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I've seen quite a variety of family outpatient medicine from homeless to affluent, but I would be totally lost in the ICU. 

Here's a thought: at what point is a physician a superior clinician to an experienced PA. I know it isn't the first day of internship, but sometime later.

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Why are we trying to compare ourselves (PAs) to be equal to a physician? We are NOT physicians and will never be be. We do not need a set amount of practice time or etc to be equal cause we will never be equal in the respects of being a physician. We will never have the formal education that a physician gets with schooling, but that does NOT mean we cannot be up to date on the latest and newest things or sit in our local library studying immunology, but again there is not standard to compare that to formal training. I think we (PAs) need to stop worrying about comparing ourselves or trying to be equal to a physician work harder on advancing our profession. I am NOT saying that an experienced PA can work along side a physician and do just as good of a job, but again that physician does have that extra training that sets them apart from PAs. I am HAPPY to be a PA and did not want to go to medical school so my outlook is a little different cause I am practicing in a rural clinic by myself and I see my CP 8 hrs every month (I have access to call if needed). I think I am happy with my choice of being a PA cause I know it was a choice (I could have got into medical school if I wanted too, but chose not to go that route as it did not fit my life). I graduated with several friends that are finishing medical school or are in residency now, but I know they are not working 32 hrs/week and making >$100,000 :). 

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Totally agree that we are not physicians nor equal to them.  Training is totally different.  If we wanted that, then we should go to medical school.  I agree.

My goal is to stop being hassled by people (insurances, DME companies, etc) because they somehow think that the care I provide is substandard.  If my care is substandard, I should and would quit.  What I'm pushing for in my previous statement is recognition that we practice to the same level as physicians and so need the leeway to do so.  My practice is inhibited by the restrictions placed on me even though I know what needs to be done.

A side goal is to stop being hassled by MDs who somehow think that my care is substandard or that I'm not the best HCP for my patients.

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11 minutes ago, Acebecker said:

Totally agree that we are not physicians nor equal to them.  Training is totally different.  If we wanted that, then we should to go medical school.  I agree.

My goal is to stop being hassled by people (insurances, DME companies, etc) because they somehow think that the care I provide is substandard.  If my care is substandard, I should and would quit.  What I'm pushing for in my previous statement is recognition that we practice to the same level as physicians and so need the leeway to do so.  My practice is inhibited by the restrictions placed on me even though I know what needs to be done.

A side goal is to stop being hassled by MDs who somehow think that my care is substandard or that I'm not the best HCP for my patients.

Could not said it any better Acebecker. I still don't see how it is fair PA/NPs get 85% of reimbursed....when you really think about it that is telling us and the patients are care is only 85% of that of a MD/DO. I get sick of insurance companies and DME companies as well. The pencil pushers that are not in health care make all of our decisions and the laws do not even make sense. There are a lot of MD/DOs that fight for what? Most do not want to be in family practice so why bother me, let me work in my rural health clinic without all the red tape. I am from a small town and understand what these people go through daily and how they live. I can speak their language cause I grew up the same way. I know I am the BEST HCP for them in this town of 607 people, cause I know it and most of the town has told me to my face that I am the best thing this town has been in a long time. Why limit me on what I can do with a CP coming out here to sign papers that I can sign (home health orders/direct over site) when my CP has never even seen these people. You then get the pencil pushers in the county or state saying we have no access to care in this county/area, but they don't see the direct effect that PAs/NPs have in these areas. I am here to help people/give them my time/love/knowledge and the people in Washington D.C. (and/or your local state) cannot see that nor care. 

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Yes, but difficult. I had a hard time finding work the first year at all--Hamot ED never got back to me and St Vincent's ED wanted full time only. Urgent care was scant at the time (I think there was only a MedXpress and I didn't like their concept at all). PA pay was far lower than I was accustomed to as the area is saturated with 22yo who will work for 30/hr. I did teach a physical diagnosis class for the PA program and that provided a small amount of income and I enjoys it. Really I had no business working M1 anyway as that was the most challenging time academically.

