Thoughts on the first job in EM

[EMEDPA]

I had several discussions over the last few days with folks at sempa in las vegas about what constitutes the "best" first job in EM.

some folks are in favor of working at an academic medical center, others a rural site, and still others a community facility.

having thought about this a lot for a while I think the answer is any of these as long as there are good teaching opportunities. this seems to be more location dependent than anything else. on the west coast working in a major medical ctr as a new grad at most places means fast track with minimal input from docs and senior PAs, not a great situation. on the east coast it seems like there is more teaching at the academic ctrs.

west coast rural and community jobs tend to offer more one on one interaction.

I think the BEST option for any new grad is an em residency as this is structured learning. if you can't swing that look at the first job not in terms of hrs or money but in terms of learning potential. be willing to make a bit less and work some long shifts for a few years if you can maximize learning at one place as opposed to another that pays well with a great schedule but has little option for interaction with peers.

other thoughts?

[treejay]

I've been thinking about this as well given that I will graduate PA school this upcoming December and hope to go into EM. I feel I will be quite "green" and I want my first position, weather it be in an ED, fast-track, urgent care, or what not, to have strong avenues for good professional development, with mentor clinicians who are able, willing, and invested in helping me with that. And I have already made that a priority in selecting a job, not the highest salary. I am relatively less flexible on location. I suspect it might be tricky to find and suss out. I'll be looking for this type of work in Puget Sound region (open to recommendations from those in the region). When I am job searching and interviewing, what are good ways I will be able to evaluate weather a potential job might provide me with strong mentorship to help develop me professionally?

[EMEDPA]

check out north sound emergency physicians. I have heard that is a good group to work with. also team health/nw emergency physicians at st. joseph's and st. francis in seattle.

[Guest Paula]

Upper Mi and WI em/uc jobs I had were not the best to have physician mentors, and most of the cah's I worked at had one doc, one PA or Np on, so teaching time was not plentiful. If a new grad is looking for a CAH I would recommend an EM residency first before going to a rural area. One reason I decided to get out of EM completely is I wanted more in-depth training so I was competent in handling higher level cases, but the small CAH's I was at just were not equipped to train, physicians didn't want the responsibility, and administration resistant to actually setting any additional training up. Do an EM residency if at all possible.