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I am currently working on finishing out my second to last didactic semester and starting to plan for clinical rotations.  I worked as a ED tech prior to PA school and loved it.  I also worked a telemetry/cardiac floor tech and between that and lots of shadowing was most interested in EM.  I would consider primary care and hospital medicine as well.  
 

Is an emergency medicine residency a must in order to work ED? Can anyone give pros and cons? I am interested in a residency, but also would consider primary care or hospitalist medicine and maybe transitioning to ER eventually if I could not get an ER job right away without residency.  Is that unreasonable to think of transitioning? 
 

As far as rotations are there any rotations to try to get to either prepare for a EM residency or to apply for ED jobs without residency? We have 3 electives, plan to do extra EM electives.  Is that the best way to use all 3 extra electives? Or add Trauma surgery, urgent care, critical care/ICU? 

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If you can do an EM residency, i.e. can afford the 12-18 months of lower income and can get accepted, by all means do a residency.  You'll be head and shoulders above new grads, and even above some experienced EM PA's in what you can do.  A very important caveat: only do legitimate EM residencies, not the "residencies" advertised by employers.  Look for ones which include off-service rotations and other didactics.  There's lots of good discussions on this forum.

The same reasoning applies to picking your elective rotations: trauma surgery and ICU rotations will be very helpful.  Urgent care not so much.  If you have time and funds, take ATLS and ultrasound training.  You can do a 2nd EM rotation, but don't make that your exclusive elective choice.  The others will get you skills that are very EM applicable that are hard to get in the ED itself.

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5 minutes ago, ohiovolffemtp said:

Or, you will be able to work your way up to seeing higher acuity, but it will take several years, likely 3-5, of dedicated work on your part.

3-5 would be fast. Took me 16 to go from fast track to solo coverage. Could have done it a bit faster, but had really great pay, retirement, and benefits at my job before going solo, so probably stayed there a bit longer than I needed to, despite it being a move the meat trauma ctr kind of place

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