Cook County New PA Residencies

[deleted6669]

New EM and Surg. PA residencies at Cook County:
http://ccparesidency.com/index.html

By my count this is the 12th EM PA residency in the country with several more in the works.
(There are probably 25+ Surg. PA residencies out there if you count general + CT+ortho+neuro+urology+derm+ent+ob)

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[AnnoyedByFreud]

Hey emedapa,

I have another question for you. Is it true that some PA residencies will also accept NPs? I thought I remembered reading that here before, but now I can't find it.

 

[badasshairday]

.

 

[deleted6669]

Hey emedapa,

I have another question for you. Is it true that some PA residencies will also accept NPs? I thought I remembered reading that here before, but now I can't find it.

a few do. I can think of 3 off hand in psych and critical care.

 

[prodoc]

Midlevels do not do residencies. What a joke.

 

[Makati2008]

Midlevels do not do residencies. What a joke.

??? You come in here and insult the PA's while making a new account? Also the PAs that I know that the the +1 postgrad training are very very strong in their respective fields. I personally think they are fine due to MLPs getting more autonomy(whether you like it or not).

I have no dog in this fight since i am in med. school but I hate the cannabalistic things in medicine such as this.

 

[deleted6669]

"The importance of the PA's role at Cook County Hospital cannot be understated. Physician assistants are an integral part of the patient care team, taking an active role in the assessment, management and daily care of patients. The PA residents will provide 24-hour coverage including night and weekend on-call, coverage of the hospital floors, the operating room and the ICU."

hmm, all that, 80 hrs/week and $43k/yr...sounds like a residency.....

and from the Montefiore PA surgical RESIDENCY:
"On rotation, the PA works side-by-side with physician house staff and assumes full PGY-1 level responsibility, which includes assignment to the operating room. Education on the clinical rotations comes from bedside clinical teaching by house staff and attendings as well as formal conferences. The call schedule is every third night."

and from the St. Lukes Trauma/critical care PA RESIDENCY:
"The PA/NP Fellow will have full responsibility as a trauma team leader, gaining a broad range of experience in the management of blunt and penetrating trauma, along with emphasis on trauma team organization, resuscitation, diagnostics and therapeutics."

and from the Yale/Norwalk Pa Surgical RESIDENCY:
The importance of the PA's role at Norwalk Hospital cannot be overstated. Physician assistants constitute the entire surgical house staff, taking an active role in the assessment, management and daily care of patients. The PAs provide 24-hour coverage including night and weekend on-call hours, staffing the hospital floors, the OR and the ICU.

and there are probably 50 other PA RESIDENCIES out there with similar experiences equivalent to pgy-1 physician residents...

we are not doing these to replace docs but to better pa's. more training/skills=fewer errors = better medical practice.

 

[AnnoyedByFreud]

Do you mind posting (or since this thread is taking a turn for the ugly, PMing) me the list of the PA residencies that will take psych NPs? I would really appreciate it. Thanks!

 

[deleted6669]

links to all residencies can be found at www.appap.org

 

[Makati2008]

glad he is banned. now back to our discussion....

 

[grayscaleart]

i don't agree with these programs being called "residency" or "fellowship". these terminologies should be restricted to accredited MD/DO GMEs. the point of residency is to lead to specialization of an MD/DO which takes years!!! not months. using these terms tries to equate the calibre of midlevel training to the MDs/DOs, NOT FAIR. and i know attendings that would agree with me on this and have actually seen an attending correct midlevels about calling themselves residents/fellows because it is misleading! i think the more appropriate term is "certification", just like what the nurses use, because they're really just extra experiences in a field and the midlevels do not become specialists/consultants.

 

[deleted6669]

i don't agree with these programs being called "residency" or "fellowship". these terminologies should be restricted to accredited MD/DO GMEs. the point of residency is to lead to specialization of an MD/DO which takes years!!! not months. using these terms tries to equate the calibre of midlevel training to the MDs/DOs, NOT FAIR. and i know attendings that would agree with me on this and have actually seen an attending correct midlevels about calling themselves residents/fellows because it is misleading! i think the more appropriate term is "certification", just like what the nurses use, because they're really just extra experiences in a field and the midlevels do not become specialists/consultants.

pa's working in specialties serve as consultants more frequently than you realize. I know many ortho pa's who take first call to the er for difficult reductions, etc for example.
you call the ortho md for the consult and they send a pa from their service to do the work. if the pt requires an o.r. procedure the pa does all the pre-op workup, H+P, etc then first assists in the o.r.
know who you get if you call for a crashing neonate at many places? a neonatal np who is in house 24/7 in the nicu.

