INTRODUCTION TO THE MASTER OF PHYSICIAN ASSISTANT STUDIES CLINICAL YEAR

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1 It is our Mission at The University of Manitoba Master of Physician Assistant Studies to educate outstanding Physician Assistant clinicians as generalist medical providers in service to our communities in Manitoba and Canada. We nurture the future leaders of the profession and lead the field in academic preparation of Physician Assistants in Canada. INTRODUCTION TO THE MASTER OF PHYSICIAN ASSISTANT STUDIES CLINICAL YEAR A Physician Assistant (PA) is a medically educated clinician who practices medicine within formalized relationships with physicians. PAs are healthcare professions educated as medical generalist with the goals of providing and improving access to quality care. PAs can function as a patient s primary health care provider or in hospitals as part of a patient-centred physician directed team. The philosophy of the PA profession is to approach the provision of medical care in collaboration with the physician but as a critically thinking and problem solving medical professional. The Physician Assistant is placed in positions of trust and responsibility and must demonstrate professionalism and medical expertise in all aspect of their career. The standards for PA education in Canada are presented as CANMEDS-PA (formally the National Competency Profile or NCP), and accredited by the Canadian Medical Association. Our program s comprehensive curriculum consists of an academic first year (48-weeks) comprised of classroom, small group, clinical skills, and didactic instruction provided by experts of the Faculty of Health Sciences College of Medicine at the University of Manitoba. This is followed by 12-months of clinical rotations in a variety of medical and surgical environments. The CANMEDS-PA provides a comprehensive and yet not exhaustive list of competencies that an entry level PAs is expected to demonstrate prior to graduation. Clinical Year General Objectives 1. The primary objectives of all clinical rotations are to provide the PA-Student with practical clinical experiences through supervised patient contact; applying the principles of disease management that builds on knowledge learned in the academic portion of the program.

2 2. The PA-S will, at the completion of the clinical rotation, have demonstrated the ability to accurately obtain a clinical history and perform the appropriate physical examination skills required to develop differential diagnosis. 3. Building from the differential diagnosis, the PA-S is expected to be able to order and interpret the appropriate diagnostic studies. 4. Correlating the information obtained from the patient encounter the PA-S should be able formulate a treatment plan for the diseases and conditions common to the services of the clinical rotation, and present that information and plan for approval to the physician supervisor. Clinical rotations allow PA students opportunities to further develop and demonstrate principles of the PA profession. These principals include the role of medical expert, professional, communicator, collaborator, manager (now leader), scholar, and health advocate. Mastering these roles and skills is essential so that the PA student can take their place on the health care team. The MPAS evaluation process builds on these component roles. It is understood that these skills will grow with each successive rotation. To foster the development of clinical and procedural skills, students should initially be closely supervised until they achieve a level of competency that is satisfactory to the preceptor. It is understood that not all procedures or conditions listed will be available to students on each rotation. The preceptor evaluation is focused on determining if the PA-S can be trusted in caring for the patients seen in the practice environment. Evaluation and Program Requirements 1. All cases seen by the PA-Student are to be entered in to the physician assistant tracking system (PAST) by the student. This is a requirement for completion of this rotation and the program Observed Mini-Clinical Examinations (Mini-CEXs) are required during the Clinical Year. These are preceptor observed demonstrations of the PA-S clinical or procedural skills. 3. Mid-point and End-of-Rotation In-Training Evaluation Reports (ITERs) are required to be completed by the Preceptor and returned to the program within ten days of completion. An electronic format is utilized to facilitate this requirement. 4. PA-Students are expected to work 40 hour weeks and be available for 1-in-3 on-call scheduling for the duration of the rotation, in line with the Faculty of Medicine s guidelines and policy. 5. All PA-Students are required to wear name tags and identify themselves as a PA-Student in all encounters with patients and staff. (Provincial and CPSM regulations)

