Practicing medicine with online degree

[FiremedicMike]

Sorry but I believe that PA schools should abandon the HCE requirement and start the enforcement of the MCAT for admission. There should be a minimum MCAT for admission to PA school perhaps 25. I would recommend 30 for average acceptance (on the old MCAT). We would attract better applicants with broader educational preparation who are able to reason well in a number of areas. If someone cannot pass organic chem, biochem, general chemistry, physical and math, I have doubts about their intellectual capacity to practice medicine.

 

I have to smile at the "I was exposed to this or that before PA school because I was a whatever."  Being exposed is not the same as being responsible for. I am exposed to a lot of NFL football on Sundays. I doubt that I could start as Quarterback for a professional team next week. The only thing relevant is the experience you gain AFTER PA school. You will do absolutely well on clinical rotations by doing what Medical student do for rotations without HCE. Study. 

 

I already have to take nearly the entire pre-requisite course list for medical school to apply to PA school.  If I had to take the MCAT too, I would just apply to medical school.

[Febrifuge]

This kind of thinking clings to a difference that doesn't add value. That is to say, the argument that a PA with hce is superior to an MD with residency and MCAT, USMLE 1,2,3 and ABIM is absurd.

It is - but it's also not an argument anyone here is making. You're arguing from a false premise. If you really want to get into it, then my point is only that PA and MD training models both have a place and a function, and while they do overlap, they have important differences. Those differences, especially at the beginning of training, are important enough that my school made them a factor in admissions.

 

 

We need to abandon the idea of selling something that doesnt sell. This is why NPs are beating us to death.

 

You're clearly bitter about the NP vs PA situation; maybe you're in an area where there is tough competition for jobs. It's not like that everywhere. My state has decent NP saturation, and yet plenty of employers prefer to work with PAs. In general, everyone gets along and people get judged on their skills and merits. I agree that in the national level, we need to advocate for our profession, and we can learn from the example of the NPs, who in many ways are far ahead of us, in terms of lobbying. But that doesn't mean I don't still believe in the PA profession.

 

What Febrifuge says is that his PA program will reject a motivated applicant with superb undergraduate training because they prefer intellectually lazy and fearful applicants who cannot undertake rigorous entrance exams.

Yeah, that is definitely NOT what I am saying. And it's significant, I think, that your idea of the message is so far off.

[HMtoPA]

Back when I was in PA school, the students had a hand in admissions interview days. We rejected a guy when we learned he had MCAT scores in the system. The professor I was working with explained that we wanted people interested in being PAs, not people who were lacking confidence in their ability to get into 4-year med school.

 

 

It seems silly and rather petty to penalize an applicant for having MCAT scores on file. Now, if they were poor scores, that's another thing entirely.

 

But this idea that someone should just have a burning desire to be a PA, instead of an MD or DO, or heck, even an NP, is sort of absurd. The details of the credentials are mostly unimportant to aspirants (not too mention the fact that the distinctions between them in real life are largely invisible), they just know they want to "practice medicine," whatever they think that means at the time.

 

There are real, tangible differences to being a PA versus a doctor, of course, that applicants need to be aware of and think through. But I think it's perfectly natural for someone who is curious to be considering the two fields concurrently, and even taking steps to be prepared as much as possible for both fields. Heck, when I took my PA school pre-reqs, I took a couple of extra courses that I knew I wouldn't need (Human Growth & Development, Nutrition) because I was considering nursing school as an option. 

[8404PA]

Deleted

[True Anomaly]

Refrain from the ad hominem attacks please.  Argue the talking points, not the person

[Febrifuge]

I think I can clarify a little: my program had 55 seats the year I started, and if I remember correctly, we got something like 1800-2000 applications. When you need to reject over 95% of all applicants, you can absolutely concentrate on people who want to be PAs. Those seats go to people who have a solid plan, one which is in line with the priorities of the program.

 

And it's less about a "burning desire" as it is about having a solid sense of what you want. Find me an applicant who doesn't really care whether they get accepted to PA school or NP school, and I'll show you a future clinician who has a higher than average chance of having a crisis about it within a few years.

[Kaepora]

I complete disagree.  I think the ultimate goal is to practice medicine (whatever the underlying driving force - "I really like science/biology/medicine", "I really want to help people", etc).  I encourage people to apply to MD/PA/NP concurrently if they have the necessary prerequisites.  So if a qualified applicant was denied from medical school you don't think it appropriate for them to apply to PA school?  They should change fields altogether?  That just doesn't make sense.  If someone is applying to a program of study there must be something within them that wants it.  I would rather a person express a desire to practice medicine than to be in a specific profession.  MD/PA/NP are more similar than different in practice so what does it really matter if a person applies to all 3 and becomes whichever is accepting of them?

