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INTERSERVICE PHYSICIAN ASSISTANT PROGRAM (IPAP)
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MISSION
To provide the uniformed services with highly competent, compassionate physician assistants who model integrity, strive for leadership excellence, and are committed to lifelong learning.

Interservice Physician Assistant Program Vision: To be recognized as the world-class leader in Physician Assistant education.

History of the Physician Assistant

The profession of "Physician Assistants" has only been recognized for about 45 years. The lack of medical doctors in both the military and civilian health care systems led to the development of the Physician Assistant. In a 1961 article in the Journal of the American Medical Association, Hudson first broached the subject of the "extern." This "extern" would be responsible for most of the technical procedures and some of the medical responsibilities of the medical doctor under whom they would work.

Dr. Eugene Stead, chairman of the Department of Medicine at the Duke University Medical Center in Durham, North Carolina in 1965, developed the first Physician Assistant program. Using four ex-Navy corpsmen, the two-year Physician Assistant program began. The curriculum was based on the fast-tracking of a doctor`s program developed during World War II. In this program the first nine months were spent on sciences and clinical skills. The next 13 months were spent doing clerkships in a variety of hospital clinics. The final two months were spent with their preceptor learning their professional skills. The Public Health Service at Staten Island Hospital developed one early program. The merchant marines began a nine-month training program for purser mates (the people in the merchant marines responsible for overseeing ships` documentation and customs declarations, as well as medical care) in 1966. At the University of Washington, Dr. Richard Smith designed a program called MEDEX (Medicine Extension) to train former military medics to service areas of Washington State that were lacking in medical personnel. This program required three months of concentrated study and 12 months of preceptorship with University medical doctors.

Today, most programs are 24 months in length with the first 12 months spent in the classroom. The subjects studied include anatomy and physiology, pathology, diagnosis, treatment, disease processes, communication and patient assessment.

History of the Military Physician Assistant

The military Physician Assistant program was first developed by the United States Air Force in 1971 under the direction of the Air Force Surgeon General, Lieutenant General Alonzo Towner at Sheppard Air Force Base School of Heath Care Sciences in Texas and was modeled after the program developed by Stead at the University of North Carolina. The first enrollees in the program were senior enlisted medics. There was one year of didactic training followed by one year of on-the-job training ; a four-year payback period was incurred. By 1978, the Air Force had 275 commissioned officers who were Physician Assistants. The United States Army began its Physician Assistant Program in 1971. The school that Army PA students attended was the Medical Field Services School PA program at Fort Sam Houston, Texas. The Navy began their Physician Assistant program in 1971 as a trial program and by 1973 the Navy and George Washington University developed a partnership to train Physician Assistants. In 1972 the Navy and the Air Force began training Physician Assistants at Sheppard Air Force Base in Texas. The United States Coast Guard did not institute their own PA program but began accepting PAs from the civilian sector in 1974.

History of the Interservice Physician Assistant Program

The military services combined their various Physician Assistant programs to form the Interservice Physician Assistant Program (IPAP), located at the Army Medical Department Center and school (AMEDDC&S), Forts Sam Houston, Texas, due to mandatory cutbacks by the federal government in 1996.

The IPAP mission is to educate and train PAs for the uniformed services. Our graduates are commissioned into the officer corps of their respective service and take their place beside other military health care professionals in providing medical services to active duty military personnel, their dependents, and retirees.

In 1996 the IPAP at the AMEDDC&S reached an agreement with UNMC that the latter would provide faculty and administrative support for the IPAP. The IPAP graduate earns a Masters of Physician Assistant Studies (MPAS) degree from the affiliated university.

