80 new PA programs scheduled to open by mid 2016

[EMEDPA]

E,

I am apparently on his resource list for lecturers.

excellent. you guys will get along great and I know he plans to treat his faculty, staff, and guest lecturers well. when done with my doctorate I may fly out and do a block of guest lectures there at some point.

[chickitabanana]

This is very concerning, indeed! I understand the need for more PAs, but am worried, like many others, that the quality of PAs/PA school applicants will go down which will hurt the profession instead of helping it. I hope that standards for applicants will not decrease, but feel that if all of these new schools are trying to fill their seats and get their program going that is a possibility. I don’t want it to be another JD degree that essentially means nothing if you didn’t go to a top tier school. I would hate to work so hard to get into and then graduate from PA school and not be able to find a job afterwards!

 

I have to disagree somewhat with marie926 re: more schools in Boston. By 2016 there will be 5 schools all within the minutes of each other (BU, Tufts, NEU, MCPHS, MGH Institutes of Health). As it is now, Northeastern is affiliated with Tufts Medical School, so what will happen to Northeastern’s program once Tufts has their own program, too? I have no doubt these schools will produce excellent PAs (and it is nice to see them join the list of PA schools), but fear that Boston will become like Philly and NYC as far as too many schools all within the same area. The fight for clinical rotations will increase, too, because these schools already have MD programs, so adding 100 or so more PA students every year will be challenging. I’m sure they’ve figured it out as far as accreditation purposes, but until its implemented in real life no one knows how it’ll work out. Just one additional school opening near my program has impacted rotations for current students (for all three schools in the area). The only students on my general surgery rotation were myself and another classmate. We had multiple cases to go to every day and were exposed to a large variety. We sat down one-on-one with the chief resident who went over knot tying with us and again with one of the attending surgeons to do the same. One year later when I was completing a specialty surgery rotation at the same hospital I saw a PA student from the class under mine on his general surgery rotation. He said there weren’t that many cases to go to and he really didn’t get to do all that much because there were 5 or so students on general surgery with him. I’m not saying that additional school that opened shouldn’t exist, but know that the experience with one rotation (and perhaps others) in the area has impacted students from all three schools that are within 30 minutes of each other.

 

It might not be so bad if these 80 programs were dispersed better across the US. There is one in Maine, two in NH, NONE in Vermont, and Massachusetts schools are all in Boston (except for Springfield College). Another poster already said there is still only one school in SC, too. Additionally, I don’t see how some of these programs can even support a PA program if they have no other health science professions already at their school. IMHO, Johnson and Wales and Bryant college have no right to be starting PA programs. I strongly believe they are “jumping on the cash cow wagon” since neither of them have any other health professional degree currently nor do they have the resources needed to produce quality PAs. It upsets me that Brown University refuses to start a PA program when it would be such a better option for Rhode Islanders wishing to become a PA.

 

As far as HCE I think it’s important to have some prior to PA school, but do agree with others that you can’t expect students these days to live of MA or CNA salary for 2-3 years (plus another year waiting for school to start after you’ve been accepted). I was lucky that I was able to live at home while gaining HCE because, despite having a kinesiology degree, the only “hands on” care I could get while taking pre-requisites was volunteering part time as an MA for almost a year at a doctor’s office. After that, I was able to get a paying job as an MA, but still, 13.50/hr isn’t going to pay the bills to live on my own. As it is, I wasn’t able to save up a ton of money prior to grad school in order to take out fewer loans. I’m still 100K in debt from PA school despite the fact that I worked for two years (one of them being unpaid) between undergraduate and starting PA school. I may not have been an EMT, but I do think that I gained valuable knowledge and experience that helped me while I was in PA school. While we do want to limit the applicant pool to qualified individuals, if we make it too strict for students to get in I think many of them will go the NP or MD route instead (since science pre-reqs are similar and NP and MD programs do not require HCE) and we’ll be losing some great individuals in the PA field. It’s somewhat unrealistic in this economy to expect someone to graduate, spend money and 1000 hours on an EMT course, then work for 2-3 years as an EMT and THEN begin working towards becoming the profession he/she really wants when he/she is in his/her mid-late 20s or even 30s.

