Statistics on PA residency advantages??

[NationalPAEducation]

Has anyone located statistics on salary differences between PA's who did a residency vs. those who haven't? I would like to write a my next blog post on this topic but I am having trouble finding information. Any help is welcomed.. even if you just list the advantages/disadvantages you experienced/observed with a residency. Thanks!!!!

[Sabsaf123]

Has anyone located statistics on salary differences between PA's who did a residency vs. those who haven't? I would like to write a my next blog post on this topic but I am having trouble finding information. Any help is welcomed.. even if you just list the advantages/disadvantages you experienced/observed with a residency. Thanks!!!!

 

You will (likely) make more your first year out of residency than what you would have made your first year out of PA school but that comes at the opportunity cost of making less in residency. I know PAs that worked for a year out of school @~90k a year and are now making 120k a year in their second year of practice. Residency PAs make ~60k a year and then go straight into 100k+ after residency.

 

Doing a residency will teach you a lot but the financial incentive is weak/nonexistent

[cinntsp]

 

Doing a residency will teach you a lot but the financial incentive is weak/nonexistent

 

That's a common misconception stated by people that haven't actually done one.  It may also be perpetrated by the likelihood that most folks are offered a position where they trained, in which case they are generally facing more rigid pay scales and lower salaries due to working in big systems at more desirable locations.  

 

It's really all about how the residency grad capitalizes on that experience to get the job and salary they want.  My counterparts all stayed within the system and were started further in the pay scale than a new hire(essentially given credit for 1.5x experience) plus given a large sign-on bonus. Even with that, the numbers are still in the negative.  On the other hand, I interviewed at a number of places and was offered 1) jobs that would normally require 3+ years of experience to get an interview, 2) better scope of practice, and 3) considerably better salary/benefit packages.  Any lost income is more than a wash..

 

I do think it's important to obtain this type of data but we should do so keeping in mind that it's reductive to think about this topic solely in terms of salary differences.  The education itself is priceless and there is a lot of worth to being confident in your practice and knowing you are doing right by the patient.  It's possible to make very high salaries even as a new grad in the right places so I would not recommend doing postgrad training if the only incentive is a potentially higher salary.

[Sabsaf123]

Do you mind sharing how much the "considerably better" package was?

 

"3) considerably better salary/benefit packages."

[Torshi]

I don't think it's only a about money , but position, autonomy, and choices that open up after doing a residency that play an obvious role in security and comfort

[EMEDPA]

know any unemployed residency grads or residency grads in any field making less than 100k/yr? I don't.

[FfIghter23]

*sigh* those that question the benefits of a residency obviously have never worked in an ER.

 

Hospital admin: "oh yeah, let's credential new grad PAs to see every acuity patient, do all procedures, and let's pay them $120k."

 

It's funny because this is the expectation of every new grad wanting to work in EM. And the turnover rate is high when they realize they will be stuck in fast track the rest of their life.

 

Doing a well established residency provides you with all the tools to become a great EM PA. Just ask the residency trained PA in my area who works two-24 hour shift a week at a low volume ER for $80/hr. They wouldn't even look at anyone unless they had 10-15yrs + of EM experience or a residency grad.

[EMEDPA]

I'm not a residency grad(there were no residencies when i graduated or i would have done one) and it took me 18 yrs to start landing quality solo rural jobs after 10 prior years as a medic and er tech.

[NationalPAEducation]

*sigh* those that question the benefits of a residency obviously have never worked in an ER.

 

Hospital admin: "oh yeah, let's credential new grad PAs to see every acuity patient, do all procedures, and let's pay them $120k."

 

It's funny because this is the expectation of every new grad wanting to work in EM. And the turnover rate is high when they realize they will be stuck in fast track the rest of their life.

 

Doing a well established residency provides you with all the tools to become a great EM PA. Just ask the residency trained PA in my area who works two-24 hour shift a week at a low volume ER for $80/hr. They wouldn't even look at anyone unless they had 10-15yrs + of EM experience or a residency grad.

Thanks for the great response. This is something I didn't think of and ERs have to be the best example of that. 

 

However, aren't the first few years of a PA's career essentially a residency minus terrible pay? We all have to learn the clinical/bedside aspects of medicine at some point, why not learn while being paid to do so?

[FfIghter23]

Thanks for the great response. This is something I didn't think of and ERs have to be the best example of that.

 

However, aren't the first few years of a PA's career essentially a residency minus terrible pay? We all have to learn the clinical/bedside aspects of medicine at some point, why not learn while being paid to do so?

That's a common misconception about a residency vs. on the job training. In EM, you may have some teaching moments throughout your first 12-18 months of employment, but you aren't there to learn. You are there to move the meat and see patients. Much of the learning is self-directed and there are very few mentors who are able to do their job while at the same time teaching you. In a residency, you are there to learn. You are also allowed the opportunity to learn medicine through several off-service rotations. These are invaluable and really separate on the job training vs residency. Some examples from an EM residency: PEDSEM, ANES, ORTHO, U/S, TRAUMA, EMS, ENT, OPTHO, CCU, TOX, SICU, G.SURG, NEURO, IM, BURN.

 

There is not a job out there where you can learn to intubate in a controlled environment, learn bedside ultrasound to the tune of 200 in a month, a month in Optho will let you see enough eye complaints to feel good about treating on your own vs. consulting on every eye complaint. There is also an academic side of EM that you will not get if not in a residency.

 

See the reports/posts in this section of the forum to read about the benefits of a residency. I can't firsthand tell you the benefits, but I am supporter of residencies and may attend one myself one day.

