laurac Posted March 6, 2013 It looks like I may have to reapply to PA school this year and I'd like to apply to some different schools. I applied mostly based on geography last year and I realize that I applied to some schools that were not a good fit. I don't want to do primary care. I'm most interested in Emergency Medicine and Hospitalist Medicine. I also don't want to practice in a rural area. I'd be perfectly happy continuing to work with the urban uninsured, sometimes homeless, sometimes IV drug using with comorbid psychiatric issues population that I work with now. Can someone recommend schools that have less of a primary care (especially rural primary care) focus? I live on the east coast now so I'd like to stay east of the Mississippi if possible.
Friction Posted March 6, 2013 I think your best bet would be to do a general PA program and then do a fellowship after that. I don't think there are too many programs that specialize at the initial level.
cinntsp Posted March 6, 2013 There are a couple programs that focus on surgery and another on peds that I know of but ultimately all schools teach PAs to become primary care providers. You will still be exposed to all of the usual areas of medicine(FP/IM/EM/Surg/OBGYN/etc) regardless of what program you go to.
laurac Posted March 6, 2013 Author The cold might kill me if I move back to the Chicago area, but Rosalind Franklin does look interesting. Thank you huntstyle. Friction, it's not so much that I expect to specialize right out of the gate, more that I'm trying to avoid applying to schools that have turning out primary care PAs as their mission. I guess I answered my own question - look at the school's mission statement.
Friction Posted March 6, 2013 The cold might kill me if I move back to the Chicago area, but Rosalind Franklin does look interesting. Thank you huntstyle. Friction, it's not so much that I expect to specialize right out of the gate, more that I'm trying to avoid applying to schools that have turning out primary care PAs as their mission. I guess I answered my own question - look at the school's mission statement. I want to practice EM as well so I know what you mean, but unfortunately 95% of programs are primary care focused. On the bright side, they have a EM residency in the LA area you could apply for :)
Moderator EMEDPA Posted March 6, 2013 Moderator look for programs with more electives or selectives(you have to do surg but trauma surg is ok, etc). my program was a standard primary care focus but with electives and selectives I ended up with 27 of 54 weeks of clinicals in em, peds em, and trauma.
Moderator EMEDPA Posted March 6, 2013 Moderator homepages...also ask about electives and wiggle room within required rotations( can you do trauma surg for surg? can you do peds em for peds?)
Hemegroup Posted March 6, 2013 I'd be perfectly happy continuing to work with the urban uninsured, sometimes homeless, sometimes IV drug using with comorbid psychiatric issues population that I work with now. I work in primary care and what you've described sounds exactly like many of my patients. It sounds like you might benefit from trying to shadow a primary care provider for a day to get a better idea of their work ... I assure you, we see it all. As for working with the homeless, that is something that you can try and incorporate into your projects and studies while you're learning but is ultimately going to have to wait until you're licensed, certified and ready for employment. When that time comes then you can try and focus on urban areas where your skills and goals can best be developed, working with a certain type of population. Primary care can also be referred to as general medicine ... including psychiatric and substance abuse issues.
Moderator EMEDPA Posted March 6, 2013 Moderator you can volunteer at a free clinic now both to familiarize yourself with that population as well as to build valuable experience.
Hemegroup Posted March 7, 2013 Remember too that primary care also includes Emergency Medicine as well as Pediatrics. Don't think because a program is 'focused towards primary care' that you'll be learning any differently than another unless it's for example a surgically focused program such as Cornell. And like emed pointed out, many if not most programs will allow you to tailor your learning experience by choosing a rotation or two ... my program offered primary care electives in either Family Medicine, Emergency Medicine or Pediatrics. You'll see plenty of uninsured, homeless, IV abuse and psych issues in the ER, I assure you. No, I PROMISE you lol
Joelseff Posted March 7, 2013 I work in primary care and what you've described sounds exactly like many of my patients. It sounds like you might benefit from trying to shadow a primary care provider for a day to get a better idea of their work ... I assure you, we see it all. As for working with the homeless, that is something that you can try and incorporate into your projects and studies while you're learning but is ultimately going to have to wait until you're licensed, certified and ready for employment. When that time comes then you can try and focus on urban areas where your skills and goals can best be developed, working with a certain type of population. Primary care can also be referred to as general medicine ... including psychiatric and substance abuse issues. Hear hear! I see this population too. Everyone sells Primary Care short but coming from 2 specialty practices prior to this, I see a whole lot more now. I have to really keep abreast of novel therapies and guidelines and no two days are the same. I think what most ppl think is that we in PC are just seeing colds, coughs, easy htn, Dm etc. And hit the easy button and refer past that....my community does not have a lot of specialists who take Medicaid so I rarely refer but when I do, its after exhausting all I can do. Oh I attended a "Primary Care" program. It was there in the name. But only like 9 of us went into PC. Most are in EM, ortho, surgery, heck we have one go to Rad/Onc and one is in a medspa! Sent from my myTouch_4G_Slide using Tapatalk
laurac Posted March 7, 2013 Author I didn't start this thread because I'm down on primary care. I started it because I had a negative experience interviewing at a school with a primary care (especially rural primary care) inclination. I got some very negative feedback about where I work (large urban hospital) and the patient population I work with (see above). I'd like to avoid a repeat of that. Joelseff, I have been shadowing a PA who has a practice very similar to yours. It has been an amazing learning experience. I never expected him to have HIV+ patients he'd been seeing for 20 some years. There is a lot of variety in primary care/general medicine and there is no such thing as "easy" dm or htn. I just prefer hospital medicine whether inpatient IM or emergency medicine. I like the pace. I'm just going to crawl back under my rock now and obsessively search the PAEA database.
