Please click on the link to read about the policy pertaining to the release of your Committee materials. The Committee is authorized to send your materials ONLY to the professional health schools to which you are applying as well as formalized post-baccalaureate programs and specified Health Professions Scholarships Programs (HPSP). We are unable to release your letters for other purposes such as research programs, internships, employment opportunities, etc. Please consider approaching faculty to compose letters specific to these purposes. These letters can be stored by creating an account with Career Services Reference File Service.
Medical Schools Should Re-Examine Admissions and Training Methods, Experts Say
By KATHERINE MANGAN
Medical schools should take advantage of the first major expansion in 30 years to update an outmoded physician-training model that has resulted in the wrong mix of people being trained in the wrong settings at too high a cost, according to a report released on Thursday by the Josiah Macy Jr. Foundation.
The report, “Revisiting the Medical School Educational Mission at a Time of Expansion,” calls on medical schools to adopt sweeping changes in order to attract students of more diverse economic and ethnic backgrounds, train them in community settings as well as hospitals, and, in some cases, compress the time it takes to become a physician. (A summary of the report is available on the Macy foundation’s Web site.)
The report is based on the work of 36 educators who met at a three-day brainstorming session in October and a series of commissioned studies. Jordan J. Cohen, who was president of the Association of American Medical Colleges from 1994 to 2006, led the panel of educators.
Amid warnings of a looming shortage of physicians in the United States, nine new schools for training medical doctors are being built or planned, and 108 of the nation’s 126 traditional medical schools are expanding their class sizes. Some are also opening new branches (The Chronicle, January 12, 2007).
In addition, the number of osteopathic schools, which tend to graduate larger proportions of primary-care doctors than traditional medical schools do, has grown from 19 in 2000 to 28 today, with more in the works.
“We feel this is a unique moment in time—the first expansion of medical schools and medical-school enrollments in 30 years in this country, combined with the need and real possibility of health-care reform” under the Obama administration, said George E. Thibault, president of the foundation, which is in New York.
Dr. Cohen concurred. “The overarching message is that medical schools must accelerate the pace of change in order to meet the rapidly evolving needs of society.”
The staggering debt loads that doctors in training incur are scaring away many potential students, including minority-group members, and discouraging graduates from considering careers in primary-care medicine. The report notes that 80 percent of new physicians owe $130,000or more in student loans. One strategy the panel suggests is to follow the lead of some Canadian medical schools and examine ways to compress four years of medical education into three, possibly by combining the fourth year of medical school with the first year of residency training.
De-emphasizing standardized-test scores and looking at applicants more holistically could enable medical schools to diversify what is too often a predominantly white and affluent student body, the report notes.
Medical students and residents should also spend more time in a variety of practice settings, it says.
“Increasingly … much more medicine is being practiced outside the hospital, in clinics, doctors’ offices, and even in the home,” Dr. Cohen said. “We need to provide more opportunities for our students to practice in the real world, as well as the hospital.”
Effective Monday, Feb 9, Dalene Aylward, senior academic advisor and prehealth advisor will also be seeing junior and senior students for prehealth appointments. Dalene has been involved with prehealth advising services for several years now and will be available for your questions pertaining to the Prehealth Committee and the various professional health school application processes. As always, you can call 645-6013 to set your appointment.
If you attended the Kaleida Hospital Volunteer orientation on Saturday January 17, please read the following procedures to assure a smooth application process.
Application Procedures for Students Who Attended the Kaleida Volunteer Orientation
Completed applications should be handed directly to one of the three prehealth advisors in Norton Hall:
Nicole Schwab – 108B Norton
Dalene Aylward – 108A Norton
Libby Morsheimer – 107F Norton
Please be sure that your application includes ALL of the following:
Yellow “Kaleida Health General Orientation Program Checklist” that was given out at the end of the orientation – Please complete the top portion and sign and date the back (Many students already submitted this at the orientation. If you did NOT already submit this form, please be sure to bring it in with the rest of your completed application).
ADULT (NOT Student) Application Form. Application forms are available at the link.
Health Forms Signed by a Physician. Health forms are included with the Kaleida application; however, a copy of your health records from UB Health Services is also acceptable. Please contact Health Services in Michael Hall at 829-3316 and request a copy of your records. Health records should be given/sent directly to you to bring in with the rest of your completed application (Please do NOT have health records mailed/faxed directly to your preferred volunteer site or to Prehealth Advising).
Letter of Recommendation. This can be from a professor, work supervisor, pastor, neighbor, etc. It should NOT come from a relative.
Please make a copy of all documentation for your own records.
QUESTIONS? Please contact Nicole Schwab at nmschwab@buffalo.edu or 645-6031.
