# EMT-P to PA-C



## xswatmedic (Feb 20, 2007)

Hello, I am new to your forum.  I signed up because I want to be certain to "never forget where I came from."  I am a former EMT-P, currently working as a PA-C (Physician Assistant).  I wanted to ask how many of you out there have gone this route, know someone who has gone this route, or would like to make the transition yourself.

My motives are these:  EMT-P's are not now, nor have we ever been paid what we are worth.  Most of us do it just for the love of the work (I am about to go on as a reserve in the area I live, just because I miss it!).  I have seen countless medics go into nursing or leave medicine all together.  My humble opinion is simply; if you are a good medic, love medicine (not nursing, but medicine) then you should consider PA-C.  It is a NATURAL transition from EMT-P.  The thing I miss the most about my work as an EMT-P are the men and women I worked with.  Keeping that in mind, I hope to use this forum to help anyone who would like to make the transition and/or communicate with those of you who are experienced with the transition.

Hope this is the right spot for this post.  

Be Safe,

Joe Hamilton, EMT-P, PA-C


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## firecoins (Feb 20, 2007)

yes. I agree being a PA-C is a good progression.


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## Ridryder911 (Feb 20, 2007)

I had went into a PA program at one one time and decided not to continue. I personally felt it was to confining and limited. Nothing personally wrong with PA's, but for personal reasons rather have the ability to practice and bill on my own license, if I so do choose to. I am now in a nurse practitioner program, which allows me to specialize.  

Good luck in your continuation of your program.

R/r 911


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## xswatmedic (Feb 20, 2007)

Good for you, R/r. Practice in California (I haven't practiced in other states) is certainly not restricted for PA'S as "dependant practitioners."  I trained at Stanford School of Medicine, a program that has the good sense to accept primarily RN's and medics.  My RN peers were able to apply for NP as well as PA once they finished, great program!  The only "down side" is there was no degree issued, however we more than made up for that with 1700+ hours of clinical time and finished in 15-16 months.

Good luck with your NP program, given your background (EMS) you will do great!

Joe Hamilton, EMT-P, PA-C


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## firecoins (Feb 20, 2007)

At what point is it simply best to go to med school?


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## fm_emt (Feb 20, 2007)

xswatmedic said:


> "dependant practitioners."  I trained at Stanford School of Medicine, a program that has the good sense to accept primarily RN's and medics.  My RN



Hrm, where are you now? 

Stanford is expanding the med school quite a bit.


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## xswatmedic (Feb 20, 2007)

fm_emt said:


> Hrm, where are you now?
> 
> Stanford is expanding the med school quite a bit.



I am in Central Cal. (Bakersfield).  I came here to pay back my NHSC Scholarship and decided to stay.  I lived in Sunnyvale when I was up there!  How are things?  Do you work for AMR or the city?


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## Luno (Feb 24, 2007)

xswatmedic, did you work in sunnyvale?  I had a friend who was a medic there, worked for the city, he's now moved on to "other" things...


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## BossyCow (Feb 25, 2007)

firecoins said:


> At what point is it simply best to go to med school?



Right after the rich aunt dies, or after marrying into money.


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## Guardian (Feb 25, 2007)

xswatmedic said:


> Hello, I am new to your forum.  I signed up because I want to be certain to "never forget where I came from."  I am a former EMT-P, currently working as a PA-C (Physician Assistant).  I wanted to ask how many of you out there have gone this route, know someone who has gone this route, or would like to make the transition yourself.
> 
> My motives are these:  EMT-P's are not now, nor have we ever been paid what we are worth.  Most of us do it just for the love of the work (I am about to go on as a reserve in the area I live, just because I miss it!).  I have seen countless medics go into nursing or leave medicine all together.  My humble opinion is simply; if you are a good medic, love medicine (not nursing, but medicine) then you should consider PA-C.  It is a NATURAL transition from EMT-P.  The thing I miss the most about my work as an EMT-P are the men and women I worked with.  Keeping that in mind, I hope to use this forum to help anyone who would like to make the transition and/or communicate with those of you who are experienced with the transition.
> 
> ...




