University of New Mexico Emergency Medicine Residency

[UNM EMPA]

The University of New Mexico School of Medicine, Department of Emergency Medicine, is excited to announce that we are seeking applicants for the inaugural class of our Emergency Medicine Physician Assistant Residency. This is an 18-mont program that will equip physician assistants with the clinical experiences and didactic teaching that will enable them to practice high-quality, evidence based emergency medicine.  We are seeking applicants for two positions that will begin mid-June, 2016.

 

It is our goal that our graduates have comfort and competence in the care of critically ill patients, the broad scope of emergent presentations, and the skills necessary to be leaders in their profession. Our curriculum includes weekly didactic sessions, with an emphasis on simulation, as well as the following rotations:

 

- Dedicated orientation block (4 weeks)

- Main Adult ED (32 weeks)

- Pediatric ED (8 weeks)

- ED Resuscitation Unit (4 weeks)

- Medical ICU (4 weeks)

- Trauma/Neuro ICU (4 weeks)

- Orthopedics (4 weeks)

- ED Ultrasound (2 weeks)

- OB/Gyn (2 weeks)

- Cardiology (2 weeks)

- Electives (7 weeks, with possibilities including EMS, disaster med, research, toxicology, wilderness medicine, and others)

 

Benefits include:

 

- $55,000 yearly salary

- Up to 4.5 weeks paid vacation for program

- Health Insutance (60% University paid)

- Retirement contribution

- CME/Travel allowance

- SEMPA membership, ECG weekly subscription, and other educational resources

 

Our department is an incredibly place to work and learn. Some highlights:

 

- We are located in the only level I trauma center, children’s hospital, and burn center in the state

- 82-bed department with high-acuity in trauma (penetrating and blunt) as well as medicine

- Highly regarded EM program with world class faculty in EMS, Peds EM, EM/Crit Care, and research

- Faculty used to working with PA’s, who are both excited to teach and experienced in doing so

 

As the only EMPA residency in the inter-mountain west, our location can’t be beat. Albuquerque has world class hiking, biking and climbing opportunities right outside the city, with some of the Southwest’s best skiing a short drive away. The food and culture in the city can’t be bear, all while maintaining a reasonable cost of living.

 

Our application will be due Feb 1^st, 2016. Our anticipated start date is June 14^th, 2016. As of now we are anticipating interviews in late February with notifications in March.

 

Below is a link to the website for the program:

 

UNM EMPA Website

 

**** Application materials will be loaded to the site in the coming days****

 

 

We encourage you to also check out the rest of the department’s site for a better idea of the department and program. We are incredibly excited for our first class of residents, and hope you will consider applying

 

Please direct any questions to: Jveesart@salud.unm.edu 

UNM EMPA flyer.pdf

[EMEDPA]

looks great! added to residency list at top of em forum.

[Torshi]

I'll consider for next year for sure since I'll be on rotations this year

[JDayBFL]

Thanks for the information. Looks like a great program. Will be applying for 2017 as I have fall graduation dater his year. :(

[PAjunky]

how is the work schedule like in the new mexico program? does anyone know...

[overthehorizen]

This is a new program so it still remains to be seen whether or not it will be a legitimate training program or a place for cheap grunt labor. Having worked at the UNM system recently, I learned a few facts. The system is overwhelmed by demand and they lack supply.  In the ED, wait times average 16 hours, the longest in the region. There are published reports comparing UNM wait times with Presbyterian and Lovelace. UNM is more than double. The other problem with UNM is cost control. They have a mandate to treat all indigent population in the county; a noble cause. To control costs, employees (PA, NP and all other staff but NOT doctors) must get their healthcare delivered by UNM. In essence, if you and your family need care, it comes from UNM or else you pay $10,000 yearly for insurance outside UNM. It may not sound like an issue until you learn that the wait time to see a primary care provider is between three and six months. The wait time to see a specialist ranges from nine to twelve months. People who work there discovered that after waiting a year to see a specialist, they were told that the specialty service doesn't have the capability to treat their condition because nobody stays at UNM after the training. Thus, you wait six months to see the primary care provider to authorize the specialist visit. You then wait twelve months to see the specialist to get care. After an eighteen month wait, you discover you cannot get the care you need so you end up paying the full cost of the care "out of network" because UNM won't pay it. Remember though, the doctors who are working there have their health insurance delivered through a separate plan. They can freely go to Lovelace and Presbyterian for immediate access without penalty. THe PA cannot do that. 

