PA/NP to MD Bridge??

Specialties NP

Published

Does anybody think that there will ever be a bridge program like that? I think it would be a great idea. Anybody else?

Well, it's obvious I disagree with Papadoc, but I wanted to point out a few things.

You were saying that you were not given an advantage over new med students being an RN in the BASI SCIENCE courses. This is a "duh" in my opinion as NPs nor RNs have the basic science courses med students take regarding certain chemistry/ochem courses etc. However, this is what such a bridge program could offer.

Secondly, I don't know what type of RN role you have/had, but when I was an RN I had to tell residents what to order and WHY because of my previous experience. Again, I didn't take a full year of o-chem, but I knew why you gave potassium and D50 to a hyperkalemic patient.

The role of the "basic science" courses--mind you of which are 2 years--is being questioned as useful for being a good doctor, and while the challenge is resisted, it is there. This is not to say basic science courses aren't important, but you certainly can't say they are what make MDs better than NPs since many MDs don't remember the basic science courses anyway. You'll see--you will find some of your basic science courses are in the end not very useful. Again, a bridge program could cover those basic science courses people think are so important.

As for the usefulness of "bootcamp" for medicine, this is also an ongoing argument, as the good ol' boys who run medicine are being replaced by some women and more balanced men who look at things from a diffferent angle. Everyone know the studies out there about "intelligence" and how to measure it or what we can't measure. An NP with experience has been through boot camp of real world practice. Don't forget such a bridge program would have admissions requirements. And don't forget there are a lot of bad medical schools out there, and bad doctors, who make bad decisions despite going through "boot camp."

I think you cannot say a PA is better prepared to be an MD thaan an NP, as a PA prpgram does not measure intelligence any more than an NP program. Just does more of those "basic sciences" courses everyone is so big on.

Also, I know you said you can't know unless you've done both. I will have to say that in my FNP program, I know of 2 students who applied for my year and did not get in, but they got into the associated med school the following year. So, who's more picky in this case? And I also know of FNPs who've gone back to med school, and they did it for money and prestige, and felt the basic science courses were a waste--albeit necessary one--of time. It did not affect their practice. They have done both and they can affirm that they learned more, but that a bridge program woud have sufficed and saved a lot of people and underserved patients a lot of time and money.

I hope this helps in giving a voice to those who HAVE done both. I am glad you are in medical school, Papadoc, but please don't think it's the holier-than-thou place they want everyone to think it is.

What can I say? I feel your pain. And I must tell you that your friends who went into medicine for money and pristige weren't very bright. Because they will get neither. But one important thing the've learned that basic science were not as important:uhoh3: BTW USMLE step1 (basic science) score is looked at as your ticket to the residency. Many program directors don't even look at the applicants below a certain score. Most ppl haven't even taken stepII (clinical) when applying for a residency match. There is a lot more emphasis these days on medical genetics, biochem, and cel/mol biology than good ol' path, physio, antomy, neuroscience etc. You've got to know those for modern farmacology and pharm kinetiks. So more and more of basic science is being considered "good" doctoring. It's very hard to argue with indoctrinated ideology. BTW I wasn't talking about me as RN not having advantage at med school. I did say that I had a lot of classmates who wereNPs and PAs, PTs , chiros etc. Of course, most of us would shine in clinicals over the sculls full of mush, who only learned things in theory. But the trick is to get there. This is where the the real fun begins. So there is nothing unusual in you teaching new interns what IVs to order etc. I've done it gazillion times. My background is (hospital): med/surge, ER, psych/chem dependency, and (paper pushing) home care, UR/managed care. I've said it before, and I'll say it again, you don't know what you don't know until you go thruogh e whole thing. My take on all of that was just like yours when I talk the talk, but my tune quickly changed when I walked the walk.

But we could always agree to disagree

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I have heard of a program such as this through a Carribean University but question how good they are or if they are accredited in the US.

I believe you're talking about this place http://www.uhsa.ag/

...But...

DO NOT GO THERE if you want to practice in U.S. I o not know on or even of a one their graduate practicing medicine as a LICENSED physician.

