What % of a doctor's knowledge do PA's have?

[camoman1234]

If there is only 100%... how could it move...??

100 questions on a test. 100 correct answers..

How does little johnney make a 125%... ????

 

Your analogy doesn't make sense nor applies in this instance. Medicine is NOT static, it is evolving every minute of every day. Your 100% is stating that the MD/DO knows 100% about EVERYTHING in FP or GYN, etc. and the PA knows 85% of EVERYTHING. A better way is to say that the entire medical community knows 10% of the histology on teeth and that the MD/DO knows 100% of that 10% and the PA knows 85% of that 10%. The body will ALWAYS amaze "us" humans and we will NEVER know 100% of what goes on in the body. Just like my physiology professor said in undergrad., "I have been doing this for 30 years and I have just begun to scratch the surface of what the human body holds, so believe me, if you think you got an ear full this semester, just wait until graduate school."

[bjl12]

1.The "textbooks associated with medical school" are the same books used in PA school (Netter, Harrison, Cecil, Steadman, Bates, Guyton, Sabiston, etc....)

We both have to learn the same clinical medicine. The differences are what time and depth our programs put into underlying basic science (histo, embryo, level of patho, etc) and the time we have in clinical rotations.

 

I didn't know the textbooks were the same. Even so, any information a PA doesn't receive during PA school can easily be obtained by reading/learning in greater depth. I think that's what you were saying anyhow, so thanks for clearing my misunderstanding up

Edited January 8, 2013 by bjl12

[bjl12]

The PAs "craft" is MEDICINE... so HOPEFULLY, that PA is spending a considerable amount of time YEARLY with their nose planted in a medical text " honing their craft"...

 

For Clarity...

I am in NO way suggesting that what PA's are exposed to in school is equivalent to what physicians are typically exposed to in school.

 

What I'm saying is that there is NO super secret, special "physicians only" knowledge out there... its ALL in books somewhere.

 

I agree. I'm clearly not as knowledgeable about the difference (if there is any) of operational duties between PA/physician... as I'm not a PA or PA student yet.

 

But your post suggests there isn't and so that has helped clear up some misunderstandings. Thank you

Edited January 8, 2013 by bjl12

[Contrarian]

Medicine is NOT static, it is evolving every minute of every day.

 

I agree... and with this... one should also then be able to see that learning and the attainment of knowledge is also not static... therfore, having a PA-C behind one's name doesn't mean that they will forever be deficient in all medical knowledge to those with MD/DO behind theirs.

 

Your 100% is stating that the MD/DO knows 100% about EVERYTHING in FP or GYN, etc.

 

But that's the problem... some folk do think that MDs/DOs know everything and the PAs are by default stuck at 85% of that in a static comparative knowledge relationship. So if the PA learns something new... the MD/DO will automatically already know that info simply because he/she has MD/DO behind their name.

 

And getting a physician to admit the "85%" is like finding a kebbler elf... rare.

 

A better way is to say that the entire medical community knows 10% of the histology on teeth and that the MD/DO knows 100% of that 10% and the PA knows 85% of that 10%.

 

Not sure if that's "a better way" since the book the MD/DO read to learn it can also be downloaded on a kindle/nook by anyone who can read...

 

Again.. we live in a phenomenal "Info Age" where just about ALL technical knowledge is at anyone's fingertips who has electricity and a connection to the world wide web.

 

So I guess my problem here is the insistence on the use of the word "knows."

What someone "Knows" is kinda individualized and mostly determined by their personal desire to seek out specific knowledge. Then they have to retain and be able to recall that knowledge long past "the test" for one to Truely "Know" something.

 

Maybe a "better way to say it" is:

'The entire medical community knows 10% of the histology on teeth and that the MD/DO HAS BEEN EXPOSED to 100% of that 10% during their training and the PA HAS BEEN EXPOSED to 85% of that 10%.

 

5 yrs post training and testing... a percentage of both MDs/DOs and PAs may have allowed their medical knowledge base to retract, or expanded. Meaning they may have forgotten much of it or learned a lot more than they were exposed to in their respective training programs.

 

If a PA is always ONLY gonna know 85% of the 100% of what physicians know of the 10% known by the medical community on the histology of teeth... then how do we account for the multitude of google pages of Folks out there listed as Med School Faculty with both PhDs in Physiology who also have NCCPA certification...???

 

(google=Phd Physiology + PA-C)

 

Aren't these PA-Cs TEACHING and testing young medical student on the 100% of the 10% known by the medical community on the histology of teeth...???

Edited January 8, 2013 by Contrarian

[discogenic]

 

And getting a physician to admit the "85%" is like finding a Keebler elf....

