Is 2 years enough to become a competent clinician?

[ventana]

After 20 months in PA school & 9 more months in front of me (plus about 7 years previous HCE as a corpsman), I think I can say with a fair amount of confidence that I will not be a truly "competent clinician" upon graduating. Sure, I can get through a Hx & PE just fine, and generate a pretty good DDx for common presentations, and occasionally I surprise myself with some unexpected insight, but there's just so damn much to know that I think it's going to take a couple of years of post-school practice before I stop feeling like such a noob. As others haves said, it's the combination of Knowledge and Experience (talking post-grad experience here) that make a great clinician. Young PA's should expect to pay their dues, IMO. It's no different in any other profession. Incidentally, this is what I think really seperates a physician from a PA - residency, aka a structured environment in which one acquires experience after all those years spent acquiring knowledge. IPAP, like all PA programs is broken up into two sections, which we call Phase 1 (didactics) and Phase 2 (clinicals). But we also talk about an unofficial Phase 3, which is the period of time immediately following graduation that is basically OJT, with lots of self-directed book learning PRN. I think anyone who expects to be a fully-cooked PA right out of school is kidding themselves. My $0.02.

 

 

Excellent!!!!!!!!!!!!!

[ventana]

After 20 months in PA school & 9 more months in front of me (plus about 7 years previous HCE as a corpsman), I think I can say with a fair amount of confidence that I will not be a truly "competent clinician" upon graduating. Sure, I can get through a Hx & PE just fine, and generate a pretty good DDx for common presentations, and occasionally I surprise myself with some unexpected insight, but there's just so damn much to know that I think it's going to take a couple of years of post-school practice before I stop feeling like such a noob. As others haves said, it's the combination of Knowledge and Experience (talking post-grad experience here) that make a great clinician. Young PA's should expect to pay their dues, IMO. It's no different in any other profession. Incidentally, this is what I think really seperates a physician from a PA - residency, aka a structured environment in which one acquires experience after all those years spent acquiring knowledge. IPAP, like all PA programs is broken up into two sections, which we call Phase 1 (didactics) and Phase 2 (clinicals). But we also talk about an unofficial Phase 3, which is the period of time immediately following graduation that is basically OJT, with lots of self-directed book learning PRN. I think anyone who expects to be a fully-cooked PA right out of school is kidding themselves. My $0.02.

 

 

Excellent!!!!!!!!!!!!!

[EMEDPA]

Excellent!!!!!!!!!!!!!

agree. you never stop learning.

[EMEDPA]

Excellent!!!!!!!!!!!!!

agree. you never stop learning.

[jester32]

I was recently accepted into PA school and after reading some of these posts, I have to say that I'm a little dismayed and discouraged. I am one of several young pre-pa students who met the minimum DHCE working as a CNA. With that said, I understand that several people in this forum would still discourage folks like me to apply to and start PA school. However, because I don't intend to withdraw my acceptance, I'd like to hear some advice and/or perspective from experienced PAs regarding young students like me who are/will be in PA school, but have not had significant DHCE. What are your thoughts about this group of potential PAs?

 

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

[jester32]

I was recently accepted into PA school and after reading some of these posts, I have to say that I'm a little dismayed and discouraged. I am one of several young pre-pa students who met the minimum DHCE working as a CNA. With that said, I understand that several people in this forum would still discourage folks like me to apply to and start PA school. However, because I don't intend to withdraw my acceptance, I'd like to hear some advice and/or perspective from experienced PAs regarding young students like me who are/will be in PA school, but have not had significant DHCE. What are your thoughts about this group of potential PAs?

 

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

[EMEDPA]

my advice to all new grads(especially those with little prior experience) wishing to go into a field outside of primary care is to do a residency.

in the early 90's as an er tech with 5 yrs experience and a bs with all pa school prereqs I was told by numerous folks that I didn't have enough experience or high enough level experience to apply to pa school.

times have changed(obviously), but the benefits of significant high level experience remain.

[EMEDPA]

my advice to all new grads(especially those with little prior experience) wishing to go into a field outside of primary care is to do a residency.

in the early 90's as an er tech with 5 yrs experience and a bs with all pa school prereqs I was told by numerous folks that I didn't have enough experience or high enough level experience to apply to pa school.

times have changed(obviously), but the benefits of significant high level experience remain.

