How To Become Dermatology Nurse Practitioner – Properties | March 2022 Elephant in the Exam Room: Emerging Dermatology Credentials of Different Stripes and Types How Professionals from Different Backgrounds Can Support Changing Academic Standards and Each Other’s Specialty Faculties promote?
The qualifications and descriptive terms for nurse practitioners (NPs) and physician assistants (PAs) in dermatology are controversial. As revealed in a study by Kridor et al., 2021, office workers’ understanding of non-physician clinician (NPC) qualifications may be poor. al., who found that in 18 percent of dermatology clinics, receptionists referred to NPCs as “dermatologists,” “physicians,” “physicians,” and “board certified.”
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A number of factors contribute to the general uncertainty about NPCs’ credentials, particularly recent events that warrant discussion.
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In 2019, an organization called the American Board of Physician Assistants in Dermatology was created but quickly disappeared from public discussion after opposition from the American Board of Dermatology and the American Academy of Dermatology (AAD). That group has re-emerged with a new name, the National Board of Dermatology Physician Assistants (NBDPA), whose website says its inaugural group will be “certified dermatology PAs tables” (a phrase they highlighted) in October 2021.2 In a similar dispute. , American PAs The academy decided in 2021 to replace “associate” with “associate” in their job title, which the AAD opposes, believing it to be a misrepresentation who is fighting with patients.
The Dermatology Nurse Practitioner Certification Board offers the certification as a Dermatology Certified Nurse Practitioner (DCNP), 3 patients equivalent to a physician board certification in dermatology. Some doctoral-educated NPs treat patients as a “physician,” which is legal in some states. Some might consider the hypothetical statement “Dr. Smith is board certified in dermatology” in relation to NP, based on geography.
These language divisions between NPCs and dermatologists can lead to conflicting instructions given to staff, reducing the ability to send a consistent message to patients. As more dermatologists in group practices employ NPCs, a substantial portion of dermatology offices are facing these and nomenclature-related challenges.
With the expectation of a positive NPC presence in the specialty amid a continuing shortage of dermatologists, these controversies should encourage interprofessional communication and fair evaluation of relevant NPC credentials. Standardized certifications for dermatology NPCs are becoming more widespread, such as the Diplomate Fellowship (an online course offered by the Society of Dermatology Physician Assistants (SDPA) taught by dermatologists, dermatopathologists, and PAs) and the DCNP and NBDPA exams previously mentioned. The National Commission for the Certification of Physician Assistants (NCCPA) recently announced the release of a standardized written exam, the Dermatology Certificate of Additional Qualifications (CAQ), beginning in 2023, and we have summarized to do these requirements in Table 1. Promote accuracy and transparency.
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Applicants to NP programs must first be registered nurses (RNs), and typically receive a year or two of clinical nursing experience before pursuing graduate study.
After completing a master’s or doctorate in nursing practice and passing a 175-question certification exam, an RN becomes a nationally certified NP. After earning a state license and accumulating 3,000 clinical hours in dermatology within a three-year period (a small portion of which may come from dermatology clinical rotations during NP school), the NP can sit for the 175-question DCNP written exam . .3
Prior to their graduate education, PAs must fulfill direct patient care experience requirements by volunteering in healthcare facilities and performing roles as medical assistants, paramedics, nurses and the like. Specific requirements for patient care vary among PA programs, but the national average among matriculants is 3,240 hours.8 Accredited PA programs must have a medical director who is a licensed physician,
And PA students must complete at least 2,000 hours in supervised clinical rotations with licensed NPs, PAs, and physicians.
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After graduation, they are eligible to sit for the 300-question Physician Assistant National Certification Exam, apply for a state license, and seek employment. To sit for the NCCPA’s Dermatology CAQ exam, which consists of 120 questions, licensed PAs must complete 75 hours of dermatology-specific continuing medical education and 4,000 hours of dermatology placement. 5 To sit for the NBDPA’s 125-question exam, PAs must be in good standing with their state medical board and have three years of work experience with the same dermatologist.
Open communication between healthcare disciplines is essential to clear, well-defined and consistently communicated credentials. Whether as their assistants or colleagues, NPCs share an interconnected future with dermatologists, so maintaining respectful relationships is paramount. Specific dermatology training by NPCs should be encouraged but clearly represented: patients should clearly know the physician’s type of license and dermatology credentials and where they can find reliable information about relevant credentials if they are curious. Physicians should be familiar with these unique qualifications and discourage staff from suggesting they are the same.
