NYU 3 year MD program

[rxtechhk]

http://communications.med.nyu.edu/media-relations/news/nyu-school-medicine-debuts-three-year-md-program

 

NYU approved for a three year MD program. What bothers me is why PA to MD/DO programs are unable to create a true bridge. Clearly three year programs are on their way to becoming mainstay. How about at the minimum eliminate MCAT requirements and possibly reduce the term to 2 years versus possibly 3 years with the ability to continue working.

[EMEDPA]

I talked to the director of the lecom bridge about this 2 yrs ago.

there is a min # of hrs that need to be done to be an accredited med school (either md or do) in the u.s.

lecom's bridge is only a few weeks over this limit. because of this, a 2 yr bridge is not feasible.

[lancer_dancer01]

Is lecom the only pa to do/md bridge program?

[rxtechhk]

Then how about removing MCAT requirements...and yes currently it's the only bridge program

[jdumoch]

from what i can tell this is not a pa-md bridge. it is simply an accelerated medical school open to anyone who meets the qualifications. correct me if i am wrong

[Gordon, PA-C]

Then how about removing MCAT requirements...and yes currently it's the only bridge program

 

the individual school has no choice -- they must have an MCAT or they cant get accredited by the LCME.

 

Getting rid of the MCAT requires a nationwide policy change at the LCME level, not likely.

 

Besides the MCAT is easy. You make it sound like its some kind of impossible obstacle.

[Gordon, PA-C]

I read more into the program, basically they guarantee you a match into whatever NYU residency you want. Now obviously at first look that is absurd because they cant fit 20 people who all want plastic surgery residencies. So they have it limited by specialty group (i.e. they accept 50 med students who want primary care, they accept 2 students who want plastic surgery, etc). Getting into the surgical subspecialty tracks is going to be ridiculously competitive I would think.

 

The problem I see is at the residency level. What this does is force the program directors hand -- he HAS to accept a fresh untested 1st year med student into their residency 3 years later. I think its a dumb idea and I'm shocked that the residency program directors would agree to that. What happens if the med student does fine with grades but just doesnt have the technical skills to be a surgeon? They wont find that out until AFTER a residency spot has already been guaranteed to them and it puts the PDs in a tough spot.

[Gordon, PA-C]

from what i can tell this is not a pa-md bridge. it is simply an accelerated medical school open to anyone who meets the qualifications. correct me if i am wrong

 

Yes thats correct, it is an accelerated MD program.

[discogenic]

Yes thats correct, it is an accelerated MD program.

 

Accelerated? But I thought MD school was so intense it couldn't possibly be accelerated any further? :=D:

[EMEDPA]

Is lecom the only pa to do/md bridge program?

the only reputable one. there are a few Caribbean ones but getting a residency in the u.s. is highly questionable.

[EMEDPA]

Accelerated? But I thought MD school was so intense it couldn't possibly be accelerated any further? :=D:

4th yr is a joke. it's mostly electives, vacation, and time to go all over the country and interview for residency.

remember pa school is 100 weeks of instruction in 2 years and med school is 150 weeks of instruction in 4 yrs....

[EMEDPA]

 

Besides the MCAT is easy. You make it sound like its some kind of impossible obstacle.

for someone years out of school it is a HUGE obstacle. for me to take it and get the minimum lecom bridge score (23) would take at least a year of prep courses. without the mcat I could apply and start next term. it's a huge deal. I got straight A's in physics over a decade ago. think I remember enough of it to test well? nope.

[surgblumm]

You are correct and their educational requirements may be decreasing but they have a residency. A residency is like being a practicing PA in a specialty for seven years.

bob

[MedicinePower]

One way to effectuate a true 2 year PA->MD/DO program is for a group of highly motivated PAs to find a group of MDs/DOs to teach, educators to design a curriculum, lease a space, equip a school, and gain AOA or LCME approval. If it is all done to the highest educational standards and using accreditation specialists (those who have extensive experience in AOA or LCME accreditation) then it would be difficult for accreditation to be denied.