Nice of you to join, I hope you stick around and give us insight from time to time.  I've seriously considered PA or MD school.  It's interesting that you call it a natural transition given how different the two are.  I think many paramedics would love to go onto PA school.  I also think the majority of paramedics wouldn't have a chance at getting in PA school because of the education and scientific background needed.  Realistically, to most, it's not even an option.  Also, it seems PA and med schools frown upon non-traditional applicants and thus, automatically weed out most paramedic applicants which is sad.  What was your background, college major, and how did you beat the odds?


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## Glorified (Mar 1, 2007)

I am an infant to EMS and health care in general.  I am young now, and look forward to the excitement that EMS offers.  I'm just gonna see what happens.  Anyways, I have heard of PA's but what does the "C" stand for?  My Instructor also talked about our school trying to develop a Paramedic to PA bridge program, and it would only take an additional year to become a PA.  She caled it "the wave of the future."  I am just trying to focus on the present righ now, because I think about the future so much I distract myself from my tasks at hand (becoming a great EMT).


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## Guardian (Mar 1, 2007)

physician assistant certified. please note, you could have found this with a google search in under a minute.

wave of the future? maybe but right now, they are white collar professionals that rake in money and we are working stiffs.  Most PA's have master's degrees nowadays and require a bach to even apply to PA school.  A year from paramedic to PA, maybe in 20 years, maybe, then again with all the baby boomers, who knows but I wouldn't bet on it.


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## Guardian (Mar 1, 2007)

Now, there has been talk for years about paramedics, especially in rural areas, taking on more responsibilities and acting in some cases similarly to PAs.  But bridge to PA, I don't think so.


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## akflightmedic (Mar 1, 2007)

There already is a bridge program and has been in effect for seveal years.

Google the Medex program out of WA.

I have two medic buddies that went through it and they are now both successful PAs.


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## Ridryder911 (Mar 1, 2007)

Many of the bridge programs are under fire, not because of their lack of success or products of what they turned out; but because they are not master degree prepared programs. 

There was one I attended that consequently changed because of this, that the national accreditation is attempting to have all PA programs be at that the minimal level of being a graduate degree. 

The same action is took place for nurse practitioner programs a few years ago, now all graduating NP's have to be at least graduate level, and by the year 2015 have a DNSc. This is for professional, political and reimbursement reasons.  

Many are not aware too that the PA has to have CEU's and re-take the board test every 6 years (and we thought, EMT re-cert was bad). This may not seem to bad, but figure the individual whom works with a dermatologist, now has to review OB, ped.'s, surgery, etc.. even though they may never work in it. But, the good point is they are thoroughly reviewed. 

PA programs is one of the health professions that went form an associate degree level to a master degree format within a few short years. In some areas, it is much harder to enter the PA program than medical school itself. I know in my area it was the first master degree program and is part of the medical school, and they attend the same classes as med school students; however ironically if they return later to become a M.D. they have to retake those same classes. It will not count because it was not for physician level.. 

My advice is to check very carefully on all programs and the future of that profession. Be sure there is not hidden or further studies later one will have to acquire to be in that profession. PA is much needed and great profession.

R/r 911


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## Glorified (Mar 1, 2007)

akflightmedic said:


> There already is a bridge program and has been in effect for seveal years.
> 
> Google the Medex program out of WA.
> 
> I have two medic buddies that went through it and they are now both successful PAs.



cool. found it here http://www.washington.edu/medicine/som/depts/medex/applicants/prerequisites.htm


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## firecoins (Mar 1, 2007)

I have been considering this program
http://www.hscbklyn.edu/pa/default.html

Its for a BS for a PA-C.

Since I am not a medic and already have a B.A. I am getting my science requirments at my community college.  I may take the paramedic program first but am unsure Ill do that.


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## Ridryder911 (Mar 1, 2007)

Be very careful, many physicians and their associations (HMO's) prefer to have at least graduate degree PA and NP. I am in school with many already NP, that had to return back to get their graduate degree. 

I have several friends that have their certificate and B.S. as a P.A-C. and as I described when competition is already there, why chance it ? 

Remember, you are basically going through a fast pace medical school... 

