Jambi Posted August 6, 2009 Share Posted August 6, 2009 here ya go He's at albert einstein in philadelphia. the place is a major knife and gun club.he will come out of there an em stud! Quote Link to comment Share on other sites More sharing options...
jthpac Posted August 7, 2009 Share Posted August 7, 2009 Jambi/ Christina-- True Anomaly, I think is doing his rsidency in Philly. Vachon is doing his post grad in Wisconsin. Jim PS Vachon enjoy the Beer, German food, and sharp Cheddar Cheese, :) Quote Link to comment Share on other sites More sharing options...
mainiac Posted August 8, 2009 Share Posted August 8, 2009 It's with Childrens Hospital of Wisconsin (#3 in US, Level 1 Trauma Center) and next door is the Adult Hosptial: Froedtert Hospital. PS I've started a new thread....Look 4 it! Can we also make it a sticky? Since Anomaly is in ED & I'm in Surgical Residency, might be nice to have 2 different sticky threads.....Thx! Quote Link to comment Share on other sites More sharing options...
mainiac Posted August 8, 2009 Share Posted August 8, 2009 Jambi/ Christina-- True Anomaly, I think is doing his rsidency in Philly. Vachon is doing his post grad in Wisconsin. Jim PS Vachon enjoy the Beer, German food, and sharp Cheddar Cheese, :) BTW - Vachon is a Female! :) Quote Link to comment Share on other sites More sharing options...
apple810 Posted August 8, 2009 Share Posted August 8, 2009 BTW - Vachon is a Female! :) Love it! Women in surgery rule! Quote Link to comment Share on other sites More sharing options...
bchernock Posted August 9, 2009 Share Posted August 9, 2009 TA....awesome!!! I have been following and researching the program you are in. Although I am just starting clinical year, if I get the opportunity to do a residency I want to be where you are!!! Thanks so much for the posts...keep em coming (time permitting of course). Good luck! Quote Link to comment Share on other sites More sharing options...
mainiac Posted August 9, 2009 Share Posted August 9, 2009 Wow Vachon congrats, I remember a while back you were looking hard for a job and now look at you, in a residency!! Congrats, I'm jealous, well kind of..... Thanks Iain! Are you doing IR now? [interventional radiology] I'm still debating on my 2 electives. Let me know if you would recommend it? Why / what you like / hate about it. Thanks, V2 :) Quote Link to comment Share on other sites More sharing options...
jthpac Posted August 9, 2009 Share Posted August 9, 2009 Female![/b] :)] V-- Sorry-- I Know never assume,. I may type slow, but my typing, somtimes, is quicker than my thught process. An Embarrassed Jim :o Quote Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted September 7, 2009 Author Moderator Share Posted September 7, 2009 My first full month in the ER is over, and I already miss it. I did a few stretches of 6 days in a row, with three days off in between. It does make for a nice schedule, and with how we rotate hours it keeps it fresh. For instance, I’ll do three noon-midnight shifts, then three 9 AM-7PM shifts, or three 7 PM-5AM shifts in a row. Some days I’m in the “trauma” part of the ER, where we get more emergent patients as well as all the traumas that come in (our trauma bay has three beds). While this is the case, the ER has the policy of “any patient, any bed, any time”- so just because you’re in one of the back areas doesn’t mean you’re gonna miss all the MI’s or respiratory distress cases, which I’ve certainly learned the hard way. For the most part, everyone has been wonderful to work with- the attendings are all patient with us new interns and most of them enjoy their limited times to teach. The senior residents, while they are adjusting to their new roles of running each area of the ER, are also very understanding of “the kids”, since they were just in our shoes a few years ago. And at no time has anyone looked down on me simply because I’m a PA- I’m seen no differently than the physician interns in regards to what patients I’m allowed to see. At some times I’ve been in the right spot at the right time, which has enabled me to place a couple central lines and do a couple LP’s on my patients. With our extensive use of bedside ultrasound in our ER, I’m getting some good looks at looking for viable intrauterine pregnancies, cholecystitis/cholelithiasis, free fluid in the abdomen based on FAST exams, and learning ultrasound-guided IV placement. The only hard-and-fast