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The LECOM "bridge" Is anyone thinking of doing it?


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I am planning on applying to medical school for 2013. My husband is currently finishing his residency and we have a two year old so we're trying to maintain some sort of balance in our training. I'm certainly interested in this program, but my concern would be match as LECOM is a DO program so how much is this going to limit people interested in surgical subspecialties or highly competitive fields. I work as a very autonomous hospitalist right now but I don't think I want to necessarily work in a primary care speciality when I'm done. Just wonderingif anyone else is thinking of applying in the near future or even starting it this year! What a fantastic time for our profession. Think of the changes and support for our profession this will bring with more of our own becoming doctors. Name change wont be far behind I would imagine.

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I disagree - I do not think it is fantastic more PAs will become doctors. Wouldmuch rather see experienced PAs advance autonomy and skill set through CME or residency programs. I do not think this is goodfor the PA profession. Will we lose our most motivated? Will PA be viewed as an MD stepping stone?

 

On a side note.... just had a friend finish DO school and said he wish he went the PA road... Not sure how much of this is true... said it is very hard to getinto competitve residency programs as an avg DO and he is doing something not his ideal interest.

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Wouldmuch rather see experienced PAs advance autonomy and skill set through CME or residency programs.

this would be ideal but many pa's who complete residency are treated just like pa's who haven't as they are in a cookie cutter mold of "pa scope of practice" as determined by their hospital credentialing committee. I work with a residency grad of the very hard core usc/la county em residency. guy used to run c-booth as a resident (that's all medical codes back to back for an entire 12 hr shift) and see any type of pt presenting to la county/usc; trauma, mi's, anything.

he is not treated any differently than a new grad by our hospital.

the best way to have good autonomy as a pa is to work nights/weekends in very rural settings or work internationally.....that's where I am headed unless I end up doing one of these bridge programs.....

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The bridge programs seem less like a "bridge" and more like a "med school that only accepts PAs." The difference in time is minimal/non-existant compared to some other medical programs.. seems like a lot of time lost, money (no salary + medical school loans) for a slight improvement in autonomy? Say you lost a 100K salary for a minimum 7 years + 200K in loans at 6.8-8+% interest... no thanks. Sounds like financial suicide to me, as most of the higher paying specialties will be hard to enter (especially with the unknown surrounding these hybrid programs) and are generally longer than 3-4 years.

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it's not about salary. it's about scope of practice and respect. in primary care a pa can have an equivalent scope of practice to an md/do. in other specialties this is very difficult, more so in major metro areas. for me to have a full em scope of practice I need to move to the upper ne (maine/vt/nh) and work solo in a low volume er, this is probably where I will end up...

the program does save you an entire yr. and allows admission without several worthless prereqs. and with only a min mcat score requirement(22).

there are only 2 other 3 yr programs in the country, both are very competitive and both limit you to primary care.

my $# for medschool is around 1 million dollar opportunity cost( 6 yr lost salary+ cost of school+ life expenses minus residency pay).. would probably take 20 yrs to make that up. would break even when most folks retire yet still considering it...

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it's not about salary. it's about scope of practice and respect.

my # for medschool is around 1 million dollar opportunity cost( 6 yr lost salary+ cost of school+ life expenses minus residency pay).. would probably take 20 yrs to make that up. would break even when most folks retire yet still considering it...

 

For that lost time and $, what new things would you be allowed to do in the ER? I certainly wouldnt pay 1mil for some respect...

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For that lost time and $, what new things would you be allowed to do in the ER?

run(not participate in) all codes/traumas, deep procedural sedation(can only do "moderate " as a pa), regular and u/s guided central lines, difficult airway procedures, thoracentesis, upper airway endoscopy, chest tubes, etc ( some of things I am credentialed to do now but only really get to do if all the docs are busy or I am working solo...which I do 75% of the time now for just that reason(but at a facility with fewer resources so end up transferring many folks instead of managing them throughout their course).

respect is actually worth a lot. wait until you have been told "you can't do xyz because you are ONLY a physician'S assistant" around 1000 times...it gets old really fast. seeing new grad fp docs with 3 mo total time spent in the er in their entire medical education get privileged to do more than an em pa and former medic with almost a quarter century in em really sucks. then that new grad fp doc who you helped train when they were an intern( your "supervisor" when you work together) runs all their cases by you because they don't know what to do...oh yeah, their hrs are better than yours and they make 20 dollars more/hr. they are a partner and you are an employee. when a pt crashes in the dept the staff grabs you, not the doc. it gets old. trust me.

