EM Residency: Resident is Primary Member on Flight Crew

[MedicJosh]

I know a lot of residencies say their residents get to "fly", I'm interested specifically in programs where the resident's are the primary caregiver on the flight crew as opposed to just an observer.

Here's the list of places that I have so far:

University of Cincinnati
Mercy St Vincent Medical Center
Geisenger Health
University of Wisconsin

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[Doctor Bob]

University of Illinois at Peoria

 

[pianoman511]

Buffalo

 

[racerwad]

I know a lot of residencies say their residents get to "fly", I'm interested specifically in programs where the resident's are the primary caregiver on the flight crew as opposed to just an observer.

Here's the list of places that I have so far:

University of Cincinnati
Mercy St Vincent Medical Center
Geisenger Health
University of Wisconsin

FWIW, last year when I interviewed at Mercy, I was told that the residents weren't a primary provider.

 

[alpinism]

FWIW, last year when I interviewed at Mercy, I was told that the residents weren't a primary provider.

Really?

Per their website:

"During the second and third year of residency, our residents serve as the primary flight physicians for the Life-Flight/Mobile Life Critical Care Transportation Network. The residents are responsible for the stabilization and treatment of patients during all first-call Life Flight responses."
http://mercymedicalresidency.org/index.php/emergency-medicine/

Just curious since I though that was one of the major selling points of their program...
(unless they've changed things recently)

MetroHealth/Cleveland Clinic also lets you fly as an R3 (supposedly as the flight physician not an observer).

 

[kmb1908]

University of Chicago.

 

[deleted547339]

FWIW, I'm at a program where I have no flight exposure and we graduate truly impressive EPs.

 

[Birdstrike]

Considering that in community EM one will rarely, more likely never, fly on a chopper again, lacking this experience in EM residency is absolutely no big deal, whatsoever, from what I've seen. Do it if you think it would be fun, but in my opinion, never having done it is a non-issue. For the most part, its an advanced paramedic and/or nursing and essentially a non-physician position. From what I've seen its more of an EM residency recruitment tool than anything else. Like good salesmen know, you'll sell more meat by selling the sizzle, than the steak.

When I was interviewing I really wanted to do this and ranked one of these programs #1. Then when I matched somewhere else without a mandatory flight program, I was later very happy about that and was asking myself, "Why the hell did I want to do that again?"

That being said, I know several EPs that have done down flight work (mostly in residency) and liked it. So, "To each, his own."

 

[sonofva]

The Army.

 

[InFactotum]

Considering that in community EM one will rarely, more likely never, fly on a chopper again, lacking this experience in EM residency is absolutely no big deal, whatsoever, from what I've seen. Do it if you think it would be fun, but in my opinion, never having done it is a non-issue. For the most part, its an advanced paramedic and/or nursing and essentially a non-physician position. From what I've seen its more of an EM residency recruitment tool than anything else. Like good salesmen know, you'll sell more meat by selling the sizzle, than the steak.

When I was interviewing I really wanted to do this and ranked one of these programs #1. Then when I matched somewhere else without a mandatory flight program, I was later very happy about that and was asking myself, "Why the hell did I want to do that again?"

That being said, I know several EPs that have done down flight work (mostly in residency) and liked it. So, "To each, his own."

I suspect, based on his avatar, he is interested in HEMS/EMS after residency. I agree that when I interviewed at programs that had flight, they used it as a recruiting tool.

 

[engineeredout]

UPMC and allegheny health in Pittsburgh both have residents fly as crewmembers I believe

 

[MedicJosh]

I suspect, based on his avatar, he is interested in HEMS/EMS after residency. I agree that when I interviewed at programs that had flight, they used it as a recruiting tool.

correct

 

[MedicJosh]

UPMC and allegheny health in Pittsburgh both have residents fly as crewmembers I believe

are you sure allegheny does? on their site it says: "PGY3 residents gain valuable prehospital critical care experience on the LifeFlight rotation and serve as medical command physicians for LifeFlight." -- medical command to me generally means like medical oversight from a base station sort of thing as opposed to providing physician-level care in the prehospital environment

 

[namethatsmell]

I get the desire to be a on a bird as a med student. Sounds cool and looks fun. The real benefit and selling point in my opinion was the increased autonomy the resident got...then I spoke with residents at the EMS/chopper-heavy program--lots of down time with a few cool things now and then and then even fewer life and death situations to grapple with.

Many residencies offer more high-yield autonomous experiences on terra firma. For example my program's MICU and SICU rotations include overnights with you being the most senior person on the respective service in the hospital (attending and/or fellow available by phone from home). You want to put on your big boy/girl pants in residency? Find a program with something similar to this and you'll get plenty of opportunities.

You want to be an EMS medical director in the future? Learn the most about medicine you can during the short time you have during residency and then do an EMS fellowship.

 

[Tenk]

Learn the most about medicine you can during the short time you have during residency and then do an EMS fellowship.

You do not need to do an EMS fellowship to be a medical director and you have plenty of time in residency to engage in lots of EMS style activities if you are proactive about it.

