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akdEM last won the day on January 17 2016

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About akdEM

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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. Yeah, that no-compete clause is pretty brutal. I wonder why they feel the need to be so restrictive? Are they able to give you any idea of what kind of "bonus" you could expect? 75k is low, but maybe the bonus will make up for that. If you make 90k after the bonus and work 45 hours per week, that comes out to $38 per hour. Just based on the numbers, it doesn't seem like a great package to me. Are they willing to negotiate?
  4. 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.
  5. 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!
  6. It sounds to me like a case of some mild OCD. I don't think you were dealing with a rational person. I've had similar conversations with more reasonable patients and it has gone well.
  7. 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
  8. 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!
  9. Unfortunately, I think that salary is pretty much about the standard for NYC from what I have heard. If you absolutely must work in NYC, you probably won't do a whole lot better. But might I suggest looking upstate just a bit? There are some great hospitals north of the city that probably pay far better than the ones in NYC. TeamHealth staffs quite a few EDs in the area.
  10. You made a great decision, and I think his response to you wanting to learn LPs and central lines is very telling. He wants to use PAs in the narrowest possible sense. You would not have gotten the kind of experience you wanted out of that job.
  11. North Carolina is a pretty nice place. Especially PA friendly, close to the beach, close to the mountains, mild climate, and some pretty cool cities (Charlotte, Raleigh, Durham, Chapel Hill). I'd give it a look!
  12. I agree with all of the people above. I think you know what the right call is here. It sucks to turn down an ER offer, but this really would not be the kind of training that would really benefit you in the long term anyway. It's just an excuse to pay you less than a nurse while deciding if they want to hire you full time or not.
  13. 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.
  14. I think most agnostics and atheists would argue that you are working from a false premise here by implying that ethics flow directly from religion. Sure, they influence one another, but they can exist totally separately as well. What ethics are you referring to in this thread that are specifically western anyway? The belief in the sanctity of human life and the idea of "do no harm" are not unique. You don't have to accept Judeo-Christian religion to hold those beliefs.
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