flight medicine

[Arctic Char]

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so i am gunning for a good EM reidency, but my primary interest is flight medicine. i'd like to integrate my background in aerospace medicince with EM, and i am an absolute aviation *****. i can't get enough flight time, cessna or sikorski. medicine and aviation are the two things that make me happy, that make me forget to eat, to forget the time, to forget to sleep. they both excite me passionately.

anyway, can some people list some programs that have strong flight programs that might be right for me - someone wanting to be heavily involved in medical flight operations, perhaps even at an academic level.

thanks everyone

-mountain

 

[FoughtFyr]

Not for primary training but New Mexico has a fellowship you might be interested in:

http://hsc.unm.edu/emermed/Fellowships/AMTFellowship.shtml

- H

 

[Arctic Char]

thanks a lot

 

[monkeyarms]

u chicago, cincinnati, and indianapolis are the traditional midwestern strongholds amongst emergency residencies. cleveland and pittsburgh also do a good deal of flight for physicians.

 

[Arctic Char]

thank a lot! my god, that is exactly the kind of thing i am looking for, although i am a long ways from such a prize. nice to know that i can direct my career towards something though. thanks again

any residencie that anyone knows of that can help facilitate this pathway? i know utah is good, but i am still curious about OHSU . . . haven't had any word about their flight operations . . . ?

 

[southerndoc]

Hartford Hospital's Life Star program also has a fellowship if you can stand living in Hartford, Connecticut for a year or two.

 

[crewmaster1]

Some other programs with good flight experiences (docs integrated into care, not observational): Medical college wisconsin, U. Chicago (also fixed wing international insurance transports), U. Mass, U. Michigan, I'll add more later if I think of it. Oh, loma linda I think may do some flight stuff. UCSD fly's. Of note, look at the percentage of scene vs interfacility transports. Cinci does like 40% scene, U Chicago only like 5%, USCD claims 80%.

 

[FLTDOC1]

If you are truly interested in prehospital medicine and avaition - look at the programs that allow you to work as a dedicated flight physician. This usually involves specialized training along with your normal EM stuff. There are quite a few programs that offer "aeromedical and EMS electives" but in these situations, you are basically a glorified observer.

The programs that I have had experience with

Univ of Chicago
Cincinnati
Cleveland Metro
Univ of Wisconsin ( new program)

 

[pushinepi2]

...an excellent inquiry. The UMass Worcester program is very flight intensive; they require that their interns serve as physicians on their brand new EC 135. That residency also sponsors a busy hospital based EMS service. As I recall, it was one of the most EMS focused and EMS friendly programs that I visited. UConn also has a busy transport service, as already mentioned.

It should be mentioned that residency, like medical school, is often what you make of it. Though other programs aren't quite as EMS focused, you should be able to find a niche in any respectable residency. To be honest, University of Maryland's EMS rotation does not require that the resident complete a flight component. For residents interested in aeromedical transport, however, there are tons of resources. The University of Maryland just recently expanded their interfacility critical care transports through the acquisition of two new UH412's. Furthermore, one of our faculty members serves as the state EMS aeromedical director for the Maryland State Police. The MSP aviation command holds a virtual monopoly over scene calls within the state and operates eight dauphin helicopters in various locations.

Definitely ask this question during the interview season. EMS electives vary widely in their scope of resident involvement; looking for residencies with established EMS fellowships may also give you some more information. Good luck-

UMass Worcester Lifeflight Program
http://www.umassmed.edu/emed/lifeflight/index.aspx

University of Maryland EMS Fellowship
http://umem.org/fel_ems.php

 

[Arctic Char]

you guys rock. thanks a bunch!

 

[Arctic Char]

by the way, what could anyone have against hartford? seems like a lovely place to live. granted, i've only been through once for a day or two, but it seemed pleasant enough. i guess everyone has their tastes . . .

 

[streetdoc]

by the way, what could anyone have against hartford? seems like a lovely place to live. granted, i've only been through once for a day or two, but it seemed pleasant enough. i guess everyone has their tastes . . .

Hartford is great as long as you stay in your car and stay out of downtown...not my cup of tea!
Also check out Geisinger's LifeFlight.

