PAs teaching PAs

[rcdavis]

I am throwing this out there for consideration.

 

In a private conversation with another senior PA, (between the two of us, we have 65-70 years of PA experience), the question of teaching as a full time job came up.

 

 

And we lamented that neither of us would be qualified to do so due to a lack of post graduate work,

 

Both became PAs before the degree creep occurred... And were ourselves taught by experienced senior PAs.

 

And both, in own way, have blazed pathways which, particularly in "john's" part, have advanced the profession... From BEING the financial, PA salary, avant garde by creating previously unheard of salaries, to creating OJT and institutional "fellowships" for junior PAs to get specialty training.. Those who have followed have benefited from our having been sucessful highly functioning PAs.. Upon whose reputations and capacities the profession flourished.

 

As we stood on the shoulders or those who went before (and in my case, there were damn few), now we have become the shoulders on which the next two or three generations are standing.

 

But, because we have no masters degree, neither can be accepted as full time facility in any PA teaching institution.

 

Guest lecturer seems to be all that we are good for.

 

Me? I have funded my retirement and need never to work again. but not "John", who probably needs to continue working another 10 years, and is beginning to feel the grind of being an on the floor, in the trenches, daily in the bay (OR, ER, ICU, TRAUMA) PA.

 

And, selfishly, it irks me no little bit that the very programs which shun my application for permanent teaching positions seem to have no problem with my lack of academic degrees when it comes to placing their students in my hospitals for rotations, mentoring their students, or having prospective PAs shadowing me.

 

There is some serious hiprocracy here.

 

So, I put it to you, the rank and file, and maybe some of educators..

 

1. Is there a place at the lecturn for FULL TIME PA instructors with, say, greater than 25 or 30 years of sucessful practice, even though they have no masters?

 

2. How about the old certificate graduates?

 

3. Would you early twenty years old folks working on your masters currently in school feel somehow cheated if so taught?

( makes me think of what we are asking our patient's to do when they see us, rather than the doctor.. Or when we are treating an MD...)

 

4. Are the academic educator rules so wacky that there is no longer a place for John and me at the adult table... Or, is it that now, having helped create and expand the very profession you are educating, we senior guys are to be relegated to a "children's table"?

 

The other, perhaps bigger issue, that needs to be explored, is: what to do with senior PAs?

 

If academics is closed to we who have now no masters, the same will occur to you who currently do have a masters, and 20 -30 years down the road want to " slow down"... By then and probably sooner, you will need a PhD to teach, minimum.. And you will see what I mean..

 

There is another glass ceiling that "john" and I are facing.. And are trying to crack ( once again to the benefit of those who come behind) and that is, where do we go after 20 plus years of working in the trenches? Is there room in the profession of non clinical , for PAs to be outside of clinic?

 

Unlike nursing, there are few if any administrative roles for PAs ( there are some... But they are few), and due to lack of "stand alone" name reconition, there are limited roles in administrative directorships, places on review boards, etc.

 

Like the educators, our "physician partners" have not embraced the idea of an Emeritus PA position, where we are hired for our brain more than our metaphoric brawn.

 

Physassist has mentioned this in his musings ( I am sure there can be a paper in this along the lines of " a prospective analysis and methodological evaluation of taking the practicing PA out of the examining room and placing him on track for a corner office" ) :)

 

 

I do not know the answer, yet.

 

But I would like to serve a caution to you younger types.. When you do start making what is a very very good living at a very very young age... START SAVING EARLY, and start your exit plan early.. So that, if you are 25 now, when you are 45 or 50, and still doing this, you can get out... Abd not have to look at your stethoscope as a shackle, or as a noise.

 

It is, I and John are discovering, not enough to be very good clinically.

 

It is not enough to have spend a lifetime in a profession which in my case required loss of holidays, weekends, and family time.

 

It just is not enough

 

But, it can be...

 

I think.

 

What do you say?

[andersenpa]

Great post Davis.

 

 

1. Is there a place at the lecturn for FULL TIME PA instructors with, say, greater than 25 or 30 years of sucessful practice, even though they have no masters?

 

At a glance, definitely. We are a profession that has historically (although not always in the modern era) valued competency over credentials. I think for those of us that are in a hiring position, we would take an uber-experienced clinical master over a cerebral academician any day of the week.

 

Advantages of the masters in 2013 are

-the grad degree is likely to provide some guarantee that the PA has been exposed to nonclinical topics that are relevant in our global practice (how health systems work, health care finance, how to read/analyze medical literature, and perhaps some non-clinical leadership skills)

 

2. How about the old certificate graduates?

 

 

I’d say a PA is an indirect marker of tenure and experience! But each PA should be evaluated on a case by case basis….a cert PA is not automatically “inferior”, nor is an MPAS/DHSc/etc “superior”….

 

3. Would you early twenty years old folks working on your masters currently in school feel somehow cheated if so taught?

( makes me think of what we are asking our patient's to do when they see us, rather than the doctor.. Or when we are treating an MD...)

 

I’m not a twenty something but I’d say you’re a fool to think that you don’t have something to learn from ANY PA you come in contact with at that level of training.

