UNC midlevel residency program

[UnoMas]

Advanced Practice Provider Dermatology Fellowship - Penn State College of Medicine Residencies and Fellowships

The Advanced Practice Provider Dermatology Fellowship at Penn State Health Milton S. Hershey Medical Center is a one-year, non-ACGME-accredited program that admits one fellow per year.

residency.med.psu.edu

Totally jacked. Its all gone under.

Like the program closed down?

---

Members don't see this ad.

 

[Modanq]

Penn Medicine - The Eastern Association for the Surgery of Trauma

www.east.org

Critical Care Nurse practitioner fellowship. They go around calling themselves fellows!
Posted on EAST's website. We have truly gone mad.

 

[Modanq]

Like the program closed down?

No what I meant is medicine has gone under. This APP program is alive and well Dermatology has been raided. Literally every APP and nurse practitioner student BSN RN QPTR that I know is gunning for Derm.
One of my good friends from Medical school has been asked to sign supervising contracts for Derm Procedures by APP and PAs in large practice settings.

 

[deleted941485]

Penn Medicine - The Eastern Association for the Surgery of Trauma

www.east.org

Critical Care Nurse practitioner fellowship. They go around calling themselves fellows!
Posted on EAST's website. We have truly gone mad.

I’ve seen these idiots at my shop. Saw one get chewed out by attending and what does she do run to her nursing supervisor for help.

 

[littlejuan]

I wonder if they removed it from the web temporarily because they were worried it would affect rank lists (rightfully so).

 

[deleted1011020]

https://webcache.googleusercontent....cd=2&hl=en&ct=clnk&gl=us&client=firefox-b-1-d

[/URL]

Yeah, they definitely took it down. Error message "page not found" even when I google it and click on the link provided by google.

UNC Hospitals and UNC School of Medicine Name Hrdina as Program Director of Advanced Practice Provider Residency Program
Jason Hrdina, a clinical assistant professor and director of clinical education in the Department of Allied Health Sciences’ Physician Assistant Studies program, will lead a new advance practice provider (APP) residency program, a joint initiative between the UNC School of Medicine and UNC Hospitals. Hrdina will serve as program director.
The 18-month residency program, housed in the School’s Department of Emergency Medicine, will launch its first cohort of students in June. It will be the first dual clinical and didactic opportunity at the University for PAs and nurse practitioners to seek additional training and be better equipped to practice high-quality emergency care in rural, urban, and underserved populations.
“Because of how the world of health care is changing and how providers are being utilized, having that more clinical and didactic experience makes you a more well-rounded provider,” Hrdina said.
Hrdina, a veteran of the U.S. Air Force and U.S. Army, said the residency program will bridge a knowledge gap. The residency program is modeled after the three-year emergency medicine physician residency.
“It’s going to bring more opportunities for students after they graduate,” Hrdina said. “This knowledge base will allow for our residents to become invaluable to underserved and rural areas. They’ll be a valuable asset to hospital administrators.”
Following the residency program, graduates will be eligible to obtain a certificate in emergency medicine and be able to pursue scholarly work or teaching opportunities.
Graduates of the program will be skilled in caring for critically ill patients and to be leaders in their profession. Applications are open until March 1, 2020.
Additional residency leadership includes Medical Director James L. Larson, MD, and Associate Program Director Benjamin Linthicum, DNP, NP-C, CEN. Jane Brice, MD, MPH, serves as chair of the Department of Emergency Medicine.

Cached link. Not liking the censorship whatsoever. Hope this helps anyone who needs to decide between programs.

Edit: added it to Wayback Machine

 

[jw3600]

Here’s my theory:

Emergency medicine is one of the fastest growing specialties right now in terms of residency seats, behind only IM and FM I believe.

On top of the residency growth is the NPP, non-physician provider, residency positions.

My theory is the large corporations that are buying out group practices want to completely flood the EM market with doctors and NPPs so they can decrease the salaries and make more profit.

