Journey to DMS | Chapter 6

We finished up the nephrology module and are now in the third week of hematology for the LMU Doctor of Medical Science program. I just finished reading a MKSAP chapter on Oncologic Emergencies, so I thought I’d take a few minutes to provide an update before working on some NEJM questions and catching up on reading from last week.

The hematologist running this module is very active on the discussion boards. We got used to two-part cases during the cardiology and nephrology modules but my group’s last heme/onc case had 5-6 parts! They are challenging cases and typically from the physician’s own practice. I had to laugh when we spent a week trying to figure out if our last patient had catastrophic antiphospholipid antibody syndrome or a rare renal presentation of thrombotic thrombocytopenia. At the end of the week, the physician said that they actually weren’t able to decide either–they called it an “overlap syndrome”, treated her for both and she got better!

Reading assignments

We don’t seem to have as many lectures in this module from the radiologist who covers both imaging and anatomy. But what we lack in lectures is made up in reading… Just this week we have 3 UpToDate articles:

• “An overview of the initial treatment and prognosis of lung cancer”
• “Systemic treatment for HER2-positive breast cancer”
• “Cardiotoxicity of trastuzumab and other HER2-targeted agents”

Even the primary care physician I work with was surprised by how specific some of our readings are!

I’m unfortunately a little behind in this module. In addition to this being the largest section in ACP’s MKSAP (22 chapters; cardiology and nephrology had 13 and 12 respectively), I spent the first two weeks recovering from a nasty respiratory bug. Thankfully, not COVID! I hope to catch up next week over the week break we get for Thanksgiving. Too bad I don’t get a break from the clinic.

I finally have a research project in mind. An introduction is due by the end of this semester to make sure we have identified a topic and formulated a clinical question. From my conversations with my faculty mentor, this is more about making forward progress than producing a perfectly written piece; I hope to have this ready by Thanksgiving as well.

On an unrelated note…

There was an interesting post on social media today about a PA to DNP bridge. I thought it was a fair question. The person asking seemed to recognize the dwindling number of PA jobs in comparison to NPs. Quite a few people were critical of this person and accused her of abandoning the profession. I don’t think there’s anything sacred or holy about being a PA. I believe we are “taller than the shortest giants” and ought to have full practice authority but I’m not married to being a PA–that’s not how I identify myself.

I’m blessed to take care of people and to make a good living doing so. I don’t care if that’s as an MD, PA, or DNP. I do believe, however, that current restrictions of PA autonomy do nothing to improve patient care and actually harm it.

I wish becoming a Doctor of Medical Science would remove some of those restrictions, but unfortunately at this present time, that’s not the case. I am certain, however, that I’ll be a better clinician when it’s all over and that’s really all that matters.