On behalf of the Commander and staff of the AMEDD C & S, Fort Sam Houston, Texas, we welcome you to the IPAP. As you will learn, we are responsible for the training of the finest Physician Assistants for the uniformed services of the United States Department of Defense and Department of Homeland Security. Our main campus is located on Historic Fort Sam Houston, Texas, in the heart of beautiful San Antonio, Texas. Here all IPAP students complete their 16-month didactic phase of training. Phase 1 consists of basic medical science courses intended to develop a student`s knowledge of critical medical concepts (see Phase 1 curriculum). After completing this portion of the curriculum, students continue with their medical clerkships at one of 21 medical Phase 2 sites across the country. These Phase 2 sites are located at military installations with medical facilities adequate to support the base rotations required to be a successful Physician Assistant (see Phase 2 curriculum). Our Phase 2 Clinical Coordinators are responsible for the administrative support and ensuring that clinical preceptors provide appropriate clinical training. This training allows IPAP students to obtain the skills necessary for becoming a physician assistant in the uniformed services. Our vision is this: "To be the premier Physician Assistant training program in the country; the choice of America`s finest."
If you have further questions or concerns after viewing this portal, you may contact us at: 210-221-8004

NEWS INTERSERVICE PHYSICIAN ASSISTANT PROGRAM Performance
National Commission on Certification of Physician Assistants (NCCPA)-Physician Assistant National Certification Exam (PANCE) Performance Report (Past 5-years)
NCCPA

CURRICULUM
Interservice Physician Assistant Program Mission: To provide the uniformed services with highly competent, compassionate physician assistants who model integrity, strive for leadership excellence, and are committed to lifelong learning.


IPAP Phase 1 Curriculum (Didactic):
Phase 1 didactics last approximately 16 months. During this time, students are exposed to the basic medical sciences and progress into clinical medicine courses that help them understand critical medical concepts and application of those concepts in patient scenarios. These include:

IPAP Curriculum Class Fall 2011
COURSE

SUBJECT

Semester Hours
FRESHMAN TERM
MPAS 500 ANATOMY & PHYSIOLOGY I (Genetics 6hr) 7
MPAS 502 BIOCHEMISTRY 3
MPAS 503 MICROBIOLOGY 5
MPAS 504 CLINICAL LABORATORY 4
MPAS 506 MEDICAL LAW & ETHICS (15/15) 2
MPAS 608 RESEARCH EVALUATION 2
MPAS 624 PA PROFESSIONAL ISSUES 0.33
MPAS 601 MEDICAL HISTORY 1 1
  RESEARCH & Master Seminar  
SOPHOMORE TERM
MPAS 501 ANATOMY & PHYSIOLOGY II 7
MPAS 505 PATHOLOGY 3
MPAS 631 PHYSICAL EXAMINATION I 3
MPAS 603 RADIOLOGY 2
MPAS 604 PSYCHIATRY 3
MPAS 611 ENDOCRINOLOGY 2
MPAS 612 DENTAL 1
MPAS 602 PHARMACOLOGY I 3
JUNIOR TERM
MPAS 630 PHARMACOLOGY II 4
MPAS 632 PHYSICAL EXAMINATION II 2
MPAS 605 ORTHOPEDICS 4
MPAS 607 PULMONARY 2
MPAS 609 GASTROENTEROLOGY
MPAS 606 ECG & CARDIOLOGY  6
MPAS 613 CLINICAL CORRELATIONS Part I  1
MPAS 624 PA PROFESSIONAL ISSUES  0.33
MPAS 614 PEDIATRICS  3
MPAS 620 NEUROLOGY  2
SENIOR TERM
MPAS 613 CLINICAL CORRELATIONS II  1
MPAS 615 SURGERY  4
MPAS 629 RHEUMATOLOGY/GERONTOLOGY  2
MPAS 617 OBSTETRICS & GYNECOLOGY  3
MPAS 618 EMERGENCY MEDICINE & ADV TRAUMA MGT  5
MPAS 619 INFECTIOUS DISEASES  3
MPAS 616 DERMATOLOGY  2
MPAS 622 GENITOURINARY  2
MPAS 623 MILITARY PUBLIC HEALTH  1
MPAS 624 PA PROFESSIONAL ISSUES  0.34
MPAS 628 OTOLARYNGOLOGY & OPHTHALMOLOGY  2
MPAS 600 HEMATOLOGY & ONCOLOGY  1
  Total 101