Hmmm fascinating. Thinking a submission to NEJM for this one?

 

[CajunMedic]

Magnolia Regional in Corinth, MS has one geared for NP's that they call a "fellowship". It's been in place for several years. Their EM residency (discussed in it's own thread) still hasn't been accredited yet.

 

[jw3600]

What do Chair of EM Jane Brice and residency PD Nikki Binz have to say about the complete degradation of their emergency medicine physician program?

Edit: for the love of god. Can a UNC resident make a throwaway and freaking talk about this? There's 40 of you. How are the interns not freaking out?

 

[UnoMas]

What do Chair of EM Jane Brice and residency PD Nikki Binz have to say about the complete degradation of their emergency medicine physician program?

They took the page down so I think they have gotten quite a few angry emails about this. Whether or not they'll make a statement or respond is another thing

 

[qwerty89]

Advanced Practice Provider Dermatology Fellowship - Penn State College of Medicine Residencies and Fellowships

The Advanced Practice Provider Dermatology Fellowship at Penn State Health Milton S. Hershey Medical Center is a one-year, non-ACGME-accredited program that admits one fellow per year.

residency.med.psu.edu

Totally jacked. Its all gone under.

Notice how both the past 2 graduates from this fellowship stayed at the same place for a job?
These programs are ingenious for employers. You get cheap labor for a period of time and can vet them before you decide to pay them their full salary (or not if they really suck).

 

[jw3600]

They took the page down so I think they have gotten quite a few angry emails about this. Whether or not they'll make a statement or respond is another thing

I said it in another thread. Taking it down is an admission of guilt to what they're doing: selling out doctors for their own careers/pockets.
They will not respond. They will employ 21st century PR strategy in the times of outrage culture to not answer questions, let it die down, and continue with their egregious actions. It has nearly a 100% success rate.

 

[EctopicFetus]

Is UNC really considered a top program?

No too new and little track record. IMO.

 

[deleted547339]

I said it in another thread. Taking it down is an admission of guilt to what they're doing: selling out doctors for their own careers/pockets.
They will not respond. They will employ 21st century PR strategy in the times of outrage culture to not answer questions, let it die down, and continue with their egregious actions. It has nearly a 100% success rate.

Potential to play the victim. We just wanted to ensure the best care for our patients and mid levels are valued members of the team and blah blah blah.

 

[jw3600]

Potential to play the victim. We just wanted to ensure the best care for our patients and mid levels are valued members of the team and blah blah blah.

Damn you're right. Forgot virtue signaling on my list.

 

[EM Junkie]

I'm just going to leave this here --

Thomas Ivester, MD, MPH
Vice President of Medical Affairs and Chief Medical Officer
UNC Health Care System
[email protected]

 

[EM Junkie]

Found another one - this one even has a *gasp* one page application to fill out.

Emergency Medicine Physician Assistant Program

...

www.bcm.edu

 

[Rekt]

Is UNC really considered a top program?

No.

No too new and little track record. IMO.

For whatever reason people automatically assume big name academic centers automatically mean top tier clinical training when EM is the only specialty where that doesn't work unless you like transfers with everything already done.

 

[Rekt]

Found another one - this one even has a *gasp* one page application to fill out.

Emergency Medicine Physician Assistant Program

...

www.bcm.edu

"Fellowship" "Residency". We shouldn't even perpetuate these terms.

 

[gamerEMdoc]

What the hell?

i wonder if a student contacted them regarding this and how it would affect their training there? Maybe they took it down temporarily? I hate to be a conspiracy theorist, but with match lists being certified in a couple days, if even a single student contacted them in a negative light about this, I can imagine taking it down for one week until match Lists are due.

 

[qwerty89]

i wonder if a student contacted them regarding this and how it would affect their training there? Maybe they took it down temporarily? I hate to be a conspiracy theorist, but with match lists being certified in a couple days, if even a single student contacted them in a negative light about this, I can imagine taking it down for one week until match Lists are due.

and thankfully google caches everything

 

[deleted941485]

and thankfully google caches everything

If true clearly trying to hide it which mean it’s should be blasted accross the web. Maybe even get a kevin MD article out of it.