[EMEDPA]

in my mind if someone goes through the trouble of taking all the md/do prereqs, takes the mcat, etc they should focus for at least several cycles on becoming an md/do. if they don't get in anywhere after 3 cycles they probably aren't a great applicant for some reason and would likely have problems getting into a pa program too. think about it. name a factor that would keep you from md/do but wouldn't be a problem for pa. research? DO programs don't care about research. gpa? big deal anywhere. mcat? if you have a poor mcat you probably don't have a great gpa too.

being a doc and being a pa have some very significant differences. sure, both are practicing medicine, but the culture of the two professions and the trajectories are very different.

[Febrifuge]

I complete disagree.  I think the ultimate goal is to practice medicine (whatever the underlying driving force - "I really like science/biology/medicine", "I really want to help people", etc).  I encourage people to apply to MD/PA/NP concurrently if they have the necessary prerequisites.  So if a qualified applicant was denied from medical school you don't think it appropriate for them to apply to PA school?  They should change fields altogether?  That just doesn't make sense.  

 

Man, this is a great week for people restating my arguments - which I honestly do appreciate, because it's a helpful building block for understanding - and getting them wrong. A few more of these, and I'm going to start thinking the problem might be me.

 

Anyway, no. That doesn't make sense, I agree, but it's also not what I'm saying. If a qualified applicant gets denied admission from MD school, what that person should do is re-apply next year. And in the meantime, they should do whatever they can to improve their chances. Maybe that means getting more HCE, maybe that means applying to a wider array of schools. Whatever. What they should definitely NOT do is figure "well, being a PA is basically, kind of, mostly like being a doctor, so I guess I'll apply to PA school and see what happens," and then somehow manage to take a seat away from someone who actually wants to be a PA.

 

If someone is applying to a program of study there must be something within them that wants it.  I would rather a person express a desire to practice medicine than to be in a specific profession.  MD/PA/NP are more similar than different in practice so what does it really matter if a person applies to all 3 and becomes whichever is accepting of them?

You have the word "student" right there in your screen name, so please don't take it as sarcastic or condescending, but there's a perspective lacking in your argument. Grab 10 MDs at random as you go about your day, and ask how many of them cared whether they were actually MDs, or would have been fine just practicing medicine any old how. See how many PAs would have been just as happy doing 4-year MD school, residency, and then being locked in to one specialty forever.

 

Do I know PAs who wish they had done MD school, looking back? Sure. I know a couple who went back and did it, actually. Do I know MDs who sometimes wish they had done PA instead? Maybe. I don't hear it all that often. Point is, either of those will be the exception. Even among unhappy MDs, I don't think it's a major theme that what they're unhappy about is the fact they practice as MDs; they're just unhappy with medicine, or maybe in general.

[steve.bannon]

Back when I was in PA school, the students had a hand in admissions interview days. We rejected a guy when we learned he had MCAT scores in the system. The professor I was working with explained that we wanted people interested in being PAs, not people who were lacking confidence in their ability to get into 4-year med school.

 

You are being quite eloquent in your defense, but let's be real - none of that is what you said, either.  Your original statement belies the insecurity that runs deeply within PA adcoms and spills out into the workforce.  A paradoxical insecurity born of immense popularity, yet apparent within the profession's gatekeepers.

[Kaepora]

Anyway, no. That doesn't make sense, I agree, but it's also not what I'm saying. If a qualified applicant gets denied admission from MD school, what that person should do is re-apply next year. And in the meantime, they should do whatever they can to improve their chances. Maybe that means getting more HCE, maybe that means applying to a wider array of schools. Whatever. What they should definitely NOT do is figure "well, being a PA is basically, kind of, mostly like being a doctor, so I guess I'll apply to PA school and see what happens," and then somehow manage to take a seat away from someone who actually wants to be a PA.

 

 

You have the word "student" right there in your screen name, so please don't take it as sarcastic or condescending, but there's a perspective lacking in your argument. Grab 10 MDs at random as you go about your day, and ask how many of them cared whether they were actually MDs, or would have been fine just practicing medicine any old how. See how many PAs would have been just as happy doing 4-year MD school, residency, and then being locked in to one specialty forever.

