He also advocated an online program that would consist of 20 health care professionals–turned–medical students. The students would be required to spend one to two weeks on the medical school campus before starting their online coursework. During that time, they would undergo a series of written and oral tests, clinical trials, and other evaluation methods to determine the additional courses they would need to pass the qualifying examinations for medical practice. Each student would then begin an individualized online course of study. At the end of the program, the students would take both the basic sciences and qualifying examinations in the same week, and their scores would be compared with those of traditional four-year medical students. If the nontraditional students performed at the same or higher levels as the traditional students, the program would have been deemed a success and primed for implementation.
Dr. Stead listed some requirements for those entering the program. Applicants would need to be NPs or PAs with a master’s degree from an accredited educational program, already working in areas of medical need. They should have completed at least three years of practice, and they must have a physician mentor once they are accepted into the distance-learning program.
To sum up, there can be no doubt that the need exists for fast-track programs. And we have various models to draw on to fine-tune these programs.
A key question remains, however: Is there enough interest among PAs and NPs to pursue further education to become physicians? Would they consider leaving their profession for medical school, especially when recent job satisfaction surveys show PAs, at least, are very happy with their positions? (Only 65% of NPs, on the other hand, actually stay in practice as NPs.) In their textbook Physician Assistants in American Medicine, Hooker and Cawley suggest that only 4% of PAs move on to medical school, although others believe that number could be as high as 8%. It is not known what percentage of NPs make this move.
Equally important, is there enough interest among medical school administrators in offering fast-track programs? While opinions may vary as to the efficacy of an accelerated medical school program, it seems the only way to really know for certain is through a pilot program. Would medical schools be interested in conducting such studies?
Other unanswered questions relate to public policy. Would society ultimately benefit from these programs? Would they indeed improve primary care delivery? Or would PAs- and NPs-turned-physicians follow the same maldistribution patterns currently seen among traditional physicians today, toward specialization and urban practices and away from primary care in rural settings? Could NPs and PAs who enter fast-track programs be compelled to practice in rural and/or primary care settings?
Obviously, there is much to discuss here. And to further the dialogue and the debate, I would love to hear from you on this intriguing issue. Send your comments to PAEditor@qhc.com.