R/r 911


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## Ridryder911 (Mar 1, 2007)

firecoins said:


> I have been considering this program
> http://www.hscbklyn.edu/pa/default.html
> 
> Its for a BS for a PA-C.
> ...



If you have your B.A. already, why go for a B.S. ? Why not a M.S.? Most P.A. programs do not care if it is a B.A. or B.S. as long as you meet the entry requirements as all P.A. schools require. Then you can write your ticket anywhere.. As well, why are you taking community college level science in lieu of 300 and 400 level courses or even 500 or 600 level science courses. You should had met the general science level with a B.A. 

R/r 911


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## firecoins (Mar 1, 2007)

Ridryder911 said:


> If you have your B.A. already, why go for a B.S. ? Why not a M.S.? Most P.A. programs do not care if it is a B.A. or B.S. as long as you meet the entry requirements as all P.A. schools require. Then you can write your ticket anywhere.. As well, why are you taking community college level science in lieu of 300 and 400 level courses or even 500 or 600 level science courses. You should had met the general science level with a B.A.
> 
> R/r 911




I am 29.  When I was in college, I was not going for a PA-C or pre med. I was an economics major. The science classes need for requirements were for non science majors.  There was no need to take advanced science classes. The 2 science classes I did take dealt with physics and neurology.  The community college I go to has the required science classed needed for most PA programs. Since both are SUNY the classes can be transferred. 


Because the program I would like to do is run by a state school, it is alot cheaper than the private ones which award a master's. I am not really interested in the degree given as much as the cost of school.  

You were right in the other thread at pointing out te medic wasn't needed. I wanted the medic but now I an unsure I want it.


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## premedtim (Mar 1, 2007)

firecoins said:


> At what point is it simply best to go to med school?



When you decide that you want decent compensation for being a health care provider and you accept the fact that student loans are a necessary evil.


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## Ridryder911 (Mar 1, 2007)

No problem, but just be very aware physician groups and many state boards are pushing towards master degree entry level. I just would hate to hear one having to return to school in just a few years to be able to maintain a position. 

As I said, I was in a P.A. program and quite aware of the political arena that is going on. They are pushing for more professional standards, much more than we are in EMS, understandably so. 

I highly suggest anyone seeking any PA, medical etc. school to be sure to check their passing average on the boards as well. Not their employment rates, etc.. but the pass rate the 1'st time... I was shocked by many when I first applied at some. This is very important when one graduates, they would like to get a job to pay off those student loans.. * as most schools will not allow you to work, during your second year due to clinical demands. 

Good luck to all !

R/r 911


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## Guardian (Mar 2, 2007)

Why did you leave PA school for NP instead rid?


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## firecoins (Mar 2, 2007)

Guardian said:


> Why did you leave PA school for NP instead rid?



He wanted to work under his own license.


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## xswatmedic (Mar 5, 2007)

*Sorry, been away*

I am sorry to have started this thread and not be involved.  I have never done this before, monitored it for a while and kinda thought that it had died out.

The PA profession is flourishing.  It is no better and certainly not worse than NP.  The only differences between the two professions are legal. Functionally we are the same.  If you are considering practicing medicine and you are not an RN, check out PA Programs.  If you already have an RN consider going into an NP program.  Better still if you are an RN consider a program that will allow you to certify in both professions, such as Stanford or UC Davis.

As far as masters degrees versus non-degreed certification programs are concerned, consider the following;  I got into Stanford's PA program with an associates degree, the proper science courses and street experience as a medic.  I finished at the top of my class, passed in the top 7% in the country on my boards and finished with... an associates degree and a PA-C.

Today I practice MD level medicine, often in the clinic alone and enjoy a six figure income, four day work week, and NO call.  I am currently training an NP with a Masters degree (could have easily been a PA with a masters, but I chose this NP because of his background... not his academic degree).  My objective is to get him up to speed (seeing patients) and together we will work side by side doing much the same work.  

What does all of this mean?  Only that "you can do it too!"  And well you should.  If you are a veteran medic you deserve it.  I am not interested in papers, degrees and academics.  I am interested in clinical medicine.  I posted here because I am interested in speaking to anyone out there who is working hard, maybe doesn't have degree, and feels like there is nowhere else to go in medicine.  Not so.

