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Expanding Healthcare Opportunities in Oxford: Miami's Plan for Their New Physician Associate Studies Program

Expanding Healthcare Opportunities in Oxford: Miami's Plan for Their New Physician Associate Studies Program

In 2021, Miami announced its plan to offer a new graduate degree, Master of Medical Science in Physician Associate Studies, which will be housed in the new Clinical Health Sciences and Wellness building. The PA program, under the direction of associate teaching professor Dr. Christopher Howell, intends to provide a versatile, interdisciplinary model that will produce well-rounded, professional clinicians with a penchant for service to underserved and rural communities. The program will be matriculating its first class this May.

Addressing rural healthcare disparities directly

According to the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) “[physician associates] (PAs) are academically and clinically prepared to provide health care services as a member of collaborative health care teams.  PAs make clinical decisions and provide a broad range of diagnostic, therapeutic, preventive, and health maintenance services” [1] .  " The training and licensure of this profession allows skills to be provided in a variety of clinical disciplines, which in turn improves patient and community access to quality healthcare (AAPA) [2].  Given the forecasted rise in physician shortages, physician associates have long been advocated as a solution to increasing access to affordable care to underserved populations across the country [3,4].

Resources:

  1. About PAs – ARC-PA
  2. f-833-4-8256527_dk6DMjRR_Prescribing_IB_2017_FINAL.pdf (aapa.org)
  3. Is There a Physician Shortage in the US? What the Stats Say (physiciansthrive.com)
  4. U.S. physician shortage growing | AAMC

Miami's University’s Physician Associate Studies program was developed to address these reported disparities directly. Within the mission of the program, is the creation of an environment that “fosters professional clinicians with an interest in rural medicine and clinical research to enrich the medical sciences” [5]Mission, Vision, and Goals | Physician Associate | CAS - Miami University (miamioh.edu)."We want to ensure that our graduates are postured for success- garnering clinical experiences that enhance their clinical and professional acumen, while challenging critical thinking skills that serve to improve the clinicians practice and the lives of their patients in rural communities.. To do so effectively, a program must be intentional with this mission, addressing those needs directly and holistically," Howell stated.

Miami University’s didactic curriculum plans to explore common healthcare afflictions observed within rural regions both nationally and locally (within Ohio). Following the first semester, students will become members of the Ohio Rural Health Association (ORHA) and develop several research projects related to rural medicine and medical practice interests. Students will also work with newer technology that could benefit their practice, allowing the clinician to evaluate and treat patients more rapidly and at a decreased cost, vital to rural communities. One such instrument, incorporated within the framework of the didactic and clinical curriculum is the clinical point-of-care ultrasound (POCUS).  According to Dr. Howell, the use of ultrasound at the bedside has changed clinical practice, improving overall care and patient outcomes. It has been reported that in the hands of a skilled examiner, ultrasound is "the stethoscope of the future", and an invaluable instrument available to a clinician. However, students will also consider the role of other technological advances that could be used in their practice, including telemedicine, during their didactic training.

Following the didactic training, which is offered over 15-months and delivered in modular format around systems, the program will offer 12, four-week clinical rotations While the program does have required rotations in family medicine, emergency medicine, behavioral health, obstetrics & gynecology, pediatrics, and general surgery, and internal medicine; the program also requires orthopedics and four additional electives.  The electives are delivered as three “structured electives” and one “general elective”, allowing students to explore clinical interests related to the several disciplines. Generally, students would complete rotations at multiple healthcare facilities within the region.

Inspiring passions in clinical research

The field of medicine is a constantly adapting field, requiring clinicians to be up to date with the newest technologies, ideas, and research to treat patients successfully. Miami's program plans to incorporate methods of reviewing and discussing research relevant to emerging concepts in rural healthcare.

"We want to provide our students with the skills to pragmatically apply new ideas in research to their practice and how they can incorporate them into new projects in clinical research settings, to serve their patients and communities," Howell said.

Students will develop multiple research-related projects, working with a mentor on a review article within their area of clinical interest and a poster presentation reflecting on  a rural health affliction. The program will focus on reviewing contemporary practice paradigms, evidence-based medicine, clinical disciplines, and patient centered care within journal clubs, writing assignments, and presentations of their research.

"Our responsibility to our students isn't only to teach them what we know, from clinical experience, but to teach them how to grow within their profession and discipline as new evidence emerges. We want to encourage them to incorporate best practice strategies, using evidence-based medicine and be able to apply what they are learning to collaborate with other professionals and care for their patients- successfully."

Focusing on student wellbeing and career success

Burnout in healthcare and related training/schooling is becoming increasingly prevalent and a serious issue. A study conducted throughout Virginia PA schools found that students have shown more significant depression, anxiety, and overall emotional exhaustion than the general population (Johnson et al., 2020). Ensuring student well-being, both during graduate education and into clinical practice, is something Miami University has considered within its curriculum. The didactic and clinical years provide students with health seminars that address recognition, treatment, and prevention of burnout throughout their career, providing them with tools they need to create a balance between personal life and work.

Setting realistic expectations for adjusting to the professional world can be challenging for many recent graduates at any level. Miami’s PA program will address this by providing its students with personal and professional strategies for adapting to their careers. The program will educate its students financial literacy, time management, team building, and goal setting throughout the curriculum, which is meant to foster early and adaptable planning.

Finally, it is understandable that potential applicants may be hesitant to commit to a newer PA program, that is entering a provisional pathway in accreditation. This is not lost on the Miami University PA program faculty and staff.  Yet, Dr. Howell remains confident in what has and is being developed at Miami.

"Miami University is an exceptional institution! They fully support the development of this program, expansion of the health sciences, growth of the students, and the improvement of our communities.  It's not lost on us the investment a person makes to come to our program. We are honored to be representatives of the profession, humbled to be members of the Miami family, and are thrilled to partner with students in their graduate medical education goals. We know that the graduates of our program will provide exceptional service to their community," Howell answered.

Miami's program will utilize proven course sequences that have been successful at other institutions, allowing for spaced repetition and emphasis on challenging systems. The program, awaiting accreditation status in September 2022, would matriculate its inaugural class in May 2023.