Randito

I totally agree. You're already playing the long game by getting a graduate degree. Residency is 12-18 months of self investment after you've already invested 2-4 years into becoming a PA. Defer your loans if you have to. I'm probably making 25k per year more for having done a fellowship program and I'm not in a particularly well paying region. I'll make up for the lost wages in about 2-3 years and still have all the benefits from the training.

Agree 100% with EMRAP (C3 is great for basics, Corependium is in development, but a really good reference). There are also many very good free EM podcasts. I really like EMCast. Finally ECG Weekly with Amal Mattu is $26 per year and the best EKG tutorial out there in my opinion. In addition to what you can do at home, just be prepared to be uncomfortable for a while. Let the experienced PAs and docs know that you are highly motivated. When the opportunity arises, stay late to learn new procedures. Make friends with the consultants and pick their brains.

I agree, that it should not be a problem. A PA that worked in my former group did the same thing. Took a position for about 9 months until her husband completed fellowship. There were no hard feelings from anyone in the department, because we knew she would likely be moving in less than a year. Maybe try to get a position in the same academic center that your partner is in. I think short term turnover is a little more accepted due to the nature of constantly having residents and fellows rotate through the different departments.

At least 3-5 times per shift. Usually just after telling me that they're taking Norco q4 for chronic pain.

I think the best way to make yourself more competitive for your PA school application and fellowship/residency application is by immersing yourself in EM culture prior to school. If you are not an EMT, you should become one. Get a job as a tech. If you are already an EMT, become a paramedic. I had pre-PA experience as an EMT and tech, but wish that I would have become a medic before school. I still think about doing the accelerated Nebraska program at some point prior to retirement so that I can more easily pursue search and rescue, adventure medicine, etc.

I think that this sounds like a pretty nice position. 30 minute appointments, 1 full day for paperwork, lab review, etc and good PTO. I think that the regular schedule will make this 5 day/week schedule feel less daunting. My first job was in hepatology and transplant. The schedule was really nice. I had built in time for things like transplant committee, pathology review, etc. If you want a nice, regular clinic position in an interesting specialty, you should go for it.

Agree with it being a weird job market. Do not expect to be compensated for the HCOL. Definitely be aware of the sacrifices you will make in salary, autonomy, commute. I lived in SD for 10 years pre-PA and still look at the job boards frequently as I would love to go back at some point. If we do move back it will be when we are completely debt free and less than 10 years to retirement due to the financial hit. Even so, I would estimate that I see less than 5 jobs per year that I'm interested in. I can't even remember the last EM job that I saw posted.

Show initiative. Do both of the things recommended above. Let attendings know that your goal is to get more comfortable with trauma. Just standing in that background for a while to learn the flow and who does what is really helpful at first. Be specific about your goals. 6 months in, most of the EM interns have done plenty of EFAST and won't mind letting a really motivated PA take this over. Maybe there are shifts with no junior resident and the senior would be willing to let you intubate or start a CVL? Is there a particular shift when all the EM residents are in conference? Ask to work that

Agree! Build that knowledge and procedural base working in the SICU. Most any surgeon would be happy to train you for a future position in the OR, knowing that you already have the ability to take care of some of the most critically ill patients in the hospital.

Yeah, agree with above. Do an EM residency/fellowship. It’s not much of a learning experience when every “interesting” patient that you see gets shipped out to the ED. Even working ED fast track, you are generally going to see more interesting pathology than in an UC. You can then at least follow their course if their care is taken over by another provider. Not having confidence as a new grad is expected and exactly the reason to do post-grad training. Focus on making yourself competitive for an EM program.

Great to see you’re still active here. Mel always mentions just how popular the rural medicine segment is and I have to agree. Fantastic case and looking forward to hearing more from you!

I'm so impressed with the PA representation on EMRAP recently. This month there was a case presentation of a patient with mesenteric ischemia by PA David Lane in a CAH in Iowa. Then on the recently added "PA Edition" they spoke with a PA who runs small EM group in Vermont and staffs 2 CAQs. In Jan they spoke with 2 EMPAs in NY that were asked to staff COVID ICUs during the height of the pandemic in NYC. All have been fantastic and really inspiring. If any of you are on these boards, just want to say thank you for being such great representatives of our profession and examples of what PAs

Couldn’t agree more with @EMEDPA. Fellowship/Residency is your best option, not only because of the current job market, but also because EM is really hard. You need to have a wide knowledge base, be comfortable doing a large variety of procedures, have confidence calling consultants and telling them why they need to come see your patient and you have to be comfortable making hard decisions. If post-grad training is just not possible, your attitude on your elective rotation is everything. Preceptors will generally bend over backward for a really eager student, but a student that doesn’t s

Congratulations! I think the big factor that you only touched on is the amount of training and eventual scope of practice. So important as a new grad. You should be fairly familiar with these as you worked there previously. I think that working 130 hours per month may be a good thing initially. Gives you plenty of time to treat the first year like a residency and read, read, read. Even though it’s out of you’re pocket, get a subscription to EMRAP. It’s become a go to for everything. I’m using their online refererence Corpendium almost every shift.

Oh, I believe you and would love to move to the PNW. Doing an EM program a few years ago was pretty tough on the family, but now that we have 2 kids under 5, I think my wife would leave me Really sounds like a great program and I would highly encourage anyone interested in critical care to apply.