 

Regarding the PANCE, from what I understand from my more seasoned preceptors, there used to be a clinical portion of it, right? Why was that stopped? My school required us to pass an exam before graduation with standardized patients and focused H&Ps (similar to USMLE Step 2CS format), but do all schools? For those feeling that a multiple choice test is not adequate, perhaps some of the older PAs on this site can provide some insight as to why the clinical portion of the PANCE was discontinued. Personally, I think that if you’re inept clinically then you probably would’ve failed a rotation or two and thus, not made it to graduation so a multiple choice board exam seems fair.

[True Anomaly]

 

Regarding the PANCE, from what I understand from my more seasoned preceptors, there used to be a clinical portion of it, right? Why was that stopped? My school required us to pass an exam before graduation with standardized patients and focused H&Ps (similar to USMLE Step 2CS format), but do all schools? For those feeling that a multiple choice test is not adequate, perhaps some of the older PAs on this site can provide some insight as to why the clinical portion of the PANCE was discontinued. Personally, I think that if you’re inept clinically then you probably would’ve failed a rotation or two and thus, not made it to graduation so a multiple choice board exam seems fair.

 

I haven't been a PA long enough to take the PANRE, so others on the forum can answer better, but I do know from what I was told as a student from our program director is that when the practical portion of the PANCE was dropped, it was agreed that all PA programs would, in it's place, have a "capstone course/final exam" that consisted of those elements on the older PANCE. So while the exam now is a long multiple choice test, my own final exam before graduating school was an OSCE-type problem-focused exam and coming up with a treatment plan with a mock patient, then an oral test with a faculty member, then a long-form test with imaging studies, pharmacology and clinical scenarios that required to come up with treatment plans, writing prescriptions and executing patient care decisions. It was extremely thorough, and I'm sure what the older PANCE was like.

[robidf]

It’s somewhat unrealistic in this economy to expect someone to graduate, spend money and 1000 hours on an EMT course, then work for 2-3 years as an EMT and THEN begin working towards becoming the profession he/she really wants when he/she is in his/her mid-late 20s or even 30s.

 

IMHO, I disagree with this statement.

 

Its very doable and reasonable to work your way through school or work for something you want, so I see no problem with being a CNA/ER-TECH/EMT/RRT/RT etc... for 2-3 years while you're taking your undergrad classes. This is just my opinion...maybe I'm an "old" 27 year old complaining about the attitude of immediate satisfaction that seems to be rampant nowadays.

[andersenpa]

There's no one "life track" to produce a PA...or an NP or a doc.

PA training is showing that.

I'm not sure that the growth in residencies is a direct result of the changing admissions criteria, as others here tend to suggest. I don't know, but I don't think anyone has the "true math".

Too many unknowns about the impact of factors OUTSIDE PA training/education and how it affects PA-C competency.

[chickitabanana]

IMHO, I disagree with this statement.

 

Its very doable and reasonable to work your way through school or work for something you want, so I see no problem with being a CNA/ER-TECH/EMT/RRT/RT etc... for 2-3 years while you're taking your undergrad classes. This is just my opinion...maybe I'm an "old" 27 year old complaining about the attitude of immediate satisfaction that seems to be rampant nowadays.

 

I don't disagree with working for a few years to get HCE prior to applying to PA school. I think it was very valuable to have before starting school for more than one reason. I had the required 2,000 for most schools when I applied and gained that experience in the two years between undergrad and grad school. (I tried to get HCE during the summers, but the hospitals near me would basically only let me be a candy striper.) The point I was trying to make was that if being a medical assistant/cna isn't "worthy enough" HCE as some of the previous posts suggest and the only hours that should count are jobs like RN/EMT that that is somewhat unrealistic. If people know right away out of high school they want to be a PA then they can gain four years of experience while in undergrad and be fine. Or, they would apply to programs such as Quinnipiac that have a 6 year program straight from high school. The reality is that most 18 year olds have no idea what they want to do and take at least a year or two in college to figure it out. If the HCE expected is RN or EMT then I think the RNs might still become PAs or just go for their NP. If someone realizes mid-way through college that they want to be a PA and that they have to be an EMT first (which would require 1000 hours of training on top of 2000-3000 HCE hours) they may choose a different route (MD or NP) and thus, quality future PAs may be lost.

