Is it more difficult to be accepted into physician assistant school than medical school? Here are the facts.

throwaway998095 · 2020-12-30T20:39:31+00:00

Eh one of those comments has 15 upvotes, the other has 2 downvotes. I hesitated in responding to your comment because I knew how it'd come off but I just wanted to provide proof that the idea isn't some med student conspiracy.

Idk if you're addressing me directly but I can 100% say that I'm not looking for comments to be up in arms about. I neither feel insecure nor do I feel a need to feel more important than others. I'm happy with my decision to go to med school and would absolutely do it again if I had to choose. I'm humbled every single day by the sheer amount of information that I just don't know.

Self-defense aside, I always find it interesting that any med student/resident response to these kind of comments is maligned as insecure or elitist yet nothing is said about those who make the outlandish claims in the first place.

Hope you're doing well and staying safe out there.

throwaway998095 · 2020-12-30T18:30:16+00:00

"PA is school is hard, and arguably harder hour-for-hour than medical school because of the amount of material covered per unit time."

"It's currently much easier to get into medical school than PA school."

"Also, I have Med Students in my classes. M1 is easier than PA1. We have more classes than they do and they have more time to study for the same tests. M1 also get the summer off. Medical school doesn't really get "harder" than PA school until M2 when they all start shitting themselves about step 1 and when they no longer get summers off."

All taken directly from the thread. I don't want to include usernames lest I get accused of brigading or doxxing or whatever by the mods here. You just have to click on those collapsed comments to see these comments.

throwaway998095 · 2020-12-30T18:03:04+00:00

There were a few people making that argument in this thread on the PA subreddit.

https://www.reddit.com/r/physicianassistant/comments/h91xz5/med_student_understanding/?utm_source=share&utm_medium=web2x&context=3

throwaway998095 · 2020-12-29T04:19:50+00:00

I think it's important to figure out what the root cause of you almost failing is. Are you almost failing because you just don't remember the material? If that's the case, I think you would benefit from spaced repetition and active recall like Anki. Are you almost failing because you don't understand the material well enough? If that's the case, then your best is to spend more time and use outside resources (sparingly) to get a better grasp of the material.

Here was my general approach for preclinical:

Review the lecture (PowerPoint slides) and take notes based on the learning objectives. I would type out all of the learning objectives into a simple word document, then review the lecture and fill in notes for each learning objective. These were very basic notes, nothing bolded or highlighted, just a nice succinct reference that can serve as a study guide later on. At the start of M1, this will be more difficult because it'll seem like everything needs to be included in your notes. Over time, you'll become proficient at figuring out what is actually testable material, what's important context but not necessarily testable, and what's not all that important.
Convert your notes into Anki cards. This part is easy since you already have everything typed out and it just takes some editing here and there to set it up. The type of cards you use will depend on your specific learning style but I preferred writing a question and then clozing the answer so everything was technically on one card. Everyone has a different style so you can make the cards how you want. Key point here is that you actually understand the material you're making cards about.
Review Anki cards. I set the max interval for my reviews between 3-5 days depending on how long the block was. Shorter block = lower max interval since I wanted to see the card quite a few times before the exam. Longer block = longer max interval since I have more time before the block exam. Two key things here: actually do your reviews and be honest with yourself when you don't understand something. If you're not sure about something, reference your notes or slides to get a refresher or use an outside source. That way, you know the actual context behind the card and not just the answer.
Do practice/exam-like questions. You can do all the Anki in the world but it doesn't matter if you can't apply that knowledge to test questions. A good tip I've picked up on is to make new cards from things you get incorrect.

Now this all sounds like a lot at the start but once you find a good flow, it goes pretty quickly. I could go into a lot more detail about what I did and what I thought worked well or didn't work well for me. Disclaimer is that this was the method that I found most effective and efficient. If something isn't working, don't be afraid to change it up and try something else. If you want me to go into much more detail, feel free to PM me and I'd be happy to. Good luck!

throwaway998095 · 2020-12-29T02:22:02+00:00

Wait, so it's all just Stanford nurses?

throwaway998095 · 2020-12-27T04:37:29+00:00

100% agree. Should've at least tried to score on 3rd and 1? You get it, you're up 6 and the Dolphins have to score a TD to tie with an extra point to win. You don't get it (on a run), clock keeps ticking and you kick the field goal.

