PA to MD vs DO

[EMEDPA]

29 minutes ago, LT_Oneal_PAC said:

Been in committee for nearly a year. Likely it’s grave. One can hope it’ll survive

I would rather see FPA/OTP for 100,000 PAs than expansion of practice rights for a "new profession" with <50 members.

[LT_Oneal_PAC]

10 minutes ago, EMEDPA said:

I would rather see FPA/OTP for 100,000 PAs than expansion of practice rights for a "new profession" with <50 members.

100% agree! But I'm okay with the school trying with 0 dollars out of my or the PA PAC pocketbook

[EMEDPA]

My fear would be this: LMU grads get expanded autonomous rights by medical boards and are then held out as the standard for FPA/OTP..."Well we let them do it because they went to school for an extra 2 years, why should we let run of the mills PAs do the same thing?"

[LT_Oneal_PAC]

10 hours ago, EMEDPA said:

My fear would be this: LMU grads get expanded autonomous rights by medical boards and are then held out as the standard for FPA/OTP..."Well we let them do it because they went to school for an extra 2 years, why should we let run of the mills PAs do the same thing?"

Reasonable and valid fear.

[camoman1234]

13 hours ago, LT_Oneal_PAC said:

100% agree! But I'm okay with the school trying with 0 dollars out of my or the PA PAC pocketbook

If one wants to be a MD/DO then go to medical school. There is no short cut so I hope it does not pass. I did not go to PA to become a MD/DO, I want to be a PA and only a PA. That would be suicide for PAs if this passed. I would rather see OTP.  

[LT_Oneal_PAC]

10 hours ago, camoman1234 said:

If one wants to be a MD/DO then go to medical school. There is no short cut so I hope it does not pass. I did not go to PA to become a MD/DO, I want to be a PA and only a PA. That would be suicide for PAs if this passed. I would rather see OTP.  

I hardly see how it’s a short cut requiring 3 years of practice before you can apply and limited to primary care. 

Still agree I’d rather see FPAR.

[camoman1234]

On 1/9/2018 at 9:17 PM, LT_Oneal_PAC said:

I hardly see how it’s a short cut requiring 3 years of practice before you can apply and limited to primary care. 

Still agree I’d rather see FPAR.

We are missing the MS-1 classes (I have taken organic I and II, biochemistry, physics I and II, molecular biology (500 level), cardiopulmonary physiology (500 level), pharmacology (500 level), genetics, microbiology, etc in undergrad, most of these classes were with CRNA and PA students, they just had to do a presentation at the end of classes, there was no difference in testing except they did not have the lab portion) and I still do not feel like my knowledge basis after PA school is close to the knowledge one gains in MS-1 (I just have talked with friends that are MD/DOs). Also, 3 years of practice does not equate to MS-3/MS-4 rotations that give you a variety of experiences, long hours, etc (I rotated all my rotations with medical students, residents, fellows) so I could not image getting another year of rotations throughout more fields of medicine than we do in PA school. These same rotations are for any medical student going into any specialty. So, yes MD/DOs experience are much more broad than ours and 3 years of (maybe) adequate experience in one or even two different fields (IM/FM/PEDs) I think is NOT comparable to going through the MD/DO route. Let me not even get started on 3-7 years of residency + fellowship....I think you get the point, but I would like to see OTP. 

[EMEDPA]

agree that the typical pa student does not get much exposure to ms1 material.

for all intents and purposes though pa2=ms3 at any respectable pa program.

the quality of ms4 can vary a lot between med schools. some folks do a full year of hard core rotations while other folks at other more lenient programs might spend most of the year interviewing, on vacation, doing self arranged "rotations" (a friend of mine spent 6 months of ms4 hiking in the Himalayas between rural clinics and wrote a paper about it....), or doing a cush sub-Internship at a place they really want to match.

comparing new grad med students to new grad pa students is a fair comparison. not counting prior experience of either, the medstudent will know more basic sciences and may have a bit of a clinical advantage depending on how they spent ms4. obviously, you can't compare a post-residency physician with a new grad pa. no comparison.

