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Virginia Mason Franciscan Health Critical Care APP Fellowship in Tacoma


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I love the addition of a new program but the contractual obligation to remain for 2 years after completion is a buzzkill for me. That's exactly why I became disinterested in Emory. Just my personal opinion. For the right applicant sounds awesome though. 

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57 minutes ago, dphy83 said:

I love the addition of a new program but the contractual obligation to remain for 2 years after completion is a buzzkill for me. That's exactly why I became disinterested in Emory. Just my personal opinion. For the right applicant sounds awesome though. 

I totally get it. 🙂

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35 minutes ago, rtPA20 said:

With the contractual obligation, what is the salary after completing the fellowship? Is it higher than what a starting Pulm/Cc app would begin at?

It is! Starting salary will be a little over double the stipend. In general we don't hire anyone with less than 3-5 years of ICU experience. Let me know if you have any questions regarding the remainder of the benefits etc!

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@MediMike
 

There is obviously more to being good at CCM than procedures, but what kind of procedure numbers can a fellow expect, and do you have minimums established for graduation?

Is the health system a 501c non-profit for those trying to qualify for PSLF?

I don’t think the 2 year contract is a deal breaker, but is there room for growth at facility since over 3 years most will have planted roots in the area and feel compelled to stay regardless. Teaching responsibilities? Committees? Admin?

I’m sure the level of responsibility depends on the resident, but will they be more intern level, or is there eventually opportunity for more fellow like opportunities such as taking ED triage or transfer calls, or learning more broad over arching management of the ICU?

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1 hour ago, LT_Oneal_PAC said:

@MediMike
 

There is obviously more to being good at CCM than procedures, but what kind of procedure numbers can a fellow expect, and do you have minimums established for graduation?

Is the health system a 501c non-profit for those trying to qualify for PSLF?

I don’t think the 2 year contract is a deal breaker, but is there room for growth at facility since over 3 years most will have planted roots in the area and feel compelled to stay regardless. Teaching responsibilities? Committees? Admin?

I’m sure the level of responsibility depends on the resident, but will they be more intern level, or is there eventually opportunity for more fellow like opportunities such as taking ED triage or transfer calls, or learning more broad over arching management of the ICU?

Great questions man, I can speak to some of this but not all as I am a cog in the machine rather than the driver 🙂

Procedures: I hate to use the phrase "ample" but it's true.  There will be minimum standards, and they are probably established already I simply don't have the information in front of me.  Anecdotally I had three intubations in a single shift the other day, central lines are around enough that I lean on the PICC nurses because I'm a little tired of them. Institutionally our group is a fan of arterial lines.  We have several interventional pulmonologists in our physician group, as such bronchs are widely available as well.  Chest tubes are hit or miss, believe there was talk about arranging time with surgery for greater exposure.  I don't do many as I work near exclusively nights but it seems the day team ends up performing a fair amount.  LP's are almost exclusively performed in the ED or via IR, we will occasionally do them.

We are a 501c3 organization.

Our group is fairly new to the system having only been around for ~5-6 years, in that time we have "infiltrated" multiple committees, participate in active teaching with nursing staff, take turns doing a journal club etc.  Our manager is a PA who was the prior medical director of the entire hospitalist group at one of our satellite hospitals, the medical director of our group is a PA and we have strong support from our physician colleagues in pursuing additional roles.  I'm currently performing some research in anticipation of revamping our code team for instance.

In regards to your final question the culture of our team is currently the attending for the day (or night) takes the initial call and then we manage it from there.  Managing the "bigger picture" of the ICU isn't something that we deal with on a regular basis. Plan will be for a gradual escalation of responsibilities to the point where you will be considered competent to practice autonomously upon completion.  (Not complete independence, merely functioning as a member of out team)

@EMEDPA one of our physicians is a CHEST certified ultrasound instructor who does a lot of teaching, not sure if there is plans for a formal U/S course or certification.  COVID killed our OR time this last year, we are fighting to get back in, the pulmonologists we work with are very skilled at airway management with excellent opportunities to practice.

Also, @rtPA20 I confirmed that starting salary post-fellowship will be $137,500.

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How many years has the fellowship been in place? Do by "new" you mean this will be the first class, or new in the sense where there has only been a few classes? What are some of the other benefits in addition to the stipend? How competitive is the selection process? Finally, what is the schedule/workload for the fellows such as hours? I have mainly been interested in Emergency Medicine fellowships, but this honestly sounds like a really good program. Thank you!

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