Physician Assistant ?

Peak said:
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.
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Who knows. They haven't been very active pursuing this, but it does mostly depend on the state, not on who created what.

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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Agree that PAs are usually more suited to surgical work. As I understand it NPs usually need to undertake additional training to assist in the OR.

True that NPs are a bit more specialized in training (roughly specialized programs versus fully generalist NP programs), but how much this matters seems to vary. I have certainly seen FNPs working in the acute care setting.
 
Peak said:
Since the AMA created PAs they will always be somehow under the supervision of a Doc
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Not so sure about that: Big News for OTP in North Dakota

Economics is a hard force to ignore over the long term, and economics definitely favors independent "mid level" (again, I hate that term because it is demeaning and factually inaccurate) practice.

For purely political reasons, PA's lag far behind NP's in this area, but they will eventually catch up.
 
Brandon O said:
As I understand it NPs usually need to undertake additional training to assist in the OR.

True that NPs are a bit more specialized in training (roughly specialized programs versus fully generalist NP programs), but how much this matters seems to vary. I have certainly seen FNPs working in the acute care setting.
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Yeah, NPs would need to get their RNFA.

There are FNPs who work acute care, but they have mostly been there before the proliferation of acute care NP specialties. New FNPs will have a much harder time finding acute care jobs than before. Every RN I know who when FNP instead of AGNPAC or PNPAC ended up having to take a clinic job, this isn't universal by any means but the demand is so much higher in primary care now.

Remi said:
Not so sure about that: Big News for OTP in North Dakota

Economics is a hard force to ignore over the long term, and economics definitely favors independent "mid level" (again, I hate that term because it is demeaning and factually inaccurate) practice.

For purely political reasons, PA's lag far behind NP's in this area, but they will eventually catch up.
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I wasn't aware of that but I'll be surprised if it actually passes.

Like you said it's all political, and I think the medical and nursing interests will likely both be against it in the long term.
 
I know Yale Univ's GEPN program only requires a Bachelor's degree and you only have to score well on the GRE exam.
 
Kavsuvb said:
I know Yale Univ's GEPN program only requires a Bachelor's degree and you only have to score well on the GRE exam.
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that's a year old program, and us used as a leadin prereq to a MSN.
Upon completion of the prespecialty year, students continue on with their graduate studies which includes theory, practice, and research. Students are admitted into their designated specialty when accepted into the program. The Certificate in Nursing and a license to practice nursing in Connecticut are the two prerequisites required for the GEPN student to continue with their graduate work to earn their M.S.N. degree.
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DrParasite said:
that's a year old program, and us used as a leadin prereq to a MSN.
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Here's what the Degree plan for YALE UNIV GEPN Plan.

Graduate Entry Pre-Specialty in Nursing (GEPN)

The GEPN program allows those with a non-nursing background to take advantage of a Yale nursing education to pursue a rewarding career in advanced practice nursing. This accelerated three-year program combines preparation in basic nursing with advanced training in a specialty that leads to a...
nursing.yale.edu nursing.yale.edu

Here's their Admission requirements. https://nursing.yale.edu/admissions/how-apply/graduate-entry-pre-specialty-nursing