I just wrote the whole "poem" about legit and illegit Carib med schools. But my post somehow disappeared, and I can't retrieve it now. http://www.valuemd.com is a good site for getting some useful info. But personally I would not look beyound these schools (in that order)

St.George's University SOM (Grenada)

ROSS Univ SOM (Dominica, West Indies..NOT...Dominican Republic) I went there :angryfire

American Univ of Caribbean SOM (Sin Maarten:Dutch/French)

SABA Univ (Saba, Dutch Anthelies) a 5X5 square miles piece of rock sticking out of the ocean in the middle of nowhere, and no beach:devil:

St.Matthews University SOM (Grand Cayman) the most civilized (because it's still British territories) but very,very expensive island. Also SMU was disapproved by California Medical Board. Damn this Hollywood:devil:

Good Luck to All;)

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Specializes in Education, FP, LNC, Forensics, ED, OB.

hello, papadoc,

i am curious since you are no longer in med school, have you considered going to the np or pa program? i know you discussed this in another thread (and, possible crna, too.).

what have you decided?

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hello, papadoc,

i am curious since you are no longer in med school, have you considered going to the np or pa program? i know you discussed this in another thread (and, possible crna, too.).

what have you decided?

hi siri!

good to hear from you again . i didn't notice your post right away. i looked at all of the options np, crna, pa. to be honest with you none of these will provide me with the satisfaction of being the physician. i know many ppl choose crna for the buzz of making some $$$, but it's not exactly what i invision myself doing. my classmate from my acupuncture school is a crna with over 18 years in the business. she absolutely loves what she does. but realistically, it's very hard to be in or for such long periods of time, without being able to have a break etc. i don't mean being lazy, but for my personal health reasons i need to keep my blood sugar stable, and eat, in fact, very little but with more or less even intervals. so "gas" is out for now.

pa is kind of starting at the bottom of the food chain by crossing over to medicine, altough not completely rulled out. np is a viable option...but...i realized that my mistake was not going to medical school alltogether, but in the route i chose to get there. basically, it was exactly 2 yrs ago, when i left for dominica (ross university som). i chose the path of least resistance, applied only to off shore schools, got in all three applied to. but i cut some corners,never took mcat, and didn't brush up on some basic stuff before going. i didn't take into consideration te adjustment to the 3rd world hellhole in the middle of nowhere, and mos importantly being away from my daughter and family. yes, i know...med school is a sacrifice, but this wasw unneccssary stress being added for the reason of my own poor judgement, and i must admit,lazyness. almost all ppl i've met there applied in the states and canada first. so the carib schools are like spill over, and have the stigma being attached to them. of course, it doesn't mean that all students over there are sub par, but many are, and should never have been admited in the first place. i guess same happens in u.s, but if get through you don't have to jump through so many hoops as imgs do. anyway, i don't want to go on this rant much longer. my plan is to keep working on mcat. if i can rock it, i'm sure i'll get in stateside, or in d.o. schools. if not...well, may be there is a message there from above. i'm quite happy between rn and acupuncture. but going away again...for me is not an option:nono: there is a lot more to the the medical school/residency endevor. i'm not likely to succeed without full support of my family. and it disapears over time, when i'm away. i just don't want my dream to become their nightmare.

o'k , sorry for the long rant.

have a good one

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Specializes in ICU, CVICU.

I don't see it happening. A think a better alternative would be a nurse-doctor degree where you could have the title Dr. but you'd have different credentials. Does that make sense. It would be another alternative to MD and DO.

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Very true labcat, and there are already DrNP programs being started. Though, DrNPs need to be careful with the "Dr" title when in a pt. care setting. It is too confusing to the pts who understand "Dr." meaning physician, which is totally different than Dr of Nursing. It also doesn't make them very marketable b/c physicians are turned off by the "dr" thing.

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i think that it is about time we raise the standard of care. i do not feel that dnp need a md to be a physician. mds have stolen the term "doctor", which was originally given to a "doctor of philosophy". personally, i think md jobs are being challenged and they are sweating. i would rather have a nurse practioner, who has been in the field for over 10 years than a resident work on me any day. i have worked in the hospital for over five years and the nurses know more than the 3rd year residents. i come from a family of doctors and nurses. most times the nurses in my family catch the problem before the docs because they take the time and treat the patient not the disease. the degree doesn't cure a patient, but a well thought out diagnosis does based on patient's history, current symptoms, personal life and the ability of the physician to collaborate with the staff to execute the treatment. it is time we raise the standard there should be a "doctor of healthcare", which can be achieved post phd or md route.

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Specializes in ED, Cardiac Medicine, Retail Health.