3 6. Chart entries and orders must be countersigned by the preceptor or delegate, and the PA- Student is required to use the PA-S designation after their entry. PA-Students are required to copy a selection of these notes for critic by core faculty with appropriate attention to eliminating patient identifiers. 7. It is required that all PA-S conduct themselves with high degree of professionalism and in a respectful manner while as a guest on the rotation. The Clinical Year will consist of: PAEP 7202 Family Medicine for Physician Assistants 8 weeks 6 credits PAEP 7210 Clinical Internal Medicine for Physician Assistants 4 weeks 3 credits PAEP 7220 Clinical Surgery for Physician Assistants 4 weeks 3 credits PAEP 7230 Orthopedic & Sports Medicine for Physician Assistants 4 weeks 3 credits PAEP 7240 Clinical Pediatrics for Physician Assistants 4 weeks 3 credits PAEP 7250 Clinical Psychiatry for Physician Assistants 4 weeks 3 credits PAEP 7260 Community Health (Family Medicine 2) for PAs 4 weeks 3 credits PAEP 7270 Clinical Emergency Medicine for Physician Assistants 4 weeks 3 credits PAEP 7280 Clinical Obstetrics & Gynecology for PAs 4 weeks 3 credits PAEP 7290 Clinical Anesthesia for Physician Assistants 2 weeks 1.5 credits PAEP 7204 Clinical Electives for Physician Assistants I 2 weeks 1.5 credits PAEP 7206 Clinical Electives for Physician Assistants II 2 weeks 1.5 credits PAEP 7300 Year Two Comprehensive Assessment of Clinical Skills (CACS) Pass/Fail PAEP 7350 Year Two Capstone Project Pass/Fail See next page for description of rotations

4 MPAS Clinical Year Rotation Descriptions & Course Numbers PAEP 7202 Family Medicine for Physician Assistants: 8 weeks 6 Credits The Family Medicine learning experience consists of 12 weeks of clinical experiences divided into an 8-week block (PAEP 7202) and a second 4 week block of time (PAEP 7260) with a focus on Community Family Medicine - Primary Health Care. The two courses can be merged or delivered separately by the program. Time in both courses is spent with a Physician who specializes in Family Medicine. The PA- Student (PA-S) will be supervised by a responsible licensed physician in all clinical health care settings, who may at their discretion, delegate supervisory responsibility to a qualified resident physician, a Certified Physician Assistant, or Registered Nurse Extended Practice. PAEP 7260 Community Health (Family Medicine II) for Physician Assistants: 4 weeks 3 Credits The Family Medicine learning experience consists of 12 weeks of clinical experiences divided into an 8-week block (PAEP 7202) and a second 4 week block of time (PAEP 7260) with a focus on Community Family Medicine - Primary Health Care. The two courses can be merged or delivered separately by the program. Time in both courses is spent with a Physician who specializes in Family Medicine. The PA- Student (PA-S) will be supervised by a responsible licensed physician in all clinical health care settings, who may at their discretion, delegate supervisory responsibility to a qualified resident physician, a Certified Physician Assistant, or Registered Nurse Extended Practice. PAEP 7210 Clinical Internal Medicine for Physician Assistants: 4 weeks 3 Credits The 4-week Internal Medicine rotation is to provide the Physician Assistant - Student with practical clinical experience and education through supervised patient contact in a hospital inpatient learning environment. The skills and knowledge acquired during this rotation will build upon the material covered during the Academic first year. By completion of this rotation the PA-Student will have demonstrated competencies related to the generalist role the PA has in patient-centered medical care supplementing Internal Medicine physician services, and have further developed the skills require in internal medicine practice. PAEP 7220 Clinical Surgery for Physician Assistants: 4 weeks 3 Credits The 4-week Surgery service rotation is to provide the Physician Assistant - Student with practical clinical experience and education through supervised patient contact in a hospital inpatient surgery learning environment. The skills and knowledge acquired during this rotation will build upon the material covered during the Academic first year. By completion of this rotation the PA-Student will have demonstrated competencies related to the generalist role the