[LT_Oneal_PAC]

9 hours ago, camoman1234 said:

We are missing the MS-1 classes (I have taking myself organic I and II, biochemistry, physics I and II, molecular biology (500 level), cardiopulmonary physiology (500 level), pharmacology (500 level), genetics, microbiology, etc in undergrad, most of these classes were with CRNA and PA students, they just had to do a presentation at the end of classes, there was not difference in testing except they did not have the lab portion) and I still do not feel like my knowledge basis after PA school is close to the knowledge one gains in MS-1 (I just have talked with friends that are MD/DOs). Also, 3 years of practice does not equate to MS-3/MS-4 rotations that give you a variety of experiences, long hours, etc (I rotated all my rotations with medical students, residents, fellows) so I could not image getting another year of rotations throughout more fields of medicine than we do in PA school. These same rotations are for any medical student going into any specialty. So, yes MD/DOs experience are much more board than ours and 3 years of (maybe) adequate experience in one or even two different fields (IM/FM/PEDs) I think is comparable to going through the MD/DO route. Let me not even get started on 3-7 years of residency + fellowship....I think you get the point, but I would like to see OTP. 

Agree again with rather have OTP

but as to it being a short cut, PAs have 7 semesters as opposed to 9 semesters for a 3 year med school or 10 semesters for a 4 year. Then the practice requirement, then 2 years of clinical education with including clinical requirements. So a PA will will spend about 7 years (cutting it a bit short just to make sure I’m being fair) to practice in a primary care specialty. Similarly, a primary physician will spend 7 years. I see no time short cut.

As far as experience, I worked with an IM physician in the military that didn’t know how to remove an ingrown toenail, so that’s all relative. Some residencies are crap and not nearly credited equal.

i see no short cut, but your welcome to have that opinion.

[pitou]

Some people compare PA school to being a forever intern. Do you folks feel that way? I'm sitting on one acceptance now and I'm starting to think that maybe I need to give it up, take the mcat and re-evaluate my understanding and what I want my career to be. I thought that being PA was the right path for me but the longer I work in healthcare, the more I'm starting to question whether this style of practice is right for me.

[charlottew]

I work inpatient, I see being a PA as being a forever-resident in a lot of ways. My goal clinically is to progress to being regarded as a fellow-equivalent. I will never have the autonomy of an attending. Career-wise if I wanted to do more, I could move into more of an admin role, or teaching.

[Oldhorn]

I can echo people's sentiments about being a forever resident/fellow, definitely how a lot of gigs are around the country.

As for me I've been thinking about going to Med school ever since I started PA school and realized how much I LOVE MEDICINE. It's been 2 years now, working in CT surg/ICU and side gig in IM, and most of my feelings haven't changed. 

Still love medicine, I want to know a lot more, I want to do so much more...

Taking the MCAT in April and I'll be applying to local MD/DO programs for my wife's sake. We'll see what happens ;)

I'm 27, no kids. 

[newton9686]

I think it is really practice dependent. I was 30 minutes outside Raleigh, NC with a Cardiology PA who basically ran the hospital at night. Only time we called the doc is if we needed a transcutaneous pacer or something of the sort. Even as students we were given almost as much autonomy as first year residents. It just all depends on the location and the specialty and what percentage of the time you are willing to be degraded. So pick the right location, specialty and have a little thicker skin than your MD colleague and there will be no limit do you job satisfaction. However if you are not interested in practicing outside the city limits, want to do a surgical specialty or care about what you are referred to as, go to medical school.

[Chasenab]

I don't understand why there couldn't be a shorter bridge program or even some new type of practicing Dr., like this DMS degree. If the program truly filled in the missing information, why couldn't a graduate sit for the USMLE's? They would have to take them like one after the other. But, so what? If they could pass, they possess the same level of knowledge, no? Maybe, even the schools that offer these degrees could offer residencies afterwards. Just wondering.

[pitou]

I think it has to do with ACGME and funding in terms of residency spots, I would imagine. With new Medical School popping up and grads looking for spot with non-increase in residency slot, this will cause a headache, trying to find that bridge for working PAs. 

[Jdabrowski]

49 minutes ago, pitou said:

I think it has to do with ACGME and funding in terms of residency spots, I would imagine. With new Medical School popping up and grads looking for spot with non-increase in residency slot, this will cause a headache, trying to find that bridge for working PAs. 

Isn't there even less residencies for medical graduates due to lack of funding than there was 5 years ago?