 

The other problem at the UNM system is that the doctors LOVE PAs. They don't love training them though. They despise doing that.What they they love are the benefits they get from PAs. They can go on a one month long vacation without any warning by simply taping a 3M stick note the PA's computer screen. WHen the PA comes to work on Monday, the note will read "I'm going to Europe for one month. Please cover my patients. THank you , Dr Go F Yourself". Other doctors will do similar stunts by taking six leave for six weeks for "back problems." Again, the sticky note. The doctors never communicate with the PAs there. They only abuse them and use them. 

 

By now, some folks are already lined up for this mess. I hope it goes well. I just anticipate that the only training you'll get is whatever you teach yourself under condition of getting paid only sixty percent of what you are truly worth and not having access to healthcare for you or your family. In time, you will find out that the physicians there just take advantage of the PA and offer little if anything in return. You will get the scut work that the ED residents want to dump on you so they can get higher quality training. Be prepared for a year long course in suturing.

[UNM EMPA]

To all interested applicants to the UNM EMPA program,

 

I do feel as though several things in the above post are in need of response, and are potentially inaccurate.  I am not personally familiar with the author above's interaction with one of the entities that makes up potential PA employers in the University of New Mexico Health Science Center  (UNM Hospital, the UNM School of Medicine, and the UNM Medical Group), and so I can't comment directly on that interaction. I also have concerns that the person authoring the post above has not had any work experience in the emergency department at UNM, which by no means makes his or her experience invalid, but I believe may cast an inaccurate picture of our new residency's work environment.

 

A few points:

  

1) All UNM EMPA residents are afforded a choice of three different insurance plans (UNM, BCBS, or Presbyterian), paid 60% by the University, for individual, couple or family plans. They are not required to seek care only at UNM.

 

2) All UNM EMPA residents are employed by the Department of Emergency Medicine, in the School of Medicine at UNM.

 

3) Our program adheres to the Society of Emergency Medicine Physician Assistants' Post-graduate Training Program Standards. These were developed by SEMPA specifically to ensure programs provide rigorous clinical and didactic education to EMPA residents. They were developed by a committee of emergency medicine PA educations leaders.

 

The guidelines are available freely online here:

https://www.sempa.org/uploadedFiles/SEMPA/PostGraduate_Program/EMPA%20Postgraduate%20Training%20Standards%20PDF%20File%20for%20Website.pdf

 

4) As a residency, we embrace the fact that we are the only level I trauma center, the only children's hospital, and the only burn center in the state. We strive to recruit PAs who are invested in the system that provides an overwhelming majority of uncompensated care for one of the populations with the greatest need in the state. While this does mean that our waiting times are longer (though not averaging 16 hours), it also affords our trainees to see a level of pathology that one encounters in few other places. We hope to recruit PA residents that are interested in the kind of training that only a safety-net tertiary care center can provide.

 

5) Our doctors do love us as PAs. They also treat us with great respect, enjoy educating, and have little ego. This is one of the reasons the medical residency in EM at UNM is held in such regard. Having begun my career here as a new graduate and moved into the community before returning, I can honestly say there is nowhere else where a PA in the emergency department could gain experience. Attendings are receptive to staffing patients, letting PA's perform procedures, and impart their respect to their training residents. I can only imagine that the characterization above did not come from our department.

 

6) One of our core missions is educating PA residents to take care of the sickest of the sick, and this priority is recognized by and advocated for by departmental leadership (including our chair). In contradistinction to "a yearlong course in suturing" (our program is 18-months), our residents will have opportunities for airway management, central lines, unstable patients, and the gambit of emergency care. I have personally sent more patients to the ICU, intubated more patients, and performed more procedures in the last month here than in the year prior in the community (at a level I trauma center). Our intention is for the residents to have an every greater exposure than this.

