discogenic Posted January 11, 2011 Share Posted January 11, 2011 Does anyone know the percentage of PAs that go on to do residencies? Aside from the obvious additional training, what are the benefits of doing a residency? Better employment opportunities? Higher starting pay? And are there any specialties where a residency is a must? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 11, 2011 Moderator Share Posted January 11, 2011 About 5% currently although i think this will increase markedly in the next decde or so as hospitals require more and more evidence of procedural skills in order to get credentialed. Better training, better initial job and pay right out of residency.. Any specialty can be accessed via on the job training but a residency grad will know many procedures that others may never get credentialed for. Link to comment Share on other sites More sharing options...
discogenic Posted January 11, 2011 Author Share Posted January 11, 2011 With so few PAs pursuing residencies, can we assume that the time, considerable effort and relatively low pay of residency just isn't worth it? As you say, though, hospitals requiring residency-level training in the future would change things. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 11, 2011 Moderator Share Posted January 11, 2011 I think it's is definitely worth it and encourage everyone to consider it...I'm still considering one now as there are procedures I can't get credentialed for because I haven't done enough of them.... Link to comment Share on other sites More sharing options...
discogenic Posted January 11, 2011 Author Share Posted January 11, 2011 If I understand what you are saying, in order to perform certain procedures a PA must be credentialed to do them. And without residency training, a PA won't be credentialed for those particular procedures. Is the credentialing based just on number of procedures done? In other words, how does the credentialing process work? It sounds as though one PA may be able to do a certain procedure while his colleague may not. Link to comment Share on other sites More sharing options...
coloradopa Posted January 13, 2011 Share Posted January 13, 2011 If I understand what you are saying, in order to perform certain procedures a PA must be credentialed to do them. And without residency training, a PA won't be credentialed for those particular procedures. Is the credentialing based just on number of procedures done? In other words, how does the credentialing process work? It sounds as though one PA may be able to do a certain procedure while his colleague may not. Its a little more complex than that. We train for credentialing under another provider that can do the procedure. For example I have to do 10 central lines to be credentialed. I did these during my orientation and got them signed off. I have done a lot of paracentesis which we do relatively rarely. So I'm signed off but some of the other PA/NPs aren't. Basically each hospital will have a minimum number of a procedure that you have to do to get credentialed. They usually have a way to be precepted to get that number. Outside of a procedure which is done rarely I can't think of a reason to do a post grad program just to do procedures. The other issue is that to maintain credentialing you have to do a certain number per year. I haven't bothered with intubation since we have a lot of residents who can intubate and 24 hour anesthesia coverage. Even if I went to the OR and got credentialed I wouldn't get enough per year to continue credentialing, so I would have to arrange a couple of days in the OR every year. Not worth the bother for me. If you want to do the residency to get the experience managing a specific patient population then thats reasonable. To do it to get procedures seems redundant. Basically less than 4% of PAs do post graduate programs. The vast majority of PAs are trained on the job. Link to comment Share on other sites More sharing options...
rudypa Posted January 13, 2011 Share Posted January 13, 2011 I looked into the PA surgical residency that was recently started at the Medical College of Wisconsin and spoke with a PA that was going thru the program. That PA was extremely disappointed and left the program half way thru due to a lack of procedures. She stated that the residents and fellows were always given priority. My take away message here, this coming from a fantastic teaching institution, really look into the residency and talk with current PA residents. I think the major issue with more programs than not, is you are competing with residents and fellows to gain procedures and "quality experience", which they seem to be given priority. And as competitive as these residencies are and the 2-3 spots that open each time, you may be as likely to interview with a specialty that can guarantee along with your employment of getting procedures learned and done in a timely fashion. After all, the hiring SP wants your contribution to the bottom line. But at the end of the day, I would agree with EMEDPA, within the next 5+ years, the residency programs will be designed better and the experience for the PA will be necessary and well worth it! Link to comment Share on other sites More sharing options...