 

[gamerEMdoc]

Yep. Seems like the majority of these are in University settings. I know Im biased towards community hospitals, but this is just deepening my bias. Haha.

 

[deleted941485]

Yep. Seems like the majority of these are in University settings. I know Im biased towards community hospitals, but this is just deepening my bias. Haha.

University hospitals aren’t exactly known for paying their faculty all that well. I guess a pipeline of midlevels is what the doctor ordered.

 

[UnoMas]

Someone please forward this to the EM residency app online word document or their Discord


Sent from my iPhone using SDN mobile

 

[gamerEMdoc]

Yep, a certain university hospital that happens to be where I went to med school pays there faculty about 100k less than what our faculty make about 2 hours away. IDK why our core faculty is always full and they are perpetually advertising for faculty in every journal every month. Granted, I'm sure their faculty they do have are very academically accomplished, I don't doubt that one bit. But you can't can't pay people way under the going rate just for the "privilege" to work in a University setting.

 

[Dantrolene FC]

Hmmm fascinating. Thinking a submission to NEJM for this one?

Is that sarcasm?

 

[ZX10R]

Wouldn't be surprised if they worked less hours for the 60K either.

 

[deleted941485]

Yep, a certain university hospital that happens to be where I went to med school pays there faculty about 100k less than what our faculty make about 2 hours away. IDK why our core faculty is always full and they are perpetually advertising for faculty in every journal every month. Granted, I'm sure their faculty they do have are very academically accomplished, I don't doubt that one bit. But you can't can't pay people way under the going rate just for the "privilege" to work in a University setting.

Wait you only underpaying them at the main site? Oh boy oh boy count yourself lucky as mine recently “standardized” the compensation accross the system guess who got screwed on that one

 

[TheComebacKid]

EM as a specialty is definitely leading the charge on midlevel provider propagation. I've grown to appreciate midlevels and how they advocate for their own practice. Can you blame them? If I was a midlevel I would be doing exactly what they are doing

One of the faculty at my residency program trained at UNC. She is exceptional clinically. It's sad to see a place like UNC, especially with all their big names there (Tintinalli, Brice, etc) let this happen.

I'm glad I am getting out of training before it happens at my current shop.

We can blame hospitals and healthcare corporations all we want. We can blame the midlevels. It doesn't change the fact that WE are the problem. The old guard right now doesn't care about you. They made their killing in EM, banking 350/hr for the past several decades.

The most dangerous person is the "ED medical director", usually a physician, many whom will sell you out at a moments notice after sitting on some hospital committee and thinking about ways to advance their own career.

 

[UnoMas]

EM as a specialty is definitely leading the charge on midlevel provider propagation. I've grown to appreciate midlevels and how they advocate for their own practice. Can you blame them? If I was a midlevel I would be doing exactly what they are doing

One of the faculty at my residency program trained at UNC. She is exceptional clinically. It's sad to see a place like UNC, especially with all their big names there (Tintinalli, Brice, etc) let this happen.

I'm glad I am getting out of training before it happens at my current shop.

We can blame hospitals and healthcare corporations all we want. We can blame the midlevels. It doesn't change the fact that WE are the problem. The old guard right now doesn't care about you. They made their killing in EM, banking 350/hr for the past several decades.

The most dangerous person is the "ED medical director", usually a physician, many whom will sell you out at a moments notice after sitting on some hospital committee and thinking about ways to advance their own career.

Hmm no I would argue it's Anesthesia that has been leading the charge against midlevel provider expansion. EM and all other specialties just didn't care for like the past 20 years and have been asleep at the wheels. The surgeons are not losing sleep over this right now but soon they will come for them. They are here for EM now.

