Jump to content

PA vs MD didactic portion


Recommended Posts

I remember having the same questions myself when I was first going through PA school.  I was at a PA school that was paired to an MD program, and we saw the medical students only having class until 12 or 1pm, while we'd have to stay until 3-5pm every day.  They had exams once a month, we had exams once a week.  They had their first summer off and a very laid back 4th year, we never had more than 1 week off the whole time.  Crunching the numbers, I thought that we must learn comparable amounts of info during school.  Since we were part of the MD institution, we had access to all of the video recordings of our lectures AND the medical students' lectures.  Over the past year, I've watched a number of their lectures and have been able to do a "bilateral comparison" of sorts. I have found they honestly go into significantly more depth than we ever did.  Things that we had 2 powerpoint slides and 20 minutes of explanation would sometimes have 4 hours worth of lecture for them.  And for what it's worth, I went to a very highly regarded and well established PA program.

 

Now I am doing a residency side by side with physician residents and I can see the results of their education... and its much more than just basic science minutiae and embryology.  They have a much better understanding of physiology and pathophysiology, which are clinically relevant.  For example, as we are learning about toxicology, I've noticed that the other residents are much quicker to pick up on and remember everything, because their base of phys and pathophys is so strong.  All they have to hear is "its an antimuscarinic" and they immediately internalize it.  I've had to do some serious studying to relearn the ANS (and more than the basic version taught in PA school), and I realize that I still won't ever really internalize it as well as my fellow residents.  While I don't think their didactic knowledge is directly helping them with everyday clinical duties, I do think it helps them learn things at a much faster rate.  

Link to comment
Share on other sites

PAS-1 here, started about 5 weeks ago at a school that also has a DO school. Already I can tell you that my education is NOT comparable to the DOs. They are responsible for a far greater depth of material than we are. Simple as that. They learn more, are taught more, are examined more rigourously in the basic sciences and therefore know more.

 

We all follow the same block schedule, as a PAS-1 I have 5 blocks then move on to the clinical year. The DO's have 8 blocks, then move into their clinicals. Cadaver anatomy for us is a 1 block class, for the DOs it is a 4 block class. The speed we have moved through the disection is boggling, but the amount of material we are responsible for is far less than the DOs. 

 

They spend more time on basic medical sciences using the same professors that teach us PAs so it is only natural that they would end up knowing more.

I can't see how that is even in doubt. 

 

I believe that SERENITY above has explained one possible difference that this deeper foundation in science provides, the ability to assimilate new information. Biomedical science is not a static field and having the ability to absorb new information is critical to both PAs and MD/DO.

 

Now one difference in our favour is that we start practicing our clinical skills straight away. We have already had a couple of encounters with the DOs where they act as our patients and we perform exams on them. These are done in a simulated setting and recorded for our feedback. The DOs have said that they were surprised at the extent of our physical exams and that we were responsible for much more material for each exam than they were.

Link to comment
Share on other sites

...

Now I am doing a residency side by side with physician residents and I can see the results of their education... and its much more than just basic science minutiae and embryology.

...

 

You are kind of making my point for me. You are doing a residency side by side with physicians and it sounds like you are handling it well. Yes, physicians learn more. Yes their education is superior. I don't think anybody denies that. But if you can do a residency side by side with them, doesn't that kind of prove the point that a PA going back to medical school for four years is functionally unnecessary?

 

If you had 1 year of dedicated medical science classes to bridge that gap, do you think you would still be at a deficit? Maybe two years? Three?

How much time would you reasonably estimate it would take to have a level foundation in the sciences you feel you are lagging behind your peers in?

Link to comment
Share on other sites

  • Moderator

You are kind of making my point for me. You are doing a residency side by side with physicians and it sounds like you are handling it well. Yes, physicians learn more. Yes their education is superior. I don't think anybody denies that. But if you can do a residency side by side with them, doesn't that kind of prove the point that a PA going back to medical school for four years is functionally unnecessary?

 

If you had 1 year of dedicated medical science classes to bridge that gap, do you think you would still be at a deficit? Maybe two years? Three?

How much time would you reasonably estimate it would take to have a level foundation in the sciences you feel you are lagging behind your peers in?

