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PA Sem Exam -1 Review with Accurate Solutions

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PA Sem Exam #1 Review with
Accurate Solutions

-Started in 1965 as physician substitute by Chairman Mao
-Initial training lasted 2-3 months
-Viewed as a peasant with some medical skills
1.3 million trained in 10 years
-Functioned independently, but linked to hospitals for training and supervision
-Given priority for medical school admission - ANS-Barefoot Doctors in China

-Originally military healthcare providers trained to care for Russian troops
-17th and 18th century
Later worked in remote areas as civilians
-Eventually schools established to train civilian feldshers
-Program housed in schools of nursing
-The feldsher training program lasted 2 years
-Most graduates women
-Top students encouraged to take Medical School entrance exam
-Had both an MD substitute & complementary role - ANS-Feldshers in Russia

-Community Nurse Midwife in the USA
-Assistant Medical Officer in various African Nations
-Some of these African providers took the name Physician Assistant (including those in
Liberia) - ANS-Other Physician Extenders & Substitutes in Africa

When did the first PA Program start at Duke University? - ANS-1965

Who started the program at Duke? - ANS--Dr. Eugene Stead, Professor of Medicine
and Chairman of the Department of Medicine at Duke University
-Believed "a curriculum could be devised, consisting of 2-3 years of college work with
certain prescribed courses" that paralleled medical school
-Thelma Ingles, RN worked with Dr. Stead to create MS degree for nurse clinicians
-Rejected by the National League of Nursing (NLN)
-NLN felt new profession too much like MDs and not consistent w/ nursing
-Program began in 1965 with 4 military corpsman, but open to those with other
backgrounds
-Philosophy was to train students in the "medical model" similar to MDs
-Primary care format
24 months; 9 mos. basic sciences and 15 months of clinical training
-"Trial of PA Concept"

, What were the 4 early PA Programs? - ANS-1. Hu C. Myers, MD was a general surgeon
in small clinic / hospital
-Living in rural West Virginia, recognizing physician shortages
-1968, Developed PA Program for students without previous medical training or college
experience

2. Alderson-Broaddus College is a private, liberal arts college, not associated with
medical school
-Has a small on-campus hospital
-2 yrs. basic science and liberal arts, 1 yr. didactic medical education and 1 year of
clinical rotations
-First to award a BS degree (1972)

3. Richard Smith, MD, MPH was committed to caring for underserved populations
-Worked with Public Health Service and Peace Corp
-Settled in Washington State and developed MEDEX PA ("MEDicine Extension")
program in 1969
-Focused heavily on career military corpsman
-MEDEX Program introduced idea of "apprenticeships" for clinical rotations
-Deployed PAs into under-served areas
-Most rural precepting MDs later hired PAs

4. He

What happened in Chalmers-Francis v. Nelson Case? - ANS-(1936)
-Court ruled Nelson (nurse anesthetist) was not engaged in illegal practice
-In accordance with a direct MD order and "typical OR practice"

What happened in the Magit v. Board of Medical Examiners Case? - ANS-(1961)
-Hiring of unlicensed foreign medical graduates to work as anesthesiologists.
-Violation of California Medical Licensing Act

What was the People v. Whittaker Case about? - ANS-(1966)
-Once more called into question the right of a MD to delegate tasks to a subordinate.
-Who is providing the treatment? MD or the subordinate....?
-Roger Whittaker - ex-military corpsman
-Long history of first assisting
-Job as a Surgical Tech at UCSF (1963)
-George Stevenson, MD - Neurosurgeon "supervising MD"

-Whittaker assisted in complicated neurosurgery case
-Whittaker charged with violating Business and Professions Code of California and
practicing medicine without a license
-Charges also filed against Dr. Stevenson by State Board of Medical Examiners
-Eugene Stead, MD testified as defense witnesses

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