Description of the Critical Care Residency for Physician Assistants
In this one year training program for Physician Assistants, our mission is to provide a comprehensive foundation to support PA resident growth in becoming well- trained critical care providers. This is done through didactic training, hands on simulation, and a multitude of clinical rotations. These clinical rotations are completed at both the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center to optimize patient exposure and a variety of clinical experiences.
When on rotations, Physician Assistant Residents will be working within a team to provide comprehensive and consistent care of 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, as well as management of ventilator modes.
PA Residents will follow the same schedule and adhere to the same call requirements as the surgical and/or anesthesia medical 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 Johns Hopkins Simulation Center.
Learn more about:
- Didactic Opportunities
- Responsibilities of the PA Resident
- On Call Activities
- Completion of the Program
- Paid time off (PTO)
Throughout the year, PA residents rotate through many clinical settings. PA residents work alongside PAs, NPs, Resident Physicians, Fellows and Attendings. This relationship facilitates intense mentoring and collaboration required for growth in surgical, medical, and critical thinking skills.
Rotation schedules have been organized to optimize education and growth for critical care providers. During the year, the PA residents rotate on the following services at both the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center.
- Medical Intensive Care Unit (JHH and JHBMC)
- Surgical/Trauma Intensive Care Unit (JHH and JHBMC)
- Neurosciences Critical Care Unit (JHH)
- Burn Intensive Care Unit (JHBMC)
- Cardiac Intensive Care Unit (JHH and JHBMC)
- Cardiac Surgical Intensive Care Unit (JHH)
- Emergency Medicine
- Renal Consult Service
- Infectious Disease Consult Service
- Palliative Care Consult Service
- Airway Days in the OR
- Elective Rotations:
- Oncology ICU
- Procedure Team
- 2 week hospital and residency orientation prior to starting clinical rotatio s
- Weekly PA Resident Lectures focused on critical care specific material
- Weekly Grand Rounds
- Weekly Intern Lectures
- Weekly Morbidity and Mortality Conference
- Monthly APP Grand Rounds
- 50 Category 1 AAPA approved CME Credits
Certifications and Training Opportunities:
- ENLS: Emergency Neurological Life Support
- ABLS: American Burn Life Support
- SCCM Critical Care Ultrasound Course
Simulation Training Opportunities:
- Central Line
- Arterial Line
- Foley Insertion
- Mock Codes
- Standardized Patients
During rotations, you will be mentored by Attendings, Fellows, Residents, Physician Assistants and Nurse Practitioners. For most 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.
During some rotations, you will be on call at night and paired with a resident, NP, PA and/or Fellow. PA Resident do not write orders on any service until their skills are validated by the PA Residency Leadership along 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 absolute 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.
- Maintain up to date Procedure log that 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.
- Maintain all certifications. This includes but is not limited to Maryland License, CPR/BLS, ACLS, PANCE, CDS, and DEA.
On some rotations, the PA resident is required to participate in a number of call shifts. 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.
In order to successfully complete the program, the following standards must be met:
- On rotation evaluations, receives a score of 6.5/10 on overall performance on 70% or more of total evaluations at six month and final evaluations. If not meeting this benchmark at six-month evaluation, shows consistent improvement in scoring over last two months that indicates goal is achievable by ninth month of program.
- Prompt and consistent attendance to all scheduled shifts, didactic labs, and lectures.
- Upholds/demonstrates the Johns Hopkins CORE values.
- Score of 75% or higher on final written examination or 15% improvement from initial testing to a minimum of 65% on the final written examination.
- Score of 70% or higher on final Critical Care identification examination.
- Active participation in all simulation labs, with demonstration of average abilities by sixth month of program in preparing for and demonstrating central line placement and intubation.
- 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.
- Vacation Days: 22 total Vacation days acquired throughout the year. 2 weeks of vacation are given to each PA resident and the remaining days are used for interviews
- Holidays: Given that PA residents are resident status, you will not be guaranteed time off for the 13 holidays recognized by the hospital system. Each PA resident will have guaranteed time off over the Christmas Holiday or New Years Holiday
- Illness: JHU provides Sick and Safe Leave days in the event of an un expected illness
CME and Conference Funding:
- Throughout this year, you will have access to gaining > 50 Category I CME.
- Upon successful completion of this residency, you may also list 50 Category 1 CME on the NCCPA website.
- Through the Tuition Reimbursement program through JHU, each PA resident will have funds up to $5,250 to cover expenses of enrollment into conferences.
- Through the Yearly Professional Allowance, up to $750.00 will be covered for funding of travel expenses for conferences.
The Johns Hopkins Critical Care Physician Assistant Residency Program is a 12-month long program. The stipend is $57,160.00 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.