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spensj

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Everything posted by spensj

  1. Googled "PA jobs in Wisconsin" and applied. I had no idea about the training period until my interview
  2. I've worked in emergency medicine and part time in addiction medicine for 8 years. I trained for 6 months at an opioid treatment program and then did a post graduate emergency medicine residency. I currently work at an opioid treatment program managing patients on Medication Assisted Treatment. I find it very rewarding and a great change of pace from my EM job. Relatively low stress with competitive pay...my hourly addiction medicine rate is higher than my EM pay. Much of the clinical work is protocol driven. Individuals with substance use disorders are very underserved and appreciate being treated like a patient and not a drug seeker. It can be frustrating at times (i.e. relapses) but this fits into what we know about addiciton being a chronic brain disease. Addiction medicine is highly regulated by the state/feds so I've run into state and federal laws that limit my scope of practice. Hope this helps! Pro: pay, low stress level, appreciative patients Cons: protocol driven = boring and redundant at times, meddling government
  3. Hello Fellow PAs, I have a list of clarification type questions I'm hoping to have answered regarding the Navy Reserves. Background: When I was in PA school almost a decade ago I applied for the HSPS scholarship but withdrew my application to pursue an Emergency Medicine post graduate residency at J.H. Stroger/Cook County Hospital. After completing the residency, I've been working full time in an urban ED AND as an adjunct professor for my local PA program. I find myself somewhat burned out in my current job and was looking for a "part time" position in the military as a PA. I've always wanted to be a part of the military and something "bigger" than myself. It is my belief that serving in a reserve capacity would be a smart choice for my career. I was able to pay off my students loans 2 years ago; therefore, this is not a factor in my desire to serve in the Navy Reserves. The Air National Guard unit closest to my geographical location does not have any open positions. The closest Air Force Reserve billet is in another state (5 hours drive). The Navy Reserve seems like the best fit. I've found my Navy medical recruiter helpful, but wanted to hear about Navy Reserve service straight from a PA in the reserves. I've read most of the messages re: the reserves on this message board but wanted to discuss more before I sign on that dotted line. Let me know if you can help me. Thanks!
  4. EM residency grad here: Good grades, glowing recommendation from your EM preceptor, join sempa. Consider attending acep conference. The actual interview is very important. I interviewed for 2 different EM residencies...batting .500 I was top of my class, had a recommendation letter from my EM preceptor stating that I was "one of the best students he's ever had," joined sempa. I completely bombed my first residency interview - didn't get a spot offer. I was more prepared for the 2nd interview and could articulate why I love emergency medicine and what I have done to further my EM knowledge...spot offer same day. You won't regret doing a residency
  5. Looking for some guidance re: possibility of loss of PA privilege. Quick background, I've posted in this forum several times primarily about Emergency Medicine and my residency experience (my primary field and full time job). For years I have worked part time as an Addiction Medicine PA (special interest of mine and extra $), primarily my clinic works with opioid dependent individuals. Our State Opioid Treatment Authority and Department of Quality Assurance is STRONGLY contemplating changing the interpretation of the rules to state that a physician is the only one who can change a patient's methadone dose, for example. I have been granted this privilege for YEARS as long as a supervising physician signs my charts and orders. I realize this is a very small niche in medicine (addiction), but I think changing this interpretation and possible law change would be a HUGE step back for our profession. I don't need this job but something seems amiss when I can place a chest tube under the supervision of a MD but can't adjust an opoid dependent individual's medication under the supervision of a MD. This is especially disheartening given our nation-wide opioid epidemic. Our governor has enacted very pro PA legislation in the past so I don't understand why this change is taking place. I have contacted the AAPA but would appreciate input, referrals/contacts, etc regarding this matter. Thanks for reading. Sam
  6. Was in the middle of registering for my EM CAQ today and came across two specific date ranges for the exam, i.e. August 1st - 5th. Perhaps I'm missing something, is the testing a 5 day ordeal or are those dates I need to be available but testing is only a 1 day event? Can someone shed some light on this for me? Thanks.
  7. Would like some input about the CAQ exam....especially from the PA's that have passed the EM CAQ. A little about myself: I did an Emergency Medicine residency at Cook County and have been practicing as a EM PA in the Midwest for 3 years. I don't plan on leaving my current job but I think it would be a positive to have a certificate that says I have substantial EM knowledge and "proof" that I can perform advanced procedures in case I decide to make a job change. Do you think it's a test worth taking? Does anyone see negatives in CAQ exams in general besides the "pigeon holed in a specialty argument" (I know SEMPA supports the idea). I had difficulty finding the actual total cost of registering for the CAQ exam. Does anyone know the bottom line price to take the exam?? I looked at the sample questions on the NCCPA website - they seem fairly basic. Is the actual exam more challenging? Thanks for the responses!
  8. A "fasttrack" beauty last night. 30 yo arrived in the department after MVA. Was in a high speed head on collision. Airbag deployment.Wearing seatbelt. EMS reports patient was AMBULATORY on scene. C/o chest tightness, hip pain. Vitals signs: T98.3, P67, RR18, POx99RA. Etoh on board. Diminished breath sounds on R. No tracheal deviation. No respiratory distress.Pelvis feels stable. She's just hanging out in wheelchair looking very stoic. Order a CXR to eval for PTX and R hip w/pelvis. Try getting her to xray multiple times but she can't walk from wheelchair to xray table. Of course I got upset with her and informed her of the EMS report - She denied ever being able to walk - reports she was extricated from the car. Immediately get her on a bed and over to main ED with the help of multiple staff members - has 90% R sided PTX, After chest tube done, Pelvic XR shows multiple pelvic fractures. Doing well in the ICU. Lesson: listen to your patient once in a while :) - hopefully doesn't remember "the mean PA who tried to make me walk on multiple pelvic fractures." Triage RN was quite defensive about it. Remember, sometimes EMS reports can cause bias!
  9. @bjmcell @akdEM sorry for the late response. I should check the forum more often. Liked the program. Prepared me well for the ED. I think around 25 people applied for 4 positions when I was accepted; however, i suspect it is becoming more competitive as more and more PA students realize the benefits of doing a postgrad residency. I truly believe postgrad programs are the wave of the future. Obviously you learn to think like a EM PA-C. Was able to place chest tubes, central lines, etc in the trauma rotation. The elective rotations (ultrasound, anesthesiology, plastics, etc) were extremely helpful to my current practice. For example, I often use bedside ultrasound during my shifts (FAST exams for the trauma patient, transabdominal exams for the +hcg. Lectures/M&M conference once a week. Overall, great program.
  10. Had a discussion with one of my sp's yesterday about using nsaids as an adjunct pain med in fractures ....I tend to avoid due to effect on bone healing (?theoretical) but will rx in addition to opioid in very minor, non displaced adult fx's in the ED. My sp told me evidence of nsaid effect on bone healing is ONLY theoretical and can use for essentially any fracture (save for hip fx's, pelvic fx's i assume) . Not sure if I buy this statement. Your thoughts?
  11. Agree with above. Graduated 6 months ago from post grad EM program at Cook County Hospital. Base $55/hr + Rvu bonuses (amounts to about $15,000ish a year). Work about 35 hrs a week. Also get compensated for over night shifts (base x 1.5) and working holidays (automatic $200). We also get longevity bonuses every year (1st year $200, 2nd year $400, 3rd year $600, etc). $3500 CME, 401k, and great bennies. My emergency medicine group looks very favorably upon PA EM residencies. Would highly recommend as you will be PAID to learn advanced clinical skills you may never learn.
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