Winthrop University Hospital, a 593 bed teaching hospital affiliated with Stony Brook University School of Medicine, is pleased to offer the well qualified Physician Assistant a post-graduate opportunity in the growing field of surgical critical care. The twelve month, rigorous program has been designed to provide the Physician Assistant the advanced knowledge and technical skills necessary to provide an evidence based approach to the management and care of patients with critical illness and injury. Critical care medicine is practiced using a multidisciplinary team approach consisting of board certified Critical Care Intensivists, Attending Physicians and a well seasoned team of Physician Assistants in the fields of Cardiothoracic, General and Neurosurgery. Combined with the knowledge and experience of Critical Care Nurses, Respiratory and Physical Therapists, Dieticians and Social Workers, the educational experience will be truly interdisciplinary and well-rounded. Formal lectures and small group discussions will set the foundation for broad based learning and clinical insight, while hands-on procedural training will provide the technical skills necessary to practice with competence and confidence in the field of surgical critical care. The standards of care embedded at Winthrop University Hospital are unsurpassed. Practicing “good” medicine is much more than the day to day clinical management of patients. Entrenched within the twelve months of residency, the moral obligation we have to our patients and to their families will be re-enforced. Respect, compassion, a patient’s right to privacy and a cognizance of cultural sensitivity are paramount to, and an integral part of, the healing process. The goal of this Residency program is to train the Physician Assistant to be an extraordinary practitioner in the field of surgical critical care medicine. It is through the interface of teaching, intense clinical training, ethical awareness, and a strong dedication to the Physician Assistant profession that this can be accomplished.
In response to a projected shortage of critical care clinicians as stated by the Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS) and fostered by the exemplary model of the Physician/PA critical care team which has been applied successfully in critical care settings across the nation, and in particular, at Winthrop University Hospital, a postgraduate Critical Care Residency is being offered to a select candidate who meets the competitive application criteria and who is able to meet the physical and cerebral demands of a critical care environment. The program will enhance the fundamental concepts of critical care medicine learned in a PA Program and further foster ones knowledge of patient care, evidence based medical knowledge, research principles, systems based medicine, and communication among the healthcare team, patients and their families.
Interested applicants must fulfill the following prerequisites:
Graduation from an ARC-PA accredited Physician Assistant education program.
Successful completion of the NCCPA Physician Assistant National Certifying Examination and current NCCPA certification
Possess a valid New York State License to practice as a Physician Assistant
Current BLS/ACLS certification
Submission of a completed application including 3 letters of recommendation from preceptors, supervising Physician Assistants or Attending doctors. One letter must be from the applicant's school program Director if the applicant is a new graduate.
The program consists of 12 months of intensive training in the sub-specialties of Cardiothoracic Surgery, General Surgery, and Neuro-Surgery critical care. Training is I.C.U. based and encompasses a multi-disciplinary team of health care professionals. Patients on each of these units are managed 24/7 by physician/PA teams whom you will regularly interact with. The faculty consists of renowned and well respected Critical Care Intensivists, Neurosurgeons, Neurologists, Cardiothoracic Surgeons, Cardiologists and PA’s. Formal lectures will be provided throughout the program year; however, the majority of didactic learning comes from small group discussions and interaction with surgeons, critical care intensivists, teams of highly seasoned Physician Assistants and other members of the health care team. An intensive training course is also offered in A.T.L.S. Additional lectures offered by other hospital departments will be attended at the discretion of the program director.
The Physician Assistant will be involved in all phases of patient care including emergency department evaluation, admission orders, History and Physical evaluation, daily progress notes, morning and evening rounds, morbidity and mortality conference and all preoperative and post-operative intervention and management. The last month of the 12 month program will be spent on the service of the Physician Assistants’ choice. In addition, the Physician Assistant will be responsible for case presentations and writing a paper on the topic of his or her choice as it pertains to surgical critical care. A daily log will also be kept for review by the Program Director to ensure the Physician Assistant is gaining the knowledge and experience necessary to be a successful practitioner in the field of surgical critical care.
Technical skills will also be taught and perfected throughout the program year. The Physician Assistant will become proficient performing a vast array of invasive procedures, including, but not limited to, central line placement, arterial catheter placement, chest tube placement and Swan-Ganz catheter placement. In order to maximize the clinical experience, the Physician Assistant will work rotating hours to a maximum average of 60 hours/week, and during his/her training, will be paired with at least one or more experienced P.A.’s
“The Post-graduate Surgical Critical Care Residency at Winthrop was an intense but rewarding experience. Training in three different sub-specialties of the surgical I.C.U. has given me the knowledge and skills to become a confident critical care provider. I would highly recommend this program to any P.A. who is considering a career in critical care.”
-2011 Program Resident
Interfaced with rotations and clinical practice in the Surgical ICU, Neurosciences Special Care Unit and the Cardiothoracic ICU will be lectures and case discussions specific to each sub-specialty as well as the overall management of the critical care patient. Below are examples of some of the topics discussed throughout the program year.
Hemodynamic Monitoring
Cardiac Physiology
Pulmonary Physiology
Intra Aortic Balloon Pumping
Chest/Pulmonary Injury
Acute MI
Acute Renal Failure
Acid/Base Balance
Hemodialysis/CVVH/Ultrafiltration
Electrolyte Abnormalities
Management of Arrhythmias
ALI/ARDS/Respiratory Failure
Mechanical Ventilation
Management of the types of Shock
Sedation in the ICU
Pain Management in the ICU
Nutrition in the ICU
TPN
Toxicology
Vasoactive Drug Pharmacology
Ischemic CVA Management
Traumatic Brain Injury/ICP Monitoring
Seizures/COMA
Abdominal Trauma
Pelvic Trauma
Critical Care Endocrinology
Pancreatitis
Hepatic Failure
G.I. Bleeding in the Critically Ill
Bariatric Surgical Emergencies
Critical Care Ultrasonography
SIRS/Sepsis
DVT/PE and Anticoagulation
Hematologic Disorders in Critical Care
Nosocomial Infections in the ICU
Antimicrobial Therapy
Management of Decubitis Ulcers
OB-GYN Critical Care
As part of the Residency Training Program an intensive two day course will be provided in A.T.L.S.
Residents will also be required to write a paper on a subject pertinent to surgical critical care and prepare two lecture presentations.
A certificate is awarded upon successful completion of the program.
Admissions Process and Timetable
The Physician Assistant Postgraduate Surgical Critical Care Program runs approximately from October to October. Applications are accepted from April 1 to August 1 for the up-coming year. Presently, one position is offered per year. Competitive applicants will be invited for an interview. For more information about the application process, please visit www.Winthrop.org and follow the Education links to our program homepage.
