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Wednesday, March 9, 2016

Career Advancement for PAs

Career Advancement for PAs
Updated: 03/09/2016
About 1.9% of PAs have obtained a doctoral degree of some sort (PhD, EdD, DHSc, DPH “public health”, PsyD, PharmD, DHEd, DHA “healthcare administration”, DGH “global health”, DPA “public administration” etc.) according to the 2014 Statistical Profile of Certified PAs released by the NCCPA in 2016. PAEA’s 2014 Faculty and Program Director’s Report showed 174 faculty held doctoral degrees, with 30 DHSc, 15 EdD, 56 PhD, 12 PharmD, and other (JD, etc.). Of the 48 program directors who responded, 19 held a PhD, 10 DHSc, 7 EdD. Degree creep is upon our profession as it has affected many of our colleagues in the healthcare workforce. With increased competition from our peers, we are continually being challenged to step up to the educational demands of our employers and address the deficit in leadership and education nationwide. Doctoral degrees, while not the be-all-end-all of expertise, can offer physician assistants an opportunity for career advancement in many areas, including public healthy policy, education, and administration. This is why so many physician assistants have chosen to seek higher education - to open up new opportunities. While some may argue that doctoral degrees are unnecessary to obtain these potentials, not every PA will be offered the same experiences in the same amount of time with the same amount of experience.


Many PAs wonder about the incentives for pursuing a doctoral degree. Some include:
  • Most PA programs require a doctoral degree for tenure status, which can make you more marketable if you are considering education (Dean or program director)
    • Recommended: DHEd (higher education), EdD (education), DHSc (health science) or PhD (philosophy)
  • Governmental jobs pay higher based on degree attainment
  • Some private sector jobs offer higher financial incentives for higher degrees, most do not
  • Competition faced against DNPs
  • International opportunities to work in global health
  • Administration and organizational management gateway
    • Recommended: MBA, MPA, MHA
  • Feasibility of conducting research as the primary investigator and applying for grants
    • Recommended: PhD
  • Managing public health departments or providers
    • Recommended: DrPH

In as many as 27 states, nurse practitioners are allowed to practice independently of their supervising physician (full autonomy), which has created lots of competition to hiring PAs for those same positions. Qualified individuals are not receiving adequate compensation for lacking the “proper credentials.” There are many fields in which a doctoral degree is already required, such as physical therapy, pharmacy, audiology, psychology, and advanced nurse practitioners. Arguably, some PAs feel this is a major threat to our profession and that PAs need to develop a degree specific to our profession or as an entry level degree. Unfortunately, there are few degree programs that allow PAs to pursue an advanced route in medicine to enhance their careers especially in a cost-effective manner.

Click here to read the Clinical Doctorate Summit which highlights many of the opinions centered around the doctoral degree, degree-creep, and deciding what the terminal degree should be for physician assistants.

Some of the more difficult questions you might ask yourself if you are considering a doctoral degree:
  • What are my plans after I obtain the degree and how long will it take me to obtain the degree?
  • How time consuming will this be, can I afford it, and how invested in it am I?
  • How do PAs work toward advancing their career in leadership within the larger administration they work within?
  • What programs or training are available beyond pursuing an MBA, MHA or PhD?
  • Should I get a doctoral degree in healthcare sciences? Beyond education, what new career opportunities justify the expense of obtaining a DHS? Same question applies to DHed and EdD.

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Doctor of Health Science (DHSc) Programs
Currently, there are 2 DHSc programs well attended by PAs, although MCPHS has recently started a new program. Both programs are academic instead of clinical doctorates. Both are doctorate degrees in the health sciences, so each degree will allow you to do similar work as with a MPH. PAs have a great opportunity for lateral movement in medicine, but the struggle remains to move up vertically in any hierarchy. The DHSc has brought forth administrative opportunity and responsibility. Obtaining a doctoral degree can make any candidate more marketable, but keep in mind that a DHSc may not improve what you are already capable of clinically. Patients may be better served by a doctoral degree that offers a different area of expertise, such as public or global health, hospital administration, or leadership/organizational behavior. These specialty areas can make PAs more of an asset
  • AT Still University Mesa, Arizona
    • Outcomes: prepare students to better understand, effectively manage and evaluate solutions to ongoing challenges of healthcare access, cost, and quality
    • Knowledge and skills to excel in project management, decision-making, organizational leadership, establishing evidence-based standards and gaining competencies to apply research to professional practice
    • 64 credit hours of distance education + 1 week residency in AZ
    • 8 quarters long, may start in any quarter, take 1-2 classes per quarter
    • No on campus requirement except graduation
    • Admission Requirements: master’s degree, 2 years experience, 3.0 GPA
    • 70 credit hours total
    • Cost: $34,370
  • Nova Southeastern Ft. Lauderdale, Florida
    • Outcomes: provide evidence based knowledge in health sciences, including health professions education, epidemiology, global health, health policy, clinical professionalism and ethics, and effective delivery of culturally competent services to populations and individuals in U.S. and internationally
    • Online course delivery with an internship and practicum, doctoral analysis, two 1-week on-campus institutes
    • No dissertation required, complete the program in as little as 2 years (or up to 3.5 years), 1-2 classes per semester
    • 61 credit hours at $628/semester hour = $38,308
    • Admission Requirements: Master’s degree, 3.0 GPA, prior healthcare experience
  • MCPHS Boston, Massachusetts
    • Outcomes: pursue educational opportunities in teaching in higher education or leadership in healthcare delivery organizations, advanced managerial and administrative positions within private care facilities, government agencies, pharmaceutical industries, clinical and research settings, etc.
    • Part-time option available, two-1 week Boston residencies in January and July
    • Dissertation required
    • Two concentrations:
      • 1) healthcare administration
      • 2) academic health sciences
    • Admission requirements: master’s degree, 3.0 GPA, 3-5 years of health related work experience
    • 54 semester hours at $870/credit hour = $46,980

