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Statistics on PA residency advantages??

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Has anyone located statistics on salary differences between PA's who did a residency vs. those who haven't? I would like to write a my next blog post on this topic but I am having trouble finding information. Any help is welcomed.. even if you just list the advantages/disadvantages you experienced/observed with a residency. Thanks!!!!

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Has anyone located statistics on salary differences between PA's who did a residency vs. those who haven't? I would like to write a my next blog post on this topic but I am having trouble finding information. Any help is welcomed.. even if you just list the advantages/disadvantages you experienced/observed with a residency. Thanks!!!!

 

You will (likely) make more your first year out of residency than what you would have made your first year out of PA school but that comes at the opportunity cost of making less in residency. I know PAs that worked for a year out of school @~90k a year and are now making 120k a year in their second year of practice. Residency PAs make ~60k a year and then go straight into 100k+ after residency.

 

Doing a residency will teach you a lot but the financial incentive is weak/nonexistent

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Doing a residency will teach you a lot but the financial incentive is weak/nonexistent

 

That's a common misconception stated by people that haven't actually done one.  It may also be perpetrated by the likelihood that most folks are offered a position where they trained, in which case they are generally facing more rigid pay scales and lower salaries due to working in big systems at more desirable locations.  

 

It's really all about how the residency grad capitalizes on that experience to get the job and salary they want.  My counterparts all stayed within the system and were started further in the pay scale than a new hire(essentially given credit for 1.5x experience) plus given a large sign-on bonus. Even with that, the numbers are still in the negative.  On the other hand, I interviewed at a number of places and was offered 1) jobs that would normally require 3+ years of experience to get an interview, 2) better scope of practice, and 3) considerably better salary/benefit packages.  Any lost income is more than a wash..

 

I do think it's important to obtain this type of data but we should do so keeping in mind that it's reductive to think about this topic solely in terms of salary differences.  The education itself is priceless and there is a lot of worth to being confident in your practice and knowing you are doing right by the patient.  It's possible to make very high salaries even as a new grad in the right places so I would not recommend doing postgrad training if the only incentive is a potentially higher salary.

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Do you mind sharing how much the "considerably better" package was?

 


"3) considerably better salary/benefit packages."
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I don't think it's only a about money , but position, autonomy, and choices that open up after doing a residency that play an obvious role in security and comfort

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know any unemployed residency grads or residency grads in any field making less than 100k/yr? I don't.

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*sigh* those that question the benefits of a residency obviously have never worked in an ER.

 

Hospital admin: "oh yeah, let's credential new grad PAs to see every acuity patient, do all procedures, and let's pay them $120k."

 

It's funny because this is the expectation of every new grad wanting to work in EM. And the turnover rate is high when they realize they will be stuck in fast track the rest of their life.

 

Doing a well established residency provides you with all the tools to become a great EM PA. Just ask the residency trained PA in my area who works two-24 hour shift a week at a low volume ER for $80/hr. They wouldn't even look at anyone unless they had 10-15yrs + of EM experience or a residency grad.

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I'm not a residency grad(there were no residencies when i graduated or i would have done one) and it took me 18 yrs to start landing quality solo rural jobs after 10 prior years as a medic and er tech.

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*sigh* those that question the benefits of a residency obviously have never worked in an ER.

 

Hospital admin: "oh yeah, let's credential new grad PAs to see every acuity patient, do all procedures, and let's pay them $120k."

 

It's funny because this is the expectation of every new grad wanting to work in EM. And the turnover rate is high when they realize they will be stuck in fast track the rest of their life.

 

Doing a well established residency provides you with all the tools to become a great EM PA. Just ask the residency trained PA in my area who works two-24 hour shift a week at a low volume ER for $80/hr. They wouldn't even look at anyone unless they had 10-15yrs + of EM experience or a residency grad.

Thanks for the great response. This is something I didn't think of and ERs have to be the best example of that. 

 

However, aren't the first few years of a PA's career essentially a residency minus terrible pay? We all have to learn the clinical/bedside aspects of medicine at some point, why not learn while being paid to do so?

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Thanks for the great response. This is something I didn't think of and ERs have to be the best example of that.

