cabrom Posted April 20, 2011 Share Posted April 20, 2011 Hello, I would like some input on working in intensive care. I just interviewed for a position in the MICU. I have 3 years experience in family practice and 1 year in internal medicine (no critical care experience). They understand this and are willing to train from the "ground up". I would be the first PA (or mid-level) coming into this unit. They have described the job as alot of training over time, many procedures, patient assessments, and over time becoming an integral part of the team. One ICU physician I interviewed with stated I would basically develop (over time) the same expectations, skills and experience as an ICU physician. My thoughts are that it would be one of the most challenging paths for me to go at this time. I know I would learn so much and am thinking it would be positive for me in the long run. The concern is I feel like I would be jumping from "M to Z" and definitely out of my comfort zone. I also have concerns about if this would help me in the long run or limit me too much. I may want to go back into IM in a few years (perhaps not) but wondering if I did take this job, should I moonlight after a while just to keep outpatient skills up and does this sound like a great opportunity or a "red flag" situation? I would love feedback from anyone with experience in the ICU. Thank you. Link to comment Share on other sites More sharing options...
coloradopa Posted April 20, 2011 Share Posted April 20, 2011 Hello,I would like some input on working in intensive care. I just interviewed for a position in the MICU. I have 3 years experience in family practice and 1 year in internal medicine (no critical care experience). They understand this and are willing to train from the "ground up". I would be the first PA (or mid-level) coming into this unit. They have described the job as alot of training over time, many procedures, patient assessments, and over time becoming an integral part of the team. One ICU physician I interviewed with stated I would basically develop (over time) the same expectations, skills and experience as an ICU physician. My thoughts are that it would be one of the most challenging paths for me to go at this time. I know I would learn so much and am thinking it would be positive for me in the long run. The concern is I feel like I would be jumping from "M to Z" and definitely out of my comfort zone. I also have concerns about if this would help me in the long run or limit me too much. I may want to go back into IM in a few years (perhaps not) but wondering if I did take this job, should I moonlight after a while just to keep outpatient skills up and does this sound like a great opportunity or a "red flag" situation? I would love feedback from anyone with experience in the ICU. Thank you. It sounds like a great situation. I moved from transplant to the ICU and love it. We get tons of autonomy with great backup in an environment where our presence is respected. From my experience your going to be in the middle of what we would expect. New grads get 9-11 months or progressive responsibility. Experienced PAs (but not critical care) get 3-9 months and PAs with critical care experience get 3-6 months. You will be surprised how much of IM is applicable. The procedures are relatively easy (IMO) the hard part is the critical thinking and when a patient moves off trajectory. For me it has the advantages of being able to have some patient continuity with the further advantage of they go to the floor when they are no longer interesting. Kind of like the ER with no cough and cold and being able to follow them longitudinally. With the work rules changes there are going to be tremendous opportunities for PAs in the ICU. Link to comment Share on other sites More sharing options...
rcdavis Posted April 20, 2011 Share Posted April 20, 2011 ^^^^^ ditto. There is NO WAY that spending anytime in this specialty will ever negatively hurt your career. If you are at all interested in critical care medicine, then this sounds like as perfect a set up as you can get. There are some students and new grads here who would take the opportunity for almost no pay just to get their foot in the door. And David is right.. The future is rosey for ccm PA's. Link to comment Share on other sites More sharing options...
andersenpa Posted April 20, 2011 Share Posted April 20, 2011 I've worked in critical care for 10 yrs now- gen surg, trauma, neuro, and now cardiac (everything but MICU). The important things are strong support, a good academic base in the beginning (most intensivists are), and IMO little competition w/ residents. You need repetitive exposure to the fundamentals and first shot at assessments, procedures etc. Pal up with the resp therapists and learn the vent inside out. If you stick with it, join SCCM and attend the Fundamentals of Critical Care Support (FCCS) course. To learn general CCM principles takes a year at least. Then it takes 3-5 yrs to master. Good luck. Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted April 20, 2011 Share Posted April 20, 2011 I'm on the lookout for an opportunity like this when I graduate. Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 20, 2011 Moderator Share Posted April 20, 2011 ^^^^^ ditto. There is NO WAY that spending anytime in this specialty will ever negatively hurt your career. If you are at all interested in critical care medicine, then this sounds like as perfect a set up as you can get. There are some students and new grads here who would take the opportunity for almost no pay just to get their foot in the door. And David is right.. The future is rosey for ccm PA's. agree 100% do it- but make sure your contract has some good compensation and overtime pay - you don't want to be their lacky in the long run, but instead a respected provider. Therefor overtime pay, time off, good CME (especially in that you have to learn), annual reviews. this is an area that will likely grow very quickly - check out the "day in the life" of the recent PA mag (think JAAPA but not sure) .... amazing PA story Link to comment Share on other sites More sharing options...
cabrom Posted April 21, 2011 Author Share Posted April 21, 2011 Wow, thank you everyone for you input. I am alot more "clear" now in what I should do. I definitely do have the interest in working in this specialty, just wasn't sure with my background if it would be the right thing to do this early in my career being it is such an advanced specialty. I really appreciate everyone's comments! Link to comment Share on other sites More sharing options...
cabrom Posted April 21, 2011 Author Share Posted April 21, 2011 Also, any more comments or advice from others is welcome and appreciated! Link to comment Share on other sites More sharing options...
familygal Posted April 27, 2011 Share Posted April 27, 2011 I just started my first job in CCM, after 2+ years working in the specialty of pulmonary medicine after graduation. I work with a large group of midlevels (10+ of us), and their support is what keeps me from feeling I'm completely over my head. I would say to anyone to just go for it if you are confident you'll get the support you'll need! I am also doing a lot of reading on my own time--usually an article or 2 a day. I certainly think there is plenty of support out there if you just look. The ICU Book by Marino is a great resource. Personally, I think that my particular experience in CCM (I rotate thru MICU, SICU, and neuro in an oncology hospital) is going to be great for my resume, even though I hope to stay where I am for a while! Link to comment Share on other sites More sharing options...
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