Geisinger Health System's Life Flight program currently operates a Sikorsky S-76 aircraft from Geisinger Medical Center in Danville, an American Eurocopter BK-117 from the Wilkes-Barre/Scranton Airport in Avoca, and a Sikorsky S-76 from the University Park Airport in State College. (can't seem to get pictures to work)

 

[Arctic Char]

don't worry about pics, i know the models. bad ass mate, bad ass

thanks for the input

 

[matt_mt19]

Based on my trip to Indianapolis they are quite proud of their LifeLine flight program. The EM residents here are truly flight physicians if they are interested, if not- they don't have to fly. The opportunities seem abounding especially for someone like you. The program seems very rewarding if you are looking for this aspect. I was pleasantly surprised and will be ranking this program near the top.

 

[EM_Rebuilder]

I interviewed at Geisinger; flight is certainly a big part of their program (so big that you had to sign a waiver that stated you understood that flying was mandatory!). As a resident, you do like 2-3 of your ED shift as a flight personal. They hang in the ED and run up when they need to fly. Think they said approx 80 missions over your 3 years with them.

The town it is in (Danville, PA) is tiny and far from large towns (Harrisburg was like 100 miles away) however you can find all you really needed nearby.

I dont know much about aircraft, but of all the choppers I saw on the trail, theres were one of the largest.....

Might be a place you should check into....

 

[Arctic Char]

thanks again. i have looked into geisinger and they do look like a good fit. i asked my buddy from pittsburg if he knew danville at all - he shrugged his shoulders. but i don't really care about that. indianapolis however . . . i would have to seriously think about that. i made myself a promise a long time ago to avoid the midwest. no offense to anyone, but i just don't like it. i need mountains and water. but, given what you've said, i'll take a look anyway

i'm from alaska originally, thats where i started flying. now i'm here in israel studying at the MSIH until i go back to Columbia next year. all the aeromedical flights are military, in and out of Gaza, so i'm having a hard time getting any exposure. unless i want Mussad and the israeli airforce breathing down my neck, i have to stay off the choppers. crossing my fingers though that i can find a way through a back door somehow . . .

 

[quideam]

This is more of a question for southerndoc, but if anyone else knows... Do the residents have an opportunity to fly at Yale? If they do, is it just observation shifts, or are they an active part of the crew? Are there opportunities throughout the year(s), or just for a few weeks as part of an EMS rotation? Thanks!

Q

 

[streetdoc]

thanks again. i have looked into geisinger and they do look like a good fit. i asked my buddy from pittsburg if he knew danville at all - he shrugged his shoulders. but i don't really care about that. indianapolis however . . . i would have to seriously think about that. i made myself a promise a long time ago to avoid the midwest. no offense to anyone, but i just don't like it. i need mountains and water. but, given what you've said, i'll take a look anyway

i'm from alaska originally, thats where i started flying. now i'm here in israel studying at the MSIH until i go back to Columbia next year. all the aeromedical flights are military, in and out of Gaza, so i'm having a hard time getting any exposure. unless i want Mussad and the israeli airforce breathing down my neck, i have to stay off the choppers. crossing my fingers though that i can find a way through a back door somehow . . .

Not to harp on the Geisinger stuff, but I truly love that area! If you are from alaska, then danville won;t seem rural. It's got mountains and you can always find water somewhere. And you will be buying a sweet 3 bedrrom house while your fellow grads are stressed over how to meet their rent. not to mention they have some great simulator stuff (an ultrasound simulator that is great experience). And the flight shifts are probably more like 6-8 shifts per month.
I spent a good bit of time around there and may be able to field questions...
good luck
streetdoc

 

[southerndoc]

This is more of a question for southerndoc, but if anyone else knows... Do the residents have an opportunity to fly at Yale? If they do, is it just observation shifts, or are they an active part of the crew? Are there opportunities throughout the year(s), or just for a few weeks as part of an EMS rotation? Thanks!

Q

You can spend a week with STAT MedEvac during your PGY-2 EMS month. You can also do a month elective in aeromedicine with Connecticut's LifeStar program. There is no direct patient care involvement during the week with STAT (you're an observer only), and I do not know how the LifeStar setup works. I am thinking of doing the elective, but if I get approved for an additional J&J elective in Africa, I will use up my maximum four months of away electives during residency and won't be able to do the LifeStar rotation. I do know that the LifeStar rotation is more administrative in nature.

We have an active EMS division for research, QA, education, etc. There are plenty of opportunities to become involved. We are not, however, strong on flight medicine. We will likely never be as our EMS division chief is not a fan of helicopter transport systems and does not think Yale needs such a system since LifeStar serves the state.

 

[Arctic Char]

thats great to hear. funny you mention the house thing . . . i'm always looking at "top programs" and asking myself "whats so great about a program that makes you live in a crummy apartment?"

if having a decent lifestyle is important in one's career decision, why shouldn't it also be a consideration for reidency?

