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The Johns Hopkins Hospital Department of Anesthesiology/Critical Care Medicine Postgraduate Critical Care Residency for Physician Assistants
When on rotations, Physician Assistant Residents will be working within a team to provide comprehensive and consistent care for your patients. You will be responsible for assessment, diagnosis, management, selection of interventions, required procedures, and consistent evaluation of the patients progress towards goals. You will have ownership of patients with complex surgical and medical conditions, and will manage all aspects of their care, from fluid resuscitation and antibiotic management to pressor use, interpretation of Pulmonary Artery Catheter readings and other invasive/non-invasive hemodynamic parameters, and management of ventilator modes and strategies
PA Residents will follow the same schedule and adhere to the same call requirements as the surgical and/or anesthesia residents on the team. All residents will follow the guidelines established by the Accreditation Council for Graduate Medical Education that became effective on July 1, 2011.
Physician Assistant Residents will be taught core clinical skill competencies in the Minimally Invasive Surgical Training Center (MISTC),as well as in the new Johns Hopkins Simulation Center.
Learn more about rotations, supervision, responsibilities of the resident, on-call activities, program completion, paid time off (PTO),continuing medical education (CME) ,stipend and conference funding.
Modeled after the surgical MD resident program, you will follow the same schedule and adhere to the same call requirements as the surgical and/or Anesthesia residents within the ICU. You will work closely with the existing ICU Physician Assistants and Nurse Practitioners. This relationship facilitates the intense mentoring and collaboration that is required for your growth and development in surgical, medical, and critical thinking skills.
Rotation schedules have been organized to provide the most educational and supportive environment in which to learn. Any concerns related to the rotations should be brought immediately to the attention of the program directors or educational coordinator. We reserve the right to change the rotation schedule at any time in order to meet the needs of the individual PA resident, the needs of the institution, and in response to quality of education and experiences within the units as the year progresses.
Intensive Care Unit Rotations may include but not be limited to the following:
Residents will also have an elective rotation which could include repeating of an ICU rotation or time on a surgical or specialty service. These will be personalized for each resident.
Didactic opportunities include:
During these rotations, you will be mentored by Attendings, Fellows, Surgical and Anesthesia Residents, Physician Assistants and Nurse Practitioners. For the majority of the rotations, you will be paired with a NP/PA/Resident with whom you will provide a totality of care: assess and respond to patient care needs, provide medical, surgical and ICU management, and assess both patients and families to meet their immediate and long-term needs.
You will be on call at night and paired with a resident, NP, PA and/or Fellow. No PA Resident writes orders on any service until their skills are validated by the PA Residency Leadership in conjunction with the preceptors. When moving from one rotation to another, you will be expected to demonstrate your abilities before more degrees of independence are provided, especially when in the specialty units.
The objective of on-call activities is to provide residents with continuity of patient care experiences throughout a 24 hour period. In-house call is defined as those duty hours beyond the normal work day when residents are required to be immediately available in the assigned situation.
Completion of Program:
Successfully Completed: This category is consistent with an “average to above average” evaluation rating and is considered the minimal performance standard for successful progression through and completion of the Johns Hopkins Post-Graduate Critical Care Physician Assistant Residency Program.
Clinical Performance/Professionalism:
Laboratory/Classroom Testing:
Successfully leads the presentation of a total of two case studies in PA lecture series throughout the academic year-at least one case to be completed before the six month evaluation period.
The Program and Medical Directors will ultimately hold the responsibility for determining graduation status. In the event of a dispute, the decision will be made by the Chair of the Department of Anesthesia and Critical Care.
Remediation
Graduation criteria have been developed out of respect for the residents who come to the program and invest time and effort to ensure that they leave the program stronger and more proficient than when they entered.
Throughout the program, faculty and residents will meet periodically (usually at three, six, and nine months into the program) to evaluate progress and needs. Frequency and content will be determined by resident rotation evaluations, informal and formal feedback from preceptors, concerns identified by the individual resident and clinical performance and laboratory/classroom testing sessions. You may also request additional meetings for reviews and/or feedback at any time throughout the program.
If the faculty and/or resident perceive that the resident will be unable to meet the criteria for Successful Completion of the Residency Program, the following actions will be taken:
1. Program Faculty and the PA resident will meet to discuss performance and/or knowledge deficiencies. An individualized performance improvement plan (PIP) will be designed and agreed upon by the resident and faculty to address the deficiencies over a specified time period.
2. During this period, the PA resident will be placed in a probationary standing.
3. If a resident, despite discussions and implementation of a performance improvement plan, is unable to meet the standards of care, practice and safety established by the faculty of the program, they may be terminated from the residency. The circumstances leading to this decision are reviewed by and the decision to terminate is made with the Chair of the Department of Anesthesiology and Critical Care Medicine, and is not subject to appeal.
PA residents are Hospital employees, and as such are held to the same disciplinary rules and processes as all other Hospital employees. Please refer to the JHH Employee Handbook for any and all details of these policies.
The Johns Hopkins Hospital Department of Surgery Postgraduate Surgical Residency for Physician Assistants will be a twelve month employment contract. The stipend is $51,500.00 with twenty-two days of personal time off (PTO) to be used as vacation or sick time. Meal vouchers during call will be provided. Health and dental insurance, life insurance, short and long-term disability are available. Physician Assistant Surgical Residents will be subject to the guidelines established by the Accreditation Council for Graduate Medical Education. Maryland Controlled Dangerous Substance number, License fee, and delegation fee will all be paid for by the hospital. A minimum of fifty Category I and II credits will be available at no cost through various academic requirements during the residency.
