Physician Assistant Post Graduate Training

The UNM PA Post-Graduate Training Program in Emergency Medicine, formed in 2016, strives to equip physician assistants with the clinical experiences and didactic teaching needed to enable them to practice high-quality, evidence-based emergency medicine preferably in the underserved areas of New Mexico. Our graduates will have comfort and competence in the care of critically ill patients, the broad scope of emergent presentations, and the skills necessary to be leaders in their profession.  We strive to recruit and foster PAs who are advocates for their patients, tireless learners, and enthusiastic about working in a multi-disciplinary healthcare team.  Our program is one of >30 physician assistant post-graduate training programs in EM nationwide and the one of the only programs in the inter-mountain West region of the United States.

Our program is 18-months in length and is designed to equip our trainees with both the fundamentals of emergency medicine practice, as well as broad exposure to the skillset needed to be an Emergency Medicine PA. Our trainees work as a team with our EM physician attendings, residents, our nurses, pharmacists, techs and the entire emergency medicine family to provide the best care possible to our patients.

The University of New Mexico School of Medicine residency in emergency medicine is an approved three-year training program which was established in 1987. In 1991, the School of Medicine recognized the contribution of emergency medicine by granting full departmental status. Our trainees rotate primarily at the University of New Mexico Hospital, which is the only level I trauma center in the state, the only children’s hospital in the state, and the major tertiary referral center for our region. Our department has a 70-bed adult emergency department and a dedicated 12-bed pediatric emergency department. Our volume is over 82,000, which does not include the volumes in our on-site urgent care center, open six days per week. Residents also rotate in our three ICUs, with our orthopedic and cardiology teams, with our anesthesia providers, and in our OB/Gyn testing and triage areas. Our trainees also rotate at our sister community hospital for one block, Sandoval Regional Medical Center, to gain skills in the community ED environment

The program is nationally known for its unique location and culture, its dedication to critical care, wilderness and international medicine, EMS activities, Center for Disaster Medicine and DMAT, and dedication to public service in the only level I trauma center in the state and the state’s primary public safety-net institution.

  • 82-bed emergency department (>80,000 visits annually)
  • New Mexico’s only Level I Trauma Center and only Children’s Hospital
  • Tertiary Referral Center
  • World class faculty specializing in EM Education, EMS, Pediatric EM, Wilderness Med, Disaster Med, and EM/Critical Care
  • High-acuity patient population (trauma and medicine) with high admit rate

All rotations are in 4-week blocks.  Our curriculum may change based on experiences this year and as new opportunities arise, so rotations in upcoming years may not be identical to the current configuration listed in this manual.

Orientation (1 block):          

EMPA post-graduate trainees complete the orientation block alongside the new EM interns, before true clinical work begins. During orientation small 4-hour clinical shifts are scheduled to get new trainees used to being in the ED, but the primary emphasis is getting familiar with the training program and the Health Sciences Center/University Hospital. ATLS, FCCS, and an airway course are taken during this block.

Main UNMH ED (8 blocks):

Rotations in the adult ED form the core of the EMPA post-graduate training program. PA post-grad trainees will work in the Sandia and Manzano pods alongside attending physicians and experienced PAs. All patients will be staffed by an attending in the Sandia and Manzano pods, with individual attention by PA faculty. PA post-grad trainees will be expected to see all levels of acuity and actively help manage flow in the department.          

During the latter part of residency, PA Post-grad trainees will rotate in the Emergency Department Resuscitation Unit, longitudinally, working alongside an EM attending and EM resident. During this timeframe, interns are not rotating in the resuscitation area, leaving ample opportunity for exposure to critically ill ED patients. PA Post-grad trainees will be expected to take on a significant role in the management of these very ill medical and trauma patients.

Pediatric ED (2 blocks):      

PA Post-grad trainees will spend two blocks in the pediatric ED, seeing all level of pediatric complaints. Ideally each PA Post-grad trainee spend one summer rotation and one winter rotation in the Peds ED, to ensure that PA Post-grad trainees are exposed to all manner of peds emergencies. Some Peds ED attendings work in both the Peds ED and the main Adult ED while other attendings are Peds EM fellowship trained faculty.

SRMC ED (1 block):

During the last six months of training, the PA Post-grad trainee will rotate for one block at the Sandoval Regional Medical Center Emergency Dept. This rotation will impart skills associated with a generalist community emergency medicine practice, including seeing all spectrums of age, having limited consultant availability, transfer skills, and allow the PA Post-grad trainee to work on their pace and flow. Attendings are the same as those that work in the UNM main.