 

Do I know PAs who wish they had done MD school, looking back? Sure. I know a couple who went back and did it, actually. Do I know MDs who sometimes wish they had done PA instead? Maybe. I don't hear it all that often. Point is, either of those will be the exception. Even among unhappy MDs, I don't think it's a major theme that what they're unhappy about is the fact they practice as MDs; they're just unhappy with medicine, or maybe in general.

 

 

And when they don't get accepted the second time?  Or third?  Reapply all you want but there are perfectly qualified applicants that simply don't get accepted for whatever reason.  I think it's perfectly reasonable for this student to apply to PA school.  

 

I feel like I'm pointing out the obvious here, but why give up on a field of interest because you just HAVE to be a PA/MD/NP?  Nothing else will do?  You would simply hate being a PA if you really wanted to be an MD?  Get over it.  If you can't reasonably be a physician then go be a PA or NP.  If you don't get into NP school go be a PA or vice versa.  I think it's great to have a preference.  But life doesn't always go as planned.  Luckily there's a few paths to essentially the same end.  OH yes yes I know the medical model is SO SUPER different than the nursing model and all that.  But practice is pretty darn similar.  Maybe even exactly the same in the same position.

 

I agree with the above that this line of thinking stems from a feeling of inadequacy/inferiority.  Nothing more.

[overthehorizen]

These things that the PA profession is clinging to in order to advertise some unique value just doesn't have substance in the market place. Health care experience is irrelevant. A PA or NP or Resident will make up in 6 months with a panel of patients what the Pre-PA labored for several thousands of hours  watching other people do stuff while being paid miserable wages as a way of showing commitment. It just doesn't sell. Until we, as a profession, start to recognize that we are on a sinking ship, we will continually wave a hearty bon voyage to NPs and MDs/DOs as the sail past us.

 

I'll say again in case anyone forgot my mantra. End the unnecessary board exams every ten years that serve to fill the coffers of NCCPA but add no value to the PA-C. Eliminate dependent practice so PAs can profitably open their own practices.  No undergraduate should consider entering the PA field unless and until the two former statements have been effected. I personally will not precept a student because I don't believe we are helping students; we are only helping PA programs make a nice buck while the futures of the students are quite bleak. 

[UpRegulated]

see my post #24. I'm not wild about anyone, PA or NP, learning physical dx over 1 weekend/semester when the course easily can take 10+ hrs/week of hands on practice in formal sections and outside of class.

 

Yeah, me either.  Especially for those that have never held a stethoscope, an otoscope, or an opthalmoscope in their hands, or palpated an abdomen until the first few weeks of graduate school, who in a mere 24 months after doing the same for the first time are then licensed to diagnose and treat.  These are those that have never been formally trained in head-to-toe physical examination until their first week of grad school, who again, in a mere 24-months are handed a license to practice medicine.  These are people that have had no-to-barely any training training in pharmacology, pathophysiology, full physical assessment, etc. until grad school yet in 24 months of largely observational clinical experience, are handed a medical license.  These are EMT's, paramedics, RT's, PT's, OT's, CNA's, who have all levels of experience, yet whose training is very limited -- but who meet my stated criteria -- that are handed these licenses all day long in only 24 months after starting grad school.

[roger777]

Interesting. Did you forget the history of our profession? (If you are even a PA) It's built on prior healthcare experience. Pick up a book. Obviously the new programs sprouting up aren't aware of it. My program hasn't forgotten..If we replaced HCE with MCAT what's the point? Funny you mention the basic science courses and math. For most programs those are a prerequsite to even applying. It's not like there is a shortage of great applicants. It the MCAT is used why wouldn't you just go into medical school after taking the MCAT?

 

I agree that being responsible for is better than exposure. Save that for the scribes. I was responsible for a lot of patients. Combat medic/EMT/paramedic experience will always be superior experience. To say experience prior to school is irrelevant is ridiculous. It makes you a better PA AFTER school. I am sure those who have precepted students that have had quality HCE vs none can tell the difference.

 

How is Joe blow the college student that heard that being a PA sounds cool and applying better than a combat medic or an EMT with years of service that has been in the $hit and has experienced medicine? Hands down I want someone who's experienced.

 

Alas, you obviously don't like our profession. You make it abundantly clear every time you post on this forum and it's quite sad. I wonder how your patients feel.