andersenpa Posted January 13, 2011 Share Posted January 13, 2011 I looked into the PA surgical residency that was recently started at the Medical College of Wisconsin and spoke with a PA that was going thru the program. That PA was extremely disappointed and left the program half way thru due to a lack of procedures. She stated that the residents and fellows were always given priority. My take away message here, this coming from a fantastic teaching institution, really look into the residency and talk with current PA residents. I think the major issue with more programs than not, is you are competing with residents and fellows to gain procedures and "quality experience", which they seem to be given priority. And as competitive as these residencies are and the 2-3 spots that open each time, you may be as likely to interview with a specialty that can guarantee along with your employment of getting procedures learned and done in a timely fashion. After all, the hiring SP wants your contribution to the bottom line. But at the end of the day, I would agree with EMEDPA, within the next 5+ years, the residency programs will be designed better and the experience for the PA will be necessary and well worth it! This has been discussed here before- I think anyone who hinges their decision about residency about how many OR cases or procedures they do is looking at it the wrong way. (EMEDPA has his own reasons, but they are much different than the typical new grad/inexperienced PA going into residency). You will NOT be operating independently after residency. You will be assisting a surgeon who will train you to do it his/her way, even if you are "residency trained". you WILL be doing procedures like lines/tubes/drainiage...and if you are in a teaching institution, even one with physician residents, there is no reason that a PA resident can't get a good handful of procedures under their belt. Show up early, know your patient, and BE THERE when there's procedures to be done. For whatever my personal experince is worth, I've been working with students and residents for a while now. I do procedures and operate regularly in my current job. If the resident is interested and taking an active role in their training, they do the procedure while I stand there. If not, I do it and they watch. Most places I've been at are the same way. If you are a go-getter, you'll do plenty. If you expect tasks and duties to be given to you or to be paged when things are going on, you're going to miss out on alot and have a lackluster experience. Link to comment Share on other sites More sharing options...
discogenic Posted January 13, 2011 Author Share Posted January 13, 2011 What are the specialties for which residencies are done? I know there are ortho residencies. Are there others? Link to comment Share on other sites More sharing options...
NewtonsApple Posted January 13, 2011 Share Posted January 13, 2011 There is a thread in this forum listing available programs as well as here: http://www.appap.org/Programs/tabid/58/Default.aspx Link to comment Share on other sites More sharing options...
discogenic Posted January 14, 2011 Author Share Posted January 14, 2011 Great info everyone. Thanks! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 14, 2011 Moderator Share Posted January 14, 2011 at my most recent per diem job credentialing I actually had to pull some of my paperwork form paramedic school 20 yrs ago to get credentialed for a few procedures. as far as other procedures in our dept (at my primary job) most of the docs are not in "teach mode" they are in "work mode" as we work on production(which I personally think is a bad idea) so most of the adv. procedures I am credentialed for are based on prior jobs. only about 1/2 of our pa's do lp's because you need to document 5/yr so those of us who have worked extensively elsewhere can show those #s but 1/2 can not. I have done paracentesis enough to be credentialed but if I wanted to do thoracentesis, cutdowns, or deep sedation I would need more documented cases. I think I am the only pa in the dept who intubates enough to stay credentialed. I am one of 2 pa's who does moderate sedation.( at my rural job I can do deep). I can't do u/s at my primary job as they require 800 cases( only 1 pa-a former u/s tech- and maybe 1/2 the younger docs have those #s). at my rural job I need 25 cases (which I have ) so I can do basic ob u/s, fast exams, etc I would also like more icu experience with vents, etc as I did trauma surg/sicu as a student and stay current in fccs but don't work with that population as much as I would like. I don't skip over old/sick pts(and leave them for the doc) like some of my colleagues do. they are often surprised to hear I am working up a 90 yr old gi bleed on coumadin, etc Link to comment Share on other sites More sharing options...
dxu Posted January 14, 2011 Share Posted January 14, 2011 I have a question much in the same vein. Approximately 5% of all current PA-C further their education with a post-grad residency and I think it is a fantastic option for those who desire more clinical experience and knowledge from a formal setting. But how competitive is obtaining a residency? If a program has two spots in EM or CC for example, how many applicants would be expected to apply? Do you think there will be a substantial boom of PA residency programs opening up in the future? Also, how do you think residency programs will affect practice in the future? I almost get the thought that our medical education system, in particular MD/DO, is one small step, sneeze, or cough away from completely being razed and rebuilt. That of course is not the worst thing ever seeing as medical education as it currently stands is terribly inefficient. Link to comment Share on other sites More sharing options...
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