 

 

To summarize then, the extra 15% is really just cookie-baking knowledge. :;;D:

[KCMA79]

Not to change the subject abruptly, but is the PANRE generally seen by PAs to be a good thing (revisit, stay up on things) or an unnecessary pain in the butt? I've seen some comments along the lines of the latter, particularly when the topic of comparing PA to NP comes up, so I'm not sure where the majority of PAs stand on PANRE.

 

The PANRE is a dark evil thing that hangs over most PAs heads with the threat of loss of lic and job.

[discogenic]

The PANRE is a dark evil thing that hangs over most PAs heads with the threat of loss of lic and job.

 

Do most PAs take some kind of review course to study for the PANRE? Use review books? What's the strategy?

[Contrarian]

Personally, I use my yearly $2500 CME allowance to go to ANY CME in ANY area of medicine that interests me and that may expand my billiable knoweledge(so lately Psych, Cardiology, Addiction, Chronic Pain) ... but only for 5 yrs... THEN I use it to only do Primary Care CME/REview courses the Yr right before PANRE time and take the PANRE at the beginning of the 6th yr.

[EMEDPA]

I've been taking panre yr 5....yup, I'm a chicken....

[DonnieDFrank]

On 1/7/2013 at 7:18 PM, Mordechai said:

I would disagree based on what I know, but you may know more. What are MD's exposed to in their didactic phase that PA's are not? As far as what they are exposed to outside of school I don't think anyone can deny or prove one over the other as what anyone is exposed to is relative to their particular experiences.

as far as the question "what are MDs exposed to in their didactic phase that PAs are not", one thing I can think of is histology. Looking at cells under the microscope, determining what tissues they came from, which cells are normal vs dysplastic vs metastatic. Is that an example of an answer to your question? I think that is not something that pops up on the PANRE. I wont say that that is relevant to every doctor in practice, and some people never use that knowledge again. but that is just one subject that I think MDs get in didactic that a lot of PAs do not.

 

One other thing I kind of noticed (but this isn't formal knowledge and just a mindset rather) medical students just loveeeeee jumping to the most random, whacky, rare 1 in a million diseases. I think that PA school emphasizes the important (and easily forgotten) point of "common is common. hear hoof beats think horses". I think medical students tendency to spend more time on rare diagnoses unfortunately this is due to standardized testing. Sometimes it is easy to lose sight of medicine and to be pressured to learn what will be on the test. I think the PANRE is preparing PA students for most likely diagnoses that they will encounter in practice. I think the USMLE step 1 is trying to test concepts of basic sciences. So the USMLE will have a lot of rare diseases, not because they will likely be encountered by the medical student, but because the disease is a good way to test knowledge of a certain biologic process. So even though most medical students will never see a patient with ornithine transcarboxylase deficiency in their entire life, every medical student will learn it in great detail because it is a good way to test the medical student's understanding of the urea cycle and the effects of hyperammonemia. Every medical student will learn how orotic aciduria works, not because they will ever see a patient with that disease, but because on the test they need to prove they understand all of the enzymes in the de novo pyrimidine synthesis pathway

 

 

that leads me to one last subject. though as someone mentioned already, all knowledge is in a book and it is not restricted. anyone can learn more if they are interested  medical students spend a lot of time learning biochemistry. I am not sure if that is the same in PA school or not. Though I told myself I will never need to know how purines and pyrimidines are generated or recycled, it see hints of these in a lot of places. Immunosuppressants that block DNA synthesis leads to backup of metabolites in other pathways that intertwine with urea cycle and this helps me understand how gout can be precipitated. or another example is thinking about how ALT and AST actually function as transaminases in glutamine and ammonia handling.  it doesn't really change the practice. We will all see elevated ALT and AST and know this can be a sign of liver distress. We can see AST >> ALT and remember that alcoholism is potentially the cause. These values that we remember come from knowing that AST is located in the mitochondria and cytosol of hepatocytes while ALT is only in the cytosol; with knowing that alcohol metabolism in zone III of the liver requires significant NAD+ consumption. This creates a lack of NAD+ to be used in oxidative phosphorylation, which occurs on the inner membrane of the mitochondria. This mitochondrial damage leads to AST release. And this is why you would suspect alcoholic hepatitis when AST>>ALT versus other causes of hepatitis. Other forms of hepatitis will leave the mitochondrial membrane intact, sequestering some of the AST. But does that information really matter? if you know AST>>ALT is likely alcoholic hepatitis, does it matter how you came to the conclusion? some will say yes and some say no. Thats just another example of what (i think) may not be included as much in PA school. But I could be wrong, because I have never been to PA school. These are two things that come to my head. Im sure a lot is the same. I dont mean this in any sort of negative way, this is just objectively two things that I thought of that seem different. 

[EMEDPA]

agree. Intensive basic medical sciences are the main didactic difference between PA and Med school. No argument here.