[SERENITY NOW]

What Ffighter says is true.  There is something to be said about taking 1 month to totally immerse yourself in a specialty, living and breathing it, seeing more cases than you'd probably see in 2 years, getting a sense for how the specialists think, how they ask their patient's questions, what they look for, the most important details to know about their commonly used medications, etc.  Its really invaluable, regardless of the salary change you'll get on the other side.

[Guest Paula]

Thanks for the great response. This is something I didn't think of and ERs have to be the best example of that. 

 

However, aren't the first few years of a PA's career essentially a residency minus terrible pay? We all have to learn the clinical/bedside aspects of medicine at some point, why not learn while being paid to do so?

 

No, physicians aren't all that great at caring about a new grad PA.  Neither are administrators.  They hire us to see patients and expect a lot from the outset.  I have not had the experience of a good mentoring physician, especially when I worked ER as a locum and as a part-time employee.  When I asked for the training for intubation, procedures I didn't get to do in PA school (lumbar puncture, thoracentesis, etc.) they all said, oh, yeah we'll train you, but it never happened....They do not have time, and the PA pulls the fast track charts for the most part. 

 

Residencies are valuable and I can only imagine would help a graduate of one to obtain a higher salary as cinnstep posts. 

[EMEDPA]

Agree with Paula. for the most part if you want to do high end procedures in em you need to come in knowing them already from doing a residency or prior high level training like medic, RT, etc. It is rare today to find an em group willing to train a new grad in full scope em outside of a rural area.

[andersenpa]

My experience is that first few years of work is not residency-minus-the-low-pay. Well structured postgrad programs have a didactic component, heavy faculty support, and an educational focus that is not present in a traditional PA staff position.

 

I have heard for years about the residency urban legends- one yr residency = 3-5 yrs "regular work" experience, higher salaries, etc. I've never seen data on it.

 

If you haven't talked to APPAP they would be the best source of info. 

[EMEDPA]

My experience is that first few years of work is not residency-minus-the-low-pay. Well structured postgrad programs have a didactic component, heavy faculty support, and an educational focus that is not present in a traditional PA staff position.

 

I have heard for years about the residency urban legends- one yr residency = 3-5 yrs "regular work" experience, higher salaries, etc. I've never seen data on it.

 

If you haven't talked to APPAP they would be the best source of info. 

I would argue that some people probably NEVER get the experience a residency might provide....if you work in a place without folks who value you professionally and want to help you advance your career you might never get a chance to increase your scope of practice beyond the basics of your job.

[moy505]

Agree with Paula. for the most part if you want to do high end procedures in em you need to come in knowing them already from doing a residency or prior high level training like medic, RT, etc. It is rare today to find an em group willing to train a new grad in full scope em outside of a rural area.

 

Even if you do a residency it's very likely that the place you are working at places restrictions on PAs so that they cannot do many "high end procedures". So you might learn how to do a central line in residency but then you HAVE to work in a specific location that allows PAs to do central lines to take advantage of your training. This likely means a rural setting. If rural settings provide good clinical education (w/o losing money on low residency pay), why not just go to a rural setting straight outta PA school? Seems to me like you lose some flexibility by doing a residency.

 

I shadowed 2 ortho PAs. One did residency and probably had 10+ years of experience and the other graduated from a 3 year program ~3 years ago. They split the patients during the clinic day and they are scheduled interchangeably in the OR. The residency guy probably knows more but the place he is working at simply has certain jobs that are done by the PA and certain jobs done by the doctor. He also probably makes a bit more money but that has more to do with his natural salary increases over the years, at the practice, than it does with his residency training. 

[EMEDPA]

working rural helps get training, as opposed to many/most urban jobs which provide zero training, but you still don't have dedicated off service rotations focused just on learning where you can intubate 100 pts, do 100 u/s, run codes with someone over your shoulder, reduce fxs with an orthopedist, etc.

life isn't all about money, it's also about job satisfaction.

[moy505]

working rural helps get training, as opposed to many/most urban jobs which provide zero training, but you still don't have dedicated off service rotations focused just on learning where you can intubate 100 pts, do 100 u/s, run codes with someone over your shoulder, reduce fxs with an orthopedist, etc.

life isn't all about money, it's also about job satisfaction.

 

Then we should be honest about a residency being about gaining job satisfaction more than it is about money.

[Guest JMPA]

residency = cheap labor and no substantial benefits that one could not get otj

[EMEDPA]

STRONGLY DISAGREE. when was the last time you intubated 100 pts in a month at work with an anesthesiologist critiquing your technique?

[cinntsp]

residency = cheap labor and no substantial benefits that one could not get otj

 

False.

[tunafish]

STRONGLY DISAGREE. when was the last time you intubated 100 pts in a month at work with an anesthesiologist critiquing your technique?

With all respect, I doubt that Anes MD residents can show these numbers in a large med center

[MediMike]

I believe you are mistaken. 

 

As a PARAMEDIC student years ago I obtained 30+ intubations in 4 days at a medium sized hospital.

[EMEDPA]

as a student on anesthesiogy rotations you just go from OR to OR intubating pts with different docs or crnas. I recently had to do some to keep up credentialing at one facility(regional trauma ctr) I work at. I got 6 in 2 hrs. If I had stayed all day I probably could have gotten 15-20 in ONE DAY.

[EMEDPA]

With all respect, I doubt that Anes MD residents can show these numbers in a large med center

the residents have to stay for the whole case. as a student, you do the intubation then move on to the next one. you are in each room maybe 10-15 min.