Physician Assistant ?

philslat

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What are peoples thoughts or experiences on becoming one from an ems background ?

What routes are out there for paramedics to study for the position ?
 

DrParasite

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i know quite a few people who went that route.

route: get a bachelors degree. then get a masters degree from a PA program. hard to do full time and go to PA school, but part time/per diem as a medic is def doable.
 

Brandon O

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Get your bachelors with the necessary prereqs, then apply. The field experience will be useful. Don't plan on being able to work during school.
 

johnrsemt

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I had a couple of coworkers who did PA school while working FT, one as an EMT Basic, and one as a Medic. Depends on your work and study habits, and if your company and partner lets you sleep between patients.
 

wtferick

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A handful of PAs at my Hospital job worked as EMTs/Medics prior to going to PA school. Some local firefighters have even tried to attend PA school but scheduling was tough.
 

Akulahawk

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Get your bachelors with the necessary prereqs, then apply. The field experience will be useful. Don't plan on being able to work during school.
That's one of the reasons I chose not to try for PA school. I had to work full time.
 

DrParasite

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Insert some sort of GIF here about... loans.
As someone who had paid off his student loans, and is now dreading more loans when I go for my masters degree.....

Loans are great to help you pay FOR school. They don't always help you pay the mortgage/rent car payment/insurance, food etc. When I was looking at PA school, they told every applicant that they COULD NOT WORK during the PA program. While I'm sure I could have gotten away with a slow 24 hour shift on Saturday or a busy 12 hour shift on the weekend, it wouldn't have made that big of an impact on my ability to pay my bills. If I had a sugar momma, or lived with family, I could likely pull this off, at least for a few years until I finished school. Once I became an adult, this became much more difficult. Now that I have a wife (who isn't sugar momma level yet), and a child (who doesn't being in any revenue, and costs a fortune in diapers), I can't quit my full time job to complete grad school. I plan on getting loans to help pay for school, but I still have expenses that need to get paid, and student loans won't cover them.
 

Brandon O

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That sounds... correct. Glad I didn't need to support a family during school.

I guess there's NP school. They usually work.
 

Akulahawk

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That's exactly the problem. Loans are good for paying for school but they usually don't help with the other issues with life. At the time I didn't have much in the way of recurring expenses but they included a mortgage, family, car insurance, etc. Fortunately I didn't also have a car payment. I still had the usual utilities, gas, and the like. On top of school costs, just add on another $80k for the two years I'd have had to take out for all those other costs, and more for a huge lack of health insurance... which my full time job provided. I barely squeaked out of school with no major debts, but I was able to do it. Going forward, if I choose to do PA school, I'd have to be able to step away from work for 2 full years as well as arrange for all school costs to be covered too.

I'm not as young as I once was. Before I was as encumbered with such life expenses, PA school would have been far easier to manage.

NP school should be easier to do from a logistical standpoint but the end result wouldn't allow me the flexibility that a PA has.

While this is a bit off the topic of PA school per se, it's something people do have to consider when deciding to go beyond Paramedic or Nurse, or whatever, and become a mid-level provider or higher. Certain costs can be prohibitive to a degree if you're not aware of them.
 

FiremanMike

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I've mentioned this before on other forums, but I'll mention it here. I can't for the life of me understand why people choose PA over NP these days. On the front end, the pre-requisite courseload for PA school is nearly all of the pre-requisite coursework for medical school. If I'm going to take all those classes, I'm just going to take the MCAT and be a doctor. For those with a bachelors degree, direct entry NP programs only require A&P, biochem, and pharmacology.

While in school, at least with the programs in my area, you will be a full time student with a heavy course load. Around here, most will have to quit their jobs entirely to accommodate the workload. NP school can be done part-time.

On the back end, NP's have full autonomous practice authority and PA's likely never will. While I don't personally plan on being completely off on my own, it sure would be nice to not have that monkey on my back for the rest of my career. On top of that, they're competing for the same jobs, so it's not like PA's are getting better jobs than NPs..
 

