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, 2003.
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.
For specific information on rotations, supervision, responsibilities of the resident, on-call activites, program completion, PTO, CMEs, stipend, or conference funding either click on the work or scroll down.
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:
- General Surgical ICUs – includes trauma, transplant, vascular, oncology, craniofacial, orthopedic, hepatic, pancreatic, thoracic, endocrine, plastics, and other surgical patients
- Burn ICU
- Pediatric ICU
- Neurosurgical ICU
- Cardiac ICU
- Medical ICU
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:
- Core lectures in Intensive Care
- Surgical/Anesthesia Grand Rounds
- Morbidity and Mortality Rounds
- General Topics in Surgery and Anesthesia
- Intern and Resident conferences
- Didactic lectures in cardiology, fluids, and electrolytes, hyper-alimentation, surgical emergencies, pulmonary disease, renal disease and other areas
- Core Policy and Safety Modules
- Leadership Modules
- FCCS/ACLS/PALS courses
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.
- It is the job of each resident to make these experiences the best they can be, to provide the very best care they can provide, and to learn everything you can from the mentors surrounding you each day.
- PA residents are required to log BOTH their duty hours and their procedures. These logs are reviewed weekly in order to ensure compliance with the 80 hour work week. Failure to comply with these logging policies will result in disciplinary action.
- Procedure logs must be kept and logs will be reviewed by residency faculty at 3, 6, 9, and 12 months.
- Evaluation of rotations: These evaluations are done and must be completed after each rotation has occurred. This information will be used to improve future rotations as well as to determine the appropriateness of the rotation for future residents.
- It is your responsibility to ensure that all your certifications are kept current. This includes but is not limited to Maryland License, CPR/BLS, ACLS, PANCE, CDS, and DEA. If you require any assistance with for scheduling or paperwork, it is your responsibility to let us know.
- TB Testing- Hospital policy requires a TB test from all employees annually. However, occasions may arise when they require it more frequently, and you will be notified by email. Failure to be tested can result in termination of employment.
- This list is not all inclusive. Further detailed responsibilities will be provided in PA Resident Handbook which will be distributed during orientation.
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.
- In-house call must occur no more frequently than every third night, averaged over a four week period.
- Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Residents may remain on duty for up to six additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care as defined in Specialty and Subspecialty Program Requirements.
- No new patients, as defined in Specialty and Subspecialty Requirements, may be accepted after 24 hours of continuous duty.
- At-home call (pager call) is defined as call taken from outside the assigned institution. The frequency of at-home call is not subject to the every third night limitation. However, at-home call must not be so frequent as to preclude rest and reasonable personal time for each resident. Residents taking at-home call must be provided with one day in seven completely free from all educational and clinical responsibilities, averaged over a 4 week period.
- When residents are called into the hospital from home, the hours spent in-house are counted towards the 80 duty hour limit.
After successful completion of the program a certificate will be awarded. The residency faculty have defined three levels of program completion:
- Completed with Honors -- This resident met all and consistently exceeded the performance objectives for completion of the post-graduate critical care residency. This resident will have achieved an outstanding level of performance in the program, as recognized by individual evaluations, performance of the role in general, and participation in OR, classroom and lab experiences.
- Completed -- This resident met all criteria for successful completion of the post-graduate critical care residency.
- Attended program – This resident attended and actively participated in the year long residency program but did not meet the basic performance objectives for successful completion of a post-graduate critical care residency.
Throughout the year, we will be meeting with you to discuss your performance and abilities as you move through clinical experiences. Everyone will receive formal evaluations at 3, 6, 9, and 12 months into the residency. Additional individual evaluations will be provided as needed or at the request of the resident, especially if concerns arise regarding competency and performance evaluations, affect, or disciplinary issues.
Should it be determined that a resident is not able to perform at the expected level despite increased educational efforts and implementation of a performance improvement plan, the residency faculty reserves the right to change the clinical rotations, focus, and venue for a resident. Such a change is not taken lightly, and will only be made after all efforts are exhausted to assist the resident in achieving a baseline level of competency and performance.
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 after six months. The circumstances leading to this decision are reviewed by and the decision to terminate is made with the Chair of the Department of Anesthesia/Critical Care Medicine, and is not subject to appeal.
- Vacation Days: You have a total of 22 days of vacation. Given your week/hour schedules as a resident, a “week” of vacation is counted as 6 days.
- Holidays: There are 13 paid holidays within the hospital system. Given that you are resident status, you will not be off for each holiday. You will be guaranteed time off around the Christmas holiday. This holiday is broken up into two weeks and you will have time off around Christmas or New Year’s.
- Conference/Interview Days: In addition to the 22 vacation days, you will have the opportunity to spend 4 days at a conference, particularly the AAPA Annual Conference. You may also choose to use those days towards the end of the year for job interviews.
- Unplanned Absences - If you are not able to make it to work or will be unexpectedly late, it is your responsibility to notify the program director(s) and the Fellow/Attending on your service as soon as possible of the absence. The information must be relayed via direct conversation -- emails or text pages are not sufficient.
- Illness- The program requires that you not pre-schedule at least 4 days of your PTO. These days can then be used for sick time throughout the year.
- Throughout this year, you will have access to gaining > 50 Category I CME. It is your responsibility to sign-in at each and every conference you attend at Johns Hopkins.
- Upon successful completion of this residency, you may also list 50 Category II CME on the NCCPA website.
The Johns Hopkins Hospital Department of Surgery Postgraduate Surgical Residency for Physician Assistants will be a twelve month employment contract. The Stipend is $45,000.00 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 is available. Physician Assistant Surgical Residents will be subject to the guidelines established by the Accreditation Council for Graduate Medical Education. DEA, 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.
As an academic institution, we support research. Therefore, we encourage the you to submit an interesting case or poster for presentation at the AAPA Annual Conference. We will be happy to mentor you in the process, also. If accepted, we will provide some financial support to assist you in this endeavor.
For Additional information about working at Johns Hopkins, please see the employee handbook.