 

I worked for ZERO pay for an entire year after school to get half of my HCE hours (1000 hours) while the rest of my friends were moving into their own apartments and starting jobs making 50K. I lived at home and barely had money to go out with them because the cash I earned during waitressing in undergrad dwindled slowly. When I finally did get hired the most I made was 13.50/hr which is better than nothing, but not nearly what someone graduating with a bachelor's degree should be making. I put my entire life on hold for 5 years after undergraduate before finally becoming a PA-C and sacrificed a lot (like most of us had to do), so please don't imply that I don't know what it's like to work for something you want. I'm equally as "old" as you are. :heheh:

[LESH]

RC: me=popcorn watching where this leads!!!

I bet LESH is watching from the shadows as well!;)

LOL I just saw this MaryFran.

[robidf]

I don't disagree with working for a few years to get HCE prior to applying to PA school. I think it was very valuable to have before starting school for more than one reason. I had the required 2,000 for most schools when I applied and gained that experience in the two years between undergrad and grad school. (I tried to get HCE during the summers, but the hospitals near me would basically only let me be a candy striper.) The point I was trying to make was that if being a medical assistant/cna isn't "worthy enough" HCE as some of the previous posts suggest and the only hours that should count are jobs like RN/EMT that that is somewhat unrealistic. If people know right away out of high school they want to be a PA then they can gain four years of experience while in undergrad and be fine. Or, they would apply to programs such as Quinnipiac that have a 6 year program straight from high school. The reality is that most 18 year olds have no idea what they want to do and take at least a year or two in college to figure it out. If the HCE expected is RN or EMT then I think the RNs might still become PAs or just go for their NP. If someone realizes mid-way through college that they want to be a PA and that they have to be an EMT first (which would require 1000 hours of training on top of 2000-3000 HCE hours) they may choose a different route (MD or NP) and thus, quality future PAs may be lost.

 

I worked for ZERO pay for an entire year after school to get half of my HCE hours (1000 hours) while the rest of my friends were moving into their own apartments and starting jobs making 50K. I lived at home and barely had money to go out with them because the cash I earned during waitressing in undergrad dwindled slowly. When I finally did get hired the most I made was 13.50/hr which is better than nothing, but not nearly what someone graduating with a bachelor's degree should be making. I put my entire life on hold for 5 years after undergraduate before finally becoming a PA-C and sacrificed a lot (like most of us had to do), so please don't imply that I don't know what it's like to work for something you want. I'm equally as "old" as you are. :heheh:

 

That was implicated at the idea of taking two-three years to work for something you want as being inconceivable. I suppose I was more so surprised by that comment about graduating at mid-twenties or thirties. I feel perfectly comfortable graduating at 28, and I would even say glad because it has allowed me to get some professional and life experiences.

 

I guess I am of the mindset that the profession was designed to build on prior medical knowledge, and sadly it seems that medical knowledge is taking backseat to GPA/GRE. I wont go on about my anecdotal life experiences because its unnecessary to compare apples and oranges. But I still think many would agree that we are seeing the profession dwindle down in terms of being a means by which a practicing professional can expand their responsibilities.

[sillycibin]

We are looking at a 50% increase in schools in 3 years. That is ridiculous.

It bears repeating, the law school example is a lesson we all need to take to heart. Just wait and see what happens to the economics of our profession when the market conditions suddenly flip from too few to too many providers. And we are DEPENDENT providers. We can't even practice if we don't get employed by someone. NPs will be able to compete independently eventually. We won't have that ability.

We are a profession and we need to protect it. We train future PAs, not the schools. The clinical year is the important year. So we have some control over the expansion.

[EMEDPA]

It might not be so bad if these 80 programs were dispersed better across the US. There is one in Maine, two in NH, NONE in Vermont.

JUST AN FYI- the college of St. joseph in rutland VT is looking at starting a pa program. I saw an ad for faculty a few months back(and tried-to no avail-to talk the wife into my applying for it).

[RHC81]

Now I know this was many years ago, however, as I review where the new programs have opened recently and some that are “in the pipeline” I am concerned that we are seeing fewer PA programs opening in medical school or affiliated with teaching institutions and more programs opening in smaller universities/liberal arts colleges where the PA program is their first and only health care program in the college..

 

^^This, 1000x. Some of us PA-hopefuls are also thinking this. Being affiliated with an established medical program is a huge factor for me when considering where to apply.

