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First PA-C to DO bridge program!

Posted 4 years, 2 months ago by Eric Holden, pa-c, emt-p Acute Care/Emergency Medicine

LECOM will announce a newly approved pa-c to physician( DO) bridge program within the next 2 weeks. the director of the program( Dr. Kaufman) is a DO who was previously a PA.
Details available at this point:
program length 2 yrs, 10 months.
format: all of ms1 and ms2 then a hybrid clinical yr
ba/bs degree and mcat required for admission
first class size 12 seats
grads eligible for match to any residency but they will prescreen applicants to try to get 50% who are interested in primary care.
it’s been a long time coming. we need to send the best and the brightest to this so that it catches on and becomes an option at other medical schools.

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  • Disaster and Emergency Services
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Keywords

Discussion

  1. Sharon Bahrych
    4 years, 2 months ago

    where is this school located?

  2. 4 years, 2 months ago

    Wow.  So, here’s an interesting tidbit of information:
    LECOM (Lake Erie College of Osteopathic Medicine) is located in Erie, PA.
    Dr. Mark Kaufman is married to Michele Kaufman, JD, PA-C. 
    Michele is the director of the PA Program at Gannon University in Erie, PA. 
    They’re both good people.  They’re well-positioned and have the experience to make this work.  I hope it pans out.

  3. 4 years, 2 months ago

    I really don’t see the value in this. LECOM already has a three year primary care pathway for those interested working in that realm. Where’s the bridge? Basically you have 4 years for a bachelors, 27-30 months for PA school, then the 3 year “bridge,” plus residency. I don’t see the incentive, nor do I see any reward for our previous training and clinical experience. Too me, it looks like a fancy spin on having PAs invest in med school from scratch, under the guise of a bridge program. If bridge programs do indeed become realty, the creators need to think outside the box.

  4. 4 years, 2 months ago

    this program doesn’t limit one to a primary care residency like the 3 yr program does.

  5. 4 years, 2 months ago

    I understand that, but the complete first and second years? I’m going to have to master Bates’ again? Learn how to interview a patient, go through pathophys for a second time, pharmacotherapy, etc., etc.. I can understand requiring maybe the biochem, embryology, and histology, but to start from scratch? Again, I think this is way to get PAs to go to medical school using the guise of a bridge, when in fact there appears to be no bridge. Just condensed clinicals, and not by much. If you just want the doctor title and the boost in pay, maybe, but to truly address the shortage of physicians by utilizing highly skilled and aptly trained PAs? Don’t get me wrong. I’m a huge proponent of a true PA to physician bridge, but, sadly, this is not the way ...

  6. 4 years, 2 months ago

    And if this does fly and becomes the norm, where’s the incentive to become a PA?

    1) bachelors, 27-30 months for PA school, 3 years for the MD/DO, then residency

    vs.

    2) bachelors, 36-48 months for med school, then residency

    The choice looks clear to me. Choice one puts you near 66 months of medical/clinical training. You’re back to square one. Why choose PA school if the end goal is to be a physician? It doesn’t make sense.

    I think a much better option would be something like requiring MS1 with the hardcore sciences (or a one year hybrid) and one year of condensed clinicals, then residency.

  7. Sharon Bahrych
    4 years, 2 months ago

    How about having a condensed basic science curriculum (say 12-15 months) and a condensed clinical (1 yr of rotations we haven’t had since PA school, i.e. if we are a medical person this yr would consist of mostly surgical rotations, or if we are surgically trained as a PA then this yr would consist mostly of medicine rotations) and then having a condensed residency, instead of 3 yrs only doing 18 months (providing we are trained as a medical PA and not a surgical PA, etc).  Many of us are already very proficient in the practices we work in and I can assume that if we decide to do the bridge program we would return to the field we worked in before.  So the bridge program would just give us the additional broad base of knowledge and experience we would need to function on the MD level.  How does that sound ‘huskymed?’

  8. 4 years, 2 months ago

    That sounds like a winner Sharon! Certainly more reasonable than the program rumored through LECOM. Truly gets behind the essence of a bridge program ... and rewards us for our knowledge and prior training.