[rev ronin]

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

 

Find me a new graduate who says "Hey, as a CNA with <500 hours, I was ready to hit the ground running as a PA immediately upon licensure". Why are the voices of the experienced PAs who say you need more experience, or those of the moderately experienced new PAs (like me) who say "Man, I still needed more..." the only ones on the forum? (I mean, aside from the defensively self-righteous Pre-PAs who tell us we're wrong, that is) That's because those new PAs who didn't have enough HCE are busy 24x7 with more important things like, oh, trying not to kill patients and trying to catch up on things they already should have known.

 

Being a PA is hard. If you do it very wrong, you will kill people. If you do it moderately wrong, you will fail to catch things, fail to cure the curable, cause avoidable morbidity, and require more handholding than is appropriate. The healthcare industry does not need new PAs who listen to their mommies' opinion on when to take the PANCE (actual thread, last month, IIRC). What it needs are competent clinicians with enough life experience to have a spidey sense for when things aren't right, and act appropriately; who have seen people dying who know they're dying, people who are dying who don't know they're dying, people who think they're dying but aren't, and people who act like they're dying to try and get something out of you, AND CAN TELL THE DIFFERENCE; who are confident enough to strike out on their own, smart enough to know when they need help, and humble enough to ask for it when needed. If you think 1000 hours as a CNA can get you that, I think you're quite optimistic.

[rev ronin]

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

 

Find me a new graduate who says "Hey, as a CNA with <500 hours, I was ready to hit the ground running as a PA immediately upon licensure". Why are the voices of the experienced PAs who say you need more experience, or those of the moderately experienced new PAs (like me) who say "Man, I still needed more..." the only ones on the forum? (I mean, aside from the defensively self-righteous Pre-PAs who tell us we're wrong, that is) That's because those new PAs who didn't have enough HCE are busy 24x7 with more important things like, oh, trying not to kill patients and trying to catch up on things they already should have known.

 

Being a PA is hard. If you do it very wrong, you will kill people. If you do it moderately wrong, you will fail to catch things, fail to cure the curable, cause avoidable morbidity, and require more handholding than is appropriate. The healthcare industry does not need new PAs who listen to their mommies' opinion on when to take the PANCE (actual thread, last month, IIRC). What it needs are competent clinicians with enough life experience to have a spidey sense for when things aren't right, and act appropriately; who have seen people dying who know they're dying, people who are dying who don't know they're dying, people who think they're dying but aren't, and people who act like they're dying to try and get something out of you, AND CAN TELL THE DIFFERENCE; who are confident enough to strike out on their own, smart enough to know when they need help, and humble enough to ask for it when needed. If you think 1000 hours as a CNA can get you that, I think you're quite optimistic.

[Guest JMPA]

I was recently accepted into PA school and after reading some of these posts, I have to say that I'm a little dismayed and discouraged. I am one of several young pre-pa students who met the minimum DHCE working as a CNA. With that said, I understand that several people in this forum would still discourage folks like me to apply to and start PA school. However, because I don't intend to withdraw my acceptance, I'd like to hear some advice and/or perspective from experienced PAs regarding young students like me who are/will be in PA school, but have not had significant DHCE. What are your thoughts about this group of potential PAs?

 

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

Welcome to healthcare. Backstabbing, incompetent, a--kissing, know-it-alls who feel that they alone are all self important. After many years maybe you to will join those ranks.

[Guest JMPA]

I was recently accepted into PA school and after reading some of these posts, I have to say that I'm a little dismayed and discouraged. I am one of several young pre-pa students who met the minimum DHCE working as a CNA. With that said, I understand that several people in this forum would still discourage folks like me to apply to and start PA school. However, because I don't intend to withdraw my acceptance, I'd like to hear some advice and/or perspective from experienced PAs regarding young students like me who are/will be in PA school, but have not had significant DHCE. What are your thoughts about this group of potential PAs?

 

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

Welcome to healthcare. Backstabbing, incompetent, a--kissing, know-it-alls who feel that they alone are all self important. After many years maybe you to will join those ranks.