[pitou]

1 minute ago, Jdabrowski said:

Isn't there even less residencies for medical graduates due to lack of funding than there was 5 years ago?

 

1 minute ago, Jdabrowski said:

Isn't there even less residencies for medical graduates due to lack of funding than there was 5 years ago?

That’s what I’m saying. There’s more grads than ever but no increase in spots. 

 

So so I would assume in order to control the increase and keeping it from saturation like law field, there might not be a less hassled bridge for those who want to pursue med school after PA school. I don’t know, it’s just a thought 

[SedRate]

On 1/10/2018 at 5:10 PM, pitou said:

Some people compare PA school to being a forever intern. Do you folks feel that way? I'm sitting on one acceptance now and I'm starting to think that maybe I need to give it up, take the mcat and re-evaluate my understanding and what I want my career to be. I thought that being PA was the right path for me but the longer I work in healthcare, the more I'm starting to question whether this style of practice is right for me.

Some may feel that way, although I would say residents rather than interns. It likely depends on your work environment and physician colleagues. I can definitely see that happening in an environment where PAs and physicians do some of the same things, such as ICU, FM, hospitalist, EM, etc. PAs may continue to have to fight for their respect in those environments, as EMEDPA said. Anecdotally, at the trauma center I work at, the hospitalist PAs and trauma PAs are often treated like residents by certain physicians. 

 

As a surgical PA, my role is to assist the surgeon, so there's not much autonomy there. But in our setup, there are plenty of things that I'm in control of such as our OR schedule, rounds, wound care, any problems, and pretty much anything patient-related while the surgeon does surgery. I like my assistant role and can't imagine myself going through all that the surgeon did to get where they're at when I'm standing right next to them at the operating table. It's cool to be able to do what I do without the medical school, residency, and fellowship PLUS I have the backup I need in case sh*t hits the fan. I knew I wanted to go into surgery but definitely not as a surgeon.

 

The "assistant" role isn't for everyone. Some fields offer more autonomy but often without the added respect one would expect in such fields. So I think it depends on what you plan on doing with your career, how you feel about potentially peaking, and what kind of environment you end up working in. Physicians themselves are experiencing the squeeze of lowered reimbursement and meeting metrics, so they're noticing less pay, especially surgeons, but they still don't have to fight for the respect and scope of practice like PAs do.

 

Hope that helps!

[pitou]

31 minutes ago, Sed said:

Some may feel that way, although I would say residents rather than interns. It likely depends on your work environment and physician colleagues. I can definitely see that happening in an environment where PAs and physicians do some of the same things, such as ICU, FM, hospitalist, EM, etc. PAs may continue to have to fight for their respect in those environments, as EMEDPA said. Anecdotally, at the trauma center I work at, the hospitalist PAs and trauma PAs are often treated like residents by certain physicians. 

 

As a surgical PA, my role is to assist the surgeon, so there's not much autonomy there. But in our setup, there are plenty of things that I'm in control of such as our OR schedule, rounds, wound care, any problems, and pretty much anything patient-related while the surgeon does surgery. I like my assistant role and can't imagine myself going through all that the surgeon did to get where they're at when I'm standing right next to them at the operating table. It's cool to be able to do what I do without the medical school, residency, and fellowship PLUS I have the backup I need in case sh*t hits the fan. I knew I wanted to go into surgery but definitely not as a surgeon.

 

The "assistant" role isn't for everyone. Some fields offer more autonomy but often without the added respect one would expect in such fields. So I think it depends on what you plan on doing with your career, how you feel about potentially peaking, and what kind of environment you end up working in. Physicians themselves are experiencing the squeeze of lowered reimbursement and meeting metrics, so they're noticing less pay, especially surgeons, but they still don't have to fight for the respect and scope of practice like PAs do.

 

Hope that helps!

Thank you so much for this reply. I have some questions if you don’t mind. Do you first assist on the cases? Do you work at an academic center? What is schedule like? Thanks! 

 

Most of my my experiences have been with outpatient and inpatient PAs, not so much surgical PAs

[SedRate]

1 hour ago, pitou said:

Thank you so much for this reply. I have some questions if you don’t mind. Do you first assist on the cases? Do you work at an academic center? What is schedule like? Thanks! 

 

Most of my my experiences have been with outpatient and inpatient PAs, not so much surgical PAs

Sent you a PM