Moderator EMEDPA Posted January 31, 2012 Moderator Share Posted January 31, 2012 my thought is that around 45% of pa's go into primary care. no residency needed there. yes, there are still more grads going into specialties than folks wanting the slots but a mandate to have pa's do a pgy year would do one, probably both of the following: more folks would go into primary care to avoid having to do it and more hospitals would open residency programs because they make money for the hospital, just like md residencies do. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 31, 2012 Moderator Share Posted January 31, 2012 my thought is that around 45% of pa's go into primary care. no residency needed there. yes, there are still more grads going into specialties than folks wanting the slots but a mandate to have pa's do a pgy year would do one, probably both of the following: more folks would go into primary care to avoid having to do it and more hospitals would open residency programs because they make money for the hospital, just like md residencies do. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 31, 2012 Moderator Share Posted January 31, 2012 my thought is that around 45% of pa's go into primary care. no residency needed there. yes, there are still more grads going into specialties than folks wanting the slots but a mandate to have pa's do a pgy year would do one, probably both of the following: more folks would go into primary care to avoid having to do it and more hospitals would open residency programs because they make money for the hospital, just like md residencies do. While I'm all on board with residencies and on the same page as Emed, you do have to wonder how long it will be before it's required for even primary care. Remember docs first could practice immediately after med school, then only after an intern year (and technically still can), but now with insurance and hospital privileges, ect., you pretty much have to complete a residency in something. How long before PAs have to do a FP residency? (which I would be for if given an expanded scope of practice) Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 31, 2012 Moderator Share Posted January 31, 2012 my thought is that around 45% of pa's go into primary care. no residency needed there. yes, there are still more grads going into specialties than folks wanting the slots but a mandate to have pa's do a pgy year would do one, probably both of the following: more folks would go into primary care to avoid having to do it and more hospitals would open residency programs because they make money for the hospital, just like md residencies do. While I'm all on board with residencies and on the same page as Emed, you do have to wonder how long it will be before it's required for even primary care. Remember docs first could practice immediately after med school, then only after an intern year (and technically still can), but now with insurance and hospital privileges, ect., you pretty much have to complete a residency in something. How long before PAs have to do a FP residency? (which I would be for if given an expanded scope of practice) Link to comment Share on other sites More sharing options...
Gonadometrics Posted January 31, 2012 Share Posted January 31, 2012 Oneal writes "How long before PAs have to do a FP residency? (which I would be for if given an expanded scope of practice)" I have been saying this all along. If residencies are mandatory, then PAs must receive the right to practice independently and the right to use the title of Doctor just as our fellow residency graduates would do. I repeat myself but it is worth saying that first year residents do not explain when they introduce themselves as Doctor by mentioning that they are supervised by attendings and have a restricted medical license. So, if PAs are going to be forced to complete the same PGY-1 training then we should expect the same privileges. Although when I say use the title, Doctor, I don't mean M.D. There must be a new Doctor title for post residency trained PAs. You will have M.D. doctors, D.O. doctors and P.A. doctors (post residency). Until that point, PAs should say "No thank you to residencies." Link to comment Share on other sites More sharing options...
Gonadometrics Posted January 31, 2012 Share Posted January 31, 2012 Oneal writes "How long before PAs have to do a FP residency? (which I would be for if given an expanded scope of practice)" I have been saying this all along. If residencies are mandatory, then PAs must receive the right to practice independently and the right to use the title of Doctor just as our fellow residency graduates would do. I repeat myself but it is worth saying that first year residents do not explain when they introduce themselves as Doctor by mentioning that they are supervised by attendings and have a restricted medical license. So, if PAs are going to be forced to complete the same PGY-1 training then we should expect the same privileges. Although when I say use the title, Doctor, I don't mean M.D. There must be a new Doctor title for post residency trained PAs. You will have M.D. doctors, D.O. doctors and P.A. doctors (post residency). Until that point, PAs should say "No thank you to residencies." Link to comment Share on other sites More sharing options...
paraguru Posted January 31, 2012 Share Posted January 31, 2012 I like the lively discussion about this topic. I recently graduated last August and have been doing Primary Care / ED / Hospital care in a very very very tiny rural hospital. Granted I am never ever going to see the volume of patients or level of acuity that some bigger hospitals do. Still, even here I sometimes wonder if a residency would be a good thing to have under my belt because I cover my small ED on my own. Just like in EMS, you just never know what is going to walk through the door. The question is...can someone build their skill set without a residency? Sure, I suppose so. Yet, I think the time it is going to take me to reach the level of competency that some one right out of an EM residency will be is a really long time. With that said, anyone know of any residency programs that cater to Rural medicine practice? Link to comment Share on other sites More sharing options...