After and during. And that is something you can leverage during rotations so you get more out of it. I worked at a near-RN level in the troop clinic on deployment. This kind of thing keeps paying dividends; think of it like compounding interest. Many premeds take months off and study for the MCAT. I spent my time at the end of prereqs reading journals, working in a clinic and practicing discussing med lists with my patients, doing PEs etc. Much better use of time preparing for PA school. SWIM is like a year ahead of the 3rd yr med student they work with on rotation. The idea is that they will eventually catch up during residency. Maybe. PA programs are guided by a different philosophy a big component of which is focusing on what is really important to patient care in order to optimize the shorter period of time spent in training. I think it works pretty well. 

[roger777]

I think I can clarify a little: my program had 55 seats the year I started, and if I remember correctly, we got something like 1800-2000 applications. When you need to reject over 95% of all applicants, you can absolutely concentrate on people who want to be PAs. Those seats go to people who have a solid plan, one which is in line with the priorities of the program.

 

And it's less about a "burning desire" as it is about having a solid sense of what you want. Find me an applicant who doesn't really care whether they get accepted to PA school or NP school, and I'll show you a future clinician who has a higher than average chance of having a crisis about it within a few years.

We've also had someone leave for med school during first term the last 2 years. In a 25 seat program thats significant.

[Hckyplyr]

FWIW if one has a reasonable background of HCE and life experience you can get into many DO schools with a 24 on the mcat. they are really more interested in well rounded applicants than MD schools, which are just about the #s.

 

As you probably already know, this is the absolute minimum, and students accepted with this score would be an extreme outlier. I've seen plenty of MD schools with a low "minimum" as well. I guess each school needs a defined cut off at some point. Generally, average DO MCAT scores are about 2 points lower than average MD scores. However, all this means nothing when applying for residency. Whoever (DO or MD) has the higher board scores and stats gets the spot. 

I admittedly didn't look at DO schools when I was looking at medical school.  But that just goes to show that getting into medical school isn't necessarily all that difficult.  Scoring a 24 should be relatively painless.  I had friends who took the Kaplan course and everything and still didn't do well though, so who can say.  I must admit my very first question was about the nature of charged particle in an electric/magnetic field and I had a moment of panic.  Once I calmed down it wasn't terrible.

 

You originally wanted to become a physician, I'm assuming it didn't work out for MD, so you decided to go to NP school? I'm assuming this by your name.  I know you didn't, but why didn't you apply DO since they are fully fledged physicians with full practicing rights in every specialty? Or you could have went to a caribbean school just so you could get your "MD." They accept anyone with a pulse. Although your chance of matching a residency in the U.S is about 50%. Match rates for US MD and DO students is >90%. 

[Kaepora]

You originally wanted to become a physician, I'm assuming it didn't work out for MD, so you decided to go to NP school? I'm assuming this by your name.  I know you didn't, but why didn't you apply DO since they are fully fledged physicians with full practicing rights in every specialty? Or you could have went to a caribbean school just so you could get your "MD." They accept anyone with a pulse. Although your chance of matching a residency in the U.S is about 50%. Match rates for US MD and DO students is >90%. 

 

 

I did originally want to go to medical school.  I applied, interviewed and was accepted at at least 1 school when I got extremely sick.  A couple years and few emergency surgeries/harsh medication regimens later and I had a different mind set and goal.  When I was still in the midst of all this I decided to hold off on medical school (as I didn't want to take on all the debt and not be able to finish or flunk out, etc) and I went to get my BSN instead.  I figured I could work in healthcare, make some money and then apply to whatever field/path I wanted (whether it be MD, CRNA, PA, NP, yada yada).  Once I recovered and my health was being well managed, I decided NP was the appropriate choice for me going forward.  I was at a different point in my life with new priorities and perspectives.  I would have liked going PA, but for a few reasons the NP track made more sense for me.

 

When I was originally looking I wasn't applying to DO schools.  Perhaps it was a prestige thing.  I was concerned about that at the time.  I certainly didn't care for OMM although I hardly knew what it was.  And I personally wouldn't consider or recommend Caribbean schools unless I was absolutely desperate to be a physician and didn't care doing a terrible FM residency in the middle of nowhere. 

 

I had a few friends who didn't get great grades in undergrad, did a post bacc or SMP, and then were accepted into DO schools (LECOM mainly) with average MCAT scores.  It only added on a year or 2 for them and now they're physicians...  

[EMEDPA]

I know lots of folks with varied life experiences and the full gambit of grades and mcats who have gone to DO school and become excellent physicians, several of them double boarded. a friend of mine who posts occasionally on this board was a former PA who got into a DO program with a 3.2 undergrad gpa and a sub -20 (18) mcat, which they essentially disregarded due to his 4.0 in PA school and years of PA experience. . he rocked his DO program and residency.