PA - NP TRANSITION
FROM SPECIALTY PRACTICE
Physician assistants and nurse practitioners have a
unique ability to change specialties and practice within all fields of
medicine. How do they competently and safely move from one specialty to
You are listening to ReachMD XM 157, the channel for
medical professionals. Welcome to the clinician's roundtable. I am Dr.
Lisa D'Andrea your host and with me today is Dr. Candes
Cain. Candes is a Physician Assistant and the Founder and CEO of Clinical
Concepts, a preceptorship program to assist PAs and NPs in specialty
Today, we are discussing the PA-NP transition from
Hi Candice! Welcome to ReachMD.
What we do is we match someone and when I say someone, I am
speaking of nurse practitioners or PAs, that are wishing to transition into
another specialty, something that they do not have experience in with someone
who is actually practicing in that specialty. So, if someone contacted
Clinical Concepts and say for instance, they had 5-6 years in family medicine
and wanted to go to a more specialized field such as cardiology, there would be
some transition for them. They would have seen patients that certainly have
cardiac disorders in family medicine, but they did not actually treat them
specifically for those disorders by certain testing and medications. So, what
they will do is they go and work with a nurse practitioner or a PA who is
working in cardiology specifically and just spend the time with them learning
the perils that they have learned over the years, learning certain tests and
they do rounding on hospital patients, seeing patients in clinic, learning
specific exam techniques and also obtaining the knowledge that they learned of
what works for that patient.
How is this different from PA or NP clinical rotations?
That is a good point. They do have some residency programs
available. They are more specific for surgical training, but to do a residency
program, you are going to have to dedicate about a year to 12 months of your
life and you are going to have to travel to that location. I am only aware of
2-3 programs that are available postgraduate for residencies and that would
require you being away from your family, away from your home for that amount of
time, you would make a small of salary, but many times as individuals that have
become professionals in this field, we have already developed a home, a family
requirements that would not allow us to be out of our type of work for that
period of time.
So, let's say about being a clinician for 5 years, but I
have practiced solely in family medicine and now I want to practice orthopedic
surgery. How does Clinical Concepts help me?
Well, I would pair you with a provider in orthopedic
surgery. You would go to their normal daily practice. You would travel to
their clinic and hopefully with the amount of preceptors we have in the US, I
would be able to match you closely to your own home location and you would work
with that individual strictly on a one-on-one basis. You would round with that
person, see consult patients, go over diagnostic imaging, MRI, CT scan, x-rays,
see different exam techniques on the patients and then determine which
treatment protocol would best fit that patient. So, you got their attention
one-on-one to ask them very specifically why didn't you choose this medication
over this medication, why didn't your next step include a CT scan versus MRI?
And say, you can take that knowledge and apply it to your patients in orthopedics.
And how long is this process?
It is tailored for you, it's how we describe Clinical
Concepts programs because you can do the preceptorship for as long as you are
able to. Most people, like we said before, are already practicing
professionals who are going to be spending vacation time or actually
transitioning into a new specialty, so generally we see about a week to 2
Does anyone get hired into the practices that they rotate
If you are just joining us, you are listening to the
clinician’s roundtable on ReachMD XM 157, the channel for medical
professionals. I am Dr. Lisa D'Andrea and I am speaking with Dr. Candice Cain,
founder and CEO of Clinical Concepts, a preceptorship program to assist PAs and
NPs in specialty transition.
I think it is a good idea. I think it is necessary idea.
So many physicians that are specialty based are needing the assistance of
midlevels or clinicians to help them with their practice. I myself went
straight into a specialty from school and it would be very difficult for me to
transition into family medicine without having some steps to take towards going
into that. Right now, I don't practice family medicine. I am in a surgical
specialty and if I had to treat hypertensive-diabetic patient, they would be a
learning curve for me.
Ultimately, I would say you need more time, however, when
you consider what we are and what we are actually doing, it is sufficient. It
provides a working base knowledge. It is not going to make them technically
proficient in skills and have them ready to start the practice without any
further training from their physician, but it will provide them a very strong
working base knowledge to build upon. Remember we are all licensed
individuals. We have all had the training at one point. We just need that
extra brushing that revamping if you will.
I find it to be scary myself and I hope that that is not
really what is happening. I hope that yes someone is going from family
medicine to CV surgery, that before they actually scrub in for a case to do the
vein harvesting or assist in a case, they have had some bridge to gap the
experience they did not have. I would hope they wouldn't go from Friday in the
family medicine to Monday scrubbing into surgery. I think that it needs to be
a knowledge they are based on all parties, on the providers, the physicians,
and the patient expectations that we are able to do that, but it is a
transition for us and there is going to be a learning curve. Some facilities
have also contacted Clinical Concepts when they are credentialing a new
provider for a surgical specialty in the hopes that they can attend one of the
preceptorship programs just to kind of get them a little more information and
help bridge that gap.
Yeah, I know that some of the PA specialties have started
some specialty recognition training as well. Do you think that is a good idea
and how do you feel about specialty certification?
I think that it is a good idea when we are talking about
going into new specialties; however, I would hope and I am a little fearful
that it may come into play in the future that its requirement before we can do
any type of specialty transitioning and I think that that might hurt our
profession. If we had to attend a residency program, for instance there was 12
months to 24 months to change specialties that would significantly decrease the
availability of PAs and nurse practitioners for some physicians that are
needing specialty trained extenders because if you have a practice that you
have done for 5 or 6 years, I know it would be extremely difficult for me to
quit work, move, go to a residency program for 12 to 24 months just to be able
to change specialties, so I myself would probably stay in the specialty that I
was in. Thereby, making our <_____> much hindered and so I hope that it
does not come