 

The other option is to make a true clinical doctorate for PAs, called something like "Doctor of Medical Practice" or something similar, and convince the Federation of State Medical Boards that this is the "new DO" doctorate level. I am under the impression that Nurse Practitioners going to the clinical Doctorate of Nursing Practice (DNP) level may very well end up as a true clinical doctorate with residencies and fellowships.

 

Thoughts? It's a rough idea but I think it's possible if people are highly motivated and the money is available. It may require working closely with NPs in order to create a PA/NP to MD/DO program simply for the numbers.

 

a new accelerated three-year Doctor of Medicine (MD) degree, approved earlier this month by the New York State Education Department

The key part to this is the approval from the NYS Education Department. I feel confident that at least one state's education department can be convinced to have a 2 year PA->MD/DO program, which may start the ball rolling.

 

[h=1]Shortening Medical Training by 30%[/h]JAMA. 2012;307(11):1143-1144. doi:10.1001/jama.2012.292.

Source: http://jama.jamanetwork.com/article.aspx?articleid=1105095

 

Wouldn't that make it the same length as a master's level PA program (within a few weeks)?

[Contrarian]

... [brevity edit]... It may require working closely with NPs in order to create a PA/NP to MD/DO program simply for the numbers... [brevity edit] ...

 

Ummm ...

They already consider the care delivered by NPs to be equivalent to that of Physicians (just as we consider the medicine we practice to be).

Sooooo.... Convincing the Nursing Establishment to endorse ways for nurses to LEAVE nursing for medicine... and thereby basically aknowledging that the care delivered by NPs may NOT be equivalent to that of Physicians (if it already is... then why go to school to become a physician) is NOT Likely...

 

Not really a big deal for us because we would still be "practicing medicine."

Any NP that did this would no longer be practicing "advanced nursing" but would be practicing MEDICINE.

[Gordon, PA-C]

Accelerated? But I thought MD school was so intense it couldn't possibly be accelerated any further? :=D:

 

thats not the real issue though, the real issue is that YOU DONT NEED TO KNOW KREB'S CYCLE in order to be a good medical provider/doctor.

 

We need to stop this ridiculous nonsense that you need to learn electromagnetic fields in order to take the MCAT so you can "prove" yourself worthy of an MD. We also need to stop the nonsense of pretending that you need all the stupid BS that is the first year of med school. Those classes are conjured up by PHDs who are trying to justify their salary. They serve no purpose in medical education. No doctor can diagram out the minutiae of heart development in utero, and you know what, they dont need to unless they want to go into genetics which in that case they can learn in a fellowship.

 

Here's my solution:

 

No college

2 years medical school

Year 1: anatomy, physiology, pharmacology, pathophysiology, statistics, epidemiology

Year 2: clinical rotations

3-8 year residency depending on specialty

 

Thats ALL you need. You dont need physics, calculus, chemistry, biochemistry or any of that other BS, all a complete waste of time (ask the MDs they will tell you this too)

[Gordon, PA-C]

One way to effectuate a true 2 year PA->MD/DO program is for a group of highly motivated PAs to find a group of MDs/DOs to teach, educators to design a curriculum, lease a space, equip a school, and gain AOA or LCME approval. If it is all done to the highest educational standards and using accreditation specialists (those who have extensive experience in AOA or LCME accreditation) then it would be difficult for accreditation to be denied.

 

I'm pretty sure LECOM did this already. Are you saying they screwed it up and could have shortened it further? They are stuck by the LCME criteria

 

The other option is to make a true clinical doctorate for PAs, called something like "Doctor of Medical Practice" or something similar, and convince the Federation of State Medical Boards that this is the "new DO" doctorate level. I am under the impression that Nurse Practitioners going to the clinical Doctorate of Nursing Practice (DNP) level may very well end up as a true clinical doctorate with residencies and fellowships.