paraguru Posted January 31, 2012 Share Posted January 31, 2012 I like the lively discussion about this topic. I recently graduated last August and have been doing Primary Care / ED / Hospital care in a very very very tiny rural hospital. Granted I am never ever going to see the volume of patients or level of acuity that some bigger hospitals do. Still, even here I sometimes wonder if a residency would be a good thing to have under my belt because I cover my small ED on my own. Just like in EMS, you just never know what is going to walk through the door. The question is...can someone build their skill set without a residency? Sure, I suppose so. Yet, I think the time it is going to take me to reach the level of competency that some one right out of an EM residency will be is a really long time. With that said, anyone know of any residency programs that cater to Rural medicine practice? Link to comment Share on other sites More sharing options...
kibbie Posted January 31, 2012 Share Posted January 31, 2012 I will just add that several people i know both in residencies (PA) and physicians have said residencies are just a way to get you to do your regular training under less pay- jobs will train you to do everything to do your job and residencies dont make it more likely to get a job- from my experience they are looking for someone with a good personality that is trainable more than anything else... I did know someone who went into residency for ER just bc she had a hard time finding work in her area and it was a way to earn a salary- from her viewpoint she was thrown in with the residents and treated as such, except for less pay... residencies need more time and more work before they can contribute to improving the profession... Jobs will all train you to do what you need and i can see how a residency will help get more experience to aid in that however, most of the time at least in surgery its the surgeons at the job that want you to do things exactly their way which you would only learn on the job anyway... also, personally i dont like the idea for residencies for our profession - i feel like it could lead to a reduction in pay for training they should already provide us... good luck Link to comment Share on other sites More sharing options...
kibbie Posted January 31, 2012 Share Posted January 31, 2012 I will just add that several people i know both in residencies (PA) and physicians have said residencies are just a way to get you to do your regular training under less pay- jobs will train you to do everything to do your job and residencies dont make it more likely to get a job- from my experience they are looking for someone with a good personality that is trainable more than anything else... I did know someone who went into residency for ER just bc she had a hard time finding work in her area and it was a way to earn a salary- from her viewpoint she was thrown in with the residents and treated as such, except for less pay... residencies need more time and more work before they can contribute to improving the profession... Jobs will all train you to do what you need and i can see how a residency will help get more experience to aid in that however, most of the time at least in surgery its the surgeons at the job that want you to do things exactly their way which you would only learn on the job anyway... also, personally i dont like the idea for residencies for our profession - i feel like it could lead to a reduction in pay for training they should already provide us... good luck Link to comment Share on other sites More sharing options...
andersenpa Posted January 31, 2012 Share Posted January 31, 2012 I will just add that several people i know both in residencies (PA) and physicians have said residencies are just a way to get you to do your regular training under less pay- jobs will train you to do everything to do your job and residencies dont make it more likely to get a job- from my experience they are looking for someone with a good personality that is trainable more than anything else... I did know someone who went into residency for ER just bc she had a hard time finding work in her area and it was a way to earn a salary- from her viewpoint she was thrown in with the residents and treated as such, except for less pay... residencies need more time and more work before they can contribute to improving the profession... Jobs will all train you to do what you need and i can see how a residency will help get more experience to aid in that however, most of the time at least in surgery its the surgeons at the job that want you to do things exactly their way which you would only learn on the job anyway... also, personally i dont like the idea for residencies for our profession - i feel like it could lead to a reduction in pay for training they should already provide us... good luck The facts about residencies are somewhat different. IMO there are certain features of residency which are not available in a non residency job. See my first post in this thread. In a nutshell it is accelerated training. In a regular job it will take longer to accrue the number of pt encounters and there are things you may only see in a residency that you wont get elsewhere...acuity, complexity etc To say they are just slave labor is inaccurate, and a bit insulting to the PA educators who train residents. Link to comment Share on other sites More sharing options...
