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College kids being discouraged?


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Because those schools are mills...I dont care if your son got into a program tat calls itself "advanced level..." The practice of medicine in the scope of a practitioner is NOT an entry level position...I AM a PA! It is NOT entry level...we should not head down the way of the NP profession in terms if training and schooling. I have held many entry level medical positions and PA is so much more. We are held to the sane standard as MDs but without the benefit of their residencies.

 

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There are TONS of entry level MD programs. (meaning guaranteed placement, which is what the 0-6 schools are)

I'm actually kind of confused, as most MDs apply right out of college without any hce. I feel like these programs are actually helping to improve the profession. And please don't call them mills without reading up on (some) of them.

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This has gone from a "college students should go to med school" discussion to a "PA students should have large amounts of HCE" one. We are being encouraged to go to med school, where there are very little hce requirements, but at the same time told that we need hce to gain bedside manner. Most people go into med school with very little hce.

 

Because medical school is designed to put you through a lot more before letting you practice. You mature in the program. You are 22 when you start, at the 0-5 rate you could be 22 and practicing as a PA! I also have to say one thing I always respected about all PAs is their attitude, humility, ability to relate... A lot of that is from experience before PA school.

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I am still very genuinely curious whether or not there are things left out of PA programs because they except student to have known these things from their HCE.

 

Yes my program stated so on their website and application. They reinforced it at interviews and throughout the program. I don't know about some of these DE programs but even if they "taught" you these skills, it takes years to be proficient...I mean whatever the Horse is out if the barn now since there are so many DE programs but straight outta High school? Really? Smh....

 

 

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There are TONS of entry level MD programs. (meaning guaranteed placement, which is what the 0-6 schools are)

I'm actually kind of confused, as most MDs apply right out of college without any hce. I feel like these programs are actually helping to improve the profession. And please don't call them mills without reading up on (some) of them.

 

Med schools have residencies did you not see me make that point....whatever. enjoy...I got charts to do lol

 

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I understand how putting it as "entry level" or "straight out of high school" sounds really bad, but by entry level it just means that you're accepted to both portions, not that the profession itself is entry level. And there are WAY more direct entry MD programs than PA programs. It's just a way of securing your seat if you've proven yourself already.

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I understand how putting it as "entry level" or "straight out of high school" sounds really bad, but by entry level it just means that you're accepted to both portions, not that the profession itself is entry level. And there are WAY more direct entry MD programs than PA programs. It's just a way of securing your seat if you've proven yourself already.

 

Ok one last......

 

Sigh....a entry level MD/DO program has a residency attached to it. So, AFTER residency, the doc is NOT entry level. PAs are not expected to be entry level medical personnel (like emt, RN,rt, ma etc) because we practice medicine. AND we don't have the benefit of a residency. So we as practitioners are expected to practice gold standard medicine out the gate along with our MD colleagues without the experience the new Docs (prob around the same age as these new PAs) have had thanks to a minimum of 3 years of HANDS ON HCE as a resident.

 

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Soon this discussion will be even more divisive. Let's see. First, we say the 5 year programs are "mills" like a previous poster claimed. Then we can say that if you get into PA scoop with less than a 4.0 that the schools are taking dummies. Then we can say that if you don't graduate from a school ranked 1, 2, or 3 in the nation, that "my degree is better than you degree". Then the PA I shadowed had 20 years experience but yours only had 10 years, and therefore, I received twice the amount of knowledge. Then I had 20 years of HCE and you only had 5 years before going to PA school, so I am superior to you and I'm a better PA. On and on. I'm not discouraged. I'm excited & proud of getting into a couple of 5 year BS/MS programs. I'm proud of my CNA, GNA, & surge tech. I know it's basic. I know it doesn't equal all of the HCE some people have. But, I also know that it is a good start & I have faith in the Schools!

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kmill- the cna and surg. tech will definitely help you.

I was an er tech and paramedic before going to pa school. I didn't see a lot of new stuff on rotations but the repetition certainly helped cement stuff in my head. having the basics down before day 1 of pa school really helps. while my classmates with less experieence were learning to draw blood and start iv's I was learning chest tubes and central lines. when they were learning ekg's I was learning how to do a bedside u/s or read a ct scan in trauma, etc

everyone has a learning curve. if you start out further along the curve it can only help. residencies for those with minimal experience are also an excellent idea.

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Ok one last......

