<p>I've posted before with questions, but I'm back and would appreciate some advice.
I've been shadowing a cardiothoracic surgeon and PA this whole week. I initially was observing the PA but since the SP and PA are pretty everywhere together, I kind of got the best of both worlds. Spending 10-hour days with them, I realized that the PA gets to do pretty much nothing surgically and does a lot of the paper work/phone calls/etc. I'm not interested. If there's one thing I dislike, it's watching other people do what I want to do. </p>
<p>I basically have no good reason NOT to do medical school except for the fact that I may not get in, but that would never stop me. I don't have a family and don't want a family (not anytime soon at least!). I want a career and I want it to be in medicine. Although I'm not wealthy, the cost of medical school would never scare me away, because I'm aware of all of my options to pay for school.</p>
<p>Like I've posted before, I'm not a typical student, meaning I won't finish my undergraduate in 4 years and had no idea that medicine was something I wanted to do. So I'm behind to say the least. I'm doing a Biological Sciences undergrad soon to be at NC State. I will probably take summer classes every summer until I graduate, which I don't want to do because I'd rather shadow, volunteer, and try to get involved in research, but then again I don't like the fact that I'll be almost 26 before I even apply to medical school if I don't take summer classes. I COULD deal with the age issues if the best thing to do is to save my summers for EC's (which I've read over and over). What's worse, taking too long to finish undergrad or taking summer classes?</p>
<p>The only science classes I've completed so far are my biology's. So my science GPA is kind of useless at this point (at least to make any determinations from it). NC State will be the 5th school I've transferred too and all of my previous GPA's have been 3.6-3.7 overall. </p>
<p>So I basically just want your advice as to what my best options are to be accepted to medical school. What would you do? Be honest. Constructive criticism is welcome (I'm expecting it).</p>
<p>Personally, I would go for it. You sound very driven, and if going to med school is something you want that badly, I'm sure you can find a way.</p>
<p>As far as logistics, take it one step at a time. Working on your course requirements while keeping good grades should be your first priority.</p>
<p>I hope that helps, but I know it's pretty weak advice compared to what others can give. Good luck!</p>
<p>It depends on how long we're talking to finish. A 5-year degree out of State (for future reference, that's what I call NC State) isn't a problem. An 8-year degree, as you seem to be discussing, probably would be. I'm a little confused as to how inevitable this track is. How old are you now? How much have you finished?</p>
<p>Too, I have to be honest: what you've described isn't really representative of my experience with an NP, and I've always been told that their responsibilities are pretty similar. The NP I shadowed had responsibilities in surgery, although she was not of course the surgeon. She was basically the first assistant, a position that would (I think) typically go to a senior resident if the surgery were happening at an academic hospital. On clinic days, she consulted patients independently and made her own recommendations and judgments, stopping only once or twice a day to consult with the surgeon directly -- usually when a patient had specifically requested him, not because she was out of the bounds of her expertise. (Of course, the patients were assigned so that the tricky ones were given to the surgeon to begin with.) I've also seen NP's in a couple contexts in which they've acted essentially as my physician, providing me checkups and immunizations without any physician anywhere nearby (that I knew of).</p>
<p>Again, maybe my experiences were anomalous, or maybe NP's and PA's aren't nearly so similar as I thought. It will be helpful to hear BRM chime in, as I suspect he's gained a lot of exposure to them over the past year. But my suspicion is that their responsibilities vary a great deal from practice to practice.</p>
<p>The national mean for first-year medical students is 25; so if you're 26 when apps get sent out, you'll be 27 when you matriculate and be only two years older than average.</p>
<p>NP and PA responsibilities really depend on who their supervising physician is. Some docs allow their extenders a lot of autonomy, others don't - I can't stress this enough. Certainly surgery is something a little bit different than clinic. BDM is correct that PA's will frequently function as first assists in situations where there aren't students or residents. I do have a surgery PA who I consider a pretty good friend who works under a surgeon in a small town and she gets to do most of his in-office procedures. The only thing she didn't was ultrasound guided core biopsies. </p>
<p>In my expeirence, NP's are much less likely to be in subspecialties - surgical or otherwise. Obviously CRNA's are in on surgeries as gas passers, and Nurse Mid-wives will help on OB related surgeries. Again, just what I've seen, but PA's have a lot more freedom to enter more specialized fields. I have close friends that are PA's and practicing in Pediatric Endocrine, Anesthesiology, and Adult GI. In my clerkships I've worked with PA's in Pediatric Orthopedics, rural Family Med, Peds Pulm, Peds Hem/Onc, and acute care internal medicine (with significant responsibilities for teaching third year medical students). </p>
<p>Again, biggest thing is that autonomy is determined by the relationship between the physician and the extender.</p>
<p>I suppose I assumed the PA would be doing more during the surgery's other than holding a scope and passing instruments to the surgeon. The PA that I'm shadowing talks to her SP constantly. They are literally always together, so the PA sees patients in office and surgery, but it's always with the Physician. </p>
<p>I may be able to do a 5-year at State, BUT I'd have to do summer classes every summer and do at least 16 hours each semester, which is probably average anyway (I don't know for sure). That just worries me because I want to do volunteering and more shadowing during the summers...I suppose I would just have to squeeze those in sometime. I started college at 18, I took a year of classes, then took a semester off (fall). Transferred to another college for the next semester (spring), then transferred to another college the next semester (fall). Took the next semester off (spring), then transferred to a school in North Carolina for the fall semester. I'm at that same school at this point. So I've been to four colleges so far. I left the first three because of a combination of not being happy at those places, being unsure of what I wanted for my future, and plans falling through (I was supposed to go to a fashion school in Los Angeles, but backed out both times which correlates why I also took two semesters off). So I have 3 years under my belt, but one of those semester I only took 9 hours, another I only took 12. And I haven't covered most of State's requirements for major yet.</p>
<p>I'm going to say that five years would be pushing it, but if it's what I have to do, then I'll talk with the health advisors and academic advisors at State when I get there and see what can be done.</p>
<p>Well, there's no doubt that the hardest parts of surgery will always be left to the surgeon. In my experiences in ortho, an RN was "circulating" to pass instruments in and out of the field, a technician (presumably a BS) was in charge of helping the surgeon measure and prepare the devices used, and the NP was assisting him in suture and cutting and suction. Her main responsibility was to close the patient after the surgery was done.</p>
<p>You've done 2.5 years of school at this point. Hm. How long does it take with 16 course-hours a semester, no summer work? Or one summer's worth or work?</p>
<p>BDM - the technician was probably the ortho equipment rep. Basically a pharmaceutical rep.