"
The GEPN Program is the first of a three-year, full-time course of study that combines preparation in basic nursing with advanced preparation in a clinical specialty. Students are offered experiences in acute-care hospital units and community settings to achieve YSN’s overall mission of better health for all people.
Upon completion of the pre-specialty year, students continue their graduate studies in theory, practice, and research within their chosen nursing specialty areas and concentrations.
All GEPN candidates for admission to Yale School of Nursing are required to submit the following:
• Online Application
• Current Resume/Curriculum Vitae
• References
Three letters of recommendation (academic, professional, or clinical) must be submitted electronically through the online application system.
• Transcripts
One official transcript from each college or university attended must be mailed to Yale School of Nursing, or sent digitally via Parchment or eScrip. Unofficial transcripts should also be uploaded to the online application. International transcripts must be evaluated by a credentialing agency, such as World Education Service or Educational Credential Evaluators. This includes a course-by-course evaluation, as well as a certified English translation of all non-English transcripts. International applicants should also review: International Applicants Information.
• Test Scores
Scores from the GRE General Exam are required for applicants. (Note: The GRE requirement can be waived for applicants with a previously completed masters or doctoral degree).
Registration information is available at www.ets.org/gre. YSN’s GRE code is 3998. The GRE needs to have been taken in the last five years. GEPN and MSN candidates should take the GRE no later than mid-October. Scores from either the TOEFL or the IELTS are required of all non-native English speakers.
• One essay and two short answer responses to the following questions
Essay (400 – 600 words)
Please address the following three questions in an integrated and comprehensive essay, plus two short answer questions (separately). Applicants will be evaluated on their ability to compose a well-written and well-organized essay as well as on the substance, thoughtfulness, and clarity of their responses:
Why do you wish to pursue a career in advanced practice nursing?
Please expound upon: (a) your decision to pursue nursing rather than another health care field; (b) your choice to pursue advanced practice nursing (i.e., an APRN/MSN rather than an RN/BSN); (c) your selection of the particular clinical specialty to which you are applying.
What factors have influenced your decision?
Please describe any significant life experiences that have contributed to your self-understanding and development, with respect to your interest in advanced practice nursing. You may discuss, for example, how academic and professional experiences, cross-cultural engagement, or volunteer roles and service projects have shaped your career aspirations and ambitions.
Why are you applying to Yale’s Graduate Entry Prespecialty in Nursing (GEPN) program?
Please articulate how specific aspects of the program, curriculum, faculty, or any other of the Yale School of Nursing’s resources or characteristics, will empower you to achieve your goals in the nursing profession.
Essay Short Answer (150 - 300 words) for each question
Please provide a balanced assessment of your personal characteristics as they pertain to a professional environment. Identify your strengths and weaknesses, as well as areas you are working to improve. Discuss your interpersonal style, both in interactions with individuals as well as in group settings. What leadership qualities, conflict management skills, and other characteristics of yours influence how others perceive and respond to you?
Yale School of Nursing’s mission is “better health for all people.” What does that phrase mean to you? How do you intend to inhabit and implement YSN’s mission over the course of your nursing training and career?
• Application Fee
A non-refundable application fee of $100 payable by credit card is due at the time the application is submitted.

Please note: Candidates to the GEPN program are not required to take any prerequisite courses to apply and be admitted to the program. "

They don't require an Preq's like other NP schools and I have seen YALE Univ GEPN Students because my endocrinologist is a Faculty for them and she uses me as a Lab rat because I have 2 rare diseases.
 
My dear friend,
PA is spelled out,
"Physician Assistant",
There is no 's,
After physician.
 
He thinks he’s speaking in haikus...
 
I preferred the third person talk from our friend from down under to this "dear friend" of ours.

But I also have other things to worry about than someone who wishes to sound condescending on the internet.
 
A simple suggestion for anyone going after a higher rung in the ladder, be it NP or PA or similar. Take it in stages. You can do a lot of the pre reqs while working full time. See a good councilor/advisor who knows the classes and normal limits of students. Consider spacing your curriculum out over several years.
From start to finish, my BME was spaced out over nearly 20 years.
 
FiremanMike said:
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.
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Even as a RN I have debated the PA route vs NP because in many cases it really is a better education.

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.
FiremanMike said:
On top of that, they're competing for the same jobs, so it's not like PA's are getting better jobs than NPs..
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There are some specialties, i.e. surgery, that are dominated by PAs. Autonomous practice is a perk but for many in-patient jobs like critical care and surgical it really is a mute point for mid levels.
 
VFlutter said:
Even as a RN I have debated the PA route vs NP because in many cases it really is a better education.

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.

There are some specialties, i.e. surgery, that are dominated by PAs. Autonomous practice is a perk but for many in-patient jobs like critical care and surgical it really is a mute point for mid levels.
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To me, it's simple: If you are already an RN or plan to become one, then NP probably makes much more sense. If you are not an RN already and have no desire to be one, then PA is the way to go.

The educational models are very different, and there's no question that PA programs on average are better, but there are also plenty of NP programs that provide quality training and they aren't had to find and the schedule is typically much more convenient because they are designed for RN's who work full time. That's the other advantage of NP over PA; the ability to do your education in "stages", working full time the entire time you are going to school.

