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Current PA Emergency Fellow @ Albany Med; Blog


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Hello All! My Name is Jordan, and I am a current PA Fellow(resident) in the Emergency Department at Albany Medical Center. I decided to create this on-going discussion as I found one of these useful when I was considering applying for residencies/fellowships. From here on out I'll refer to the program as a fellowship because it is annoying to type /residency. In case you didn't know, they are the same thing as far as PA's go, its basically just whatever your institution wants to call it. I'm sure we will spend many hours at the conference some year deciding between the two. I digress

Currently I am about a month and a half into the program and it has been a blast. We (the other fellow and I) pretty much jumped right in to the action of the Albany Med ED right off the bat. We had a short orientation and shadowing experience and were walked through a few patient care scenarios our first few days, as we waited for our first rotation to start...Ultrasound. Ultrasound was two weeks and it was amazing the amount of skill that could be acquired during that short time. I accumulated nearly 200 scans during that period. Ultrasound will be one of the most useful tools for me as I plan to go rural when I finish my year here in Albany. The instructor for the course was Dr. Beth Cadigan, an attending in the ED/ Ultrasound guru. She was great to learn from and patient with each individuals learning curve (us fellows and 1st year ED residents), she stated several times that it took her awhile to acquire US skill, which was probably related to her being the worst kid on the street at video games! We spent 2 weeks in the ED ultrasounding willing participants, several hours in the simulation lab receiving training, and individual time with online US lectures.

We are currently on our Radiology rotation, mostly spending time in a radiology suite looking at chest films. As for rotations, next we will enter Ophthalmology, and subsequently Pediatrics (ED), and then in no particular order, SICU, EMS, Trauma, Toxicology, electives, interspersed between all of these are ED shifts. I believe total AMC ED shift time will be around 7-8 months.

I'll finish today with a comment about the faculty in the AMC ED. They have been AWESOME! The attendings, PAs, and residents have been great to work with and willing to take time to teach.

Any questions, just ask.

Be back soon!
 

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Albany and all the other residencies/fellowships/postgrad programs pay a stipend between 40-60k.(see link at top of em forum to all 19, regularly updated by yours truly)http://www.physicianassistantforum.com/forums/showthread.php/2159-Emergency-Medicine-Links-Residencies

the hurley ten week trauma exposure is the only program I know of which charges a fee to attend.

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  • 2 weeks later...
  • 1 month later...

Hey Y'all, time for another update. My last post finished with us (the other pa fellow and I) finishing up our radiology rotation and transitioning into our ophthalmology rotation. The optho rotation consisted of one week of clinic and one week of on-call ED shifts, it was nice to focus on one body system for 2 weeks and get a good grasp on the use of the slit lamp. I've also been training with our ultrasound machine in the ED, scanning eyes for retinal detachments and/or signs of increased intracranial pressure. I try to do this on anyone I see with vision changes.

 

I've also completed 2 wks of specified pediatric ED training. We will dedicate 2 more weeks in the summer, to get both seasons. The 2 weeks consisted of a host of viral illnesses, which manifested with plenty of youngsters in respiratory distress, febrile seizures, and reassurance of parents. Also of course the flu has come early and heavy in the East this year. Albany Med had to make a public service announcement requesting that people with flu-like symptoms stay home rather than seek care in our ED. I was anxious for my 2 weeks in the "peds zone", but I found that I enjoyed it more than I thought I would. Our next rotation coming up is AIRWAY!, were I'll get to spend some time with anesthesia and hopefully get around 30 advanced airways.

 

Overall, my time at the hospital is going great. Now that I'm starting to accumulate general emergency knowledge and also the hospital's systems, I find that I am enjoying myself more and becoming more efficient. We'll be starting interviews for the next class soon. If you haven't applied yet, you should. I look forward to seeing those of you who will be interviewing with us. The website! http://www.amc.edu/Academic/GME/programs/ed_pa_fellowship/index.cfm

 

Any Q's?, just ask!

Jordan

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To mjohn7wy and jd4mvp, I've enjoyed reading your posts about your residency experience and am comforted to know that you think it is beneficial to you. I'm a 2nd yr PA student doing my clinicals and I finally made the decision to do an ER residency b/c I wasn't sure whether it would be something worth doing but your posts say it all. I am interested in either Albany's or NY Presby's program.

In terms of the application, was there anything in particular that these residency programs are looking for?

In terms of future job prospects, will you try and work at Albany Med or look for work somewhere else? Does the residency program help you obtain employment there or elsewhere?

 

Part of the reason I want to do a residency is because most jobs want experience so I figure doing a residency couldn't hurt.

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  • 2 weeks later...

Hey Mercedes, great questions. Personally I do not plan to stay at AMC, I came from Montana and have planned from the start to return there when I'm done and work rurally. The program can tailor your needs to your future plans. For instance I plan to do an elective rotation in wilderness medicine, etc.

In regards to employment, the word is that we'll be sitting pretty. Our previous fellows have had excellent results (interviews at Hopkins and Cleveland clinic, offered positions w/o interviews elsewhere , teaching ultrasound). In regards to enumeration, informal reporting looks like we'll start on the scale equivalent to 3-5 yrs experience. The program educates on job placement. If anything were to be a must for an applicant, I would say a definite commitment to Emergency Medicine.

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  • 2 weeks later...