Remi

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I've mentioned this before on other forums, but I'll mention it here. I can't for the life of me understand why people choose PA over NP these days. On the front end, the pre-requisite courseload for PA school is nearly all of the pre-requisite coursework for medical school. If I'm going to take all those classes, I'm just going to take the MCAT and be a doctor. For those with a bachelors degree, direct entry NP programs only require A&P, biochem, and pharmacology.

While in school, at least with the programs in my area, you will be a full time student with a heavy course load. Around here, most will have to quit their jobs entirely to accommodate the workload. NP school can be done part-time.

On the back end, NP's have full autonomous practice authority and PA's likely never will. While I don't personally plan on being completely off on my own, it sure would be nice to not have that monkey on my back for the rest of my career. On top of that, they're competing for the same jobs, so it's not like PA's are getting better jobs than NPs..
I think the reason has a lot to do with people in EMS just having a bad impression of nursing, and/or for whatever reason just no desire at all to be a nurse in any way, shape, or form. I certainly felt that way early in my EMS career. I went to nursing school very grudgingly only because I planned to make a career out of HEMS and it made no sense to do it as a paramedic when I could do the same job as a nurse and make a lot more money. Turns out it was by far the best career move I could have made for myself, but that's just me.
 

FiremanMike

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I think the reason has a lot to do with people in EMS just having a bad impression of nursing, and/or for whatever reason just no desire at all to be a nurse in any way, shape, or form. I certainly felt that way early in my EMS career. I went to nursing school very grudgingly only because I planned to make a career out of HEMS and it made no sense to do it as a paramedic when I could do the same job as a nurse and make a lot more money. Turns out it was by far the best career move I could have made for myself, but that's just me.
I've had those feelings too, and whether nursing undersells it or EMS folks just ignore it, a BSN alone opens up so many different opportunities that you wouldn't even consider. I used to believe that RN = wiping bottoms and taking orders, but there's such a wide range of different types of jobs that one can get with a BSN it's just staggering.

I will say that I still maintain I would not be happy as a floor nurse, but I can certainly see a variety of jobs that would make me happy if I had my BSN. I do still plan on going on to NP school as I feel the practitioner role more clearly fits my personality..
 

DrParasite

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I've mentioned this before on other forums, but I'll mention it here. I can't for the life of me understand why people choose PA over NP these days. On the front end, the pre-requisite courseload for PA school is nearly all of the pre-requisite coursework for medical school. If I'm going to take all those classes, I'm just going to take the MCAT and be a doctor. For those with a bachelors degree, direct entry NP programs only require A&P, biochem, and pharmacology.
When I was looking at nursing school, there were no direct entry NP programs. They all required you to be an RN and have a bachelors already. So even if you were a paramedic, you would need to complete nursing school and take the NCLEX before you could even think about NP school.

While you are correct, the PA school requirements are the same as for medical school, the workload is much different.

PA school was also 2 to 3 years, and then you were free to practice as an allied health professional. med school is 4 years of schooling, plus a fellowship, then residency (another 3-4 years, plus an internship), and then you are attending (and a provider who doesn't have to run orders by a higher up).

On the back end, NP's have full autonomous practice authority and PA's likely never will. While I don't personally plan on being completely off on my own, it sure would be nice to not have that monkey on my back for the rest of my career. On top of that, they're competing for the same jobs, so it's not like PA's are getting better jobs than NPs..
please explain how NP's have full autonomous practice authority (while still operating under and MD's license), yet PAs who practice under a MD's license have less autonomy....

A buddy of mine is an NP, and has his own clinic.... while he runs it on his own, he still has an MD who he is actually comes in once or twice a month to do stuff, as its operating under his license.

BSN alone opens up so many different opportunities that you wouldn't even consider. I used to believe that RN = wiping bottoms and taking orders, but there's such a wide range of different types of jobs that one can get with a BSN it's just staggering.
wiping bottoms has been delegated to the CNA or hospital techs. **** jobs roll downhill. There are plenty of NURSING jobs, and plenty of jobs that the nursing lobby group have pushed for RN credentials (I still don't understand why you need an RN cert to handle bed management), but a BSN is still an entry level nursing degree. the only time a BSN is more is when an RN earns her BSN, and has 5 years of experience in addition to the new shiny BSN.