 

[grayscaleart]

consultant (kənˈsʌlt ə nt)

— n
1. a. a senior physician, esp a specialist, who is asked to confirm a diagnosis or treatment or to provide an opinion
b. a physician or surgeon holding the highest appointment in a particular branch of medicine or surgery in a hospital
2. a specialist who gives expert advice or information
3. a person who asks advice in a consultation

well, just because a person can answer a page does not make them a consultant. the PA/NP is the consultant's extender. doing a 12 month "residency" does not make anyone an expert/consultant of a medical specialty.

 

[core0]

i don't agree with these programs being called "residency" or "fellowship". these terminologies should be restricted to accredited MD/DO GMEs. the point of residency is to lead to specialization of an MD/DO which takes years!!! not months. using these terms tries to equate the calibre of midlevel training to the MDs/DOs, NOT FAIR. and i know attendings that would agree with me on this and have actually seen an attending correct midlevels about calling themselves residents/fellows because it is misleading! i think the more appropriate term is "certification", just like what the nurses use, because they're really just extra experiences in a field and the midlevels do not become specialists/consultants.

For what its worth PA eductators agree with you. In the medical field an internship, residency and fellowship have specific meaning. In particular residency is for a physician in training. A Physician Assistant Post Graduate program is for licensed PAs who wish to pursue further opportunities.

 

[deleted6669]

For what its worth PA eductators agree with you. In the medical field an internship, residency and fellowship have specific meaning. In particular residency is for a physician in training. A Physician Assistant Post Graduate program is for licensed PAs who wish to pursue further opportunities.

HOWEVER, the majority of these programs started by physicians for pa's are officially refered to as " pa residencies". If a pa does exactly the same pgy-1 year as an md why can't they be called a "pa resident"?
there are md residents and pa residents, how hard is that to understand?
so david, what would you call someone in a "postgraduate program" if not a resident or fellow?
ps: while I will grant that "resident" has a specific meaning with regards to hospital postgraduate training, "intern" is a fairly generic term. there are paramedic interns( EMT-P(I) ) , nursing interns, production interns on TV shows, interns at the cdc,etc etc

in·tern [ íntərn ]
1.junior doctor in hospital: a doctor who has recently graduated from medical school and is receiving practical supervised training in a hospital
2.trainee: an assistant or trainee working to gain practical experience in an occupation

 

[deleted6669]

consultant (kənˈsʌlt ə nt)

2. a specialist who gives expert advice or information
.

if an ortho pa goes to the er and does a reduction or procedure which the ed attending could not do they have performed a "specialty procedure" and therefore are a pa specialist.
why is it so hard to fathom that a pa who does one thing full time for years might know more about it than a physician who does not work in that specialty? do you know how much of the HIV/HEP C care done in this country is done by pa's and np's with minimal to no input from physicians? The county HIV clinic in my town is run by an np who has done nothing but that for over 20 years. he does all his cme in hiv care, reads multiple hiv magazines/studies per month, participates in trials of new medications, etc. yes, he knows more about hiv than an fp doc or generalist im doc who does not work in infectious dz. .
I have a pa friend who is a headache specialist. many of his referals come from generalist neurologists. he did a headache fellowship at mayo and worked for 5 years at the only inpatient headache facility in the world.he has written books about headache management and published papers with the american h/a assoc.,etc. he has done nothing but headache medicine for 25 years.patients come from hundreds of miles away to see him and he has a long wait list of patients waiting to get in to see him.
he is a pa headache specialist
I am not saying that a specialty pa knows more about their specialty than an md specialist in the same field but it is likely that they know significantly more about their area of expertise than a physician who does not practice that specialty.

 

[acesup123]

Are these PA residencies 80 hr work weeks like real residencies?

 

[deleted6669]

Are these PA residencies 80 hr work weeks like real residencies?

YES. PA residents have the same requirements as pgy -1 md/do residents in the same specialty.
from one site:
The PA residents will provide 24-hour coverage including night and weekend on-call, coverage of the hospital floors, the operating room and the ICU."
from another:
the PA works side-by-side with physician house staff and assumes full PGY-1 level responsibility

years ago I visited a friend who was attending the norwalk surgical pa residency. he was on call all the time and was working 100+ hrs/week(this was before the 80 hr rule). he actually lived in residents housing at the hospital for the entire year. the year after graduation he stayed on as chief resident with a slightly improved salary and schedule.

 

[Makati2008]

For what its worth PA eductators agree with you. In the medical field an internship, residency and fellowship have specific meaning. In particular residency is for a physician in training. A Physician Assistant Post Graduate program is for licensed PAs who wish to pursue further opportunities.

Quick question for you. How does the AAPA feel about the PA-to-DO bridge in your opinion? i heard there was some grumblings by our society which if that is true is a very poor stance to take.....(Random question but seeing your thoughts)

 

[deleted6669]

I'm guessing they are against it as they did not take a pro-bridge program stance when the masters standard came out last yr.
the other thing that makes no sense is that they won't advertise the fact that american pa's can get reciprocity to function as licensed clinical officers in some nations in Africa( kenya and malawi that I know of). what a great option that is for folks who want to provide services over seas....

