Journey to DMS | Chapter 1
It’s finally here! The start of my LMU Doctor of Medical Science program.
It’s been 8 months since I was accepted into the program and I’ve been anxiously awaiting this journey. This blog was actually first conceptualized as a way to document my path from PA to Doctor of Medical Science.
Our Origin Story
Since that time, this project has grown and evolved. We are now documenting the journey of all PAs. We want to unequivocally declare our desire and capacity to practice medicine at the top of our training and license and we will continue to fight for a place at the table. American healthcare needs PAs.
Our purpose at The PA Doctor is to advocate for Optimal Team Practice and Full Practice Authority for all PAs. This should not be viewed as an affront to physicians. It truly pains us that some will choose to see it this way. We appreciate and respect the physicians with whom we associate. We are grateful to learn from them. But the model of residency-trained Doctors of Medicine is not meeting the needs of our nation.
We truly believe that PAs are the solution and that PAs who study clinical medicine for 2 more years and go on to become Doctors of Medical Science can increasingly fill the shortages created by the current system. We believe PAs are awesome and get better with time and experience but we also believe that PAs with a clinical DMS are even more capable.
New Student Orientation
We met together as a cohort for the first time last week. Most of my classmates seem to be from the East Coast though a few are from the West Coast and one or two are from the Midwest. There are at least two PAs with over 20 years of experience and a few with around 10 years of experience. The majority, however, seem to have around 5 years of work experience. We met via Zoom for a few hours and discussed pre-program requirements and laid out an outline for our research project. The meeting was led by Drs. Moran and Miksa, both DMS PAs.
Our first assignment is to take a 60-question Family Medicine mock board exam through the New England Journal of Medicine Knowledge+ program. The questions were excellent and very appropriate for primary care—my chosen cognate (the clinical DMS track at LMU has three cognates available: primary care, internal medicine, and emergency medicine). I finished my exam with a higher-than-average score.
If in doubt, choose “C”!
I’ve always felt this is a relevant point… If PAs could take and pass physician board exams, why not grant them physician rights? It would be an excellent way to prove the competency and the validity of alternative educational models. I think PAs should be able to challenge and test out of USMLE Step 3. What complaint could someone have about a PA with 5 to 10 years of experience that also passed the same final licensing exam as a physician? What if that PA then passed the very same specialty board exam? Residency training is extremely valuable but it’s not the only way to produce a competent clinician.
At the end of the DMS program, we will all take the same mock board exam once again. LMU uses this data for its own internal QI. We were also told that as we progressed through the modules pertaining to major organ systems, we would have to return and complete a certain number of questions from the same NEJM database.
I haven’t had homework in a long time.
There would also be assigned readings and more assigned questions from what is referred to as the MKSAP or the Medical Knowledge Self-Assessment Program. This is another board-prep program produced by the American College of Physicians. I purchased the digital version of MKSAP 18 for approximately $600. It would have been a bit cheaper had I also become a member of the ACP, but I didn’t really want to mess with that.
We were given the option of purchasing the MKSAP Complete which is a combination digital and print package that would have cost around $1,000 for a non-ACP member. I considered this as I would have liked to make notes in a physical copy but ultimately I value the portability and minimalist approach of the digital version.
Class starts in about 10 days, on Monday the 24th. The University uses a learning management system called Blackboard. From Blackboard we’ll be able to access recorded lectures and other assignments.
Grand Rounds
Another core feature of the DMS at Lincoln Memorial University is the 2-hour “grand rounds” occurring every Sunday evening throughout the 4-semester program. As I understand it, these discussions are physician-led and involve small groups presenting a case on which they collaborated throughout the week. We were encouraged to prepare a PowerPoint to facilitate the case presentation.
Our first module is cardiology.
What is the goal of obtaining a DMS degree?
To be a better clinician. To take better care of people. To grow and to improve.
Now that the LMU program has been halted, what program are you in?
The LMU DMS is still open and currently taking applications for 2023.
What are the lectures like? Is most of the program self directed learning through reading with input from educator?
Great question, Zack. Most of the work is assigned readings from MKSAP, UpToDate, Lachman’s Case Studies in Anatomy, and various journal articles. There are several pre-recorded imaging/anatomy lectures from the radiologist each week. Then there are weekly group cases that we work on asynchronously. Those cases are then summarized in weekly live presentations with a specialty physician (a 2-hour class each Sunday).