ATTENTION:
Those applying for fall 2010 admission to the professional health schools. If you are a junior this year and/or plan on applying for the entering class of 2010 to medical school (MD or DO), dental school, veterinary school, optometry, etc., please read below. You also will want to consider making an appointment for prehealth advisement several weeks prior to the April 1 Prehealth Committee deadline to be sure you are well informed and prepared to come through the Committee in support of your fall 2009 application.
DEADLINE: APRIL 1, 2009 with at least 4 individual letters due NO LATER THAN April 15, 2008
Four to seven individual letters of recommendation can be sent to the office in 109 Norton Hall anytime in support of your application. If you are unclear as to what is involved in applying to the Committee, please click on the link. All necessary forms are located at the link.
All forms, aside from the Preprofessional Data Sheet/Application, are also available in 108 Norton.
**There is a detailed checklist of what you need to assemble for the Prehealth Committee on the shelf in 108 Norton.**
A minimum of FOUR letters of recommendation MUST BE RECEIVED for you no later than APRIL 15, 2009.
Please remember that applications to these professions school have been on the rise and; therefore, they are extremely competitive schools in which to gain admission. If your overall or science/math GPA is around or below a 3.0 (e.g., 2.9 to 3.3/3.4), please make an appointment to see a prehealth advisor prior to applying to the Prehealth Committee.
Please call 645-6013 to set up an appointment if you need more information regarding this process.
Please note that at least three, one hour Prehealth Committee Information Sessions will be scheduled in February (see dates and times below). Please consider attending any one of these to obtain an overview of the Prehealth Committee process and to review Frequently Asked Questions (FAQs).
- Thurs, Feb 12 from 3:30-4:30 p.m. Room 145A Student Union
- Tues, Feb 24 from 5:00-6:00 p.m. Room 145B Student Union
- Wed, Feb 25 from 4:00-5:00 p.m. Room 145C Student Union
You do not need to sign up for these sessions.
A New Degree and Exam Create ‘Doctor Nurses,’ Irking Physicians
By KATHERINE MANGAN
For years, advanced-practice nurses have struggled for greater autonomy from doctors while physician groups have fought back, trying to protect what they see as their turf. Now, a degree that is sweeping through nursing schools and a controversial new certification test are blurring those boundaries even further.
About 80 nursing schools offer “doctor of nursing practice” degrees, and by 2015, the number is expected to reach 200. Last year 1,874 students were enrolled in such programs nationwide, up from 862 students the year before, according to the American Association of Colleges of Nursing.
At the end of 2008, about 40 nurses with these doctorates sat for the first certification test for the degree, which was administered by the same board that licenses new physicians. The nursing test is based on the final section of the three-part licensing test that medical-school graduates must pass to practice.
The test, and the degree it certifies, has raised the hackles of some physicians while giving some nurses hope that they will finally get the respect they feel they deserve.
“If nurses can show they can pass the same test at the same level of competency, there’s no rational argument for reimbursing them at a lower rate or giving them less authority in caring for patients,” says Mary O’Neil Mundinger, dean of Columbia University School of Nursing, which began graduating students with the degree in 2005.
A nursing group called the Council for the Advancement of Comprehensive Care teamed up with the National Board of Medical Examiners to create the voluntary exam, which is based on a section of the medical-licensing test that measures how well people apply medical knowledge to patient scenarios.
The drive behind the degree and the test comes from demographics as well as trends in physician career choices. As the population ages and the number of medical students choosing to go into primary care continues to drop, what some proponents are calling “doctor nurses” could help fill the gap.
The practice doctorate, nursing educators say, is not designed to turn nurses into doctors. Already, nurse practitioners are able to diagnose and treat patients, as well as prescribe medication in most states. But they usually do this with some kind of review or supervision from a physician. Advocates say the doctoral degree will give advanced-practice nurses the extra clinical experience they need to independently treat patients with complex needs in a variety of settings.
Earning a practice doctorate and passing the certification test won’t automatically give nurses autonomy in states that require physician oversight; however, both the degree and the test could provide leverage to nurses seeking changes in “scope of practice” laws.
But some physician groups continue to vehemently oppose efforts to grant nurses such autonomy. They argue that even with a year of clinical experience and a doctorate, a nurse’s experience does not compare with the training of a physician who has completed seven years of study, including at least three clinical years.
Ted Epperly, president of the American Academy of Family Physicians, says the medical board “crossed the line” when it began offering the nursing certification test.
“This is not the National Board of Nursing Examiners; it’s the National Board of Medical Examiners,” says Mr. Epperly, a family physician in Boise, Idaho. The degree, he says, may confuse patients.