 

My husband and I are alumni of two of the schools previously listed. In my alma mater's case, the university has an established medical school, nursing school, and health sciences school. They've been around forever, and, while they aren't a top tier school, they turn out good doctors and healthcare professionals. They are also located in a state that desperately needs PAs. I am certain (and it's not alumnus bias) that their PA program will have good clinical sites and competent instruction, partially because they have their own large university hospital for some of the clinical rotations. Now, my husband's alma mater is a small liberal arts college known for producing excellent teachers, among other things. However, they have no health sciences program of any kind - no nursing or allied health. They are not affiliated with the big medical school in the area, and their only other masters-level programs are liberal arts. The area does need PAs, but student PAs will be competing for clinical sites with several established nursing (ASN, BSN, and APN) programs and a top-tier medical school.

 

Both of these programs require fewer than 500 hours of HCE.

 

Now, this is just my opinion, so take it for what it's worth. It is extremely important to me to be in a school that has experience producing quality healthcare providers. I'm not opposed to a new program, but I am extremely leery of a university with no experience in training healthcare professionals at all that suddenly wants to have a PA program. It makes me think they're more about the bandwagon and potential dollars than being committed to making me a competent PA.

 

As a pre-PA (thus, part of the applicant pool), I would strongly support requiring a minimum of 2,000 hours of HCE for PA school entry in every school that wants accreditation. That's about 1 year of working in a healthcare field, so I don't think it's too much or an undue burden on would-be applicants. It will select for those who want this enough to get some boots-on-the-ground experience in healthcare versus the applicant that is good on paper with a killer GPA and GRE but has no real-world experience in healthcare (except for visiting Grandma in the hospital) and decided to go to PA school when their underwater basketweaving degree wouldn't translate to a job.

 

For the record, before anyone gets upset, I have one of those underwater basketweaving degrees. :heheh:

[EMEDPA]

[quote name=RHC81;378686As a pre-PA (thus' date=' part of the applicant pool), I would strongly support requiring a minimum of 2,000 hours of HCE for PA school entry in every school that wants accreditation. That's about 1 year of working in a healthcare field, so I don't think it's too much or an undue burden on would-be applicants. It will select for those who want this enough to get some boots-on-the-ground experience in healthcare versus the applicant that is good on paper with a killer GPA and GRE but has no real-world experience in healthcare (except for visiting Grandma in the hospital) and decided to go to PA school when their underwater basketweaving degree wouldn't translate to a job.

 

For the record, before anyone gets upset, I have one of those underwater basketweaving degrees. :heheh:

 

TOTALLY AGREE.

UBW is fine as long as you have all the pre-reqs.

looks like you have a great attitude about the process. you should get into several programs. best of luck.

[RHC81]

TOTALLY AGREE.

UBW is fine as long as you have all the pre-reqs.

looks like you have a great attitude about the process. you should get into several programs. best of luck.

 

Thanks, EMEDPA. :)

[Joelseff]

IMHO, I disagree with this statement.

 

Its very doable and reasonable to work your way through school or work for something you want, so I see no problem with being a CNA/ER-TECH/EMT/RRT/RT etc... for 2-3 years while you're taking your undergrad classes. This is just my opinion...maybe I'm an "old" 27 year old complaining about the attitude of immediate satisfaction that seems to be rampant nowadays.

 

Totally agree. It's what I and many other PAs *had* to do....

 

Sent from my myTouch_4G_Slide using Tapatalk

[Gordon, PA-C]

The dumbing down of medical education is happening at all levels:

 

1. MD residencies are a joke compared to how they used to be; 80 hour workweek rule

2. DNP programs that are 100% online where you never ever have to step foot in a classroom or in a hospital/clinic

3. PA programs with zero hospital footprint and absolutely zero experience with healthcare training

 

Med schools are popping up in towns as small as 100k people, where the biggest hospital is a 50 bed community hospital with zero subspecialists and only very basic surgeries. That would have been UNTHINKABLE 20 years ago. Hell there's FOR-PROFIT DO SCHOOL in Colorado where every single one of their students has to move away to rural clinic rotation sites and the only clinical exposure they get is following around some rusty family practice doctor who is 80 years old.

 

The next generation of MDs, DOs, NPs, and PAs are going to be a shadow of the earlier generations. I dont think ANY of those new trainees will deserve to be called "doctor"

[zepoPA]

The overall premise of this post is incorrect in several ways.

