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Offer sounds pretty good. A couple of questions you should ask: 401K match - one large national company advertises that they have it but don't clearly state that it's at the company's discretion and have been underfunding it; what kinds of patients will you be seeing. 10 pt's in 12 hours is very low volume. If there's not a good mix of complexity/acuity you won't learn as much as you might.

Best girl scout cookie story from my fire service past: A semi-trailer of girl scout cookies caught fire. My department responded mutual aid with a water tanker - no hydrants along the interstate. Anyway, the contents of the trailer received enough water and smoke damage that the cookies couldn't be sold, so the trucking company gave them all to the firefighters. The cases and individual boxes had to be pitched, but the plastic wrapping of the cookies themselves was intact and the cookies were fine. It took a while, but my family went through 24 CASES of free cookies - as did the families of many other local firefighters.

Only did this once, and it wasn't a cardiac arrest, but the femoral caths used for post-arrest hypothermia can be used for re-warming. Still, I don't think there was any way for that resuscitation to be successful.

I've received Cat 1 CME hours for precepting and once a student gave me a box of my favorite tea bags, but no cash.

Before you consider an EM residency at a VA hospital please look VERY carefully at what their ED actually sees. In ~35 years of pre-hospital medicine and over 5 years as a PA in the states I practice (Ohio, KY, Indiana) VA ED's see very little compared to what civilian ED's see: no peds, minimal trauma (that goes to trauma centers), minimal serious cardiac (no VA facility I know of has a 24 hour cath lab), etc. The patient population is strongly skewed towards males, so you'll see much less OB/Gyn that you'll see in a civilian ED.

From my job hunt right after graduation a number of years ago, here's what I saw matter: Being licensed, or at least passing PANCE so licensing is just a bureaucratic process away. Finding a place that's hiring. Contacts/references from rotations. So, the school only helps indirectly by being a source of rotations in the geographic region in which you wish to work. So, unless you're planning to work in California, don't spend the extra money to go to school there. I work in Ohio and the few OU students I've encountered seem well prepared. If you're planning to work in Ohio, going to OU, or most of the other Ohio schools would be fine.

I've been through EM credentialing at 2 different hospital chains within the past year. Both wanted procedure logs. I got them from the quality department at the hospital I was working at at the time. As others have said, this is a common request by hospitals. Your current hospital(s) should be able to run a report fairly easily for you. I keep scanned copies on my PC so I can email them off as needed.

@Gordon "The one and only reason why NPs are so far ahead is the fact that NPs are regulated by nursing boards, not medical boards. Nursing boards can declare that NPs can do neurosurgery solo and there's not a damn thing the medical boards can do about it." Actually, this is dependent on the individual state's medical practice acts. At least in Ohio, this limits certain practices to physicians only. The NP's can only do things that are specifically permitted in the nursing practice acts. This includes things like ordering and interpreting medical testing, prescribing medications, and performing some procedures. It is not a blanket authorization to perform surgery or other procedures, just like the PA practice acts. While there are often some differences between the two, there are mostly similarities about what an NP and PA can do. The primary differences are in the "supervision" vs "collaboration" vs "independence" requirements.

I do EM so my patient relationships are different and not part of an ongoing course of treatment. I do confront patients who have been abusive to the nurses and techs. I tell the patient what they can and can't do when interacting with them. Short version, it's OK to bring things to the techs' and nurses' attention, to complain, etc., but it's never OK to be rude or abusive. In a very few cases where the patient's conduct was way over the line and they didn't have anything critically wrong with them I made it clear that if their behavior continued unchanged they would be discharged immediately and escorted off the premisis if needed. In OP's case discussing the situation with the surgeon and refusing to see the patient is the right path. The surgeon can decide whether to fire the patient or not.

Have any of you folks dealt with patients who are taking St. John's Wort for their depression/anxiety? It seems to be the preferred herbal supplement. It also seems to have many drug interactions.

Interestingly enough, the EM group I work for considers Michigan more PA friendly than NP friendly. Don't know the details, but we staff small critical access hospitals with a doc doing 12 hours of day coverage with a PA or NP doing the overnight 12's with the doc on call.

I do EM, so sometimes I do feel I make a difference. I like the short feedback loop of EM with relatively rapid turnaround on diagnostics and the ability to see the effect of interventions. Plus, I like procedures. In EM patients always go away: they get better, they get worse, they go home, they get admitted, but they always go away. I do envy the EM docs training and knowledge, but this is my 3rd career, so it was the right trade-off for time invested vs rate of return. Had I started this path 10 years earlier I would have gone the DO route. I'm happy with my choice and working on my knowledge and skills as I go. I've been fortunate in my jobs with the opportunities to learn and now that I'm doing solo overnight coverage with a doc on call that I'm growing my individual responsibility too.

From the AANP web site: https://www.aanp.org/advocacy/state/state-practice-environment

Like most folks here have said, if I work with them regularly (I'm an ED guy), e.g. ED attendings, most hospitalists, some specialists it's 1st name for direct conversation but "Dr xxx" in front of patients. Other docs are Dr yyyy.

Your best information will come from the school itself. They will know how big their wait list is and where you are on that list. They'll also know how many folks typically actually get seats. Many people apply to multiple schools and if they are good enough applicants to be accepted at one school they are often accepted at several. This is what leads to folks being accepted off wait lists.