BSNs at Disadvantage for PA School?

Smitty08 · Oct 28, 2009

Sorry but I think that PA who advised you has rocks in his/her head. I'm not sure why you would choose PA over NP, especially when one builds on your knowledge already. I reject the idea that one path is "medical" - they both are! I can't imagine any real PA school holding a "BSN" against you, if you wanted to go in that direction, that just doesn't make any sense. If you choose the PA route, I would still think that would be helpful experience.

core0 · Oct 28, 2009

Hi everyone!
I'm 29 years old and headed back to school after burning out in another field. I already know I'd like to stay with it through an advanced degree, but the question of "Nurse Practitioner" vs "Physician Assistant" is one I'm still trying to grok.
Anyway, I stopped six months short of my first bachelor's degree, so I'm not quite a 'second-degree'er. I thought it would be best for me to pursue a BSN in nursing first, as then I could get that coveted "healthcare experience" (and an income, hooboy) and have a few years to get a better idea of what the different roles in the medical world really do. And then when I was comfortable with a decision on my path, apply to NP or PA school.
But recently, I was told by a PA that people who get their BSN are actually at a disadvantage when applying to PA school, and that this wasn't a good idea at all. She said if you get a BSN you've basically trapped yourself in nursing; you've got to make the decision about "nursing" or "medical" straight off the bat, and do BSN for the former and biology/chemistry for the latter.
This has kind of panicked me. Do I really have to make this "path" decision RIGHT NOW, before any experience or anything? Have any of you found this to be true/not true?
((If I put this in the wrong forum, I apologize!))

Most PAs have relatively little clue what goes on in the admissions for PA programs. Nationally 5-10% of any given PA class are RNs. My class for example had 5 RNs in a class of 50 and many programs are similar. Programs differ widely in their criteria but generally nursing will be desireable experience. For programs that differentiate among medical experience its generally listed with Paramedic and Army Medic at the top rank of medical experience.

A couple of caveats. Clinicals in the nursing program do not count as experience. Also the "trap" that you may find yourself in is that you will not meet pre-req requirements for most PA programs. This means that you will have to take additional course work after your BSN to get into PA school. With the competitiveness in many nursing programs nursing is not the easy answer for medical experience that it once was.

David Carpenter, PA-C

Darjeeling22 · Oct 29, 2009

Hi!

Smitty - Having read what I have so far about NPs and PAs, I'm not sure why anyone would choose the (more restricted, from what I can glean) PA route either! But there must be reasons and I want to be sure I understand everything before having to make a decision. Luckily it's still quite some time away :)

Core - Thank you for that! When I said "healthcare experience" I more meant the opportunity to work after nursing school, in direct patient care, before going further. I was just over on a PA forum browsing a thread where people posted their experience before applying to PA school; I saw folks with 15-20 years of EMT/therapist/etc experience who were still rejected from PA school. YIKES!

BmoreCRNP · Oct 30, 2009

The only reason I can see someone choosing PA school over NP school is they may feel the education is similar to medical school, thereby giving them an advantage. They probably get better practicum experience (xrays, suturing, procedures, etc) than NPs do. However I think PA school is designed that way because someone can theoretically enter without having prior medical knowledge or experience. Therefore to make sure PAs are completely competent the program is more rigorous. That's just my theory. Most NPs have been nurses for a number of years before having gone back to school. I understand the role of an RN is different than an NP's, but I do believe the RN experience counts for something.

jjjoy, LPN · Oct 30, 2009

I do think there's some truth to the OP's aquaintance's comment, though it's not absolute nor completely accurate. The requirements for most RN/BSN programs do not include the level of science and math courses that most PA programs require (though there are always exceptions). Training and working as a nurse does give you an inside perspective on health care, but it IS training and working as a nurse. There is TONS of nursing-specific material dumped on stduents as well as nursing-specific research projects, nursing-specific clinicals, nursing specific presentations and community outreadh projects. And while it's noble to want to get one's hands dirty and get some real experience as a nurse in an acute care setting, the workloads are often so heavy and hectic, that one may find that it takes longer than they'd think to really begin to focus on much more than just making through the day. Once one has earned that nursing degree, it can be awfully tempting to just apply to the next level of training instead of 'wasting' one's own time, and the facility's investment in oneself, working in a role that you plan on soon leaving anyway. Of course, it depends upon the person.

On a side discussion...

My understanding is that when PA programs began, the target group was army medics, who did have previous training and experience. That somehow morphed into a self-contained 2-3 year PA program that may accept students without any prior health care experience. And my understanding of NP programs is that they primarily were developed to "bridge the gap" for experienced nurses who could practically already function as a mid-level. The NP certification would allow them to legally practice beyond the usual scope of nurses. But there's likely much more to the stories than that.

core0 · Oct 30, 2009

The only reason I can see someone choosing PA school over NP school is they may feel the education is similar to medical school, thereby giving them an advantage. They probably get better practicum experience (xrays, suturing, procedures, etc) than NPs do. However I think PA school is designed that way because someone can theoretically enter without having prior medical knowledge or experience. Therefore to make sure PAs are completely competent the program is more rigorous. That's just my theory. Most NPs have been nurses for a number of years before having gone back to school. I understand the role of an RN is different than an NP's, but I do believe the RN experience counts for something.

PA programs are designed to do one thing, produce minimally competent PAs. How you get there is up to the school. There is a PA blueprint put out by the accrediting body that describes what areas must be taught and what experiences the student must have in the clinicals. Schools are accredited on whether they meet that standard, whether they graduate a sufficient percentage of students, and whether those students pass the certification exam. Within that blueprint there is a certain amount of latitude and there exist schools that will emphasize primary care or surgery for example.

Its also about how the profession evolved to answer the other posters question. The original Duke program took Navy corpsman and trained them as PAs. However within a few years there were multiple other programs that were training "physician extenders" as they were then known. Among the various innovations tried was varying degrees of medical experience (including none) as well as various specialty programs including surgery, primary care, orthopedics, pediatrics and OB/GYN. Over the years these programs coalesced into the system that we see today. A few remnants of the specialty programs exist such as the two remaining surgical PA programs or the remaining MEDEX programs. There are other stand alone remnants around such as the orthopedic PA and the anesthesia assistant which is now a separate profession.

The reasons for RNs going into PA school are varied (at least according to my classmates). Some wanted a medical model. Others wanted to go into specialties that were traditionally PA friendly such as orthopedics or surgery. Others looked at the local job market and decided that their chances of doing what they wanted to do were better with a PA degree. As been stated here, there is tremendous variability among local markets.

David Carpenter, PA-C