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About dfw6er

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  1. yeah absolutely this happens. It's well-documented that physicians are more likely to settle in the geographic region they did their residency....so if the area is medically underserved, opening up residencies is an evidence-based remedy.
  2. I've found a change of venue and/or specialty is great when you're feeling burned out. Tired of FM.......try IM. Tired of that, try rural med. Tired of that, try ER or a surgical specialty like orthopedics. The other nice thing about hopping specialties is it makes you a better provider as you've seen lots of different pathology and acquired a variety of skills. Employers and recruiters recognize this, in my experience.
  3. If they've brought in residents to do some of the work I don't think things are going to go back to the way they were before. Is there a new surgical residency at your facility or near-by that's sending them to rotate through vascular surgery? If so I doubt your situation will revert back to your happy baseline. You can stay or look elsewhere. Don't be afraid to approach a recruiter.......experienced surgical PAs are a hot commodity and you'll likely find something that will appeal to you.
  4. I did it for 2.5 years. Lived in the DFW area, took a job in Huntsville (north of Houston) to have my loans repaid by NHSC. I found a studio for $485/month and basically worked every Mon-Wed 12 hr shifts, then drove home. (3 hr commute)....between the salary the rural health clinic paid and the check the NHSC cut me, it definitely made financial sense. But it's time away from friends/family. OTOH, if you're a real go-getter, you can pick up another job on your days off and pay down bills/loans pronto.
  5. All but one PA program (last I checked) are full time in-class programs and will not easily allow you to work while enrolled. The exception is an online PA program at Yale...which is full-time, just blended with on-site activities and distance learning. I don't think even that program would easily allow you to work on the side and still have time for studying all the material the extent needed to pass the program, let alone the PANCE. If you're serious about PA school, get your backup career, pay off all your debt (or as much as possible), get your prereqs, plenty of shadowing hours with PAs in a few different specialties, and get lots of patient contact hours as a medic. Make sure your undergrad GPA is as high as possible as well as your GRE if required by the programs you're applying to.
  6. A contract reviewed by a lawyer before you sign it is one of the best ways to make sure you're not going to be shafted. I've known PAs in various specialties who worked for a fixed salary +/- bonus based on productivity (I, myself included), and PAs in various specialties who've worked hourly wages +/- productivity-based bonus (again, myself included). Some group settings will treat you as an employee, some may allow you to own part of the group (stocks, buy-in, etc.) So, depending on the contract, you could be considered salaried or hourly. Salaried has pros & cons as do hourly wage earnings. NCCPA and AAPA have surveys they do periodically that break down how PAs are compensated by specialty, region of the country, etc. As for avoiding burnout, keep a realistic work schedule that allows for a semblance of a work-life balance and get a hobby or two that you're really into. Your work should never be the sole thing that defines who you are. Be well-rounded and take personal time and you'll be way ahead of those who don't as far as avoiding burnout.
  7. I believe screening with vitals doesn't create an obligation to treat, nor is it illegal without consent. EMTALA actually mandates you medically screen all patients who present to your ER and makes NO EXCEPTIONS FOR MINORS. If vitals or what you're observing are off enough to give you concern, then you're obligated at that point to stabilize at a minimum. If you at any time feel a life/limb threatening condition may exist, then it needs to be dealt with regardless of lack of consent. And parents aren't allowed to refuse care in emergent situations, even if their religious beliefs are contrary to the care the child needs. Lastly, you have to do what's right for the patient. If you document the direness of the situation, unsuccessful attempts to obtain consent from legal guardian/parent, and your belief the child has an emergent life/limb-threatening injury/condition, a jury is quite unlikely to return a finding against you. However, if you refuse to treat something that was potentially life/limb threatening because you didn't have consent, you may be in violation of both EMTALA and be open for a malpractice lawsuit. The American Academy of Pediatrics and the American College of Emergency Physicians have position papers which reflect my beliefs as well.
  8. We'd get the child's name, SSN, demographics, insurance info and mom's/dad's/insured's info....generally then the RN and registration staff could look it up and see if the info adds up. With the internet, this information is verifiable 24 hrs/day generally. As for the ER....they can provide care if there's an imminent threat to life/limb. If it's something like a rash or pink eye, generally the ER isn't able to provide emergent care without prior consent from the parent/guardian.
