Transcript Professional Education of Physicians and Nurses: The U.S

Professional Education
of Physicians and
Nurses:
The U.S. and Mexico
Policy Forum
Access to Health Care in the
U.S.-Mexico Border Region
El Paso, TX
October 14, 2004
Presenters
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Steven R. Shelton., M.B.A., PA-C
• Executive Director, East Texas Area Health
Education Center, The University of Texas Medical
Branch at Galveston
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MC. Noemi Alcaraz Moreno
• Directora, Facultad de Enfermeria,
Universidad de Colima
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Lic. Patricia Salazar Diaz
• Directora, Programa Universitario de
Ingles y Centro de Auto acceso
• Universidad de Colima
Physician Education in the U.S.
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125 accredited allopathic medical
schools
Liaison Committee on Medical
Education(AAMC and AMA) accredits
US and Canadian allopathic schools
20 accredited osteopathic medical
schools
Commission on Osteopathic College
Accreditation for osteopathic schools
Preparation for Medical School
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Preferred academic preparation
varies by medical school, depending
on emphasis/values
• Science/technology background
• Humanities background
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Work experience in health care highly
valued
Community service of interest to
some schools
Minimum of 90 credit hours, usually
prefer a degree
Application to Medical School
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Candidates consider their “fit”
with schools of interest
• Professional interest
• Cost/finances
• Special interests
• Location
• Student support
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Early guaranteed admission
Application…
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Medical College Admission Test MCAT
Texas Medical and Dental
Schools Application Service –
TMDSAS
Amer. Assn. of Colleges of
Osteopathic Medicine Application
Service
Selection to Medical School
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Schools rank candidates based upon
formula scoring preferred attributes
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MCAT
Grade point averages
Service points
Recognition points, etc
Candidates interviewed and re-scored
Ranked and invited to attend
Admission to Medical School
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Candidates select preferred
school to enter
Student entry planning
completed
• Financial aid
• Pre-matriculation programs
• Orientation
• Housing ,etc.
Medical School Curriculum
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School by school variations
• Traditional curriculum - lecture
• Innovative curriculum
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Problem-based curriculum, case studies
Independent study curriculum
Standard Elements of
Curriculum
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Year one
• Basic sciences
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Anatomy and
physiology
Neuroscience
Behavioral science
Biochemistry
• Introduction to
patient
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Hx and PE
• Genetics, nutrition,
human sexuality, etc
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Year Two
• Basic-to-Clinical
Sciences
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Pharmacology
Microbiology
Pathology and
disease states
Immunology
Integrated clinical
medicine
• Clinical Introduction
• Community med,
public health, ethics,
etc
• Sit for national board
exams, part 1
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Year Three
• Clinical Clerkships
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Four week blocks of
required rotations
Medicine
Pediatrics
Surgery
Obstetricsgynecology
Psychiatry
• Sit for national board
exams, part 2
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Year Four
• Clerkships and
electives
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Four week blocks
Neurology
Dermatology
Family medicine
Radiology
Otolaryngology
Specialties
• Apply, interview and
match to residency
training
Post-graduate Medical Education
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Internship – first year in specialty or
rotating among specialties
Residency – up to five years of
specialty training, followed by state
board certification for practice entry
Fellowship – additional years of
training/teaching within specialty
Nursing Education in the U.S.
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About 1700 accredited nursing
schools
Voluntary accreditation of US
schools by National League for
Nursing Accrediting Commission
• Interpretive Guidelines for
Standards and Criteria for all levels
of nursing education
Levels of Nursing Education
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Practical nursing - certificate
• LPN/LVN - training usually at
community college or vocational/
technical training center
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56 in Texas, 3 accredited
~12 months of study
Sit for licensing examination by
National Council of State Boards of
Nursing (NCSBN)
Licensed as LVN in Texas
Levels of nursing education…
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Diploma nursing
• RN – training conducted by a
sponsoring organization, usually a
hospital
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Two accredited in Texas
Graduates often work for sponsor
Sit for NCSBN-administered NCLEX-RN
exam
Licensed as registered nurse
Levels of nursing…
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Associate degree programs ADN, at a community college, or
rarely at an upper division school
• 24 – 36 months in duration
• Licensed as RN through NCLEX-RN
examination
• RNs may be certified by American
Nurses Assn in area of specialty
• 49 programs in Texas, 39 accredited
Levels…
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Baccalaureate - BSN, usually at
a general higher education or
health science campus
• Two years of general studies
• two years of nursing studies
• Licensed as RN through NCLEX-RN
• BSN usually required for advanced
education
• 27 programs in Texas, 14 accredited
Levels…
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Masters – MSN
• Is now recommended job standard for
advanced practice, supervising nurses and
usually preferred minimum for faculty
• Clinical nurse specialists – CNM, NP, CNS
• 14 programs in Texas, seven accredited
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Doctoral – PhD, DScN
• Preferred among faculty, and top
executive positions
• 7 programs in Texas, none currently listed
as accredited by NLNAC
Preparation for Nursing School
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High school preparation should
be in recommended or
distinguished graduation plan
Work experience in health care
highly valued
Community service of interest to
some schools
Application to Nursing School
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Candidates consider their “fit”
with schools of interest
• Professional interest
• Cost/finances
• Special interests
• Location
• Student support
Selection to Nursing School
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Schools rank candidates based
upon formula scoring preferred
attributes
• Grade point averages
• Service points
• Recognition points, etc
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Candidates interviewed and rescored
Ranked and invited to attend
Nursing School Curriculum
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Strong attention to detail in standards
for curriculum at all levels helps
uniformity
Curriculum has broad scope and
depth, relevant to each level
Range includes community,
workplace, and individual patient care
elements
Illness care is balanced by wellness
and prevention
Research essential in BSN and up
Core Competencies of
Curriculum
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Population-based health
care skills
Means to assure access
to care
Evidence-based
clinically competent
care
Understanding role of
primary care
Use outcome measures
Use balanced approach
to care
Practice prevention and
wellness care
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Involve patients and
families in decisionmaking
Promote healthy
lifestyles
Adopt communications
and technology in
practice
Improve system
operations and
accountability
Understand role of
physical environment in
health
Exhibit ethical
behaviors in practice
Resources
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Association of American Medical Colleges, www.aamc.org
American Medical Association, www.ama.org
Liaison Committee on Medical Education, www.lcme.org
American Association of Colleges of Osteopathic Medicine,
www.aacom.org
National League for Nursing, www.nln.org
NLN Accrediting Commission, www.nlnac.org
American Nurses Association, www.ana.org
American Association of Colleges of Nursing, www.aacn.org
Texas Nurses Association, www.texasnurses.org
National Federation of Licensed Vocational Nurses, www.nflpn.org
Texas State Board of Medical Examiners, www.tsbme.state.tx.us
Texas State Board of Nurse Examiners, www.bne.state.tx.us
www.texashotjobs.org
Federation of State Medical Boards, www.fsmb.org
Educational Commission for Foreign Medical Graduates,
www.ecfmg.org