PA/NP to MD Bridge??

bethem · Mar 14, 2006

I hope there will. Here in Australia, it would not surprise me if they ended up having a NP:MD conversion, probably with the caveat that the new doctor works in rural health for a certain amount of time. I hope it happens because I really would like to do medicine, but the amount of time it will take with no income and full-time study, close on the heels of three years of little income and full-time study doing nursing, is too much for me. I do want to become a NP, but if they had a conversion later on I would be on it like a shot.

Papadoc · Mar 14, 2006

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

I don't think it's a great idea at all(see my post on the link below). But how many years/months of the med school do you think you deserve for the advanced placement(if you are RN/NP). Have you seen medical school course outline? PA education closely resembles med school, but is much more abbreviated version of both basic science, and clinical rotations. If you want to be a doctor...just go to medical school. It's rough, but cutting corners is even worse,IMHO:nono:

Joebird21 · Mar 18, 2006

I don't feel your cutting corners. I mean if you go to school for 6 years to become an NP and NP's can diagnose and prescribe meds already then why not have a bridge program that allows you to cut off a year or two?

Papadoc · Mar 19, 2006

I don't feel your cutting corners. I mean if you go to school for 6 years to become an NP and NP's can diagnose and prescribe meds already then why not have a bridge program that allows you to cut off a year or two?

If you go to school for that many years to become an NP, then why do you need a bridge or a tunnel, or anything else. The # of years to become a midlevel is not equal to the in debth training that med school requires. I'm an RN, and I also did basic science portion of the med school. I had lots of PAs and NPs, and RNs in my class, also a bunch of PTs,chiropractors, and other health professionals. This is where reality hit us. Let me put it to you this way. When you are an NP you see a "tree", when you are a physician you see "the whole forest", not in terms of practice, but more so in terms of debth and length of the education. Yes you learn a few things as an NP, esp as far as common conditions go, but do not kid yourself that it's the same thing as a doctor, only better:chuckle

anapurnas · Mar 19, 2006

I think the previous posts are trying to say that having a bridge program would allow the NP to "see the forest" without having to re-do a lot of their education. Also, experience is worth a lot. I don't think anyone is trying to say being an NP is like being an MD.

In addition, I know plenty of med students/resident/physicians who felt that their 2 years of basic sciences was useful for the tests but are rarely used on a daily basis. And none of them still remember most of those basic sciences details. But they, as we all, can look them up when needed and understand what's going on.

NPs actually see more of the forest in my opinon as they're trained to see the person as a whole, not just the disease process.

NP education should be more standardized are there are many poor-quality programs out there.

If you think about an MD preperation, it's 2 years of basic sciences (of which NPs have some of that), 2 years of clinical education and additional science courses (of which NPs have a lot of), and a residency. Most NPs with experience have already had the experience of what part of a Family Practice residency would be like, and a bridge program could add to that the additional time and higher acuity of exposure.

In my NP program, I rotated WITH the Family Practice residents and was seeing the same patients as the Chief of the FP residency program (I was paired with him). I saw them independently and would just run my plan by him. I have to say that as a result of my program, he agreed with my plan almost always. I had to look up more, but I felt with a bridge program an NP could quickly catch up to the level of an MD. Of course, this is because I feel my NP program was excellent, and I fear that most are not.

Papadoc · Mar 19, 2006

I think the previous posts are trying to say that having a bridge program would allow the NP to "see the forest" without having to re-do a lot of their education. Also, experience is worth a lot. I don't think anyone is trying to say being an NP is like being an MD.
In addition, I know plenty of med students/resident/physicians who felt that their 2 years of basic sciences was useful for the tests but are rarely used on a daily basis. And none of them still remember most of those basic sciences details. But they, as we all, can look them up when needed and understand what's going on.
NPs actually see more of the forest in my opinon as they're trained to see the person as a whole, not just the disease process.
NP education should be more standardized are there are many poor-quality programs out there.
If you think about an MD preperation, it's 2 years of basic sciences (of which NPs have some of that), 2 years of clinical education and additional science courses (of which NPs have a lot of), and a residency. Most NPs with experience have already had the experience of what part of a Family Practice residency would be like, and a bridge program could add to that the additional time and higher acuity of exposure.
In my NP program, I rotated WITH the Family Practice residents and was seeing the same patients as the Chief of the FP residency program (I was paired with him). I saw them independently and would just run my plan by him. I have to say that as a result of my program, he agreed with my plan almost always. I had to look up more, but I felt with a bridge program an NP could quickly catch up to the level of an MD. Of course, this is because I feel my NP program was excellent, and I fear that most are not.

Again...I know it's very tempting to think that as an NP, because in the end of the day you do similar, or even same work as some of the FP docs, to think that it's close to MD. As I've stated in the above post, I'm an RN for quite a few years, and I thought before starting my med school, that I have an edge over young premeds. Not so, at least when it comes to the basic science portion of the program. It's something that you guys just ouhgt to try. I'm afraid it's impossible to explain to those who haven't tried both.

But good luck with your cause.

miss_fit · Mar 20, 2006

Are ya saying it's like wanting to be a Marine or Navy Seal without going through boot camp to prove yourself, papa?

I would have to agree, especially with the NP being attainable through accelerated and direct-entry programs. I feel gulty taking advantage of them, myself.

Papadoc · Mar 20, 2006

Are ya saying it's like wanting to be a Marine or Navy Seal without going through boot camp to prove yourself, papa?

I would have to agree, especially with the NP being attainable through accelerated and direct-entry programs. I feel gulty taking advantage of them, myself.

Hey miss_fit!

Absolutly! That was my point. Many ppl think just because they can diagnose and prescribe it's the same thing as having gone through countless hours of med school, clinical rotations, residency etc. The "bridge" is impossible to do after nursing program. I could see some remote possibility of PA doing them because they are like a "Minie ME" of the "Dr. Evil":roll :chuckle j/k. But as far as their training it's a brief version of the med school, and no residency. But nursing programs vary so much. How would you quantify, and qualify some of the courses. Of course, we're just discussing some hypothetical issue, which will never come to pass. First, medical school, just like everything else is a business. The tuition is a revenue. Second neither AMA/LMCE, nor AOA schools will ever allow such an encroachment on their turf. If anything ever goes wrong with the pt under the care of such "bridged", "tunneled" or other wise "speed up" doctor, these malpractice lawyers will be salivating all over it. They do as it is, but when you can punch some holes in the arguement, and show that the whole education proccess was flawed and fraud, good luck to you prooving it to the jury and the judge that you "don't feel like you are cutting some corners, and that you prescribed and diagnosed" even before you ever entered medical school. I don't think that proponents of these things are using critical thinking. It's one thing when political lobbying allows you to do certain things, and it's another to turn it up a notch, and open up a can of worms, and set a precedent for other allied health to "bridge" into "the bridge". Trust me folks...if you want to be regarded as full-fledged physicians, then do what millions of oters have done.Go MD/DO route. There is simply no substitute for it. And even if it was possible, you would never be respected by your peers in the medical community, and rightfully so IMHO

lalaxton · Mar 21, 2006

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.

miss_fit · Mar 21, 2006

I'm with you, papadoc, 100%. Well put. :)

anapurnas · Mar 21, 2006

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.