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[jalmostpa]

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Hi everyone. I am very interested in becoming a PA but am now having doubts about whether it's the right career or not. Basically, I would like to work in a trauma center. I shadowed a PA last week and saw him work with a lot of "ordinary" cases (orthopedic injuries, general illness, sutures, etc.). I am concerned that PA's are generally not going to be working in a trauma setting. Instead it seems this is left to doctors and residents while PA's see the more day-to-day cases. What have people seen out there? Does this depend totally on the hospital? Am I never going to get the chance to intubate a pt if I become a PA? I realize the medical world is not what we see on ER and I am certainly not expecting to work only with major trauma patients, but I would like the opportunity. Thanks for any help.

 

[deleted6669]

I work in a busy trauma center. it is possible as a pa but generally involves doing lots of extra work like getting certified in acls/pals/atls and possibly doing an em or surgery residency or fellowship. I have a friend who works in NC doing only trauma stabilization at a level 1 trauma ctr. he intubates pts, puts in central lines, etc before the surgical team takes the pts off to the O.R.
this is not the norm but the jobs are out there for the right candidate. it also helps if you have prior em experience like paramedic or rn to land one of these jobs.
good luck

 

[jeffdowjones]

jal-i hear what you're saying! i'm a PA student and would love to so either trauma or ortho surg. but i worked in a clerical position in a level 1 t.c for 2 1/2 yrs, and got to do a lot of poking around as to who gets to do what in regards to residents and pa/np's...i realized that it would be great as a pa to be able to run a code or trauma and do all the cool stuff in ortho like reaming and screwing bones etc, but the fact is that wherever there is a hospital where residents are training, THEY get the heavy stuff. that's why they're there in the first place! they are training to be attending docs (read-where the buck stops). it wouldn't be fair for a pa/np to take on the more complex cases, because we will ALWAYS have backup in the form of an attending. someday the residents will not, so they need all the training they can get. if you tubed and did a thoracotomy on every patient that came through the door, than it would be a non-issue-we all would get to do them. i'd love to do a tkr or thr in the o.r., but realize the residents will do the important stuff and i may be the putz that just sits there and holds retractors.

but a special thanks goes out to emed-he points out even moreso that the resounding thing as a pa is that who you work for is the key-one ed may let you handle everything (ie if your patient you were working up for cp poops out and you now have to intubate)-YOU do it all. other eds will have the residents/anesth. step in if intubation is needed-it all depends where you work. talk to as many pa's as you can. one ortho pa said all she did in the o.r was hold retractors, another said he got to go skin to skin and all the doc did was ream and set the hardware. if you want to be sure you do everything, be a doc. good luck! i know i'm thinking about it =). peace

 

[Febrifuge]

I work as a tech in a busy (~100k visits a year) Level One ED, and we have at least one PA who is very well thought-of. Depending on which EM attending happens to be on that day, this PA might have a doc standing over her shoulder, be chart-checked repeatedly, or left totally alone for pretty much an entire shift. That's nothing to do with her skills or reputation (which are both excellent), just the whim of the attending.

But... we have residents and students a'plenty in this place, so it's also luck of the draw as to which area people are assigned to. If she's working alongside residents, it's more like what you describe above.

jalmost, would you be averse to working somewhere that isn't a teaching hospital? Like maybe a smaller community hospital ER, or possibly in a rural area? I would think the 'country doc' route would be a good fit for an EM PA who likes variety and can establish him/herself within a team.

 

[deleted6669]

FYI REGARDING TRAUMA-
there is a new trauma surgery/critical care residency for pa's at ryder trauma ctr in miami florida. it is 1 yr long. residents are treated as members of the trauma house staff and receive salary and benefits as a 1st year surgical resident. the program includes didactic, icu, clinic, and o.r. time. the 1st 6 mo the resident functions as a surgical intern including full call tresponsibility. the second 6 mo the resident completes tasks of 2nd and 3rd year surgical residents including 1st assisting on major trauma cases and having their own icu pts to follow. looks like a great opportunity for someone who wants to break into this area of practice. for info call the residency at 305-585-1178.
they take 3 residents/yr.