So, Real Talk: Do you actually need HCE?

[MT2PA]

4 hours ago, EMEDPA said:

physicians get a 3+ year residency to learn about medicine. I like thinking of HCE as "pre-training". I could not do my current job without the skills I learned and the experiences I had working as a paramedic.

^Agreed.  My HCE wasn't paramedic but regardless, it is helping me succeed in my clinical year.  I don't spend days to weeks getting comfortable in each rotation; I can hit the ground running and get the most out of my time.  I pull from previous knowledge that other PA and MD students don't have on my rotation which has prompted what everyone hopes to get on their rotations: job offers.

So no, 2000 HCE hrs as a CNA may not be a direct line into a derm job, but if you pick your HCE right (and not just do it to get the hours and mark a box) it CAN be incredibly valuable later on.  

[EMEDPA]

13 minutes ago, 8404PA said:

my program has switched to requiring more HCE. There's a clear delineation between those with and without. Frankly, it boarders irritation sometimes in situations when most of the class with quality HCE knows what's going on and the rest do not and causes a bottleneck. This delineation is perceived more during OSLERs/PE and clinical skills.

I guess my main gripe with the "No HCE" argument is that it detracts to the grass roots of this profession which seems to happen day by day. I was a Corpsman so I feel a strong attachment and respect to how and why this profession exists and when I see 21 y/o without any HCE (or very little - like a scribe or CNA for 1 year) getting in to a program, I shake my head and anticipate Dr Stead rolling in his grave.

 

PS. I think scribing is the lowliest of HCE, and shouldn't be "counted" because it's not true hands on nor any clinical judgment is really involved - you don't impact the patients outcome directly. Sure your efforts may result in proper documentation to prevent a problem but you didn't directly affect the patient with some form of care.  Yes, you get a grasp for things but its realistically more like being paid to shadow and you're taking notes.

agree with 100% of this!

[Palurker]

Since everyone else has shared their opinion on HCE and EXACTLY what you need to get out of it to be successful, I'll tackle a different point.

 

I would caution against applying to just one school. What if you don't get in? Do you have any sort of backup plan? Banking on getting an interview and acceptance from just one school is incredibly risky. Definitely recommend trying to find more schools you can target with your specific situation.

[8404PA]

10 minutes ago, Palurker said:

Since everyone else has shared their opinion on HCE and EXACTLY what you need to get out of it to be successful, I'll tackle a different point.

 

I would caution against applying to just one school. What if you don't get in? Do you have any sort of backup plan? Banking on getting an interview and acceptance from just one school is incredibly risky. Definitely recommend trying to find more schools you can target with your specific situation.

yup. I spent ~$1,200 on applications including secondary apps. I got 2 interviews and 1 yes. 

[Kaepora]

22 hours ago, karebear12892 said:

Current PA student here. First off, to answer the OP's question, healthcare experience is essential not only in the admissions process (regardless of what the school's website says), but it is also necessary in order to succeed in PA school. If I hadn't worked in the ER between undergrad and PA school, I would be having a much harder time comprehending and applying what I'm learning in the classroom. Besides, you want to be 100% sure about your career choice, and the best way to make an informed decision is by spending time in the field. Honestly, I'm surprised more medical schools don't require some sort of clinical experience to be considered for admission for that reason alone. 

I also want to (respectfully) disagree with the advice above and share one of my posts from a different thread. I was a medical scribe for two years prior to PA school.  If I had to do it all over, I would hands-down be a scribe again. This was the best pre-PA school job I could have ever asked for. As a scribe, you gain insight into the medical decision making of a healthcare provider that no other experience offers.

Just like any other job, as a scribe, you get out of it what you put into it. I told the physicians I worked with that I wanted to learn as much as possible --- so they taught me how to interpret labs, EKG's, x-rays, etc. After the physician looked at the EKG, they would hand it to me and ask me what I thought. If a patient was wheezing, they would say, "come over here and take a listen to this person's lungs and tell me what you hear. What tests do you think I'll order?" For two years, I strived to learn something new from every patient encounter, and I never hesitated to ask questions if I didn't understand the provider's train of thought. 

By the time I started PA school, I already had a basic knowledge of differential diagnoses for just about any complaint. I already knew the doses and indications for common drugs. After spending literally thousands of hours attached at the hip with an ER doctor, I had already been exposed to the presentation, work-up, and treatment for a variety of diseases and injuries. Yes, I still have plenty to learn. But I have a very solid foundation on which to expand my knowledge. 

