Quote from prairienp
Did the AAPA also oppose the BS? master's degree? I thought I read the a disproportionate share of PAs opt to do speciality versus rural primary?
The AAPA's official position "endorses the baccalaureate degree as the current minimum degree for physician assistants and encourages all physician assistants to possess a minimum of a baccalaureate degree."
The use of endorses here is important as opposed to mandate. There is further policy that PA education occurs at the Masters level. However a number of attempts to mandate the masters for PA education have been summarily dismissed. APAP (the association of PA progragms) states the following:
1. The Association of Physician Assistant Programs (APAP) recognizes that PA education in accredited programs is conducted at the graduate level and recommends that PA programs grant students a credential* reflective of this level of curriculum.
2. The credential granted should reflect the institutional mission and needs of the local and regional communities served by the program, and maintain the academic integrity of the curriculum and the competency of students. After careful study or reaffirmation of its mission, a program may determine that offering an alternative credential (non-masterís degree) may better serve its institutional mission and the needs of the community."
Their statement is essentially the status quo. They want the masters but recognize that some programs/communities cannot grant a masters degree.
As far as specialty movement. The number of PAs in primary care remained static while the percentage of PAs in primary care is falling. The numbers and percentages of PAs in specialty care is increasing. Depending on the numbers primary care will probably cease to be the largest percentage somewhere around 2010. One study shows that programs changing from bachelors to masters had an increase in the percentage of students going into primary care. Another study however, showed that non-masters programs had a larger percentage of students going into primary care (even when including a surgical non-masters program). Masters programs also decrease the number of under-represented minorities (although this effect is uncertain).
Quote from prairienp
Interesting in that you say there is no difference between a certificate/Associates, bachelors or Masters PA. If this is true why ? Are there studies that support the "null"
There are a number of studies. The only real metric we have is pass rates on the PANCE and graduation rates. These are identical. There are other studies that look at the first year salary and they are generally identical. This should not be a suprise. The way that PA education is structured means that an certificate program and a masters programs students are taught the same material according to the educational blueprint. Generally the change from a bachelors to a masters program has been adding a research class and a paper (at least in my program and others I have examined).
Quote from prairienp
I still see PAs following the NP route, like it or not you will see some form of clinical doctorate for the PA with in the next 2 years. I have been around for each educational leap, 1st the NPs jump, soon afterwards the PAs jump.
We haven't jumped yet. While the majority of PA education is at the masters level there are still certificate, bachelors and associates programs being created. There have been associates programs created in the last four years. There are a couple of issues that make it different than the NP front. One is that there is no group calling for a doctorate. There is in fact no group currently calling for the masters to be required. There is in fact a large group that are firmly opposed to any sort of degree requirement. The four main arbiters of PA policy (AAPA, APAP, ARC-PA and NCCPA) are in agreement here. There is some push to make the masters mandatory from some of the masters programs but there are enough non-masters programs to oppose this. A summary can be found here: http://www.aapa.org/clinissues/DegreeIssue1999.html#ref
and here from AAPA: http://www.paeaonline.org/0500docs/Webpaper051800.pdf
The other issue that PA programs and the PA profession will have to consider with the degree issue is opportunity cost. On the average
(yes I know that there are exceptions) PA students are not competitive for medical school they are extremely competitive for DO school. The top 20-30% of PA students would probably be competitive for many medical schools. Looking at the prerequisites there is only 1-2 classes needed for medical school. If the PA profession goes to a clinical doctorate presumably most students would shift to medical school leaving less competitive students for PA school.
The one current PA doctorate (Baylor) is two years of full time work (40+ hours per week). It consists of six months of didactic, six months of EM research and 12 months of clinical rotations in EM, anesthesia, toxicology, EMS and other areas. Adding this to the typical PA program would make the program the same time frame as medical school. At that point it does not make sense to go to PA school.
Given nursing's prediliction to try to make the masters mandatory for PAs (Ohio and Missouri) the masters may eventually be mandatory. However, it will be over the resistance of PAs that understand the difference between clinical competence and a degree.
David Carpenter, PA-C