andersenpa Posted January 31, 2012 Share Posted January 31, 2012 I will just add that several people i know both in residencies (PA) and physicians have said residencies are just a way to get you to do your regular training under less pay- jobs will train you to do everything to do your job and residencies dont make it more likely to get a job- from my experience they are looking for someone with a good personality that is trainable more than anything else... I did know someone who went into residency for ER just bc she had a hard time finding work in her area and it was a way to earn a salary- from her viewpoint she was thrown in with the residents and treated as such, except for less pay... residencies need more time and more work before they can contribute to improving the profession... Jobs will all train you to do what you need and i can see how a residency will help get more experience to aid in that however, most of the time at least in surgery its the surgeons at the job that want you to do things exactly their way which you would only learn on the job anyway... also, personally i dont like the idea for residencies for our profession - i feel like it could lead to a reduction in pay for training they should already provide us... good luck The facts about residencies are somewhat different. IMO there are certain features of residency which are not available in a non residency job. See my first post in this thread. In a nutshell it is accelerated training. In a regular job it will take longer to accrue the number of pt encounters and there are things you may only see in a residency that you wont get elsewhere...acuity, complexity etc To say they are just slave labor is inaccurate, and a bit insulting to the PA educators who train residents. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted January 31, 2012 Moderator Share Posted January 31, 2012 The facts about residencies are somewhat different. IMO there are certain features of residency which are not available in a non residency job. See my first post in this thread. In a nutshell it is accelerated training. In a regular job it will take longer to accrue the number of pt encounters and there are things you may only see in a residency that you wont get elsewhere...acuity, complexity etc To say they are just slave labor is inaccurate, and a bit insulting to the PA educators who train residents. To piggyback off of this....residencies are also one of those things that "you get out of it what you put into it". Sure, you could land a residency spot because "you can't find a job", and if you go into it with that attitude you're less likely to take advantage of the opportunities you're given. But if you put the effort into it- be proactive, read a LOT, learn from fellow physician residents (plus get access to all the free stuff they get)- it'll become an actual learning experience. I could've slept through my residency and gotten half out of it what I ultimately did. If you're gonna make the decision to do a residency and take at least half the pay you otherwise could as a PA, you better make it worth your while in your learning Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted January 31, 2012 Moderator Share Posted January 31, 2012 The facts about residencies are somewhat different. IMO there are certain features of residency which are not available in a non residency job. See my first post in this thread. In a nutshell it is accelerated training. In a regular job it will take longer to accrue the number of pt encounters and there are things you may only see in a residency that you wont get elsewhere...acuity, complexity etc To say they are just slave labor is inaccurate, and a bit insulting to the PA educators who train residents. To piggyback off of this....residencies are also one of those things that "you get out of it what you put into it". Sure, you could land a residency spot because "you can't find a job", and if you go into it with that attitude you're less likely to take advantage of the opportunities you're given. But if you put the effort into it- be proactive, read a LOT, learn from fellow physician residents (plus get access to all the free stuff they get)- it'll become an actual learning experience. I could've slept through my residency and gotten half out of it what I ultimately did. If you're gonna make the decision to do a residency and take at least half the pay you otherwise could as a PA, you better make it worth your while in your learning Link to comment Share on other sites More sharing options...
Gonadometrics Posted January 31, 2012 Share Posted January 31, 2012 TrueAnomaly writes "If you're gonna make the decision to do a residency and take at least half the pay you otherwise could as a PA, you better make it worth your while in your learning" I would add. You better make it worth your while in your learning AND YOUR RIGHT TO PRACTICE INDEPENDENTLY AND THE RIGHT TO A TERMINAL DOCTORATE WITH CLINICAL USE OF "DOCTOR" TITLE. Why are so many PAs willing to give up time and treasure to simply be able to make more money for our Masters? Link to comment Share on other sites More sharing options...
Gonadometrics Posted January 31, 2012 Share Posted January 31, 2012 TrueAnomaly writes "If you're gonna make the decision to do a residency and take at least half the pay you otherwise could as a PA, you better make it worth your while in your learning" I would add. You better make it worth your while in your learning AND YOUR RIGHT TO PRACTICE INDEPENDENTLY AND THE RIGHT TO A TERMINAL DOCTORATE WITH CLINICAL USE OF "DOCTOR" TITLE. Why are so many PAs willing to give up time and treasure to simply be able to make more money for our Masters? Link to comment Share on other sites More sharing options...
whimsygirl Posted January 31, 2012 Share Posted January 31, 2012 Deleted ..... Link to comment Share on other sites More sharing options...
whimsygirl Posted January 31, 2012 Share Posted January 31, 2012 Deleted ..... Link to comment Share on other sites More sharing options...
Gonadometrics Posted January 31, 2012 Share Posted January 31, 2012 Actually, I am very happy as a PA. Remember, what is being pushed on PAs is mandatory residencies at our own expense and increased length of PA school. So, my argument is that if hospitals want more Doctors, they should go to Medical schools to get them to increase their class size. What is happening instead is that PAs are expected to pay for nearly the same amount of training as M.D.s but then remain eternally grateful for being taught by Doctors but paid substantially less. The push for residencies is a win for physicians, a win for hospitals and a loss for PAs. I only advocate independence and the terminal doctorate (with title) so it then becomes a win for PAs too. Do you want to enter a deal where the other parties win and you always lose? Link to comment Share on other sites More sharing options...