 

First off, in the early days of the profession and PANCE, it was HCE that matterred to the admission committee of a PA program much more so than high GPAs.

Seems like all of these early PA's with low GPAs but high numbers of HCE did a fine job passing the PANCE, becoming exceptional PA's, growing the profession, increasing duties, responsibilities and expectations for the profession, being ground breakers in physician practices, hospitals, networks all without having a high GPA.

 

The high GPA, low HCE criteria that is seen today is a recent development in the last 8-10yrs because it does correlate to passage rate of the PANCE.

d.

 

I must clarify something, especially for the uninformed. I would not want the new generation PAs to have the impression that "all these early PA's with Low GPA's" were admitted to PA programs bc "it was HCE what mattered to the admission committee of a PA program..." Wow, what a statement! My class in the very early 90's was mostly BS grads with high GPAs in undergrad. We all came from different schools nationwide, with substantial HCE, all science course pre-req's completed, and YES a high GPA in the science courses was also looked for. I was part of a small study group (3 of us): BS in Bio, BA in psych with minor in BIO, and myself BS in Chemistry. All 3 of us came with a very high GPA from our respective Universities. And 2 of us graduated PA program Magna Cum Laude and one Cum Laude. We each had thousands of hrs. HCE (I had over 12k hrs when I applied). So please, don't think that the "early days PAs" got a break upon admission. WE DI NOT. It was highly competitive then as well. In my small study group we did not have Military experience, but in my class there were a couple Medics who had completed ALL the pre-Reqs with high grades as well.

[Will352ns]

^^This^^

 

I've seen this a lot on this site. It is assumed that folks with high levels of HCE have lower GPA's.....way too often. Many of the "HCE required/or not" threads break down to this argument. There is another thread that shows the CASPA stats over the last 6 years. While the HCE hours have gone down for the average applicant, it is true that the GPA's have gone up.....but not actually that much. I think it was 3.3 in 2006 and now it is 3.4'ish; this is off the top of my head.

 

Another thing to consider for the high HCE crowd. Many of these folks had to maintain a competitive GPA while working full time. I, as an example, have never been a full time student. I have no idea what it will even be like to simply focus on school. I'm not unique.

[physasst]

It’s somewhat unrealistic in this economy to expect someone to graduate, spend money and 1000 hours on an EMT course, then work for 2-3 years as an EMT and THEN begin working towards becoming the profession he/she really wants when he/she is in his/her mid-late 20s or even 30s.

 

Disagree completely.....I didn't start PA school until I was 28 and I was younger than the average age of my class. FWIW, my program at the time required 4,000 hours of prior HCE. To be honest though, every successful applicant in my program I knew had that crushed.

 

PA wasn't initially designed to be an entry level career, and I have some misgivings about it becoming so. I can tell you anecdotally, that while I primarily precept medical students, I have also taken the occasional PA student as well. All seem very young, some seem quite good, others cannot even figure out how to take a blood pressure. I now let them hang with the RNs for 3 days first to learn some basics (ECG lead placement, IVs, blood draws, foleys, VS, etc.) THEN they can come with me.

 

FWIW, the prior HCE that I had also helped me, and I was able to continue working full time all the way through PA school. So, it can be done.

[Justeco]

I fully understand that more healthcare experience makes the profession look better in the eyes of the public. However, has it ever been proven that it actually improves outcomes? There is little need to harp on the young'ins, who may have less HCE, if it has not been proven either way. Just putting this out there...

[chickitabanana]

I fully understand that more healthcare experience makes the profession look better in the eyes of the public. However, has it ever been proven that it actually improves outcomes? There is little need to harp on the young'ins, who may have less HCE, if it has not been proven either way. Just putting this out there...

