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akdEM

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akdEM last won the day on January 17 2016

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  1. Well, you're coming in at kind of a weird time. EmCare just merged with Sheridan Health. We aren't really sure what is going to change but things almost certainly will. With EmCare, in my experience pay is very competitive but benefits are a little lacking. No 401k match or anything like that. We also don't have paid vacation. Hourly rate is high enough that none of that really bothers me. Sheridan really seems to like RVU based models, and there has been talk we may move that direction. Who knows... I'm in the Atlanta area, btw. What city are you near?
  2. Hard to believe it has been almost a year since graduating the program. I still get a lot of messages regarding Albany Med and PA residencies in general. It makes me very happy to see the level of interest out there and to see all the awesome new programs popping up across the country. Just wanted to re-extend the invitation that, if anyone has any questions about residency programs, feel free to PM me.
  3. My wife and I wanted to be near family and I didn't want a long commute. Basically, the pay and location are so perfect that I was willing to compromise a little bit on scope of practice. Scope is probably the most fluid of the 3 variables (pay, location, and scope). There are plans for PAs to become more involved in critical care, and the medical director hired me specifically for that purpose given my training. I certainly don't feel under-utilized, but there is some room for growth.
  4. Hello all, It has been a long time since I have posted anything, but I just wanted to do one last update. A bit of an epilogue... My fellow PA fellows and I all finished our program about 3 months ago. I found that, having done a fellowship, the whole job-search was pretty easy. A lot of recruiters and medical directors hadn't heard of these types of programs, so I did have to do a fair amount of educating. Those that were aware of what a fellowship has to offer were instantly more interested in making an offer. Ultimately, I ended up moving back to my hometown in metro Atlanta and taking a job at the hospital 10 minutes from my childhood home. My scope of practice out in the community setting is definitely not what it was at Albany Med, but that is to be expected. When you're in the midst of it, it's really hard to grasp how much you've learned or how much your confidence level has changed. But my first week on the new job, it really began to set in. I have so much left to learn and by no means do I consider myself an expert PA. But when it's just you and one other resident on night shift and you have 5 critical patients with multiple stab wounds roll through the door, or when you spend 4 weeks working side by side with 3rd and 4th year residents in the ICU, or when you just spend a year dealing with the day to day controlled chaos that is an urban level 1 trauma center, it makes a lot of other things seem a whole lot easier and considerably less scary. You can debate whether doing a fellowship will make you more money in the end (I'm not sure it does, but it certainly lets you be picky about what job you take), but you simply cannot replicate or replace the kind of intense, hands-on experience I got from this fellowship program. It would take years to accumulate the kind of experiences that I've had in the last year. I still have years and years of learning to do, but I wouldn't trade my fellowship experience for anything. For anyone out there who is on the fence, I'll just echo what so many others have said: If you go into it with the right reasons in mind, you will not regret it. It was the most intense, challenging, and rewarding year of my life. Feel free to ask any questions... I'll try to be better about logging in more frequently!
  5. Well it has been a while since any of us have posted, so I thought I'd give everyone an update.... We're closing in on the last couple months of the program. Matt and Eric actually finish up next week. Jenelle and I have until the end of September. Since the last update, we've all had the chance to spend a month in the Surgical ICU. I think I speak for all of us when I say that was a pretty great experience. Definitely a change of pace from the ED. Days start around 6am but usually end around 5 or 6pm, so that's kinda nice. For the most part it was 5 days a week. Very manageable. The morning was spent pre-rounding and then rounding with attendings and the rest of the clinical team. Each day you'd have 3-4 patients you were responsible for. Do a daily note, update medications, maybe a procedure or two... In the afternoon, admissions would start to roll in, which usually meant lots of procedures (mostly intubations, chest tubes, and central lines). All in all, it was cool to see what happens to our critically ill patients after they leave the ED. We've also had the chance to get into the simulation lab a few times in the last couple months. Basically, we pair off into teams of 2 and each of us takes turns running some kind of critical care scenario. I got lucky enough to have the seizing infant/respiratory distress case... Aside from using the wrong end of the Braslow tape and probably overdosing the child with ativan, I think it went fairly well...! Our program directors, 2 ED attendings, several ED nurses, and one of the former PA fellows volunteer their time to help put the simulations together. It can be nerve wracking, but everyone is always so supportive and patient. We're lucky to have such a cool facility. I know that they're hoping to incorporate it into the the curriculum more heavily next year, too. For the last 6 weeks, I've been working nights. We each do a stint of overnights in the A Zone (mostly trauma and critically ill patients with a sprinkling of psych patients). I was nervous about it. I wasn't sure if I was ready to handle the patient loads or the acuity level. I've got to say, though, that it has really been one of my favorite rotations. There have been some rough nights, no doubt. There have been times where I was counting the minutes until the AM team arrived... But my ability to carry lots of patients, sort out the sick from the not sick, and get people where they need to be has increased exponentially these last few weeks. When it's just you and one other resident carrying half of the department, you realize that getting stressed out doesn't change a thing. All you can do is keep seeing patients. We've had a fair amount of a stabbings, shootings, MVCs, etc... Working nights feels like much more of a "team sport" than days. It's been a lot of fun. Tomorrow is my last night. I'll miss it, but I'm also ready to have a normal sleep schedule again! I got to fly with the LifeNet helicopter crew a few weeks ago, too. We only transported one patient during my two days, but we did get several calls and would hover around the scene of the MVC before being told to stand down. It was a cool experience. I have a new found respect for the medics and flight nurses who do that for a living. They are some of the sharpest medical providers I've come across and they all seemed to love their jobs. I can see why... I want to look into what kind of opportunities exist for PAs... Other than that, it's been just a lot of regular ED shifts for the 4 of us. We've finished all of our off-service rotations. Jenelle and I are doing "electives" for the last month. For me, that means a few days seeing nothing but ortho cases, a few days of lacerations and plastics cases, a few days of bedside ultrasound, and a few days of fast track. Ironically, "fast track" patients are still one of the areas that I feel like I need more experience in. Learning to see lots of patients efficiently but safely is a skill that comes with time, and it's one that I want to start working on. I know in the "real world" there will definitely be a lot more pressure to move the meat. Well that's all I've got for now. I'll check in one more time a few weeks from now. That will be right as I'm finishing up the fellowship program. Please feel free to PM or post any questions in the mean time.... -Andy
  6. Glad to see another residency blog! The more the merrier. It sounds like a great program. Being 18 months long, you guys really must get a lot of great off-service rotations. Looking forward to hearing more!
  7. I'm not a graduate of their program, but I did apply and started the interview process. When I got into Albany, I withdrew my application. I did have the chance to meet and hang out with the director of the Arrowhead program during the EM Academy in Las Vegas a few weeks ago. He was super personable and very passionate about post graduate training. From everything I've heard from my own program director and what he was saying, it sounds like a really strong program. He is all about supporting his residents and getting them the best possible education. His graduates seem to land some pretty sweet jobs after finishing up that program. It's definitely a top-tier program and not just a CEP internship.
  8. akdEM

