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Hey all,

 

I've been a licensed PA for about 9 months, working for the past 5 months.  I took my first job as a general medical provider/psychiatry PA at a locked psychiatric hospital in a rural area.  It is a very, very poor environment to be an APP in many ways, thus I am already seeking an out. I certainly don't feel comfortable with practicing medicine yet and I'm getting zero training/supervision by my current physician.  

 

However, I interviewed and was accepted into a primary care fellowship at a very well-respected academic center in my current city which would start in July.  I am hopeful that some of you current or past residents/fellows can give me some insight on your training and your practice ability after the fellowship/residency ended.  In my area (Midwest) fellowships and residencies for APPs are just now starting to appear so 99% in my area don't have them.

 

The details are as follows:

 

Mostly internal medicine specialty rotations, some urgent care, some FP rotations (+/- rural FP/ER, depending on the location), didactics, research, examinations, presentations, etc.  It's 12 months in length.  The hospital system has stated that they "plan to place all fellows in positions with the system after completion of training".  I realize this is not a guarantee, but I'm also not bound to take a position with the hospital afterward either, so that clause is fine with me.  

 

I'm still trying to figure out what I want to practice in medicine, which is one reason I chose to become a PA - so I could switch if need be.  I like so many areas of medicine, which is why I think doing a primary care residency would be great option for me. But, I want to see what other residents/graduates think of their experience and how they were received by employers after the fact. 

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I think naming the primary care residency would help. I've not seen any primary care residencies that I would highly recommend. Actually I don't even know if any outside the Carolinas healthcare system.

 

I plan I doing an EM residency. If there were a true FP residency or a true IM residency, that would be great. Most of the ones I know are outpatient or inpatient only

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I am a PA student in my second semester of didactic. We are currently discussing PA legislation and other topics and we began a discussion on PA residencies. We can't find any data to support a question we have focused on, and I am hoping someone can at least give some perspective. (opinion or hard data) Do PA residencies improve patient outcomes for new grad PAs compared to new grad PAs that do not complete a residency. Main point of the question is- regardless of residency completion, aren't all PAs legally still under the supervision of a physician, thus, wouldn't it make sense that the outcomes should be equal if the physician is still supervising adequately? We have researched pros and cons of residency, and one of the most impactful (in my opinion) is that PAs in a residency program may be exposed to more than a PA that jumps right into practice. This would obviously build confidence and experience more rapidly. Hope I can get some feedback, thanks!

 

 

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in most situations beyond one doc working with 1 pa the concept of PA supervision is a joke. docs really have no input into care if they are just rubber stamping charts hours to days to weeks after the pt has been seen. As a PA you owe it to yourself to deliver the best medical care possible and not depend on a doc to armchair your bad decisions, because it likely won't happen. a residency makes for a much safer and competent PA hands down. I can say this having worked with hundreds of new grad PAs over the years and many residency grads. it is night and day. it is the difference between working with a physician his first day out of med school as an intern vs when he starts his 2nd year as a more seasoned resident. we are talking about 5000 or so more patient encounters that the resident has learned from that the new grad has not.

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1 hour ago, EMEDPA said:

in most situations beyond one doc working with 1 pa the concept of PA supervision is a joke. docs really have no input into care if they are just rubber stamping charts hours to days to weeks after the pt has been seen. As a PA you owe it to yourself to deliver the best medical care possible and not depend on a doc to armchair your bad decisions, because it likely won't happen. a residency makes for a much safer and competent PA hands down. I can say this having worked with hundreds of new grad PAs over the years and many residency grads. it is night and day. it is the difference between working with a physician his first day out of med school as an intern vs when he starts his 2nd year as a more seasoned resident. we are talking about 5000 or so more patient encounters that the resident has learned from that the new grad has not.

Awesome input, thank you very much for your experience and insight. 

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