Program Details

Mission

The University of Kentucky PA Academic Hospital Medicine residency based at St. Claire HealthCare is dedicated to training Physician Assistant graduates in the field of hospital medicine to provide exceptional healthcare to critically ill patients.

Purpose

  • To educate and prepare PA graduates for transition into hospital medicine
  • Meeting the healthcare needs for providing hospital medicine in the community
  • Changing how PAs are educated in the everchanging healthcare delivery system from a physician training on the job of a new graduate and graduates who want to make a change to the field of hospital medicine to now meeting the demands of employers (hospitals) to be ready to practice at a higher level of competency

Benefits

  • Readiness to start working at a higher level of competency
  • Competitive advantage in employment
  • Meeting the need for sub-specialize care in the hospital industry

Program Goals

  • To prepare the physician assistant (PA) to deliver healthcare in a rural setting in the field of hospital medicine that is beyond the newly graduate-level to an advanced level of knowledge and skills
  • Educate competent hospital medicine physician assistant to function at a higher level than a generalist PA
  • The education of the physician assistant for the practice of managing and caring for in-hospital patients encompasses education in basic science, training in cognitive and technical skills, development of clinical knowledge, and maturity in the acquisition of clinical care thinking and judgment
  • To train the UK PA Academic Hospital Medicine Resident in a rural setting at St. Claire HealthCare in Morehead, KY to provide hospital coverage for floors, and Emergency Department with a focus on procedures
  • To be trained in being a lead or team member of response teams such as medical resuscitation and sepsis response teams.

Program Objectives

  • Medical Knowledge:
    • Acute and Chronic Respiratory Failure as well Ventilatory-Associated Events
    • Shock/Resuscitation
    • Acute and Chronic Renal Disease
    • Cardiac Disorders
    • Neurologic Disorders – ie. stroke
    • Gastrointestinal (GI) Disorders
    • Hepatic and Biliary Tract disease – ie. Liver Failure
    • Nutritional support
    • Infectious Diseases-hospital acquired infections
    • Sepsis
    • Pulmonary Diseases
    • Substance use disorders
    • Hyponatremia
    • Syncope
    • Pain management
    • Perioperative Medicine
    • Emergency Medicine
  • Patient care:
    • Respiratory Failure
    • Acute and Chronic Pulmonary Disease
    • Shock/Resuscitation
    • Acute and Chronic Renal Disease
    • Cardiac Disorders
    • Arrhythmias
    • Neurologic Disorders
    • Gastrointestinal (GI) Disorders
    • Liver Failure
    • Infectious Diseases
    • Sepsis
    • Substance use disorder – Alcohol and drug withdrawal
    • Hyponatremia
    • Nutritional support
    • Stroke
    • Syncope
    • Seizures
    • Emergent and Urgent Care in the Emergency Department
    • Procedural Competencies * see the list of procedural competencies below
  • Systems-Based Practice
    • Administrative Responsibility
    • Coordination and Transitions of Care
    • Billing and Coding
  • Practice-Based Learning and Improvement
    • Improvement of Care
    • Teaching
    • Self-Directed Learning
    • Clinical skills and procedures
  • Professionalism:
    • Professionalism and Personal Behavior
    • Ethical Issues in Critically-ill Patients
    • Personal Responsibility
    • Healthy Work Environment
    • Interpersonal and Communication Skills:
    • Effective Communication with Patients and Families
    • Effective communication with the Healthcare Team

Rotation Schedule

  • 1st month: Orientation & Hospital Medicine – Day service (Core didactic – Review of ACLS, Pre, and Post-op care, general surgery conditions)
  • 2nd month: Hospital Medicine – Day service (Core didactic -GI)        
  • 3rd month: Emergency Medicine –Day/Evening service (Core didactic -Pulmonary & Shock)
  • 4th month: Hospital Medicine Medical ICU (MICU) – Day Service (Core didactic – Cardiology)
  • 5th month: Admitting service – Day/swing/nights service (Core didactic – Neurology-stroke)
  • 6th month: Hospital Medicine Consults – Day service (Core didactic – Seizures)
  • 7th month: Perioperative/postoperative Medicine – Day service (Core didactic – Nephrology)
  • 8th month: Family Medicine floor – Day service - (Core didactic – Infectious disease with emphases on sepsis)
  • 9th month: Hospital Medicine - MICU – Day service (Core didactic – Critical Care)
  • 10th month: Floor/Admitting service – Night service (Hematology/Oncology)
  • 11th month: Elective (Family Medicine hospital, Diagnostic/(Interventional Radiology, Rehabilitation Medicine, Medical ICU, Cardiology, or any of the core areas required)
  • 12th month: Hospital Medicine Consults/admissions – two weeks on nights and two weeks on days

12 months Total

Procedural Competencies *

  1. All the items in the St. Claire HealthCare for medical privilege
  2. Trach changes
  3. Ventilation management and care
  4. Bronchoscopy
  5. Thoracentesis
  6. Vascular access - Central lines, Ultrasound for PICC and PIVS lines, and arterial lines
  7. Management of Central lines, arterial lines, chest tubes, and others as directed
  8. ABGs
  9. Laceration closure
  10. Tracheostomy first assist
  11. Drain removal and central line removal
  12. Suture and staple removal
  13. Percutaneous endoscopic gastrostomy (PEG) first assist
  14. Lumbar puncture
  15. Intubations
  16. Imaging interpretation
  17. ECG interpretation and telemetry monitoring

Essential Experiences

  1. Run specific response teams such as:
    1. Acute medical resuscitation team (Hospital floors and Emergency Department)
    2. Sepsis response team
    3. Disaster response team to external events
  2. Training in quality assurance and process improvement (resident research project)
  3. Consulting for acute and critical patients in the hospital and emergency department
  4. Rehabilitation Unit
  5. Medical Ethics board/Patient Safety Training
  6. Ventilator orientation with the Respiratory Therapy Department
  7. Fundamental of Critical Care Course (Oct.)

Conferences

  1. Tumor Board every 1st & 3rd Fridays
  2. Grand Rounds once a month on Wednesday
  3. Recommend one national conference