    VA Careers

    GetMeOut, what specialty are you in?
  9. I agree with all of the above. It's tough gathering info on programs. My strategy was to narrow down a few places based on location, info on the website, application timing with my graduation date and then dig deeper into those 3-5 programs. I emailed program directors, spoke to a few on the phone, and eventually ended up applying to a couple of the programs. I would also recommend asking if you can speak to some current or former fellows/residents. That's the best way to learn about a program in my opinion. As far as the APPAP and the whole accreditation thing... accreditation for PA fellowships is still in its infancy. They still working out the details on what the standards should be and trying to come up with a more uniform education process similar to the MD residents. It's a work in progress. At this point, getting accredited costs a lot of money and offers no real benefits to the program or its graduates. I wouldn't put much stock in accreditation right now.
  10. akdEM

    PAs @ NYP?

    I know nothing about the nature of the work there, but I know a fellowship grad who was offered somewhere in the neighborhood of 80k to work in their ED. They didn't take the job.
  11. Good luck! Maybe we'll get to meet you when you come up for an interview. I kind of wish I had focused more on my internal medicine and pharmacology skills. As PAs, it's our bread and butter, but it's easy to lose sight of just how important all that "family medicine" stuff is in the ED. We all know the line between EM and family medicine is blurring, but I think I was still a little naive coming in. Other than that, just get a nice broad foundation. Learn as much as you can in each specialty rotation, because it will ALL come in handy eventually in the ED.
  12. If you are absolutely set on doing a residency, then, yes, I would suggest applying to several. They are pretty competitive, but if you're a good candidate you won't need to apply to 12 programs to get in. The Arrowhead program, for example, takes I think 12-14 people each year. Residencies are definitely getting more competitive, but there are also more and more programs being added each year.
  13. As far as GPA and experience goes... I don't think either is a major factor in admission. A GPA below 3 might be a dealbreaker, but I think what they really look at is potential and desire to work in EM. I would guess that all of us had GPAs in the neighborhood of 3.5 or maybe a little higher, but don't put too much stock in that. I was an EMT for a couple of years before PA school, and that may have helped some. But I know that there have been several fellows in the past and present classes who went straight through from undergrad to PA to fellowship. So the short answer is, there really isn't a formula that they're looking for. The biggest thing is just to have some good EM rotations and demonstrate that you are passionate about this specialty.
  14. We're scheduled to work 4 days one week and 5 the next. Plus there are things like Wednesday morning conference we attend. Our shifts are 10 hours long. The usual shifts are 11-9p, 12-10p, 2-midnight, 4-2am, and the occasional 9-6pm or something like that. On conference day we usually work 6 or 8 hour shifts. So it comes to probably 50-55 hours a week on average I would say. When you're doing off-service rotations, the scheduling just depends on how busy that service is. For example SICU is more hours than ophtho. I'll just say that going into it, hours and being worked to death were one of my biggest concerns. I knew that it would be more hours than a regular job, but that's how you get experience. I haven't felt overworked. Adam and Sara, the directors, are very flexible with scheduling understand that we have lives outside of emergency medicine.
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