Clinical Doctorate in Anesthsia

[Lambert5883]

I've read and heard that eventually, 2011 - 2013, the entry level degree into Nurse Anesthsia will be a Doctorate (comparable to PharmD). Can anyone at this time offer any specifics on how this is to be implemented?

I was pretty excited about reading this. I hope that it is more than just a measure to appease egos and status and more of a venture into an advanced knowledge base (research and clinical).

Do you think that it is even needed?

[alansmith52]

I wish we didn't have so many nay sayers within our own ranks. It doesnt' help our cause.

as far as widing the gap between doctors and nurses.. so be it. I say

I dont wanna to cozy up to any of them anyway. true competitors can not be friends, allies, teamates or colluges. and so it is with us and them. they may be nice to your face. but that is only to kill you with kindness.

remeber who you are and what you stand for.

[Maxs]

we all know that....i think the poster knows that for sure

i think the poster was relating to a clinical setting, probably O.R.

DUH!

We all don't know that because you obviously don't know that, Podiatrists introduce theirselves as doctors in clinics. Perhaps you forgot to read the part where the podiatrist introduces him/herself as a doctor in a clinical setting. I see where some of you are coming from. This is a nursing profession and there can't be such thing as a nurse doctor because it just doesn't sound right to your ears. Learn to Live with it. More education will mean more freedom for Nurse Practitioners or spand their practice of scope as the public is demanding them to be their primary care providers. Also, this will not affect the shortage because it wont be mandatory it's an optional. Just so you know, CRNA's don't only work in hospital settings, some travel to hospitals, private clinics to MRI and X-ray facilities.

Maxs

[Lambert5883]

We all don't know that because you obviously don't know that, Podiatrists introduce theirselves as doctors in clinics. Perhaps you forgot to read the part where the podiatrist introduces him/herself as a doctor in a clinical setting. I see where some of you are coming from. This is a nursing profession and there can't be such thing as a nurse doctor because it just doesn't sound right to your ears. Learn to Live with it. More education will mean more freedom for Nurse Practitioners or spand their practice of scope as the public is demanding them to be their primary care providers. Also, this will not affect the shortage because it wont be mandatory it's an optional. Just so you know, CRNA's don't only work in hospital settings, some travel to hospitals, private clinics to MRI and X-ray facilities.

Maxs

I think the intent is to have the doctorate(clinical) be the entry level degree in Nursing Anesthesia, sometime in 2011 - 2015. So, it won't be optional for those coming into the profession at that point.

[mwbeah]

"This is an incorrect assumption. DNP is a terminal degree, a full fledged academic doctorate. It is not a research doctorate. Neither is a MD, by the way! True, a PhD is the top of the totem pole, and qualifies a person for higher academic positions. But do not count out practice doctorates. I know several tenure track faculty in this category."

I am reading this post and am amazed at the lack of understanding that people have with the definitions of the "doctorate" degrees. The problem I see is this, if we as healthcare professionals cannot differentiate these differences between a practice doctorate and a research based doctorate then how will this affect out relations within the healthcare community and the public.

After reviewing what is being added to these practice doctorates, it seems that these programs are not adding more clinical hours. It appears that the increase is based on theoretical types of classes. We must understand that if this is going to work, we have to increase the focus on clinical hours and cases. What I mean by that is that the average MD who goes through an anesthesia residency obtains roughly 2000 cases (at least in the military) prior to graduation. We are requiring (what is it now) I believe 550 cases for board attendance. In my opinion, I think that at least another 1.5 years of curriculum should be added yeilding a total of 4 years to garner the practice doctorate.

I am attending a research based PhD program in neuroscience and the requirements for my program involved intensive study in advanced biochemistry, neurophysiology, neuropharmacology, anatomy and physiology, etc. It also requires that I have oral and written board exams to advance in my candidacy for laboratory work. This program can take anywhere from 4-7 years to complete depending on the individual.

I understand the intent to advance the practice but we must not rush into this foolhardy. Our credibility could (and it appears already is) suspect.

Mike

[NeuroNP]

We must understand that if this is going to work, we have to increase the focus on clinical hours and cases. What I mean by that is that the average MD who goes through an anesthesia residency obtains roughly 2000 cases (at least in the military) prior to graduation. We are requiring (what is it now) I believe 550 cases for board attendance. In my opinion, I think that at least another 1.5 years of curriculum should be added yeilding a total of 4 years to garner the practice doctorate.

I didn't realize that the clinical caseload was so different! Well, that makes me understand a little more why MDAs feel they're better trained. I definitely think that CRNAs should up that requirement. I mean, for a 3 year residency, they're doing more cases in each year than SRNAs are total.