 

However, aren't the first few years of a PA's career essentially a residency minus terrible pay? We all have to learn the clinical/bedside aspects of medicine at some point, why not learn while being paid to do so?

That's a common misconception about a residency vs. on the job training. In EM, you may have some teaching moments throughout your first 12-18 months of employment, but you aren't there to learn. You are there to move the meat and see patients. Much of the learning is self-directed and there are very few mentors who are able to do their job while at the same time teaching you. In a residency, you are there to learn. You are also allowed the opportunity to learn medicine through several off-service rotations. These are invaluable and really separate on the job training vs residency. Some examples from an EM residency: PEDSEM, ANES, ORTHO, U/S, TRAUMA, EMS, ENT, OPTHO, CCU, TOX, SICU, G.SURG, NEURO, IM, BURN.

 

There is not a job out there where you can learn to intubate in a controlled environment, learn bedside ultrasound to the tune of 200 in a month, a month in Optho will let you see enough eye complaints to feel good about treating on your own vs. consulting on every eye complaint. There is also an academic side of EM that you will not get if not in a residency.

 

See the reports/posts in this section of the forum to read about the benefits of a residency. I can't firsthand tell you the benefits, but I am supporter of residencies and may attend one myself one day.

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What Ffighter says is true.  There is something to be said about taking 1 month to totally immerse yourself in a specialty, living and breathing it, seeing more cases than you'd probably see in 2 years, getting a sense for how the specialists think, how they ask their patient's questions, what they look for, the most important details to know about their commonly used medications, etc.  Its really invaluable, regardless of the salary change you'll get on the other side.

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Thanks for the great response. This is something I didn't think of and ERs have to be the best example of that. 

 

However, aren't the first few years of a PA's career essentially a residency minus terrible pay? We all have to learn the clinical/bedside aspects of medicine at some point, why not learn while being paid to do so?

 

No, physicians aren't all that great at caring about a new grad PA.  Neither are administrators.  They hire us to see patients and expect a lot from the outset.  I have not had the experience of a good mentoring physician, especially when I worked ER as a locum and as a part-time employee.  When I asked for the training for intubation, procedures I didn't get to do in PA school (lumbar puncture, thoracentesis, etc.) they all said, oh, yeah we'll train you, but it never happened....They do not have time, and the PA pulls the fast track charts for the most part. 

 

Residencies are valuable and I can only imagine would help a graduate of one to obtain a higher salary as cinnstep posts. 

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Agree with Paula. for the most part if you want to do high end procedures in em you need to come in knowing them already from doing a residency or prior high level training like medic, RT, etc. It is rare today to find an em group willing to train a new grad in full scope em outside of a rural area.

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My experience is that first few years of work is not residency-minus-the-low-pay. Well structured postgrad programs have a didactic component, heavy faculty support, and an educational focus that is not present in a traditional PA staff position.

 

I have heard for years about the residency urban legends- one yr residency = 3-5 yrs "regular work" experience, higher salaries, etc. I've never seen data on it.

 

If you haven't talked to APPAP they would be the best source of info. 

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My experience is that first few years of work is not residency-minus-the-low-pay. Well structured postgrad programs have a didactic component, heavy faculty support, and an educational focus that is not present in a traditional PA staff position.

 

I have heard for years about the residency urban legends- one yr residency = 3-5 yrs "regular work" experience, higher salaries, etc. I've never seen data on it.

 

If you haven't talked to APPAP they would be the best source of info. 

I would argue that some people probably NEVER get the experience a residency might provide....if you work in a place without folks who value you professionally and want to help you advance your career you might never get a chance to increase your scope of practice beyond the basics of your job.

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Agree with Paula. for the most part if you want to do high end procedures in em you need to come in knowing them already from doing a residency or prior high level training like medic, RT, etc. It is rare today to find an em group willing to train a new grad in full scope em outside of a rural area.

 

Even if you do a residency it's very likely that the place you are working at places restrictions on PAs so that they cannot do many "high end procedures". So you might learn how to do a central line in residency but then you HAVE to work in a specific location that allows PAs to do central lines to take advantage of your training. This likely means a rural setting. If rural settings provide good clinical education (w/o losing money on low residency pay), why not just go to a rural setting straight outta PA school? Seems to me like you lose some flexibility by doing a residency.

