The Online Doctor of Medical Science - A New Type of Physician

Lincoln Memorial University (Harrogate, TN) has created a new online Doctor of Medical Science for physician assistants with at least three years of experience to turn them into practicing physicians.

LMU ANNOUNCES A NEW MEDICAL DEGREE: DOCTOR OF MEDICAL SCIENCE - Lincoln Memorial University

LMU adds Doctor of Medical Science program

 

Darn. I was hoping that this was a new "robot" doctor (software) hooked directly into the various diagnostic equipment, and makes medical recommendation from the best practices available.

 

No, that's not until next year.

 

This won't exactly turn a PA into an MD or DO (at least not with the present licensing laws). PA's who graduate from this program will earn a Doctor of Medical Science degree and will be able to refer to themselves as a "Dr. _____" although I'm not sure how that would work in a clinical setting since the white coat and Dr. title would seem to imply that they are a physician (which they're not, at least not until the licensing board in their state says otherwise). In other words, for now their scope of practice will not change from what it is currently as a PA.

Interesting program though - nice to see that a good portion of it is online (the didactic portion, anyway).

 

The article seemed to imply that they would be able to operate as physicians. The article said the program was developed to help address the physician shortage. What would be the point of the program otherwise?

 

From the article:

 

You know, I've read the two articles over and over and it really isn't clear whether this is some kind of super PA program or some kind of new physician. I'm going to email LMU and see what they say. Since it's now Friday evening, I don't expect to receive a response until Monday.

 

States would have to change their laws to allow a PA to become a physician without an MD or DO.

 

This. And you know that the state MD and DO medical societies would likely resist this type of change. It's one thing for a PA to go back to school and obtain a medical degree (MD or DO) but this is a different model and would challenge their authority. Currently, a PA must operate under the supervision of a licensed physician.

 

I guess the 3 years of practice as a PA is supposed to take the place of a residency? Interesting, but I'll believe it when they get a medical license.

 

I guess. I really don't know how it all operates.

I do know that this is kind of how nurse practitioners started out. There was a major doctor shortage in rural Appalachia and a small nursing school that almost no one had ever heard of (now known as Frontier Nursing University) started the first nurse practitioner program. It all has to start somewhere...

About FNU | Frontier Nursing University

Edit: I just read that Frontier also claims to be the birthplace of Nurse Midwifery.

 

This is not quite so, at least not in the clinical setting. The title "doctor" connotes "physician" there. Nurse practitioners who hold the DNP are faced with this dilemma and do not go by the title "doctor" when practicing. Many nurses and NPs hold doctorates, either scholarly ones (PhD, EdD, etc.) or professional ones (like the DNP). But, for now, they don't practice with the "doctor" title--but they often use the title in non-clinical settings. I have a sense that this is a moving target, however, and is creeping towards making DNPs on par with other paramedical "doctors." We'll see.

 

I got a response from LMU this morning:

So, for now the degree is purely academic, although it does look like they are going to start working to change laws. There is precedent for this, like when the nurse practitioner programs were developed back in the 60s. LMU's response still didn't answer my question about whether the program was intended to create some sort of super PA or be a bridge to physician program. Perhaps they are being intentionally vague.

 

Maybe the same thing happened when the first PsyD degrees started in the mental health field? Used to be just PhDs then all of a sudden these upstart PsyDs started showing up. It's just a guess on my part.

 

For what it's worth, when I was in the hospital for ankle surgery I met my entire team of "doctors" though they were exceptionally careful to identify their role.

Dr. So-and-so, my clinical pharmacist
Dr. Yada-yada, my physical therapist

And I dealt pretty extensively with Dr. Name-redacted, my nurse practitioner and Dr. It-Doesn't-Matter, my podiatric surgeon.

The only time I encountered an M.D. was for my pre-surgical physical (which required an M.D. or D.O. signature).

I'm sure that the convention differs from state to state.

But it does sort of raise the question that perhaps, at this phase, we need to rethink how we educate physicians in this country. It used to be that the lower tier of doctor wannabes were forced into the Caribbean. Even a medical degree from Grenada was better than giving up and moving back in with your parents. But now, becoming a PA or a Nurse Practitioner gets you the same white coat, the same prescription pad and often far less debt. So it makes it an attractive option for even highly capable students who want to work in the field of medicine but don't feel like putting themselves at the mercy of medical school admissions and the dreaded residency match.

This is a minor sign that the "old ways" are breaking down.

Missouri providing a pathway to practice for medical school graduates who haven't completed residencies is a more significant sign (note this is about Assistant Physicians, a new license class, not Physician Assistants).

And things like this are further closing the gap.

I think bridge programs are the next logical step. But that's going to hurt a lot of feelings and the change won't be pretty, at least for a little while, if and when it does come.

 

LECOM already has a bridge program, but PAs are graduating with a DO and don't have to worry about law changes.

 

It's a three year program, though. And you're not earning it part-time while you practice as a PA. You're basically just going to medical school normally (just one year less).

I'm disinclined to call this program a "bridge program" and instead use its preferred nomenclature; an accelerated Physician Assistant program. That's great. And I realize it fits the legal definition of a "bridge program." But you can also get away with 3 years of medical school if you participate in a 7 year accelerated program (where your final year of undergrad and your first year of medical school are combined).

So, 3 year medical school can either be for a highly trained medical professional with years of clinical experience and a Masters degree OR someone with zero clinical experience who got into the 7 year program fresh out of high school.

I'll qualify my earlier statement and say "revised and enhanced bridge programs are the next logical step."

 

PAs BEWARE - This has all the makings of a phenomenal scam to the sum of $48,000 for the unsuspecting, uninformed and over-zealous PA that is a closet MD-wanna-be! Graduates from this proposed Doctor of Medical Science degree program (90% completed online BTW) are not eligible to sit for the USMLE (To be eligible, you must be in one of the following categories at the time you apply AND on the day of your examination:

a medical student officially enrolled in, or a graduate of, a US or Canadian medical school program leading to the MD degree that is accredited by the Liaison Committee on Medical Education (LCME),
a medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degree that is accredited by the American Osteopathic Association (AOA), or
a medical student officially enrolled in, or a graduate of, a medical school that is outside the US and Canada, listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, and that meets other eligibility criteria of the ECFMG.

This is a tiny school looking to make $48,000+ on each PA that should have, by all rights, used that money for the first few terms of a legitimate medical school program. This is NOT Johns-Hopkins, Wake-Forest, Duke University Medicine, Harvard, etc.

Finally, how serious can a program that would award a Doctoral degree in Medical Science be that uses such textbooks as "Clinical Neuroanatomy Made Ridiculously Simple" or the "Moore Clinically Oriented Anatomy" which is essentially an anatomy coloring book. PAs actually fallin prey to this will truly be the laughing stock of the Keurig room. If you want to be an MD - go back to medical school. The AMA will NEVER let there be a bridge-program, and they never should. Be an excellent PA (and happy to be one) or just go the long run like everyone else has. Or, retire.