 

7) Finally, please do not let one person's experience outside the emergency department in a different part of the system cloud your view of a department that on all levels is supportive of training and keeping engaged, bright, and intellectually curious PAs. I am more than happy to answer any prospective applicants' questions, and provide more background into what will be an amazing program. Our first class is enrolled, to start at the end of June this year. We will be taking applications starting Oct. 1st, 2016, to Feb 1st, 2017 for the class to begin at the end of June, 2017.

 

Best regards,

 

Clint Kalan, PA-C, MMSc

EMPA Residency Program Director

UNM School of Medicine, Dept. of Emergency Medicine

cpkalan@salud.unm.edu

[UNM EMPA]

PAjunky,

 

   Our program begins June 28th, and is 18-months in duration. It is split into 19 4-week blocks. The curriculum is as follows:

 

- Dedicated orientation: 1 block

- Adult Main ED: 8 blocks

- Pediatric ED: 2 blocks

- Emergency Department Resuscitation Unit: 1 block

- Medical ICU: 1 block

-Trauma or Neurosurgical ICU: 1 block

- Orthopedics: 1 block

- Cardiology Consult Service: 1 block

- Ultrasound 1/2 block (1 full block, but only afternoons)

- Anesthesia 1/2 block (mornings)

- OB/GYN 1/2 block

- Toxicology 1/2 block

- Electives 2 blocks

 

While on rotation in the ED, residents are expected to cover 18 clinical shifts per block. This is in addition to weekly conference on Wednesday from 10 am - 4 pm. Didactic curriculum will include simulation, core content, as well as regular assessment. One week per month in the last 6 months PA residents will cover a shift as a "senior" resident in the main ED instead of conference, with didactic education rescheduled.

 

Our program will run from the last week of June one year to the end of December the next. While this does make start dates hard for some graduating PA programs, we do believe collegiality with the physician residents is vitally important, and one of the best ways to foster this is going through the same orientaiton month.

 

Please feel free to contact me with any other questions.

 

Best regards,

 

Clint Kalan, PA-C, MMSc

EMPA Residency Program Director

UNM School of Medicine, Dept. of Emergency Medicine

cpkalan@salud.unm.edu

 

 

 

how is the work schedule like in the new mexico program? does anyone know...

[overthehorizen]

It is notable that PA Kalan has taken time to thoughtfully address reservations about a newly forming PA residency program without much transparency until now. I appreciate the brief but superficial response to the salient points that I offer for consideration before investing a long period of time into something without a known track record. It appears that there are multiple health care options. The devil is in the details. I still question if one can truly go outside the UNM network without substantial financial penalties being incurred. PA Kalan doesn't offer any background on these plans and we are forced to take him at his word as it were. Given my experience with UNM, I'm less inclined to take someone's word but instead need to see it on paper. He does state that the program wants an applicant who is invested in their mission, treating the indigent. If you plan to remain at UNM, where will you get your health insurance? Will you remain an employee of the Medical School and have a lot of options or be forced into an employment contract with only UNM as healthcare source. I looked at the UNM Emergency Deptment SOM website and see no PAs or NPs so I wonder where the graduates will work (UNM Hospitals...oh my!). PA Kalan states their commitment to training curriculum standards. As I have said before, it is early to know if this will be accomplished. The wait times still remain double the other ERs in region. Costs are still a major factor. To achieve reductions in wait times, UNM pays PAs and NPs to do "fast track" work just outside the main ER. They are paid $75 per hour. If the program can replace those fast track PAs with trainees at $55k/year, the cost has nearly been cut by 1/3rd (55k is $27 per hour). I am not saying the program doesn't have the potential to become a viable training facility in the future. I merely offer a sincere word of caution to those are thinking of investing too much in an unknown group with no track record. I would wait to see what happens after the first class finishes and read their views for a more informed opinion.