 

[ucbsmd]

i believe the CASE Metro/Clinic program does and many of the SUMMA residents moonlighted on the metro choppers as providers

 

[medicsb]

As a former paramedic, I would not go to any program that REQUIRED residents to fly, as I would not want to. It has potential to provide great experience, but largely there are wayyyy too many HEMS programs, so the sort of scene flights or transfers that would really challenge you are rare, but flying patients with borderline indications for HEMS is abundant. Most important is that US HEMS is VERY dangerous (but not so much outside the US). Helicopters are falling from the sky too frequently for me to climb in to one as a crew member. Would I fly in Europe or Australia? Absolutely. They don't feel the need to over saturate their countries with un-needed helicopters, and safety is actually a real priority.

 

[RobbingReality]

FWIW, last year when I interviewed at Mercy, I was told that the residents weren't a primary provider.

I graduated from St. V's a year ago and can gaurantee you that as the physician on the helicopter you are the primary provider. You place chest tubes, manage lines, intubate, make the call if the helicopter stays or goes. You can not fly until you go through multiple flight simulations including live water training. If you want the lifeflight physician experience it is the real deal.

 

[Birdstrike]

As a former paramedic, I would not go to any program that REQUIRED residents to fly, ...flying patients with borderline indications for HEMS is abundant. Most important is that US HEMS is VERY dangerous (but not so much outside the US). Helicopters are falling from the sky too frequently for me to climb in to one as a crew member. ..

I was going to put this anecdote into one of my longer posts, or my book. Maybe I still will. But I'll drop it right here, since it's appropriate for this discussion. 100% true story, no artistic license use:


One morning, I get into work for the 7 am shift. It's a sh--y, rainy morning with lots of cloud cover. As I walk into the main ED module and say hello to everyone, the night doc say to me, "By the way, don't wast any time trying to call the chopper. They can't find it."

I was like (eyes bulging out), "They can't FIND it? Uh...okay. That's never good. I guess anyone that needs to ship, goes by ground, then."

Often, this particular chopper wouldn't fly in bad weather. Well, this night they had dropped patient off (sick child) and were headed back to their base airport. Some storms had developed in the area and the possibility of staying overnight at the destination facility was discussed. The pilot decided, to say f--- it, and head back through the weather. Well, halfway back, it got a little dicier than expected and the pilot decided to divert to an airport in between. The end result was that they did find the chopper. What they found was a pile of ashes and burned up metal.

It seemed like a pretty nice crew, too, though I didn't know them too well. Flight-nurse mom with kids. Youngish paramedic. Pilot around 40-45. This was about 6 years ago. It was a pretty bad run for air ambulances there for awhile.





.





"FAA Initiatives to Improve Helicopter Air Ambulance Safety"

https://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=15794

 

[alpinism]

FWIW I'd agree that unless you're interested in flying after residency (US/overseas) or becoming an EMS director (FD/air transport), going to a program with a flight requirement is probably a waste of time for the most part. There is some benefit however to being able to gain the extra autonomy that comes with managing pts in the field w/ no attending backup (or so i've heard).

My med school's EM program is one of the 7 listed above (there goes my nonexistent anonymity...) and most of the residents seem to love their flying shifts. A good number stay on every year after residency to moonlight a couple shifts a month on the bird. At the same time, most flying shifts are slow (i.e. only go on few missions over a 12 hour shift) and they spend most of the day watching movies/sports after checking out all the equipment and doing the daily shift briefing. Then again that's typical for most EMS jobs and who doesn't love getting paid to watch college football on a Saturday.

 

[DrDrummer]

Just to clarify for applicants, there are no programs in the country with a requirement to fly. That's an RRC rule. There may be immense social pressure to fly, but you always have the option to make your required EMS experience land-based if you elect to, for any number of very legit reasons. Not everyone is designed to fly on helicopters, not everyone wants to, and residency program leadership usually make that clear at interviews.

 

[dchristismi]

I thought I wanted to train at a HEMS-heavy program - really wanted that flight experience. Well, I matched elsewhere (which was totally a better fit for me in the end). We still had fly along options during our EMS rotation. One of which I thought for sure would be my day - we listened to a shootout on the radio... and all 4 victims were sent by ground. Groan.

Far better was just booking a bird to fly over the NaPali coast of Kauai. Forget patients, just enjoy the view!

The above poster who suggested you look for ICU rotations on the ground to gain autonomy experience nailed it. I spent a very formative month overseeing a 42 bed ICU at a community hospital with an open heart unit and no other residents, and worked my ass off. As in, I'd start rounding at 7 am, and I'd usually be done the next morning around 3 am. The attendings would pop in every so often to "teach," but mostly just be off doing bronchs. We did pretty much all the procedures, and tried to keep-em-alive-until-7:05. That was when I learned I could run 2 simultaneous codes - one in person, and one by phone.

 

[racerwad]

I graduated from St. V's a year ago and can gaurantee you that as the physician on the helicopter you are the primary provider. You place chest tubes, manage lines, intubate, make the call if the helicopter stays or goes. You can not fly until you go through multiple flight simulations including live water training. If you want the lifeflight physician experience it is the real deal.

I stand corrected. I must've written my notes down wrong.