Advantage of Flight Program?

[Spartan 2BE DOC]

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Unfortunately, there's no flight program where I'm at. For those with first-hand experience, what makes a great flight program? What should I look for?

Other than personal preference, what are the advantages to matching in a residency with great flight experience? Any real disadvantages? Thanks.

 

[Y2KPSD]

To the wise EM residents and attendings:

What makes a great flight program? What should I look for?

Other than personal preference, what are the advantages to matching in a residency with great flight experience? I can see if you have a fear of flying that it can be a disadvantage for YOU. But are there any true disadvantages? Thanks.

Sitting back quietly, and waiting for the fun to begin.. 🙂

 

[ERMudPhud]

Any real disadvantages? Thanks.

1. Crashes

2. Sitting around waiting forever waiting for an interesting run

3. The smell of aviation fuel

4. Going deaf from the noise

5. Oh yeah... that crashing thing again

Just my bias

If you search the forum for "flight" you'll find all kinds of old threads

 

[EM_Rebuilder]

1. Crashes

2. Sitting around waiting forever waiting for an interesting run

3. The smell of aviation fuel

4. Going deaf from the noise

5. Oh yeah... that crashing thing again

Just my bias

If you search the forum for "flight" you'll find all kinds of old threads

I agree, I do not see how mandatory flight experience adds anything substantial to your 'training'.

I think its simply a ploy for cheap/free labor by some places to attract some poeple that simply get off on the action of it.

If its your thing, then go for it. Life has lots of risk; some people are just more apt to put their lives on the line than others. Not saying thats bad... I certainly hope there are people willing to be flight nurses, fireman, etc etc....just not my thing.

 

[roja]

1. Crashes

2. Sitting around waiting forever waiting for an interesting run

3. The smell of aviation fuel

4. Going deaf from the noise

5. Oh yeah... that crashing thing again

Just my bias

If you search the forum for "flight" you'll find all kinds of old threads

ditto!

 

[SolidGold]

There is no advantage that a program obtains by having residents fly with the flight program. The RRC requires that every program in EM have a significant EMS experience and some programs have extended that on to their own EMS flight service.

Some people want that experience (me) and some people don't, but there is no advantage.

 

[ZigZag]

If you plan to look for a job in the area after the residency than the flight program can be a good way to get to know people at the other hospitals.

Other than that I can't really see much of educational benefit. And those things do fall from the sky.

 

[Spartan 2BE DOC]

There is no advantage that a program obtains by having residents fly with the flight program. The RRC requires that every program in EM have a significant EMS experience and some programs have extended that on to their own EMS flight service.

Some people want that experience (me) and some people don't, but there is no advantage.

So the "advantage" is the experience, having an understanding of EMS flight service. I do see programs selling themselves for their unique flight experience.

Those in a program with mandatory flying, would you say you're expectations were met? How so?

 

[Dr. Will]

So the "advantage" is the experience, having an understanding of EMS flight service. I do see programs selling themselves for their unique flight experience.

Those in a program with mandatory flying, would you say you're expectations were met? How so?

We don't start flying until our R2 year in Cinci (although we're supposed to do buddy flights starting in Nov.). I think our program has it set up in a great way. You always have the opportunity to fly when you work your shift as an R2. While there is a flight nurse, you call the shots and do all the procedures. We have about 40% scene calls, with the rest being transfers. You can argue that you get a whole lot of autonomy while you're on the flight, but you get that in the ED as well. It teaches you to be resourceful...but not hugley so compared to other programs. Ultimately, I think it's a great experience in the sense that you get to do something that you wouldn't otherwise get to do.

As for the safety issue, our program has had an exceptional record, which I hope continues over the next 4 years as I begin to fly.

 

[corpsmanUP]

I see it as a dual edged sword that can have benefits and risks. I think if you are part of a well established flight program that allows you to function as one of the primary members of the flight team, that it can be a good experience. Many of us were paramedics and understand the benefit of being the first person to see a patient and evaluate them on scene. Of course you can get this type of experience on a medic ground unit, but you have to run 20 BS calls to get one really valuable experience.

The program I recently left had a flight program that was basically a nurse run helicopter with 2 RN's and rarely a resident in the "tour guide" chair. It was more for PR, as our director liked the idea of a physician walking into a small ED in a flight suit and shaking the doc's hand, all the while the nurses did the packaging. I don't believe it is worth risking the life of a resident for calls like this.

I have heard that the program I am headed to primarily uses residents on scene flights and not for the all the inter-hospital transports and such. I think that is a fair and reasonable approach to placing residents in harm's way.

 

[BADMD]

Unfortunately, there's no flight program where I'm at. For those with first-hand experience, what makes a great flight program? What should I look for?

Other than personal preference, what are the advantages to matching in a residency with great flight experience? Any real disadvantages? Thanks.

Before you make that your deciding factor, see if you can ride with a crew for a day. I spent one day flying as a medical student and after that, I always asked if flying was optional if the program ran their own helicopters.

