Thoughts: UK physician = US PA?

[MedicinePower]

I was discussing the different training methods for physicians outside of the US with a friend who has been in higher-education for many, many years. He reminded me how the UK trains their physicians in 5 years, 2 years of basic science courses and the remaining 3 years of medical and clinical training. No bachelor's degree required prior to starting, no liberal arts classes, no mandated foreign language requirement.

 

We then compared this with US PA training for a Master's Level PA program. BA/BS required in any topic with required sciences (same as the 2 year UK basic science curriculum). 1 year classroom, 1 year clinical, sometimes followed by a 1 year optional residency. If the optional residency was made mandatory then the US PA program would be equal in time commitment (and maybe educational standards) to the UK physician training.

 

This brings up a whole host of curiosities, such as UK physicians with the MBBS (Bachelor of Medicine, Bachelor of Surgery) degree allowed to come to the US for residency and take the USLME exams and being called "doctor" without having any doctorate.

 

Thoughts? Discussion?

[Will352ns]

It's apples and oranges to compare UK with US.

 

In the UK, most of what we consider "high schoolers" finish when they are 16. From there they take tests on different subjects called GCSC's. These tests (English, History, Sciences...and so on) will determine if the student stays for two more years and studies for and complete their A-Levels. This is called their 6th form...or used to be, I'm getting this from my wife who is English. This period of studying A-levels is equivalent to the first couple of years of our college/university. Think of it as the comp education that we all have to do; Eng 101/102, Bio 101/102....so and so forth. Then they take their A-Levels and that will determine what they can study in University.

 

In essence, a student starts University with all the comp stuff complete, so they go directly into the professional part of their schooling.

 

 

You also have to understand that there is a big difference in collage and university here. College is vocation oriented, University is professional oriented. The terms are not interchangeable like they are in the States.

 

Add two years of college/university level education to those figures, and you will see that it is about the same.

[jmj11]

Interesting, and probably some unequivocal terminologies. I was reviewing the UAE national requirements for getting a medical license and if you read it carefully, we meet the qualifications. But it is based on the British model and the "musts" include finished a Bachelors in medicine and at least one year in clinical practice. I wrote them about if i would qualify and never heard back. I have a feeling the would not look at a PA, even a masters, as the same as a bachelors in medicine.

[MedicinePower]

Interesting, and probably some unequivocal terminologies. I was reviewing the UAE national requirements for getting a medical license and if you read it carefully, we meet the qualifications. But it is based on the British model and the "musts" include finished a Bachelors in medicine and at least one year in clinical practice. I wrote them about if i would qualify and never heard back. I have a feeling the would not look at a PA, even a masters, as the same as a bachelors in medicine.

 

JMJ, to the best of your knowledge is does the British Medical Council have a group that they entrust with the evaluation of foreign medical credentials? It would be very interesting to have then review your or another MS-level PA's credentials and see if they are comparable to the UK MBBS physician. If it turns out to be comparable then a whole other discussion could happen.

[CBrody]

I have a feeling the would not look at a PA, even a masters, as the same as a bachelors in medicine.

 

Some of the US PA schools offer a Masters in Medicine, and in that case, I wonder how that would compare to the British Bachelors in Medicine?

[EMEDPA]

Some of the US PA schools offer a Masters in Medicine, and in that case, I wonder how that would compare to the British Bachelors in Medicine?

they still have a full yr of basic med sci built into their curriculum that no pa program has.

[MedicinePower]

they still have a full yr of basic med sci built into their curriculum that no pa program has.

 

In theory this is covered in the pre-PA undergraduate curriculum, with courses in A&P, microbiology, biochemistry, organic chemistry, etc and the didactic year of PA school can be the bridge from basic science to clinical medicine. -?-

[EMEDPA]

In theory this is covered in the pre-PA undergraduate curriculum, with courses in A&P, microbiology, biochemistry, organic chemistry, etc and the didactic year of PA school can be the bridge from basic science to clinical medicine. -?-

nope. how many folks have a yr of histology, embryology, pathophysiology, etc taught by medical professionals with clinical correlations thrown in before pa school? some folks have a few of these courses. I had a great pathophys course for example but no biochem, histology, etc

[MedicinePower]

nope. how many folks have a yr of histology, embryology, pathophysiology, etc taught by medical professionals with clinical correlations thrown in before pa school? some folks have a few of these courses. I had a great pathophys course for example but no biochem, histology, etc

 

Really good point. I am lucky to have taken biochem and gotten a good histology education in undergrad. I am also planning on taking a pathophysiology course before the start of PA school (I just filled out CASPA!). Perhaps the pre-reqs need to be strengthened?