[Contrarian]

Find me a new graduate who says "Hey, as a CNA with <500 hours, I was ready to hit the ground running as a PA immediately upon licensure". Why are the voices of the experienced PAs who say you need more experience, or those of the moderately experienced new PAs (like me) who say "Man, I still needed more..." the only ones on the forum? (I mean, aside from the defensively self-righteous Pre-PAs who tell us we're wrong, that is) That's because those new PAs who didn't have enough HCE are busy 24x7 with more important things like, oh, trying not to kill patients and trying to catch up on things they already should have known.

 

Being a PA is hard. If you do it very wrong, you will kill people. If you do it moderately wrong, you will fail to catch things, fail to cure the curable, cause avoidable morbidity, and require more handholding than is appropriate. The healthcare industry does not need new PAs who listen to their mommies' opinion on when to take the PANCE (actual thread, last month, IIRC). What it needs are competent clinicians with enough life experience to have a spidey sense for when things aren't right, and act appropriately; who have seen people dying who know they're dying, people who are dying who don't know they're dying, people who think they're dying but aren't, and people who act like they're dying to try and get something out of you, AND CAN TELL THE DIFFERENCE; who are confident enough to strike out on their own, smart enough to know when they need help, and humble enough to ask for it when needed. If you think 1000 hours as a CNA can get you that, I think you're quite optimistic.

 

B-e-a-u-t-i-f-u-l...!!!!:;-D:

[Contrarian]

Find me a new graduate who says "Hey, as a CNA with <500 hours, I was ready to hit the ground running as a PA immediately upon licensure". Why are the voices of the experienced PAs who say you need more experience, or those of the moderately experienced new PAs (like me) who say "Man, I still needed more..." the only ones on the forum? (I mean, aside from the defensively self-righteous Pre-PAs who tell us we're wrong, that is) That's because those new PAs who didn't have enough HCE are busy 24x7 with more important things like, oh, trying not to kill patients and trying to catch up on things they already should have known.

 

Being a PA is hard. If you do it very wrong, you will kill people. If you do it moderately wrong, you will fail to catch things, fail to cure the curable, cause avoidable morbidity, and require more handholding than is appropriate. The healthcare industry does not need new PAs who listen to their mommies' opinion on when to take the PANCE (actual thread, last month, IIRC). What it needs are competent clinicians with enough life experience to have a spidey sense for when things aren't right, and act appropriately; who have seen people dying who know they're dying, people who are dying who don't know they're dying, people who think they're dying but aren't, and people who act like they're dying to try and get something out of you, AND CAN TELL THE DIFFERENCE; who are confident enough to strike out on their own, smart enough to know when they need help, and humble enough to ask for it when needed. If you think 1000 hours as a CNA can get you that, I think you're quite optimistic.

 

B-e-a-u-t-i-f-u-l...!!!!:;-D:

[Acebecker]

I was recently accepted into PA school and after reading some of these posts, I have to say that I'm a little dismayed and discouraged. I am one of several young pre-pa students who met the minimum DHCE working as a CNA. With that said, I understand that several people in this forum would still discourage folks like me to apply to and start PA school. However, because I don't intend to withdraw my acceptance, I'd like to hear some advice and/or perspective from experienced PAs regarding young students like me who are/will be in PA school, but have not had significant DHCE. What are your thoughts about this group of potential PAs?

 

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

 

Here's the deal: you were accepted to your program and your program knows what you are coming to them with. They feel, and probably have done so in the past, that they can make a decent clinician out of you. I don't disagree. But the point of this thread - the point of all of the discussion on HCE - is that the less you have, the harder it will be and the more dangerous to your patients you will be right out of school. I don't dispute that I was dangerous as a new grad because my HCE was not extensive - but I had a good amount with a variety of types of patients from pre-hospital to on-their-death-bed geriatrics. You can choose to feel unwelcomed or you can understand your situation. You are minimally qualified, but still qualified. A teenager who passes their driving exam with 80% still gets their driver's licence. A PA who passes the PANCE with a score of 250 (or whatever the minimum was this year) is still a qualifed PA. A doctor who graduates at the bottom of his class is still a doctor. The point of these statements is this: you now recognize that you were minimally qualified - so you know that you'll need to work twice as hard to learn everything that is thrown at you the first time around and there will be a crap-ton that you won't recognize because of your experience. And then, when you're in practice after you pass the PANCE, you'll need to be very proactive about gaining experiences and insight into your patients. I second EMEDPA's response - if you're going to specialize, either find someone who will put you through an ad-hoc residency or go to a formal residency program.

