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Statistics on PA residency advantages??


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and intubation is just one skill. residents can spend a week with a vascular access team just starting central lines and pic lines for 40 hrs...or with an u/s tech doing 2 weeks of bedside ultrasounds, etc. and these are just skills...what about the valuable time spent rounding on pts in a medical ICU or working with an ID doc with critically ill immunocompromised pts. This is so much more than you could do working a typical job where your only purpose is to move the meat seeing 2-4 pts/hr with little interaction with anyone except for nursing staff.

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In my residency I not only was trained to do central lines - Swan, CVC, VasCaths, TVP but was also trained to perform more advanced procedures like inserting an IABP. We have folks on my team that have been practicing in the CCU for years that have never had that opportunity. Being a resident and teamed up with a physician who was willing to teach allowed me this opportunity. I was also given the chance to sit down with a physician for several days and read echos, cardiac MRI's and CT's. I think you'd be hard pressed to find a job that would allow you to have days on end simply focused on reading and performing echos. Cheap labor....maybe....but getting the best training in the shortest period of time. 

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

Wrong. I can speak on this as I have worked in both environments. If YOU have that same experience, let us know how they were different. 

The educational environment and support system in place for residency far exceeds that in OTJ training. 

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  • 2 weeks later...

that just means he is not taking full advantage of his residency training...

Agree, another advantage I have seen from residency trained EM providers: they learn the language of the specialists in the hospital. One of the worst feelings in the ED is sounding like an idiot on the phone with a specialist. When you spend a month with them... you learn what they want and need to know. This goes a long way in building trust. I know, because many of us learned the hard way.

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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.

Love the conversation going on here. This is a great point. I'm considering doing a blog post about this alone.

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Residencies  and CAQs are the future.  If you have been in  a specialty for 10 years or you work in primary care you can certainly get by without one, but many PAs in emergency departments just won't get enough numbers of certain procedures to become competent or maintain competency in securing any airway on any patient every time, instead of some airways on some patients some of the time because there is always someone else there to take over.   It can make that big percentage of difference with a relatively small number of patients, but it is a life-altering difference.   And that's just with procedures....the enhanced diagnostic ability and fund of knowledge that comes from seeing lots of very sick patients is absolutely life-changing.  You will learn five times as much in that residency year as you learned in your clinical year of PA school and at least as much as you would learn in five years of practice.  Just make sure you pick the very best residency for you and move forward while you are young.    

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  • 1 year later...

Re-opening an old post... Thank you to all who have posted and shed so much light on this topic already!

 

I have just started clinical rotations and anticipate wanting to do a lot of procedures and have as much autonomy as I can in future clinical practice. I am actually only in my 2nd rotation, so I'm still not quite sure what specialty I want to practice in. I noticed that the majority of the discussion on this post is with regards to doing a residency in Emergency Medicine. I know that there are residency opportunities in a variety of specialties, but does EM tend to be the most useful residency? Any thoughts on residencies on other fields like Pediatric Critical Care, Critical Care in general, etc.? 

 

Also, I realize that autonomy is highly dependent on the individual, their level of experience, location of practice, and physician they practice under, but do there seem to be specialties that tend to offer the most autonomy regardless of those factors? Just as a background to the locations I'm working with, I live in a small city in Indiana and don't necessarily see myself practicing/living in a rural setting; if I was to move, the most likely moves would be to Indianapolis, or someplace in MI or IL.

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Honestly, I think that residencies would be worthwhile for a PA in any field.  PA school training is geared towards the core specialties (FM, IM, EM, etc) for the most part, so the specialties that deviate from that would be even more helpful to do a residency, like in critical care for example, which PA school surely does little to prepare you for.   Similarly, working in subspecialty fields will probably afford you less autonomy because its just not what our training is geared towards, so of course we would need more supervision there.  

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I will echo the sentiments of others that there is no comparison to OJT and a well structured residency. Having completed a residency in Neonatology has allowed me to take a position at a top ten children's hospital as their first PA in the NICU, at an hourly rate in excess of $100+.

I will agree though that compensation is what you make of it. I had a colleague who stayed at our training institution who will make half that, still 100k a year, but less than what the market is offering for our specialized skill set.

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Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

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1 hour ago, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

Do you mean like a long-term plan as in over the next 10-20 years or so? There are only 20 ish ER residencies currently taking 2-3 students each, seems like it would be difficult for an ER to get one residency trained PA, much less have all of them residency trained.

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9 hours ago, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

How did your residency affect your salary negotiation vs other PA starting salary with no exp or no residency. What part of cali?