Feeling a little burnt and jaded this month due to schedule so keep that in mind when you read my rant.. working 220 hrs in 3.5 weeks at 3 different facilities with multiple day/night shifts back and forth to cover a bunch of sick leaves in our group....and they mandate an emr training right in the middle of this...I get off at 2 am, training starts across town at 7 am...all day...double the next day swing/night followed by a day shift, etc...

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I agree with emed. I feel it is very short sighted to see it as a loss to the profession. Is it a loss to the rn profession when people become NPs sure but them you gain a great NP? Or a good paramedic becoming a PA....The majority of PAs will NOT want to take on the debt and hours and scut of going to med school. The bridge cuts out a year, and therefore 1/4th the debt and tediousness. I wish allopathics would follow suit but guess when they will, when more former pas who are now MDs help push it! I personally would/will ALWAYS be a huge supporter of the profession that allowed me to fully realize my potential but for me I didn't know how it would feel till I was there, pushing against the glass ceiling. It's unfair to expect people to know what they want for infinity, well, ever! I had an inkling, yes but pa as a stepping stone is a very expensive long way no matter how you cut it and most sane people won't do it!

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I'm doing it in T-5 months. (Eek!) PA for 10.5 yr now, highly autonomous positions, varying scopes of practice in many different settings, but I cannot be a PA at the whim of the attending of the day for 30 more years of my career. For me it has very little to do with money and a whole lot to do with INDEPENDENCE and a deeper fund of knowledge. I'm willing to suck up the opportunity costs to take this plunge although I freely admit it is NOT for everyone. FWIW, I am giving up a whole lot to do it (including selling a house I loved at a loss to be rid of it and very likely will do the 2-state marriage thing for 2 years of didactic as my husband is not sure he can find work in PA and is happy in SC). No, I don't have kids. Can't imagine how I would do it if I did.

IMO if you can't imagine why a PA would go through this then the program is not designed for you. Plenty of PAs I know--I would venture to guess MOST of them--are perfectly happy and content as PAs. Only ~4% of PAs go on to become physicians. I expect that number may increase with the advent of APAP and other similar tracks (if you build it they will come...) but it will take quite a while to see how this experiment pans out.

FWIW I am not tied to primary care and will be free to choose the specialty I can match into. Most likely for me this will be some primary care field as that's what I enjoy most but it's nice to have options. Also FWIW if you are a savvy PA who has worked a while you likely have lots of contacts you can tap for residency leads. I already have 2 very good allopathic residency options lined up, one a well-regarded unopposed FM program in the SE that prides itself on training the next generation of rural physicians :) It's gonna work out.

:) PM me if you have questions.

Lisa

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If I was younger I would do it. I'm not in any position to do it anymore and that goes for many other PAs. The ones with children...big sacrifice, Huge! PAs that are the main or only family income might not be able to do it considering the number of yrs. It can break up a relationship/marriage very easily. Then there's the wear and tear on the body. The first yr is going to be difficult, maybe the first 1 1/2. If none of you have done OM(I have), it's going to be a strange concept to grasp onto in the beginning. Best of luck...

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If I was younger I would do it. I'm not in any position to do it anymore and that goes for many other PAs. The ones with children...big sacrifice, Huge! PAs that are the main or only family income might not be able to do it considering the number of yrs. It can break up a relationship/marriage very easily. Then there's the wear and tear on the body. The first yr is going to be difficult, maybe the first 1 1/2. If none of you have done OM(I have), it's going to be a strange concept to grasp onto in the beginning. Best of luck...

 

We take quite a few courses with the med students at my program so we've had to sit through several OMM lectures. It's a whole bunch of pumping spleens and redoming diaphragms...

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Also in the FWIW collumn:

 

I can totally see why a PA would "move on" to medical school... for a lot of reasons that many above have stated: Including greater respect for one's work, increased scope of practice, and increased depth of medical training.

 

These are good reasons to pursue a medical degree (MD or DO). Certainly $$$ is NOT king in this instance and if one's choices are not limited by economic concerns a bridge program would be a good option. It would be great to have a group of SPs out there that were once where we are now... So, No, I don't think that PAs moving on to become doctors is bad for the profession.