 

Sigh....a entry level MD/DO program has a residency attached to it. So, AFTER residency, the doc is NOT entry level. PAs are not expected to be entry level medical personnel (like emt, RN,rt, ma etc) because we practice medicine. AND we don't have the benefit of a residency. So we as practitioners are expected to practice gold standard medicine out the gate along with our MD colleagues without the experience the new Docs (prob around the same age as these new PAs) have had thanks to a minimum of 3 years of HANDS ON HCE as a resident.

 

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You nailed it right here.

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Ok one last......

 

Sigh....a entry level MD/DO program has a residency attached to it. So, AFTER residency, the doc is NOT entry level. PAs are not expected to be entry level medical personnel (like emt, RN,rt, ma etc) because we practice medicine. AND we don't have the benefit of a residency. So we as practitioners are expected to practice gold standard medicine out the gate along with our MD colleagues without the experience the new Docs (prob around the same age as these new PAs) have had thanks to a minimum of 3 years of HANDS ON HCE as a resident.

 

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If someone goes through their clinical portion and doesn't feel prepared...then they should do a pa residency! This has turned into more of a curriculum issue than anything else, of which I can't really comment on. I agree that if these direct entry programs don't adequately prepare one to be a PA they shouldn't have them, but from all of my research on them they do. Most of the grads got job offers from their preceptors during clinical year, so they were obviously doing something right in the eyes of the physicians.

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are they getting jobs as "doctor's little helpers" or pa's though?

many new grads today don't know better and take jobs in which they truly are "assistants" and not "providers".

If 2 yrs out of school you can't run the office by yourself when the doc is on vacation then you are selling yourself short...

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are they getting jobs as "doctor's little helpers" or pa's though?

many new grads today don't know better and take jobs in which they truly are "assistants" and not "providers".

If 2 yrs out of school you can't run the office by yourself when the doc is on vacation then you are selling yourself short...

 

I can't be sure on this, the two that I shadowed from direct entry programs were definitely not hired as "doctor's little helpers" but I can't speak for the rest of them. Based on the average salary of the graduating class, they were at least paid with a pa's salary.

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If someone goes through their clinical portion and doesn't feel prepared...then they should do a pa residency! This has turned into more of a curriculum issue than anything else, of which I can't really comment on. I agree that if these direct entry programs don't adequately prepare one to be a PA they shouldn't have them, but from all of my research on them they do. Most of the grads got job offers from their preceptors during clinical year, so they were obviously doing something right in the eyes of the physicians.

 

This is the thing - what you see as a weakness in curriculum is BY DESIGN. The intent of a PA Program was not and has never been to teach you everything from scratch. Read up on the history of the profession. It is not a flawed curriculum because it doesn't teach you A to Z and in between... It is how the career has evolved. These 0-5 programs are not in line with the way the profession has evolved but as long as there's a quick way people that are young and ambitious will monopolize on it. I don't really BLAME you but I agree it is a negative for the profession as a whole.

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This is the thing - what you see as a weakness in curriculum is BY DESIGN. The intent of a PA Program was not and has never been to teach you everything from scratch. Read up on the history of the profession. It is not a flawed curriculum because it doesn't teach you A to Z and in between... It is how the career has evolved. These 0-5 programs are not in line with the way the profession has evolved but as long as there's a quick way people that are young and ambitious will monopolize on it. I don't really BLAME you but I agree it is a negative for the profession as a whole.

 

The profession also started based on the idea that PAs should be in primary care.

 

I only see it as a weakness if these types of PA programs accept students like me. There are some schools that require lots of hce and build on that knowledge. I'm totally fine with this and like it, but I REALLY hope that my program is not structured the same way, as I don't have the extensive hce that some of you have.

 

If these 0-5 programs are showing that they can produce good PAs right out of college, why not encourage it? I think the high rate of hiring from the physicians where the students did clinical shows that they are good, though I understand that it's not enough evidence to convince someone; I hope as it becomes more commonplace these grads will be able to SHOW that they are good PAs who were properly trained.

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I was referring to the origin of the profession...

 

Yes you're right, I was confusing things. Please respond to my other points though, I'm curious as to what you have to say.

 

I'd also like to add that the reason I keep pushing back is that I know someday you will all be my colleges, and I'd like a fair shot to not be looked at as inferior or incompetent upon based on the way I became a PA. (which I know will come more through my actions and those of other direct entry grads, but i have to at least try)

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seriously what ?

yes, the 6 yr programs describe themselves as "entry level master's physician assistant" programs.