 

 

4. Are the academic educator rules so wacky that there is no longer a place for John and me at the adult table... Or, is it that now, having helped create and expand the very profession you are educating, we senior guys are to be relegated to a "children's table"?

No idea about the academic circles. As a regular clinical preceptor like you and “John”, I think PA programs are in a sellers market for PA educators. Beggars can’t be choosers and they need to see the value in ALL educators.

 

 

FWIW I recall classes in PA school in subjects like nutrition, clinical lab science etc that were taught by non-masters folks. Maybe not the best example but we can find value in both degree credentials AND clinical experience equally.

[Teasip]

Excellent post, and I am right there with you. I've posted over the past month or so about a desire to merge into teaching, specifically EMS, at a local community college where the income level would be roughly half of what I've been making after 30 years. I checked into my former program's MS degree program and frankly, I don't wish to mess with the thesis issues, and I fail to see how what I'd be paying to learn would benefit me in the long-term in comparison to the out-of-pocket expense. While not quite there yet (5-10 years possibly), I also am getting closer to having the retirement situation taken care of (no state income taxes in Texas, real estate remains relatively low in comparison to other corners, and I'm vested in a governmental retirement pension plan). My daughter is a sophomore in college but funding is there to get her through the last two years (this year is already paid). The house is paid for and there are no outstanding debts at this time. An unfortunate fact of life is that my one remaining parent will probably pass in the next couple of years and when that occurs there will be modest financial assets (no debt either) to disburse evenly with my brother which will go directly to further funding my retirement. As a result, it is time to find something more enjoyable.

 

I do believe that we've paved the way for many coming behind us; those of us who were part of the first 20 years of the profession, and it would be nice to spread our wings in areas outside the grind of daily patient care. This is why I find the EMS instruction appealing because it is the one medical field where I still have some sense of excitement and desire to advance my knowledge (hospital based EM and field EM are two separate entities in my mind). While the additional income will be missed, I'd rather spend this time doing something that I enjoy more, since the majority of my days are still spent in the workplace. I believe that those in academia are being short-sighted by not taking advantage of the available resources available to them. Once again, I'd rather have someone with street smarts than book knowledge, though I'd prefer BOTH if available. I guess that the adage of see one, do one, teach one only works in a clinical setting and not the classroom.

 

In reference to the post above, we didn't even get nutritional education in my program, though we commented in our surveys that it would have been beneficial. Boy, were we right looking back on it now!

[EMEDPA]

excellent post. I totally agree with you that non-ms holders should b able to teach at pa programs.

as a pa in the middle of my career I had the opportunity to go back for a doctorate(about 1/2 way through now) because as you say I think it will be required someday. if I want to teach at 55-60 or so I don't want that door to be closed to me so the doctorate is a little insurance policy...also ammo against the dnp's have doctorates and pa's don't bs, etc

[rpackelly]

PA Programs belong to universities and colleges that must have regional accreditation agencies (SACS, NorthCentral, WASC, etc.). The regional agencies set the rules. The US Department of Education supervises the regional accreditors. However, some are more concrete in their interpretation of federal rules than others. A prior employer of mine required a masters because their regional agency did; SACS, which governs institutions in the south, is beginning to enforce the doctoral degree in order to teach masters students. Additionally, SACS insists that their faculty have at least 18 graduate credits in a subject prior to serving as the core instructor for that subject. This, believe me, leaves out many PAs at a number of levels.

 

Since pretty much all programs are going towards the masters or are already there (a couple of exceptions on the west coast), this explains the hiring policies you see. At the institutional level, some universities require certain degrees for certain types of appointments or “full citizenship” in the faculty ranks. So pretty much the program directors and even the deans have to bow to institutional pressures on at least three levels.............university, regional agency, and the US DOE.

[rpackelly]

Understand, I am not saying this is the way it should be (the higher degree issue); just what is right now. I have no evidence that it impacts the quality of education, now versus “back in the day”. I would say that a majority of the PAs who are in doctoral programs right now view the degree(s) needed to be a successful PA educator or director over the duration of their anticipated career as their major motivator. Degree type just does not have a large impact on clinical or clinical/administrator salaries for PAs, although it is the major player in educational salary level, promotability to associate professor or professor, and tenure.

[Timon]

As someone with a masters (in another subject [MBA]), its just a piece of paper or credential that means a lot to some people but has no practicality when it comes to being able to perform a job function. Yes I practiced and made use of my masters degree but everything I used on a daily basis I learned on the job and my education only reinforced what I already knew (for the most part). No credential can substitute experience and that is regardless of field or industry.

 

Unfortunately those in academia and making policy believe formal education that can be standardized and regulated take prescidence over hands on experience. There's two sides to the coin on the argument since some people practice old outdated methods versus some newer or up and coming method. As a person who will be attending my didactic year in July I can truthfully say I really don't care if you have a cert, AA, BS, MS, or PhD. If you can captivate me and push me to learn the material to pass the PANCE and be an excellent practitioner I could care less what piece of paper you have. Just my opinion.