There is no inter-specialty unity among physicians. It's how we got to where we are in the first place.

 

[gamerEMdoc]

Hmm no I would argue it's Anesthesia that has been leading the charge against midlevel provider expansion. EM and all other specialties just didn't care for like the past 20 years and have been asleep at the wheels. The surgeons are not losing sleep over this right now but soon they will come for them. They are here for EM now.

There is no inter-specialty unity among physicians. It's how we got to where we are in the first place.

I agree. Way bigger issue in Anesthesia.

 

[Listen2Savage]

man all this shyt is bumming me the eff out

 

[Modanq]

I agree. Way bigger issue in Anesthesia.

But to some degree we know our enemy in Anesthesia. EM still is figuring it out...is it NPs, PAs, APPs, DO approved ACGME umbrella programs, FP doing EM, IM doing EM, Anyone with a pulse doing EM, CMGs taking over. I really believe EM needs to figure this out or with will be in the wilderness like we have been in Anesthesiology for the last 20 years.

 

[boolin_1]

Here is a list of
PA Emergency Medicine Residency Programs

Albany Medical Center - Albany, NY
Albert Einstein Medical Center - Philadelphia, PA
ArrowHead Regional Medical Center - Colton, CA
Atrium Health - Charlotte, NC
Baylor College of Medicine - Houston, TX
Capitol Emergency Associates of TeamHealth - Austin, TX
Carilion Clinic - Roanoke, VA
Gunderson Health Emergency Medicine PA Fellowship - La Crosse, WI
St. Luke's Hospital - Bethlehem, PA
Jane R. Perlman / NorthShore University Health System - Evanstone, IL
Johns Hopkins Bayview Hospital - Baltimore, MD
University of Kentucky - Lexington, KY
Marquette University Aurora Health - Milwaukee, WI
Mayo Clinic Minnesota - Rochester, MN
University of Missouri - Colombia, MO
Nemours/Alfred duPont Hospital for Children - Wilmington, DE
New York Presbyterian Weill Cornell Medical Center - NY
NYU Langone Health Advanced Practice Provider Fellowship in Emergency Medicine - NY
Regions Hospital - St. Paul, MN
Staten Island University Hospital - Staten Island, NY
Team Health EMAPC Fellowship - OKC
Team Health EMAPC Fellowship - Orlando FL
University of Iowa - Iowa City
University of New Mexico School of Medicine - Alberquerque, NM
UCSF Fresno
Yale New Haven Hospital - New Haven, CT
Post-Graduate Advanced Practice Provider (APP) Emergency Medicine Fellowship At Lakeland Regional Health - Lakeland, FL

 

[Kardio]

DO approved ACGME umbrella programs

What’s that?

 

[em26862]

1. It sounds like some person (perhaps, eager person) leaked this WITHOUT this program even being approved yet... hence, why it got pulled. I bet we'll hear something from leadership soon.

2. I haven't heard on the salary, but it also sounds again like this was not approved by leadership... I hope that's not the case.

3. ^ as above, there are a lot of other places that have these including CMC and Regions. Are you going to sink all of these good programs because of this? I wouldn't recommend so.
Will the residency leadership let a new APP program take away experiences from the residents? They will fight tooth and nail for the residents, and I also heard they wouldn't be going to Wakemed nor primarily work in the high acuity bays.
CMC:

Emergency Medicine Fellowship | Center for Advanced Practice

The Emergency Medicine Advanced Practice Provider (APP) Fellowship is a 12-month post graduate program to reinforce physician assistants and nurse practitioners with the fundamentals to addressing clinical matters in a variety of emergency settings.

atriumhealth.org

Regions:

PA Residency – Regions Emergency Medicine Residency

regionsem.org

Yale:

Yale New Haven Hospital Emergency Medicine APP Residency Program - APPAP

YNHH Emergency Medicine APP Residency Program Program Information Yale New Haven Hospital (YNHH) Emergency Medicine APP Residency Program 464 Congress Avenue, Suite 260 New Haven, CT 06519 203-737-4303 https://medicine.yale.edu/emergencymed/education/residency/pa/ Contact Information Kevin...

appap.org

Kentucky:

APP Residency – UK WildCat EM

wildcatem.com

No.

