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Thoughts on Required Post-Grad PA Residencies & Fellowships.

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I have been reading quite a few of the post grad PA residency/fellowship blogs and am blown away by the sheer amount of material and skills that new grad PAs are able to grasp and perform straight out of a PA residency. This got me thinking.

What if the PA profession embraced required post grad PA residencies/fellowships?

There are several benefits to doing something like this in my eyes.

1) PAs would hit the ground running--we would be incredibly capable straight out of the gate.
2) PAs would instantly have a major advantage over NPs, even if those NPs have had years of RN experience before they became an NP.
3) It would allow us to stand on something more than just our education when attempting to fight for any legislative hurdles.
4) We would be afforded more autonomy if #2 would work.
5) I think we would gain more respect from our MD/DO colleagues.
6) Possibly slow down over-saturation.

Of course there would be some negative consequences to a mandatory post-grad residency.
1) Currently PAs who do a residency have a major advantage over new grads and even experienced PAs. This would go away if all new PAs completed a residency.
2) PA school would go from 2ish years to 3ish years.
3) Experienced PAs may see new PAs as a threat.
4) Finding enough hospital systems to embrace the idea of a PA residency and finding enough positions to accept all the PA spots after graduation.

5) loss of lateral mobility.

I know this is pretty unrealistic right now, but I think PAs are going to have a hard time fighting for more autonomy if we do not change our current educational tract. More and more schools are accepting students with NO clinical experience what so ever. If this is the case, can we really fight for autonomy? That was a hallmark of the PA profession and a major selling point, but now that this is going away, I think a residency would be the solution to that problem. A good solution too, as residency PAs would be top notch straight out of school!


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This is very interesting, however the loss of lateral mobility is, IMO, a very big loss. One of the most attractive aspects of PA vs MD (to me) is the professional and personal flexibility that the profession fosters. I also think that the flexibility contributes to the considerable difference in professional satisfaction between MD and PA. Another consideration is what happens to all the current PAs that aren't residency trained? Are the forced to go back and do a residency? I agree that something needs to change to get more autonomy and compete with the NPs but those are just a few things that stick out to me.


Also, 100% agree that schools are moving towards students that fit the more traditional med-school applicant profile- i.e. high GPA, little HCE. I think this is the result of many factors including a more competitive applicant pool, the pressure to have low matriculation rates and high PANCE pass scores, and the sheer number of new programs opening. I think the PAEA getting involved and setting minimum standards for all programs would be a good start to curbing the trend. 

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I think the last 2 cons you listed are the biggest and what would prevent it from becoming a mandatory thing in the foreseeable future.  As it is, there aren't enough residency slots for physicians (hence the whole "assistant physician" debacle)... so to go from the current 100ish PA residents / year that we have now to covering the thousands of PAs graduating every year would be a huge jump.  We likely don't have the training capacity in our academic institutions, and the biggest question is ... who would fund it?   

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The amount of current residency spots and potential ones would make it not possible or not for a long time. Some residencies would only benefit for getting cheap labor. I believe this is why being a life learner fits the PA so well.



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I think the last 2 cons you listed are the biggest and what would prevent it from becoming a mandatory thing in the foreseeable future.  As it is, there aren't enough residency slots for physicians (hence the whole "assistant physician" debacle)... so to go from the current 100ish PA residents / year that we have now to covering the thousands of PAs graduating every year would be a huge jump.  We likely don't have the training capacity in our academic institutions, and the biggest question is ... who would fund it?   


Who would fund it?  Students.  


Mandatory residencies would likely transition from a 'residency' situation where graduates get paid to some degree to being something that we must pay for in some sort of tuition format.  I could even see it becoming something that must be completed prior to graduation - which all around makes it less of a residency but if it's required to practice, what good is a degree without it?  It's honestly the only way I see it even feasible to be part of the training for all PA student/graduates.


Let's face it - if we must do it, someone somewhere is going to find a way to make us pay for it.

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