Physician Assistant Post-Graduate Residency in Geriatric Medicine @ Michael E. DeBakey VA Medical Center - Houston, Texas

[BLM8867]

Hey Y'all,

I'm currently a  PA-S2 doing my clinicals in the Lubbock/Plainview, TX area. I am a veteran and would really like to work at the VA for some time after graduation. Growing up, my family ran multiple assisted living facilities and skilled nursing facilities so I was around the geriatric population frequently, I genuinely do enjoy working with the elderly (especially Veterans [so many awesome stories])   which makes me really interested in this Residency.

I wanted to see if anyone has attended this residency and has any information on what its like to go through this training. Any info helps!

Program Website: https://www.houston.va.gov/Education/Physician_Assistant_Residency_Geriatric_Medicine/Physician_Assistant_Residency_Geriatric_Medicine.asp

Program Brochure: https://www.houston.va.gov/Education/Physician_Assistant_Residency_Geriatric_Medicine/PAResidencyInGeriatricsBrochure2019.pdf

[virtuous woman]

I am considering this residency as well. I would also like more information regarding what the day-to-day in this residency looks like and what the job prospects are after completion.

[sammylittle12`]

Hey guys, 

I currently work at the Houston VA. I don't have much info on the residency but Mike Anderson, the point-of-contact listed on the application is very friendly and I'm sure would be happy to answers more of your questions. 

[BLM8867]

This is an old topic, but just in case if anyone wanted to learn more about the Geriatric Residency here at MEDVAMC, I was accepted and I am currently in the 5th month of residency. Feel free to ask questions if you are interested!

[virtuous woman]

What was the interview and selection process like? 

Tell us about a typical day in the residency.

What is the likelihood that you could get hired on at the VA following the residency?

Do you know about any of the PAs that completed the program before you? What specialties did they find work in immediately after the program?

What are your favorite and least favorite parts of the residency?

What are some things you wish you'd known about the program before you started?

[BLM8867]

On 5/21/2022 at 10:50 AM, virtuous woman said:

What was the interview and selection process like? 

Tell us about a typical day in the residency.

What is the likelihood that you could get hired on at the VA following the residency?

Do you know about any of the PAs that completed the program before you? What specialties did they find work in immediately after the program?

What are your favorite and least favorite parts of the residency?

What are some things you wish you'd known about the program before you started?

1. I interviewed during heavier covid restrictions, so interviews were via zoom. During my interview I was interviewed by the program director, medical director, one other staff physician, and by two PAs that had previously graduated from the residency. Each interview was one-on-one, so I had a total of 5 interviews . Each interviewer gave each candidate a score. Each score was added up and the top candidates with the highest scores got in. Pretty simple.  Since this is the VA, being a Veteran gets you extra points but by no means will they not consider you if you’re not a veteran. My cohort totals 5 and only 2 of us are Veterans. 

2. During the residency you will have a different rotation every month So every month you will have a slightly different experience. You will have exposure to both inpatient, outpatient, and home based settings. There will be one designated day during the week for the entire year that will be your “continuity day”. Your continuity days are your primary care days dedicated to the geriatric primary care clinic. But generally speaking  you’re going to see a patient alone, present the patient to your attending, Tell your attending what you want to do and why,  You will then see the patient with your attending  And depending on what  The attending sees and hears s/he will either bless off on your plan or critique it. You will also be the one to put in all the orders or prescriptions and to follow up on any consults or labs. In terms of schedule, it is a Monday through Friday 8 AM to 4:30 PM day. All federal recognize holidays you have off.  I usually choose to get into work around 7 AM, I chart review my patients for the day, start work at 8 AM, lunch from 12:30 to 1 PM, off by 430pm. Your patient load is not going to be large because you are a learner. Expect feedback with every patient encounter. Houston VA is a very large teaching hospital. Every Thursday you will have morning didactics. During this time you will be doing ground rounds, Journal club, M&M, or Geri  fellow Borderview questions. All PA residents will be expected to present a grand round to Geri fellow, residents, PA residents, and staff providers at some point during the residency. Also BCM PA students will be rotating through the geriatric clinic for their geriatric rotation so they’ll sometimes be following you around learning from you. This also allows you to reinforce and teach new knowledge that you had heard and done already. 

3.Relative to an applicant that has never worked at the VA but has equal experience, you have a higher likelihood of getting a job at the VA after completing this residency.
The VA and the program faculty encourage PA residents to seek employment at any of the VAs throughout the country.  The VA likes to promote and hire from within. Every week I get emails from a national PA email chain that Promotes new job openings for PAs. The program director will also go above and beyond to help you find employment at the VA if you choose to stay in the VA. 
 

4. I was lucky enough to do an elective rotation in the geriatric clinic at the Houston VA during PA school.  This Provided me the opportunity to meet the PA Resident ‘s before my  Cohort. There were three residents at the time. two of them stayed at the Houston VA And one ended up Getting a really good job offer at a private practice. The two That stayed were offered positions in home based primary care and inpatient spinal cord injury. There was a couple days overlap with the previous cohort finishing and my cohort starting so we got to pick their minds and they were very helpful. 

5.

-Favorite Parts: all attending are a plethora of knowledge and are so patient with learners. I also appreciate The vast amount of resources the VA has. At the Houston VA, we literally have every specialty and sub specialty in the same building. If there’s something that we can not handle, there’s someone in the building that can handle it. My attending said it best, here at the VA you have a nice “Bat Belt” of services to use to provide care to Veterans. I love working with the vast majority of the patients. So many cool stories. I’m a veteran myself and minored in military history during undergrad, so talking to all the veterans ( the population I see mostly served in World War II, Korea, Vietnam) is a huge plus for me. 

-Least Favorite Parts: I mentioned above “I love working with the vast majority of the patients” but there are a few that I dread. Now this is nothing new to medicine, but at the VA you cannot “fire“ patients. This develops a level of “entitlement” that some veterans will display when in clinic…..they’re not fun. Also veterans can complain to their congressman about you. Never happened to me but I’ve met providers that have had it happen to them. 
 

6. I really don’t have anything In particular I wish I’d known before starting. The program director is very transparent and will help you the entire way. 

[virtuous woman]

Thank you for your detailed response! Are there any geriatric PA residencies at any other VAs, or is this the only one of its kind?

Edited May 26, 2022 by virtuous woman

[BLM8867]

29 minutes ago, virtuous woman said:

Thank you for your detailed response! Are there any geriatric PA residencies at any other VAs, or is this the only one of its kind?

This is currently the only one in the VHA.