 

I shadowed 2 ortho PAs. One did residency and probably had 10+ years of experience and the other graduated from a 3 year program ~3 years ago. They split the patients during the clinic day and they are scheduled interchangeably in the OR. The residency guy probably knows more but the place he is working at simply has certain jobs that are done by the PA and certain jobs done by the doctor. He also probably makes a bit more money but that has more to do with his natural salary increases over the years, at the practice, than it does with his residency training. 

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working rural helps get training, as opposed to many/most urban jobs which provide zero training, but you still don't have dedicated off service rotations focused just on learning where you can intubate 100 pts, do 100 u/s, run codes with someone over your shoulder, reduce fxs with an orthopedist, etc.

life isn't all about money, it's also about job satisfaction.

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working rural helps get training, as opposed to many/most urban jobs which provide zero training, but you still don't have dedicated off service rotations focused just on learning where you can intubate 100 pts, do 100 u/s, run codes with someone over your shoulder, reduce fxs with an orthopedist, etc.

life isn't all about money, it's also about job satisfaction.

 

Then we should be honest about a residency being about gaining job satisfaction more than it is about money.

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STRONGLY DISAGREE. when was the last time you intubated 100 pts in a month at work with an anesthesiologist critiquing your technique?

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STRONGLY DISAGREE. when was the last time you intubated 100 pts in a month at work with an anesthesiologist critiquing your technique?

With all respect, I doubt that Anes MD residents can show these numbers in a large med center

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I believe you are mistaken. 

 

As a PARAMEDIC student years ago I obtained 30+ intubations in 4 days at a medium sized hospital.

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as a student on anesthesiogy rotations you just go from OR to OR intubating pts with different docs or crnas. I recently had to do some to keep up credentialing at one facility(regional trauma ctr) I work at. I got 6 in 2 hrs. If I had stayed all day I probably could have gotten 15-20 in ONE DAY.

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With all respect, I doubt that Anes MD residents can show these numbers in a large med center

the residents have to stay for the whole case. as a student, you do the intubation then move on to the next one. you are in each room maybe 10-15 min.

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and intubation is just one skill. residents can spend a week with a vascular access team just starting central lines and pic lines for 40 hrs...or with an u/s tech doing 2 weeks of bedside ultrasounds, etc. and these are just skills...what about the valuable time spent rounding on pts in a medical ICU or working with an ID doc with critically ill immunocompromised pts. This is so much more than you could do working a typical job where your only purpose is to move the meat seeing 2-4 pts/hr with little interaction with anyone except for nursing staff.

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In my residency I not only was trained to do central lines - Swan, CVC, VasCaths, TVP but was also trained to perform more advanced procedures like inserting an IABP. We have folks on my team that have been practicing in the CCU for years that have never had that opportunity. Being a resident and teamed up with a physician who was willing to teach allowed me this opportunity. I was also given the chance to sit down with a physician for several days and read echos, cardiac MRI's and CT's. I think you'd be hard pressed to find a job that would allow you to have days on end simply focused on reading and performing echos. Cheap labor....maybe....but getting the best training in the shortest period of time. 

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residency = cheap labor and no substantial benefits that one could not get otj

Agree with everyone else. Until you actually do one or are at least involved in one, your opinion doesn't mean much

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residency = cheap labor and no substantial benefits that one could not get otj

Wrong. I can speak on this as I have worked in both environments. If YOU have that same experience, let us know how they were different. 

The educational environment and support system in place for residency far exceeds that in OTJ training. 

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A classmate and I work at the same job. Same salary. He had a residency, I didn't. His first job was in his specialty (ortho) , mine was urgent care. I transitioned to ortho, and actually gave him the reference to where we work currently. We both make the same.

 

Sent from my SM-G900V using Tapatalk

 

 

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that just means he is not taking full advantage of his residency training...

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that just means he is not taking full advantage of his residency training...

Agree, another advantage I have seen from residency trained EM providers: they learn the language of the specialists in the hospital. One of the worst feelings in the ED is sounding like an idiot on the phone with a specialist. When you spend a month with them... you learn what they want and need to know. This goes a long way in building trust. I know, because many of us learned the hard way.