rule in regards to procedures in our ER is that the second-year residents always do the airway, and the third-year residents run any traumas that come in. Because of the extensive support, I feel I’m able to forge ahead and try to manage as many patients as possible- right now I feel that 5 is definitely pushing the limit of what I’m capable of at the moment. I’m certainly hoping that by the time I’m finished here, managing 6 patients at once will seem like a breeze. Oh yeah...and with the characters that come into this ER, I'm keeping a private journal that maybe, years from now, will make for some hilarious reading. :D Right now I’m two weeks into my first off-service rotation in general surgery. To keep this a mostly positive post, I’ll just say that my experience has not been what I expected, and we’re struggling a little to find the best way to integrate me into the surgical team. That, coupled with the chaotic nature of the surgery service, makes me long for the “ordered chaos” of the ER. (As a side note, I just don’t know how some of y’all in surgery deal with surgeons….). This isn’t to say that I’m not learning; just by watching their reactions to what those of us in the ER determine is a surgical admission is enough of a lesson in what NOT to do. In a couple weeks I begin rotation on the telemetry service, which should be a bit more uniform. So overall….two and a half months into this thing, and I’m definitely glad I’m here. The sights and sounds of Philly are keeping me well entertained, as well as the people I’ve met here. It does get a bit lonely at times, but there’s always a reminder of something to read or do. Quote Link to comment Share on other sites More sharing options...
Hemegroup Posted September 7, 2009 Share Posted September 7, 2009 It does get a bit lonely at times, but there’s always a reminder of something to read or do. Roadtrip! Dude, serious, I was going to say let's head to the coast and grab some sun and surf until I just checked the weather and see that rain will be here just about every day until my rotation starts in a couple weeks :( But hey isn't it my turn for dinner on your side? (first thing he says to me, "ohh, you're old!!" grrreat, thaaanks, nice to meet you too!) Quote Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted September 7, 2009 Author Moderator Share Posted September 7, 2009 Roadtrip! Dude, serious, I was going to say let's head to the coast and grab some sun and surf until I just checked the weather and see that rain will be here just about every day until my rotation starts in a couple weeks :( But hey isn't it my turn for dinner on your side? (first thing he says to me, "ohh, you're old!!" grrreat, thaaanks, nice to meet you too!) Actually, I was referring more to female companionship... ;) Yeah, it's about due for dinner again; I just have to get out of this surgery rotation alive. Hopefully you'll still be alive yourself, since you're so old and all :D Quote Link to comment Share on other sites More sharing options...
Hemegroup Posted September 8, 2009 Share Posted September 8, 2009 Actually, I was referring more to female companionship... ;) Well, excuuse me! Seriously, c'mon now, surely you have a few lady nurses in your black book (pda) by now? Hopefully you'll still be alive yourself, since you're so old and all :D har har ... just wait till you hit 38, young whipper-snapper! Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 8, 2009 Moderator Share Posted September 8, 2009 (first thing he says to me, "ohh, you're old!!" grrreat, thaaanks, nice to meet you too!) I'm older than you and he didn't tell me I looked old when we met at sempa in tuscon last yr. you really must look like crap!:eek::p;):D Quote Link to comment Share on other sites More sharing options...
istat2 Posted September 8, 2009 Share Posted September 8, 2009 I'm older than you and he didn't tell me I looked old when we met at sempa in tuscon last yr. you really must look like crap!:eek::p;):D Dude, They aren't talking years :eek: They be talking MILAGE :D Quote Link to comment Share on other sites More sharing options...
mainiac Posted September 12, 2009 Share Posted September 12, 2009 Female![/b] :)] V-- Sorry-- I Know never assume,. I may type slow, but my typing, somtimes, is quicker than my thught process. An Embarrassed Jim :o No worries Jim! Quote Link to comment Share on other sites More sharing options...