Doctor of Physician Assistant Studies Programs
In February of 2014, Lynchburg College in Virginia announced its plans to develop a doctoral PA program to suit the needs of the future of health care and PA students. They have notified the Southern Association of Colleges and Schools (SACS) of their decision. Director and Founding Chair, Jeremy Welsh, DHSc, PA-C, says that a degree beyond a master's would be beneficial to those seeking leadership positions such as a program director or chair. It would also allow PAs in emergency medicine to gain expertise in the specialty. The program will consist of a fellowship, advanced didactic training in leadership, and a commitment to student research. This training could also prepare someone for teaching PA education as some PA educators lack a doctoral degree. Students wishing to enter this degree program would first graduate from Lynchburg College's Master of PA Medicine (MPAM) program and pass the PANCE. The first graduates will be in May 2018.
  • Outcomes: leadership and organizational behavior, healthcare management and law, disaster medicine, and global health
  • Clinical fellowship in any area of medicine
  • 9-12 months of academic and clinical preparation
  • Admission requirements: master’s degree

Physician Assistant to Doctor of Osteopathic Medicine
  • Lake Erie College of Osteopathic Medicine Accelerated Physician Assistant Pathway - WI
    • Fast tracked, 3-year medical school curriculum leading to Doctor of Osteopathic Medicine degree
      • 1st year of didactic instruction
      • 2 primary care focused clinical clerkships: 1 family medicine, other in general IM, pediatrics, family medicine, or OB/GYN
      • 2nd year of didactic instruction
      • 48 additional weeks of clinical clerkships
    • 12 students accepted annually: 6 undeclared (students take residency of their choice), 6 primary care (commit to 5 years in family practice, internal medicine, pediatrics or OB/GYN)
    • Admission requirements: PA-C, GPA 2.7+, at least one physics/organic chemistry course with lab, minimum 23 on MCAT, U.S. citizen or permanent residency
      • LECOM Academic Index Score - alternative for applicants who have no taken MCAT (undergraduate/graduate GPAs + ACT/SAT scores)

Doctor of Public Health
    • Outcomes: lead practice-based research, influence public health policy, effect change in health systems and institutions, and assume key roles in the public health community at local, national, and international levels
    • Distance based learning with a one time 3-day summer institute
    • Dissertation required
    • 28 semester hours

Dual-Degree Programs
Master of Physician Assistant Studies (MPAS)/Master of Public Health (MPH/MSPH)

Master of Physician Assistant Studies (MPAS)/Master of Healthcare Administration(MHA)
If you’re looking to become an administrator of a hospital or health care education, you’ll probably want to look into dual programs that offer MPAS/MHA degrees. Other PAs who move into administrative positions also have Master of Business Administration degrees, in which case you could also look into doing a MPH/MHA or MPH/MBA degree before PA school as well. If you’re looking into management after PA school, you could apply to become an operations manager (junior administrator) and eventually be promoted to operations administrator (hospital administrator). It is highly advised that if you’re looking into health care administration, you go with a program offering a dual MHA program.

MMs-PhD Program for Physician Assistants
  • Wake Forest School of Medicine - a 5-7 year program that combines a Master of Medical Science in PA Studies with a PhD in Molecular Medicine and Translational Science (MMTS)
  • This program primarily targets students interested in clinical research, community research and translation of knowledge into improved human health
  • Lab research is supervised by physician scientists and molecular medicine pathway is clinically oriented, and after research and dissertation are complete, the PA facet begins with connections to population and translational research applications.
  • PhD candidates also gain mentored experiences in teaching.




Sources:
http://www.physicianassistantforum.com/index.php?/topic/1764-taking-the-dhsc-plunge
http://huddle.aapa.org/communities/community-home/digestviewer/viewthread?GroupId=31&MID=8870&tab=digestviewer&CommunityKey=e54b07fe-0e40-4c0c-a8e4-25d744d979b5
http://huddle.aapa.org/communities/community-home/digestviewer/viewthread?GroupId=31&MID=7782&tab=digestviewer&CommunityKey=e54b07fe-0e40-4c0c-a8e4-25d744d979b5
http://huddle.aapa.org/communities/community-home/digestviewer/viewthread?GroupId=31&MID=7502&tab=digestviewer&CommunityKey=e54b07fe-0e40-4c0c-a8e4-25d744d979b5
http://huddle.aapa.org/communities/community-home/digestviewer/viewthread?GroupId=31&MID=7502&tab=digestviewer&CommunityKey=e54b07fe-0e40-4c0c-a8e4-25d744d979b5
http://huddle.aapa.org/communities/community-home/digestviewer/viewthread?GroupId=31&MID=3405&tab=digestviewer&CommunityKey=e54b07fe-0e40-4c0c-a8e4-25d744d979b5
http://huddle.aapa.org/communities/community-home/digestviewer/viewthread?GroupId=19&MID=643&tab=digestviewer&CommunityKey=780d3be8-0bd7-43c4-a007-63a171fda94f

2 comments:

  1. Hello,

    I am a new MPAS, PA-C with an interest in research. I meet the requirements for the online DHSc and Health Science PhD programs and have applied to them. I was wondering if you believe that these online degrees are respected and viewed as valuable or are laughed at by institutes? I have heard differing views and am unsure as to whether I should pursue them or if it would be a waste. My employer would cover the cost of the program. Am hoping that you have some input....

    Thanks

    ReplyDelete
    Replies
    1. I definitely see them being valuable and respected. Many PAs have them and continue to accomplish great things inside and outside of academia. Best of luck to you.

      Delete