  9. jcbPA-C
    4 years, 2 months ago

    There should be a more efficient bridge.  I had a classmate who was accepted to med school as she started the PA program.  She made the wise decision during the first semester to continue in the DO program.  We have completed a full year of rotations and preceptorships with medical residents already and our PA profession is based on the medical model of education and training.

    Best of luck to anyone who undertakes this new program.  I love to learn but one of the major pros for PA school was the ability to start helping people STAT.  This may be a great option for those just embarking on their career path.

  10. 4 years, 2 months ago

    I am not sure if I am pro this at all. If PAs could get their act together we could with increased residency training be recognized as full primary care providers. Who needs to do all the basic science, etc for WHAT?
    And if I maintain that we are missing the real residency training-so let’s concentrate on that and make a PA to autonomous PA (Medical Clinician) bridge program. Its the lack of vision that has kept us where we are, not the lack of basic science, etc.

    I do applaud the program for being “out there” but I want a profession with vision, not to be a physician.
    Dave

  11. 4 years, 2 months ago

    Dave- one positive spin on this is the following:
    what other ASSISTANTS get credit for a year of medschool when they apply?

  12. 4 years, 2 months ago

    I agree with Eric.  People are missing the boat a little on this.  I don’t think this program, or other future programs like it, would be for people who want to get on a preset path of undergrad. > PA school > Med. school.  Those people would just be going to Med school in the first place.  This program is for someone (like myself) that has been a PA for 10 plus years and wants to consider the possibility of Med. school but finds the task of completely going back and starting over daunting (not to mention financially difficult).  I agree that it would be even better to see a 2-yr pathway, especially if wanting to go into Primary care.  But this is a good start.  And I’m looking forward to any further innovation this program might encourage.

  13. 4 years, 2 months ago

    So what we are saying is that our own profession lacks the ability to design a way for some of us to grow into an autonomous clinician?
    Funny, I think the total opposite.If only we could dream.
    BUT I still do not think they gave us a real break for what we know. Let us take a one year primary care residency and then take the DO Boards. That would be a break. If we are not good enough, we will be better trained PAs. If we are, we can start a primary care practice. I bet a high % would be very good. NOW THAT WOULD BE A REAL NOD TO OUR EXPERIENCE AND TRAINING.
    Dave

  14. drude1
    4 years, 2 months ago

    Dave, that would be great, but probably not realistic.  There will never be a program or pathway that would allow someone to put in less official training than regular Med. school to become a physician.  And unfortunately, because there is no real way to qualify a person’s experience (ie. previous years of actual practice), it will probably never account for much, other than giving you a nod in getting into such a program.  I think a 2 year program would be reasonable, but like I said, at least the door is open.

  15. 4 years, 2 months ago

    If you choose to become a physician I agree with you.
    If you, like me would want to see PAs doing this themselves (after we change the name, etc) then this is no bargain.
    Anyway, like I said kudos to them for even doing it.
    Dave

  16. easppac
    4 years, 2 months ago

    I like the idea of a bridge, but I am with Dave, as a profession we need to look at developing within, not look to other organizaions.  NPs have been doing this, maybe us PAs need to step back and evaluate what future trends we want.

  17. 4 years, 2 months ago

    Check out my just posted blog. It gets my feelings out on this well and throws in some on the DNP. I could not leave my NP colleagues out.

