JMann

ED work. 3 yrs out of school. Completed ED residency. Primary job is ~$120K/yr for 24hrs of coverage/wk at a critical access hospital. Mostly weekend overnights. Midwest area. Also do locums at varying amounts. For this survey, let's say around $20k for this year which is about 10-11 24hr shifts.

If you are <30 and have no kids or other weird life situation, go to med school. Hard stop, end of talk. The plusses far outweigh the minuses in the long run. Most docs I know are happy enough with their decision. Sure being a FedEx pilot is definitely more ideal! If your >30, have kids/spouse or other life responsibilities, then you gotta look at pro vs con of time, $ etc. I was 35 when I started PA school. I looked into med school, but wouldn't have started until 36. Having 3 kids <10, I didn't want to miss large chunks of 4-5 yrs of their lives. Going the PA route, I still missed 2yrs for school and another 1.5yrs for residency. I'm happy with how it turned out, but had I been younger or different life circumstances then med school would have definitely been the route I would have gone. I also knew I wanted to do EM which plays a factor in that thinking I guess.

Look heavily into the logistics of doing this post graduation. As mentioned above, finding a job outside of your place to let you do this will be tough I think. I think you end up working CCM and moonlighting/locums in EM long term unless you stay where you are since the splint like they have at your current place is unique. I do like the thought of this. You will be uniquely prepared. You'll just have to find an environment where you can utilize those skills.

All ACGME required weekly conference time should count as Cat. 1 CME if it is an ACGME EM residency for physicians. You should have well over 100-150 hours from that alone. The residency should be able to give you a printout of this whenever needed. When I finished residency at Iowa, I got a printout of every hour I attended weekly conference and had around 150 hours.

Just to follow up DLane- I completed the Iowa residency with a wife working full time and three school age kids. I'll say it's tough. I had episodes of decent time off, but looking back I simply remember it being rough. My wife would definitely agree! His description of the hours/wk is spot on. The didactic, Thursday morning conference, is the kicker. That's one of the big reasons to do residency, but it's also the bane of your existence while your going through it. As far as procedures- I had a similar experience and procedures as that point in the program. My first ED shift was a call in shift because someone was sick. Came in for overnight shift around 2245 and first pt is a head bleed, not intubated and decompensating. First pt = intubation, critical care and a change of pants! I also agree with US being the new stethoscope. Lots of US can be done if you are willing to put in the time to learn. The average Iowa body habitus can make US tough sometimes though!

Know why you want to go into EM, why you like that program, what you plan to take away from the program and be able to articulate it well. Also, have a couple of questions for them. It can be something as simple as how they utilize US on a day to day basis in their ED to what kind of jobs their graduates have ended up in. Good luck!

It's a newer residency so might not have any grads and only a few applicants. It's Duke though, so you know it's going to be competitive. Can't get in if you don't apply!

Who all will be at SEMPA this year? I'll be there. It would be great to put some faces with names from here.

If you find a great teaching job straight out of school that will really train you well, you are in the great minority I believe. I am a big proponent of residency training because I did one and can see the benefits. That is not for everyone though, because a lot of folks don't want to work at the top of their license. If you want to work to the top of your license in EM, you'll wish you had gone to med school at some point. An EM physician can work solo jobs across the country without issue. A PA cannot do that. There is a small ER about 1-1.5 hrs from me, sees 8K pts/yr with decent amount of trauma since it's right off a major interstate, staffed by one single physician. They won't hire me for that job. They won't hire any PA for that job. That's why I say you should go to med school if you have the option. BTW, not all EM physician residencies are created equal. Several have pretty good work/life balances and don't stay beat down all of the time. It's all about working hard and getting the correct fit. Difficult with the match process, but possible.

Numerous threads on how to be competitive for residency application. Start with a search. Short answer- like EM, know why you want to do it, how a residency will help you and be able to articulate all that very well. Or have a butt load of EM experience and a great personality... Excellent reference letters are very important as well. I graduated in Dec and started a summer residency program. You can either find a job and work in the meantime, or spend time with your family and rest up, because residency sucks the life out of you.

If you're young, go to med school. If you want to work in a surgical field, go to med school. If you want to work in emergency medicine, go to med school. Reasons for med school have been listed above. Primary 3 reasons that I would have gone to med school if I were younger and didn't have kids: $$, Respect and Opportunity. It's not that being a PA isn't great, because I do enjoy what I do. Getting 1/3 to 1/2 the pay for the same work sucks! Having to deal with hospitals and other employers who don't like PAs or don't understand our abilities and scope is frustrating. Having to deal with the whole NP argument is a drag, though the physicians are dealing with that as well with the attempts at independent practice. Educate yourself and make a decision knowing all sides of the issue.

I agree and I was implying that there could be an association in certain instances. Original poster didn't mention other potential benefits of working as IC, but I was just attempting to point out what some of the possible advantages could be.

The beef is with the perception of online education. John Q Public doesn't understand the difference between an online NP degree or an online PA degree. Heck, he might not even know what a PA is... I congratulate the folks in the Yale online class and I hope they succeed greatly. I know in our didactic classes there were really boring lectures that I could have watched at home on 2x speed and gotten the teaching points in a much better fashion. The real success to the Yale online program will be in their selection of applicants who are independent and visual learners. Someone who has to have structure and be told what to do likely will not do well. I would challenge the Yale online students to prove to the profession that their education is working and is worthwhile. Do that by learning, showing up, getting into residencies, getting good jobs and succeeding. You're not going to prove it to the profession via a keyboard arguing here. In fact, you are likely driving a deeper wedge. Show up, work hard and be humble.

Several of the broader scope of practice jobs I've seen have been independent contractor jobs. Some of the more rural places I've looked into are IC only. Not that there aren't IC jobs in very limited scope urban centers! Leaving a restrictive W2 position to work as an IC at a rural, solo coverage place would definitely increase your scope.

That sucks dude... Keep your head up and use this lesson well. Good luck in your search.