1 year would do it.

Link to comment
Share on other sites

  • 1 year later...

the MS1 year is very focused on basic medical sciences to a depth not explored in PA school. We had a few lectures on microbiology, they had a whole course. ditto neurophysiology, immunology, biochem, etc.

The best person to answer this question is someone who has attended both programs. we have a few of those folks on the board, hopefully they will chime in.

I'm sure the vast majority of physicians know a lot more basic medical sciences than I do. I can't say that it makes them better clinicians, however as much of that knowledge only applies to narrow fields or pursuits such as designing new medications or treatment protocols. the purpose of medical school is to create a medical scientist ready to start clinical training in earnest in residency. the purpose of PA school is to produce a clinician ready to practice primary care as part of a team the first week they are in practice.

USMLE step 1 is not clinical in nature. it is a mechanism for med students to demonstrate knowledge of the basic medical sciences learned in the MS1 year. step 2 and step 3 are fairly similar to PANCE and I believe most PA students could pass these, certainly step 3.

Again, I hate digging up an old thread for the second time in two weeks, but do you think avoiding embryology, immunology, biochemistry (this one particularly), neurophysiology, and other courses that delve into the complexities and cellular level of medicine that medical school does are a good enough reason to avoid medical school and go PA? This is one of my main driving factors amongst others (time + debt). Although this is probably my #1. I'm a great student when it comes to anatomy, physiology, micro, genetics, chemistry, and so on. Although when I started to attempt courses like biochemistry I was completely lost. I just couldn't grasp it and deeply despised the subject because the whole time I thought to myself "I will never need this garbage as a professional in my every day job." It just seemed so useless. Granted I understand that we need individuals with this knowledge and they serve a purpose, although like you said I never thought it made someone a better clinician.

 

My thought process was/is that I'd have a very very difficult time in medical school versus PA school due to this, as well as Step 1 versus the PANCE.

Link to comment
Share on other sites

Again, I hate digging up an old thread for the second time in two weeks, but do you think avoiding embryology, immunology, biochemistry (this one particularly), neurophysiology, and other courses that delve into the complexities and cellular level of medicine that medical school does are a good enough reason to avoid medical school and go PA? This is one of my main driving factors amongst others (time + debt). Although this is probably my #1. I'm a great student when it comes to anatomy, physiology, micro, genetics, chemistry, and so on. Although when I started to attempt courses like biochemistry I was completely lost. I just couldn't grasp it and deeply despised the subject because the whole time I thought to myself "I will never need this garbage as a professional in my every day job." It just seemed so useless. Granted I understand that we need individuals with this knowledge and they serve a purpose, although like you said I never thought it made someone a better clinician.

 

My thought process was/is that I'd have a very very difficult time in medical school versus PA school due to this, as well as Step 1 versus the PANCE.

 

Hate to break it to you but PA school has biochemistry.  And immunology to an extent.  Maybe not *quite* the same depth as MD school, but we had dedicated biochem courses and immunology sections.   You may not be reciting the Kreb's cycle in your everyday work but you certainly need to understand why and how something like statins work and the downstream effects and, sorry, but that's biochem.

 

I highly suggest you bite the bullet and take a biochem course (and attempt to really GET it) before you attempt PA or MD.  You'll be thankful you did either way.

Link to comment
Share on other sites

Hate to break it to you but PA school has biochemistry.  And immunology to an extent.  Maybe not *quite* the same depth as MD school, but we had dedicated biochem courses and immunology sections.   You may not be reciting the Kreb's cycle in your everyday work but you certainly need to understand why and how something like statins work and the downstream effects and, sorry, but that's biochem.

 

I highly suggest you bite the bullet and take a biochem course (and attempt to really GET it) before you attempt PA or MD.  You'll be thankful you did either way.