MASTER`S PAPER:
Students are required to compose master`s theses prior to graduation. Students will be mentored by IPAP Faculty on their individual thesis topic. Mentors will also be available when the students prepare their theses for presentation at Phase 2. The purpose of this activity is for each student to identify a research question that he or she can further develop by investigating current and relevant literature. By using evidence-based medicine, students will be able to apply and share what they learned. This assignment serves to improve students` written and verbal communication skills. Presentation of theses to a panel of experts at Phase 2 will also serve to further verbal communication skills as well as to augment skills in critical thinking.

Grading Standards
A = 90-100, B = 80-89, C = 75-79, Fail = Less than 75




 
IPAP Phase 2 Curriculum (Clinical Clerkship):
Phase 2 training lasts approximately 57 weeks (including hospital orientation and mandatory facility training). During that time, students rotate through a variety of clinics in order to gain clinical knowledge and experience. These include (but are not limited to):

COURSE ROTATION Weeks
MPAS 700 Surgery  5
MPAS 701 Dermatology  4
MPAS 702 Obstetrics/Gynecology  4
MPAS 703 Orthopaedics/Podiatry  5/1
MPAS 704 Psychiatry (Behavioral Health)  3
MPAS 705 Internal Medicine/Neurology  6
MPAS 706 Otolaryngology (ENT/Allergy)  4
MPAS 707 Pediatrics  5
MPAS 708 Ophthalmology  2
MPAS 709 Emergency Medicine  2
MPAS 710 Family Practice/Long Term Care  4/1
MPAS 711 Clinical Elective of Choice  2
MPAS 711 Radiology Overview  1
MPAS 712 Directed Study
1. Master Paper (Phase 1 Grade)
2. Professional Topic Presentation
3. Medical Topic Presentation
4. Master Oral Presentation
5. Professional Attributes
Integrated
Logs Performed Procedures > 120
  ER Hours (evening/weekend) > 160 hours
  Patients Encounters > 1200
     


MASTER`S PAPER and PRESENTATION REQUIREMENTS:
During Phase 2, with the assistance of assigned mentors, students will further refine their theses in preparation for oral presentation as noted above.

Phase 2 Sites & Web-links

Air Force
Eglin AFB, FL
Keesler AFB, MS
Langley AFB, VA
Nellis AFB, NV
Offutt AFB, NE
Travis AFB, CA

Army
Fort Benning, GA
Fort Bliss, TX
Fort Bragg, NC External Link
Fort Campbell, KY
Fort Carson, CO
Fort Hood, TX External Link
Fort Knox, KY
Fort General Leonard Wood, MO
Fort Polk, LA
Fort Riley, KS
Fort Sill, OK
Fort Stewart, GA
Tripler Army Medical Center, Honolulu, HI External Link
United States Military Academy-West Point, NY

Navy
Naval Medical Center-Balboa, San Diego, CA Phase 2 Evaluations
Student evaluations are based on the PA competencies (http://www.arc-pa.org/documents/CompetenciesFINAL.pdf)External Link

How are students graded during Phase 2?
Each course requires a preceptor`s evaluation and an end-of-rotation written examination.

Clinical Grade:
Students earn a clinical grade by the preceptor at the end of each rotation using the database in www.MyEvaluations.com*. The clinical grade equates to 75% of the final rotation grade (passing grade is a minimum of 75%).
Examination Grade:
Students will take an end-of-rotation examination through "UNMC Blackboard" in each of the following rotations: Surgery, Dermatology, OB/GYN, Orthopedics, Psychiatry, Internal Medicine, ENT, Pediatrics, Ophthalmology, Emergency Medicine and Family Practice/Long Term Care. Examination equates to 25% of the final rotation grade (passing grade is a minimum of 75%).