briepm Posted March 7, 2013 Hey Laurac - just wanted to chime in because I have absolutely no interest in primary or outpatient care either. One thing to consider, though, is the passing the boards. As I understand, they are largely based on primary care, musculoskeletal, and cardiology (I know there are several threads that discuss exactly what's on the PANCE). My point is - even if you aren't excited about it, that's what you'll have to learn at any rate to pass your boards. I wonder if it's not your experience, but the way you presented it that was the problem? I worked at an urban HIV clinic before getting into school - my primary-care centered school loved that! So, yes - look at the mission statement before you get apply and before you interview. But regardless of where you get interviewed, think about how what you've already done fits that mission and is inline with their values. After you graduate you can do whatever you want - the important things are 1). getting in and 2). passing the PANCE. Focus on doing what you need to do to make those things happen, working with what you already have.
CornellSPA Posted March 7, 2013 Laurac....I was in the same position as an applicant, I knew I wanted to due surgery. I went to Cornell which has a surgical focus, but enough primary care for the boards!! There is also a one year ER residency after which is available....cool!
Joelseff Posted March 7, 2013 I didn't start this thread because I'm down on primary care. I started it because I had a negative experience interviewing at a school with a primary care (especially rural primary care) inclination. I got some very negative feedback about where I work (large urban hospital) and the patient population I work with (see above). I'd like to avoid a repeat of that. Joelseff, I have been shadowing a PA who has a practice very similar to yours. It has been an amazing learning experience. I never expected him to have HIV+ patients he'd been seeing for 20 some years. There is a lot of variety in primary care/general medicine and there is no such thing as "easy" dm or htn. I just prefer hospital medicine whether inpatient IM or emergency medicine. I like the pace. I'm just going to crawl back under my rock now and obsessively search the PAEA database. Oh no worries no need to crawl under the rock...lol. I was just commenting on the lack of practitioners wanting to work in PC because of the perception that its easy and not exciting (my own personal pet peeve) and I truly understand the want to specialize. To each their own but PC us an awesome field that often gets downplayed as routine or simple. That's all....I wish u the best. Sent from my myTouch_4G_Slide using Tapatalk
Hemegroup Posted March 7, 2013 There is a lot of variety in primary care/general medicine and there is no such thing as "easy" dm or htn. I just prefer hospital medicine whether inpatient IM or emergency medicine. I like the pace. I'm just going to crawl back under my rock now and obsessively search the PAEA database. Again, my program considered Emergency Medicine as an option on our Primary Care preceptorships (I went to Drexel-Hahnemann). You're on the right track going through all the programs and writing your list to include ones which would be your best fits. Remember too, even if a program doesn't have preceptorship options in hospitals, you'll still be rotating through hospitals as well as the ER. You're not going to school to work, you're going to learn. It's a temporary time. Your time to flourish in your chosen specialty will come after, although as emed pointed out you can hopefully have the option to tailor your education while you're in school. All PA programs have certain criteria they must meet, as far as education ... for instance, every PA program is mandated to give you experience in nursing homes.
shannon_28 Posted March 8, 2013 Is there a list of programs that offer a residency program after completion of PA school? I haven't heard of this before.
Moderator EMEDPA Posted March 8, 2013 Moderator http://www.appap.org separate deal. not connected to schools for the most part.
shannon_28 Posted March 8, 2013 www.appap.orgseparate deal. not connected to schools for the most part. Thanks EMEDPA
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