Masters of Physician Assistant Studies

Discussion in 'General Distance Learning Discussions' started by LadyExecutive, Jun 9, 2019.

  1. LadyExecutive

    LadyExecutive Member

    Came here after an exhaustive study for a blended Masters of Physician Assistant Studies degree. Two of my daughters will complete their B. Sc in Biology in July. Both will graduate on the President's List. Both would like to immediately enroll in an accredited PA program. The problem is, my husband died unexpectedly in January and my girls feel they aren't ready emotionally or financially to leave home.

    There are two universities within a little more than an hour drive from our home. Tuition for both are in excess of 80,000 USD. We're looking for a PA program that costs less and one that would allow them to complete the didactic phase through distance education with or without on-campus residencies. We live in Florida but they'd travel to any state for days or weeks or however long the residency requirement is per year.

    I've been combing the WWW and found Master of Physician Assistant Studies at the University of Wisconsin-Madison. Tuition is also very high but if we can't find anything cheaper, we're going to consider applying to that. Does anyone know of any other such programs based in the US?

    Thanks, Shannon
  2. Phdtobe

    Phdtobe Well-Known Member

    Can one be A PA with an MD? For that price, there is a Caribbean medical school accredited for the USA/Canada being discussed.
  3. copper

    copper Active Member

    First of all, my condolences on your loss. Secondly, congratulations to your daughters on their academic successes. As you probably know, admission to PA school is now as competitive if not more so than medical school. A number of factors are taken into account when selecting students to attend. Pre-requisites, GPA, many hours of volunteer work, preferably in healthcare circles, letters of recommendation, etc. It's nice to have a few schools picked out when applying because typically, there are over 10 applicant per slot available. Understandingly, tuition and other costs of attendance are a factor in your decision. My advice is to apply to the local schools within Florida. The two year masters program in PA studies averages about $80,000 to $120,000 nationwide.

    After graduation, there are opportunities to get employed in under-served areas that help with tuition reimbursement. In addition, there are specialties after graduation that pay much more than primary care. I understand tuition is a concern but the PA program is what it is! My guess is the admission window for Fall of 2019 has already passed so they will be applying for Fall of 2020. Central application:

    I'm not too familiar with online PA studies. From my experience, I can tell you the academics may be able to be accomplished online but the there are many other obstacles! For example, unlike the local schools, schools in other states face challenges in getting clinical rotations for their students. They have to jump through legal hoops and often the student is left trying to secure clinical rotations on their own. If one attends a local school, the relationships are already in place to have a smooth transition to clinical rotations.

    My advice is to apply to PA schools broadly but specifically within your home state. In-state tuition is a much better deal! I have recommended many students to PA school and they all had to apply to many schools and log hundreds of hours of volunteer time. Many obtained the Basic EMT as well to strengthen their CV. Best of luck!

    Found this link to an online PA school to Yale:
  4. copper

    copper Active Member

  5. Hille

    Hille Active Member

    Good Morning.
    I am very sad for your situation. Did either of your ladies consider getting a short term medical certificate? I am talking CNA, HomeHealth Care, EKG and having a hospital or medical facility pay the tuition. This may seem like a step backwards but it may save them a huge amount of money moving forwards. Also I believe there are several schools which will giving free medical school in the next few years. I believe one of them is Rowan in NJ. PM me and I will search around in the next few days for information.
  6. Jonathan Whatley

    Jonathan Whatley Well-Known Member

    Some PA schools differentiate themselves by only accepting, or strongly favoring, experienced allied health professionals. Others welcome applicants with no prior healthcare work experience (but exposure, such as much shorter periods of volunteering or shadowing, may be expected even in this second category).
  7. SteveFoerster

    SteveFoerster Resident Gadfly Staff Member

    At the same time, 40 hours per week, 50 weeks per year means one works 2,000 hours per year, which means 1,000 to 4,000 is six months to two years.
  8. copper

    copper Active Member

    True but most applicants are finishing undergrad degrees in pre-med so the transition to a Masters in PA is necessitating a break in college after graduation to get experience. Although many pre-med (PA, MD, DO) students do volunteer work. A 1000 hours of volunteerism while in school is a couple years! Some suggestions are to get an EMT and volunteer, secure a clinical research position with patient/subject interaction, work as a translator in a hospital or clinic, etc. Obtaining an allied health credential can take at least months if not years that could be spent attending a Masters PA program.
  9. Jonathan Whatley

    Jonathan Whatley Well-Known Member

    In one light 1000 to 4000 hours is a lot. In another light, we'd barely blink if a graduate program to prepare school principals or instructional leaders expected two years, three years, or more of full-time professional teaching experience, or if an EMBA expected five years of related full-time professional experience.
    SteveFoerster likes this.
  10. Kizmet

    Kizmet Moderator

    This is a good point
  11. Neuhaus

    Neuhaus Well-Known Member

    No. You have to graduate from a program specifically approved to crank out PAs. No substitutions.

