead years to decades of OTJ training. It also helps those of us whom have a certificate (myself) or BS in physician assistant studies to differentiate from the masters level PA being made now and cements our professionalism.

 

The above quoted article is a great example of where PAs can make a difference in a specialty that is in dire need of help. At my community hospital we have a psychiatrist that visits once every several weeks, is booked solid for months out and does not take call nor contribute much to the care of the acute psychiatric patient either in the attached clinic or the ED. This tepid support and presence from the psychiatric community is a shame but could be alleviated by PAs trained in psychiatry and the psychiatry CAQ can serve as a benchmark to strive for to ensure quality of care.

 

Whether this designation gets you more money or prestige or closer parking space is moot. We live in a time where the public wants and demands credentialing. Anyone who naysays is in danger of being left behind sooner or later. Personally, when I got the CAQ in EM, there was a perceptible appreciation from the medical staff and the hospital that I chose to get a designation that no one forced me to but did because I thought it was the proper thing to do as the senior PA here. The bottom line is that many long practicing PAs in certain specialties have plenty of hours to qualify, have done the procedures listed and can likely pass the exam with a bit of self directed study. The issue is the cost, about $300. Have your employer pay it or use CME funds if that will break the bank, thats what you negotiated for.

 

G Brothers PA-C

 

Well, two things. First, re: the article I linked, it would have been nice to see one of the PAs from the Association of PAs in Psychiatry making comment on an issue regarding their specialty.

Second, take an NCCPA staffer pushing the CAQ with a grain of salt. There's a reason speakers need to disclose their relationships before a talk!

 

CAQ, if they wanted to do it right by PAs, should be THE primary recert tool, NOT PANRE. I agree w. you that we need to document competency (knowledge base is an element of competency). If they obviated the USELESS PANRE then the $300 CAQ wouldn't be such a big deal.

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 I actually know Greg from the NCCPA and have talked with him at length about the CAQ process. Not only is he a good guy, he makes a very necessar and coherent argument that the CAQ is a necessary step in a PA's career.

I talked to him as well at sempa a few years ago. he was a great resource on the CAQ and not helpful at all for the changes to panre. he couldn't tell me what would count for the PI or SA components and so far only AAPA has made this make any sense at all by posting a limited list of acceptable activities.

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Well, two things. First, re: the article I linked, it would have been nice to see one of the PAs from the Association of PAs in Psychiatry making comment on an issue regarding their specialty.

Second, take an NCCPA staffer pushing the CAQ with a grain of salt. There's a reason speakers need to disclose their relationships before a talk!

 

CAQ, if they wanted to do it right by PAs, should be THE primary recert tool, NOT PANRE. I agree w. you that we need to document competency (knowledge base is an element of competency). If they obviated the USELESS PANRE then the $300 CAQ wouldn't be such a big deal.

In a perfect world, the CAQ would be the recert tool. But what about the PA who in a ten year cycle works in the ED for a year, 2 yrs a hospitalist, 4 yrs FP, returns to hospitalist per diem but then has a full time gig working IT? Where do you plug them in? Does the AAPA have any data to indicate how many PAs stick with at least a specialty for a length of time in order to make a logical decision about this? Will the NCCPA be able to provide a level of service we desire without the revenue brought in by the PANCE, PANRE and CAQ?

G Brothers PA-C

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I talked to him as well at sempa a few years ago. he was a great resource on the CAQ and not helpful at all for the changes to panre. he couldn't tell me what would count for the PI or SA components and so far only AAPA has made this make any sense at all by posting a limited list of acceptable activities.

At AAPA Boston, Greg gave lectures about PI and SA. I found the staff at the NCCPA booth very ready to discuss the new CME components. Got to point out the NCCPA is not a CME provider, AAPA is. I think AAPA are moving too slow on approving both SA and PI especially in the specialty areas given that there is only ONE PI activity being considered in EM. Since nearly 10% of PAs identify themselves in EM in some way, that is a substantial amount of folks to leave hanging. But if I am interpreting the NCCPA graphic correctly, you could load all 40 PI credits into the 4th two yr cycle giving those who start their 10 yr cycle in 2014 till 2020 to start doing PI. Gives the AAPA 6 years to work on this. I also think you will see a ground swell of CME providers getting their conferences and publications approved for SA at least. National specialty organizations and others will use PI to push guidelines and standards into practice. I think it will come into place eventually. I also note that there were some workshops I attended at AAPA Boston that had been approved for SA credits. I think more conferences will advertise this fact in order to draw attendees.

Then the 2 largest issues are this:

1. Feeling justified paying the fees for these CME activities. Do we feel we are getting our monies worth? Seems like initially there is a level of concern about this anecdotally.

2. Changing from passive learners (most of us) ie sit in lecture hall and get info delivered to us that we dont retain for too long or becoming active learners and engaging in the process (more work than listening to someone blah blah blah)

G Brothers PA-C

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In a perfect world, the CAQ would be the recert tool. But what about the PA who in a ten year cycle works in the ED for a year, 2 yrs a hospitalist, 4 yrs FP, returns to hospitalist per diem but then has a full time gig working IT? Where do you plug them in? Does the AAPA have any data to indicate how many PAs stick with at least a specialty for a length of time in order to make a logical decision about this? Will the NCCPA be able to provide a level of service we desire without the revenue brought in by the PANCE, PANRE and CAQ?