I am not saying that hands-on experience isn't valuable --- it certainly is. I agree that there is something to be said for "feeling the stress of taking care of patients," but you will begin learning this during your clinical year and grow more comfortable under pressure with experience. I firmly believe scribing can be outstanding preparation for PA school if you're willing to make the most out of it. 

You never cared for a patient.  You have no real idea of whether you like interacting with patients as a provider.  All you know is you like working up patient scenarios.  I am a huge proponent of HCE for advanced practice providers.  I don't even approve of direct entry NP schools.  Just because you took nursing courses like pharm/patho/and did 1000 hours on rotations in school.  No.  Doesn't count.  You were shielded by your preceptor the entire time.  As a nurse/paramedic/RT you are formally trained in understanding lab indices, ekgs, physical assessment.  Everything you described PLUS you are responsible to care for patients.  In no way will I ever be convinced that scribing is an acceptable form of HCE.

[DizzyJ]

15 hours ago, EMEDPA said:

physicians get a 3+ year residency to learn about medicine. I like thinking of HCE as "pre-training". I could not do my current job without the skills I learned and the experiences I had working as a paramedic.

Agreed!  My prior HCE made learning medicine and treating patients much easier.  I had been exposed to so much before starting PA school that things just clicked easier from those prior experiences. 

[MT2PA]

1 hour ago, ACNPstudent said:

You never cared for a patient.  You have no real idea of whether you like interacting with patients as a provider.  All you know is you like working up patient scenarios.  I am a huge proponent of HCE for advanced practice providers.  I don't even approve of direct entry NP schools.  Just because you took nursing courses like pharm/patho/and did 1000 hours on rotations in school.  No.  Doesn't count.  You were shielded by your preceptor the entire time.  As a nurse/paramedic/RT you are formally trained in understanding lab indices, ekgs, physical assessment.  Everything you described PLUS you are responsible to care for patients.  In no way will I ever be convinced that scribing is an acceptable form of HCE.

I think it's important to delineate HCE from PCE here.  I think scribing is fine HCE.  It's not PCE.  It may be semantics but (some, many?) schools do differentiate the two.

[Kaepora]

8 minutes ago, MT2PA said:

I think it's important to delineate HCE from PCE here.  I think scribing is fine HCE.  It's not PCE.  It may be semantics but (some, many?) schools do differentiate the two.

Haha.  It's kind of a distinction without a difference.  Bottom line is you need experience working with patients.  Scribing is not working with patients.  Therefore, scribing is not acceptable.

[EMEDPA]

5 hours ago, ACNPstudent said:

You never cared for a patient.  You have no real idea of whether you like interacting with patients as a provider.  All you know is you like working up patient scenarios.  I am a huge proponent of HCE for advanced practice providers.  I don't even approve of direct entry NP schools.  Just because you took nursing courses like pharm/patho/and did 1000 hours on rotations in school.  No.  Doesn't count.  You were shielded by your preceptor the entire time.  As a nurse/paramedic/RT you are formally trained in understanding lab indices, ekgs, physical assessment.  Everything you described PLUS you are responsible to care for patients.  In no way will I ever be convinced that scribing is an acceptable form of HCE.

totally agree. scribe is mobile transcriptionist + shadowing. no responsibility other than typos.

[karebear12892]

I feel very confident that I learned more than enough as a scribe to succeed in PA school and make an informed decision about my career choice. Agree to disagree, I'm just sharing my personal experience. The point is that the OP should consider some type of HCE/PCE, even if the school does not require it. 

[Kaepora]

[8404PA]

Taking a step back I think we all can agree that the premise of the question, "So, Real Talk: Do you actually need HCE?" is a disturbing question to the intrinsic nature of the profession. Historically up to the last decade, you didn't go to PA school or NP program unless you had been in another medical profession for a number of years ( Nurse, RT, Paramedic, military Medic ect...). 

[JD2012]

Asking if you need experience shows how little you know about the history of the profession.

"If you have to ask you can't afford it" type of deals.

 

[tracerswarner]

@JD2012 maybe so but the intensity of this thread's debate only proves my point - it isn't cut and dry! It's worth discussing. 

[mmchick]

On 7/21/2017 at 10:46 PM, 8404PA said:

Taking a step back I think we all can agree that the premise of the question, "So, Real Talk: Do you actually need HCE?" is a disturbing question to the intrinsic nature of the profession. Historically up to the last decade, you didn't go to PA school or NP program unless you had been in another medical profession for a number of years ( Nurse, RT, Paramedic, military Medic ect...). 

I completely agree that the history foundation of this profession was a sort of bridge career for those with extensive healthcare experience wanting more responsibility; however, in this day and age, I think this comment is a little irrelevant given the current nature of this career. It's admirable and respectable to know the history of one's profession, but it is exactly that- history.