To each their own. People leave very clinically sound and do whatever they want. I'm biased as an alum, but feel it is a top program. Is it the best? Who knows, no program is perfect. Does every resident walk away doing a thoracotomy? No, but multiple that hadn't, had done so flawlessly after graduating because we are trained well. Can we move at a good patient per hour and run a BAFERD resus? You bet. Do alum go do awesome things? You bet.

For whatever reason people automatically assume big name academic centers automatically mean top tier clinical training when EM is the only specialty where that doesn't work unless you like transfers with everything already done.

I hear what you are saying. UNC's program is balanced by WakeMed, a large community hospital. And sometimes, transfers are super sick and far from packaged neatly with a bow.

What do Chair of EM Jane Brice and residency PD Nikki Binz have to say about the complete degradation of their emergency medicine physician program?

Edit: for the love of god. Can a UNC resident make a throwaway and freaking talk about this? There's 40 of you. How are the interns not freaking out?

It sounds like the residents and the EM faculty were largely blindsided by this. Which is insanely untimely and less than ideal.

 

[MedicineZ0Z]

Hmm no I would argue it's Anesthesia that has been leading the charge against midlevel provider expansion. EM and all other specialties just didn't care for like the past 20 years and have been asleep at the wheels. The surgeons are not losing sleep over this right now but soon they will come for them. They are here for EM now.

There is no inter-specialty unity among physicians. It's how we got to where we are in the first place.

Meanwhile, nurses/NPs/PAs will defend each other over the tiniest things and scorch the earth over it. Doctors? They make fun of other specialties and could care less about each other.

 

[Giovanotto]

Trash can move. I can't even imagine what it's like to be a resident there right now.

 

[OnePunchBiopsy]

Advanced Practice Provider Dermatology Fellowship - Penn State College of Medicine Residencies and Fellowships

The Advanced Practice Provider Dermatology Fellowship at Penn State Health Milton S. Hershey Medical Center is a one-year, non-ACGME-accredited program that admits one fellow per year.

residency.med.psu.edu

Totally jacked. Its all gone under.

Don't worry, they'll all just go into cosmetics. You can have all the pyoderma to yourself.

 

[Old_Mil]

Would it be worth contacting faculty to ask how this will effect training if we interviewed and ranked this program?

No...the very fact that they are going here indicates that this isn’t somewhere you want to be.

 

[The Knife & Gun Club]

To be fair Carolinas has one of these PA residencies and even though I was just a med student it seemed fine. And no one is debating that CMC is a serious EM program.

Everyone was friendly and the PAs just saw a bunch of the ESI 4/5s with an occasional 3 thrown in. Residents were grateful because they could spend more time seeing higher acuity/complexity patients.

Also to be fair - PA school is FAR more rigorous and educationally valid than NP. They have real classes coving physiology and pathophys, often taught by MDs, real exams, and real clinical rotations with actual expectations.

 

[homebaseddad112818]

To be fair Carolinas has one of these PA residencies and even though I was just a med student it seemed fine. And no one is debating that CMC is a serious EM program.

Everyone was friendly and the PAs just saw a bunch of the ESI 4/5s with an occasional 3 thrown in. Residents were grateful because they could spend more time seeing higher acuity/complexity patients.

Also to be fair - PA school is FAR more rigorous and educationally valid than NP. They have real classes coving physiology and pathophys, often taught by MDs, real exams, and real clinical rotations with actual expectations.

“Real exams” - get that noise out of here

 

[Dr Mantis Toboggan]

plus the article specifically stated that they would learn to care for critical patients. if you have a lit super busy ED like CMC, and say the goal is to train midlevels to run a fast track, that’s one thing. if you’re not that busy and take away learning opportunities from the residents, that’s quite another.