 

I ended up making my first FM rotation into a Saturday job and it was a godsend as I was running out of money by then. Honestly having some regular income allowed me to stay in school at a time when financial hardship was the most difficult. (I was sending half my loan check every semester back home to support my husband and dogs...don't do that...it only leads to resentment and erosion of respect). I worked all through M2 quite regularly and sporadically during M3 when I could, although very difficult on rotations and there is no vacation in the accelerated program.

 

 

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So you're married throughout the program? How tough was that? My wife and I made it through PA school but that was real rough on us. I could only imagine how hard it would be with med school and residency. This is a big reason why I am not going for the LECOM program and waiting on another bridge type program... Maybe the LMU DMS program

 

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Marriage did not last but for many other reasons. Me pursuing APAP was only a small part of many other difficulties.
One could argue that I sacrificed home life for career. For me, that was the right choice, but I don't have kids.


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Marriage did not last but for many other reasons. Me pursuing APAP was only a small part of many other difficulties.
One could argue that I sacrificed home life for career. For me, that was the right choice, but I don't have kids.


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Sorry to hear that. Thanks for your input Lisa. It feels like only yesterday when you announced you were going back to med school!

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On 8/17/2017 at 4:54 AM, primadonna22274 said:


Yes, but difficult. I had a hard time finding work the first year at all--Hamot ED never got back to me and St Vincent's ED wanted full time only. Urgent care was scant at the time (I think there was only a MedXpress and I didn't like their concept at all). PA pay was far lower than I was accustomed to as the area is saturated with 22yo who will work for 30/hr. I did teach a physical diagnosis class for the PA program and that provided a small amount of income and I enjoys it. Really I had no business working M1 anyway as that was the most challenging time academically.

I ended up making my first FM rotation into a Saturday job and it was a godsend as I was running out of money by then. Honestly having some regular income allowed me to stay in school at a time when financial hardship was the most difficult. (I was sending half my loan check every semester back home to support my husband and dogs...don't do that...it only leads to resentment and erosion of respect). I worked all through M2 quite regularly and sporadically during M3 when I could, although very difficult on rotations and there is no vacation in the accelerated program.


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Is lecture attendance required? I've heard of a few PAs that went back to med school and would work as a PA and listen to the lectures on a faster speed at home. Was wondering if you tried that/thought it was doable.

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Is lecture attendance required? I've heard of a few PAs that went back to med school and would work as a PA and listen to the lectures on a faster speed at home. Was wondering if you tried that/thought it was doable.

Mandatory attendance for lecture pathway (I found I learned best this way).
PBL and IDP require less time in seat but much more reading and if you fall behind, you are toast. Must not miss mandatory meetings and there is always OMM which is non-negotiable.
Anybody who expects to work even half-time in any clinical capacity and is found to miss class obligations will be canned.
Would you take that risk at 50+k/yr? I wouldn't.


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On 8/18/2017 at 8:18 AM, primadonna22274 said:


Mandatory attendance for lecture pathway (I found I learned best this way).
PBL and IDP require less time in seat but much more reading and if you fall behind, you are toast. Must not miss mandatory meetings and there is always OMM which is non-negotiable.
Anybody who expects to work even half-time in any clinical capacity and is found to miss class obligations will be canned.
Would you take that risk at 50+k/yr? I wouldn't.


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Most professional programs i.e. Medical School, Pharmacy School, PA School, etc... are very accommodating. Once you are in, they usually do everything they can to keep you, even if people screw up, or show non-compliance. LECOM, however, based on what I've heard so far seems to be the exact opposite. It seems that if you fail to abide by their standards and rules in even minor ways, you are really in hot water, and in jeopardy. Am I correct in my presumption? 

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LECOM does have a reputation of being rigid. Can't argue with their results though.
Go anywhere you want, but don't expect an established program that's worked the way it's worked for 25 years to accommodate you.