The PA profession has moved beyond simply being a "bridge" program, it now is a respectable career path for anyone that is desiring to get a career started in the medical field. It is as much of an alternative to medical school as medical school is an alternative for PA school. They both are two sides of the same coin with very similar career outlooks, with different training, atmosphere, and longevity. Its extremely backwards to still view this career as though only "veterans" of some other related field can start; so all in all, I wouldn't deem OP "disturbing" but just more like "lazy" and not aware of what any healthcare profession requires, let alone specifically the PA profession.

Its the same thing if you ask "do you really need a GPA above a 2.5 to get into medical school?" or "do you really need LORs to apply to any graduate program?" These are essential pieces to any program as is PCE to a PA program. Without it, the school has no way to ensure you are ready for rigorous program nor a way to ensure you should/could even be part of the medical force.

[tracerswarner]

1 hour ago, mmchick said:

I completely agree that the history foundation of this profession was a sort of bridge career for those with extensive healthcare experience wanting more responsibility; however, in this day and age, I think this comment is a little irrelevant given the current nature of this career. It's admirable and respectable to know the history of one's profession, but it is exactly that- history.

The PA profession has moved beyond simply being a "bridge" program, it now is a respectable career path for anyone that is desiring to get a career started in the medical field. It is as much of an alternative to medical school as medical school is an alternative for PA school. They both are two sides of the same coin with very similar career outlooks, with different training, atmosphere, and longevity. Its extremely backwards to still view this career as though only "veterans" of some other related field can start; so all in all, I wouldn't deem OP "disturbing" but just more like "lazy" and not aware of what any healthcare profession requires, let alone specifically the PA profession.

Its the same thing if you ask "do you really need a GPA above a 2.5 to get into medical school?" or "do you really need LORs to apply to any graduate program?" These are essential pieces to any program as is PCE to a PA program. Without it, the school has no way to ensure you are ready for rigorous program nor a way to ensure you should/could even be part of the medical force.

It's frustrating that everyone is acting like it's super obvious. I was previously pre-med (unofficially, at UC Berkeley since they don't have an official pre-med program). No one in my program had any HCE or PCE. It just wasn't discussed. So, since I've been investigating the PA program, it's been weird to see how many people have to get OTHER certifications just to get into the MPAS program. There are EMTs and MAs... that just seems really silly to me! Why are PAs treated differently than med students?

[8404PA]

42 minutes ago, tracerswarner said:

 that just seems really silly to me! Why are PAs treated differently than med students?

Then don't do it and see where it gets you. There's thousands of kids out there that are going to get those certifications and look better than you. 

PA school and medical school are about jumping through hoops and being an adult with initiative. I disagree with that there's a difference with us and med school applicants - the successful med applicants that I know of are much more competitive with HCE and they tend to get accepted too with that HCE. Also the argument can be made that since we don't do intership's/residencies and the fact that we only have 15 months of class work, it's valuable to have HCE going in and usually resolves with better outcomes. 

"It's frustrating that everyone is acting like it's super obvious. I was previously pre-med (unofficially, at UC Berkeley since they don't have an official pre-med program). No one in my program had any HCE or PCE. It just wasn't discussed."

That's the initiative I'm talking about. No one is obligated to tell you how to get in to a professional school and you have to figure out on your own - which is what you seem to be doing. So good on you!

 

1 hour ago, mmchick said:

 I wouldn't deem OP "disturbing" but just more like "lazy" and not aware of what any healthcare profession requires, let alone specifically the PA profession.

Its the same thing if you ask "do you really need a GPA above a 2.5 to get into medical school?" or "do you really need LORs to apply to any graduate program?" These are essential pieces to any program as is PCE to a PA program. Without it, the school has no way to ensure you are ready for rigorous program nor a way to ensure you should/could even be part of the medical force.

Very well said. 

[mmchick]

@tracerswarner Well for one, MPAS and MD/DO programs have pretty different admission requirements: (GRE vs MCAT, HCE/research emphasis, shadowing preferences, etc.) so you can't really be surprised that if you were previously pre-medical school and really only associated with other pre-med students, you didn't hear much about PA program requirements. As 8404 mentioned, you need to take your own initiative and do extensive research about any graduate program before you think about applying. This is basic understanding for literally any career field, and any school of any discipline will expect the same.

So to further not beat a dead horse, the takeaway here is that you obviously need to do more extensive research into PA programs and accept the state of how you need to prepare. If you think its "silly" or not worth it, then look towards other programs, because I can tell you entering a program with that attitude already is going to set you up for a lot of disappointment and perhaps get in the way of your success.

Best of luck.