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Best route for pre-health students (MD, NP, PA)

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Hey, I have yet to see any threads asking this question so I thought I would bring it up. As a fair warning, i'm a Quebec student finishing high school, so I still have a while to think about the subject.

As someone interested in health sciences, specifically medicine, there are indeniably far more opportunities and routes than before. Doctors aren't the only practitionners of medicine: NPs and PAs have expanded their scopes of practice and can suppliment a physician in certain cases. In the US it seems as though NPs can completely replace a primary care physician. However, in Canada scopes of practice are very different, especially in Quebec.

So, what is the defining difference between the scope of practice of an NP and an MD, in Canada? For PAs it's quite simple; they practice under an MD. (At least from what I understand) I'm curious since i'll be choosing very soon what route i'll be taking. I lean towards medicine since becoming a specialist is what interests me. What roles exist for NPs in non primary care areas (Specifically things such as IM specialties and surgery) Do you think Canada will follow the US in integrating more expansive roles for NPs and PAs? Will PAs ever be integrated in all provinces or will the project be scraped? 

Thanks for any answers!

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I’m not familiar with NP scope of practice/legislation in Quebec so maybe someone familiar could give you more information.

I wouldn’t say there is one ‘defining’ difference between NP and MD practice, there are a multitude of differences. NPs are Registered Nurses first and foremost with advanced training and education in assessment, diagnosis and treatment. NPs often approach patients holistically because of their nursing model of education, and do a lot of work around health promotion and disease prevention, and management of chronic illness, in addition to any medical or nursing treatment they provide. NP treatment is often centered around pharmacotherapy, but NPs can also perform minor procedures such as suturing, excision and drainage, intubation, some insertions, and other things depending on provincial legislation and the individual NP’s competencies. There are also several legal differences and physicians are legislated by Medical Acts and NPs by RN acts (at least in Nova Scotia) which defines certain things NPs can and cannot do, along with the nursing regulatory bodies. 

NPs (at least in NS) are autonomous practitioners who are required to practice “in collaboration” with a physician/group of physicians. This means that NPs here are responsible for their own patients and can perform all their own diagnostics/procedures and write their own orders/prescriptions but have a formal agreement with a physician(s) that the physician is available for consultation or to assume care of the patient if required. The definition of ‘collaboration’ varies by geographic area and area of NP practice and can range from direct oversight to phone/email contact if needed.

There are many different areas you can work in as an NP, almost all IM specialty areas. NPs often work in nephrology/dialysis, cardiology, endocrinology, respirology etc. Surgical roles for NPs are definitely more limited as NPs don’t perform surgery, so if you’re interested in surgery, NP probably isn’t for you.

All the NPs I’ve spoken to recently (at least in NS) see the NP scope as continuing to expand, and NPs to assume greater roles in acute care. If you are considering becoming an NP you should first decide if you want to be a nurse, because NPs are nurses first, and you will have to go through nursing school and work as an nurse before taking NP education. You could take nursing and then apply for med school as well, and if you enjoy nursing, it could be an excellent career if you don’t end up getting into medicine and you could take NP down the road. Hope that answers some of your questions regarding NP. Again I can’t speak specifically for Quebec, nor do I really know anything about PA practice so someone else may be able to help you out there.

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Hey does anybody have advice on what I should do? I want to do a major in life science at McMaster as like premed but I’m not sure if I can do it. My sister didn’t make it into med school and my whole family isn’t supporting me in wanting to go. If I see that I can’t get at least a 3.6 gpa in life science first and second year and that my mcat score will be too low should I just go into an accelerated nursing program and later on become a np? Cause I want to have a backup plan if I can’t make it into med school or pa school and I know I won’t be able to do anything with a degree in life science. I would do a four year nursing degree but nursing is super hard and I def wouldn’t get a high enough gpa to get into med school. What major should I do that in ur opinion would be easier to get a high gpa in ? Kin life science or nutrition even I don’t know. Or maybe is nursing a safer route so then If I don’t make it to med school I can just be a nurse and later an np?

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On 5/3/2018 at 1:11 PM, angelav said:

Hey does anybody have advice on what I should do? I want to do a major in life science at McMaster as like premed but I’m not sure if I can do it. My sister didn’t make it into med school and my whole family isn’t supporting me in wanting to go. If I see that I can’t get at least a 3.6 gpa in life science first and second year and that my mcat score will be too low should I just go into an accelerated nursing program and later on become a np? Cause I want to have a backup plan if I can’t make it into med school or pa school and I know I won’t be able to do anything with a degree in life science. I would do a four year nursing degree but nursing is super hard and I def wouldn’t get a high enough gpa to get into med school. What major should I do that in ur opinion would be easier to get a high gpa in ? Kin life science or nutrition even I don’t know. Or maybe is nursing a safer route so then If I don’t make it to med school I can just be a nurse and later an np?

Hi Angela!

When you are considering a professional program (e.g. Nursing, MD, PA, Nurse Practitioner etc.), what's more important are the courses you take to fulfill requirements - not the major. There isn't a "best" major to get into any of the professional programs as many successful candidates come from various backgrounds. Some come from heavy science backgrounds (e.g. Biology, Life Sciences, Biochemistry, Pharmacology, Biomedical Sciences... etc.) and others from Non-Science/not-as-heavy science majors (e.g. Social Work, Philosophy, Humanities) - this is applicable to PA, medicine, and some other health care programs too. 