 

[FISKUS]

As far as safety - only one EM resident has ever died in an EMS helicopter crash - that was over 25 years ago. Before most of us were born... There have been hundreds of thousands of resident flights since then with no injuries or deaths. The industry has changed alot for the better

I see folks have a lot of opinions on safety, medical utility, educational value of helicopter EMS(HEMS). Everyone has the right to their opinions ( I know how much we value the radiologists view of EM payscale and the surgeons astute observations on EM burnout).

Most of the residents I have spoken to that are involved in HEMS ( Cinti, UofChicago) think it is a great experience

If you want accurate info on EM - speak to EM docs

If you want info on HEMS - talk to a doc involved in the field

 

[emtcsmith]

I'm sure your ride to work or shift in many urban ED's are more dangerous then working a tour on a helicopter. I wouldn't let it be your deciding factor on if you would pick a program but working in the field is something everyone working in the hospital needs to experence.

 

[Spartan 2BE DOC]

Thank you for all who replied. I am better informed now. Good luck to those interviewing!

 

[roja]

Advantages:

Exposure to something you might really like, might want to be involved with.
Its cool... no doubt about it.


Disadvantages:
Potentially dangerous.
Limited educational value if you have no intentions of being a 'flight' doctor.


Point for deciding on residency? be cautious. it should be one of *MANY* points you should take into consideration (unless you know already you are absolutely planning on doing it). Keep in mind, most plkaces have some elective time, you could also do a flight elective, if you end up dying to do it.

 

[AmoryBlaine]

As an applicant applying this year I have decided not to make flight an issue when looking at programs. From my standpoint I agree with everyone who is dubious of the educational value, it seems like more of a "brag to your friends" type of situation.

I guess I also wonder what having an MD on a chopper really adds to patient care. I mean, EMS is EMS for a reason. I don't think anyone is saying that having a doc in the back of a 'bambulance improves patient outcomes.

I remember back interviewing for med school when one place included their chopper as part of the tour. Flight is sexy, bottom line.

 

[FLTDOC1]

Advantages:




Disadvantages:
Potentially dangerous.
Limited educational value if you have no intentions of being a 'flight' doctor.

Dangerous - not at all, as Fiskus pointed out there has only been one resident death a long time ago. I have known several residents who have died in MVAs, one from Glioblastoma, a suicide or two.. look at the stats.


Limited education value? Its obvious you have never spent time on a helicopter or with rural EMS... I think it is one of the most valuable rotations any EM resident can do. The vast majority of resident flight physicians never continue with aeromedical transport once they finish residency. One of the greatest learning situations of being a resident flight doc is getting you out of the isolated and sometimes unrealistic envrionment of an academic ED. You will spend time in the " real life" of very isolated basic EMS- miles and sometimes hours away from even a general surgeon. You will also spend time in small community hospitals - EDs staffed by PAs and nurses, sometimes an FP. These are things you will never see in your standard EM rotations. It will give you a lasting respect and appreciation of medicine outside of the ivory towers of academia that you would otherwise never experience

 

[EM_Rebuilder]

Dangerous - not at all, as Fiskus pointed out there has only been one resident death a long time ago. I have known several residents who have died in MVAs, one from Glioblastoma, a suicide or two.. look at the stats.


Limited education value? Its obvious you have never spent time on a helicopter or with rural EMS... I think it is one of the most valuable rotations any EM resident can do. The vast majority of resident flight physicians never continue with aeromedical transport once they finish residency. One of the greatest learning situations of being a resident flight doc is getting you out of the isolated and sometimes unrealistic envrionment of an academic ED. You will spend time in the " real life" of very isolated basic EMS- miles and sometimes hours away from even a general surgeon. You will also spend time in small community hospitals - EDs staffed by PAs and nurses, sometimes an FP. These are things you will never see in your standard EM rotations. It will give you a lasting respect and appreciation of medicine outside of the ivory towers of academia that you would otherwise never experience

I think we could argue that moonlighting would give much of the same experiences. I hear people mention the pros as autonomy, being a cowboy, seeing some unique and different things in a different setting than in the crib.....I am still too young to partake, but it certainly sounds to me that moonlighting lends these experiences as much or more so....and it pays for the Porsche (which can take care of that sexy part).

 

[FLTDOC1]

I think we could argue that moonlighting would give much of the same experiences. I hear people mention the pros as autonomy, being a cowboy, seeing some unique and different things in a different setting than in the crib.....I am still too young to partake, but it certainly sounds to me that moonlighting lends these experiences as much or more so....and it pays for the Porsche (which can take care of that sexy part).

I bow to your extensive experince and insight...................

 

[southerndoc]

I'm sure your ride to work or shift in many urban ED's are more dangerous then working a tour on a helicopter.

Dangerous - not at all, as Fiskus pointed out there has only been one resident death a long time ago. I have known several residents who have died in MVAs, one from Glioblastoma, a suicide or two.. look at the stats.