All that being said, if you already have a degree, much better still.  I don't want anyone who does the day to day work of prehospital medicine to sell themselves short however because their not an RN or don't have a degree.

Good Luck to you all!


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## Guardian (Mar 6, 2007)

great post xswatmedic, you're a real inspiration.  I can't believe you got into Stanford's PA program with only an associates degree, thats amazing.  What other experiences/education were you able to put on your application?  I would love to know some specifics so I can get a feel for the caliber of applicant they are looking for.


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## Guardian (Mar 6, 2007)

Also, did you know someone important that "put in a good word for you" or hold a high leadership position while in ems?  How many years ems experience did you have before you applied?  I'm asking all these questions because I'm curious what convinced them to accept you to PA school.  I think the average paramedic with an associate degree and "the proper science courses" doesn't have a very good chance of being accepted into a PA program.


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## xswatmedic (Mar 6, 2007)

*EMS is where it's at!*

Guardian,

Thank you for your kind words.  I have a strange background and I think it actually helped.   I had worked for about 4 years as a medic in southern Calif., lost my mind (just kidding) and went to LAPD (86-96).  I actually loved the job but had gone through one marriage, had lived through some other less than pleasant experiences and went back into EMS.  After about four more years, and while teaching in a paramedic program I learned about the PA Profession.  I went to www.aapa.org and found a book that listed all the programs and their admission requirements.  I got back into school, worked hard to knock down the prereq's and applied.  I should also note that I bought and used a text titled: Getting Into the PA School of Your Choice, by Andrew Rodican and followed it's guidance.

Once I got my acceptance call at Stanford, I was invited to an orientation meeting.  After the meeting my wife and I asked ourselves "how in the hell are we going to pay for this!"  Housing is very expensive, the program itself is relatively inexpensive, suprisingly.  At any rate, there is a section in Rodican's book that listed scholarships, I applied to everyone I could, and got the granddaddy; NHSC = full ride with a stipend.  I finished the program and gave the government two years' service (making about 62k while doing so) as "payback" for my scholarship... I took care of migrant field workers and their families here in Central Calif.  It was awesome.

EMS is an awesome place to get great experience!  In my life as a student and teacher I have met many pre-med students who have taken EMT classes for the express purpose of looking better on their interview for med school.  These smart undergrads recognize what too many of us in EMS don't; the work we (you) do is important for the community and an awesome builder of great clinicians.   

Weather you decide on NP, PA, MD, DO  doesn't matter, you are very prepared because of your experience.  I honestly beleive in my heart you deserve it.  The one thing I hated/hate about EMS is that it's practitioners will never get compensated for what their worth.

Sorry for the long wind, and multiple spelling errors... kinda compressed for time!

Joe H


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## firecoins (Mar 6, 2007)

whats a DO?


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## xswatmedic (Mar 6, 2007)

DO =  Doctor of Osteopathy, or Osteopath, as opposed to and Alopath or MD.  Osteopaths endure the same core curriculum of an MD program and add OMT = Osteopathic Manipulative Therapy, muskuloskelatal manipulation for purposes of treatment.

DO's take the same USMLE (US Medical Licensing Exam) 1-3 that MD's do before graduating and moving on to a residency program.  There are several programs throughout the nation now and many of them have PA programs associated with as do several MD programs.  I am certain that you will see DO's in just about every specialty in medicine now.  I have worked with several in the ED and have seen others in many other practices.


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## HouseMDP (Apr 19, 2013)

*Is this Fourm still active*

I am a 10 year ca-EMT-P wanting to make the move to PA but need help and guidance.  Is there anyone out here that can help with advise


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## wanderingmedic (Apr 19, 2013)

xswatmedic said:


> I am certain that you will see DO's in just about every specialty in medicine now.  I have worked with several in the ED and have seen others in many other practices.



Ditto. I see DO's all the time at work at the University of Michigan Med Center. Actually some of the med school faculty at U of M are DO's.


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## Ewok Jerky (Apr 20, 2013)

what kind of help are you looking for?


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## ExpatMedic0 (Apr 21, 2013)

Holy thread resurrection batman!