 

[core0]

HOWEVER, the majority of these programs started by physicians for pa's are officially refered to as " pa residencies". If a pa does exactly the same pgy-1 year as an md why can't they be called a "pa resident"?
there are md residents and pa residents, how hard is that to understand?
so david, what would you call someone in a "postgraduate program" if not a resident or fellow?
ps: while I will grant that "resident" has a specific meaning with regards to hospital postgraduate training, "intern" is a fairly generic term. there are paramedic interns( EMT-P(I) ) , nursing interns, production interns on TV shows, interns at the cdc,etc etc

I would call that person a PA. While in the general world intern has a wide variety of meanings in the hospital it means someone in the first year of their post graduate medical education as a physician. You also make my point. A lot of groups try to raise their self importance by using the word intern. What is a Paramedic Intern? In my day we had a word for them - students. Same with nursing. Our nurse manager showed me a resume where someone had listed their nursing residency. On closer examination the "courses" were the required rotations for nursing school. This is simply someone trying to increase their own self importance.

To be fair in some cases its not a deliberate intent to deceive. In many cases people are trying to put the student into a framework that other people can understand. Ie. the "resident" has received some training in whatever field they are in but are still in training and have a supervisor if something seems to be going wrong. In the hospital that person is the resident. Also simply following a prescribed path doesn't make someone that specialty. I worked 80 hours this week. My paycheck is thankful that that doesn't make me an intern. If I put the janitor in the PGY-1 schedule it doesn't make them an intern either.

Probably the closed approximation for what you are looking at is the fellow. A physician fellow is someone who has completed their medical training, can be fully licensed and is seeking additional specialized training in their field. This however, discounts the knowledge and place in the hierarchy that the fellow has.

in·tern [ íntərn ]
1.junior doctor in hospital: a doctor who has recently graduated from medical school and is receiving practical supervised training in a hospital
2.trainee: an assistant or trainee working to gain practical experience in an occupation

See above. #1 is correct in the medical field. #2 is correct at Wal-Mart.

In reality this may be like the term "Doctor" the horse may be out of the barn. There are too many groups in the hospital using the term resident and intern. However, I think that I would rather be treated by the surgery intern than the dietary intern. PA post grad student is quite a mouthful but correct.

 

[deleted6669]

"What is a Paramedic Intern? In my day we had a word for them - students. "
a paramedic intern is someone who has completed all classroom and hospital based training and is in the final stage of their field training. "in my day" 20 + years ago my official state recognized title during the final phase of my training was "paramedic intern". in fact we were required by law to sign our charts " EMT-P (I). I still have my nametag from that time which reads
Emedpa
paramedic intern
xyz paramedic program

re: titles
there are currently individuals who have completed em pa residencies who are now doing fellowships. these 1 yr post-residency fellowships are EXACTLY 100% THE SAME as those done by physicians. they are occupying slots which were not filled by physicians and following exactly the same curriculum and to the same expectations. I know two of these folks very well. one is doing an em u/s fellowship and the other is doing an ems fellowship(he is a medical director for a township as part of the program and 100% responsible for medical direction of the als units, etc).
I would argue that these folks will be pa specialists when they are done(having done 2 yrs of post grad training) and they should be refered to currently as PA fellows.

 

[deleted432032]

fel·low noun \ˈfel-(&#716ō, -ə(-w)\

Definition of FELLOW

: a young physician who has completed training as an intern and resident and has been granted a stipend and position allowing him or her to do further study or research in a specialty

http://www.merriam-webster.com/medical/fellow?show=0&t=1322948349


Non-Medical Definition:

Definition of FELLOW
6
: a person appointed to a position granting a stipend and allowing for advanced study or research

http://www.merriam-webster.com/dictionary/fellow

 

[deleted6669]

"a person appointed to a position granting a stipend and allowing for advanced study"
exactly . a PA fellow is pursuing adv. studies in ultrasound or ems management. thank you for proving my point.
do a websearch for physician assistant fellowship. you will get many hits. these are all run by physicians. at this point if you guys don't like the title that is really too bad. it's out there and won't be changing.
http://www.medicine.uic.edu/cms/One.aspx?portalId=515172&pageId=4925779
http://www.mayo.edu/mshs/pa-him-sct.html
http://www.empafellowship.com/
http://www.rockfordortho.com/physicians/fellowships.html
http://www.mayo.edu/mshs/pa-otorhino-sct.html

I am a strong believer however that you guys should be the only ones called Dr. in a clinical setting. a dnp is not a physician and introducing themselves as "dr. smith" causes confusion. I am currently in an academic doctoral program. when done I will not introduce my self at work as Dr.
resident and fellow, however when amended to PA resident or PA fellow is descriptive and not any more confusing to pts than PA by itself.
someone who is confused by " Hi, I'm bob smith, one of the emergency medicine PA residents" would also be equally confused by " Hi, I'm bob smith, one of the emergency medicine PA's". ditto PA vs PA fellow.

