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Specialty Exam Announcement


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Just received this announcement of the arrival of the new "Specialty Exams" via NCCPA.

 

The first five specialty CAQs are available in:

• Cardiovascular/Thoracic Surgery

• Emergency Medicine

• Nephrology

• Orthopaedic Surgery

• Psychiatry

Earning a specialty CAQ will allow you to achieve a unique distinction for your specialty experience, skills and knowledge in times when credentials are becoming increasingly important. Once you have obtained your specialty CAQ, we hope you will be proud to share it with your patients and employers.

"For years we've heard from PAs asking for some way to document their specialty expertise. We're excited to answer that with this new program," says NCCPA President Janet J. Lathrop, MBA.

 

Admittedly, I am a bit weary after just taking my 4th PANCE so the thought of jumping through yet another certification hoop just isn't very appealing to me in my current state of post PANRE burn out. This "unique distinction" of certificate added qualification (CAQ) certainly is masterfully stated but I'm wondering what tangible benefits this offers in the real world of practicing PAs?

Your thoughts?

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I won't do it unless it is either required or someone else pays for it.

I looked at the objectives for the em test and they are frankly ridiculous.they include the ability to interpret ct scans and mri's for example....sure, I can do the basics of ct( bleeds, kidney stones, etc) but that is what a radiologist is for....also you have to get letters from your sp's basically stating that you can do anything procedurally that they can do and they are comfortable with your ability to do so...been a while since I did burr holes or cervical tongs to stabilize a c-spine fx(note sarcasm, I have never done this)....I'm sure they will love that.....it's a poorly thought out test as far as I can see and one that very few senior em pa's aside from davis can actually pass....

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I won't do it unless it is either required or someone else pays for it.

I looked at the objectives for the em test and they are frankly ridiculous.they include the ability to interpret ct scans and mri's for example....sure, I can do the basics of ct( bleeds, kidney stones, etc) but that is what a radiologist is for....also you have to get letters from your sp's basically stating that you can do anything procedurally that they can do and they are comfortable with your ability to do so...been a while since I did burr holes or cervical tongs to stabilize a c-spine fx(note sarcasm, I have never done this)....I'm sure they will love that.....it's a poorly thought out test as far as I can see and one that very few senior em pa's aside from davis can actually pass....

 

I don't need a specialty certification, and unless it becomes manditory, I won't do it either. The funny part about the radiology stuff...I'm more comfortable reading plain films than some of our newer grad EM docs. Even most of the seasoned docs are not comfortable fully reading CTs. They can see bleeds, stones, an obvious appy, but not much beyond that. And MRIs and V/Q scans, they won't even begin to try.

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I won't do it unless it is either required or someone else pays for it.

I looked at the objectives for the em test and they are frankly ridiculous.they include the ability to interpret ct scans and mri's for example....sure, I can do the basics of ct( bleeds, kidney stones, etc) but that is what a radiologist is for....also you have to get letters from your sp's basically stating that you can do anything procedurally that they can do and they are comfortable with your ability to do so...been a while since I did burr holes or cervical tongs to stabilize a c-spine fx(note sarcasm, I have never done this)....I'm sure they will love that.....it's a poorly thought out test as far as I can see and one that very few senior em pa's aside from davis can actually pass....

 

I agree, it seems the people who make the decisions are more a kin to politicians then to PA’s. I’m sure all can agree that our profession has evolved over the years. With potential sp’s gravitating toward specialties (for many reasons), it only stands to reason that PA’s would follow… Now, the folks who make the “rules” seem to be struggling with this reality. They seem to ask, do “we” stay the course, and hold true to our heritage, or do we commit to specialty training? Based on their recent decision in regard to optional “CAQ’s”, it seems they have done neither!

We as a profession need to ask, do we stay the course, despite the iceberg. Or do we learn from the Titanic, and consider mandatory specialty residencies similar to those of our sp’s? Just my two cents. Thoughts?

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We as a profession need to ask, do we stay the course, despite the iceberg. Or do we learn from the Titanic, and consider mandatory specialty residencies similar to those of our sp’s? Just my two cents. Thoughts?

 

Personally, I don't think we need to jump through anymore mandatory competency hoops. We already take recertification exams more frequently than most MDs and other midlevel NPs don't have to abide by the same standards of competency exams.

 

I think this entire "added layer" just adds confusion to the issue of national competency of our skills in the marketplace. So do PAs who don't practice in the specialty areas become less competent just because they don't take an exam ?

More importantly.....is this need driven by hard statistics of patient care needs or simply the brainstorming of our administrative/political folks?