I really love helicopters and have been called a helicopter junky by numerous people. However, the statistics show that helicopter EMS has the worst safety record of any industry.

Although only one resident has died, there have been numerous nurses, paramedics, and pilots who have lost their lives in helicopter crashes. There hasn't been more residents killed because only a minority of programs utilize nurses.

Helicopters themselves are not inherently dangerous. Landing in uncontrolled scenes in the middle of the night is dangerous. Anyone who subscribes to the CONCERN network will realize how dangerous helicopter EMS is. Just today there were two announcements.

 

[FISKUS]

Anyone who subscribes to the CONCERN network will realize how dangerous helicopter EMS is. Just today there were two announcements.

I follow the industry very closely.....

And if you have read them - they are about a fixed wing crash ( airplane not helicopter)

 

[Apollyon]

I bow to your extensive experince and insight...................

Sarcasm is fine...being a snob isn't.

 

[southerndoc]

From the FAA Website: http://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=6763

There are approximately 750 emergency medical service helicopters operating today, most of which operate under Part 135 rules. HEMS operators may ferry or reposition helicopters (without passengers/patients) under Part 91.

The number of accidents nearly doubled between the mid-1990s and the HEMS industry's rapid growth period from 2000 to 2004. There were nine accidents in 1998, compared with 15 in 2004. There were a total of 83 accidents from 1998 through mid-2004. The main causes were controlled flight into terrain (CFIT), inadvertent operation into instrument meteorological conditions and pilot spatial disorientation/lack of situational awareness in night operations. Safety improvements are needed.

 

[EM_Rebuilder]

I bow to your extensive experince and insight...................

Hrmm... I threw that out there hoping to have those more experienced to chime in about it... I admitted I am young and have little clue about 'what really goes on out there'. I should be able to still formulate an opinon or hypothesis on what little I have heard and seen; and would expect the elders to say good point or here is why that is totally flawed....

 

[FISKUS]

From the FAA Website: http://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=6763

.

The industry has dramatically improved since this data ( up to 2004) If you look at the recent stats ( 2005-pres) there hasnt been a helicopter medical crew member killed in almost 2 years and close to 1 million patient flights.
The fixed wing side of the industry appears to be having some problems

 

[FLTDOC1]

Sarcasm is fine...being a snob isn't.

You are right, that was an inappropriate remark and I apologize - I had just finished an extended argument with my 20 some year old daughter and was way too much in the "I'm the daddy" mode. Again sorry😳

Back to your question Yes, moonlighting can provide some contact with “real world” medicine and situations but on a very limited basis compared to working as a resident flight doc. In a 2 year stint as a FD you may work with 30-40 different hospitals and EMS agencies, from a true 2 room “emergency room” to other tertiary care centers. It will give you a tremendously wider view than some limited moonlighting at 1 or 2 community hospitals or riding with your city’s ALS rig for a few weeks.

As I stated in one of my previous posts:

I have taken care of tens of thousands ED patients and several thousand prehospital patients. Without a doubt, the most memorable and challenging were on the helicopter.

Experience –air vs ground. The bull**** factor is much lower in the air. Its not absent, but it is lower. The helicopter usually sees a “distilled “ acuity. As far as scene responses, the helicopter is typically called to the more severe accidents. In an ALS ground rig you are hauling a lot of minor fender benders and sprained ankles. You may go days without seeing a truly ill patient.

For interfaculty transfers , the sicker pts tend to be sent by air if available.

Bottom line – the average helicopter transfer tends to have a much higher acuity compared to your average ground transfer. Higher acuity = more procedures and fun stuff. That’s what us EM types live for. Given the same shift time – I see more acute pts in afew days on the helicopter than I saw in 2 months in a ground service.

To make it a worthwhile experience you have to be an actual, dedicated crewmember. Not an observer or ridealong. It is a really great environment to test your wings. For many, it is the first time as a physician that you are taking care of a patient without any backup.


I highly recommend the flight physician experience for all EM residents.

 

[southerndoc]

The industry has dramatically improved since this data ( up to 2004) If you look at the recent stats ( 2005-pres) there hasnt been a helicopter medical crew member killed in almost 2 years and close to 1 million patient flights.
The fixed wing side of the industry appears to be having some problems

What about Mercy in California just last year? 3 members killed. Airlift Northwest in 2005. 3 killed. MedStar in 2006. 3 seriously injured, 1 died (patient, cause of death ruled as the helicopter crash).

 

[FoughtFyr]

The industry has dramatically improved since this data ( up to 2004) If you look at the recent stats ( 2005-pres) there hasnt been a helicopter medical crew member killed in almost 2 years and close to 1 million patient flights.
The fixed wing side of the industry appears to be having some problems

Join the CONCERN network. Not only have there been deaths, but serious incidents, both mechanical and operator error, occur with truly scary frequency. And as a "per-mile-travelled" rate, the EMS helicopter is a dangerous place to play.

- H