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## firecoins (Apr 21, 2013)

HouseMDP said:


> I am a 10 year ca-EMT-P wanting to make the move to PA but need help and guidance.  Is there anyone out here that can help with advise



find out where you want to go to school, find their entrence requiments and take the pre reqs. Do well at them.


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## ExpatMedic0 (Apr 21, 2013)

firecoins, did you peruse that PA program from 6 years ago when this was posted?


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## firecoins (Apr 21, 2013)

ExpatMedic0 said:


> firecoins, did you peruse that PA program from 6 years ago when this was posted?



it was 4 years and doing pre reqs as we speak.


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## MrJones (Apr 21, 2013)

Double Tap


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## MrJones (Apr 21, 2013)

> 03-01-2007 08:35 PM





> Today, 6:24 AM
> 
> It was 4 years and doing pre reqs as we speak.



And how are those math classes going for you?


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## firecoins (Apr 21, 2013)

MrJones said:


> And how are those math classes going for you?



Not a problem right now. Bigger problems exist in scheduling and life issues.


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## Brandon O (Apr 21, 2013)

HouseMDP said:


> I am a 10 year ca-EMT-P wanting to make the move to PA but need help and guidance.  Is there anyone out here that can help with advise



I'm a Basic who's starting at a PA program in... well, about a month. Happy to answer questions if you've got 'em.


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## eprex (Apr 21, 2013)

firecoins said:


> At what point is it simply best to go to med school?



It depends what you want in life and several factors, in my opinion. Physician you're looking at 4 years of medical school and a minimum of 3 years residency (I believe). Although I would personally specialize as a PA, it's still less schooling and smaller debt. Ideally you're looking at more "normal" work weeks as well. This isn't always true however.

A friend of mine and I were both premed in college and often talked about pursuing medicine. She had mentioned that she wanted a family sooner in life rather than later. It's because of that need to be stable in a closer point in time that she's now pursuing PA.

I on the other hand have no interest in getting married any time soon and particularly no interest in having a child until at least after marriage. I also have no problem being a student for the next decade or so. I have nothing holding me back from the commitment. I'd be perfectly happy as a PA, but why not shoot for the stars? If I'm going to do it, I want to be a doctor.

The lines get a bit blurred however when you talk to people who work as PAs and RNs in various places. Some absolutely love it and would never do it over. In fact I spoke to an RN who at the age of 23 owns her own home and is overjoyed she didn't pursue MD/DO. There are however quite a few PAs and RNs who have complained of A) working as much as the doctors and being treated as one which is exactly why they didn't pursue MD/DO and B) not getting respect from colleagues or patients and their families.

The bonus is that a PA school is relatively easier to get into than MD/DO (GRE anyone?) and paramedics have a leg up with their clinical experience.

If you want to be a doctor, then be a doctor. If you want to work in healthcare then become a nurse or PA and work your way up.


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## eprex (Apr 21, 2013)

xswatmedic said:


> DO =  Doctor of Osteopathy, or Osteopath, as opposed to and Alopath or MD.  Osteopaths endure the same core curriculum of an MD program and add OMT = Osteopathic Manipulative Therapy, muskuloskelatal manipulation for purposes of treatment.
> 
> DO's take the same USMLE (US Medical Licensing Exam) 1-3 that MD's do before graduating and moving on to a residency program.  There are several programs throughout the nation now and many of them have PA programs associated with as do several MD programs.  I am certain that you will see DO's in just about every specialty in medicine now.  I have worked with several in the ED and have seen others in many other practices.



DO's can practice any specialty of medicine, but they have a more difficult time landing the harder stuff like neuro, derm, etc. It's also slightly easier to get into DO school but that's quickly changing.


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## Brandon O (Apr 21, 2013)

eprex said:


> If you want to be a doctor, then be a doctor. If you want to work in healthcare then become a nurse or PA and work your way up.



I somewhat disagree with a few of your other points, and I do disagree about "working your way up." Med schools want to mold you from scratch and mostly don't care about, or are wary of, your prior professional experience; plus there's a long enough on-ramp without adding more years to the front end. If you want to be a doctor, don't try to "stepping stone" there (a la EMT to paramedic).