 

We are getting ready to see some major changes in healthcare that will effect everyone who is involved in patient care. I would hope our profession is tuned into supporting the reality of these healthcare needs above and beyond the stated CAQ of "unique distinction".

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There is definitely a double edged sword here. Our national certification is relatively a "generalist" cert, yet it enables us as midlevels to have greater lateral mobility than our NP counterparts who must choose their area of specialty. We can move from EM to hospitalist to surgery to family practice with little difficulty as it stands.

 

I almost get this feeling that the NCCPA is dipping their toes in the water on this one, waiting to see how it is received both by the test takers as well as employers. How will it change our practice? How will it change the way we are viewed by the docs? Our peers? What does it mean for new graduates if specialty employers lean towards hiring those with these specialty CAQs? Will the ability to get a job in EM/Surg/Ortho, ect. become MORE difficult over the next 10 years because of this? Will this push new graduates into primary care?

 

How many type A's out there are pissed that it's so expensive and that it's not interchangeable with the PANRE; how many of you are going to take it anyway because it's a feather in the cap? Don't lie...

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Chatcat, I agree with you. I don’t think I expressed my point very well. In short I was trying to state that the “rule makers” are straddling the fence and don’t want to make a decision one way or the other, thus trying to please everyone. I agree with not adding another layer of bureaucracy. And I for one will not be participating in the optional certification. I feel the NCCPA need to either stick with the current model OR require us to complete a residency if we wish to work in a specialty. Much like our sp’s the “board certification” in a specialty should replace any and all future PANCE/PANRE testing, with the understanding that general medical knowledge would be tested as well. I know, I know, this opens up the whole “mobility between specialties v. no/decreased mobility” debate, but my point is the NCCPA should make a decision and move forward. Something they seem to have difficulty doing.

As for abiding “by the same standards of competency”. I don’t see that as a problem I feel that would make us better providers and only benefit our patients. The NCCPA is currently considering changing the re-cert cycle to ten years (like our sp’s).

I do think jwells78 hit the nail on the head. The NCCPA is not going to make a decision they’re just going to wait around and see what happens. After which, I’m sure they will jump off the fence on the popular side.

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I feel the NCCPA need to either stick with the current model OR require us to complete a residency if we wish to work in a specialty. Much like our sp’s the “board certification” in a specialty should replace any and all future PANCE/PANRE testing, with the understanding that general medical knowledge would be tested as well. I know, I know, this opens up the whole “mobility between specialties v. no/decreased mobility” debate, but my point is the NCCPA should make a decision and move forward. Something they seem to have difficulty doing. .

I do think jwells78 hit the nail on the head. The NCCPA is not going to make a decision they’re just going to wait around and see what happens. After which, I’m sure they will jump off the fence on the popular side.

 

 

 

Hypothetical scenario: Mandatory Residencies required for training of specialty PAs. PAs invest 2 years in PA school then another year of specialty residency.(3 years of time and major financial investment ) Specialty trained PAs enter the job market in competition with other non specialty trained mid levels ...ie NPs .

Will the market salaries support this extra time and training with increased salaries for specialty training?

With health care cost containment of all clinician salaries which mid level fares better....the NP (who can work without the mandatory specialty training requirement) or the specialty trained PA who has spent 3 years and major $$ in training? How would mandatory residency training promote our role in health care?

 

Our national organizations need to think very carefully about the course we are setting.

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Hypothetical scenario: Mandatory Residencies required for training of specialty PAs. PAs invest 2 years in PA school then another year of specialty residency.(3 years of time and major financial investment ) Specialty trained PAs enter the job market in competition with other non specialty trained mid levels ...ie NPs .

Will the market salaries support this extra time and training with increased salaries for specialty training?

With health care cost containment of all clinician salaries which mid level fares better....the NP (who can work without the mandatory specialty training requirement) or the specialty trained PA who has spent 3 years and major $$ in training? How would mandatory residency training promote our role in health care?

 

Our national organizations need to think very carefully about the course we are setting.

 

First, will the market salaries support the DNP degree as well? No one can say for sure. Will one make more money with the advanced certs? Who knows. As for the three year commitment… Well its not really three years. The entry level pa program is 24+ months. The current pa residency programs are 12-24 months in length. So, given the fact that prospective pa’s need to complete a pa program anyway. The first 24+ months is a wash. So one is looking at anywhere between 12-24 months if they complete a residency. The majority of current residency programs offer the resident a “stipend” to attend. (This averages between 32K-65K). So the “major $$ in training” is not as large as one may think. Lastly, mandatory residencies would not directly “promote our role in health care” . It would however create better trained pa’s. Thus indirectly increase the positive perception of pa’s within the public.

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