[fakingpatience]

It is notable that PA Kalan has taken time to thoughtfully address reservations about a newly forming PA residency program without much transparency until now. I appreciate the brief but superficial response to the salient points that I offer for consideration before investing a long period of time into something without a known track record. It appears that there are multiple health care options. The devil is in the details. I still question if one can truly go outside the UNM network without substantial financial penalties being incurred. PA Kalan doesn't offer any background on these plans and we are forced to take him at his word as it were. Given my experience with UNM, I'm less inclined to take someone's word but instead need to see it on paper. He does state that the program wants an applicant who is invested in their mission, treating the indigent. If you plan to remain at UNM, where will you get your health insurance? Will you remain an employee of the Medical School and have a lot of options or be forced into an employment contract with only UNM as healthcare source. I looked at the UNM Emergency Deptment SOM website and see no PAs or NPs so I wonder where the graduates will work (UNM Hospitals...oh my!). PA Kalan states their commitment to training curriculum standards. As I have said before, it is early to know if this will be accomplished. The wait times still remain double the other ERs in region. Costs are still a major factor. To achieve reductions in wait times, UNM pays PAs and NPs to do "fast track" work just outside the main ER. They are paid $75 per hour. If the program can replace those fast track PAs with trainees at $55k/year, the cost has nearly been cut by 1/3rd (55k is $27 per hour). I am not saying the program doesn't have the potential to become a viable training facility in the future. I merely offer a sincere word of caution to those are thinking of investing too much in an unknown group with no track record. I would wait to see what happens after the first class finishes and read their views for a more informed opinion.

 

 

I am highly considering applying to an ER residency after graduation, and as such I have done substantial research into the different programs offered around the nation.  Many programs are new, and do not have a graduating class.  Unfortunately, even for established programs, many do not have a large amount of details published online.  While there may be varying reasons for this, UNM has not stood out in my research as a program with a lack of published information.  I have emailed Mr. Kalan with questions I have had, and he has been very prompt to reply, and address my concerns.  

 

Your main argument seems to be with the health insurance offered by the UNM.  While I know absolutely nothing about how they run their health insurance plan, and that will be the last consideration on my list when I'm applying to residencies.  It is an 18 month program, with no requirement to remain on site after graduation; 18 months with a potentially poor insurance plan is little price to pay for a well run educational opportunity.   It sounds as though you have had a horrendous experience there; hopefully as Mr. Kalan has said, it is different with this devision, but if it is as bad as you say, well then after the 18 month residency that would be a considering factor for continued employment (if the resident is offered a permanent job)

 

Many ERs pay NPs and PAs to work in fast track; many PAs and NPs are happy with these jobs seeing lower acuity patients only.  I am not, and that is why I am looking towards a residency.  I'm confused by your ascertain that because UNM uses PAs in their fast track, that will be the experience the residents gain.   Mr. Kalan outlined above (and on their residency website, had you care to peruse it)  the various rotations the PA residents will complete during their residency; unlike a few programs naming themselves residencies out there, there are rotations out of purely the ER.  This indicates to me that they are not simply looking for "cheap labor" to staff an understaffed ER, but to truly train residents to become more competent all around providers.   Again, if during the residency one were to determine that the PAs at UNM are only used to staff fast track, you don't have to accept a job there after graduation.  

 

While there are programs I have looked at that have thrown up red flags, aside from being a new program, there have not been any concerning factors I have seen in the UNM fellowship.  

[PAjunky]

Thank you Mr. Kalan for taking time to answer our questions, honesty not many programs do that so I really appreciated it and u bet ur gonna see my application for next year!

[UNM EMPA]

Hello all,

  

    We are very excited to be working towards admitting our second class of PA residents. The admissions process for our second class closes on February 1st, 2017. Please see our website for admissions info and program description (if not mentioned here):

 

http://emed.unm.edu/education/prospective-applicants/physician-assistant-residency-in-emergency-medicine.html

 

For any further information and questions not answered, contact information for the program is provided and we will do our best to answer any and all questions.

 

Best regards,

 

Clint Kalan, MMSc, PA-C

EMPA Residency Program Director

Department of Emergency Medicine

University of New Mexico School of Medicine