Simplify Posted March 31, 2014 Share Posted March 31, 2014 I am hoping for a little perspective from any EM PAs. I will be graduating this spring. I have been weighing the pro's and con's of pursuing an EM residency. Throughout my clerkships, I have been suprised by some of the feedback from practicing PAs when I ask for their opinions on residencies. More than a few have told me they are not worth it and that I will get all the training I need through work experience. So, my question for those of you who work in EM w/ (or w/ out) residency training is- Do you think a residency would allow you to reach a level of practice that would be difficult to reach through work experience alone? And, did a residency translate into an increased scope of practice? I am not concerned about the pay discrepancy and I am not averse to working long hours during residency. Thoughts? Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted March 31, 2014 Moderator Share Posted March 31, 2014 You may get all the training you NEED just from going to work for a company/group, but that's because that company/group is training you to practice in their style so you can be productive for them- which may or may not come at the expense of you learning how to practice properly as a PA. What you WANT is training that will allow you to step into most ER environments and function. So, in answer to your original question- yes, I believe a PROPER residency/fellowship brings you to a higher level of practice quicker and more thoroughly than simply acquiring work experience. What is a "proper" residency? Well, SEMPA is currently putting together standards on post-graduate education for emergency medicine PA's- ergo, if you want to do a residency, this is what the emergency medicine PA organization feels constitutes proper training. There are "residencies" out there that are residencies in name only- they simply pay the person much less than their staff PAs and maybe there's a class or two, but its geared towards getting that PA up to speed working for that COMPANY- not on how to practice the breadth and depth of emergency medicine. I just came back from the SEMPA conference, and was shocked how many of the larger companies are doing just that- so if the people you are rotating with are only familiar with a program such as that, I can completely understand why they think its not worth it- because it isn't. I find it deplorable that these places have a program they want to call a "residency" or "fellowship" that doesnt end up teaching the PA much, and pretty much pays the PA a slave wage with the cover that they're in "training" to justify it- it takes away from what other places are trying to do with the education of PA's in this field- it piggybacks off the success of these programs. I did a residency, and I am a bit biased on this forum (if you can't tell). But, I've always maintained that a residency should not be mandatory for a PA to work in the ED - or any other specialty for that matter. There are other ways to gain good experience in order to work in the majority of EDs as a PA- I just feel that residency gets you there quicker and with more reliable training. And yes, because of residency I get more autonomy in my practice- and we're not just talking procedure-wise. Its also about how to properly approach each and every ED patient and knowing what the standard of care is and what the current literature says- which again, you can pick up over time by working, but this was also a major focus in residency. The "too long, didn't read" version- I think its worth it, but watch out for slave wage programs. Shouldn't be mandatory. Link to comment Share on other sites More sharing options...
GreatChecko Posted March 31, 2014 Share Posted March 31, 2014 TA, I bet it was lost in the transition...where did you go for your residency? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 31, 2014 Moderator Share Posted March 31, 2014 you will likely not get all the training you need on the job. you will get the training to do what THEY think you should be doing...that might just be fast track style stuff. if I graduated today I would do a residency. no doubt in my mind. I would apply to several to increase my chance of matriculation and if I didn't get in would reapply again the next cycle. When I graduated from PA school there was 1 residency program. I applied and would have probably gotten in.... and it closed that year due to a loss of funding. it has taken me almost 20 years and 7 jobs in em in 3 states to get the training an em pa residency grad gets in 12-18 months. every time I maxed out scope of practice at a job I would move on. I just got a job I am 100% satisfied with 1 year ago.... Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted March 31, 2014 Moderator Share Posted March 31, 2014 TA, I bet it was lost in the transition...where did you go for your residency? Einstein in Philly Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 1, 2014 Moderator Share Posted April 1, 2014 I am a 2002 grad Looked around for and IM residency at the time - non existed I would say YES a residency is a great idea I don't think there is any substitution for a formal residency I (against popular thought?) believe a one year fellowship should be mandatory - and with this we should loose our 'dependent' roll and practice in collaboration Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 1, 2014 Moderator Share Posted April 1, 2014 I (against popular thought?) believe a one year fellowship should be mandatory - and with this we should loose our 'dependent' roll and practice in collaboration I would have no problem with a 1 yr postgrad program being required. call it whatever you want ; residency/fellowship/postgrad program, etc. There should be a basic program everyone can do which is essentially the old "rotating internship" done by docs through the 70s or so. Those who know they want a specific field could do a program with both on service and off service rotations in their specialty of choice. At the end of the 1 yr postgrad experience, folks take a general exam and have the option of a specialty exam as well if they did a specialty track program. passage of the basic exam confers the title " Doctor of Medical Science" , passage of a specialty exam allows one to say they have a DMS with a specialization in XYZ specialty. Collaboration is coming at us fast and hard no matter what happens now, and this is a good thing. Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 1, 2014 Moderator Share Posted April 1, 2014 I would have no problem with a 1 yr postgrad program being required. call it whatever you want ; residency/fellowship/postgrad program, etc. There should be a basic program everyone can do which is essentially the old "rotating internship" done by docs through the 70s or so. Those who know they want a specific field could do a program with both on service and off service rotations in their specialty of choice. At the end of the 1 yr postgrad experience, folks take a general exam and have the option of a specialty exam as well if they did a specialty track program. passage of the basic exam confers the title " Doctor of Medical Science" , passage of a specialty exam allows one to say they have a DMS with a specialization in XYZ specialty. Collaboration is coming at us fast and hard no matter what happens now, and this is a good thing. BINGO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Link to comment Share on other sites More sharing options...
cbrsmurf Posted April 1, 2014 Share Posted April 1, 2014 A year of residency will be superior to 1 year of work experience/on-the-job training 99.9% of the time. In pharmacy, where residency is also not required, a year's residency is typically seen as equivalent to 3 years of work/experience as well as opening the door to certain specialty positions. For the record, I have not done a residency. Link to comment Share on other sites More sharing options...
JohnnyM2 Posted April 1, 2014 Share Posted April 1, 2014 I am a 2002 grad Looked around for and IM residency at the time - non existed I would say YES a residency is a great idea I don't think there is any substitution for a formal residency I (against popular thought?) believe a one year fellowship should be mandatory - and with this we should loose our 'dependent' roll and practice in collaboration You aren't alone on this and the important point (at least to me) is the emphasis on moving from dependent role to collaborative rule. However, there need to be a lot more residencies available. Sent from my Kindle Fire HDX using Tapatalk 2 Link to comment Share on other sites More sharing options...
cinntsp Posted April 1, 2014 Share Posted April 1, 2014 You aren't alone on this and the important point (at least to me) is the emphasis on moving from dependent role to collaborative rule. However, there need to be a lot more residencies available. Sent from my Kindle Fire HDX using Tapatalk 2 There needs to be many more of them for sure. I also think there needs to be more standardization of residency start dates and PA school graduation dates. Varying PA program lengths make that somewhat difficult though. Sent from my Nexus 7 using Tapatalk Link to comment Share on other sites More sharing options...
whoRyou Posted April 4, 2014 Share Posted April 4, 2014 There needs to be many more of them for sure. I also think there needs to be more standardization of residency start dates and PA school graduation dates. Varying PA program lengths make that somewhat difficult though. Sent from my Nexus 7 using Tapatalk How come it isn't more standardized? How can fellowships/residencies get away with this? Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted April 4, 2014 Moderator Share Posted April 4, 2014 How come it isn't more standardized? How can fellowships/residencies get away with this? Residencies/fellowships are just trying to find out what works for them in their own system- some have their PA's start alongside physician residents in July, and others have the PA's rotate in on a rolling admissions program every 6 months. No one has the ideal answer, and a big reason is because of the varying graduation times for PA programs. No one's trying to "get away" with anything- they're just responding to the scene as best they can. Link to comment Share on other sites More sharing options...
skyblu Posted April 4, 2014 Share Posted April 4, 2014 Definitely do a residency. Research the hell out of the program to make sure it's training you thoroughly and not just using you as cheap labor. But find a great one and do it. Vastly superior to learning on the job! Link to comment Share on other sites More sharing options...
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