The question of who can legally advertise themselves as a certification on the board and the nuances of other applicable regulations are likely to be hotly debated in the future. But if professionals from different backgrounds agree to support growing educational standards and promote each other’s special faculties, we can and must keep our main focus on what matters most: care safe and effective that is patient-centered.
The authors are grateful to Evelyn Kobayashi and Robert Johnson for their invaluable assistance as medical librarians; Angela Blood of the Association of American Medical Colleges for fact-finding; and physicians who suggested edits to the manuscript: Alan Rakoff, MD, FAAD; John Trossoyer, DNP; and three board-certified dermatologists who wish to remain anonymous.
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1. Kridor A, Desai S, Li SJ, et al. Misrepresentation by nonphysician clinicians in dermatology clinics. Inquisitive. 2021; 13(10): e18793. Published on 14 October 2021. doi: 10.7759/cureus.18793. PMID: 34804659
4. Ehrlich A, Kostecki J, Olkaba H. Employee trends and influence in dermatology practices. J Am Acad Dermatol. 2017; 77(4):746-752. doi: 10.1016/j.jaad.2017.06.030. PMID: 28784330
5. National Commission on Physician Assistant Certification. Published online September 15, 2020; Modified November 29, 2021. https://www.nccpa.net/specialty-certificates/#dermatology Accessed December 6, 2021.
6. Gviden S. Nurse Practitioner School Requirements – Admission and Prerequisites. Published online 2020. https://www.nursingprocess.org/nurse-practitioner-school-requirements.html Accessed February 8, 2022.
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7. Best Masters in Health Care. What experience is required to become a nurse practitioner? https://www.topmastersinhealthcare.com/faq/what-experience-is-needed-to-become-a-nurse-practitioner/ Accessed February 8, 2022.
8. Physician Assistant Education Association, By the Numbers: Program Report 35: 2019 Program Audit, Washington, DC: PAEA; 2020. doi: 10.17538/PR35.2020
9. ARC-PA. Accreditation Standards for Physician Assistant Education, Fifth Edition. Published September, 2019. http://www.arc-pa.org/wp-content/uploads/2021/03/Standards-5th-Ed-March-2021.pdf Accessed January 10, 2022
10. American Academy of PA. Published online 27 March 2018; Modified November 17, 2021. https://www.aapa.org/what-is-a-pa/#accordion Accessed December 6, 2021
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11. American Medical Association, Federation and Access Electronic Interactive Database. Published online 2021. https://freida.ama-assn.org/specialty/dermatology Accessed February 8, 2022.
12. American Nurses Credentialing Center. Exam Content Summary, Family Nurse Practitioner Board Certification Exam. Published online May 22, 2019. https://www.nursingworld.org/~48f9cc/globalassets/certification/certification-specialty-pages/resources/test-content-outlines/familynp-tco-may-222. pdf Accessed 31 January 2022.
Peter Young has been honored by the National Commission on Physician Assistant Certification for contributing to the development of the Certificate of Competency in Dermatology. The other authors declare no conflicts of interest or relevant disclosures. The views of the authors are their own and do not represent the views of any organization.
Peter Young is a PA and clinical researcher at Kaiser Permanente in Sacramento, CA. He is the founder of the Collaborative for Interprofessional Authorship in Dermatology (CIADerm.org), a free forum that connects early career dermatology professionals with experienced authors and provides instruction in the art of writing. for peer-reviewed journals.
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Kaylene Davis is a board-certified dermatology and family practice NP at Washington Dermatologic Surgery Center in Chevy Chase, MD. He has been an assistant professor at Georgetown University and has co-investigated clinical research studies at the Lombardi Cancer Center.
Gordon Bay, MD is a board-certified dermatologist with Stanford Healthcare and clinical professor of dermatology at Stanford University School of Medicine.
Practice Guidelines Peter A. Young, MPAS; Kaylene E. Davis, FNP-BC, DCNP; Gordon H. Bae, MD Business of Medicine leverages diverse academic and professional backgrounds to create content for our writers. This piece was developed in collaboration with one or more of our writers….
Elizabeth Clark is a board certified family nurse practitioner. His experience spans emergency departments, cardiac units, pediatric critical care and occupational health settings. She earned a Bachelor of Science in Nursing and a Master of Science in Nursing.
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