TSI/NSI (1 block):

One of two critical care rotations, in this rotation PA Post-grad trainees will experience in the treatment of the critically ill surgical and neurological patient. The PA Post-grad trainee will either spend the month in the trauma/surgical ICU or the Neurosciences ICU. This is a great opportunity for procedures and gaining comfort with the critically ill.

MICU (1 block):

In the MICU critical care rotation, PA Post-grad trainees will spend a month rotating in the medical intensive care unit. This is another procedures-rich environment with extensive, exposure to critical care medical management to include opportunities to hone skills in sepsis and ventilator management.

Orthopedics (1 block):        

In this rotation the PA Post-grad trainee will gain familiarity with management of fractures, reduction techniques, splinting, as well as soft-tissue (primarily hand and foot) wound management. This rotation will be predominantly made up of night shifts, to allow maximal experience with hands on fracture reduction alongside the orthopedic Post-grad trainees in the ED.

Cardiology (1 block):          

In this rotation, the PA Post-grad trainee will serve as an intern on the Cardiology consultation service. They will focus on the interpretation of ECGs, management of CHF, ACS, and acute arrhythmias. PA Post-grad trainees will work with senior residents from the Family Medicine residency during this rotation, supervised by the Cardiology attending, with teaching rounds provided by the consult Cardiology attendings.

Toxicology (1/2 block):        

In this rotation, PA Post-grad trainees will learn about a variety of poisonings, focusing on the pathophysiology of these conditions, including acid/base and the molecular pathology of these disease processes. This will be accomplished both through exposure in the New Mexico Poison Control Center as well as rounding with the toxicology consultative service at UNMH.

OB/GYN (1/2 block):

In this rotation, PA Post-grad trainees gain familiarity with common emergency obstetrical and gynecological complaints. This will involve spending time at OB testing and triage, where a majority of pregnant patients present with common complaints (such as vaginal bleeding) during their pregnancy. PA Post-grad trainees will also take part in normal vaginal deliveries under the supervision of OB/GYN residents and faculty.

Ultrasound (1/2 block):       

This half-block course occurs in conjunction with the Anesthesia experience, and consists of 3 afternoons per week for a month. During this time, PA Post-grad trainees receive didactic teaching on the basics of emergency ultrasound, and will have the opportunity to perform scans with the department’s resident sonographer on model and actual patients. Clips are reviewed weekly. Emphasis on eFAST, RUSH, Aortic, RUQ and Renal US.

Anesthesia (1/2 block):        

In this block the PA Post-grad trainees will gain experience in managing adult airways, ventilation, oxygenation, and patient hemodynamics. Anesthesia/OR rotations will take place in the morning,  with Ultrasound training sessions in the afternoon.

Electives (2 blocks):

Two blocks are reserved for elective time. This time is generally spent where a PA Post-grad trainee hopes to refine skills seen in other rotations. In general, one elective is expected to be clinically focused, while one can be didactic. Examples of previous electives include Ophthalmology, ENT/Plastics, EMS, Radiology, Wilderness Medicine or Disaster Medicine

Didactic Conferences and Requirements:

  • The EMPA residency program at UNM offers 5 hours per week of core education conference from 10a-3p on Wednesdays. An optional board review resident school precedes conference (9a-10a) on those days as well.
  •  The content presentations for the conferences are based on the Model of the Clinical Practice of Emergency Medicine (MCP) and on the ACGME Core Competencies which align extremely well with the SEMPA Postgraduate Program Guidelines core competencies.

The conference cycle generally maps out with the weeks of the month (there are some weeks that do not follow this pattern, and longitudinal topics are sometimes switched: 

  • 1stWednesday: ECGs, Research didactics, EM Foundations and Hot Topics 
  • 2ndWednesday: Core Content, Radiology, Toxicology, Spanish or Ultrasound 
  • 3rdWednesday: Simulation, EM Foundations and Faculty Lectures 
  • 4thWednesday:  Core Content, EBM, Faculty Lectures, Small group sessions and Peds EM 
  •  The 21 core content topics from the MCP are as follows:

