Hey everyone! My name is Eric and I am one of the 4 fellows at Albany Medical Center ER currently. I felt now was a great time to comment on my experience so far because I am about half way through the fellowship. So far in addition to all my ER shifts I have completeted rotations in: ultrasound, toxicology, ophthalmology, pediatrics, anesthesia, radiology. I still have yet to do a rotation in CCU, SICU, EMS, trauma. and my elective month.
I started my fellowship with 2 weeks of ultrasound training which was beyond amazing to learn. When we were not doing class or hands on with our attending, myself and another one of the fellows were out in the ER ultrasounding every person we could find which was amazing because patient's were very receptive to letting us practice and learn and just by explaining to the patient what we were looking at and for, helped educate the patient and us reinforce the skills and knowledge exponentially. Matt and I even took it a little further and started learning how to apply ultrasound to many other things (i.e. Ophthalmology, peritonsillar abscesses, etc.). After hearing from previous fellows how marketable ultrasound training was when applying to jobs, I made it a point to keep up with my ultrasound skills and get as much exerperience as I possibly could. So far I have about 560 ultrasounds logged of various kinds. Dr. Cadigan who is our ultrasound ER guru is exceptionally amazing to work with and will take free time to go out of her way and explain something to you if you have any questions.
As Jenelle has previously mentioned, I too feel that I did not have the confidence I should with seeing patients with eye complaints. We unfortunately did not have a great deal of Ophthalmology training in school. I will even admit that when I saw patient's initially in the ER at the beginning of my fellowship I was intimidated by doing a good and thorough slit-lamp examination or even knowing who needs to be consulted and who can be sent home with follow-up. Well after my Ophthalmology rotation with various amazing Ophtho residents and attendings at AMC, I was a rockstar! I learned so much and just learning how to perform a good and thorough slit-lamp examination alone is a huge help. I now see patient's and do things without even needing to consult Ophto residents to do. I remove foreign bodies from people's corneas. I even performed a laceration repair of a lid margin using 7-0 chromic gut sutures, which impressed the Ophthalmology resident that is something that normally requires a skilled Ophthalmologist to handle. So needless to say, I have now have a huge passion for Ophthalmology and find that other PAs, residents, and sometimes attendings have asked me questions about using the slit-lamp or with handling certain Ophtho complaints, which is a huge confidence booster.
Toxicology was beyond amazing. I never how much existed regarding tox until doing this rotation. Albany Medical Center ER is extremely fortunate that we have 3 amazing board certified Toxicologists! Between the lectures and tox cases that I had, I gained a huge amount of knowledge that I would have never learned otherwise. We learned not just drugs/medications, but how to recognize and treat certain exposures to chemicals (i.e. from patient's place of employment), plants, etc. Now when we get overdoses or exposure to random chemicals, I jump right on it and feel confident seeing those patient's and knowing how to treat them accordingly.
Anesthesia was an amazing experience. I don't know how many intubations some people may have done while in school, but after talking to some of my friends who have completed a year of ER as a PA, they have done ZERO. With that said, I did 32 intubations in 1 week alone! Talk about a great experience, after that week I felt like I could walk into any situation and intubate without any hesitation.
Pediatrics was a great rotation because let's face it, kids can be very intimidating to treat. Unless you have that background in Pediatrics, there are a lot of differences in working up a kid or newborn baby. We have some absolutely amazing Pediatric ER certified attendings and they just made the experience amazing. I loved every minute of it, and within 1 week alone I was picking up ICU level peds patient's.
All in all, my experience over the past 6 months has been beyond amazing and far exceeded my expectations prior to starting the program. It is also great because I have 3 other amazing PA fellows that I work with, and we enjoy sharing our experiences with one another because we all want to learn and help each other come out of this program with the most knowledge that we can possibly gain over this year. Everyone else in the ER has been great from nurses to the other PAs, residents, and attending physicians. I find that no matter how busy it may be sometimes, there is always someone is willing to help if I have a question or feel like I need to bounce some ideas off of them. If anyone has any questions at all about my experience or the program itself feel free to contact me firstname.lastname@example.org.
I will definitely keep updating this blog with any latest experiences or news.