MPAS 712- Directed Study:
The MPAS 712 course includes evaluations in written and oral skills. These evaluations address students` Master`s thesis paper (grade from Phase 1), three oral presentations and professional attributes.

Logs:
Students are required to log their patient encounters (= 1200) and performed procedures (= 120) on www.MyEvaluations.com*. Students are also required to perform and log their evening/weekend shifts in the ER (= 160 hours).

Is it stressful in Phase 2?
Yes. Students will experience stress during their training but they should never be suffering from stress. Stress awareness, prevention and management are the key throughout any military career and life in general. Students are encouraged to take care of themselves and each other. They are to be aware of the warning signs and risk factors and seek help from local medical treatment facility (MTF), a chaplain, a supervisor and each other as needed. Here are links for additional information:

HOOAH 4 Health
http://www.hooah4health.com/deployment/benefits/veterans_suicide_prevention_hotline.htm *External Link

Military One Source
http://www.militaryonesource.com/home.aspx?MRole=&Branch=&Component *External Link

FACULTY & STAFF

84 Faculty members, across both our Phase 1 and Phase 2 curriculum, with a diverse educational makeup including:

48 Physician Assistants, 25 Physicians, and 9 Clinical Support Educators with additional degrees in the following areas:

10 PhD (Adult Education and Research, Microbiology, Clinical Laboratory Sciences, Biochemistry, Molecular Biology and Biophysics)

3 DSc (Orthopaedics)

2 PharmD

1 DHSc

1 JD

4 MPH

5 MEd

2 MS (Clinical Laboratory Sciences and Microbiology)

1 MA

FREQUENTLY USED RESOURCES

My Evaluations
http://www.myevaluations.com/ *External Link

University of Nebraska Medical Center Blackboard
http://www.arc-pa.org/documents/CompetenciesFINAL.pdf *External Link



 Publications

Harvard Health Publications
http://www.health.harvard.edu/ *External Link

Internet Journal of Academic PAs
http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijapa/front.xmlExternal Link

JAAPA (Journal of the American Academy of Physician Assistants)
http://www.jaapa.com/External Link

Military Medicine Manuscript Submission
http://www.amsus.org/index.php/journal/submit-a-manuscriptExternal Link

PostGrad Med
http://www.postgradmed.org/External Link

*Must be enrolled or have a registered user account

Frequently asked Questions regarding PAs

How can I learn more about the Physician Assistant profession?
Please take an opportunity to learn more about PAs and the PA profession at the following link: http://www.aapa.org/ *External Link

What is a Physician-PA Team?
Please read this brochure published by the AAPA:
http://aapa.org/images/stories/IssueBriefs/Professional%20Issues/Physician-PA%20Team%20-%202010.pdf *External Link

What is a PA`s scope of practice?
Please read this brochure published by the AAPA:
http://aapa.org/images/stories/IssueBriefs/Professional Issues/PA Scope of Practice - 2010.pdf *External Link
IPAP Specific Links
Fort Sam Houston http://www.samhouston.army.mil/External Link
Army Medical Department Center & School (AMEDD C&S) http://www.cs.amedd.army.mil/
San Antonio, TX http://www.city-data.com/city/San-Antonio-Texas.htmlExternal Link
Weather/Plan Ahead http://www.weather.com/weather/today/Fort+Sam+Houston+TX+78234External Link  
 