    Which is kind of ironic. PA was originally created as a means to employ Vietnam era military corpsmen. You had these people with loads of skills that couldn't legally be employed in a medical setting as anything other than orderlies without additional training.

    In New York, up until very recently, PA was a certificate program or available as an associates program. Within a 10 year span, the profession went from "you can get a license with an associate's degree in this" to "Masters degree required and doctorates in this are popping up."

    The only option for an MD with no residency, aside from learning a new trade, is to settle in one of the states that has an Assistant (sometimes Associate) Physician license like Kansas.

    Talk about a system that could use some streamlining. It would probably save a lot of money and aggravation if they just made it into a tiered license structure.
    SteveFoerster and Phdtobe like this.
  12. chrisjm18

    chrisjm18 Well-Known Member

    Why would someone with an MD want to be a PA? That doesn't even sound right. It's like having a teacher's certification and wanting to be a teacher's assistant. Tf lol
    Phdtobe likes this.
  13. Jonathan Whatley

    Jonathan Whatley Well-Known Member

    Remember that the MD – or DO, or foreign equivalent like MBBS – is just one step in the education of a physician. An MD graduate then needs accredited residency training for a license to practice medicine in any state.

    Each year, there are significantly fewer spots in accredited residencies than there are qualified applicants who hold valid medical degrees, passing scores on Steps 1 and 2 of the United States Medical Licensing Exam (or for DOs, the equivalent COMLEX), and clean background checks.

    The great majority of graduates of U.S. MD and DO schools interested in clinical medicine will eventually land a residency somewhere, maybe not their first, or fifth, choice of specialty or location, and maybe after a postdoctoral gap doing an MPH or research or something.

    It's different among graduates of foreign medical schools. Some get in and some go on to great careers. Some, including U.S. citizen graduates of foreign medical schools, will never get in to a residency. We're talking people with every academic and legal requirement to move on to residency. There's just a large oversupply of qualified applicants relative to residency spots.

    There are some combinations of foreign country, U.S. state, and U.S. medical specialty board where U.S. authorities will give at least some number of years of credit for foreign residency training, but the combinations are limited. U.S. experience required, that old story.

    The oversupply issue can come up with foreign residency and physician spots too. An American may think "I'll go to medical school in the Philippines, and if I don't get a residency in the U.S., I'll become a doctor in the Philippines." Who's to say the Philippines will give them first a work visa, then a residency position, then an independent practice license, then a paying job?

    I've read about a country in Eastern Europe where American and international graduates of that country's medical school can pay to go on to something like a residency position. It's something to do and I trust it offers educational value, but it's not clear that this postgraduate training will be accepted towards an eventual independent practice license and a job where pay moves in the other direction, anywhere.
    Last edited: Jun 13, 2019
    Phdtobe likes this.
  14. copper

    copper Active Member

    The nurse practitioner entry requirements generally want about 1 to 2 years experience as a nurse before being accepted as well. More than anything, entry into PA school has become very competitive and having thousands of hours of healthcare experience shows a commitment to the healing arts.
  15. copper

    copper Active Member

    Foreign trained physicians unable to get licensed in the states would love to be able to get a PA license! See petition:

    Interestingly, some States licensed Foreign trained physicians as PAs in the 1970's but discontinued it. My guess is the PA schools had greater lobbying powers.
  16. Jonathan Whatley

    Jonathan Whatley Well-Known Member

    A EMT/EMT trainer/bartender, just over 40 years old, was my deservedly popular classmate in science courses at HES on campus. He went on to the Physician Assistant program at Tufts, one of the PA programs that's more demanding about direct patient care experience. 1000 hours required, 1500 hours recommended minimum, must be "clinical as opposed to custodial/administrative." Tufts has a long list of roles that qualify, but another long list of roles that, "while valuable experiences, do not meet the requirements for direct patient care experience,” the latter including personal trainer, pharmacy technician, and counselor. There are some volunteer roles that do qualify.

    Counselor is one of the more surprising exclusions, but not inexplicable. Tufts may have felt the role of counselors generally isn't integrated enough with diagnosis and treatment of clinical patients, under the medical model, in healthcare settings. It doesn't quite sit right with me that experience as a licensed professional counselor in a psychiatric setting won't count, but I get why time as a guidance counselor won't count, or as an LPC with an outpatient practice emphasizing subclinical 'problems of living.'

    These decisions are made by each PA program independently. There are PA programs that welcome 'first career' or 'first healthcare career' students (welcome, with the catch that PA admission is competitive everywhere). It's reasonable that some position themselves more as advancement programs for experienced allied health providers.
  17. Neuhaus

    Neuhaus Well-Known Member

    Here's my potentially unpopular opinion...
    At this stage, I think a case can be credibly made that physician training is unnecessarily difficult.

    I get it. Barriers to entry keep salaries high with a public facing statement that it ensures quality and safety. Right, got it.

