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Transplant Surgery Residency?

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Disclaimer: I just got accepted to PA school and am curious about whether or not my future will include a residency program.

I was browsing through a list of available residency options and saw that there was an option to do a Transplant Surgery residency at Mayo in Arizona. I honestly didn't think PAs worked in transplant surgery so I'm interested in this! Can anyone speak more about this experience?

On another side note, what's your general opinion of PA residencies? Worth the extra loans?

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I don't work in transplant per se, but I take care of transplant (liver, mostly) in the ICU. I'm familiar with our transplant service (we do liver, kidney, sometimes pancreas - but not heart or lung). Transplant has a few NP's on service, no PA's. I believe they see patients in clinic, and also in the hospital post-op. They don't go to the OR at all.

Liver transplant patients are some of the sickest patients in the hospital. Also post-op they are at risk of complications because of the immunosuppression (plus how sick/debilitated they were pre-transplant). So they can be challenging to take care of. Also it's a surgical service, so that means dealing with (transplant) surgeons.

As for whether a residency is worthwhile, it's often very valuable experience, that you might not be able to get otherwise. It's certainly possible to get a job/have a career without a residency. But if you are really motivated to learn as much as you possibly can as a PA, a residency is a good option. They generally pay at least a living wage, (and loan payments are deferred I believe), so there aren't any 'extra loans' to worry about.

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I previously worked in abdominal organ transplant, both outpatient then inpatient post-op care. I will echo what was said above about the liver transplant patients. Most are quite sick going into surgery and very delicate for a while after surgery. That said, these were my favorite patient’s to work with. The good outcomes are truly amazing and even when things don’t go well, it’s their only shot at life. Kidneys are a bit more predictable, but you still have some surprises.

Transplant incorporates a lot of different fields including GI, nephro, ID, critical care, immunology which I though was cool. 

I left because I didn’t see much career progression after the first several years. I definitely got more respect than the residents, but still had very little autonomous decision making. I also never received the procedural training that I was hoping for. The second aspect would likely be solved by doing a residency. 

If you have any specific questions about working in transplant, let me know. 

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As for procedures, we do them in critical care (central lines, arterial lines, ultrasound peripherals, occasional LP; intubations/chest tubes/pigtails/PICCs are done by other services). For transplant patient however, the surgeon prefers that the ICU APP's/residents not do these - attending only.

Point being, on a transplant service although you are taking care of very sick patients, there is a lot invested in each patient, with a large team, so your autonomy will probably be a bit limited. Even if you had done a residency, I don't think you would get a lot of procedures, on a transplant service.

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You're putting the card ahead of the horse a bit, but what I will say is not knowing anything about this particular transplant residency and what it offers, you would probably be best served by a more generalized surgical/critical care residency where you will learn valuable procedural and operative skills and a good, broad physiology base. I doubt you'd have any problem getting a job in transplant surgery after a surgical residency if that's what you end up wanting to do, but you may pigeon hole yourself a little bit if you focus just on transplant in residency.

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