Life sciences at McMaster during year 1 is the same for everyone. However once you are done, you can pick a multitude of different "majors" to specialize in, including those with co-op: 

 

Quote

 

From the Life Sci website: http://future.mcmaster.ca/programs/lifesci/

Honours Bachelor of Science (Hons. B. Sc.) Programs

  • Honours Biochemistry
  • Honours Biochemistry – Biomedical Research Specialization*
  • Honours Biology
  • Honours Biology – Discovery Sub-Plan
  • Honours Biology – Physiology
  • Honours Biology and Environmental Sciences
  • Honours Biology and Mathematics
  • Honours Biology and Pharmacology Co-op*
  • Honours Biology and Psychology, Neuroscience & Behaviour
  • Honours Life Sciences*
  • Honours Molecular Biology and Genetics*
  • Honours Neuroscience**
  • Honours Psychology, Neuroscience & Behaviour
  • Honours Psychology, Neuroscience & Behaviour – Mental Health Specialization
  • Honours Psychology, Neuroscience & Behaviour – Music Cognition Specialization

 *Co-op programs are available, beginning in Level III

Honours Bachelor of Applied Science (Hons.B.A.Sc.) Programs

  • Honours Human Behaviour
  • Honours Human Behaviour – Autism & Behavioural Science Specialization
  • Honours Human Behaviour – Early Childhood Education Specialization

Bachelor of Science (B. Sc.) Programs

  • Life Sciences

 

 

Also, there are so many different factors that go into what makes a "competitive" candidate for any health care professional program - GPA, leadership, communication, extra-curriculars, references, admission test scores (e.g. MCAT, DAT, PCAT, GRE, etc.) that looking at 'the best major for pre-med' isn't quite the right question to be asking (IMO!).

There are pros and cons to any major you take, but what's important to keep in mind:

As long as you fulfill prerequisite courses for the programs you are interested in, you can apply to that health care program. You can complete those courses when you pick "electives" in university or during your summers (be sure to check if the program will accept the course if taken in summer). 

You have to ensure you do well overall in all of your courses, including the pre-requisite courses (if applicable) for programs you are applying to. This means developing the discipline and habits to study, manage your time, plan ahead, etc. You will inevitably have to take hard courses. 

I would consider yourself "pre-health" before you decide you are "pre-med" "pre-pa" etc.  as it sounds like you are still exploring your options (kin vs. nursing vs life sciences). Have you considered other careers such as Pharmacy? Dentistry?  Optometry? Radiation Sciences? Physiotherapy? Speech, Language, Pathology? Occupational Therapy? etc. I'd suggest doing some research about different professions, going to your guidance counselor in high school (better yet, when you reach uni - find "Career Services" and see if you can setup an appointment to discuss long term planning [i.e. courses, etc] for your academic career. 

You do not have to decide your "forever career" now. Keep a few "top choice careers" in mind  - but make sure to research, research, research:

  • do an informational interview with someone who works in the field, also try to find shadowing opportunities
  • volunteer in a health clinic where the profession you are interested in is working, attend career information sessions
  • speak to current program students (e.g. Med students, PA students) - whom you can find at Career Fairs, Open House Info Sessions (for example, University of Toronto hosts "UofT Medicine Interprofessional Open House" where you can speak to students and alumni from various health care careers - including dentistry, medicine, pharmacy, PA, nursing, radiation sciences, OT, PT, etc.)
  • join the pre-med club on campus (each university usually has one) and they usually host information sessions about med schools and other health care related fields. 

Having a competitive GPA will help you, regardless of what health care program you want to apply to. Here are some tips that you may find helpful to maintain a good GPA for a class: 

  • If you are concerned about your workload for the semester, consider taking a balance of hard courses and "easier" courses (you can find out from upper year students or some of your peers which are easier to take) if you plan on having a full course load for that semester
  • Consider making use of T.A. time, or professor office hours to get extra help on problems. Form study groups. 
  • Develop techniques for studying effectively; rather than just "passively reading" material - work to apply what you learn - practice as many questions as you can (from homework assignments, or even practice questions at the end of a textbook chapter, etc.).
  • Find out what resources are available at your university for supporting students in first year (e.g. I attended a workshop in my first year of undergraduate study  run by upper year students on 'how to study for university'. )
  • If you are contemplating taking a harder course (e.g. Organic Chemistry), see if you can take it during the summer, and hire a tutor (Master's or PhD student, or you can look online). 
  • Crowdsource resources for studying - for instance while going to McMaster University I used the forum http://macinsiders.com (and we have a forum called "Learn Link") where we could troubleshot problems and share resources for courses together. Other universities may have this. Macinsiders does have a section on "First Year Success" you might find helpful!

I would suggest speaking with your guidance counselor and explore majors based on your personal interest, long term goals and skills.

  • Do some self-reflection and determine what interests  you
  • You can look at statistics of students who get in and find out what majors they are taking (might take some detective work, but I'm sure the information is out there!). 
  • Try googling, "What premed major should i take?", you'll find some advice from test prep courses like Kaplan. Some people choose majors based on what they think will help them perform better on tests like the MCAT. Take the advice with a grain of salt of course. 

You can also speak with a career counselor in your first year of university, they can talk to you about what courses to take, options about switching majors, and help you with some tools and resources to figure things out (this can include career / vocational tests, making arrangements for you to speak with a med student or PA student, etc.). 

As you go through your undergraduate studies, you may find you might have a 'change of heart' when it comes to what you want to pursue. That might come from a volunteer experience, exposure to a clinical / research opportunity, a mentor/TA/professor/ that has impacted you... 

If you're interested in reading more about what courses to take for PA admissions, you can learn more here: http://canadianpa.ca/prepa-courses/

Hope you found this helpful! Of course, this is based on my own experiences deciding on a career path/major/courses, as well as speaking to numerous Pre-PA students. Let me know if you have more questions!

Cheers,

- Anne

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