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I would argue that some people probably NEVER get the experience a residency might provide....if you work in a place without folks who value you professionally and want to help you advance your career you might never get a chance to increase your scope of practice beyond the basics of your job.

Love the conversation going on here. This is a great point. I'm considering doing a blog post about this alone.

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Residencies  and CAQs are the future.  If you have been in  a specialty for 10 years or you work in primary care you can certainly get by without one, but many PAs in emergency departments just won't get enough numbers of certain procedures to become competent or maintain competency in securing any airway on any patient every time, instead of some airways on some patients some of the time because there is always someone else there to take over.   It can make that big percentage of difference with a relatively small number of patients, but it is a life-altering difference.   And that's just with procedures....the enhanced diagnostic ability and fund of knowledge that comes from seeing lots of very sick patients is absolutely life-changing.  You will learn five times as much in that residency year as you learned in your clinical year of PA school and at least as much as you would learn in five years of practice.  Just make sure you pick the very best residency for you and move forward while you are young.    

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Re-opening an old post... Thank you to all who have posted and shed so much light on this topic already!

 

I have just started clinical rotations and anticipate wanting to do a lot of procedures and have as much autonomy as I can in future clinical practice. I am actually only in my 2nd rotation, so I'm still not quite sure what specialty I want to practice in. I noticed that the majority of the discussion on this post is with regards to doing a residency in Emergency Medicine. I know that there are residency opportunities in a variety of specialties, but does EM tend to be the most useful residency? Any thoughts on residencies on other fields like Pediatric Critical Care, Critical Care in general, etc.? 

 

Also, I realize that autonomy is highly dependent on the individual, their level of experience, location of practice, and physician they practice under, but do there seem to be specialties that tend to offer the most autonomy regardless of those factors? Just as a background to the locations I'm working with, I live in a small city in Indiana and don't necessarily see myself practicing/living in a rural setting; if I was to move, the most likely moves would be to Indianapolis, or someplace in MI or IL.

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Honestly, I think that residencies would be worthwhile for a PA in any field.  PA school training is geared towards the core specialties (FM, IM, EM, etc) for the most part, so the specialties that deviate from that would be even more helpful to do a residency, like in critical care for example, which PA school surely does little to prepare you for.   Similarly, working in subspecialty fields will probably afford you less autonomy because its just not what our training is geared towards, so of course we would need more supervision there.  

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I will echo the sentiments of others that there is no comparison to OJT and a well structured residency. Having completed a residency in Neonatology has allowed me to take a position at a top ten children's hospital as their first PA in the NICU, at an hourly rate in excess of $100+.

I will agree though that compensation is what you make of it. I had a colleague who stayed at our training institution who will make half that, still 100k a year, but less than what the market is offering for our specialized skill set.

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Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

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1 hour ago, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

Do you mean like a long-term plan as in over the next 10-20 years or so? There are only 20 ish ER residencies currently taking 2-3 students each, seems like it would be difficult for an ER to get one residency trained PA, much less have all of them residency trained.

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9 hours ago, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

How did your residency affect your salary negotiation vs other PA starting salary with no exp or no residency. What part of cali?

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On ‎10‎/‎6‎/‎2017 at 10:50 AM, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

agree with this. when I interview folks, the ones with a residency go to the top of the pile. have hired and worked with several residency grads. they all impressed me.

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On ‎10‎/‎6‎/‎2017 at 0:10 PM, radioman said:

Do you mean like a long-term plan as in over the next 10-20 years or so? There are only 20 ish ER residencies currently taking 2-3 students each, seems like it would be difficult for an ER to get one residency trained PA, much less have all of them residency trained.

if you have a dept that allows for good PA scope of practice residency grads will seek you out. I have worked in small depts. with several residency trained folks. my last job had 3. my current job has only 3 PAs with one residency grad and 2 with both the caq and doctorates :)    (one of the 3 has a doctorate, a caq, and a residency).

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On 10/6/2017 at 1:50 PM, PACali said:

Residency trained EMPA here. In my department, we are shifting towards hiring only post-graduate trained PAs. We are big on OJT too. But I found post-graduate trained PAs are easier to teach because they already have a great foundation to build on. They are rockstars compare to the new grads.  As we moving along with OTP, I suggest all new PAs should do a residency/fellowship. 

