JMann

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.

I agree with most of the above. They will likely pay for license, etc. State/government academic centers with have a no fee DEA which is nice, until you leave and have to pay that crap. Ugh! Relocation? Forget it. Don't even ask. Like LT said, if the physician residents aren't getting it through ACGME then you won't FOR SURE! Regarding residency lengths. They vary, but I would say most are 12 months. I did the 18-month variety and was ready to be done by the end. I made a concerted effort to see where I was at the 12 month mark since most other residencies I applied to were 12 months. The one year is pretty tough to see what you need to see and really get comfortable. Can it be done? Sure and there have been several good posts and experiences given about Albany and some of the others. Repetition and seeing more pt's is the key though and 18 months will give that to you. Some of the better residencies are 18-months in length- Iowa, Fresno, New Mexico, Einstein, Yale, Regions to name a few.

As I am currently debating this as well, I spoke with several of the physicians I work with (who are independent contractors while the PAs are employees) and all have said they have looked into it and it is not a significant enough benefit to justify the cost and hassle. Couple of the reasons given: offers no additional tax liability, slightly more complicated accounting and taxes. Recently discussed this with my accountant and she thought it was useless if making less than $20,000/yr as an IC. Above that, she thought it was a discussion worth having. We'll see. Do a google search on this and you'll get numerous opinions. White coat investor has a good take on it. If I remember correctly, the summary was to file under yourself, but to possibly have an umbrella policy for other "incidents," Been a bit since I read that post though so I may have forgotten something! Working as an IC definitely has benefits, particularly in the realm of flexibility of pay, taxes, scope of practice, location and schedule. It's not for everyone though!

Saw this a couple of days ago as well. Sounds like a great idea. During my residency we did the program assigned Rosh questions, but were not allowed to participate in the In-Training Exam that the physicians do early to track progress and deficiencies. This program sounds like it would allow EMPA residencies to improve their curriculum and produce a better graduate.

E- I agree that it could be brutal in the right setting. The facility is covered by a PA every other weekend and by physicians the remainder of the time for the most part. 5-10/ 24hrs is the pt load usually. I'll be commuting by air to work this one and will usually string it together is another 24hr shift on the front or back end with a day off between. Puts me working 8-9, 24hr shifts per month with opportunity to work part time at my community ED here near home if I want. Finding solo coverage jobs here in the southeast is near impossible so if I want to work that kind of job, commuting is the only way. There are some solo coverage jobs in MS and AL but the PA practice laws in those states are not agreeable. NPs can do it, but PAs have to have "supervision"....

This is a good addition to an EM residency program. Be interesting to see if other programs follow this pattern.