Academic Links
AMEDD Stimson Library (includes STAT! Ref, Ovid, LexiComp) http://www.cs.amedd.army.mil/stimlib/default.aspxExternal Link
Auscultation Assistant (UCLA) http://www.wilkes.med.ucla.edu/intro.html*External Link
eMedicine http://emedicine.medscape.com/ *External Link
Center for Disease Control and Prevention http://www.cdc.gov/External Link
Clinical Otolaryngology OnLine (COOL) http://www.entnet.org/EducationAndResearch/COOL.cfm *External Link
Lab Tests Online http://www.labtestsonline.org/ *External Link
Mnemonics http://www.medicalmnemonics.com/*External Link
Medshare Radiology Cases (Harvard) http://brighamrad.harvard.edu/education/online/tcd/tcd.html*External Link
National Cancer Institute http://www.cancer.gov/*External Link
National Commission on Certification of Physician Assistants http://www.nccpa.net/*External Link
Stat Ref https://medlinet.amedd.army.mil/External Link
Student Academy of the American Academy of Physician Assistants http://saaapa.aapa.org/student-academy/*External Link
WebPath (University of Utah) http://library.med.utah.edu/WebPath/webpath.html#MENU *External Link
Wheeless` Textbook of Orthopaedics http://www.wheelessonline.com/ *External Link
 
Test Preparation
Content Blueprint for NCCPA PANCE/PANRE http://www.nccpa.net/ExamsContentBlueprint.aspx *External Link
Exam Master for PANCE/PANRE preparation, free access for military through the Naval Medical Center, San Diego: http://www.exammaster2.com/wdsentry/nmcsd.htm*External Link
Free PANCE test prep Review http://www.testprepreview.com/pance_practice.htm *External Link
PA Board Review http://www.paboardreview.com/ *External Link
 
Physician Assistants
American Academy of Physician Assistants http://www.aapa.orgExternal Link
National Commission on Certification of Physician Assistants http://www.nccpa.netExternal Link
Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) http://www.arc-pa.org/*External Link
Best Jobs in America (CNN/Money) – PAs #2 http://money.cnn.com/magazines/moneymag/bestjobs/2009/snapshots/2.htm*External Link
Bureau of Labor Statistics Regarding PAs http://www.bls.gov/oco/ocos081.htmExternal Link
Coast Guard Association of PAs http://cgapa.com/External Link
FDA http://www.fda.gov/ForHealthProfessionals/default.htmExternal Link
Federation of State Medical Boards http://www.fsmb.org/*External Link
Navy Association of PAs http://www.napasite.net/External Link
Physician Assistant Education Association http://www.paeaonline.org/ *External Link
Physician Assistant Competencies http://www.arc-pa.org/documents/CompetenciesFINAL.pdf*External Link
Physician Assistant History Center http://www.pahx.org/*External Link
Student Academy of AAPA http://saaapa.aapa.orgExternal Link
Society of Air Force PAs http://www.safpa.org/External Link
Society of Army PAs https://www.sapa.orgExternal Link
United States Army Public Health Command http://phc.amedd.army.mil/Pages/default.aspxExternal Link
US Army Recruiting Command, Army PA http://www.usarec.army.mil/armypa/External Link
U.S. News and World Report Best Careers in 2011 http://money.usnews.com/money/careers/articles/2010/12/06/best-careers-2011-physician-assistant *External Link
U.S. News and World Report Physician Assistant School Rankings https://www.sapa.org *External Link
 
Research Links
CITI (Collaborative Institutional Learning Initiative) https://www.citiprogram.org/Default.asp?*External Link
PubMed http://www.ncbi.nlm.nih.gov/sites/myncbi/*External Link
TATRC – Telemedicine and Advanced Technology Research Center http://www.tatrc.org/*External Link
University of Nebraska Medical Center Student Research Portal http://www.unmc.edu/students/studentresearch.htm *External Link
University of Nebraska Medical Center Library http://www.unmc.edu/library/*External Link
US Army Institute of Surgical Research https://www.usaisr.amedd.army.milExternal Link
USAMRIID – Unites States Army Medical Research Institute of Infectious Disease http://www.usamriid.army.mil/External Link
USARIEM – United States Army Institute of Environmental Medicine http://www.usariem.army.mil/External Link


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