Introductory Presentation Joseph Hlavin
A Program for Texas Universities Provide an introduction State the objectives Brief history of profession/programs Needs assessment Neurosurgery training as an example Planning intent Track to development and delivery Funding Curriculum Implementation
Introduction Specialty training programs are important Only basic medical sciences provided in PA programs Surgical rotations are generally avoided Rarely are electives offered in surgical sub-specialties Postgraduate training programs are gaining recognition Presently over 60 programs in are available in a wide range of medical specialties Viability of starting a postgraduate program is warranted
Objectives of Presentation Understand the need for postgraduate PA training Recognize the benefits of post graduate training Identify common challenges Cost/funding Attitudes Using the Neurosurgical PA Training example Develop a strategy for implementation Understand the curriculum List budgetary demands and concerns
History Physician assistants have formally been a part of the medical community since the early 1960s Neurosurgical fellows (physician extenders) have been a part of the surgical team since the late 1960s Article by Dr. Sonntag (a neurosurgeon with extensive recognition) outlines use and credibility First postgraduate program developed in 1970s in general surgery Montefiore Medical Center followed by several well known medical facilities including Yale University School of Medicine and MD Anderson
Need Present PA programs provide basic medical knowledge and clinical skills 4600 students/year nationally Lack specialty focus Decreased technical ability Minimal experience in a desired area Decreased confidence Less leverage during contract negotiations Present universities with PA programs Have established training avenue but no specialty curriculum
Implications of Development For the PA Program Director Educational vehicle for advanced specialized training Offer an academic model Value to the medical community For the PA trainee Increased thinking skills Increased confidence Increased autonomy Increased salary
Challenges Funding Common costs for startup & maintenance General budget of $75,000 to $100,000 Present programs obtain from university funds specific to specialty In not provided by university must get from private practice or philanthropy/charity Licensing and credentialing issues Timing of graduation to start of program Push back from hospital systems
Challenges Delivery of training Identification of faculty Faculty investment & development Bringing in external trainers Acceptance of the training as part of the specialty team Personality conflicts Credibility by medical staff Credibility by nursing and ancillary staff
As an example
The Strategy Neurosurgical PA Training A program that utilizes the experience of specialized physician assistants Curriculum developed to maximize focused learning Measurement and evaluation models Job placement
Objectives Neurosurgery Training Understanding anatomy and physiology Perform a neurological exam Develop and implement treatment plans Manage critical care patients Master first assisting techniques Perform procedures under supervision Demonstrate administrative work in office
Entry Requirements Graduate of accredited PA program State licensure eligible NCCPA eligible or certified BLS certified Interview by selection committee
Stipend/Benefits $45,000 annual Health insurance Vacation/holidays Holidays depend on rotation/call schedule Two weeks vacation Text Lab coats Annual professional conference Membership dues
Curriculum Divided into didactic and practical sessions Four 8 week rotations in different surgeon/pa teams Three 6 week elective rotations (selecting one) Neurotrauma Pediatrics Functional Two 2 week rotations in Neuro-radiology & Pain Didactic and practical will overlap throughout the year
Curriculum Didactic Weekly lectures Faculty presentation Online learning/exams Case presentation after each rotation Research paper and submission for publication Attendance at annual professional neurosurgery meeting
Curriculum Practical sessions Each evolution or rotation will consist of: Ongoing one-on-one learning w/ faculty Surgical and procedure techniques Daily rounds Office/clinic First call to ER
Evaluation Weekly training exam Online modules have answers and results available to the faculty Faculty presentations will carry over to practical evaluations End-of-rotation Case Presentation Faculty Q/A Presentation rubric End-of-year portfolio presentation Mahara e-portfolio
End of Program Trainee is presented with: Ceremony with faculty and staff Certificate of completion from the Texas Brain & Spine Institute Medical and Program Directors Personalized gift Assistance with job placement
Implementation Recognize and be convinced that a need exists Recruit or recognize Champions to steer the program Should be the Medical (MD/DO) and Program Director (PA) Create a workable funding strategy & budget Through the university Private industry Pass through non-profit organization Central Texas Education Group (as example)
Implementation Build faculty Curriculum development May use NS program as a guide Institute university benchmarks Institute evaluation system Completion protocol and award Acceptance/candidate committee Start recruiting for candidates Select start date
Implement Clerical considerations Medical secretary Scheduling Credentialing Communications Licensure Advertising Payroll Could use university system or outside source for nonprofit corporation
Conclusion Texas universities have a unique opportunity to impact the medical community, especially specialty practice History plays a large part in recognition of demand The need exists for development and implementation of postgraduate PA training programs Builds on established PA program basics Covers the lack of specialty specific learning Development of a successful program has several benefits for both sides
Conclusion Challenges exist regarding development and implementation Funding Credentialing Credibility The Postgraduate PA Training Program created by the Texas Brain & Spine Institute offers directions for planning, developing, and implementing a successful neurosurgery PA program
Thank You From Joe, Dave, and Mark