    PAs have been picking up more responsibility over the past few decades. They have been operating with significantly less supervision. Their wages have also been steadily climbing. There is still great demand. Between the requirement for large numbers of clinical contact hours and the fact that not everyone attracted to healthcare paychecks and status is suited to work in healthcare, these programs remain highly competitive, wages keep climbing and we still don't have enough people to meet demand.

    We also have a weird patchwork system of separate licenses that overlap in many ways.

    We've been fed a line about how our MDs absolutely need four years of pre-med (despite this not having been a requirement for very long and, as of 5-10 years ago the last time I looked, there were still one or two DO schools that would admit you without a B.S. if you met undergrad course requirements). Then you need four years of med school. Then you need a residency to be ordained to the sacred rank of doctor. Anything less compromises us all.

    Except now we have colleges cranking out PAs with prescription pads left and right and the system isn't crashing down. Fewer doctors mean that the supervision of PAs, once likely actual supervision, is nothing more than a formality in many locations. I went to a walk in recently where there was no MD in the building. S/he sat at a corporate office "supervising" the PAs and NPs at multiple clinics.

    All the while we have unmatched domestically trained doctors and unmatched foreign trained doctors working as ER scribes, surgical techs or other unlicensed positions on the fringe of healthcare.

    There are not so many foreign trained doctors who can't match that if we put them into the system it would break everything.

    Kansas, in my opinion, has the right idea. Let doctors without residencies practice under supervision of another MD. The unpopular part of this opinion is I think we should allow a pathway to licensure for "Assistant Physicians" after they work in that capacity for a few years. Granted, as it stands, you can probably use that clinical experience to maybe match for a residency in the future. I'm saying skip the residency. The experience as an Assistant should do it.

    And, while we're at it, throw Physician Assistants into the same license. Create bridge programs for them to complete their MDs and let them either match with a residency or earn their license through supervised work.

    Want some more controversy? Include NPs in that same license class and allow them the same pathway. MSN/NP -> MD.

    Knock off the patchwork. The number of post-nominal licenses and certifications at a typical hospital visit is staggering.
  18. copper

    copper Active Member

    In legal terms, this is where your opinion/ideas stray. Responsibility and proficiency to do skill sets are two different things. A Physician Assistant or any career with "Assistant" means you are assisting someone who accepts responsibility for your actions. This is usually the Physician but not necessarily. Some States are considering more autonomy but ultimately, when faced with a lawsuit in our legal system, the supervising Physician will be sued because he is ultimately responsible!

    Unlike Physician Assistants or Assistant Physicians or even Residents in training, Nurse practitioners in many States have full autonomy and act independently. This in turn requires them to obtain board certification in their respective specialty, their own malpractice insurance coverage and accept full responsibility for their own actions! They are in many States, considered independent practitioners.

    Many Physicians are obviously happy with the current model because hiring PAs and even NPs, give them the resource called physician extenders. The responsible Physician potentially can earn more money "supervising" and delegating tasks to mid-levels while he/she focuses on more lucrative procedures. With that said, one of the pitfalls of choosing the PA profession is when the business is slow, the responsible/employing Physician won't hesitate to lay you off!
    Last edited: Jun 14, 2019
  19. LearningAddict

    LearningAddict Well-Known Member

    Many MDs find out that while they love medicine itself, they don't like the responsibility/hours grind of being a Doctor. I've seen many MDs say if they could do it all over again they would be a PA instead.
  20. Jonathan Whatley

    Jonathan Whatley Well-Known Member

    So many North American med schools have been experimenting with programs of three years or so, there's now a Consortium of Accelerated Medical Pathway Programs. McMaster University in Canada, a global force in medical education and research, has done a three-year MD for all its students since its founding in 1969. Also in the game but not currently in the Consortium's membership list: University of Calgary (entirely three-year MD program for many years, possibly since its founding in 1967), and Lake Erie College of Osteopathic Medicine (three-year DO pathways for two small groups of students: one cohort who commits to enter primary care [their clinical rotations are streamlined], and one cohort of Physician Assistants).

    The U.S. family medicine residency is three years. The Canadian family medicine residency is two years, and the house of family medicine in Canada is robust, well respected, and well paid. Many family physicians take an elective third year of postgraduate training in a practice interest. A large part of Canada's emergency department workforce are "CCFP(EM)s" – family physicians who took a third year in emergency medicine and are certified by the family medicine board. A longer residency program specifically in EM, hosted outside the house of family medicine, turns out leaders and researchers in EM. I should mention that there's a review underway of Canadian FM residency training, and there's some talk of extending its length.

    An advocacy site for unmatched medical doctors – "Foundation to Recognize Educate and Employ Doctors Of Medicine (FREEDOM)"describes a bill before the Missouri legislature to modify their Assistant Physician program along just those lines. As proposed, HB710 would provide "an alternative path to full physician licensure after five years of 'continuous, full-time, active collaborating practice' and passage of [USMLE] Step 3 in 'less than three attempts and within a three-year period after receiving his or her initial assistant physician license'." This would also involve "'One hundred hours of didactics during the five-year postgraduate training'," and further requirements during that time for continuing medical education.

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