The circulating RN is usually not sterile but in charge of getting materials from storage, tracking their usage for billing, taking care of a lot of the paperwork aspects from the hospital side.
Who you've described as the circulator seems more like the Scrub Tech to me - (associates...if that).</p>
<p>I'm trying to remember -- this was seven years ago for me now -- but I know that the person was called a "circulating nurse" definitely had nursing training of some kind. I think she was not sterile, but was in charge of dropping instruments into sterile areas, sometimes handing them directly to the surgeon in sterile fashion -- for example, she would open a package in such a way that the instrument was protruding out and a surgical assistant could grab it without contaminating herself.</p>
<p>The circulator is always as licensed RN. Circulator functions include medicolegal documentation, retrieving and opening supplies for the field, patient advocacy, and communication with staff and physicians outside the room.</p>
<p>Scrub may be an RN, LPN, or a tech. Scrub hands sterile instruments, holds retractors placed by surgeon, and prepares other sterile equipment.</p>
<p>Assistant surgeon may be an MD, RN first assistant, PA, scrub tech certified as assistant, resident or medical student. Assistant surgeon performs any functions delegated by the surgeon including cutting, suturing, placing retractors, operating equipment.</p>
<p>Sales or clinical rep from supplier provides technical support for equipment, but makes no medical decisions, performs no procedures or interventions.</p>
<p>See the AORN site which summarizes the nursing roles very nicely: Role of the Perioperative Nurse</p>
<p>See also the ECRI report Outsiders</a> in OR which discusses the role of sales reps (and some adverse events).</p>
<p>The PA was, in technical terms, assistant surgeon. The PA sutured, held retractors, held equipment where the surgeon needed, etc. In the OR's I've been in, the person that handed the instruments to the surgeon or to the PA, was always a surgical tech. There's also been the circulating nurse (RN), which, like BDM said "I think she was not sterile, but was in charge of dropping instruments into sterile areas, sometimes handing them directly to the surgeon in sterile fashion". There was usually another nurse in the room also that had the same duties. </p>
<p>I calculated approximately (I won't know my exact transfer credits until I hear from State) how many hours I have left to finish and it comes to 72 hours. So divide that by 4 (for my 4 semesters or two years) and I should be taking 18 hours a semester, but that sounds a little rough to me especially since all of the classes I have left to take are pretty much science courses. So I figure if I take 16 hours for 4 semesters, plus at least one class of 4 credit hours for two summers (not including this summer), that could work out. I could manage one class a summer plus volunteering and shadowing. I can make it work, but my concern is what I'm doing my best bet for acceptance to medical school?</p>
<p>Hm. Can you do two classes, 8 credits, one summer? Basically, we recommend against summer courses mostly for students who either can't come up with anything better to do or who want to avoid (for whatever reason) taking it during the school year. Coming to premed late in the game is a sufficient reason to take up at least one summer.</p>
<p>Two classes, 8 credits is definitely doable. So if that's my best bet, then that's what I'll do! There's a pre-med track at NC State and I wasn't including any of the classes from that. So if I would try to participate in that, then that would obviously add numerous hours onto my course load. But is the pre-med track even necessary if I'm majoring in Biological Sciences? I figure I'll cover most of what's needed for medical schools (of course I'll have to research into each school to see what exactly is required) with my major and then some, so it doesn't seem necessary to complete the pre-med track also. And I know some of the classes with my major and the pre-med track are the same, but some are different.</p>
<p>No, the premed track is probably not necessary, except insofar as there actually are premed requirements. You need a year of each of general chemistry, organic chemistry, physics, math (maybe), English, and biology. Obviously the biology major will cover some of that, but probably not all of it.</p>
<p>State's Biological Sciences major requires a full year of each of those you named, so I think I'm good with filling those requirements. I am so ready to go talk to the health advisors and get on with it. The fact that I have to wait is so frustrating, I feel like I'm wasting time. Thanks everyone! </p>
<p>So when should I take the MCAT? Next year?</p>
<p>Wait until you've finished the coursework mentioned, with the possible exception of physics.</p>
<p>I've been looking through my courses to take at State and they don't require Anatomy and Physiology. Is that weird? It seems weird to me.</p>
<p>Nah, it's not that weird. Most medical students are seeing it for the first time in medical school. Or, rather -- it's strange in an absolute sense, but it's pretty normal.</p>
<p>That's very interesting. Thanks BDM.</p>
<p>Something else...
I've taken Biology 1 and 2 at CC and I may have to take Chem 1 w/ lab there as well. I expect the best advice you can give me is to get an A and hope for the best?</p>
<p>Partly, yes. It will also be good if you can take the next level of classes at your four-year institution.</p>