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Professional Education of Physicians and Nurses

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  • 1. 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
  • 2. Presenters
    • Steven R. Shelton., M.B.A., PA-C
      • Executive Director, East Texas Area Health Education Center, The University of Texas Medical Branch at Galveston
    • MC. Noemi Alcaraz Moreno
      • Directora, Facultad de Enfermeria, Universidad de Colima
    • Lic. Patricia Salazar Diaz
      • Directora, Programa Universitario de Ingles y Centro de Auto acceso
      • Universidad de Colima
  • 3. Physician Education in the U.S.
    • 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
  • 4. Preparation for Medical School
    • Preferred academic preparation varies by medical school, depending on emphasis/values
      • Science/technology background
      • Humanities background
    • Work experience in health care highly valued
    • Community service of interest to some schools
    • Minimum of 90 credit hours, usually prefer a degree
  • 5. Application to Medical School
    • Candidates consider their “fit” with schools of interest
      • Professional interest
      • Cost/finances
      • Special interests
      • Location
      • Student support
    • Early guaranteed admission
  • 6. Application…
    • Medical College Admission Test - MCAT
    • Texas Medical and Dental Schools Application Service – TMDSAS
    • Amer. Assn. of Colleges of Osteopathic Medicine Application Service
  • 7. Selection to Medical School
    • Schools rank candidates based upon formula scoring preferred attributes
      • MCAT
      • Grade point averages
      • Service points
      • Recognition points, etc
    • Candidates interviewed and re-scored
    • Ranked and invited to attend
  • 8. Admission to Medical School
    • Candidates select preferred school to enter
    • Student entry planning completed
      • Financial aid
      • Pre-matriculation programs
      • Orientation
      • Housing ,etc.
  • 9. Medical School Curriculum
    • School by school variations
      • Traditional curriculum - lecture
      • Innovative curriculum
        • Problem-based curriculum, case studies
        • Independent study curriculum
  • 10. Standard Elements of Curriculum
    • Year one
      • Basic sciences
        • Anatomy and physiology
        • Neuroscience
        • Behavioral science
        • Biochemistry
      • Introduction to patient
        • Hx and PE
      • Genetics, nutrition, human sexuality, etc
    • Year Two
      • Basic-to-Clinical Sciences
        • 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
  • 11.
    • Year Three
      • Clinical Clerkships
        • Four week blocks of required rotations
        • Medicine
        • Pediatrics
        • Surgery
        • Obstetrics-gynecology
        • Psychiatry
      • Sit for national board exams, part 2
    • Year Four
      • Clerkships and electives
        • Four week blocks
        • Neurology
        • Dermatology
        • Family medicine
        • Radiology
        • Otolaryngology
        • Specialties
      • Apply, interview and match to residency training
  • 12. Post-graduate Medical Education
    • 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
  • 13. Nursing Education in the U.S.
    • 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
  • 14. Levels of Nursing Education
    • Practical nursing - certificate
      • LPN/LVN - training usually at community college or vocational/ technical training center
        • 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
  • 15. Levels of nursing education…
    • Diploma nursing
      • RN – training conducted by a sponsoring organization, usually a hospital
        • Two accredited in Texas
        • Graduates often work for sponsor
        • Sit for NCSBN-administered NCLEX-RN exam
        • Licensed as registered nurse
  • 16. Levels of nursing…
    • 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
  • 17. Levels…
    • 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
  • 18. Levels…
    • 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
    • Doctoral – PhD, DScN
      • Preferred among faculty, and top executive positions
      • 7 programs in Texas, none currently listed as accredited by NLNAC
  • 19. Preparation for Nursing School
    • 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
  • 20. Application to Nursing School
    • Candidates consider their “fit” with schools of interest
      • Professional interest
      • Cost/finances
      • Special interests
      • Location
      • Student support
  • 21. Selection to Nursing School
    • Schools rank candidates based upon formula scoring preferred attributes
      • Grade point averages
      • Service points
      • Recognition points, etc
    • Candidates interviewed and re-scored
    • Ranked and invited to attend
  • 22. Nursing School Curriculum
    • 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
  • 23. Core Competencies of Curriculum
    • 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
    • Involve patients and families in decision-making
    • 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
  • 24. Resources
    • 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