[EMEDPA]

in a perfect world pa/md courses would be taught alongside each other and for a pa to go back and finish the md/do curriculum they would just take the courses not taken the first time around. that would basically create a 2 yr bridge program. it would also allow md/do folks to opt out and do pa for a few yrs then go back and finish. I think I would be ok with that. just need to get rid of the mcat first as it has no relevance to the practice of medicine.

[MedicinePower]

in a perfect world pa/md courses would be taught alongside each other and for a pa to go back and finish the md/do curriculum they would just take the courses not taken the first time around. that would basically create a 2 yr bridge program. it would also allow md/do folks to opt out and do pa for a few yrs then go back and finish. I think I would be ok with that. just need to get rid of the mcat first as it has no relevance to the practice of medicine.

 

True. I would still be curious to see how MS-level PA program would compare against the UK MBBS in a formal evaluation from the British Medical Council. It might not be so different in the end.

[EMEDPA]

I think we would rank fine along clinical lines but they would find our science background insufficient by their standards.

I did some clinicals at a well known washington d.c. hospital that hosted international medical students from the u.k.

I can honestly say I ran circles around ALL of them. Although my experience against u.s. ms-3's was similar. I never met an m.s. -3 that matched me clinically. a few ms-4's on my IM rotation did in the field of IM. these were folks who were doing SUB-I's to get into IM residency.

[CBrody]

nope. how many folks have a yr of histology, embryology, pathophysiology, etc taught by medical professionals with clinical correlations thrown in before pa school? some folks have a few of these courses. I had a great pathophys course for example but no biochem, histology, etc

 

Good points. I guess it would depend on how strong the PA's undergraduate education was. If they majored in Biology or Physiology they may have had those classes taught by med school professors (I did). Additionally, if a PA had another MS degree in an area such as toxicology or pharmacology (I have an MS in both) that might be more than enough to cover the British requirements. Very interesting conversation thus far and something for the brass at the NCCPA to give thought to during their coffee breaks.

[jmj11]

I don't know much about the UK system. I know that when I've worked overseas that the physicians from most non-western countries could not compare to the knowledge and practice of a seasoned PA. I've been tempted to apply to get a medical license in Abu Dhabi. I worked there in 81, but I flew beneath the radar. A friend of mine, who is a hospital administrator there, told me about five years ago (when I wanted to go back) that he could not get a single PA credentialed to work there as they did not recognize PAs. I know that G. Washington U is considering helping UAE set up the first PA program.

 

I've always thought that countries that have physician shortages (not UAE) could tap into a great resource by creating a special program where PAs with 10 years experience could come and work for one year. They would be scrutinized carefully. At the end of that year they would be offered their national medical exam for physicians. If passed, they would be awarded a WHO recognized MD degree. This would not help you back in the states, but would open doors for us who would love to work in the developing world as physicians.

[Contrarian]

 

I've always thought that countries that have physician shortages (not UAE) could tap into a great resource by creating a special program where PAs with 10 years experience could come and work for one year. They would be scrutinized carefully. At the end of that year they would be offered their national medical exam for physicians. If passed, they would be awarded a WHO recognized MD degree. This would not help you back in the states, but would open doors for us who would love to work in the developing world as physicians.

 

Where do I sign up...???

 

As I would Luv to work in Chad, Darfur, Eritrea, Uganda or South Sudan as a provider with the full rights and respect of a Physician.

[EMEDPA]

C- as you now a few pa's have successfully challenged "clinical officer" exams in several African countries. those folks practice independently with a slightly narrower scope than a doc, more like an np in an "independent state " in the u.s.

[MedicinePower]

A broader question is how does PA school stack up against medical schools in such places as the Sudan and Somalia? Somalia is on the California Medical Board list of "approved" schools but without a functioning government, civil war, and piracy problems I can't imagine that the school provides the highest quality of medical education. So it begs the question- how can "National University of Somalia Faculty of Medicine" be approved to function as a physician in the United States and be considered superior to the education of a MS-level PA?

[Will352ns]

I can speak for the UK trained physicians as I have worked with them quite a bit. There is zero difference between a US and UK trained doc. Trying to compare PA to a UK physician is the same as comparing a PA to a US MD.