It's a nice idea but there just currently aren't enough of them out there. Even if we just talk about non-primary care positions, new grads far out number available residency positions.  We could quickly find ourselves in a situation where there are shady scam residencies (plenty already exist I'm sure) or even just mediocre ones pumping out residency grads the same way new PA programs are pushing out new grads.

I also wonder if the reason residency trained grads are so good is because those were likely the better students/providers to begin with - the ones that were not only accepted to residency programs but also those willing to put the time into an extra year of more formal education.  Seems like a confounding factor at least.

I'm not saying residencies don't have value, just that it's not as easy as just saying every grad should do one.

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14 hours ago, MT2PA said:

It's a nice idea but there just currently aren't enough of them out there. Even if we just talk about non-primary care positions, new grads far out number available residency positions.  We could quickly find ourselves in a situation where there are shady scam residencies (plenty already exist I'm sure) or even just mediocre ones pumping out residency grads the same way new PA programs are pushing out new grads.

I also wonder if the reason residency trained grads are so good is because those were likely the better students/providers to begin with - the ones that were not only accepted to residency programs but also those willing to put the time into an extra year of more formal education.  Seems like a confounding factor at least.

I'm not saying residencies don't have value, just that it's not as easy as just saying every grad should do one.

These were my sentiments as well. There is also no real consistency on accreditation of these residencies. I interviewed at a brand new one this year that told me the arc-PA wasn’t accrediting anymore residencies because they were too tied up with accreditation of new PA programs. I have no idea if this is true or just an excuse, but what stops a hospital from just calling something a residency to get cheap labor out of a few PAs if there’s no standardized process? I think there’s a long way to go before it’s considered a “must-do” thing for the profession. 

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On 10/9/2017 at 5:18 AM, radioman said:

These were my sentiments as well. There is also no real consistency on accreditation of these residencies. I interviewed at a brand new one this year that told me the arc-PA wasn’t accrediting anymore residencies because they were too tied up with accreditation of new PA programs. I have no idea if this is true or just an excuse, but what stops a hospital from just calling something a residency to get cheap labor out of a few PAs if there’s no standardized process? I think there’s a long way to go before it’s considered a “must-do” thing for the profession. 

I totally agree with you. I think PA post-graduate training is a great idea but we still have a long way to go. I honestly believed PA education with some kind of special primary care residency made for PAs can replace primary care docs. (I know I might get flamed)  

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Thank you, everyone to all of your thoughts, suggestions, and advice. Currently figuring out how to get the most out of my clinical rotations and then strongly considering pursuing a post-grad residency. Thanks, again!

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On 10/9/2017 at 8:18 AM, radioman said:

These were my sentiments as well. There is also no real consistency on accreditation of these residencies. I interviewed at a brand new one this year that told me the arc-PA wasn’t accrediting anymore residencies because they were too tied up with accreditation of new PA programs. I have no idea if this is true or just an excuse, but what stops a hospital from just calling something a residency to get cheap labor out of a few PAs if there’s no standardized process? I think there’s a long way to go before it’s considered a “must-do” thing for the profession. 

What ARC-PA told you is true. There is a new accreditation process coming online through CAAHEP probably some time next year. 

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Has anyone done a residency after being out in practice for several years? I've considered going back for all of the reasons being espoused here, and I think it's definitely what one should try to do if you want to be at the top of our field, but it's a lot harder now to think about taking a 50% pay cut vs had I done a residency right out of school.

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2 issues here: the PA working in the same field as the residency they intend to do and the pa thinking about changing specialties. I know as a PA I could apply to work in another field than EM, but if I were to do something unrelated to em(say CT surgery or nephrology), I really would want to do a residency in the new field. I agree that is hard to go back and do a residency in your own field after many years in practice. I still wish I could do one today as there are lots of procedures and knowledge(mostly of the critical care , u/s, and ICU pt care management variety), but no way I could take a 60-75% pay cut to do so. If I was single and without considerable debt I would still do one in my late 40s. would still consider doing the lecom bridge under those circumstances.

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