寫給曾經的醫生護士，想換工作的

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Doctor of Medicine (MD), 國內醫學院畢業的, green or citizen, USMLE, match, residency…, 苦難的曆程, 豐厚的匯報. 最理想的境界是你享受工作,高工資隻是副產品.

Physician Assistant (PA), 如你以前在國內是醫生, 你要能接受心理落差. 好處是壓力小點, 不須經住院醫.絕大多數program的申請通過CASPA(Central Application Service for Physician Assistants),絕大多數program要求北美本科學位(找承認外國本科的), 最好5年以內醫學院或護校畢業的, 要求學過生物,生化, 生理, 解刨等前期課程, TOFEL, GRE, 開銷:$30,000-40,000/年, 畢業後參加PANCE(physician assistant national certification exam), 通過後變PA-C, 然後申請州license. PA必須跟隨醫生工作,但有處方權.PA每6年須再認證一次(PANRE). PA的就業市場供不應求, 包括Mayo Clinic近年來都大量招收PA.

數據: 2009畢業人數大約5500, 起薪大約$80,000/年(65,000-90,000, Eastern: $68,000,Heartland: $89,000), 我見到$120,000/年起薪的(有國內醫學背景), 平均年薪$93,105(2009), 最高大約$150,000, 多在急診和外科專科, 88%畢業生為master degree(2009), 10%為本科(31%master/50%Baccalaureate in 1999), 64%為女性(2009), 平均年齡29.5歲,88.9%為白人, 32% 工作在primary care, 34%在外科, 目前工作在臨床的PA大約85,000, Bureau of Labor and Statistics預測2006-2016 PA 工作增長27%,

Anesthesiologist assistant (AA), 相當於PA, 僅和麻醉師工作, 多在手術室, 全美僅有5個programs(Emory University,Case Western Reserve University, South University, Nova Southeastern University,University of Missouri–Kansas City), 報考要求醫學預科成績,有的還要求北美本科學位, TOFEL, GRE, 單獨招生, 學製24-28個月, 一年實習, master degree, 開銷:$30,000-40,000/年,畢業後參加 National Board of Medical Examiners (NBME), 獲得 National Commission for Certification of Anesthesiologist Assistants (NCCAA)認證, 目前可在18州獲得license, 起薪 $95,000 and $120,000(2006), 平均年薪 $91,195-$137,492, 最高$160,000 to $180,000.

4. Nurse Practitioner (NP), 工作和工資幾乎和PA一樣, 也有處方權(Georgia不肯定),目前NP program大約300-400個. 申請進NP program首先得是RN (registered nurse), 再獲得24-36個月的master of nursing or doctor of nursing, 通過national board certification exam, 然後申請美國各州,加拿大, 英國, 新西蘭,澳大利亞license. 在21州可以獨立開業,這點和PA不同,PA隻能在美國工作, 不能獨立開業. 2004年的NP數量大約是106,000, 比PA要多, 你如在醫院工作,NP的頭銜可以看得你頭暈眼花, 諸如:

ACNP-BC (Acute Care Nurse Practitioner - Board Certified; if certified by the ANCC)

ACNPC (Acute Care Nurse Practitioner Certified)^[24]

APRN-BC (Advanced Practice Registered Nurse - Board Certified; no longer awarded, replaced with specialty-specific credentials by the ANCC ^[25])

ARNP (Advanced Registered Nurse Practitioner)

CNP (Certified Nurse Practitioner)

CPNP (Certified Pediatric Nurse Practitioner; if certified by the Pediatric Nursing Certification Board PNCB)

CPNP-AC (Certified Pediatric Nurse Practitioner - Acute Care; if certified by the PNCB ^[26])

CPNP-PC (Certified Pediatric Nurse Practitioner - Primary Care; if certified by the PNCB ^[27])

CRNP (Certified Registered Nurse Practitioner; used primarily in Pennsylvania ^[28] and Alabama ^[29])

DNP (Doctor of Nursing Practice; the terminal practice degree for NPs)

FNP (Family Nurse Practitioner)

PMHNP (Psychiatric/Mental Health NP)

GNP (Geriatric NP)

PNP (Pediatric NP)

WHNP (Women's Health NP)

Certified Registered Nurse Anesthetist (CRNA): 工作性質和收入和AA相當, 中位數工資 $157,724(2009, AMGA Medical Group Compensation and Financial Survey). 申請進CRNA首先得有一年RN (registered nurse) ICU經驗, 再獲得24-36個月的master or doctor program訓練,通過相應的Board certification, 然後申請50州license, 有些州可獨立工作,這是和AA不同的地方.

其他可以考慮的職業: Occupational Therapists 年平均工資$79,830; Radiation Therapists年平均工資$79,340; Dental Hygienists年平均工資$69,760; Nuclear Medicine Technologists年平均工資$69,960,資料來源: Bureau of Labor Statistics, May 2011