At the same time, I can see where that would present somewhat of a burden for the SRNA. MDA residents are paid (albeit not a lot :) ) whereas SRNAs are PAYING. Maybe if there was some sort of "residency" after school where a CRNA could get more clinical experience while still in a learning environment, but recieve a stiped for living expenses instead of paying tuition.

I for one would like to do more than just 550 cases in the course of my training.

[rn29306]

I for one would like to do more than just 550 cases in the course of my training.

This is the bare minimum to graduate and take boards. I sincerely hope there is no program where this is the average for their graduates. Most of our upperclassmen graduate with 900 - 1100.

[mwbeah]

This is the bare minimum to graduate and take boards. I sincerely hope there is no program where this is the average for their graduates. Most of our upperclassmen graduate with 900 - 1100.

I would say you are stretching it a bit. More than likely the cases obtained (I mean TRUE cases, not just showing up in the room and taking credit for it) is usually between 650-800 prior to taking your boards (I certainly would like to know where your program is at so I could research your numbers).

Point is that if we are moving toward a clinical doctorate, we should have a system to increase our clinical hours, like I said before in my opinion it would require another 1.5 years and make it a full time four year program.

[NeuroNP]

This is the bare minimum to graduate and take boards. I sincerely hope there is no program where this is the average for their graduates. Most of our upperclassmen graduate with 900 - 1100.

OK, even 1100. That's still almost half what an MDA does in residency. I think if CRNAs (which I hope to be) are going to say, "We do the same job as MDAs, so we should have the same rights and pay" then the training needs to get a little more commensurate.

I'm ok with saying, "no, we didn't go to medical school." From what I've been able to tell about medical school and CRNA school from talking to people who've gone to them, very little (if any) anesthesia is learned in med school, and most of the phys, anat, and pharm that you learn in med school, you get in CRNA school (at least as far as it applies to the OR/Anes setting, again, I could be wrong). But I think as long as MDAs are doing 2x the cases in training, they are still going to be able to say they're more qualified. Experience counts.

I agree with Mike. If it's going to be a clinical doctorate, increase the clinical. Not the theory. Increase the number of cases done.

[DreamweaverSRNA]

FYI - A physician anesthesia residency is 4 years in duration, not 3.

My question: where are all the doctorally-prepared nurse anesthesia professors going to come from to run these doctoral-level programs? CRNAs with a doctoral degree are few and far between at this time.

Also, if we are going to move toward a clinical doctorate, shouldn't we be discussing quality as well as quantity of cases? Who cares if you have 1000 cases if the vast majority of them are healthy patients for hernia repairs, knee scopes, and easy outpatient procedures?

Signed, A SRNA spinning my wheels at a clinical site doing those easy outpatient procedures so that anesthesia residents can do thoracotomies, kids, neuro, and complex specialties!

[mwbeah]

Also, if we are going to move toward a clinical doctorate, shouldn't we be discussing quality as well as quantity of cases? Who cares if you have 1000 cases if the vast majority of them are healthy patients for hernia repairs, knee scopes, and easy outpatient procedures?

I couldn't agree with you more..................... That has to be part of the solution. As for the PhD instructor role (of which I hope to be very soon)....that is a whole other can of worms. I have replied earlier about the lack of understanding when differentiating between types of degrees.

Mike

[NeuroNP]

FYI - A physician anesthesia residency is 4 years in duration, not 3.

Actually, some are still 3 with a Clinical BAse Year required before you start. That's why I said three years. Even with the four year residencies, it's the same amount of Anesthesia, just spread out over 4 years with the Clinical Base Year's rotations spread out over four as well.

Also, if we are going to move toward a clinical doctorate, shouldn't we be discussing quality as well as quantity of cases? Who cares if you have 1000 cases if the vast majority of them are healthy patients for hernia repairs, knee scopes, and easy outpatient procedures?

Yes, by all means! I would HATE to be relegated to doing the "scut" cases so that MDA residents can hog all the "good" cases. That is an EXCELLENT point and one that should definitely be addressed as well.

[Sheri257]

Purely from a practical standpoint ... but couldn't a doctorate requirement hurt CRNA's with the battle over AA's?

From what I've read on this board, I thought the CRNA schools were trying to increase enrollments since the major justification for AA's is the anesthesia provider shortage. If a doctorate becomes the norm, couldn't that worsen the shortage and, potentially drive the ASA's efforts to get AA's accepted by more states?

Afterall, more educational requirements usually means more barriers of entry into the labor pool. Just curious if anybody has any thoughts on this possibility ...