Aeromedical Experience

[DoctorDoogie4]

I was wondering if any of you know of any programs which programs allow direct involvement of the residents in aeromedical transport/EMS? I am very interested in EMS. Thanks!!

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[beyond all hope]

Go to the residency catalogue at SAEM. They will say something about each program and often if they allow aeromedical experience.

 

[waterski232002]

The University of Chicago has a resident run flight program. PGY-2's staff all flights 24/7. We take anywhere from 0-10 flights per day. Yes... that's our helicopter and residents you see on ER.

We also have a contract with AXA assistance (medical travel insurance company) to do international medical evacuations where we transport patients back to their home country on fixed wing planes or commercial airlines. We get paid $1,000 per transport and get to keep the 1st class airline miles (triple miles). All expenses are paid for, and you can request an extra night at the desination. This month we've had residents fly to Japan, Colombia, Peru, London, Jamaica, Egypt, and Sri Lanka.

 

[basementbeastie]

The University of Chicago has a resident run flight program. PGY-2's staff all flights 24/7. We take anywhere from 0-10 flights per day. Yes... that's our helicopter and residents you see on ER.

We also have a contract with AXA assistance (medical travel insurance company) to do international medical evacuations where we transport patients back to their home country on fixed wing planes or commercial airlines. We get paid $1,000 per transport and get to keep the 1st class airline miles (triple miles). All expenses are paid for, and you can request an extra night at the desination. This month we've had residents fly to Japan, Colombia, Peru, London, Jamaica, Egypt, and Sri Lanka.

that's pretty cool!

 

[DropkickMurphy]

The University of Chicago has a resident run flight program. PGY-2's staff all flights 24/7. We take anywhere from 0-10 flights per day. Yes... that's our helicopter and residents you see on ER.

We also have a contract with AXA assistance (medical travel insurance company) to do international medical evacuations where we transport patients back to their home country on fixed wing planes or commercial airlines. We get paid $1,000 per transport and get to keep the 1st class airline miles (triple miles). All expenses are paid for, and you can request an extra night at the desination. This month we've had residents fly to Japan, Colombia, Peru, London, Jamaica, Egypt, and Sri Lanka.

OK, that just added UC to my list of places to apply to when I get to that point.

 

[The White Coat Investor]

I was wondering if any of you know of any programs which programs allow direct involvement of the residents in aeromedical transport/EMS? I am very interested in EMS. Thanks!!

Is it that time of year again already? Do a search. This one is discussed every year.

 

[Dr_Nick_Riviera]

U of Cincinnati has a very good flight program.

 

[docflanny]

Grand Rapids ( www.grmerc.net ) has a residency affiliated flight program available for resident moonlighters in their PGY3 year. It's a lot of fun and a good opportunity to be involved with prehospital care for some of the sickest patients in Michigan. Only a 10-15 minute drive to the hangar from the hospital.

 

[waterski232002]

If you are interested in flight, make sure you understand the difference between an "elective" in aeromedical transport, and being an "essential flight doctor". There are only a few programs which have the residents actually RUN the flight program (they are THE FLIGHT TEAM, and essential to every transport, calling the shots, and making the decisions). Most programs will offer an elective, which basically means that you watch the flight nurse run the show and you don't do anything that they don't instruct you to do. These programs merely have you as a ride-a-long.

At UofC... the helicopter does not take off unless a resident is on board.

 

[mikecwru]

I was wondering if any of you know of any programs which programs allow direct involvement of the residents in aeromedical transport/EMS? I am very interested in EMS. Thanks!!

MetroHealth in Cleveland has one of the busier programs in the country, we just passed 60k flights in 24 years. About 3000+ flights a year, always a doc and nurse on board. 3 helicopters in service at once. We have central lines, intubation, thoracotomy trays, ultrasound on board. You can moonlight and get paid to work on the helicopter. We work dedicated shifts, ie, you don't get paged out for a flight while you're doing a vaginal exam. The service is too busy for that.

www.metrohealth.org and search for Lifeflight

mike

 

[DropkickMurphy]

If you are interested in flight, make sure you understand the difference between an "elective" in aeromedical transport, and being an essential "flight doctor". There are only a few programs which have the residents actually RUN the flight program (they are THE FLIGHT TEAM, and essential to every transport, calling the shots, and making the decisions). Most programs will offer an elective, which basically means that you watch the flight nurse run the show and you don't do anything that they don't instruct you to do. These programs merely have you as a ride-a-long.