 

I'd like to know this, too. I don't disagree with having HCE prior to applying to school, especially since PA school is so fast paced, but am starting to feel that those of us who went to PA school a few years after undergrad are somehow not worthy of the title because it's our "entry level career." When applying to jobs I'm still being offered the same "new grad" salary so it doesn't seem that employers are really taking into account the 2 years of HCE I had prior to school (vs. a new grad who didn't have the same experience that I did), even if it directly relates to the field/specialty. (Perhaps this would be different if I were an EMT for 10 yrs and then applied into EM...I don't know). I think on the whole that PA students are more clinically astute (given the required HCE) vs. medically students who often have none or very little HCE prior to entering school. I know someone who was a music major in undergrad and went for her APRN only one year after graduating from undergrad. (I know NPs were originally designed to build of off experience as an RN, but we all know the accelerated programs don't require that anymore.) So, it's somewhat disheartening to feel that older PA colleagues think that those of us who didn't/don't have thousands upon thousands of HCE in another career field before becoming a PA are going to be poor providers. Keep in mind that nowadays medical students rarely have any/very little clinical experience (usually the time taken off before applying to medical school is to do research in a lab as this is what top tier schools are looking for) and accelerated APRN programs don't have ANY minimum HCE requirements either (as far as I know). So, regardless of whether applicants nowadays are younger/less experienced if programs still maintain their 1,000-2,000 MINIMUM required hours then those entering will most likely still be far ahead (clinically speaking) of their MD/DO/NP colleagues when starting school.

[EMEDPA]

medstudents have another yr of clinicals and a residency to get up to speed. this is why they don't need the hce.

you could find yourself day 1 of your new job at a place with a brand new fp doc and they might expect the same performance from both of you...

[robidf]

I would question if the animosity is related to the perception of the job market. I think its pretty easy to see that the Physician Assistant degree is becoming the "new" big thing; this is made evident by the fact that we have a thread discussing the impact of 80 new PA programs. Perhaps it is frustrating to put in time working your way towards a profession that you greatly respect, to discover that there are a lot of inexperienced people going to PA school, not because they worked with patients for X years and decided that they wanted more responsibility, but because they couldn't get a job with their degree.

[chickitabanana]

medstudents have another yr of clinicals and a residency to get up to speed. this is why they don't need the hce.

you could find yourself day 1 of your new job at a place with a brand new fp doc and they might expect the same performance from both of you...

 

The med students at the school where my PA program was have 48 weeks total of clinical rotations during third year (vs. 56 weeks that PA students have when graduating). They're required to do another 4 weeks of primary care during their fourth year and then most do 2-3 Sub-Is or electives (depending on the specialty they want to match into) that are 4 weeks long. Thus, their "extra year" of clinicals is only 16 extra weeks.

 

64 total weeks of clinicals (med student) - 56 total weeks of clinicals (PA student) = 8 extra weeks of clinicals before starting residency. If you're going with that logic then PA school applicants should have 8 weeks of experience before applying to school... just so we're all on the exact same page before starting jobs.

 

Granted I only know details of the med school affiliated with my PA program, but people I know med students at other schools that are interviewing for residency from October-January (earlier if matching into ophtho or other early match specialties) and none have rotations that extend past the March 15th match date. So, the "extra year" isn't actually a full extra year. It's more like 4-5 months, tops.

[robidf]

The med students at the school where my PA program was have 48 weeks total of clinical rotations during third year (vs. 56 weeks that PA students have when graduating). They're required to do another 4 weeks of primary care during their fourth year and then most do 2-3 Sub-Is or electives (depending on the specialty they want to match into) that are 4 weeks long. Thus, their "extra year" of clinicals is only 16 extra weeks.

 

64 total weeks of clinicals (med student) - 56 total weeks of clinicals (PA student) = 8 extra weeks of clinicals before starting residency. If you're going with that logic then PA school applicants should have 8 weeks of experience before applying to school... just so we're all on the exact same page before starting jobs.

 

Granted I only know details of the med school affiliated with my PA program, but people I know med students at other schools that are interviewing for residency from October-January (earlier if matching into ophtho or other early match specialties) and none have rotations that extend past the March 15th match date. So, the "extra year" isn't actually a full extra year. It's more like 4-5 months, tops.

 

You don't consider residency part of school?

 

Trying to rationalize a degree that was built upon the premise of its applicants having PRIOR healthcare experience and comparing that to a degree that was NOT founded on the premise of its applicants having prior healthcare experience is not a good argument...

[EMEDPA]

If you're going with that logic then PA school applicants should have 8 weeks of experience before applying to school... just so we're all on the exact same page before starting jobs.

 

.

once again...RESIDENCY. THEY KEEP LEARNING WHILE WE ARE AT JOB #1.

3 YRS OF STRUCTURED CLINICALS WITH OVERSIGHT.

SO I WILL ACCEPT 3 YRS +8 WEEKS OF HCE AS ENOUGH.....:)