 

Don't complain about your place in the PA-world. You are here, among us. We will train you. But be ready to bust your butt harder than anyone else so that you don't let us or your patients down. Not to be too cheesy about it.

 

Andrew

[Acebecker]

I was recently accepted into PA school and after reading some of these posts, I have to say that I'm a little dismayed and discouraged. I am one of several young pre-pa students who met the minimum DHCE working as a CNA. With that said, I understand that several people in this forum would still discourage folks like me to apply to and start PA school. However, because I don't intend to withdraw my acceptance, I'd like to hear some advice and/or perspective from experienced PAs regarding young students like me who are/will be in PA school, but have not had significant DHCE. What are your thoughts about this group of potential PAs?

 

I ask this because after reading several of these posts, I felt unwelcomed because I was a part of a population that many experienced PAs (in this thread, at least) depreciated..as if we were negatively representing the profession because we had little (<1000hrs) DHCE prior to attending PA school.

 

Here's the deal: you were accepted to your program and your program knows what you are coming to them with. They feel, and probably have done so in the past, that they can make a decent clinician out of you. I don't disagree. But the point of this thread - the point of all of the discussion on HCE - is that the less you have, the harder it will be and the more dangerous to your patients you will be right out of school. I don't dispute that I was dangerous as a new grad because my HCE was not extensive - but I had a good amount with a variety of types of patients from pre-hospital to on-their-death-bed geriatrics. You can choose to feel unwelcomed or you can understand your situation. You are minimally qualified, but still qualified. A teenager who passes their driving exam with 80% still gets their driver's licence. A PA who passes the PANCE with a score of 250 (or whatever the minimum was this year) is still a qualifed PA. A doctor who graduates at the bottom of his class is still a doctor. The point of these statements is this: you now recognize that you were minimally qualified - so you know that you'll need to work twice as hard to learn everything that is thrown at you the first time around and there will be a crap-ton that you won't recognize because of your experience. And then, when you're in practice after you pass the PANCE, you'll need to be very proactive about gaining experiences and insight into your patients. I second EMEDPA's response - if you're going to specialize, either find someone who will put you through an ad-hoc residency or go to a formal residency program.

 

Don't complain about your place in the PA-world. You are here, among us. We will train you. But be ready to bust your butt harder than anyone else so that you don't let us or your patients down. Not to be too cheesy about it.

 

Andrew

[Joelseff]

Here's the deal: you were accepted to your program and your program knows what you are coming to them with. They feel, and probably have done so in the past, that they can make a decent clinician out of you. I don't disagree. But the point of this thread - the point of all of the discussion on HCE - is that the less you have, the harder it will be and the more dangerous to your patients you will be right out of school. I don't dispute that I was dangerous as a new grad because my HCE was not extensive - but I had a good amount with a variety of types of patients from pre-hospital to on-their-death-bed geriatrics. You can choose to feel unwelcomed or you can understand your situation. You are minimally qualified, but still qualified. A teenager who passes their driving exam with 80% still gets their driver's licence. A PA who passes the PANCE with a score of 250 (or whatever the minimum was this year) is still a qualifed PA. A doctor who graduates at the bottom of his class is still a doctor. The point of these statements is this: you now recognize that you were minimally qualified - so you know that you'll need to work twice as hard to learn everything that is thrown at you the first time around and there will be a crap-ton that you won't recognize because of your experience. And then, when you're in practice after you pass the PANCE, you'll need to be very proactive about gaining experiences and insight into your patients. I second EMEDPA's response - if you're going to specialize, either find someone who will put you through an ad-hoc residency or go to a formal residency program.

 

Don't complain about your place in the PA-world. You are here, among us. We will train you. But be ready to bust your butt harder than anyone else so that you don't let us or your patients down. Not to be too cheesy about it.

 

Andrew

 

Amen....