G Brothers PA-C

Your hypothetical is working as a hospitalist. Let them take the general med PANRE. That covers hospitalist and FP pretty well.

If people want to continue to take the generalist PANRE then so be it, to cover all their bases (as well as that exam can cover them).

 

I work in CT surgery. I get VERY little clinical yield out ofthe current PANRE. Instead of worrying about how to make specialty exams work for PAs who jump specialties, I ask what is NCCPA doing to serve the specialty PAs who are indedicated practice for many years. I should not need to take 2 exams (PANRE and CT Surg CAQ) when the first one is nearly meaningless.

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when the heck are they going to give a IM CAQ?

>20% of ALL PA's identify themselves as in IM (the biggest percentage) and the NP's are kicking out butts, yet NCCPA is not yet putting out a CAQ for us....

 

CAQ and internships are MANDATORY in the future if we are to survive ...... 

 

if not then those of us in primary care are going to be starting a bridge program to NP

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a working PA can likely become an NP in 3 yrs part time anyway if you really want to.

PA to RN one year online with excelsior:http://www.excelsior.edu/programs/nursing

if an LPN or paramedic can do it in 1 year while working full time you can too.

then as an RN with a prior MS you can do an online msn/fnp program in 2 years with minimal clinical time like this one:

http://www.westernu.edu/nursing/nursing-academics/nursing-msn-fnp/

see flexible web based option. on campus 2 weekends/semester. clinicals arranged in your home community on your time off. many rotations can be done in as little as 40 hrs. that's 3 long shifts...

voila, PA to NP bridge part time in 3 years.

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a working PA can likely become an NP in 3 yrs part time anyway if you really want to.

PA to RN one year online with excelsior:http://www.excelsior.edu/programs/nursing

if an LPN or paramedic can do it in 1 year while working full time you can too.

then as an RN with a prior MS you can do an online msn/fnp program in 2 years with minimal clinical time like this one:

http://www.westernu.edu/nursing/nursing-academics/nursing-msn-fnp/

see flexible web based option. on campus 2 weekends/semester. clinicals arranged in your home community on your time off. many rotations can be done in as little as 40 hrs. that's 3 long shifts...

voila, PA to NP bridge part time in 3 years.

This almost sounds tempting....

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This almost sounds tempting....

3 yrs full time you could be a doc.....you know, if you had a supportive spouse with a good income in a state with 3 yr med schools and cheap in state tuition.....:)

the problem with becoming an NP is you have to become a nurse first....

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for Ventana(if he wants a DNP and not an msn/fnp) there is this fully online option in his own backyard:

http://www.umass.edu/nursing/programs/doctor-nursing-practice-dnp-online

Fully online DNPs? Online NPs... I understand a lot can be done thru distance education these days, but that's another whopping training disparity in my book.

 

I can't recall coming across any online PA programs. But I also was not looking...

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Fully online DNPs? Online NPs... I understand a lot can be done thru distance education these days, but that's another whopping training disparity in my book.

 

I can't recall coming across any online PA programs. But I also was not looking...

you still have to do (limited) clinicals that you arrange yourself at your convenience in your home town.

we had a student from one of these programs recently that we failed her last day or her last clinical. she was awful all along, but the last straw was when she couldn't recognize strep throat in a kid with a fever, ST, big nodes, white exudates, and lack of cough as the source of fever. she didn't even look at the throat, just told him it was viral. I was one of her 2 preceptors. the other( a really excellent NP with yrs as an icu nurse, etc) was the one who insisted we fail her. I agreed. she is still a floor nurse today.

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I can't recall coming across any online PA programs. But I also was not looking...

that's because there are no fully online PA programs....

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we had a student from one of these programs recently that we failed her last day or her last clinical. she was awful all along, but the last straw was when she couldn't recognize strep throat in a kid with a fever, ST, big nodes, white exudates, and lack of cough as the source of fever. she didn't even look at the throat, just told him it was viral. I was one of her 2 preceptors. the other( a really excellent NP with yrs as an icu nurse, etc) was the one who insisted we fail her. I agreed. she is still a floor nurse today.

Just wow. I think that a good chunk of non-medical people, parents, etc. would have guessed Strep at that point. Also, not even looking in the throat...death of the physical exam.

 

 

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3 yrs full time you could be a doc.....you know, if you had a supportive spouse with a good income in a state with 3 yr med schools and cheap in state tuition.....:)

the problem with becoming an NP is you have to become a nurse first....

For residents of Texas (like myself) they have a new three year Family Medicine Accelerated Track (F-MAT) at Texas Tech school of medicine. As a bonus, they give you free tuition your first year in the form of a scholarship. In-state tuition is $14,400. So for $28,800, plus costs of living... and you are a med school graduate in three years and can start a family med residency. If I was a student set on doing FM I would do it in a heartbeat...

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3 yrs full time you could be a doc.....you know, if you had a supportive spouse with a good income in a state with 3 yr med schools and cheap in state tuition.....:)

the problem with becoming an NP is you have to become a nurse first....

 

Yeah, my wife already keeps pushing me towards med school- she doesn't need any more ammunition, thank you very much :)

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