“If I go into an exam room and I’m talking with my patient, I don’t want them to wonder, ‘Are you a doctor doctor or are you a doctor nurse?’” he says.
The American Medical Association, in a 2006 resolution, warned that the “quality of care rendered by individuals with a nurse doctoral degree is not equivalent to that of a physician,” adding that “patients led to believe that they are receiving care from a ‘doctor’ who is not a physician … may put their health at risk.”
Defending the Test
The National Board of Medical Examiners, which administers medical-licensing exams, defended its decision to offer the nursing test in a lengthy paper posted on its Web site. “Current and future patients of these nurse clinicians deserve a system that assures them that the clinician providing services meets appropriate quality standards,” it says, adding that there is no evidence that these nurses provide substandard care.
Susan Doyle-Lindrud, a nurse practitioner since 1994, received a practice doctorate from Columbia in May and took the certification test in November. “At this point, there’s tons of research showing that there’s no difference in the outcomes of nurse practitioners and physicians, but we still struggle to get companies to put us on their provider panels and get legislation passed that respects our competencies,” she says.
Physicians she works with at the Cancer Institute of New Jersey respect the degree, she says.
“It doesn’t change the scope of practice,” she says, “but it does change the way physicians talk to me and makes it easier to develop a more collegial relationship with them.”
To be eligible for the exam, a candidate must be licensed as an advanced-practice nurse and have a nursing-practice doctorate. The multiple-choice test is based on questions that have appeared on previous versions of the licensing exam for physicians.
Not all nurses, however, agree that a medical licensing board should be certifying nurses.
“We already have accredited certifying bodies for nurses. It makes no sense to turn this over to a medical board,” says Jan Towers, director of health policy at the American Academy of Nurse Practitioners.
“There are so many other ways to demonstrate that we are on a par or even offer superior outcomes,” she says.
Nursing groups also point out that nursing isn’t the only health profession transitioning toward a doctoral degree. The growing complexity of patient care and concerns about patient safety are prompting other fields, including pharmacy and psychology, to do the same.
“Patients know whether they’re seeing their doctor or their dentist or their podiatrist — all of whom go by the title ‘doctor,’” says Ms. Mundinger, Columbia’s nursing dean. She believes physicians are feeling threatened because “all of a sudden, we look too much like them.”
According to a report released last year by the Center for the Health Professions at the University of California at San Francisco, 11 states allow nurse practitioners to diagnose and treat patients and prescribe medication without any physician involvement. Ten states mandate some sort of physician supervision, and the rest require collaboration with a physician. This sometimes means that a physician has to approve prescriptions or simply has to be available for consultation by telephone if needed.
So why the switch to a doctorate?
Most nurse practitioners, nurse midwives, and nurse anesthetists are trained in master’s-degree programs. By 2015 the American Association of Colleges of Nursing wants the doctoral degree to replace the master’s as the standard qualification for new advanced-practice nurses. (Until recently, most doctoral nursing degrees were oriented toward research and teaching rather than practice.)
A doctorate of nursing practice typically takes four years, following a bachelor-of-science degree. A student who already has a master’s degree in nursing can usually complete the doctorate in two additional years. In each case, the final year is a full-time clinical residency.
The nurses who took the medical board’s inaugural certification test will probably get their results this month.
http://chronicle.com
Section: The Faculty
Volume 55, Issue 19, Page A7
This message is from Jennifer Rahman, president of MHRP
Hope everyone’s spring semester is going well so far! Minorities in Health Related Professions (MHRP) will be holding our first general body meeting on February 2, 2009 at 5 pm in 145C SU (ground floor of the Student Union). We will have pizza, snacks and beverages so, feel free to stop by even for a bit and bring your friends (our club is open to everyone…you don’t have to be a “minority” to join!)
We are planning to have fun games concerning little known facts about minorities in health care, as well as a forum with health care professionals in association with other pre-health clubs on campus, however we also have fun events planned for this semester such as a Movie Night on February 20 in 330 SU at 7 pm, volunteering with Ronald McDonald House and Big Brother/Big Sister, and much more!!
Also, we have an opening for MHRP Secretary, so if you’re interested in becoming a more active participant in our club by assuming the role of an e-board officer, and have any new/interesting ideas about what kinds of things we can do to broaden our reach to the UB community, feel free to come by to our first meeting on February 2nd, where we will be opening up nominations (elections will be held at the subsequent meeting).
If you have any questions or concerns, please feel free to contact us at ubmhrp@gmail.com. Hope to see you all there on Feb. 2!!
Jennifer Rahman
MHRP President (‘08 - ‘09)
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