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Pulm/CC vs IR


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Hello,

 

I would first like to thank everyone on this forum for the advice they have given, it has been so helpful. I am a new graduate PA and have two job offers, one in pulm/CC and the other in IR. I love different aspects of each of the jobs. To be honest I would love to eventually go into Emergency Medicine so my question is, of the two, which would better prepare me for Emergency Medicine and of the two which would make me a better well-rounded provider?

 

 

Thanks,

 

Can28 PA-C

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I currently work full-time in pulm/critical care and once a week in the ER, so I can't speak to IR. I will give some of my personal experience and observations... first job out of PA school in critical care has a very steep learning curve and if you do not have extensive prior health care experience (paramedic, RT, RN, etc.) it will be challenging, particularly if your supervising physician has never worked with PAs previously or there is limited guidance/patience. You will need to be very proactive in studying/reading up outside of work (for some PAs who want a 9-5 job, don't want to think about medicine outside of paid work hours, probably not the field to go into).

 

On the other hand, right out of school you will learn a TON and expand on the patho-physiology we learned. You will only work with the sickest patients in the hospital (and skip out on a lot of "non-medical" dispo/social issues that are often on floors... you spend all your time on patients that usually require some urgent intervention).

 

Other factors to consider, once you have MICU experience on your resume it will open a lot of doors; you can always go down in acuity and work with less active/sick patients in following jobs but to work your way up in acuity is far more difficult.

 

Working in the MICU has benefited me a great deal and translates well to EM (in my opinion, much better than IR). You will become very famililar with non-invasive and invasive ventilation, have more chances to perform invasive procedures (central lines, taps, etc.) that are also in the domain of EM (unless you plan only in working in fast-track/urgent care), feel much more comfortable with really sick patients and you will learn how to quickly react when a patient quickly decompensates and think critically on how to problem solve the situation and try to stabilize the patient (also helpful in the ER).

 

The MICU is a team, I work with the intensivist, fellows, residents, interns and med students, respiratory therapists - I learn from everyone. The ER, I work with my SP of the day (who generally does little teaching who is overworked to get people dispo'd and "churning the meat", but I do learn and observe as I work).

 

Maybe someone can chime in about IR and offer another viewpoint... but if you can land your dream ER job, pulm/CC isn't a bad way to go, in my opinion :)

 

Good luck.

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I currently work full-time in pulm/critical care and once a week in the ER, so I can't speak to IR. I will give some of my personal experience and observations... first job out of PA school in critical care has a very steep learning curve and if you do not have extensive prior health care experience (paramedic, RT, RN, etc.) it will be challenging, particularly if your supervising physician has never worked with PAs previously or there is limited guidance/patience. You will need to be very proactive in studying/reading up outside of work (for some PAs who want a 9-5 job, don't want to think about medicine outside of paid work hours, probably not the field to go into).

 

On the other hand, right out of school you will learn a TON and expand on the patho-physiology we learned. You will only work with the sickest patients in the hospital (and skip out on a lot of "non-medical" dispo/social issues that are often on floors... you spend all your time on patients that usually require some urgent intervention).

 

Other factors to consider, once you have MICU experience on your resume it will open a lot of doors; you can always go down in acuity and work with less active/sick patients in following jobs but to work your way up in acuity is far more difficult.

 

Working in the MICU has benefited me a great deal and translates well to EM (in my opinion, much better than IR). You will become very famililar with non-invasive and invasive ventilation, have more chances to perform invasive procedures (central lines, taps, etc.) that are also in the domain of EM (unless you plan only in working in fast-track/urgent care), feel much more comfortable with really sick patients and you will learn how to quickly react when a patient quickly decompensates and think critically on how to problem solve the situation and try to stabilize the patient (also helpful in the ER).

 

The MICU is a team, I work with the intensivist, fellows, residents, interns and med students, respiratory therapists - I learn from everyone. The ER, I work with my SP of the day (who generally does little teaching who is overworked to get people dispo'd and "churning the meat", but I do learn and observe as I work).

 

Maybe someone can chime in about IR and offer another viewpoint... but if you can land your dream ER job, pulm/CC isn't a bad way to go, in my opinion :)

 

Good luck.

 

Listen to this.

 

Is about as accurate an assessment as you can get.

 

There is little crossover between IR. and EM. Generally the things that you do in IR you do in te ED Without the Fluoro .Some of he things IR does the ERdoes not.

Having been critical care and EM, I can unequivocally tell youthat you will be a tres-studly PA coming from micu,...

 

The trick in EM is first being able to reconize ill patients, and then secondarily not backing down from them.

 

Nothing in IR teaches youthat. Everything in CC/ICU does.

 

Become a stud.

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I have spent the last 10+ years in critical care, moonlighting in ERs, and am now in IR. If you want to go to ER then I wholeheartedly agree with the above posters...go in to critical care. You will learn about sick patients and about how to perform critical care procedures. You won't learn to be fast which is what all ERs want of their midlevels. If you go directly into IR, you will be very facile with procedures, but you probably won't know how to take care of complex patients very well. You might luck out (two of my IR rads are former pulm/cc docs and one a surgeon) but probably not.

 

My advice to you is to go directly into the ER if that's what you want to do. Find a job and be the best ER PA you can...many before you have done just that. Once you learn that 12 and 24 hour shifts suck, and you miss holidays, weekends, family get-togethers, etc then your mind will drift back to the chance you had at procedures all day, no clinic/very little clinic, great salrary/benefits, and being home for dinner at 5 every night =) My 2 cents

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I have spent the last 10+ years in critical care, moonlighting in ERs, and am now in IR. If you want to go to ER then I wholeheartedly agree with the above posters...go in to critical care. You will learn about sick patients and about how to perform critical care procedures. You won't learn to be fast which is what all ERs want of their midlevels. If you go directly into IR, you will be very facile with procedures, but you probably won't know how to take care of complex patients very well. You might luck out (two of my IR rads are former pulm/cc docs and one a surgeon) but probably not.

 

My advice to you is to go directly into the ER if that's what you want to do. Find a job and be the best ER PA you can...many before you have done just that. Once you learn that 12 and 24 hour shifts suck, and you miss holidays, weekends, family get-togethers, etc then your mind will drift back to the chance you had at procedures all day, no clinic/very little clinic, great salrary/benefits, and being home for dinner at 5 every night =) My 2 cents

 

Whoa... Come to think of it, there is that.......;)

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