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Professional Education of Physicians and Nurses: The U.S. and Mexico

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... East Texas Area Health Education Center, The University of Texas Medical Branch at Galveston ... Texas State Board of Medical Examiners, www.tsbme.state.tx.us ... – PowerPoint PPT presentation

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Title: Professional Education of Physicians and Nurses: The U.S. and Mexico


1
Professional Education of Physicians and Nurses
The U.S. and Mexico
  • Policy Forum
  • Access to Health Care in the
  • U.S.-Mexico Border Region
  • El Paso, TX
  • October 14, 2004

2
Presenters
  • Steven R. Shelton., M.B.A., PA-C
  • Executive Director, East Texas Area Health
    Education Center, The University of Texas Medical
    Branch at Galveston
  • MC. Noemi Alcaraz Moreno
  • Directora, Facultad de Enfermeria, Universidad
    de Colima
  • Lic. Patricia Salazar Diaz
  • Directora, Programa Universitario de Ingles y
    Centro de Auto acceso
  • Universidad de Colima

3
Physician Education in the U.S.
  • 125 accredited allopathic medical schools
  • Liaison Committee on Medical Education(AAMC and
    AMA) accredits US and Canadian allopathic schools
  • 20 accredited osteopathic medical schools
  • Commission on Osteopathic College Accreditation
    for osteopathic schools

4
Preparation for Medical School
  • Preferred academic preparation varies by medical
    school, depending on emphasis/values
  • Science/technology background
  • Humanities background
  • Work experience in health care highly valued
  • Community service of interest to some schools
  • Minimum of 90 credit hours, usually prefer a
    degree

5
Application to Medical School
  • Candidates consider their fit with schools of
    interest
  • Professional interest
  • Cost/finances
  • Special interests
  • Location
  • Student support
  • Early guaranteed admission

6
Application
  • Medical College Admission Test - MCAT
  • Texas Medical and Dental Schools Application
    Service TMDSAS
  • Amer. Assn. of Colleges of Osteopathic Medicine
    Application Service

7
Selection to Medical School
  • Schools rank candidates based upon formula
    scoring preferred attributes
  • MCAT
  • Grade point averages
  • Service points
  • Recognition points, etc
  • Candidates interviewed and re-scored
  • Ranked and invited to attend

8
Admission to Medical School
  • Candidates select preferred school to enter
  • Student entry planning completed
  • Financial aid
  • Pre-matriculation programs
  • Orientation
  • Housing ,etc.

9
Medical School Curriculum
  • School by school variations
  • Traditional curriculum - lecture
  • Innovative curriculum
  • Problem-based curriculum, case studies
  • Independent study curriculum

10
Standard Elements of Curriculum
  • Year one
  • Basic sciences
  • Anatomy and physiology
  • Neuroscience
  • Behavioral science
  • Biochemistry
  • Introduction to patient
  • Hx and PE
  • Genetics, nutrition, human sexuality, etc
  • Year Two
  • Basic-to-Clinical Sciences
  • Pharmacology
  • Microbiology
  • Pathology and disease states
  • Immunology
  • Integrated clinical medicine
  • Clinical Introduction
  • Community med, public health, ethics, etc
  • Sit for national board exams, part 1

11
  • Year Three
  • Clinical Clerkships
  • Four week blocks of required rotations
  • Medicine
  • Pediatrics
  • Surgery
  • Obstetrics-gynecology
  • Psychiatry
  • Sit for national board exams, part 2
  • Year Four
  • Clerkships and electives
  • Four week blocks
  • Neurology
  • Dermatology
  • Family medicine
  • Radiology
  • Otolaryngology
  • Specialties
  • Apply, interview and match to residency training

12
Post-graduate Medical Education
  • Internship first year in specialty or rotating
    among specialties
  • Residency up to five years of specialty
    training, followed by state board certification
    for practice entry
  • Fellowship additional years of
    training/teaching within specialty

13
Nursing Education in the U.S.
  • About 1700 accredited nursing schools
  • Voluntary accreditation of US schools by National
    League for Nursing Accrediting Commission
  • Interpretive Guidelines for Standards and
    Criteria for all levels of nursing education