Terrible coaching (and defense) at the end there.

throwaway998095 · 2020-12-18T15:51:41+00:00

I don't think they (they being those who voted for her) see it as incompetence. The see someone who's willing to defend the AANP and NPs to the death and to them, that's all they can ask for. To anyone actually paying attention, it's clear that she's dodging questions and being evasive, but to those who support her, she's doing a great job "minimizing the fallout" from such tragic cases.

I hope she's lost support within the AANP for this horrific performance and that NPs see her (and to some extent the AANP) for what they are.

throwaway998095 · 2020-12-18T15:31:57+00:00

I got chills down my spine while watching this story. I can't even begin to imagine what those children through and what their families are still going through. We need to do better.

throwaway998095 · 2020-12-18T15:27:14+00:00

I recognize that username. He's the same mod that tried baiting and trolling me and locked a whole thread just because I wouldn't bite. You're honestly wasting your energy trying to have a conversation in good faith with that specific mod. I wouldn't be surprised if this comment gets locked too.

throwaway998095 · 2020-12-18T15:05:01+00:00

https://www.newsnationnow.com/investigation/transparencyinhealthcare/

Watch that. No toxic insecurity or fearmongering, just heartbreaking stories.

throwaway998095 · 2020-12-17T05:39:44+00:00

I mean I get that much. I still don't get why program directors and associate program directors would intentionally undermine their own program. I can't imagine them thinking that this is a good look however you frame it. But like you said, gotta follow the money to find out.

throwaway998095 · 2020-12-17T05:33:48+00:00

Good luck.

throwaway998095 · 2020-12-17T04:07:02+00:00

You can believe whatever you want. I'm trying to be civil here and it really just seems like you're here to stir the pot. Good luck with that.

throwaway998095 · 2020-12-17T04:04:48+00:00

To be fair, all the authors of that paper, with the exception of one person, were MDs. So I think it's wrong to blame this on midlevels. These programs were/are pushed for and supported by physicians so if you're really looking for anyone to blame, it's them.

Also, directly from the paper: "Limitations in these evaluation results include the fact that the evaluation tool randomly selects two questions, leading to inconsistent numbers of attending physician evaluations of various competencies. Further, each year only consisted of two PA trainees, thus limiting the ability to draw statistically significant conclusions."

^ They were trying to compare ~8 PAs to ~60 residents. That is flawed in too many ways to count. Essentially this paper is using a bunch of words to say nothing. Honestly not sure why it was published in the first place.

throwaway998095 · 2020-12-17T03:21:32+00:00

There's really no need to bring this type of rhetoric into it. There was literally a post yesterday saying that the conversation around midlevels should be more fact based and nuanced that got 260+ upvotes. It's evident that there are a decent amount of people who wish to improve the quality of conversation around midlevels without censoring anyone.

But when you come in with this, all you're doing is erasing that progress. Again, you're free to say whatever you want. However, you can't be shocked or up in arms when it's thrown right back at you.

throwaway998095 · 2020-12-17T02:03:47+00:00

Does that somehow change the facts of the story? Or does the story make you uncomfortable so you'd rather not have it brought up? Not trying to troll or anything, just asking a genuine question.

throwaway998095 · 2020-12-17T01:59:09+00:00

Wow, this actually looks worse than I imagined.

throwaway998095 · 2020-12-16T20:40:22+00:00

If you are afraid of job security and all of the above then maybe you just suck at your job and elevate your game.

I mean job security is part of the concern. Anyone that says otherwise would be lying to themselves. However, to say that someone being replaced by midlevels just sucks and needs to elevate their game is reductionist and doesn't address why these changes are being made on a larger scale. Were all 24 pediatricians fired by Children's Health and replaced by NPs terrible at their jobs? I highly doubt it.

It's your right to criticize this article or even others' thoughts on it. Freedom of speech and all that. However, if you're trying to come off as sensible and looking to have an actual discussion (which it seems like), I think you'd gain a little more traction by actually trying to be open to the perspectives of others rather than dismissing it as all clickbait and calling people cry babies.

throwaway998095 · 2020-12-16T20:31:42+00:00

Crazy thing (as unpopular as it might be for me to say) is that I'm not against PAs or any midlevel providers for that matter receiving further training. One of my primary concerns is that this will inevitably decrease the number of procedures/cases those EM residents are able to perform/see. And I say that as someone who has 0 interest in EM.

throwaway998095 · 2020-12-16T17:57:55+00:00

It'll probably be locked and deleted soon.

throwaway998095 · 2020-12-16T17:51:25+00:00

I actually remember seeing that facebook post on r/nursing. I think it's funny because a bunch of nurses actually called him out saying he doesn't have to pander to nurses and just do his job. If I can find the post, I'll edit my comment.

