They are basically just paid internships, not true residencies. They give you a structured year of training with some didactics thrown in to make you more competent at a given job, but aren't true residencies that make one capable of autonomous practice, and certainly don't confer board certification (most grant a certificate of completion).
I was about to reply to say that, if you are disheartened by having a thought or idea undermined that you should maybe get thicker skin, or reconsider Emergency Medicine as a PA or Med student. But, I looked thru your post history and it seems like you've gone thru a lot and developed a thick skin to survive to get to this point, so instead I'll just encourage you to leverage the difficult times you've had to cope with feeling disheartened about this or other situations.
Also, just want to point out that there IS a climate of furthering education - you should be learning every day as a PA or otherwise, and especially as a physician lifelong learning is key. I would also encourage any of my PA friends to go to medical school if they want to practice as a physician as that is the path that is available.
I've enjoyed the journey, but I'm looking forward to the good part!
the postgrad programs vary as well. The better ones are the same as the pgy-1 yr of an affiliated em residency. there are 30 postgrad programs/fellowships/residencies for PAs. the vast majority are quite good. most are now 12-18 months.
very few jobs now will train PAs to do full scope emergency medicine outside of a residency. most of the serious EMPAs I know either were former medics who got great jobs or residency grads. most em pa jobs, unfortunately, are fast track only or fast track + low acuity workups.
And be sure to capitalize the word "Doctor."
What do you imagine the role of PA's in the emergency department to be? Genuinely curious. I had always thought that this is exactly the role of advanced practice providers in the ED.
Depends on the individual PA, their training and experience, and the needs of their community. while most EM PAs do low acuity work(and there is certainly a place for that), PAs with a desire to see sicker patients who get additional training beyond what is available in PA school can find places that will utilize their skills. typically these are very rural or undesirable areas that can not attract/afford/retain an EM boarded physician. A good em pa is a better fit for a rural ED than your avg FP physician. After 30 years working in emergency medicine, I now work exclusively single coverage, rural, critical access hospitals seeing every patient and performing every procedure. high acuity and low volume is a lot more fun than high volume and low acuity.
idk if it needs to be super rural. I know of some areas in the mid-west that let PAs do advanced procedures they learned in residency.
typical communities that have PAs running EDs are population <25,000, often less than 10,000. the place I am working today sees about 5000 pts/year. in a typical 24 hr shift I see 8-18 pts with the full range of acuity. have intubated 20 times in the last year, multiple codes, cardioversions, traumas, reductions, etc.
the PA postgrad programs are more than just a certification course. most are equivalent to the PGY-1 yr in the same specialty. 80-100 hrs/week, 1st call, off service rotations, crappy pay, journal clubs, QA projects, etc, etc. Also keep in mind these programs are started, run, and overseen by PHYSICIAN specialists. that being said, most programs are now called "PA Fellowships". At least in EM, these programs meet a standard developed by ACEP in conjunction with SEMPA(Soc of EM PAs). the trend is for programs to meet all eligibility requirements for the EM CAQ (see post # 27 above).
actually, those of us in the PA world with doctorates(such as myself) go out of our way to NOT use the term at work as it might cause confusion.