 

The NPs pushing for doctorates and residencies has absolutely nothing to do with individual medical boards or the state medical boards. They are regulated ENTIRELY by nursing organizations and dont need the approval of any medical board whatsoever. I think its unlikely the state medical boards are going to allow PAs to do the same -- we would have to go OUTSIDE the medical establishment like the NPs if we want what they have. One way to do this would be to lobby to separate PA regulation from state medical boards. Instead of being controlled by a state medical board, we would be controlled by a state PA board and then we can do whatever we want with no interference.

 

 

The key part to this is the approval from the NYS Education Department. I feel confident that at least one state's education department can be convinced to have a 2 year PA->MD/DO program, which may start the ball rolling.

 

NYS education department approval is needed but it is NOT key. The bottleneck "key" to getting this thing to work is LCME accreditation. Without that, you've got nothing regardless of what the education department says.

[MedicinePower]

I'm pretty sure LECOM did this already. Are you saying they screwed it up and could have shortened it further? They are stuck by the LCME criteria

Correct me if I am wrong (I very well might be) but isn't the LCME for MD schools only, while the AOA accredits DO schools? I do think they can shorten it more, especially since they have a report out in JAMA that says to trim med school education by 30% which would bring it in line with PA school. If PA school was to require a 2-4 year long residency then it's possible that PA school would be the same commitment as the proposed-MD curriculum.

 

The NPs pushing for doctorates and residencies has absolutely nothing to do with individual medical boards or the state medical boards. They are regulated ENTIRELY by nursing organizations and dont need the approval of any medical board whatsoever. I think its unlikely the state medical boards are going to allow PAs to do the same -- we would have to go OUTSIDE the medical establishment like the NPs if we want what they have. One way to do this would be to lobby to separate PA regulation from state medical boards. Instead of being controlled by a state medical board, we would be controlled by a state PA board and then we can do whatever we want with no interference.

I think there would still be a required change in statute for every state to allow for DNPs to practice unlimited nursing/medicine, including independent surgery and such. As for you outside the establishment that might be a possibility, offering a degree along the lines of "Doctor of Medical Practice" or some such (tho that is easily confused with DPM).

 

 

 

NYS education department approval is needed but it is NOT key. The bottleneck "key" to getting this thing to work is LCME accreditation. Without that, you've got nothing regardless of what the education department says.

LCME or AOA accreditation is required. Going through the LCME and AOA means that the FSMB (Federation of State Medical Boards) automatically approves you, while a new standard for Doctor of Medical Practice would require a great deal of lobbying, statute passing, and regulations. Possible, just a lot of work. This is why the PAs and NPs might want to work together on this, to leverage the mutual goal.

[Contrarian]

 

This is why the PAs and NPs might want to work together on this, to leverage the mutual goal.

 

Still NOT seeing why YOU think NPs and PAs have a "Mutual Goal"...

 

The Nurses want NOTHING to do with FSMBs or the LCME...

 

Why would they want to be obstructed by "medicine" when they can do whatever they want under the label of nursing.

 

They don't want to be Physicians... nor do they want to be obstructed by physicians.

They insist that they do NOT practice "medicine"... they practice "Advanced Nursing."

This semantic was purposely formulated to avoid being cast in ANOTHER role designed to be subservient to physicians... and if you re-read your PA history, you will find this as one of the reasons they turned down the offer from Dr. Stead to become the first PAs.

 

The NP profession was born shortly thereafter.

 

Contrarian

 

btw... They also aren't intrested in the Surgical Subspecialties... but DO want parity in Primary Care.

[MedicinePower]

Still NOT seeing why YOU think NPs and PAs have a "Mutual Goal"...

 

The Nurses want NOTHING to do with FSMBs...

 

Why would they want to be obstructed by "medicine" when they can do whatever they want under the label of nursing.

 

They insist that they do NOT practice "medicine"... they practice "Advanced Nursing."

This semantic was purposely formulated to avoid being cast in ANOTHER role designed to be subservient to physicians... and if you re-read your PA history, you will find this as one of the reasons they turned down the offer from Dr. Stead to become the first PAs.