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Consider also the value of physicians who have been PAs training the next generation of PAs--promoting better scope of practice, having clout on medical boards & hospital admin to promote PAs over NPs...certainly one of my goals.

 

Lisa,

I'll come work for you.

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  • 2 weeks later...
Considering it....also another do program closer to me that i contacted may open a similar program next yr...

 

EMEDPA, If Im not mistaken I thought you said you wouldn't do it because of the time the program would take and your status at your current position and also your age, so if you dont mind me asking what made you change your mind?

 

(if you never said any of the above things then nevermind :S)

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Consider also the value of physicians who have been PAs training the next generation of PAs--promoting better scope of practice, having clout on medical boards & hospital admin...

 

 

In "theory" this would be GREAT...!!!

 

And I know YOU will be a good one, but...

 

Unfortunately, the last few PAs turned Physicians that posted here had some rather REGRESSIVE attitudes and notions about our "scope of practice," knowledge base, and utilization patterns...

 

So, in "theory" this would be GREAT... but if it will simply cause the former PAs to "switch jerseys/teams" and see PAs as inferiorly trained competition, that needs to be "directly" stupervised and not much better than "Patient Care Techs" or "Super-MAs"... :sad:

I recall that discussion becoming so contentious that one poster had the temerity to suggest settling the debate with "fisti-cuffs"... :heheh:

"Fisticuffs"

 

He'd known the game of fisticuffs had always treated him right

But no one knew the man who came and took his life that night

 

He knew the game of fisticuffs, he knew the game of might

But no one knew the man who came and took his life one night

 

He knew the game of fisticuffs, he knew the game of fight

But no one knew the game would come and take his life that night

 

 

Just a few thoughts...

 

Contrarian

 

Btw... I'll be in Chicago from Apr 13-18... so if anybody out there wants to link up for... umm... well... whatever, send me a PM...:rolleyes:

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The similar issue comes up in occupational therapy, with OT assistants and whether or not they should do a transition program to a masters in OT to become an OTR/L. Everyone has an opinion. For some it comes down to money, for some the increased scope of practice matters and others it doesn't. With therapy, though, I don't think it is nearly so controversial though. There are I think 8 transition programs, but all private and terribly expensive.

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Emed is right. It gets old dealing with people who just don't understand the concept of PA. Thinking they need a Physician to refer or ask for a consult, constantly defending what we are, being called to a crashing patient and at time nurses (in chaos) saying: "we need a Dr." or "isn't the Dr. coming?"

I've had to step back and say: "look, if you're not actively helping, leave the room- he's in surgery, I'm it..." I've won respect and gained ground over the past 4 yrs but not at the cost of becoming jaded somewhat. It also gets very old making a decision that I know is right for the patient and then that being overridden by your SP who makes the wrong decision having to watch it happen and not work and ending up coming full circle back to my original treatment plan.

 

I just don't know about the crossover. It sounds like a good idea. It's just that everyone who has gone back to Med school and posted on here has forgotten what their position was when they were a PA and regressed. Just go back and read the posts. If they did take their new education to help the PA profession it would be one thing but that hasn't been the case.

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Absolutely subjective. I have been a PA for just over a year and can relate to everything stated on this thread r/t autonomy, respect, ect. It is really aggravating to have to constantly prove yourself "worthy" to every single provider you come into contact with; especially aggravating when you get crap like "why are you calling me, have your attending look at the patient and call me." I really have to bite my tongue when that happens, but it's just part of the job.

 

From what I've gathered on the Lecom and other bridge program sites is that, as far as going from PA to DO- it's your best shot. Would I do it? Bet your a** if I didn't already have >100K in debt and 2 kids under 10 that I would never see, and a marriage that is slowly recovering from PA school. Logistically, if you started the training with very little debt, were able to cut the borrowing/ live frugally during the program- it could work. Your income potential would be greater no matter what your specialty. Down the road, this would make a difference. What would make a difference RIGHT AWAY would be the instant respect from your peers- I can understand that.

 

To each their own. Looks like a good opportunity for those able to make it work. Just don't forget your roots...

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jwells- if I can get my ducks in a row and if the local DO program opens a bridge-as they have said they are considering- I may go...and you know I won't forget my roots...I haven't worked as a medic in 16 yrs and there aren't any pa's out there who are more pro-medic than I am...

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