1. CHRISTOPHER GARIBAY EMT-P, PA-C FELLOWSHIPS AND CAQ’S INFORMATION YOU SHOULD KNOW

2. DISCLOSURE STATEMENT The ideas and information provided in this presentation does not reflect the opinion of the American Academy of Physician Assistants or affiliated organizations

3. WHAT TO DO AFTER GRADUATION Start working Self-study Conferences Constituent organization lectures Postgraduate/Fellowship training

4. FROM STUDENT TO PA-C Make connections Gain confidence Job offers during rotations Mentorship opportunities

5. WHAT YOU GET FROM THE JOB On the job training Self-Motivated learning Mentorship Getting paid

6. Why? Postgraduate/Fellowship training

7. NEED FOR ADDITIONAL TRAINING Ever increasing demand for PA’s in all areas of medicine Push for NP to DNP Expectations by Physicians for high performing PA’s joining team Independent of experience Higher autonomy expectations

8. CHALLENGES NEW PA’S FACE Reliance on PA’s Growing case and patient load Attending physician responsibilities Increasing demand on PA programs Increasing program size Changing student demographics

9. CURRENT PA STUDENTS DEMOGRAPHICS 173 Accredited PA Programs 7,285 First-Year enrollment 6,646 Graduating 50% PA Programs require prior healthcare experience All time lowest average 25 months experience 42% Practice in Primary care 27 th Annual report on Physician Assistant Education 2011, ARC-PA

10. SPECIALIST PA’S PA’s work in over 15 specialties 83,000 PA’s practicing in the U.S. Expected 30% growth by 2020 Expectation of PA independence for new graduates and experienced PA’s Special skills Patient care and load Limited mentorship Bureau of Labor Statistics, U.S. Department of Labor

11. IS POSTGRADUATE TRAINING FOR EVERYONE? Of Course Not! An option not a requirement Designed to help PA’s who seek additional training Fellowships can meet an individual’s professional goals

12. POSTGRADUATE PROGRAMS Over 40 postgraduate PA programs 15 different specialties Range from 6-18 month programs ACGME guidelines Time requirements similar to PGY-1

13. POSTGRADUATE PROGRAMS

14. Association of Postgraduate PA Programs (APPAP.org)

15. WHAT MAKE A SUCCESSFUL FELLOWSHIP? Self-Motivated Passionate about specialty Willingness to learn Ability to adjust to different practice styles

16. WHAT TO EXPECT FROM A FELLOWSHIP Professional Confidence Skills Knowledge of subject Autonomy Professional growth Networking Paid experience – fraction of working

17. WHAT TO EXPECT FROM A FELLOWSHIP Educational Teach PA’s, Patients Attend lecture sessions Specialty constitute organizations 1 year average length Certificate of Additional Qualification’s (CAQ)

18. WHAT IS A CAQ? Certificates of Added Qualifications Optional testing Documentation of special skills and knowledge Recognition of accomplishment Aids in credentialing process Attempt to compete with NP

19. CAQ SPECIALTIES (7) Cardiovascular/Thoracic Surgery Emergency Medicine Orthopedic Surgery Hospital Medicine (2014) Pediatrics (2014) Nephrology Psychiatry

20. CAQ REQUIREMENTS Valid and unrestricted licensure NCCPA Certification (PA-C) Must maintain to keep CAQ Valid for 10 years Minimum of 2000 hours of experience 150 hours of Category I CME in specialty

21. CAQ REQUIREMENTS Specialty procedure log Each specialty has specific requirements Examination $350 fee ($100 for administrative fee $250 for test) Completion of CAQ within 6 years of application Recertification: Testing/CME Resources: nccpa.net/specialtyCAQs.aspx

22. CAQ LIMITATIONS Average PA 3 specialties during career Freedom to change specialty Exclude new PA’s from entering specialty

23. Questions?

24. CONTACT INFORMATION Christopher Garibay EMT-P, PA-C California Emergency Physicians America – Redlands Community Hospital ChristopherGaribay@cep.com

25. REFERENCES American Academy of Physician Assistants (AAPA), National Physician Assistant Salary Report: Research and Statistics 2010, Internet edition at www.aapa.org/uploadedFiles/content/Research/Data_and_Statistics/Resource_It ems/2010_Salary_report.pdf Association of Postgraduate PA Programs (APPAP), Programs, Available Programs, from Internet at www.appap.org/LinkClick.aspx?fileticket=zpqLm53QUUo%3d&tabid=58 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook 2012-2013 Edition, Physician Assistants, on the Internet at http://www.bls.gov/ooh/healthcare/physician-assistants.htm (April 20,2013). National Commission of Physician Assistants (NCCPA), Certificates of Added Qualifications, on the Internet at http://www.nccpa.net/SpecialtyCAQs.aspxhttp://www.nccpa.net/SpecialtyCAQs.aspx Physician Assistant Education Association (PAEA), 27 th Annual Report on Physician Assistant Education Programs 2010-2011 Annual Program Survey 2011, Internet from www.paeponline.org/index.php?ht=a/GetDocumentAction/i/131423 (May 3, 2013).www.paeponline.org/index.php?ht=a/GetDocumentAction/i/131423 Physician Assistant Education Association (PAEA), Bridging the gap between PA programs and postgraduate residencies and fellowships, from internet, www.paeaonline.org/2007syllabus/212.pdfwww.paeaonline.org/2007syllabus/212.pdf (April 12, 2013).