I do agree, however, that if you want to take care of patients, there are a number of options available. If you want to be a doctor, be a doctor. There are perhaps other differences, but the MD is the really insurmountable one that seems to end up being the crux for most people when they're honest.


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## eprex (Apr 21, 2013)

Brandon Oto said:


> I somewhat disagree with a few of your other points, and I do disagree about "working your way up."* Med schools want to mold you from scratch and mostly don't care about, or are wary of, your prior professional experience*; plus there's a long enough on-ramp without adding more years to the front end. If you want to be a doctor, don't try to "stepping stone" there (a la EMT to paramedic).
> 
> I do agree, however, that if you want to take care of patients, there are a number of options available. If you want to be a doctor, be a doctor. There are perhaps other differences, but the MD is the really insurmountable one that seems to end up being the crux for most people when they're honest.



I was referring to PA school! Most Pa schools require a certain amount of clinical hours in the field, at least the last time I checked. Some schools I looked at required several hundred hours but I was looking at the top tier schools. The requirements are also different. Most PA schools require Anatomy, Micro, and Physio with labs. Most med schools do not.


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## eprex (Apr 21, 2013)

Brandon Oto said:


> I somewhat disagree with a few of your other points, and I do disagree about "working your way up." Med schools want to mold you from scratch and mostly don't care about, or are wary of, your prior professional experience; plus there's a long enough on-ramp without adding more years to the front end. If you want to be a doctor, don't try to "stepping stone" there (a la EMT to paramedic).
> 
> I do agree, however, that if you want to take care of patients, there are a number of options available. If you want to be a doctor, be a doctor. There are perhaps other differences, but the MD is the really insurmountable one that seems to end up being the crux for most people when they're honest.



You disagree with working your way up from Nursing and general PA? Are you opposed to becoming an NP, APRN, etc?


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## Brandon O (Apr 21, 2013)

eprex said:


> You disagree with working your way up from Nursing and general PA? Are you opposed to becoming an NP, APRN, etc?



Ah -- I figured you meant work up to MD.

If an RN wants to go that direction, then more power to them. Some don't and that's also great; the practitioner role is different from the nursing role and isn't necessarily for everyone.

As a PA you could of course specialize or build experience, but I'm not sure how many more letters you could add to your name. Of course, career growth doesn't necessarily mean "more letters" and outside of EMS (and perhaps nursing) that's more understood.

I suppose my point is that "working your way up" from something implies that it's just a stepping stone to what you really want. An RN might be this but certainly doesn't have to be, and a PA isn't at all. (Actually I'm a little perplexed that you're associating those two, since they're quite different in most respects.)


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## eprex (Apr 21, 2013)

Brandon Oto said:


> Ah -- I figured you meant work up to MD.
> 
> If an RN wants to go that direction, then more power to them. Some don't and that's also great; the practitioner role is different from the nursing role and isn't necessarily for everyone.
> 
> ...



I associate the two positions because they're of course not physicians and yet are both viable, well-paying careers that can offer a piece of what being a doctor is like without the doom and gloom of lower pay rates, increasing school debt, increasingly difficult entrance standards, and massive fear of malpractice. There's also still plenty of room for more nurses and pa's.


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## Sublime (Apr 21, 2013)

Brandon Oto said:


> (Actually I'm a little perplexed that you're associating those two, since they're quite different in most respects.)



I'm curious as to what you've found that makes them so different. I know the educational models are different, although I don't know much about the NP model of training. From what I've seen, read, and heard... they function basically the same once out of school, the only difference being that PAs are able to specialize in any area of medicine and NPs are trained for a specific field (such as acute care for family medicine). 

I am thinking that at some point in the future, I will want to go one route or the other.. but I am still not sure which one. From reading the NP forums on allnurses, I got the impression that a lot of new NPs were not very confident practicing on their own once graduating school. Maybe that's just the few vocal ones on that forum, idk... 

I like the idea that PA school is somewhat like a condensed version of med school, which includes gross anatomy... something that NPs school don't do (if I'm wrong let me know). I do however like the fact that NP school allows you to receive a doctorates degree. So I am still unsure what is the best option. The most important thing to me is getting the best medical education possible outside of going to med school.