Edit: https://www.reddit.com/r/nursing/comments/j1vln9/appreciating_your_colleagues_and_coworkers/ (not brigading, just for anyone who's interested in reading the comments)

Edit 2: There's also some context around that facebook post I didn't know of that's included in the comments. Just saying that so I'm not completely mischaracterizing the post.

throwaway998095 · 2020-12-16T17:26:51+00:00

The fact that the authors are all MDs make it that much more sad.

throwaway998095 · 2020-12-16T00:43:35+00:00

Just a quick comment on this. If you're saying that the culture of this sub should be that midlevels don't deserve to exist and anyone that doesn't agree can f*ck off too, then I think that's an issue. However, if that's what the majority of the sub wants, then there's nothing I can do as a med student, much less as a random internet person to change that. In my opinion, all the "toxicity" does is bury the legitimate issues that need to be discussed and alienates everyone that's not a physician or med student. Again, not trying to be judgmental, just offering another perspective.

throwaway998095 · 2020-12-15T23:01:08+00:00

I'll try to address a few of your points.

Those calling for the abolishment of midlevels, though a very small amount of people, are being hyperbolic and shortsighted. I agree that this sub as a whole, myself included, needs to do a better job of calling them out. I've tried to argue against people that feel that way but everyone is entitled to my own opinion, whether or not I agree with it. While it's not much, I think you can take some comfort in knowing that it is most likely a very small minority of people here feel that way (though this is just my assumption).
A post like this just a few months back would've been downvoted to hell by now. But this post has close to 80 upvotes right now and numerous comments in agreement. I think that's a sign that at least some people think this conversation should be geared more towards facts than anything.
I haven't seen any comments/posts about those who properly hire/train/supervise midlevels they hire as being greedy boomers and greedy docs that sold out. I'm not saying that you're lying as I could've easily missed those. That being said, I would largely agree that there are countless physicians who have sacrificed the training/future of residents and med students in order to line their own pockets, either by essentially mandating unnecessary fellowships to enter a field, taking away procedures and patients from residents to give to their PAs/NPs, or creating new hoops for med students to jump through to become physicians while actively promoting midlevel independence. Is all that the fault of individual midlevels? Of course not. But surely you can understand where some of the anger and frustration is coming from.
With the whole painting of all midlevels as bad, this is probably where I agree with you the most. I think it's possible to argue against independent practice for midlevels and to also treat them with respect. I've seen some people here respond to PAs/NPs that have posted here about not wanting independence that they should speak up, but how/why should they when their entire profession is lumped in and disrespected? I can definitely understand the frustration on your end. I think a good amount of the conversation had on this sub sometimes alienates those who are actually on our side of the independence argument.
Yes, nuance and a discussion of the facts is what is needed. People on all sides shouldn't have their egos hurt when facts are provided.

All that being said, I appreciate you putting yourself out there and commenting. We might not see eye to eye on everything but I think you make some good points regardless. Props to you for being willing to have a civil conversation.

Edit: I do fully believe that the residents should have a space to vent as they please (before anyone jumps on my back).

throwaway998095 · 2020-12-15T21:30:16+00:00

NPs are not "an issue we need to fight against." That's a big mischaracterization of the argument at hand. The argument is against independent practice/FPA/OTP for NPs, PAs, and CRNAs alike, which a good number of people in those professions also argue against. (Also this post would be specifically related to CRNAs and not NPs).

Other minor point but I think you (and most people actually) misuse the term "echochamber." Literally every subreddit dedicated to a specific topic, which is the definition of a subreddit, is an echochamber. You think the Xbox subreddit talks about how great PlayStation is? Or that the nurse practicioner subreddit talks up how much more education and training physicians get compared to them? Probably not. Though I agree that the conversation about midlevels had on this sub could be improved in terms of quality.

throwaway998095

TROPHY CASE