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Current PA Emergency Fellow @ Albany Med; Blog


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  • 3 weeks later...
  • 4 weeks later...

Hey guys,

 

start day is officially October first but they were flexible with me and allowed me to start the 15th. Just to echo Jordan, we are starting to see the light and I'm getting excited for my future opportunities. Jordan and I are just starting our trauma month and I was lucky enough to be involved in a throacotomy on the fourth, very interesting to see the procedure we have worked through in cadaver lab on a real person. It should be a great month as we act as the second resident for all trauma in the department.

 

sicu was a blast for me, I have always been very interested in critical care. We have a few attending who are dual certified intensivist and Ed docs who were the most helpful and really involved us in the icu team. However, overall the entire staff up there was helpful, I saw some amazing and sad cases, learned a ton about the importance of the initial ressucitation of these critical patients. I was able to get a ton of procedures(10 or so central lines, similar amount of a-lines, a few chest tubes, and intubations), learned a lot about vent management, renal replacement, and why you don't ride motorcycles(wowza). I am going to go back and complete my elective in critical care as well.

 

i continue to be very pleased with my decision, I have learned so much and been given some amazing opportunities that would not be avalible to a PA one year out of school. We just got our new interns in the Ed and watching them bumble arround really affirms how much I have grown as a provider.

 

Well that's all I've got for now, pm me with questions

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  • 1 month later...

Hey pvdude, yes I was able to defer my loans which are through Great Lakes, it was very easy, I can not comment on other loan agencies. ChiefPA - I plan to practice rurally, it looks like western ND at this point, but we are still hashing out the details. I will be back soon for a longer post, thank you for the great questions folks!

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  • 4 weeks later...

Well well well.  Here we are folks.  One year later and looking back I cant beleive how much I've learned.  Today I am mentoring our new group of fellows as they enter the forray of the AMC ED;  coming full circle I guess.  As I plan to move on to a new adventure, the feelings are bittersweet.  AMC has provided me so much in the way of medical knowledge, confidence, and experience with high acuity patients.  At this point I truly do feel that I am able to treat any patient that presents to the ED appropriately, or at least know when something is "out of my league".  I know there is still an immense amout to learn in Emgergency Medicine, but I feel that I've seen enough of the "normal" to know when something is not.  It really feels good to come to work and feel comfortable; no longer unsure, "green", scared.  People have continued to ask if I think the fellowship is "worth it".  To them I say "are you kidding!"  I really can not find a reason not to do a fellowship in Emergency Medicine (for reasons I have explained extensively previously in this blog).  I hope to keep this blog open for further communication and continued discussion.  If anyone has any questions, continue to feel free to ask.  Thanks for reading and replying.

 

-Jordan

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Congratulations! It has been great to follow your experiences for the last year. I'll be applying to AMC's EM residency when I graduate in June :-)

 

So do you plan on taking the CAQ? Are there many tangible benefits to having that certification (such as having people seek you out for job offers) or is it more of just a resume builder?

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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.

so how long is your airway rotation?

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  • 2 weeks later...

Hey Dolphins et al.

 

Our schedule wasn't bad, we worked 40-60 a week. more in some rotations but the ed was generally 4-5 10 hour days plus dictating and 5 hours of didactic or so a week. Neither of us really moonlighted, we picked up a few shifts when we had the chance to cover urgent cares associated with the hospital. We had a ton of procedures, 20+ et, 20+ central lines, 10 or so chest tubes, 10 or so ops, 400 or so ultrasounds, a few paracentesis, conscious sedations, etc. i had a surgical airway in sim lab and cadaver lab, had the chance to observe an emergent thoracostomy and complete one in cadaver lab.  

 

I think a lot of people hype on the procedures going into these residency/fellowships, and don't get me wrong its awesome and helpful. However, the biggest thing is the learning curve. I learned vastly more in the last year then what i learned during PA school. Academic medicine, journal clubs, lecture series... we are learning the cutting edge emergency medicine not text book stuff that is 5 years old by the time you read it.

 

I can say how happy I am to have completed this residency, it was amazing experience and the directors are continuing to mold it and improve it. I am sure this years class will school Jordan and I when they are done. 

 

I am going to the university of Maryland as of monday and working at shock trauma. I can tell you there is no way i would have even got an interview without this fellowship and am excited to learn some more

 

In response to the CAQ, i will likely take it at some point but not sure exactly when. I don't see it affecting my current position, i think the fellowship is more impressive

 

airway was a week(15+ tubes each), i went back and did a second week with the difficult airway anesthesiologist. 

 

hope that helps

 

matt

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  • 2 weeks later...

I am a PA Resident in Montefiore's Surgical PA Residency program and after reading your blog and posting about your experiences so far, I think that you guys are having a great time!  I agree with the whole idea behind residency/fellowship programs and that graduates of these programs may sacrifice partial salary for one year, but are more likely to start at a higher salary when they are finished due to their experience.  I am very glad I chose to pursue a Surgical residency program and would highly recommend that students that want to practice in ER or Surgery at least consider looking into some of the programs and what they have to offer.  In regards to the negative people that Jordan referred to in a previous post, there are definitely some of them.  Unfortunately sometimes that negativity is purely the result of lack of education.  I had a PA student tell me (and one of my colleagues) that only PA's that can't get a job do a residency.  Not only was he completely inaccurate, but once he was educated regarding what a residency really is and how competitive it can be to get into, his tune changed.  So keep smiling, and do what PA's do, take care of patients and keep educating patients and colleagues.

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  • 2 weeks later...
  • 2 weeks later...

This is a little bit off-topic, but how did you guys like living in Albany? I'm in the process of applying to the AMC residency, and I think my greatest hurdle is going to be convincing my wife to move there. We're young and have no kids, but Upstate New York isn't really a place we ever imagined living. I know it's only for a year, but I'd like to hear your honest opinion about the city and that area.

 

Also, how is life as a full-fledged PA? I hope that you both ended up with jobs that you love. Thanks again for taking the time to do this.

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  • 4 weeks later...

Albany is OK, it's best quality is it's access (Vermont, NYC, Boston, Montreal, international airport, skiing, hiking, climbing, lakes etc.)  You can live wherever you want (country, suburbs, city) with easy access to the hospital.  It is a top-notch fellowship, and its only a year.

 

I took a full-time position here at AMC, but will be looking to head back out West this summer/fall.

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Hey y'all!  Just wanted to update everybody on my work situation.  I landed my dream job working in the ED at a critical access hospital in rural Montana (skiing!).  We have a unique situation here with solo coverage and somewhat limited resources.  We cover all of the shifts with 2 docs and 2 PA's, each working solo, and in the same capacity.  The docs are family medicine trained, but have worked in urgent care/ emergency medicine for over 20 yrs individually.  We have a high incidence of trauma, substance abuse, mental health, diabetes, and obesity related issues, being located next to a large reservation and undeserved population (HPSA score 16).  At nights we are the only provider in house as the hospitalist is typically at home, this means we cover the codes on the floor, which I learned can be very...exciting?!.  My second day on the job I responded to a code blue on the floor where we managed to reverse a VF cardiac arrest with one shock.  Needless to say I would not be qualified, or have the skills necessary (in such short time), to perform this job adequately if not for the Fellowship at AMC.  Everyone here seems to be very impressed with my knowledge base and skill set, and as the only specifically trained ED provider, I feel I bring a strong presence to our ED.  I have already been thrown into the lecture schedule and find myself giving a much needed evidence based prospective to the clinic, ED, and hospital.  I plan to stay awhile :)

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