EM residency... getting from A to B.

[nonnocere]

Hello all, new grad here.  I focused my rotations in ER, come from EMS background etc. so I know that EM is what I want to do long-term. My next step is residency--my motivating factor being the "immersion" experience others describe.  I'm not concerned with future earning potential or low initial stipends.  I simply feel I need more training to be a good PA that knows what I'm doing in the ER, regardless of whether I end up in a rural or major teaching hospital.  I'm willing to grind for another 12-18mos in order to get where I want to be; reading what the seasoned PA's here recommend reaffirms my gut instinct that it's worth it.  That said here's my issue:

 

I just graduated last month and the program I'm considering doesn't start until the Fall.  I won't know if I'm accepted until June and I can't go unemployed (for both financial and clinical reasons) in the meantime.  I'm currently applying for EM jobs but most require experience (thus my residency pursuit).  I want to make a smart decision now that would still put me in a good position to continue toward the ED in the event that I don't get a residency.  I know many of you will say consider more programs, relocate, etc. but I have family constraints that limit me at this time.  I agree with the "if you want it bad enough make it work" mentality but I'm just being realistic with where I am right now.

 

My first thought was UC but with the offers I've received I'd be on my own seeing 35+ pts a day with little senior mentorship and it just sounds like I'd be setting myself up for failure.  What are your thoughts on taking a current position in family med vs. urgent care vs. ortho (tons of new grad opps in my area) considering my future plans?

[SERENITY NOW]

I am new to the field as well; I started my residency program within a couple of weeks of graduating and it was a nightmare trying to squeeze all of the credentialing processes, EMR training, hospital workflow training, etc into that time frame.  What's more, right from the start they threw us in the deep end seeing the complicated main ED patients, who never have straightforward chief complaints and always have tons of comorbidities. Looking back now, I think it was tough to learn everything at once especially with these complex patients, and I think it would have been great to have a few months to a year of urgent care experience to "get my feet wet" with straight forward patients, learning clinical workflows and efficiency skills/charting/ etc.  I think I would have been able to hit the ground running much faster if I had that experience prior to starting the residency.  That being said, it would be horrifying to be expected to see 30+ urgent care patients as a new grad right off the bat without extremely strong supervision and mentorship... that sounds like a recipe for disaster.  I'd see if there are any other better UC opportunities in your surrounding area.  

[Sunnyn]

Maybe this is a silly question....how liable are PA's when it comes down to malpractice, for a new grad vs an old grad?  Are PA's somehow protected, because they work under supervision? and are less to blame for mistakes?

 

Many Thanks.

[LT_Oneal_PAC]

Maybe this is a silly question....how liable are PA's when it comes down to malpractice, for a new grad vs an old grad? Are PA's somehow protected, because they work under supervision? and are less to blame for mistakes?

 

Many Thanks.

PAs are held to the same standard as physicians and equally to blame for their medical decisions and are in no way protected by having a collaboration agreement, nor is a doc at greater risk for a PAs mistake.

[Sunnyn]

PAs are held to the same standard as physicians and equally to blame for their medical decisions and are in no way protected by having a collaboration agreement, nor is a doc at greater risk for a PAs mistake.

So that a PA become less liable during the care of a patient....what? how does one do that?  especially when they are just starting out?

 

Any thoughts by everyone would be very appreciated.

 

Many thanks

[nonnocere]

I am new to the field as well; I started my residency program within a couple of weeks of graduating and it was a nightmare trying to squeeze all of the credentialing processes, EMR training, hospital workflow training, etc into that time frame.  What's more, right from the start they threw us in the deep end seeing the complicated main ED patients, who never have straightforward chief complaints and always have tons of comorbidities. Looking back now, I think it was tough to learn everything at once especially with these complex patients, and I think it would have been great to have a few months to a year of urgent care experience to "get my feet wet" with straight forward patients, learning clinical workflows and efficiency skills/charting/ etc.  I think I would have been able to hit the ground running much faster if I had that experience prior to starting the residency.  That being said, it would be horrifying to be expected to see 30+ urgent care patients as a new grad right off the bat without extremely strong supervision and mentorship... that sounds like a recipe for disaster.  I'd see if there are any other better UC opportunities in your surrounding area.  

 

Hi Serenity, thanks so much for your input.  I'm going to keep looking like you suggested.  I also interviewed for one of those "unofficial" ER fellowships.  I know how everyone feels about them, and I agree that without didactic components & off service rotations it's not technically a residency.  But, I can't help but think that temporarily working for a lower FTE salary with docs and PA's that are invested in teaching new grads is better in the long run than earning more money working for a poorly-run UC just to say I have "experience".  I don't know, just my 2cents... even if it may be naive.