bchernock Posted October 29, 2009 Share Posted October 29, 2009 any updates? Hope the program is going well. Quote Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted October 31, 2009 Author Moderator Share Posted October 31, 2009 Time for an update! I’m now four months into my training; after my first rotation in the ER, I’ve done one rotation in general surgery, followed by another in telemetry. Now I’m back in the ER where I belong, and while it’s really kicking my *** with H1N1 in full effect, it’s still better than being elsewhere in the hospital. Here’s what I learned first and foremost about my experience on general surgery- it’s very rough to be the very first person to do something- and I had the lucky honor of being the first-ever PA resident to join the surgery team. Please understand, in no way am I trying to compare myself to those PA’s in the past who had to really struggle with trying to establish their foothold in the medical world- but I certainly do appreciate their situation more! There were quite a few kinks to work out, but I tried to make the experience as meaningful as I could- lots of reading on the side about how these surgery cases correlated with what would come into the ER; trying to see as many consults in the ER as I could for the surgery team; taking the time to learn how a surgeon reads a CT scan…or for that matter, having the radiologist show me how they also read emergent surgical CT scans. The nice thing about my struggles in surgery is that there was a change made for the better for my fellow PA resident, who is now on a different surgery team and is having a significantly better experience. The next month was telemetry- a much different setting and pace from surgery. The difference in teaching between the two services was night and day- whereas little if any teaching went on during surgery, there was ample time and effort made to educate about the world of cardiology. While the attendings in surgery couldn’t be bothered with dealing with an off-service intern, the cardiology attendings were very approachable and enjoyed teaching. There was time to explore every little detail of EKG’s; every other thing that caused a troponin elevation; when a persantine-sestamibi study was actually needed along with a cardiac cath; and probably the most important lesson of all- the small amount of confidence I gained with being able to send a chest pain patient home. During the first couple of weeks on the service I wasn’t able to go down to the ER to admit patients, but was finally allowed to do so after proving myself on the team. I had some big shoes to fill after my other fellow PA resident, who is much sharper at the inpatient side of things than I am and who completed the rotation before me. The off-service rotations provided several opportunities to educate about what a PA resident really is. More often than not I got the question, “So when you’re done with this, you’re a doctor?” There’s also been other logistical issues raised, but it all comes with educating other people in the hospital about just what our role is. As I mentioned above, I’m now back in the ED for my second full month, and it really felt like a homecoming- but oh wait, here’s H1N1 to spoil the party! Our ER has been inundated enough to set up our very own “Flu Tent” outside to steer the masses there who clearly need some TLC at home for their illness (the truly sick complications from H1N1 will still get routed through the main ED). The journey through the two off-service rotations has again helped me give just a little bit of confidence when it comes to dealing with those particular types of patients, whether surgery or cardiac (not even the ED physician residents get to do a telemetry rotation- they just do a standard internal medicine inpatient rotation). I’m finally starting to feel confident on the relatively easy stuff, while at the same time being more brave with how far I can go on the more complicated patients. It’s amazing to me how dealing with the nursing home patient who can’t speak no longer brings this overwhelming tide of insecurity through me like it did before. And I’m squeezing myself into enough traumas that I’m trying to get to run either the primary or secondary surveys on the patients (on the minor stuff….but hey, you gotta start somewhere). In short…..so far, so good. I don’t think I’d be this far along in confidence and ability had I made a go of this on my own without the program. Next rotation...anesthesia! Nothing but intubating all month long! Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 31, 2009 Moderator Share Posted October 31, 2009 Next rotation...anesthesia! Nothing but intubating all month long! MAKE SURE YOU GET ENOUGH "REAL INTUBATIONS"(AS OPPOSED TO LMA'S) AS LAZY ANESTHESIOLOGISTS REALLY LIKE LMA'S FOR SHORT CASES. I'M NOT A BIG FAN OF THE LMA IN EMERGENT PTS AS IT DOESN'T ACTUALLY PROTECT THE AIRWAY... Quote Link to comment Share on other sites More sharing options...
bchernock Posted November 1, 2009 Share Posted November 1, 2009 Glad things are going well.... keep it up. Quote Link to comment Share on other sites More sharing options...
klb48 Posted November 1, 2009 Share Posted November 1, 2009 Thanks for the update! Hope you enjoy all those intubations! Quote Link to comment Share on other sites More sharing options...