Core Clinical Material

Endocrinology, Nutrition and Electrolytes

Infectious Diseases and Immunology

Trauma

OB/GYN/SANE

CV and Pulmonary

Dermatology

ENT, Ophtho, and Dental

Hematology/Oncology

Abdomen and GI

Renal and GU

Behavioral

Orthopedics and Wound Care

Nervous System

Environmental

Monthly Recurring Sessions

Administration/Legal/EMS

Toxicology

Research

ECG

Radiology

Procedures

Pediatric EM

Teaching skills

Communication skills

  • During small group sessions the classes separate by year of training for focused learning sessions. The first-year sessions focus on core EM procedures. The last six months of the EMPA Residency will focus on PA specific objectives during conference breakout sessions. Furthermore, one week per month PA Post-grad trainees will not attend conference and instead will be in the ED functioning in the role of the senior learner to gain experience in managing multiple critically ill patients.

  • The EM conference schedule is set 1 year in advance. The Education Chief will work with the faculty for each conference to coordinate the scheduling and logistics of that particular day.

  • Resident presentations will not make up more than 10% of the total conference time, excluding Morbidity and Mortality case presentations where significant faculty participation is expected. 

  • M&M/lunch conference.  Two 30-minute M&M slots are available every week during conference. PA Post-grad trainees are required to present one M&M case during their residency program, generally scheduled in the last six months .  This formal presentation will include learning issues raised by the particular case with the intern presenting researched answers to those issues.

  • PA Post-grad trainees will be responsible for supporting the PA program emergency medicine didactic block at the UNM PA program. This may be accomplished by giving a didactic lecture, or being significantly involved in a small group or clinical skills session.

  • Journal clubs will be held the first Tuesday of the month, usually taking place at the house of a faculty member. These articles will be selected from recent literature on pertinent EM topics. PA Post-grad trainees will be expected to attend 5 in the first year and 2 in the last six months.

  • PA Post-grad trainees will be expected to follow up their patients, doing a total of 40 follow-ups during the program. 30 of these can be with chart review, although 7 are required to be telephone follow up and 3 are required to be cases in which the trainee must explore the relevant literature in regards to the patients care.

 

 

 

  • Annual pay of $57,000

  • Employer contribution to health, vision, dental, life and disability insurance

  • 3-weeks per year of annual leave

  • Contribution to retirement

  • Paid conference fees and travel to the SEMPA annual conference

  • $500 Annual CME allowance

  • SEMPA membership, Tintinalli and Robert’s and Hedges textbooks, subscriptions to EM:RAP, ECG weekly, Rosh Review,

  • Weekly conference accredited for 5 hours AMA approved CME.

Albuquerque is a beautiful, multi-cultural city that is physically and intellectual heart of the state of New Mexico. Our metropolitan area has approximately one-million of the two-million residents of the state of New Mexico. This allows our trainees to experience both an urban emergency medicine experience here in the city, but also encounter a large exposure to the challenges of rural medicine given our broad referral base.

Our city has access to the wonderful outdoor spaces of New Mexico, with wilderness accessible one-half mile from the city’s eastern neighborhoods. There is hiking, biking, climbing, and skiing all easily accessible right from the city or with a short drive. Albuquerque and New Mexico are also a culinary hub, with amazing cuisine abounding. Cost of living is reasonable here, and many desirable in-town neighborhoods are walkable or bikeable to our hospital.

More about New Mexico and Albuquerque

Each year our program matriculates two trainees for their 18-month program, beginning usually in the last week of June of every year, designed to coincide with the start date of the UNM EM physician interns.

Our application is open from October 1st of the year preceding matriculation to January 15th of the year of matriculation. Interviews are generally held in late February with notification by early March.

 Application requirements:

  • Strong interest in emergency medicine and serving in a safety-net institution
  • Graduation from an ARC-PA accredited training program by May 31st in the year of matriculation
  • NCCPA certification prior to matriculation
  • Ability to obtain New Mexico PA license
  • Application Form (submitted online, below)
  • V.
  • Personal Statement (1 page ideal)
  • 3 Letters of Reference (using form provided below), including one from PA program director if currently a student
  • Copies of official transcripts sent directly to the program
  • Ability to interview
  • Application fee of $35, submitted with electronic payment (below)

Application link (contains electronic link for references, and instructions for electronic delivery)

Reference link

Application fee payment link

Department of Emergency Medicine
MSC11 6025
1 University of New Mexico
Albuquerque, NM 87131-0001