 

[deleted109597]

Well, if you read Desperado's posts in the rent/buy thread, 3 years (or even 4) of residency isn't the greatest amount of time to buy and sell a house. If you plan on staying longer, sure. Or if you plan on renting it to susceptible med students/residents then maybe. I'll definitely be talking to my financial planner before making any decisions. Thank you USAA!

 

[Arctic Char]

sure, i was thinking simple along the lines of whats comfortable to live in, not necessarily buy. boy, wouldn't it be nice though to have some kind of investment going . . .

 

[deleted109597]

Definitely that is important to me. There are some residencies I can live within walking distance of the ocean. That's pretty sweet.

 

[Arctic Char]

word. 👍

 

[quideam]

Agreed about the housing issue... where I'm living is nearly as important to me as the quality of the residency itself. After surviving NYC for three years (and gritting my teeth to make it through one more!), i'm ready to move somewhere with more trees than taxi cabs! Seriously, the only green things around here are my scrubs...!

Q 😀

 

[NEATOMD]

If man was meant to fly he'd have been given wings...😀

(Sorry, I was bored.)😴

 

[Arctic Char]

if humans were meant to be bored, they wouldn't have been given brains . . .

detaching thyself from thine earth . . . rocks the house my friend . . .

 

[pushinepi2]

The S-76 is really a nice bird; I think its patently unfair to lure applicants to a program with a bigger and sexier helicopter. 🙁 . Interestingly enough, the Sikorsky corporation features that Palm Beach County (Fl) TraumaHawk on their "helicopter EMS mission brief" page.

If I'm not mistaken, there are other South Florida aeromedical programs that utilize the S-76; either Miami Children's or Baptist (Miami) Florida might have one. Definitely the luxury liner of the EMS skies; ample room for two providers, crew, and two patiens... Perhaps even a wet bar and a nintendo wii gaming system.....

Hope you find a well fitting flight suit,

-PuSh

 

[tonem]

Take another look at UMass. The residents fly all three years as active members of the flight crew (Interns are observers). Lifeflight is supposed to be one of the busiest single aircraft services in the country. They just started flying a brand new EC145.

As far as Worcester is concerned its not as expensive as Boston. It's only about a 2-3 hour drive to Maine which is probably as close to Alaska as youre gonna get in the contiguous 48 states.



http://www.umasslifeflight.com/

 

[crewmaster1]

I'm going to be flying while I'm in Johannesburg on my trauma elective! Yeah. Hope they have nice helicopters don't in South Africa, but for some reason I'm a bit skeptical!

 

[SolidGold]

Take another look at UMass. The residents fly all three years as active members of the flight crew (Interns are observers). Lifeflight is supposed to be one of the busiest single aircraft services in the country. They just started flying a brand new EC145.

As far as Worcester is concerned its not as expensive as Boston. It's only about a 2-3 hour drive to Maine which is probably as close to Alaska as youre gonna get in the contiguous 48 states.



http://www.umasslifeflight.com/

90% patient transfers and 10% scene calls, kind of hurt my opinion of their flight program.

 

[deleted77919]

.

 

[deleted109597]

I'm going to be flying while I'm in Johannesburg on my trauma elective! Yeah. Hope they have nice helicopters don't in South Africa, but for some reason I'm a bit skeptical!

I would seriously, seriously be wary of this. You don't want to be going to scenes in many parts of Jo'burg.

 

[quideam]

Crewmaster1, did you set this up ahead of time? Was it tough to get? Thanks!!

Q

 

[crewmaster1]

I would seriously, seriously be wary of this. You don't want to be going to scenes in many parts of Jo'burg.

I am going to be cautious, thanks for looking out for me. I have actually heard working with the EMS crews can be a great way of getting to see some of the more depressed areas that you could never get into if you were alone or going as a tourist. With the protection of EMS you are a bit safer, but I have heard of a med student being held at gunpoint on scene! I'm more scared about the quality of the helicopter/pilots, but it is a 1200+ bed hospital that is the tertiary trauma center. We'll see. I'll keep you posted.

 

[crewmaster1]

Crewmaster1, did you set this up ahead of time? Was it tough to get? Thanks!!

Q

I found the rotation on trauma.org. It wasn't too hard to set up. It did take a bit of trust emailing credit card stuff (good think visa picks up the tab if it's fraud), sending a couple of pictures, getting docs from my school sent. Getting ready to go with HIV prophylactic meds, immunizations, passport, etc. The most important part is that you must apply at least one year in advance, recently I heard all the 2007 spots are filled. It's popular and fun from what I hear.