Hi guys, thank you both for taking time to do this. It is so valuable to get a glimpse at what I might be in for in a year or so. I know it's hard to quantify, but how competitive did you feel it was to get into a residency program? Did you have to just cast a wide net and hope that one of them works out?

 

Also, what kind of hours are you working? I am sure it dominates your time, but do you have much of a personal life during the program? Again, thank you both!

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Hello Akdem. I found the process to be much less competitive than I would have thought; with info from my director. I casted a small net, but perhaps was lucky. Think about what will make your application stand out. Most PA schools require keeping above a 3.0 gpa, and most students will keep well above that to reduce anxiety. Therefore your personal statement, noting why you want to do a fellowship, and your references are weighed more heavily than grades.

 

We are definitely more busy than if we were working a regular pa job, attending conferences and such. I've heard that other fellowships are even more time consuming. I've had plenty of time for personal activities; plenty of skiing this year. At AMC we will end up accumulating 20 days of paid time off. So far everyone has chosen not to take much vacation time during the year and get paid for a month after the fellowship is finished.

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Hi Jordan and Matt. Is there any chance I can contact you via email? I'm a second year PA student (graduating in December) and will be applying to AMC, Johns Hopkins and NY Presbyterian. I'm the first one to do so in my school and was looking for a little guidance! I have a few specific questions. Please let me know if this is possible! Thank you!!!

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  • 2 weeks later...

Hey yall. So I'm in the middle of my airway rotation where I hope to get as many "tubes" as i can in the OR. Its been a great week, I placed 9 tubes today! It's also been nice to focus on the various pre-treatment, induction, and paralyzing agents that I may use in the ED someday. BAGGING!, am I right? It is so important and an often overlooked aspect of proper ventilation and airway management.

 

In other news, I find myself having nearly daily discussions with staff from different areas of the hospital about becoming a PA and/or the fellowship. I encourage any of you out there who are applying for PA school or fellowships to stay strong in your conviction. You never know what school (or single person making a decision) will like how you look on paper. MANY students do not get in to school on their first attempt, as you probably know. If you beleive in what you are doing, then don't let anything or anyone stop you along the way. You will find that some (even family or "friends") will try to bring you down or discourage, this stems from jealousy. KNOW THIS and MOVE ON.

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Hey all,

 

Jordan and I are in vegas for SEMPA continuing to have an amazing experience. We both just finished our airway rotations in anesthesia. Great oppourtunitys, I was able to get 12 ET and 2 were video assisted in a week. Jordan was actually able to get something like 25 tubes. The attendings over in anesthesia were amazing, most were great educators and very patient with our learning experience. We start cardiology in april which I am very excited about, 2 weeks in the CCU should be a great chance to learn more cardiology and our first foray into critical care.

 

This continues to be a great decision from my point of view. While we do work alot, its absolutely worth while. We continue to get amazing oppourtunitys to further our education and feel more comfortable with a diverse patient load. I absolutely reccomened this for new PA's looking at going into ED and dont want to be stuck in fast tract for your first years

 

Hope that helps, and if anyone is at SEMPA PM jordan or I to meet up if you have questions. We will both be at the residency/fellowship roundtable tomorrow.

 

Matt

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  • 3 weeks later...

UPDATES>

 

Howdy! Time for some updates from the program. Matt has just completed and I am just starting my two weeks in the CCU. As you can imagine a definite change of pace from the ED to the hospital management of sick cardiac patients. I'll have more to say later about this subject as I am early in. On other news the program just interviewed 4 qualified applicants today (hello if you are reading this). It was fun to meet them and discuss where I was at and where I've come to this point. An applicant asked me what my favorite aspect of the program was????? I answered, becoming more confident and efficient in my management of ED patients (or some gumbled version of that). Something I haven't thought about yet, but is ultimately true. Speaking with them brought me back to where I was a year ago, I'm still fascinated with how much you can learn in a year. Its a nice reminder that I can do just about anything if I work hard at it.

 

CADAVER LAB! Wowza, do we have an awesome scientific gift program. Last week Matt and I were fortunate to be involved in some cadaver simulation. Apparently there is this new methanol embalming technique that is the "beez knees." This specimen was soft and pliable, fluid actually came back in my chest tubes (I clamped just in time to avoid nastiness). So basically we got a variety of airways including surgical, chest tubes, lateral canthotomies, and thoracotamies. Apparently this new methanol process makes the cadavers much easier to schedule for use as it takes around a month or something to complete. This with the pliability of the specimen = REVOLUTIONARY. I didn't realize, but apparently AMC has one of the largest scientific charitable gift donation programs in the country!

 

-Jordan

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  • 1 month later...

Hello Everyone. As I left you I was entering the CCU for some sweet intensive cardiac education. It went well and I did learn a ton about the different methods for cardiac monitoring and support, LVADs and whatnot. It was nice to get the exposure. After another stent back in the ED, I have entered the wonderful world of Surgical Intensive Care. The early mornings are fine with me as long as I can get my hands on as many central/A lines, intubations, and chest tubes as possible. I'll be here for a month and exposure to some more hospital medicine is definitely aiding me in becoming more well rounded.

About 3 1/2 months left of the fellowship and I am seeing the light at the end. Matt and I are knee deep in decisions to make about where we will be working in the fall; weighing options is a good thing. All-in-all my life right now seems like a almond-joy/mounds commercial "sometimes you feel like a nut..." More accurately clinical accumen is growing, however we all have those days that humble us. Keep calm and carry on.

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