5 PA has in patient-centered medical care supplementing Physician-Surgeons services, and have further developed the skills required by a surgical practice. PAEP 7230 Orthopedic & Sports Medicine for Physician Assistants: 4 weeks 3 Credits Orthopedic and Sports Medicine rotations provide the Physician Assistant-Student with practical clinical experiences through supervised patient contact. This rotation may consist of two two-week rotations at different sites and build upon the material covered during the academic year. PA-S should become comfortable with the differential diagnosis, evaluation, and management of normal and abnormal conditions in Orthopedic and Sports Medicine. Additionally, they should be knowledgeable about the indications and limitations for both inpatient and outpatient diagnostic and therapeutic procedures they will encounter. PAEP 7240 Clinical Pediatrics for Physician Assistants: 4 weeks 3 Credits The 4 weeks of clinical rotation in Pediatrics provides the Physician Assistant Student with clinical experience through supervised patient contact in a variety of in-patient and out-patients environments. PA students should become comfortable with the differential diagnosis, evaluation, and management of normal and abnormal conditions in Pediatrics. PAEP 7250 Clinical Psychiatry for Physician Assistants: 4 weeks 3 Credits The 4-week Psychiatry Medicine rotation provides the student with clinical experiences and opportunities to evaluate and participate in the care of patients presenting with common psychiatric disorders, including acute, sub-acute, and chronic presentations. Students will be exposed to the various treatment regimens available to the psychiatric patient, and should learn the indications for the contributions of other health care providers in evaluation, management, and treatment of the psychiatric patient. PA students should become comfortable with the differential diagnosis, evaluation, and management of common conditions encountered Clinical Psychiatry, and should be able to recognize conditions which require referral to the supervising physician or a specialist. PAEP 7270 Clinical Emergency Medicine for Physician Assistants: 4 weeks 3 Credits The Physician Assistant may be required to treat emergent conditions in the course of daily practice. Whether the acute incident occurs on the ward, in a family practice office, in a remote community clinic, or as staff in Emergency Departments the PA must have the knowledge and skills to manage basic emergent issues. The knowledge, skills, and attitudes acquired during the Emergency Medicine Clinical Rotation will build upon the material covered during Academic first year of the program.

6 PAEP 7280 Clinical Obstetrics & Gynecology for Physician Assistants: 4 weeks 3 Credits The 4-week OB/GYN rotation provides the Physician Assistant student with practical clinical experience through supervised patient contact in the clinical areas of Obstetrics and Gynecology. The skills acquired during this rotation will build upon the material covered during the academic year. PA-students should become comfortable with the differential diagnosis, evaluation, and management of conditions in obstetrics and gynecology. Additionally, they should be knowledgeable of the indications and limitations for both inpatient and outpatient diagnostic and therapeutic procedures. The PA- Student (PA-S) will be supervised by a responsible licensed physician in all clinical health care settings, who may at their discretion, delegate supervisory responsibility to a qualified resident physician, a Certified Physician Assistant, or Registered Nurse Extended Practice. Students are also required to participate in an advanced skills lab administered by the OBs/Gyn Educational Unit. PAEP 7290 Clinical Anesthesia for Physician Assistants: 2 weeks 1.5 Credits Within the anesthesiology clinical rotation, the goal is for the PA learner to develop skills to augment and support their own clinical practice. Under appropriate direct supervision and consultation, the PA learner will become familiar with the indications for, process of, and limitations of anesthetic procedures. It is expected that, through direct observation and supervised participation in patient care, the clinical rotation will contribute to a basic knowledge base, fundamental skills, and attitudes, while enabling their development. PAEP 7204 Clinical Electives for Physician Assistants I: 2 weeks 1.5 Credits This course consists of two weeks of clinical time, offering an introduction to the clinical discipline of the Physician Assistant learner's choice. Course objectives will be developed by the learner in collaboration with PAEP faculty members. PAEP 7206 Clinical Electives for Physician Assistants II: 2 weeks 1.5 Credits This course consists of two weeks of clinical time, offering an introduction to the clinical discipline of the Physician Assistant

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