Re: Nurse Practitioner or Physician's Assistant? Originally Posted by jess818 
David, I was hoping to get your opinion because I read this forum quite frequently and I see that you answer a lot the questions leading me to feel you have a real opinion on the matter. I ultimately want to practice as an NP but I am not yet an RN and would have to attend an accelerated BSN program. I could however start a PA program a year and a half from now and then be done in 27 months. I am nervous that going into PA school with virtually no patient care experience would be unfair to potential patients but I have been told that the school will prepare me. I also want to primarily work in primary care which seems to be more of an NP dominated area (at least to me) where PAs do a lot of ER and acute care. I know I can go be an RN and then go back to PA school but I just don't want to make any horrible decisions. Also, I live in Ohio which is HORRIBLE for PAs. Thanks for any advice
In the end its going to come down to your comfort level. I have a different view of non-hce PAs than most because of where I trained. The program I went to takes half the class as freshman. If you keep a B average do some volunteer time and do well in core classes you enter into the PA program after your junior year. The class I was in had around 40% of the class that started. The rest of the class is made up of people with HCE and a bachelors (my part of the class). So I have the experience of watching non-hce students up close and seeing how they do. We also get together from time to time and I've been able to keep track of a fair number.
From an academic perspective, this has been examined a couple of times. There is no measurable difference in graduation rates, passing the PANCE or entry into practice between students with or without HCE. The student with HCE may have an advantage in some parts of the clinicals but it probably is a wash given the non-HCE students more recent academic experience (and youth).
Also what a lot of people forget is that non-HCE programs are on the average longer and have more clinical training (slightly more didactic training). Essentially they substitute program time for medical experience. The statistics say they are doing this successfully.
The key in my mind is early exposure to the medical environment. My program had us doing H&Ps in the hospital on real patients from the fourth week. We also to shadow PAs in various specialties which helped focus us on why we were there. Programs that follow the older medical school model of didactics without patient interaction tend to be the ones where the students have problems (regardless of HCE).
As far as primary care, remember that one third of PAs work in primary care. It may look like its NP dominated but there are quite a few Ohio PAs working in primary care. The main issue is once you get used to the specialty money its hard to go back
. Interestingly non-HCE graduates are more likely to go into primary care than those with HCE. No one knows exactly why but the primary theory is that someone with HCE will gravitate back to the areas where they had HCE (OR, ER etc). On the other hand non-HCE students rely on their training which in most cases is weighted toward primary care. And don't worry Ohio is slowly joining the rest of the nation. PAs can even scrip there now.
Ultimately you have to decide what you want to do. I looked at nursing initially but PA school more closely fit what I wanted to do. Your the only one that can answer that.
David Carpenter, PA-C
Re: Nurse Practitioner or Physician's Assistant?
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