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