Stephanie2009 Posted January 5, 2010 Share Posted January 5, 2010 Does anyone have a general idea of the salary a PA would make after a residency such as EM? Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 5, 2010 Moderator Share Posted January 5, 2010 Does anyone have a general idea of the salary a PA would make after a residency such as EM? >100k to start in the right setting. Quote Link to comment Share on other sites More sharing options...
lov2xlr8 Posted January 5, 2010 Share Posted January 5, 2010 Does anyone have a general idea of the salary a PA would make after a residency such as EM? First year out of EM residency at a large hospital in Miami, my friend started at 120k. More and more, I see the benefits of aresidency. As many have said in other posts, your responsibilities and autonomy is greater (i.e the procedures you can do) and it seems the starting out money is worth the year of lost pay as a resident. I really enjoy this thread TA. Thanks and keep it coming! Quote Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted February 3, 2010 Author Moderator Share Posted February 3, 2010 When I started this thing, I had anticipated not posting regularly, but at least I had envisioned a post at least once a month. I’ve just been busy enjoying not only my residency but also the life I now find myself in. So I’ll spend this post catching y’all up on what’s been up with my experience as a resident. As of my last post, I was finishing up another month of the ER and excited to start anesthesia. This turned out to not be as wonderful as I had anticipated, but at least I was able to get some experience at intubations through various means- not just direct laryngoscopy, but also with the “light wand” and the new toy in the hospital, our own glidescope with LCD monitor. What was equally important to me was getting down the proper method of bag-valve-mask ventilation; I didn’t realize all the errors I had ingrained in myself with BVM’s when I was an EMT. Yes, I did a few LMA’s as well, which was fine since I hadn’t played with those much prior to PA school- and hey, at least it’s a temporizing measure. The frustrating part was fighting with the CRNA students at the hospital for procedures; this has been an ongoing problem at our facility for the physician ER residents for quite a while, and a fundamental overhaul of the anesthesia rotation is likely. So what I got out of the rotation was truly a matter of how aggressive I chose to be. I could’ve gotten a couple more intubations, but overall I felt I did enough to at least get comfortable with the action. At the end of the month I finally had a week of vacation; I chose to travel to Boston, which was the last major Northeast city I had yet to see. Boston in December probably wasn’t the smartest idea for a vacation, but it was quick, easy and something new to see. Upon return, all the ER residents (physicians and us three PA’s) split up into two groups- one half was going to work over Christmas, and the other over New Years. I chose to work the two weeks over New Years, which meant that I started LAB WEEK- a week devoted to procedure practice and lectures about those procedures, as well as refreshers in ACLS, PALS and ATLS procedures. The first day of lab week involved ENT procedures- this was the day where we performed nasopharyngeal laryngoscopy on each other with the video fiberoptic scopes. I really wanted to be the guinea pig so I knew exactly what this felt like, so after a lidocaine neb treatment and Cetacaine spray in the throat (sour bananas!), up went the tube….and oh man, is that ever uncomfortable. But once it was in I got to see my vocal cords and use my iPhone to take a picture- how cool is that??? The rest of the week involved running multiple megacodes, chest tubes, cricothyrotomies, peritoneal lavage (yeah, it ain’t used much anymore, but they still wanted us to know how), slit lamp examinations and some minor stuff. After a week spent back home in Texas for Christmas, I returned for six straight weeks in the ER, which I’m now wrapping up. This recent stretch of ER work has been a real turning point- thanks to one of our attendings (who used to run the physician EM residency and is now the chief academic guy at the hospital), I’ve learned the proper perspective of how to approach any ER patient. And I’ve seemed to arrive at some level of respect among the nursing staff (especially with the tough-as-nails night crew). It makes work so much more bearable, and is starting to feel like “home”, even if I end up leaving here at the end of my residency. I also like to think that myself and my two fellow PA residents have come to some level of respect among the physician residents; they've certainly been nothing but accomodating and helpful to me. One of them was kind enough to give me all her stuff from EMRAP that's available only to Emergency Medicine Residency Association members...an organization we're not quite able to join ;) Next week, I’ll be finding out exactly what the potential EMS fellowship will entail, and will choose to extend my contract for it or not. It’s also almost time for the next round of interviews for potential PA residents to start, and I’m quite excited to meet those folks who were in my shoes at this time last year. Quote Link to comment Share on other sites More sharing options...
bchernock Posted February 8, 2010 Share Posted February 8, 2010 Thanks for the update. That residency really sounds like a truly amazing experience. Make sure you let us know what they have in store for the EMS fellowship. Koodos to them for getting PAs more involved in EMS! Quote Link to comment Share on other sites More sharing options...
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