The accelerated physician assistant pathway: a three-year medical school curriculum for physician assistants to obtain DO degrees.

PROBLEM: To address physician shortages, many have called for medical schools to increase their applicant pool size by broadening their selection criteria. Physician assistants (PAs) are one group that has demonstrated competency and medical knowledge. However, financial and time barriers exist to their applying to traditional four-year programs. APPROACH: The authors designed a three-year accelerated curriculum for PAs to obtain DO degrees. Over the summer, after their first year of didactic instruction, students complete two 4-week primary care clinical clerkships. The second year of didactic study is followed by additional clinical clerkships, for a total of 138 weeks of instruction-82 weeks of didactic instruction, which is identical to that of the traditional curriculum, and 56 weeks of clinical clerkships. OUTCOMES: The inaugural class of 7 students matriculated in July 2011. In the first three years, 25 students joined the program. Mean age at matriculation is 31.8 years compared with the national mean of 25 years. Mean length of clinical practice before matriculation is 5.4 years. The inaugural class completed the COMLEX-USA Level 1 exam, achieving a 100% pass rate with a mean score 96 points above the national mean. NEXT STEPS: The authors will assess students' residency placements to gauge the medical community's reaction to the accelerated curriculum. They also recommend that alternatives to the existing admission requirements be considered. This program removes many barriers to PAs returning to medical school and expands the applicant pool by adding candidates with clinical experience, helping to address primary care physician shortages.

Preliminary outcomes of the Lake Erie College of Osteopathic Medicine's 3-year Primary Care Scholar Pathway in osteopathic predoctoral education.

CONTEXT: In 2007, the Lake Erie College of Osteopathic Medicine initiated its Primary Care Scholar Pathway (PCSP), a 3-year osteopathic predoctoral education curriculum. OBJECTIVE: To assess preliminary outcomes of the PCSP curriculum. METHODS: Scores for the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Levels 1 and 2-Cognitive Evaluation (CE) and pass rates for Level 2-Performance Evaluation (PE) were obtained for individuals who graduated from the PCSP program in 2010, 2011, and 2012. Scores for Levels 1 and 2-CE were compared with national mean scores. Acceptance rates for residency programs were also recorded. RESULTS: Nineteen PCSP graduates were included in the study: 3 graduated in 2010, 6 graduated in 2011, and 10 graduated in 2012. Scores for PCSP students were not significantly different than national average scores for COMLEX-USA Levels 1 and 2-CE (P>.05). All 19 PCSP graduates passed the COMLEX-USA Level 2-PE on the first attempt, and all graduates were accepted into primary care residency programs. CONCLUSION: The COMLEX-USA scores of PCSP graduates were similar to national mean scores, suggesting that it is possible for osteopathic medical students to attain the same level of education as students of 4-year programs in less time. A 3-year osteopathic predoctoral education curriculum would allow students to complete their education at a reduced cost. This potential reduction in debt burden could encourage more students to pursue a primary care career and thus could help address the shortage of primary care physicians in the United States.

The challenges of primary care and innovative responses in osteopathic education.

Numerous reports predict U.S. primary care physician shortages, with deficits of 20,000-46,000 doctors projected by 2020-25. Doctors of osteopathic medicine (DOs) could help fill some of the gap alongside their medical doctor (MD) colleagues. Many osteopathic schools have undertaken initiatives to reinvigorate primary care career choices among students. This paper describes these developments, and it highlights as examples early-stage innovations at Lake Erie College of Osteopathic Medicine and A.T. Still University School of Osteopathic Medicine in Arizona. It will be several years before the changes can be assessed. The final outcome awaits coordinated national design changes in primary care support and training and in health care coverage.

Lake Erie College of Osteopathic Medicine's preclinical problem-based learning pathway program: an alternative medical school curriculum design.

In 1999, the American Osteopathic Association approved plans for "substantive change" to the medical curriculum at Lake Erie College of Osteopathic Medicine (LECOM) in Erie, Pa. In addition to the school's traditional, lecture-based curriculum, LECOM sought to create alternative--but distinct--learning pathways: independent study (described elsewhere) and problem-based learning (PBL). After selecting a long-standing, successful PBL program to guide our efforts and after a 1-year period of planning, developing, piloting, and refining the program, we introduced PBL in the 2000-2001 academic year. This learning pathway consists of carefully constructed cases that allow for progressive disclosure across group-tutorial sessions, from patient presentation to diagnosis and management. With more than 5 years of data on student performance and evaluations, LECOM can investigate the merits of its three basic science learning pathways. The description of LECOM's longitudinal database will allow program evaluators to assess and compare each of the three basic science learning pathways.

A three-year accelerated medical school curriculum designed to encourage and facilitate primary care careers.

For the past decade there has been declining medical student interest in primary care. The cause of this trend is multifactorial and includes issues of salary and indebtedness. Educational leaders have called for careful selection of medical students and the creation of three-year medical school curricula to counter these factors. On April 30, 2006, the American Osteopathic Association Commission on College Accreditation voted to approve a new accelerated curriculum at the Lake Erie College of Osteopathic Medicine (LECOM) in Erie, Pennsylvania. This pathway accelerates the traditional four-year medical school curriculum into three calendar years. In addition to reducing the time necessary to complete medical training as a primary care physician, this pathway reduces the expense involved in obtaining a medical education. This paper describes how LECOM positioned itself to address key strategies believed to be at the heart of rekindling student interest in primary care. In the accelerated curriculum, summer vacation between the first and second medical school year is eliminated. Clinical education is streamlined by focusing on 16 rotations relevant to primary care and eliminating elective experiences. Primary care mentors are assigned at the start of medical school. Case-based capstone sessions are added throughout the clinical years to reinforce primary care concepts. Students in this curriculum are designated "primary care scholars" to recognize the fact that they are engaged in a rigorous, goal-directed curriculum. Consistent with published recommendations for increasing medical students' choice of generalist careers, a detailed description of the LECOM accelerated curriculum effort is provided.