 

[southerndoc]

I found the rotation on trauma.org. It wasn't too hard to set up. It did take a bit of trust emailing credit card stuff (good think visa picks up the tab if it's fraud), sending a couple of pictures, getting docs from my school sent. Getting ready to go with HIV prophylactic meds, immunizations, passport, etc. The most important part is that you must apply at least one year in advance, recently I heard all the 2007 spots are filled. It's popular and fun from what I hear.

You shouldn't need too many immunizations for Jo'burg. It's a developed nation. You don't need any malarial prophylaxis either, unless you plan to visit Kruger for a safari. You're probably already up to date on all your vaccinations.

 

[Arctic Char]

out of curiosity, how do you guys afford these kind of activities? how easy is it to procure loans without being formally enrolled, or while you are "taking a year off"? stipends?

and by the way, patient transport (hospital transfers) involve just as many considerations as removal from a trauma scene. whatever the breakdown of flight activity, it wouldn't add or subtract from my impresion of a program. i mean, we can all agree that trauma is more exciting. i understand the attraction. but working with patients, and considering their safety in the flight/aerospace environment is really what its all about. the adrenaline is gratuitous . . .

pushinepi- agreed, sikorski spirits are very nice. you can keep the nintendo though😉

but part of me has always fantasized about arriving with like an S-80 super stallion at a huge mass trauma scene (a balagan - thats for you quidream), and orchestrate the whole evacuation.

not that i wish for trauma or harm to anyone, of course . . .

 

[SoCuteMD]

out of curiosity, how do you guys afford these kind of activities? how easy is it to procure loans without being formally enrolled, or while you are "taking a year off"? stipends?

and by the way, patient transport (hospital transfers) involve just as many considerations as removal from a trauma scene. whatever the breakdown of flight activity, it wouldn't add or subtract from my impresion of a program. i mean, we can all agree that trauma is more exciting. i understand the attraction. but working with patients, and considering their safety in the flight/aerospace environment is really what its all about. the adrenaline is gratuitous . . .

pushinepi- agreed, sikorski spirits are very nice. you can keep the nintendo though😉

but part of me has always fantasized about arriving with like an S-80 super stallion at a huge mass trauma scene (a balagan - thats for you quidream), and orchestrate the whole evacuation.

not that i wish for trauma or harm to anyone, of course . . .

While I'm sure part of the feeling regarding patient transport is the lack of "sexiness," I think EM folks have a little bit different take on it. In EM your job is to assess a patient for life-threatening conditions, stabilize them (by yourself or with assistance) and then admit the patient to the proper unit for long term care. Scene response involves just this - acute stabilization. Transport is a bit more like critical care (which is, at long last, a pathway open to EM grads) in that you have a patient who is critical but stable, and it's your job to maintain that patient over time. I've been told by people who have done that it's a lot like ICU, but in the air. Most EM residencies have a significant number of off-service ICU months, so if you start taking department time and have residents do ICU-like work I can see where some people might feel it isn't as valuable a learning experience. I believe FoughtFyr mentioned that while he enjoyed flying, he felt that being in the department was higher yield as he saw more patients in the department than he did in the air.

 

[Arctic Char]

right, i see what you mean. thanks for the breakdown

 

[crewmaster1]

You shouldn't need too many immunizations for Jo'burg. It's a developed nation. You don't need any malarial prophylaxis either, unless you plan to visit Kruger for a safari. You're probably already up to date on all your vaccinations.

How could you go to Jo'burg and not hit up Kruger? Actually I'm spending a month in S. Africa with my wife after the rotation. We are both scuba divers and plan on seeing some shark action! Thinking about flying out to the Seychelles for a few dives, but damn expensive!

 

[crewmaster1]

out of curiosity, how do you guys afford these kind of activities? how easy is it to procure loans without being formally enrolled, or while you are "taking a year off"? stipends?

I'm not taking a year off. During my fourth year we have only 5 months of required rotations (Jo'berg Trauma surg will count as one of these).

Umm. Good question. I work as an EMT currently, I bought a condo as a 1st year and used some of the equity for res. interviews and my travel, I take all the financial aid offered (good interest rates), and most importantly I married a sugar momma (ER nurse) (that's how I could afford the condo)!

 

[Arctic Char]

I'm not taking a year off. During my fourth year we have only 5 months of required rotations (Jo'berg Trauma surg will count as one of these).