Gonadometrics Posted January 31, 2012 Share Posted January 31, 2012 Actually, I am very happy as a PA. Remember, what is being pushed on PAs is mandatory residencies at our own expense and increased length of PA school. So, my argument is that if hospitals want more Doctors, they should go to Medical schools to get them to increase their class size. What is happening instead is that PAs are expected to pay for nearly the same amount of training as M.D.s but then remain eternally grateful for being taught by Doctors but paid substantially less. The push for residencies is a win for physicians, a win for hospitals and a loss for PAs. I only advocate independence and the terminal doctorate (with title) so it then becomes a win for PAs too. Do you want to enter a deal where the other parties win and you always lose? Link to comment Share on other sites More sharing options...
jsfelder0417 Posted February 1, 2012 Share Posted February 1, 2012 I like the lively discussion about this topic. I recently graduated last August and have been doing Primary Care / ED / Hospital care in a very very very tiny rural hospital. Granted I am never ever going to see the volume of patients or level of acuity that some bigger hospitals do. Still, even here I sometimes wonder if a residency would be a good thing to have under my belt because I cover my small ED on my own. Just like in EMS, you just never know what is going to walk through the door. The question is...can someone build their skill set without a residency? Sure, I suppose so. Yet, I think the time it is going to take me to reach the level of competency that some one right out of an EM residency will be is a really long time. With that said, anyone know of any residency programs that cater to Rural medicine practice? The program at Basset seems like it's what you're looking for. Here's the link: http://www.bassett.org/bassett-medical-center/medical-education/residency-programs/rural-emergency-medicine-postgraduate-physician-assistant-program/ Link to comment Share on other sites More sharing options...
jsfelder0417 Posted February 1, 2012 Share Posted February 1, 2012 I like the lively discussion about this topic. I recently graduated last August and have been doing Primary Care / ED / Hospital care in a very very very tiny rural hospital. Granted I am never ever going to see the volume of patients or level of acuity that some bigger hospitals do. Still, even here I sometimes wonder if a residency would be a good thing to have under my belt because I cover my small ED on my own. Just like in EMS, you just never know what is going to walk through the door. The question is...can someone build their skill set without a residency? Sure, I suppose so. Yet, I think the time it is going to take me to reach the level of competency that some one right out of an EM residency will be is a really long time. With that said, anyone know of any residency programs that cater to Rural medicine practice? The program at Basset seems like it's what you're looking for. Here's the link: http://www.bassett.org/bassett-medical-center/medical-education/residency-programs/rural-emergency-medicine-postgraduate-physician-assistant-program/ Link to comment Share on other sites More sharing options...
Gonadometrics Posted February 1, 2012 Share Posted February 1, 2012 I am still struggling to appreciate the value in this residency. (Bassett) Salary : 52K Credential awarded : Certificate The real cost of the training is lost income. Typically an Emergency Dept PA might make 85-100K (maybe much more). So, if you assume 90K salary. The price of the residency is now 38K. The reward; a certificate. There just isn't enough hard data to show that these residencies translate into improved earnings for PAs and equivalent recognition (independence and terminal doctorate). If you think this is a fair bargain, let me ask Bassett to propose something to 4th year medical students. In exchange for 3 years of training at 52k per year, Bassett will give you a certificate so that you will be well trained when working under your attending for the next thirty years. Sounds pretty silly, doesn't it? Link to comment Share on other sites More sharing options...
Gonadometrics Posted February 1, 2012 Share Posted February 1, 2012 I am still struggling to appreciate the value in this residency. (Bassett) Salary : 52K Credential awarded : Certificate The real cost of the training is lost income. Typically an Emergency Dept PA might make 85-100K (maybe much more). So, if you assume 90K salary. The price of the residency is now 38K. The reward; a certificate. There just isn't enough hard data to show that these residencies translate into improved earnings for PAs and equivalent recognition (independence and terminal doctorate). If you think this is a fair bargain, let me ask Bassett to propose something to 4th year medical students. In exchange for 3 years of training at 52k per year, Bassett will give you a certificate so that you will be well trained when working under your attending for the next thirty years. Sounds pretty silly, doesn't it? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 1, 2012 Moderator Share Posted February 1, 2012 with that said, anyone know of any residency programs that cater to rural medicine practice? there is a rural em residency at bassett healthcare in cooperstown , ny. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.