 

I hear what you say and I think you might be right. I also know that the RNs were first offered to become PAs but at the time they felt this was much too unorthodox for nurses. Of course they now pursue it full-speed 30+ years later in the form of the NP.

 

I think the idea of NPs becoming "Doctor of Medical Practice" might gain some traction, especially with those who are frustrated that the DNP presents a glass ceiling. I work with a lot of NPs and NP-students and have had this conversation with them and there appears to be a frustration with DNP and a desire to do an actual "bridge" to either MD/DO or something that would truly represent a clinical doctorate. The FSMB can be avoided just like the DOs do, by having their own accreditation and medical boards.

[EMEDPA]

IF we were going to redesign medschool I would like to see the english model.

5 yrs after high school gets you undergrad + medschool. when I was a 2nd yr pa school student I was on rotation with 23 yr old senior english medstudents who were starting residency the next yr..

[primadonna22274]

Ummm... Having suffered through the past 18 mos of Biochem, genetics, embryo, more anatomy than you can imagine, detailed physio and pharm (much greater detail than I got in PA school which was pretty good), neuroanatomy, histology and path, not to mention knocking out 6 of the big systems, I humbly maintain that there absolutely IS a use for all this "fluff" in a well-rounded and competent physician. Not necessary for a PA, but makes the PA stronger. If you cut out this "fluff" you have a very weak physician indeed.

My Ddx skills are so much deeper now for what I have learned that I didn't know...and I have been a PA for 12 yr and a damn good one at that.

Don't be disingenuous. You don't know what you don't know until you know it.

[Guest Paula]

Ummm... Having suffered through the past 18 mos of Biochem, genetics, embryo, more anatomy than you can imagine, detailed physio and pharm (much greater detail than I got in PA school which was pretty good), neuroanatomy, histology and path, not to mention knocking out 6 of the big systems, I humbly maintain that there absolutely IS a use for all this "fluff" in a well-rounded and competent physician. Not necessary for a PA, but makes the PA stronger. If you cut out this "fluff" you have a very weak physician indeed.

My Ddx skills are so much deeper now for what I have learned that I didn't know...and I have been a PA for 12 yr and a damn good one at that.

Don't be disingenuous. You don't know what you don't know until you know it.

 

I appreciate your perspective on this issue. There are times I wish I could go back to school to learn more in- depth ddx and I do get stuck in a thinking pattern, so I research on my own as much as possible,discuss with my SP and sometimes that gets us nowhere. He is a GP with only a one year externship after med school. The whole issue with the 3 year med school will simply cause students to pick what they really want to be: MD/DO/PA/NP. Too late for me to go back to school, (I would be 65 by the time I would jump thru hoops, take MCAT, take physics, apply, find a school, and then 6-7 years of school considering a 3 yr. program like LECOM ). Plus, I would have no retirement money left and broke, broke, broke! SO, it means I have to be the best PA I can and that is my goal.

[MedicinePower]

The interesting thing is a UK trained physician (MBBS) can come to the states after just 5 years of a combined college/medical training, take the USLME exams, and obtain a residency. That would save them many years from the "normal" American route. I am very much under the impression that a true 2 year PA->MD/DO program can be established and gain accreditation, provided the educational standards are non-compromising and right consultants are brought on board.

 

The biggest hurdle, I think, is successfully passing the USMLE exams. They are designed for the MD and a bridge program might have to become an intensive 1 year USMLE Step 1 review. Very possible, just intense. The COMLEX would require OMM knowledge but as I understand it the COMLEX has higher pass rates.

 

The other option is as I said above, creating a new clinical doctoral level that would feed into MD and DO residencies. For this it may require a joint venture with the DNP programs.

[rxtechhk]

One way to effectuate a true 2 year PA->MD/DO program is for a group of highly motivated PAs to find a group of MDs/DOs to teach, educators to design a curriculum, lease a space, equip a school, and gain AOA or LCME approval. If it is all done to the highest educational standards and using accreditation specialists (those who have extensive experience in AOA or LCME accreditation) then it would be difficult for accreditation to be denied.

 

Would love to lobby for this