Sections/overviews are very different than full blown courses in a subject from my experience. I've covered immunology sections in several of my undergrad courses. We also touched on biochem models and concepts in my micro and organic chemistry courses. However, when I stepped into a biochemistry course itself (before dropping it) it was much different than just a section/overview of it. Reciting the Kreb's cycle, glycolysis, and electron transport chain and reproducing every single detail onto a blank sheet of giant paper was included. Reproducing this on blank paper was one of our exams for example:

 

6709a2669a4f37469829c3cde77e23ae.jpg

Link to comment
Share on other sites

You've got to do the basics before you can get to the good stuff.  Sorry, not sorry.  You may have to recite the kreb's cycle for a biochem course but that's because it's a course. It's not your everyday life.  Do I use integrals every day?  Nope.  Did I have to learn it for calculus?  Yep.  That's part of the process.

 

There's a reason so many PA programs have it as a pre-req.  You'll struggle through a section/overview if you've never taken it before.  You just will.  I watched my classmates.  You're only doing yourself a disservice by taking the easy way out.

Link to comment
Share on other sites

You've got to do the basics before you can get to the good stuff.  Sorry, not sorry.  You may have to recite the kreb's cycle for a biochem course but that's because it's a course. It's not your everyday life.  Do I use integrals every day?  Nope.  Did I have to learn it for calculus?  Yep.  That's part of the process.

 

There's a reason so many PA programs have it as a pre-req.  You'll struggle through a section/overview if you've never taken it before.  You just will.  I watched my classmates.  You're only doing yourself a disservice by taking the easy way out.

You may be right. At this point I'm not going to risk how many years it's taken me to improve my sGPA by knocking it down with a B or C by opting to take biochem again though when my state PA schools don't require it. That's not because I don't think it will help. I just don't think it's worth the risk. I merely brought it up in terms of comparing the didactic portions of PA versus MD/DO and the rigor of getting through each in addition to Step 1 versus the PANCE.

Link to comment
Share on other sites

I merely brought it up in terms of comparing the didactic portions of PA versus MD/DO and the rigor of getting through each in addition to Step 1 versus the PANCE.

Tomato, tomahto. MDs have their hoops to jump through, PAs have our own. Didactic year was tough, but I'm not in a position to compare it to the first two years of Med school. I'd suffice to say, though, that the amount of material a PA-S is expected to digest is less than that of a MS-I and MS-II, for good and obvious reasons. My PANCE boards weren't basic science heavy just as my day-to-day clinical practice isn't basic science heavy. With that said, having a solid basic science background prior to PA school made studying that much more efficient for me because I was re-learning things I had heard of before rather than trying to digest everything from the aforementioned fire hose of knowledge.

Link to comment
Share on other sites

Tomato, tomahto. MDs have their hoops to jump through, PAs have our own. Didactic year was tough, but I'm not in a position to compare it to the first two years of Med school. I'd suffice to say, though, that the amount of material a PA-S is expected to digest is less than that of a MS-I and MS-II, for good and obvious reasons. My PANCE boards weren't basic science heavy just as my day-to-day clinical practice isn't basic science heavy. With that said, having a solid basic science background prior to PA school made studying that much more efficient for me because I was re-learning things I had heard of before rather than trying to digest everything from the aforementioned fire hose of knowledge.

I appreciate the feedback guys! Thanks for making things more clear for me. Every bit of advice helps.

Link to comment
Share on other sites

  • 5 weeks later...

In the end, comparing what PAs learn to what MDs learn really is the equivalent of a D* measuring contest. Different roles in the health care spectrum require different education. It's been explained to me that upon exiting PA school, a new grad PA functions at the approximate level of an intern/PGY2 for several years before figuring out what the hell they're doing. After X amount of time that gap between a residency trained MD/DO and a PA can shrink but it will always be there. Do PAs provide substandard care as compared to MDs? No.

 

PA school was never designed to delve the depths of the hard sciences but rather as a crash course in medicine to turn providers with a ton of on the job medical experience into physician extenders to fill a shortage. The position has evolved from this, of course, but the idea remains the same. PAs are not trained in the same depth as MDs because they are fundamentally different roles. I'm okay with having more professional flexibility, better job satisfaction, lateral mobility and the ability to have a life outside the walls of a clinic but I understand that I'm sacrificing pay, professional esteem and certain aspects of the depth of my knowledge for this. >50% of MDs hate their jobs and wouldn't go back into medicine if they could do it again. I'll take PA every day

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More