 

Sent from my myTouch_4G_Slide using Tapatalk

[Joelseff]

Here's the deal: you were accepted to your program and your program knows what you are coming to them with. They feel, and probably have done so in the past, that they can make a decent clinician out of you. I don't disagree. But the point of this thread - the point of all of the discussion on HCE - is that the less you have, the harder it will be and the more dangerous to your patients you will be right out of school. I don't dispute that I was dangerous as a new grad because my HCE was not extensive - but I had a good amount with a variety of types of patients from pre-hospital to on-their-death-bed geriatrics. You can choose to feel unwelcomed or you can understand your situation. You are minimally qualified, but still qualified. A teenager who passes their driving exam with 80% still gets their driver's licence. A PA who passes the PANCE with a score of 250 (or whatever the minimum was this year) is still a qualifed PA. A doctor who graduates at the bottom of his class is still a doctor. The point of these statements is this: you now recognize that you were minimally qualified - so you know that you'll need to work twice as hard to learn everything that is thrown at you the first time around and there will be a crap-ton that you won't recognize because of your experience. And then, when you're in practice after you pass the PANCE, you'll need to be very proactive about gaining experiences and insight into your patients. I second EMEDPA's response - if you're going to specialize, either find someone who will put you through an ad-hoc residency or go to a formal residency program.

 

Don't complain about your place in the PA-world. You are here, among us. We will train you. But be ready to bust your butt harder than anyone else so that you don't let us or your patients down. Not to be too cheesy about it.

 

Andrew

 

Amen....

 

Sent from my myTouch_4G_Slide using Tapatalk

[Gaijyn]

The old saying that "You don't know what you don't know" is very apropos here.

 

As I write this I am currently just under 5 months (4months 26days to be exact...but who's counting) from graduation from PA school. Has it been a tough road? Yes. I have learned a lot it's true. But do I know enough? The answer is a quickly delivered and resounding no. There is no way I know enough for MY liking. Frankly I do not see how someone can think they do. Speaking as someone with ~10k hours of pre-pa HCE (first responder/CLS in Army and then later as a medic while deployed and continuing on when back home with 2 years as a medical ER scribe just before PA school) I had a few steps on many of my classmates in terms of experience. However, if there is one thing that scares me, and I think that it SHOULD scare you, is the moment you realize what you DON'T know. I am smart, we all are or otherwise we would not be where we are. We can all learn and put into practice what we are taught. These things are a given. However, there is not a doubt in my mind that I need to know more.

 

I have a lot of EM type experience and feel most comfortable in that arena. My rotation was great (will be doing another shortly) and the physicians felt comfortable giving me quite a bit of autonomy and several of them outright told me to apply to work for the group. However, everyday I was made aware of how much I do not know. I contemplate applying to a residency daily and truly see the benefit that they hold though I wish they were more ubiquitous. That being said there are quite a few of my peers that feel that PA school and whatever shadowing (as most are straight from undergrad so have little real-world experience) is enough. Perhaps that is true for some things. Maybe for routine Ortho or low acuity psych or something. Though I would argue that it still isn't enough. Hopefully the people with little to no experience who seem to have an over inflated sense of acumen realize what they do not know in a way that does not harm the profession, themselves, and most importantly, the patient. In medicine, there is no acceptable death rate or "misses"; at least not in the eyes of the public. If you have the badge, initials, title, etc then you are held to the same standard that the individual who has been practicing for a number of years and has a well-developed sense of medical intuition is held to. The argument that anyone is on the same level as them after two years of training is laughable.

 

Apologies for the rant. I enjoy the site and hope that no one was offended by anything I said, for no offense was meant on my part. I just think that arrogance and ignorance can do more to hurt this profession and its reputation than blunt personal honesty.

[Gaijyn]

The old saying that "You don't know what you don't know" is very apropos here.

 

As I write this I am currently just under 5 months (4months 26days to be exact...but who's counting) from graduation from PA school. Has it been a tough road? Yes. I have learned a lot it's true. But do I know enough? The answer is a quickly delivered and resounding no. There is no way I know enough for MY liking. Frankly I do not see how someone can think they do. Speaking as someone with ~10k hours of pre-pa HCE (first responder/CLS in Army and then later as a medic while deployed and continuing on when back home with 2 years as a medical ER scribe just before PA school) I had a few steps on many of my classmates in terms of experience. However, if there is one thing that scares me, and I think that it SHOULD scare you, is the moment you realize what you DON'T know. I am smart, we all are or otherwise we would not be where we are. We can all learn and put into practice what we are taught. These things are a given. However, there is not a doubt in my mind that I need to know more.