And yes, my son has been accepted to four different 0-6 programs for Fall 2013.

 

PA and "entry level" don't belong in the same paragraph. If you (since you are representing your child) had one day of HCE you would understand how of base you are.

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Sorry I didn't see your edit. Would you consider EMT-B or CNA good HCE? If so, I would argue that these skills are SO basic that if someone can't become proficient at these things in less than a week they shouldn't be a PA. If you're talking about paramedic/nurse HCE I might agree with you; I haven't been through PA school so I can't argue whether or not they thoroughly teach the basics, but as the PA school that I'm going to is a 0-5 one, I would hope that they alter the curriculum slightly to include these basics.

 

I consider EMT-B as good experience... Here's what I do and I want you to tell me that this experience is not good and is looked down on:

 

- Take vitals on every patient that comes in, situate them and put them on the heart monitor

- Initial triage of patients either walk-ins or from ambulance

- Transport critical and non-critical patients throughout the hospital (some require transporting equipment such as respiratory devices, IV Pumps, require me to bag and push a patient, etc)

- Perform CPR at all codes in the hospital

- Perform 12 lead EKGs when the EKG tech is not available (sometimes I help interpret)

- Wound care from simple cuts and bruises to amputations and burns

- Record and view diagnostic tests results and report critical values to the staff

- Key in physician orders, setup transfers / admissions, and make contact for the physicians when they need a consult

- Assist with IVs, venipunctures, and I perform finger sticks for blood sugar

- Fiberglass cast removals, assist with reductions and relocations, apply splints both preformed and plaster, shoulder immobilizers, ortho boots, and etc.

- I assist in high acuity cases that require ACLS, PALS and NRP on a daily basis

- Assist in fast track

- Suture and Staple removals

- Any incident in the hospital I respond to with a 500 yard bag, backboard, collar and act as in house EMT

- Get to use BVMs, OPAs, NPAs, and assist during intubation on real people

- Set up various procedures for the physician like perisintesis (Spell check), chest tubes, I&D, lacs, etc.

- Assist with other patient care duties such as foley caths, replacing leg bags, recording and documenting pressure ulcers, etc.

- Get to work alongside and observe almost every department in the hospital from the Cath Lab, Radiology, RT, L&D, and etc this means how they work, what their role is, and when they are utilized

- Get to use, locate, and learn all tools used in the ER And see how they are used (what sutures are used for what cuts, which rapid rhinos for which scenario, which meds are distributed from which IV site because it may be caustic or the line may infiltrate, etc)

- My pharmacology knowledge has increased dramatically... For example I learned what metformin, lidocain (with and without epi vs maracain), sodium bicarbonate, pain meds (toradol not given to people out of surgery, vs dilodid [spell check], vs morphine, vs IB Profen etc), what med to give during seizures, doses, and I get to learn their uses, that pepsin and benadril are given because they block different receptors in allergic reactions, and independently I go learn their mechanism of action and their uses and I pick 1 to 2 drugs a day and study it. So when a patient comes to me and I ask about their medical history and they say their health and when I ask what medications they take I can know what history they truly have.

- Get to see different things on a daily basis from people with scabies and lice, to elder abuse, to sexual assaults, to the crazies, the TCs, and just so much diversity in patient complaints and how things are handled.

- I get to see different zebra cases from people who get seizures when they have their period (due to over active estrogen receptors in the brain during menstration), to the 37 week pregnant woman who had a mass in her brain and we had to deliver the baby and treat the woman because she was having non stop grand mal seizures, to one case where a person had half of their brain not develop at all as a gestational defect but was fully functional teenager. I get to see those diagnostic tests from imaging to lab results.

 

I mean you make what you want out of your experience...

 

 

I guess everything I do is so basic it obviously is useless... I mean it's EMT basic and holds no value. All I do is just taxi people right?

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I would argue that raw intelligence often correlates with competence, & that MOST (there are always exceptions) highly intelligent individuals who go through a really good PA program will become competent and knowledgeable providers.

 

You just don't get it. There is much more to being a PA than being competent and knowledge. That describes a technician and PA are so much more. No PA school teaches humility, empathy or any of the other intangibles that make a good PA. That comes through HCE and life experience. 300 hrs HCE is a joke. Come back when you have 3000. Go out and get a real job where you put your hands on people, talk to them as an equal, get puked/peed on, deal with people in pain, angry people, intimidating people because NO PA program teaches that. And stop telling people how awesome you are in HS. You are just embarassing yourself.

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