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Overview
The one-year Critical Care Physician Assistant Residency trains physician assistant (PA) residents to become highly skilled in the multidisciplinary, evidenced-based management of acute and critically ill adult patients. The program attracts new graduates and experienced PAs seeking a structured educational program leading to the accumulation of knowledge and skills.
Training Rotations
The residency includes 12 four-week rotations plus vacation. Training is centered in the adult Critical Care Units of Einstein-Montefiore’s Moses and Weiler divisions. The Einstein Division of Critical Care Medicine and Montefiore Jay B. Langner Critical Care System Department of Critical Care Medicine, a multi-specialty clinical department, include the ICUs used to educate surgical PA residents for more than 3 decades.
Rotations on the Moses Campus include:
Rotations on the Weiler Campus include:
This schedule can be flexible to accommodate a resident’s interest in a specific area. In all locations, the ICU team includes critical care medicine fellows, staff PAs, and rotating housestaff under the direction of an attending intensivist physician.
Curriculum and Teaching Methods
PA residents function as housestaff members with identical coverage and call requirements as surgery or medicine residents on the same rotation. The principle teaching method is through case management of all patients including a history, physical exam, interpretation of laboratory tests, x-rays, cardio-respiratory physiology data, case presentation, and plan of care development and execution. Daily teaching rounds, weekly Grand Rounds, unit-based conferences and Critical Care core lectures are the framework of the didactic portion of the program. All procedures are performed by Critical Care housestaff.
All residents follow the guidelines established by the Accreditation Council for Graduate Medical Education.
Stipend and Bonus
There is a stipend of $50,000 paid over the year. Each PA resident is awarded a certificate and a $5,000 bonus recognizing successful completion of the program.
Faculty
Hayley B. Gershengorn, MD
Medical Director, Critical Care Medicine Clinical Physician Assistant Service and Critical Care Medicine Physician Assistant Residency Program
Assistant Professor, Department of Medicine (Critical Care)
Assistant Professor, The Saul R. Korey Department of Neurology
Dr. Hayley B. Gershengorn is interested the utilization of ICU resources and the association of resource utilization with clinical outcomes. Her most recent research focus has been on identifying variations in care delivery (e.g., ICU bed utilization, intravascular catheter use, parenteral feeding) for patients with critical illnesses. Ultimately, recognizing variability may allow for acknowledgement of best practices and, ultimately, more standardized care delivery. Her past research has included evaluation of the utility of nurse practitioners/physician assistants in the ICU, the outcomes of patients following cardiopulmonary arrest in the ICU, and the impact of natural light on critically ill patients.
Dr. Gershengorn received a Bachelor of Arts in Applied Mathematics from Harvard University in 1998 prior to obtaining her medical degree from Harvard Medical School in 2003. She completed her internal medicine internship and residency at New York Presbyterian Hospital-Cornell in 2006 and her fellowship in pulmonary and critical care medicine at New York Presbyterian-Columbia in 2010. Between her residency and fellowship, Dr. Gershengorn spent a year as a management and strategy consultant at McKinsey & Company during which time she worked closely with health care organizations to improve operations, quality, and administration. Prior to coming to Montefiore, Dr. Gershengorn was an assistant professor and intensivist at Beth Israel Medical Center in New York City.
Dr. Gershengorn joined the Einstein-Montefiore Division of Critical Care Medicine in September 2013.
Gargi Mehta, PA-C, MSHS
Program Director, Critical Care PA Residency Program
Ms. Gargi Mehta was raised in San Francisco, and completed a bachelors degree in international relations at UC Irvine, followed by a masters of health sciences from Western University in 2007. She relocated to the Bronx and completed a post-graduate residency in surgery at Montefiore Medical Center where she accepted a full-time position in the division of Critical Care Medicine. Since then, she has worked at both NYU Medical Center Critical Care divisions where she participated in weekly fellowship simulations, published along with her colleagues in the ICU Director Journal and created a monthly journal club for rotating PA students and residents.
Ms. Mehta is Director of the PA Education and Post Graduate Residency in Critical Care Medicine at Montefiore and a member within the Society of Critical Care Medicine.
She enjoys teaching surgical residents and physician assistant students, and promoting the role of physician assistants in Critical Care Medicine.
Anthony Carlese, DO
Assistant Professor, Department of Medicine (Critical Care)
Medical Director, Surgical ICU, Moses Campus
Medical Director, Critical Care PA Residency Program
Dr. Carlese is the Director of the Cardiothoracic Intensive Care Unit on the Moses campus. He received his medical degree from the New York College of Osteopathic Medicine, and completed his Critical Care Fellowship at the University of Pittsburgh in 1998.
Dr. Carlese is board certified in Pulmonary and Critical Care medicine as well as neurocritical care and Internal Medicine. He has over 10 years of experience as an intensivist, primarily in cardiothoracic critical care. He is a member of the American College of Chest Physicians and the American Thoracic Society, and is a Fellow of the American College of Chest Physicians.
Admission Requirements
Applicants are evaluated and chosen on a competitive basis.
Applicants must have the following credentials:
Application Materials
Personal Interviews
Interviews are arranged after application materials are received and reviewed.
Applicants are evaluated and chosen on a competitive basis, according to the following criteria:
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