[True Anomaly]

My own thoughts echo the above. I'm the least-experienced PA to comment on this thread so far, and because of circumstances the opportunities available for PA school when I applied were only masters-level programs, so by default I ended up with a master's degree. However, I feel the same now as I did back then when I was applying- your degree should, ideally or even practically, keep you from becoming a full-time lecturer. Any student would benefit from the years of experience of anyone on this thread. And this may be my own myopic view, but I'd like to think based on my own classmates, and now the students I precept now in the ED, that PA students today would not care what degree you have so long as you are competent and take the time to teach. There will always be those that are stuck in that hierarchal mentality though....

 

I'll be doing my very first lecture at a local PA program soon on an EM-related topic, and I guarantee you it's not the degree that made me feel confident enough to even think about lecturing students on a topic- it's the clinical experience I have so far. And it's a damn shame that you or your friend John feel you cannot transition into a full-time faculty position simply because of credential. Andersen said it best- I've always seen our profession as one that values competency over credentials.

 

rpackelly brings up an interesting point- while degree type may be a major player in educational salary level and promotability, surely it can't be a major player in keeping one from being HIRED at ANY program in the country, can it? And I'm willing to bet that your friend John wouldn't mind taking a slight salary cut if it meant that he could have a secure faculty position, yes? (If not I apologize for assuming).

 

I'd be surprised, really, if any of the 20-somethings here are willing to take a bold stance in the opposite corner from our viewpoint- I could be wrong though :)

[svonholten]

I really enjoyed reading through this post. I am coming into the PA profession a little late; I'll be starting school in a few months. I am in my late twenties and have been practicing as an athletic trainer (not to be confused with personal trainer...I do outpatient rehab on orthopedic/sports medicine patients) for six years now. My graduate institution got "dinged" so to speak for the faculty failing to have as much clinical experience as the accrediting body would have liked. I tended to agree with them. It's very hard to have as much respect for a lecturer who practiced for two years and then came right back to academia and so they are only floating on that two years of experience. As a graduate student, especially one that was currently practicing, it was hard to listen to a teacher who, while describing a certain rehabilitation, one was well aware that they hadn't performed that rehab in some time. When they've been in academia for 10-15 years, frankly, their experience starts to become outdated. But, these are also the workhorses we need to churn out research that clinically practicing professionals lack the time to do. I think the disconnect comes from this "all or nothing" attitude...either you're "all in" academia or "all in" clinically. I wish there were more options to provide more of both and I'm confident that that would also result in less burnout and stress.

 

When I was interviewing last fall, it was incredibly important to me to have faculty who had been recently practicing or who were still clinically practicing in addition to teaching. It's refreshing to have a lecturer who can give you a current overview of what is in the literature and then be able to tell of their experiences in patient care and the applicability of the research in some areas and the lack thereof in others. It's also nice to have a lecturer that can really walk students through how they handled diagnosing certain pathologies and also it seems that most clinically practicing professionals (most) will be able to own up to those times where they were off with their diagnosis and went in the wrong direction...and then describe the path that took them the wrong way and how they, hopefully, got back on course.

 

Unfortunately, I don't think it is a question of CAN you teach students or are you capable of doing so? I think as the PA educator stated, many PA programs' hands are tied because of educational accreditation standards. Even in AT, they have already begun the move in education to have PhDs teaching students. As a student, if you couldn't tell from what I wrote above, I think it would be stupid to turn down the opportunity to learn from an educator with 20-30 years of experience! In your career, you've likely seen several of those things even your teachers probably said that "you would never see." Students want that experience! In fact, they envy that experience. They will live vicariously through your experiences...I swear, I remember some of my former faculty's stories as vividly as my own.

 

I don't know what is on the horizon in PA or if there are such programs but are there transitional master's degrees where more experienced clinicians can take several supplemental classes to get the MS behind their names? I know physical therapy has really cornered this market and done it well (I apologize for the continual references to athletic training and physical therapy...that's just my world for the past 10 years.) They offer transitional DPT courses as their profession has a mandate that everyone must have a DPT by a certain year. Most of these transitional doctorates are online and relatively easy to knock out. Would you be willing to do something like that to get into academia? And again, is the option even out there?

 

Coming from an under-appreciated profession myself, I thank you for your obvious dedication to the PA profession. I feel indebted to those that have paved the way and made the PA profession so appealing.

[benny32311]

I would agree that the M.S. behind the name doesn't really mean anything, but even to teach at a community college you need to have an M.S. I don't think that it would necessarily be up to the school, but who accredits the school. It's a hoop you gotta jump through, I doubt it would even have to be a M.S. in PA studies or the like. I think a lot of people got around it with a MPH or Master of Edu. Might be something to consider.

 

As for the financial advice, YES! Thanks for the tips. I plan to resume funding the crap out of my retirement so one day I can teach for fun, or not have to worry about moving somewhere remote and work without having to require money.

[Bryce83]

I start PA school this summer. I would love to see experienced PAs teaching our program. I would not feel cheated at all to have non master's degree PAs because their Experience brings priceless knowledge and that's not something a master's degree can give. Just my opinion.