Umm. Good question. I work as an EMT currently, I bought a condo as a 1st year and used some of the equity for res. interviews and my travel, I take all the financial aid offered (good interest rates), and most importantly I married a sugar momma (ER nurse) (that's how I could afford the condo)!

must be nice to have some collateral. and, i guess, a sugar momma too

enjoy those dives . . . and don't watch "Open Water" before you go . . .

 

[quideam]

Crewmaster1, I was actually wondering how you set up the flight part of the rotation (I already have the UJohann and Bara surgery rotations set up...).

MtMed - life's a balagan 😉... as far as affording things, I have some money saved up (I worked *a lot* in undergrad - EMS, phlebotomist, even security guard)... I'm also getting some funding for the India part of my year off (research grants, that sort of thing), and i'm spreading that money out... as it stands now, i'm still waiting on two grants; if I get those, I don't need to take any extra loans out; otherwise, I might need a little bit extra...

Oh, and I agree - how could you go to J'burg and NOT visit Kruger?? But honestly, with all the shots i'm getting for India (including malaria pills), what's a little extra? 😉

Q

 

[Arctic Char]

talking like that - someone might confuse you for a 'sugar momma' . . . 😉

where did these grant come from? i'd love to get an idea . . .

 

[crewmaster1]

Crewmaster1, I was actually wondering how you set up the flight part of the rotation (I already have the UJohann and Bara surgery rotations set up...).

I've been told my previous students that it is very easy to set up while you are there. I haven't done anything for it in advance, but understand it is an easy option to take advantage of. I'll let you know when I get there.

 

[quideam]

Crewmaster - thanks, definetely let me know! Looking forward to it...

MtMed... there are two grants I applied/ am applying for: Sara's Wish Foundation (sorry, for women only! 😉) and the Ben Kean Traveler's Fellowship (for international/tropical medicine... very competitive, so cross your fingers for me). SAEM and WMS both have grants for medical students looking to do reasearch, but you have to apply early (both deadlines have passed for the upcoming year).... not sure how applicable either would be for international work, though.

Oh, and I would *definetely* recommend watching 'Open Water' before going diving... trust me, makes the entire experience much more interesting (especially if you get lost... yes, lost... but that's a topic for another thread...).

 

[tonem]

90% patient transfers and 10% scene calls, kind of hurt my opinion of their flight program.

I guess its all a matter of perspective. I'll agree that its kinda cool to shut down the Mass Turnpike during rush hour but scene calls are trauma and trauma is cookbook....it's not a big deal. It's even less of a big deal when youre standing on the side of the Turnpike for 40 minutes and its 20 degrees and they still haven't extricated the patient that youre gonna babysit for the 15 minute flight.

In my opinion the real value (and most of the learning) of the flight program is the inter-facility transfers...its kind of scary when you land at a remote 10 bed hospital to pick up the hypotensive calcium channel/betablocker OD and you realize that as a second year resident you know more about managing the patient than anyone within 100 miles of you....you're really on you own (more than you would be in any ICU or ED...no one is looking over your shoulder). Keep in mind that they are calling Lifeflight because the patient is unstable and they want nothing more than to punt.

 

[SolidGold]

I guess its all a matter of perspective. I'll agree that its kinda cool to shut down the Mass Turnpike during rush hour but scene calls are trauma and trauma is cookbook....it's not a big deal. It's even less of a big deal when youre standing on the side of the Turnpike for 40 minutes and its 20 degrees and they still haven't extricated the patient that youre gonna babysit for the 15 minute flight.

In my opinion the real value (and most of the learning) of the flight program is the inter-facility transfers...its kind of scary when you land at a remote 10 bed hospital to pick up the hypotensive calcium channel/betablocker OD and you realize that as a second year resident you know more about managing the patient than anyone within 100 miles of you....you're really on you own (more than you would be in any ICU or ED...no one is looking over your shoulder). Keep in mind that they are calling Lifeflight because the patient is unstable and they want nothing more than to punt.

This is true. Inter-facility transfers can become complicated because the patients can go south very quickly. Trauma is cookbook, but I think that being the first to respond is a slightly greater challenge because injuries are not always apparent. Being the one to pick up a tension pneumothorax and being able to needle decompress it in the field is a slightly different experience than when it's done in the ED. Of course I'm not speaking from experience but just what I hear from residents who have been in those situations.

I thought UMass had a great program with an amazing new ED, and the required flight experience is part of what I thought was great. I just felt that a more comprehensive flight experience is available at other institutions.

 

[Arctic Char]

for the divers here . . .

http://www.cartoonbank.com/product_...rints&title=Love&whichpage=104&sortBy=popular