  9. Not sure what the OP's state laws say, but in CA we could get the parent/guardian on phone and verbally get consent from them. The RN and I would document we got verbal authorization to treat the patient. I whole-heartedly agree about the lameness of turfing the problem to the ER. Only send to the ER if it's medically necessary.
  10. I did the SEMPA course a few years back in Phoenix. It was the best course I ever attended. Was better even than the POCUS courses taught by the large ER group I used to work for. I'd recommend the SEMPA course, then go practice what you learned for 6 months or so in your shop then take another POCUS course...or better yet....a POCUS regional anesthesia course. Before you know it, you'll be very proficient.
  11. In the past, during your interview they'd give a brief run-down on the 3 pathways and ask you to fill in which campus/pathway you want if accepted (Erie or Seton Hill). Now that it's only Seton Hill campus for APAP and the SH campus only offers PBL, it's a moot point if you're applying to the APAP program. That being said.....there are a few cases here and there where a person didn't get an APAP slot because the slots filled up prior to their interview and the school has instead offered the applicant a slot in the PHCS (primary health care scholars) pathway....it's also 3 years and you're contractually obligated to seek a primary care residency and work in primary care after residency. I have no idea how often this has happened in the past, just was told it's happened occasionally.
  12. yeah....that's kinda how it goes. Smaller groups often can't afford to fly out and house/feed every potential job applicant. Sometimes they can meet you in the middle and cover your hotel/food.....or even say they'll reimburse you after 6 months if you take the job. Bigger groups sometimes will pay the cost if they're desperate enough.....but being a new grad puts you at a disadvantage compared to experienced ENT PAs. You could see if Amtrac is cheaper....or just drive it. Good luck
  13. There are more PA jobs in the Central Valley of California than you can shake a stick at. And they pay really well. Some of the family med clinic jobs even qualify for NHSC loan repayment. Contact some recruiters....good recruiters will even help you polish your CV and give you interview tips....they only get paid if you get the job. If you're interested in ER jobs or in primary care and don't mind moving to north central CA, let me know and I can point you in the right direction. Some of the ER groups are willing to hire new grads. Some of the ER groups also run ER residencies for PAs, and when I left, some of the sites in my ER group were experimenting with a 6 month intensive "internship" where they pay you to do extra readings outside of work in order to get you up to speed faster as a new grad.
  14. Every time I see a thread on some forum regarding this same misconception that these programs are PA's "attempting to become real doctors", I make a concerted effort to fight the misconception. I tell the OP that the doctoral degree is for PAs needing the doctoral diploma to compete for admin jobs or to become core faculty at PA programs, that often these positions demand PhD level degrees to be a competitive applicant. Lastly I tell them the PA profession is not lobbying state legislators to become independent, unsupervised providers unbeholden to physicians. ---but then I don't miss the opportunity to remind them what the NPs are up to. Their DNP movement (funded by the very deep pockets of the nursing lobby) has 2 goals: the first is to make all NP programs doctoral and gain complete practice autonomy in all 50 states. The second goal....which many (if not most) of us see but not enough are willing to make noise about, is the endgame goal of pushing for parity of the DNP degree with that of MD/DO degree. Trust me, that's what the DNP leadership wants. Once all the NPs are DNPs and they're all autonomous, they'll lobby the crap out of legislators, telling them they have doctoral level training, are more holistic, have NP-reviewed publications showing their outcomes in care are non-inferior to physicians, and therefore they should have the same recognition, be allowed to set up their own residencies, and be allowed admitting privileges and, once DNP-residency trained, allowed to operate on a chest just as any MD/DO CT surgeon would. AAPA and NCCPA and the PA profession needs to get its crap together. The nursing lobby is huge and they're outspending us and the results are showing. The PAs need to be very tight with the AMA/AOA and aggressively counter the nursing lobby efforts. This is, of course, just my $0.02
  15. Yeah I worked in the ER at DMC Modesto for 5 1/2 years before moving on to med school. What would you like to know? I personally lived in Oakdale (13 miles from my driveway to the hospital parking garage). I never had any serious problems with crime....but if you live in certain areas of Modesto you probably will. North East Modesto is very nice, area is known as Village One....very nice homes, lower crime, reasonably close to the hospitals.
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