I am sorry, in no way does NP/PA ever equal MD. Not even close. Just look at the course work involved for both. Even PA education seems a bit more rigorous than NP education. I want to be an NP, and am applying to school soon, and I do appreciate the role of an NP in health care, But comparing the two is like comparing apples to race cars in my opinion.

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I can see a potential PA to MD/DO bridge (I believe a PA to DO bridge was recently approved actually...maybe a well-informed PA can weigh in). However, I think it's very unlikely for there to be an NP to MD/DO bridge. PAs are trained in the medical model. Their training shares some similarities to the training physicians receive. On the other hand, NP/DNP training shares almost no similarities to medical training. In my opinion, that's one of the main reasons that there will likely never be an NP to MD/DO bridge. The difference between them is too great to bridge without having NPs/DNPs go through the standard med school process.

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Specializes in Family Practice; Emergency Medicine.
I can see a potential PA to MD/DO bridge (I believe a PA to DO bridge was recently approved actually...maybe a well-informed PA can weigh in). However, I think it's very unlikely for there to be an NP to MD/DO bridge. PAs are trained in the medical model. Their training shares some similarities to the training physicians receive. On the other hand, NP/DNP training shares almost no similarities to medical training. In my opinion, that's one of the main reasons that there will likely never be an NP to MD/DO bridge. The difference between them is too great to bridge without having NPs/DNPs go through the standard med school process.

are you an NP, dgenthusiast? either way, what you are saying is completely untrue about NP curricula; the program I attended was directed ENTIRELY from the medical model.....you can argue some semantics based on course titles...sure there is some required nursing fluff in there......but, our core work consisted of intense pathophysiology, pharmacology, a physical diagnosis course and lab......lecture and clinical in pediatrics, adult, geriatrics, psych each respectively (FNP)......already being RNs we had previously completed anatomy, physiology, microbiology and undergraduate bio and chems.......we were taught to formulate differential diagnoses based on a complaint or problem.......and treat appropriately...(MEDICALLY).....so, I don't know what program model you are speaking from....but you can't practice medicine as any kind of provider unless you work 'from a medical model'..........I personally don't care if there is or isn't going to be a bridge program in the future.......I don't need to be considered equal to a physician.....and don't claim to be and am NOT....! I'm just tired of people who don't even practice as an NP or PA or PHYSICIAN.....making claims on what one is or isn't.......NPs and PAs are not physicians.....but......NPs and PAs ARE [trained to provide MEDICAL care for acute and chronic health problems utilizing a variety of therapeutic treatment options......and I'm pretty sure you could say 3 professions that share the same function generally speaking are kinda similar???!!! bottom line is we mid-level providers are out here autonomously and safely and effectively providing primary care to our patients and are pretty darn good at it.......

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are you an NP, dgenthusiast? either way, what you are saying is completely untrue about NP curricula; the program I attended was directed ENTIRELY from the medical model.....you can argue some semantics based on course titles...sure there is some required nursing fluff in there......but, our core work consisted of intense pathophysiology, pharmacology, a physical diagnosis course and lab......lecture and clinical in pediatrics, adult, geriatrics, psych each respectively (FNP)......already being RNs we had previously completed anatomy, physiology, microbiology and undergraduate bio and chems.......we were taught to formulate differential diagnoses based on a complaint or problem.......and treat appropriately...(MEDICALLY).....so, I don't know what program model you are speaking from....

The medical model is a strong basis on basic sciences (pharm, path, phys etc) with tens of thousands of hours of clinical training where you work admitting and working up patients.

About 1/3-1/2 of DNP credits are non-clinical fluff. 3 credits of pharmacology and 3 credits of pathophysiology found in the average DNP or MSN are not "intense." Undergraduate anatomy, phys etc are not doctoral level courses. 1000 (or less) clinical training hours are not a lot of hours.

You did not attend a program based on the medical model. You attended a program based on the nursing model.

The programs are so disparate that there could not be a bridge program.

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NP education would maybe knock off 2 science courses needed in medical school and that is assuming that those courses are taught at the medical school level. So it would still take a full 2 years to achieve the science coursework needed. NPs have clinical experience in ONE area, so they would still need to do all the other rotations which would take another 2 years... so even counting in the previous education, it would still be a 4 year program (unless you did one of the few 3 year programs for those going into primary care). I can see PA school knocking off a year because PA students do a lot more of the science coursework and a lot more of the rotations, but the education would have specifically dedicated to PA-MD students as you couldn't just knock off year 1 - you'd have to retake the coursework but abbreviated.

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