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## Brandon O (Apr 21, 2013)

eprex said:


> I associate the two positions because they're of course not physicians and yet are both viable, well-paying careers that can offer a piece of what being a doctor is like without the doom and gloom of lower pay rates, increasing school debt, increasingly difficult entrance standards, and massive fear of malpractice. There's also still plenty of room for more nurses and pa's.



Well, that's fair, and I've heard a lot of my coworkers voice similar things. You know, "I don't know... I'm thinking maybe PA... or my RN... or RT... or those CRNAs make good money... or electrician..."

But aside from making more money with better career stability than EMS (which is like saying more sunny days than Seattle), they're different jobs, so if we're trying to find fulfilling careers, it probably behooves one to figure out what they want to actually do.



Sublime said:


> I'm curious as to what you've found that makes them so different. I know the educational models are different, although I don't know much about the NP model of training. From what I've seen, read, and heard... they function basically the same once out of school, the only difference being that PAs are able to specialize in any area of medicine and NPs are trained for a specific field (such as acute care for family medicine).



My apologies, I probably wasn't clear. I meant PA vs. RN. PA vs. NP is a much closer comparison and commonly drawn.

It's usually described as coming from the medical model of education (diagnostic) vs. the nursing tradition (more holistic, preventative, caregiving). This difference seems to extent to the professional culture; I've never had a close relationship with the nursing world, but it's interesting to watch from outside, particularly how the professional bodies have kept pushing to change and develop their roles.

NPs can practice independently, whereas a PA is always affiliated with a physician in some respect at least (what this means varies greatly). PAs are starting to become more specialized as well, but lateral mobility is still common. And, of course, if you're already an RN, NP is a shorter route. But many times they're performing similar roles.


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## MediMike (Apr 21, 2013)

After 10 years in EMS I've started PA school so I'll add a little input here...

First off, PAs don't truly "specialize".  You're trained as a generalist, with the large majority of schools focusing mainly on primary care.  With that being said, there are a growing number of residencies available after you pass the PANCE to help you land a job in a specialty/sub-speciality.  NPs are trained in a specific specialty, be it Family Practice Acute Care etc.

The idea that PAs end up with a better work week than MDs is a definite myth from practicing folks I've talked to/shadowed/learned from, especially as you enter the realm of specialties (Ortho/Cardiology etc.)  In many offices (not all by any means) PAs are hired to perform more of the pre-op/post-op duties, as well as take call during the times that the MDs don't want to.  Primary Care offices will often hire PAs and allow them to develop their own patient panel.  From what I've seen the duties of the PA will depend on their SPs idea of how the relationship should work.  Could end up great, could end up bad!

In regards to the educational models of NP v. PA there is a large disparity.  NPs are trained in the nursing model, more of a holistic approach, whereas PAs are trained in the medical model.  Many PA programs are run by the school of medicine associated with whatever university they are at, classes are shared with MS1-4s, same faculty teach many classes etc.  So there is a large difference in the didactic period.  Clinically PA students (from what I've seen) are exposed to a greater number of hours as compared to NP students.  

A large point of contention between the two educations has been the fact that there are several online-only, and direct entry NP programs.  PAs have always been proud that there has historically been a large number of direct HCE hours required for admission to their programs, but that is starting to go away with the large number of newer programs opening up.  

A large number of states allow NPs to operate independently, that has caused quite the schism between the AMA and the BON.  And although the opportunity is there to operate independently, from what I've read it's a statistically negligible number of NPs who actually do.  PAs will always be required to have an SP, although state laws vary on what the duties of the SP shall be.  Some require the SP to perform a certain % of chart reviews, some want the SP on site, while others require that your SP be available by phone in the incident a consult is needed.

And on a last note, while the terminal degree of the NP profession is indeed a PhD, that is an academic doctorate, and (in my personal opinion) should not be used as a title in the clinical environment.  I find it to be misleading to patients, and false advertising if you will.  PAs have the opportunity to earn a PhD as well, although if you have attended a B.S. program rather than an M.S. you will of course have to achieve your master's degree prior to attending.  If I recall correctly there is the Doctorate of Physician Assistant Studies and a Doctorate of Clinical Health Sciences.