14
Levels of Nursing Education
  • Practical nursing - certificate
  • LPN/LVN - training usually at community college
    or vocational/ technical training center
  • 56 in Texas, 3 accredited
  • 12 months of study
  • Sit for licensing examination by National Council
    of State Boards of Nursing (NCSBN)
  • Licensed as LVN in Texas

15
Levels of nursing education
  • Diploma nursing
  • RN training conducted by a sponsoring
    organization, usually a hospital
  • Two accredited in Texas
  • Graduates often work for sponsor
  • Sit for NCSBN-administered NCLEX-RN exam
  • Licensed as registered nurse

16
Levels of nursing
  • Associate degree programs - ADN, at a community
    college, or rarely at an upper division school
  • 24 36 months in duration
  • Licensed as RN through NCLEX-RN examination
  • RNs may be certified by American Nurses Assn in
    area of specialty
  • 49 programs in Texas, 39 accredited

17
Levels
  • Baccalaureate - BSN, usually at a general higher
    education or health science campus
  • Two years of general studies
  • two years of nursing studies
  • Licensed as RN through NCLEX-RN
  • BSN usually required for advanced education
  • 27 programs in Texas, 14 accredited

18
Levels
  • Masters MSN
  • Is now recommended job standard for advanced
    practice, supervising nurses and usually
    preferred minimum for faculty
  • Clinical nurse specialists CNM, NP, CNS
  • 14 programs in Texas, seven accredited
  • Doctoral PhD, DScN
  • Preferred among faculty, and top executive
    positions
  • 7 programs in Texas, none currently listed as
    accredited by NLNAC

19
Preparation for Nursing School
  • High school preparation should be in recommended
    or distinguished graduation plan
  • Work experience in health care highly valued
  • Community service of interest to some schools

20
Application to Nursing School
  • Candidates consider their fit with schools of
    interest
  • Professional interest
  • Cost/finances
  • Special interests
  • Location
  • Student support

21
Selection to Nursing School
  • Schools rank candidates based upon formula
    scoring preferred attributes
  • Grade point averages
  • Service points
  • Recognition points, etc
  • Candidates interviewed and re-scored
  • Ranked and invited to attend

22
Nursing School Curriculum
  • Strong attention to detail in standards for
    curriculum at all levels helps uniformity
  • Curriculum has broad scope and depth, relevant to
    each level
  • Range includes community, workplace, and
    individual patient care elements
  • Illness care is balanced by wellness and
    prevention
  • Research essential in BSN and up

23
Core Competencies of Curriculum
  • Population-based health care skills
  • Means to assure access to care
  • Evidence-based clinically competent care
  • Understanding role of primary care
  • Use outcome measures
  • Use balanced approach to care
  • Practice prevention and wellness care
  • Involve patients and families in decision-making
  • Promote healthy lifestyles
  • Adopt communications and technology in practice
  • Improve system operations and accountability
  • Understand role of physical environment in health
  • Exhibit ethical behaviors in practice

24
Resources
  • Association of American Medical Colleges,
    www.aamc.org
  • American Medical Association, www.ama.org
  • Liaison Committee on Medical Education,
    www.lcme.org
  • American Association of Colleges of Osteopathic
    Medicine, www.aacom.org
  • National League for Nursing, www.nln.org
  • NLN Accrediting Commission, www.nlnac.org
  • American Nurses Association, www.ana.org
  • American Association of Colleges of Nursing,
    www.aacn.org
  • Texas Nurses Association, www.texasnurses.org
  • National Federation of Licensed Vocational
    Nurses, www.nflpn.org
  • Texas State Board of Medical Examiners,
    www.tsbme.state.tx.us
  • Texas State Board of Nurse Examiners,
    www.bne.state.tx.us
  • www.texashotjobs.org
  • Federation of State Medical Boards, www.fsmb.org
  • Educational Commission for Foreign Medical
    Graduates, www.ecfmg.org
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