I will say that I still maintain I would not be happy as a floor nurse, but I can certainly see a variety of jobs that would make me happy if I had my BSN. I do still plan on going on to NP school as I feel the practitioner role more clearly fits my personality..
I agree. When I was looking at nursing school, I was aiming for less than 5 years in either an ER or ICU, before moving into a non-clinical position. What NP schools allow you to enter without having any RN experience?

I went to nursing school very grudgingly only because I planned to make a career out of HEMS and it made no sense to do it as a paramedic when I could do the same job as a nurse and make a lot more money. Turns out it was by far the best career move I could have made for myself, but that's just me.
Many people say the same thing about CCT ambulances that are staffed with 1 RN and 1 paramedic.
 

rescue1

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please explain how NP's have full autonomous practice authority (while still operating under and MD's license), yet PAs who practice under a MD's license have less autonomy....
There are several states where NPs do not require a physician's authority/license to practice.
 

Remi

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please explain how NP's have full autonomous practice authority (while still operating under and MD's license), yet PAs who practice under a MD's license have less autonomy....
In no states do NP’s “practice under a MD’s license”.

A minority of states - one of which is NC - are behind the times and require that a NP maintain a collaborative agreement with a physician in order to practice. In NC this is a formal but very loose agreement with a MD that states the MD will be available for “collaboration, consultation, and supervision”, but none of those things are required when the NP is practicing within the scope of their training. No practice guidelines, no chart co-signing, no chart review, no phone calls, and no visits are required. They just must be available.

About the same number of states do not require a collaborating physician for NP practice, but do for prescriptive authority. The remaining states - about a third or so of them - require no physician relationship at all for NP practice.
 

DrParasite

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interesting.... I was misinformed.... do PAs operate in a similar manner, or do they need a loose agreement with an MD for anything?
 

FiremanMike

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interesting.... I was misinformed.... do PAs operate in a similar manner, or do they need a loose agreement with an MD for anything?
It is my understanding that PA's are lagging behind NP's pretty significantly overall in their recognition and practice rights and that their requirements for the relationship with their supervising physician were much tighter.
 

Brandon O

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interesting.... I was misinformed.... do PAs operate in a similar manner, or do they need a loose agreement with an MD for anything?
There's a requirement for PAs to have some form of an affiliation or supervisory relationship with a physician (in, as far as I know, every state still). In most places it means there needs to be someone you could call, or someone who looks over a few of your charts per month, or similar.

In practice all of these minutiae doesn't mean much, folks. Your degree of supervision is generally commensurate with your needs and level of experience. I don't know any NP or PA in their right mind who would come out of school and think they can practice without any help, regardless of the law.

Supervision is usually even easier in the acute care setting. For example, in the ICU, most places use PAs and NPs indiscriminately (sometimes they prefer one or the other, mostly out of habit), and both are "supervised" in the sense that the intensivist continues to be involved with the patients. What decisions/activities/procedures to handle independently vs collaboratively are a matter for the two of you and your system to work out. The letters don't matter much.
 

Peak

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interesting.... I was misinformed.... do PAs operate in a similar manner, or do they need a loose agreement with an MD for anything?
Since the AMA created PAs they will always be somehow under the supervision of a Doc, to what extent largely depends on what state they are in.

I think another consideration in deciding NP or PA depends on what type of practice you want to have. ED and surgical specialties seem to have a larger proportion of PAs, and generally PA training seems to be more geared towards this; neonatal, pediatric, and psych specialties seems to much more strongly prefer NPs, I suspect that this is largely due to NP training tracks specific to these practice areas.

There are some specialty oriented training programs for PAs, but they seem to have more flexibility in choosing their practice areas than NPs. This used to be the case with FNPs, but there has been a bigger push recently in some areas to have primary care NPs (compared to NNP, PNP-AC, and AGAC) to only practice in outpatient settings.
 
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