“Real exams” - get that noise out of here

 

[USCDiver]

Yeah I know a gyn/onc attending out there who works for UNC so I was just spitballing.

You seemed plugged into the region. Any idea how this midlevel residency deal will play out?

Yeah, the Ob/Gyn residency has some presence here, but that service is mostly staffed with private docs from around town. The ED is exclusively Wake Forest.

Honestly aside from the ****storm this will cause within the UNC residency program having some PAs who are committed to EM (and won't leave for a cushy outpatient job after a year) and know what they're doing (as opposed to hiring a new grad who can't reliably do anything independently for 6-12 months) is not a bad thing. The reality is that all medium-large EDs need APPs to survive and I'd rather be hiring someone who has 18 months of EM experience than someone who just graduated.

 

[Lexdiamondz]

I cant say that postgraduate training for midlevels (who get basically no real training before entering the job market and commanding 6 figure salaries) is a bad thing.

That being said, there really is no reason for midlevels to be sharing learning opportunities with residents and fighting with residents for procedures. Let them train in the level 3 trauma centres with no residents - or better yet all of those crappy HCA residencies that are diluting the value of our training and graduating marginal candidates should probably be training midlevels instead

 

[SXMMD]

I cant say that postgraduate training for midlevels (who get basically no real training before entering the job market and commanding 6 figure salaries) is a bad thing.

That being said, there really is no reason for midlevels to be sharing learning opportunities with residents and fighting with residents for procedures. Let them train in the level 3 trauma centres with no residents - or better yet all of those crappy HCA residencies that are diluting the value of our training and graduating marginal candidates should probably be training midlevels instead

While I agree with the first paragraph in theory, I'm personally becoming opposed to fellowships/residencies for midlevels because the industry as a whole has decided they can replace physicians with them. I'm just not that interested in giving more ammunition to the powers that be to accelerate that process.

 

[Southpaw]

Yeah, the Ob/Gyn residency has some presence here, but that service is mostly staffed with private docs from around town. The ED is exclusively Wake Forest.

Honestly aside from the ****storm this will cause within the UNC residency program having some PAs who are committed to EM (and won't leave for a cushy outpatient job after a year) and know what they're doing (as opposed to hiring a new grad who can't reliably do anything independently for 6-12 months) is not a bad thing. The reality is that all medium-large EDs need APPs to survive and I'd rather be hiring someone who has 18 months of EM experience than someone who just graduated.

I'm an anesthesiologist. Having a 'midlevel provider' solely dedicated to the field has done nothing to help our cause. On the surface it may seem of value, but in the end that midlevel will claim equivalence, their society will support it, and you'll fight tooth and nail to keep jobs and maintain relevance. You'll see the value in your work but look around and wonder if anyone else does. I understand your argument, but I just don't think it'll work out the way you want it to.

 

[deleted1011020]

To be fair Carolinas has one of these PA residencies and even though I was just a med student it seemed fine. And no one is debating that CMC is a serious EM program.

Everyone was friendly and the PAs just saw a bunch of the ESI 4/5s with an occasional 3 thrown in. Residents were grateful because they could spend more time seeing higher acuity/complexity patients.

Also to be fair - PA school is FAR more rigorous and educationally valid than NP. They have real classes coving physiology and pathophys, often taught by MDs, real exams, and real clinical rotations with actual expectations.

I would argue that low acuity is important to see during training to determine appropriate level of care and not over test etc. wouldnt it? I don’t know if any residents can chime in and elaborate why this is not the case.

 

[Dr Mantis Toboggan]

Sure but it’s the rare program where there’s a resident always available to see every patient. So it’s either the attending sees some by themselves or you fire up some midlevels.

I would argue that low acuity is important to see during training to determine appropriate level of care and not over test etc. wouldnt it? I don’t know if any residents can chime in and elaborate why this is not the case.