The autonomy ends up being a non-issue 95+% of the time, because it's pretty uncommon for a NP or PA to work in a setting where they are the only advanced provider. Even when they do, "physician supervision" for PA's (and for NP's where it is required) often amounts to little more than a formal relationship on paper with an MD or DO who they may never even see in practice.
 
How did I miss this thread? There is much to be clarified.

The comedic poet is correct. The title of the profession is Physician Assistant. Could we change the thread title to reflect that the good people of EMS represent themselves well and understand their partners in medicine? Thank you. (Although, the American Academy of Physician Assistants along with a majority of PAs are looking to rebrand and re-title the profession).

PA/NP (Advanced Practice Providers) roles are determined by state legislation. Therefore, the laws for PAs and their work varies widely state to state. As has been said, the nursing lobby has made great strides in advancing their profession. The PAs are behind on that front, yet they are also a much younger profession. Gains are being made by PAs with regard to federal and state legislation.

Anyone who would badmouth either profession as a lesser demonstrates they don't know what they are talking about, not that anyone has intentionally. Both have their strong suits as well as less strong suits, but they are both positions that require high levels of education and experience to provide medical care at an advanced level much like a general physician. I am not saying PA/NP =/> MD. PAs and NPs in practice are more similar than they are different. Although, practice of PAs right out of school includes prescribing, obtaining H&Ps, diagnosing and treating illness, ordering and interpreting diagnostics, counseling patients on preventative health, performing medical procedures, assisting in surgical operations. NP practice is almost identical, they must obtain additional training in most cases to assist in surgery or to see patients across the lifespan depending on the type of program they attended. NPs also enjoy certain eases in licensing in most states. Most importantly, no provider is in it alone; part of the PA role is understanding limitations and making those collaborative efforts to best serve the needs of each patient.

https://pasdothat.net/

There are certain differences in training, like many have stated. NP school is based on nursing theory and some NP programs aim to specialize right out of the gate (generally after many years of RN bedside experience). PA schools are based on the medical model (like MDs) and programs are uniformly geared towards family practice. As a new grad, a PA can go into family practice or choose to specialize in a given field which may include on the job training (most common) or applying for and attending formal fellowships (residencies, less common) if desired.
 
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Second order of business: the OTP for North Dakota did pass, so Fireman Mike, you can be surprised now. OTP stands for Optimum Team Practice. It is a revitalization effort for PAs to gain an accurate reflection of their role, capabilities, and responsibilities as providers of medicine in the legislative process nationally and at the state level. The goal is that, without unnecessary and archaic restrictive policies, PAs would be able to practice medicine at the top of their training and license, as part of a collaborative team of providers, much like our peers enjoy in their respective NP and physician roles.
ndapa.mypanetwork.com

Passage of HB 1175

North Dakota PAs, It is with great pleasure to announce that H.B. 1175 has been officially signed into law! After unanimously passing through both the N.D. House of Representatives and Senate,...
ndapa.mypanetwork.com ndapa.mypanetwork.com
 
@SandpitMedic - first and foremost, I apologize if my post came off as badmouthing PAs, my point was then and remains today that the barriers to entry coupled with the fact that PAs are so significantly behind NPs in obtaining practice rights makes it seem illogical to choose PA school.

I agree with the above posts that independent practice isn’t an issue for many and probably won’t be for me, but you have to admit it would be nicer to have that option than not.

Even after a year of posting this, I still maintain that NP seems more “future proof” or show more signs of future growth potential compared to PAs. I also agree that in most cases, PA education is more robust..

As an update to my own path, for those interested.. I am currently wrapping up my pre-reqs for the direct entry NP program I was interested in. With that said, I’ve decided to enter the medic to RN bridge at my local community college and hope to start that next summer. At that point, I’ll be at year 21 out of 25 in my pension system, so I’ve decided to use that time to take the full pre-med course load. Once it’s time to retire, I’ll see where I’m at and either make a go for medical school or NP school. Having the RN in my pocket will give me more options on NP school if I go that route.
 
I would be cautious with Medic to RN bridge programs if advanced practice is your goal as in the past some NP schools, especially CRNA, would not recognize them or require additional requriments for entry. That may have changed and I am sure some of the members on here that have gone that route can clarify. Sometimes it is better to just do the traditional route vs jumping through hoops later
 
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