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On 8/17/2017 at 9:03 AM, d2305 said:

Here's a thought: at what point is a physician a superior clinician to an experienced PA. I know it isn't the first day of internship, but sometime later.

I can answer that; I just left an organization with a large residency program working side by side with them.  

I'm gonna say roughly midway through the PGY2 year.  You have to understand that the main thrust of a residency program is to learn, so along with working, they are having didactics and tests and grades and stuff, and their progress is monitored.  They have to become better each day.  An experienced PA just kind of does their thing, and they go home at night and take vacations and time off.  By PGY3, the new docs really should have mastered everything the PA has seen and done and is busy mastering things we may or may not ever run into.  

While I'm at it, I survived a July with all the new interns - all that stuff you probably think about new interns is absolutely, 100% true.  Oh my Science did I ever see some stuff.  Plus they are all like 12 years old.

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3 hours ago, south said:

 

While I'm at it, I survived a July with all the new interns - all that stuff you probably think about new interns is absolutely, 100% true.  Oh my Science did I ever see some stuff.  Plus they are all like 12 years old.

YUP, I  just took atls with incoming em interns and had to show them how to put laryngoscopes together, etc. 

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Most professional programs i.e. Medical School, Pharmacy School, PA School, etc... are very accommodating. Once you are in, they usually do everything they can to keep you, even if people screw up, or show non-compliance. LECOM, however, based on what I've heard so far seems to be the exact opposite. It seems that if you fail to abide by their standards and rules in even minor ways, you are really in hot water, and in jeopardy. Am I correct in my presumption? 
My pa program was rigid... 2 fails you are out unless there extenuating circumstances like severe illness/near death.

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In my program if you failed 2 classes you were out. if you failed 1 class you could start the program over with the next entering class and repeat all coursework, including work previously passed. 

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Low tolerance for academic insufficiency is definitely understandable. I'm more intrigued based on things I've read, about the school's overall rigidity, academic or not. 

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I believe in my program at Harlem Hospital, if you failed one course you were out but could return the next year and repeat everything.  1986.  I am sure things have changed.

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On 8/9/2017 at 10:10 PM, EMEDPA said:

LECOM bridge is a no-brainer if you want to go back. no mcat and a smaller applicant pool. also some leniency on prereqs. For example, for the old folks like me who never took ochem, one online 3 credit ochem course without lab meets the requirement. (yes, I still think about applying in my late 40s).

Know a guy who just did that at 48. Kids were out of the house and he had settled into his specialty, so figured "Why not"? Kind of inspiring actually. 

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Does anyone have any experience or information about the school's flexability for delayed enrollment requests after being accepted. For instance if you want to delay your start date by a year?

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Does anyone have any experience or information about the school's flexability for delayed enrollment requests after being accepted. For instance if you want to delay your start date by a year?

Not likely eligible for deferral unless significant extenuating circumstances. You would reapply.


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7 hours ago, primadonna22274 said:

Last I checked there were 19 PA programs in that small state...it's probably more like 20-22 now.


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That small state is the 6th largest in population size, however, I will agree with you that it has waaaaay too many PA programs - I think 22.

Salaries in Pittsburgh are pretty abysmal.  There are 4 programs in the city and multiple more within 1-2 hours.  UPMC pays new grads $65,000.  No negotiation.  There are so many schools pumping out grads with no significant health care experience, so that salary, to them, seems decent.  BUT, I make more than that as an RN.  So those of us with health care experience are screwed and have to look further outside of the city limits.  The large hospitals here are full of new grads or people who have just stuck it out.

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On 8/12/2017 at 7:16 PM, EMEDPA said:

my understanding from interactions with Dr K a few years ago was that a good gpa + a good pance or panre score can also be used to waive the mcat requirement. I took the SAT in 1986, so probably not representative of my current academic achievement.

Hey Mr. EMEDPA, when you say GPA, is it the GPA of undergraduate, GPA of PA school, or the cumulative GPA all together?

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