This post was in no way intended to offend any NPs or future NPs here, just my simple attempt to explain some of the differences between the professions.  And now after looking at my watch, I realize that I have successfully slaughtered a large chunk of my study time...


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## MediMike (Apr 21, 2013)

Way to provide a much more succinct answer there Brandon...makin' me look all blabby...


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## Sublime (Apr 22, 2013)

MediMike said:


> After 10 years in EMS I've started PA school so I'll add a little input here...
> 
> First off, PAs don't truly "specialize".  You're trained as a generalist, with the large majority of schools focusing mainly on primary care.  With that being said, there are a growing number of residencies available after you pass the PANCE to help you land a job in a specialty/sub-speciality.  NPs are trained in a specific specialty, be it Family Practice Acute Care etc.
> 
> ...



Thanks for the post. Last time I looked I thought that the only place offering a doctorates degree for PAs was the military though, perhaps I'm wrong on that though.

And I agree on not using the title in practice, it is misleading. I still would seek out that level of education anyhow just for personal goals and increased knowledge.


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## MediMike (Apr 22, 2013)

Whoops! You are correct about only Baylor's offering of a Doctorate in EMed for PAs.  I was mistaken, there are other doctorate level degrees available to PAs though!


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## Brandon O (Apr 22, 2013)

MediMike said:


> Way to provide a much more succinct answer there Brandon...makin' me look all blabby...



Yeah, me, I'd never blab <_<

Not sure what I'd make of a PhD in PA studies, but then, I'm not sure what to make of a DNP either, so it is what it is.

Edit: Mike, are you at MEDEX?


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## MediMike (Apr 22, 2013)

You could walk around telling people you're a doctor, garnering the respect of men and the desire of women...Of course since it's an academic doctorate you'd be able to wear a tweed jacket with leather patches on it's elbows, smoke a pipe without looking like an idiot, and perhaps wear more argyle??


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## JPINFV (Apr 22, 2013)

MediMike said:


> You could walk around telling people you're a doctor, garnering the respect of men and the desire of women...Of course since it's an academic doctorate you'd be able to wear a tweed jacket with leather patches on it's elbows, smoke a pipe without looking like an idiot, and perhaps wear more argyle??




What's wrong with tweed? Tweed is cool!


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## MediMike (Apr 22, 2013)

I forgot the damn bowtie didn't I...


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## eprex (Apr 22, 2013)

MediMike said:


> After 10 years in EMS I've started PA school so I'll add a little input here...
> 
> First off, PAs don't truly "specialize".  You're trained as a generalist, with the large majority of schools focusing mainly on primary care.  With that being said, there are a growing number of residencies available after you pass the PANCE to help you land a job in a specialty/sub-speciality.  NPs are trained in a specific specialty, be it Family Practice Acute Care etc.
> 
> .



I consider that to be specializing but maybe I'm ignorant to the true definition. For instance I've heard great things about becoming a surgical PA.

http://www.aaspa.com/page.asp?tid=99&name=Surgical-PA-Specialties&navid=22


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## eprex (Apr 22, 2013)

While it's not the be all end all of medical information, I thoroughly enjoy the student doctor network. You can always ask questions there as well.

http://forums.studentdoctor.net/forumdisplay.php?f=113


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## Brandon O (Apr 22, 2013)

MediMike said:


> You could walk around telling people you're a doctor, garnering the respect of men and the desire of women...Of course since it's an academic doctorate you'd be able to wear a tweed jacket with leather patches on it's elbows, smoke a pipe without looking like an idiot, and perhaps wear more argyle??



I actually own a pipe, but I'm worried tweed will accentuate my... jowly convexities.



eprex said:


> While it's not the be all end all of medical information, I thoroughly enjoy the student doctor network. You can always ask questions there as well.
> 
> http://forums.studentdoctor.net/forumdisplay.php?f=113



The PA Forums (http://www.physicianassistantforum.com/) are great for PA stuff.


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## MainMedicMan (Sep 22, 2014)

Great information posted, Thank you!
PA is my destiny!


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