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On ‎10‎/‎6‎/‎2017 at 10:50 AM, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

agree with this. when I interview folks, the ones with a residency go to the top of the pile. have hired and worked with several residency grads. they all impressed me.

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On ‎10‎/‎6‎/‎2017 at 0:10 PM, radioman said:

Do you mean like a long-term plan as in over the next 10-20 years or so? There are only 20 ish ER residencies currently taking 2-3 students each, seems like it would be difficult for an ER to get one residency trained PA, much less have all of them residency trained.

if you have a dept that allows for good PA scope of practice residency grads will seek you out. I have worked in small depts. with several residency trained folks. my last job had 3. my current job has only 3 PAs with one residency grad and 2 with both the caq and doctorates :)    (one of the 3 has a doctorate, a caq, and a residency).

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On 10/6/2017 at 1:50 PM, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

It's a nice idea but there just currently aren't enough of them out there. Even if we just talk about non-primary care positions, new grads far out number available residency positions.  We could quickly find ourselves in a situation where there are shady scam residencies (plenty already exist I'm sure) or even just mediocre ones pumping out residency grads the same way new PA programs are pushing out new grads.

I also wonder if the reason residency trained grads are so good is because those were likely the better students/providers to begin with - the ones that were not only accepted to residency programs but also those willing to put the time into an extra year of more formal education.  Seems like a confounding factor at least.

I'm not saying residencies don't have value, just that it's not as easy as just saying every grad should do one.

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14 hours ago, MT2PA said:

It's a nice idea but there just currently aren't enough of them out there. Even if we just talk about non-primary care positions, new grads far out number available residency positions.  We could quickly find ourselves in a situation where there are shady scam residencies (plenty already exist I'm sure) or even just mediocre ones pumping out residency grads the same way new PA programs are pushing out new grads.

I also wonder if the reason residency trained grads are so good is because those were likely the better students/providers to begin with - the ones that were not only accepted to residency programs but also those willing to put the time into an extra year of more formal education.  Seems like a confounding factor at least.

I'm not saying residencies don't have value, just that it's not as easy as just saying every grad should do one.

These were my sentiments as well. There is also no real consistency on accreditation of these residencies. I interviewed at a brand new one this year that told me the arc-PA wasn’t accrediting anymore residencies because they were too tied up with accreditation of new PA programs. I have no idea if this is true or just an excuse, but what stops a hospital from just calling something a residency to get cheap labor out of a few PAs if there’s no standardized process? I think there’s a long way to go before it’s considered a “must-do” thing for the profession. 

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On 10/9/2017 at 5:18 AM, radioman said:

These were my sentiments as well. There is also no real consistency on accreditation of these residencies. I interviewed at a brand new one this year that told me the arc-PA wasn’t accrediting anymore residencies because they were too tied up with accreditation of new PA programs. I have no idea if this is true or just an excuse, but what stops a hospital from just calling something a residency to get cheap labor out of a few PAs if there’s no standardized process? I think there’s a long way to go before it’s considered a “must-do” thing for the profession. 

I totally agree with you. I think PA post-graduate training is a great idea but we still have a long way to go. I honestly believed PA education with some kind of special primary care residency made for PAs can replace primary care docs. (I know I might get flamed)  

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On 10/9/2017 at 8:18 AM, radioman said:

These were my sentiments as well. There is also no real consistency on accreditation of these residencies. I interviewed at a brand new one this year that told me the arc-PA wasn’t accrediting anymore residencies because they were too tied up with accreditation of new PA programs. I have no idea if this is true or just an excuse, but what stops a hospital from just calling something a residency to get cheap labor out of a few PAs if there’s no standardized process? I think there’s a long way to go before it’s considered a “must-do” thing for the profession. 

What ARC-PA told you is true. There is a new accreditation process coming online through CAAHEP probably some time next year. 

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  • 2 weeks later...

Has anyone done a residency after being out in practice for several years? I've considered going back for all of the reasons being espoused here, and I think it's definitely what one should try to do if you want to be at the top of our field, but it's a lot harder now to think about taking a 50% pay cut vs had I done a residency right out of school.

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2 issues here: the PA working in the same field as the residency they intend to do and the pa thinking about changing specialties. I know as a PA I could apply to work in another field than EM, but if I were to do something unrelated to em(say CT surgery or nephrology), I really would want to do a residency in the new field. I agree that is hard to go back and do a residency in your own field after many years in practice. I still wish I could do one today as there are lots of procedures and knowledge(mostly of the critical care , u/s, and ICU pt care management variety), but no way I could take a 60-75% pay cut to do so. If I was single and without considerable debt I would still do one in my late 40s. would still consider doing the lecom bridge under those circumstances.

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