 

[deleted432032]

The second definition used would be for someone in a Non-Medical setting. Unless I'm mistaking a PA is in a Medical setting.

 

[deleted6669]

The second definition used would be for someone in a Non-Medical setting. Unless I'm mistaking a PA is in a Medical setting.

actual usage in 2011 would contradict that.
we are not going to agree about this.

 

[ghost dog]

actual usage in 2011 would contradict that.
we are not going to agree about this.

It's rather simple. It doesn't matter if you "slept in the same place that residents did" ; that is meaningless.

Did you go to medical school ? If the answer to this question is no, - well then, you can't do a residency.

You are a well paid technician.

You wanna ride in the rodeo?

Cowboy up.

 

[deleted6669]

It's rather simple. It doesn't matter if you "slept in the same place that residents did" ; that is meaningless.

"the PA RESIDENT works side-by-side with physician house staff and assumes full PGY-1 level responsibility

what part of full responsibility do you not understand? I'll help with smaller words. "same job". here's a big word. "interchangeable."

http://www.annemergmed.com/article/S0196-0644(11)00129-6/fulltext

I'll save you the trouble of reading it. the gist of this physician written article is "why couldn't md residents be more like pa's?"

 

[deleted6669]

You are a well paid technician.

.

you work in canada .
this "technician" probably makes more than you do and has no overhead expenses......chew on that for awhile, eh.

 

[GoSpursGo]

Let's please try to get this thread back to the original topic and be civil; continuing to disparage other professions will result in infractions and the thread being closed.

 

[ghost dog]

you work in canada .
this "technician" probably makes more than you do and has no overhead expenses......chew on that for awhile, eh.

Oh please... suggesting that a PA is somehow more knowledgeable than an ER doc is in the realm of huh ? ( post #16 ).

The real world is calling.

If you made more than $ 315,000 ( this is after overhead, before taxes ) with 25 - 30 hours of work, then you made more than me last year.

No call , no nights, and no weekends. Pretty sweet.

Oh Canada !!!

 

[deleted6669]

Oh please... suggesting that a PA is somehow more knowledgeable than an ER doc is in the realm of huh ? ( post #16 ).

The real world is calling.

I

is it really that hard for you to accept that an ortho specialty pa knows more ortho than an er or fp doc? how often do you do finger amputations with flap revisions in your office? our ortho pa's do them in the e.r. all the time.
hello, reality calling. 50 hrs+/week doing nothing but ortho for several years...guess what, you learn about ortho...I work at 2 major medical ctrs that use ortho pa's for most of the in-dept procedures that the er providers can't do. they only call their attending on the rare occasions that they can't fix the problem at hand or if the pt needs to go to the o.r. for an o.r.i.f.. this is common practice all over the united states...and soon coming to a hospital near you in canada....according to ortho docs in canada..
http://www.coa-aco.org/coa-bulletin...-to-canadas-orthopaedic-surgeon-shortage.html

or a pa who does nothing but care for HIV+ pts...I'm guessing when they see a panel of 3000+ pts, all with HIV/AIDS and do all of their cme about HIV and have advance certifications in HIV medicine they know more about it than a typical FP doc(say you for example).

ps 315 k canadian...that's what about 20 bucks u.s, right?......

 

[Sheldon]

I've been lurking for a bit, but I have to jump in now.

I think what is lacking in a lot this thread is the lack of one thing, and it's mainly lacking from the physicians replying to it: the patient.

I'm a PT. I have a clinical doctorate in physical therapy. I don't call myself a doctor and correct those who do. I am, however, proud of earning my clinical doctorate and don't back down from defending my scope of knowledge, and practice, in the musculoskeletal realm. I've completed certifications, and now have been accepted to a residency program and then will move on to a fellowship.

Physicians, in the public's eye, are "doctors." That's fine with me and have earned that privilege. I do think it is insanely inappropriate for physicians to disparage the so-called "mid-levels" for having residency programs. Guess what...? Physical therapy has residency programs as well as fellowship programs. Many of the programs work with major academic hospitals with MDs, DOs, NPs, and PAs. Physicians DO NOT own the right and/or privelege to be the only group of healthcare providers who participate in residency programs or fellowship programs. It should be all about the patient and being the best in whatever profession you chose, and if residency and fellowship programs accomplish that, then so be it.

Enough with the turf battles. Get back to the patients.