 

I have a lot of EM type experience and feel most comfortable in that arena. My rotation was great (will be doing another shortly) and the physicians felt comfortable giving me quite a bit of autonomy and several of them outright told me to apply to work for the group. However, everyday I was made aware of how much I do not know. I contemplate applying to a residency daily and truly see the benefit that they hold though I wish they were more ubiquitous. That being said there are quite a few of my peers that feel that PA school and whatever shadowing (as most are straight from undergrad so have little real-world experience) is enough. Perhaps that is true for some things. Maybe for routine Ortho or low acuity psych or something. Though I would argue that it still isn't enough. Hopefully the people with little to no experience who seem to have an over inflated sense of acumen realize what they do not know in a way that does not harm the profession, themselves, and most importantly, the patient. In medicine, there is no acceptable death rate or "misses"; at least not in the eyes of the public. If you have the badge, initials, title, etc then you are held to the same standard that the individual who has been practicing for a number of years and has a well-developed sense of medical intuition is held to. The argument that anyone is on the same level as them after two years of training is laughable.

 

Apologies for the rant. I enjoy the site and hope that no one was offended by anything I said, for no offense was meant on my part. I just think that arrogance and ignorance can do more to hurt this profession and its reputation than blunt personal honesty.

[NewbiePA-C]

Find me a new graduate who says "Hey, as a CNA with <500 hours, I was ready to hit the ground running as a PA immediately upon licensure". Why are the voices of the experienced PAs who say you need more experience, or those of the moderately experienced new PAs (like me) who say "Man, I still needed more..." the only ones on the forum? (I mean, aside from the defensively self-righteous Pre-PAs who tell us we're wrong, that is) That's because those new PAs who didn't have enough HCE are busy 24x7 with more important things like, oh, trying not to kill patients and trying to catch up on things they already should have known.

 

Being a PA is hard. If you do it very wrong, you will kill people. If you do it moderately wrong, you will fail to catch things, fail to cure the curable, cause avoidable morbidity, and require more handholding than is appropriate. The healthcare industry does not need new PAs who listen to their mommies' opinion on when to take the PANCE (actual thread, last month, IIRC). What it needs are competent clinicians with enough life experience to have a spidey sense for when things aren't right, and act appropriately; who have seen people dying who know they're dying, people who are dying who don't know they're dying, people who think they're dying but aren't, and people who act like they're dying to try and get something out of you, AND CAN TELL THE DIFFERENCE; who are confident enough to strike out on their own, smart enough to know when they need help, and humble enough to ask for it when needed. If you think 1000 hours as a CNA can get you that, I think you're quite optimistic.

 

Love this! Perfect.

[NewbiePA-C]

Find me a new graduate who says "Hey, as a CNA with <500 hours, I was ready to hit the ground running as a PA immediately upon licensure". Why are the voices of the experienced PAs who say you need more experience, or those of the moderately experienced new PAs (like me) who say "Man, I still needed more..." the only ones on the forum? (I mean, aside from the defensively self-righteous Pre-PAs who tell us we're wrong, that is) That's because those new PAs who didn't have enough HCE are busy 24x7 with more important things like, oh, trying not to kill patients and trying to catch up on things they already should have known.

 

Being a PA is hard. If you do it very wrong, you will kill people. If you do it moderately wrong, you will fail to catch things, fail to cure the curable, cause avoidable morbidity, and require more handholding than is appropriate. The healthcare industry does not need new PAs who listen to their mommies' opinion on when to take the PANCE (actual thread, last month, IIRC). What it needs are competent clinicians with enough life experience to have a spidey sense for when things aren't right, and act appropriately; who have seen people dying who know they're dying, people who are dying who don't know they're dying, people who think they're dying but aren't, and people who act like they're dying to try and get something out of you, AND CAN TELL THE DIFFERENCE; who are confident enough to strike out on their own, smart enough to know when they need help, and humble enough to ask for it when needed. If you think 1000 hours as a CNA can get you that, I think you're quite optimistic.

 

Love this! Perfect.