    Dave

  18. 4 years, 2 months ago

    here is the press release as posted on the pa forum today by dr kaufman:
    Lake Erie College of Osteopathic Medicine announces the approval of an accelerated three-year medical school curriculum for Certified Physician Assistants to obtain a Doctorate of Osteopathic Medicine degree. On May 22nd, 2010 The American Osteopathic Association Commission on Osteopathic College Accreditation approved the Accelerated Physician Assistant Pathway (APAP). The pathway was designed and will be directed by Mark Kauffman DO, PA, MS Med Ed as a response to predicted physician shortages. Physician Assistants are healthcare professionals who work under the scope of their supervising physicians. They undergo rigorous didactic medical curriculum as well as at least one year of clinical rotations to obtain the entry level masters degree for the profession. Debate suggesting a change in the entry-level to that of a doctorate degree resulted in the PA Clinical Doctorate Summit of March 2009. The Summit conducted the 2009 Physician Assistant Doctoral Summit Survey. The results of which recognized that many physician assistants wish to become physicians citing the desire to practice independently, the need for professional growth and development, the need for increased medical knowledge and the ability to do more for their patients as the most common reasons to do so. Currently only 4% of PAs return to medical school noting cost and time away from clinical practice as major barriers.
    In 2008, 37% of PAs choose to work in primary care. Growth in demand for primary care physicians will increase by more than 15 percent over the next decade. Dr. Kauffman and LECOM have identified PAs as excellent candidates for medical school as they have demonstrated the ability to successfully complete demanding curriculum, have practiced clinically, and have expressed the desire to increase their medical knowledge. By accelerating the medical school curriculum to 3 instead of 4 years, LECOM will reduce the cost and time away from clinical practice for PAs within this pathway by one quarter. Students will complete the first year of didactic instruction followed by 8 weeks of primary care clinical clerkships. They would then return to the second year of didactic instruction followed by 48 weeks of clinical clerkship training. Applicants to the program will be required to have obtained a minimum of 22 on the Medical College Admission Test (MCAT). The first students would be enrolled in the fall of 2011.

    In response to some of the issues posted to the forum

    1) MCAT: Medical education literature notes that the MCAT is predictor for the ability to obtain core knowledge in Basic Sciences and perform well on standardized testing. It fails to recognize other areas that make good physicians like empathy and the desire to serve. Unfortunately, our accrediting body does not allow a school to pick out subsets of applicants. LECOM requires a minimum MCAT of 22, the level below which students without prior medical training struggle with the medical boards. PAs that have gone through LECOM already have scored lower on the MCAT as we do not take traditional pre-medical sciences often picking up physics, organic and inorganic chem just to meet the med school requirements and take the MCAT. However, despite the lower MCAT, their performance on the DO COMLEX Boards is superior as is there graduating class rank. Again, the rule applies that what you require of one applicant must be required of all, so even considering lower MCAT scores for APAP is not possible. I am not aware of any US medical school that does not require MCAT. If anyone knows of a school that doesn’t, please let me know. I would like to see how they do on their Boards. Another poster recommended taking a MCAT prep course. Good idea.

    2) Stepping Stone: PA’s are an extremely valuable asset to medicine. However, as noted in the press release, once experiencing medicine, some have strong desires to become physicians. The 2009 Summit Survey noted the following four reasons as the most common: Ability to practice independently, Need for professional growth and development, Need for increased medical knowledge and Ability to do more for patients. The program is in no way designed to take practitioners away from one field into another. For those who question why PAs should support those who choose to leave the profession, the answer is; which physicians will be the best supporters of the PA profession, those who are PAs themselves.

    3) Barriers to returning to med school include the financial burden and time away from practice. This program is 138 weeks of training and will cut the total cost of medical school by ¼.

    4) Twelve slots: When applying for new programs, approval is less hampered if smaller numbers are sought. Though barred from the debate process during our application, apparently it was lengthy. Anytime a new program is developed, assurance of its success must be made. With demonstration of success, advancements can be made. As noted by many forum posters, it is a start and no longer an urban myth.

    5) Pre-requisites: Schools do have the liberty to accept some courses in lieu of others. Many applicants will take all of the standard physics, organic and inorganic chem just for the MCAT but you shouldn’t hold your application if you have not had all of these courses. Each application will be assessed individually and other completed courses will be considered and approved as appropriate.

    6) Clinical experience: only completion of your PA curriculum and certification is required meaning you have had at least 1 year of clinical experience. You could go directly from PA school to LECOM.

    7) Applications for the program are through AACOMAS. If planning to apply, put it your application early and notate your PA training.

  19. Marc Benjamin
    4 years, 2 months ago

    Sign me up!!!!!!!!!!!!!! I’m ready..  can I be one of the 50% that does not want to do primary care??

  20. 4 years, 2 months ago

    How many MD & DO schools are there in the USA?......maybe around 250.  And only ONE put forth the time, initiative and creativity to formulate such a great professional advancement option for PA’s.

  21. GoaliePA
    4 years, 2 months ago

    The only way this will work for current practiceing PA’s is if someone else foots the bill.  Gov. or other company.  I was thinking how on earth could I go back to full time school and still be able to pay my bills??  I can’t.  There is not enough incentive!! If there truely is a PCP shortage then a Gov. sponsered program does sound so crazy does it?

  22. 4 years, 2 months ago

    But why lose our best PAs to becoming DOs?
    And you know NO ONE will go into primary care. That will be left up to PAs and NPs. So why not strive for a more independent status after a residency where we could do the same things without the loans.
    Dave

  23. GoaliePA
    4 years, 2 months ago

    Agreed Dave.  One of my Doc’s has said since I started with him, he thinks PA’s will eventually take over all/most pirmary care and MD/DO’s will do speciality work.

  24. Tammara
    4 years, 1 month ago

    In general, the idea is to get the recognition and respect for what we all do everyday. Autonomy is really already in our hands. For the most part, we don’t have to ask a physician what to do with a patient or how to proceed. As a primary care provider and owner of my practice, I do not have my collaborating physician on site. However,as legally mandated, he is available to me if I need him, we have our required “face time”, chart review and document signing every month. Beyond that, I refer to specialists when appropriate and have that network available to me for consult as any primary care provider would normally do. So, the letters after our name is a way to complete independence rather than a way to increase our knowledge. I think we increase our knowledge everyday, and also through continuing education, which are the same CMEs that physicians take.

    I do think we need to unite, because there are some very pressing issues that affect all of us on a daily basis. For instance, a growing number of insurance companies are reducing the reimbursement to PAs. This is really outrageous, since we do provide the same service. Don’t we? I don’t think I, or any of my colleagues, provide “reduced medical care”, so why should we accept reduced reimbursement. Isn’t that the reason a physician hires a PA? I mean, to mirror their care for the patient. Or is it to hire someone who will provide less care? How about the case of surgical first assist PAs. Do they provide a different level of service than an MD/DO first assist? I would challenge a surgeon to say they use a PA because they provide less service. Sound ridiculous? Well, that’s because it is. Therefore, we should be reimbursed the same as physicians when we provide the same service. As a business owner, I cannot pay my employees less, or any of my other overhead costs, just because I am a PA. I also agree with the comment that eventually PAs/NPs will probably take over most of the primary care. (I think we already have) But, will that be reduced care? I don’t think so. Why should we accept less reimbursement? Let’s get together and address that issue. I have already contacted the AAPA regarding this issue, but am not encouraged that they will do much in this arena. It will be up to all of us to unite and bring this issue to the forefront and fight for equal reimbursement for equal service provided. There are already some state laws on the books that legally address this issue, but as an individual, it is too difficult to fight the insurance industry. 

    Back to the original topic of “the bridge”. I think it is a bridge to nowhere. (except to more debt) We can make our own bridge if we all unite and make our voice, knowledge and profession heard.

  25. 4 years, 1 month ago

    Totally, totally agree. PLEASE BECOME A REAL PART OF OUR COMMUNITY.
    We need people from both professions who believe.
    Dave

  26. eileenrr
    3 years, 12 months ago

    The only reason to consider this program is the lack of recognition as collegues and appreciation for our contribution to patient care from the established medical community… not the patients. I agree with Dave, we can participate in evolving our profession to accomodate the changing landscape of healthcare. We are a essential to the process.

  27. 3 years, 12 months ago

    If I wanted to be a world renowned cardiac surgeon and lead the team and that was my dream, I would consider. And then why would I have become a PA or NP? But people change.
    Otherwise, agree-we should evolve our own profession starting with the name.
    Thanks.
    Dave

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