At UofC... the helicopter does not take off unless a resident is on board.

We also have a contract with AXA assistance (medical travel insurance company) to do international medical evacuations where we transport patients back to their home country on fixed wing planes or commercial airlines. We get paid $1,000 per transport and get to keep the 1st class airline miles (triple miles). All expenses are paid for, and you can request an extra night at the desination. This month we've had residents fly to Japan, Colombia, Peru, London, Jamaica, Egypt, and Sri Lanka.

I have no interest in the helicopter side of things....just the fixed wing transport. I don't believe helicopters provide much benefit in the vast majority of transport cases except in REALLY rural areas.

 

[waterski232002]

I disagree... we only transport critically ill patients. You are forgetting that the vast majority of hospitals in the country are NOT academic centers (they are community hospitals) and do not have the luxury of having a neurosurgeon, cardiothoracic surgeon, trauma surgeon, or pediatric cardiologist available. Many don't even have an ICU or general surgeon available. So these patients need to be transfered. Time is brain, heart, kidneys (essentially time is life). Even a 10 min decrease in transport time is critical when transporting a SAH, Aortic Dissection, Necrotizing Fascitis, Decompensating Congenital Heart Disease, Pediatric patient with 3rd degree heart block, Ischemic Limb, Hypotensive MI in need of Angioplasty or CABG, etc, etc, etc.... (these are typical patients we transport). It's not just Rural Trauma patients that benefit from helicopter transport.

Our job is not only to transport, but to stabilize the patient as much as possible at the hospital before transport, so it applies to both rural areas and urban areas. So... when you arrive at the outside ED, the patient often has medical needs which have not been addressed and it is our job to diagnose and fix it. We often intubate patients, place chest tubes, start drips, or even run codes at the outside hospitals before even taking off. As a resident (PGY-2 or PGY-3), we end up doing the procedures without back-up. IMO, this is great experience, and teaches you to make tough decisions on your own (if you fail the intubation, you better know how to cric the patient).

 

[DropkickMurphy]

Yes, but do you do scene responses? That is where my distaste for aeromedical evac happens to stem from. I agree with transfers to tertiary care from a outlying hospital.....but not with high risk landings on incident scenes. I've lost two friends to aeromedical helicopter crashes.....

 

[GCS:3]

Allegheny General runs a 5-6 helicopter fleet. 2nd and 3rd years can do time whenever they want to meet the RRC EMS requirement, and there's a dedicated month in 3rd year. We do all the flight command, teach flight nurses, and have a VERY dedicated aeromedical EMS director. Worth checking out if flight medicine is your bag.

 

[waterski232002]

always a doc and nurse on board. 3 helicopters in service at once.

You're saying that there 3 residents are on call 24/7 365 days a year to cover all 3 helicopters simultaneously???? This is new to me if a program has this? (3 flight docs at once to cover 3 helicopters) You must be on call like every 4th day? How do you cover the rest of the residency program and ER?

 

[FoughtFyr]

You're saying that there 3 residents are on call 24/7 365 days a year to cover all 3 helicopters simultaneously???? This is new to me if a program has this? (3 flight docs at once to cover 3 helicopters) You must be on call like every 4th day? How do you cover the rest of the residency program and ER?

MetroHealth does not cover their service with their residents exclusively. Other residency's residents moonlight there as do attendings from MetroHealth (as well as other organizations, please correct me if I am wrong Mike!).

- H

 

[mhusainy]

Allegheny General runs a 5-6 helicopter fleet. 2nd and 3rd years can do time whenever they want to meet the RRC EMS requirement, and there's a dedicated month in 3rd year. We do all the flight command, teach flight nurses, and have a VERY dedicated aeromedical EMS director. Worth checking out if flight medicine is your bag.

I am very interested in EMS and just moved from outside of Pittsburgh. I have applied to AGH. When should I expect to hear something from them. I know it is still early. I loved it there and would love to go back. Any tips?? Two of my LOR's are from local ER docs in Wheeling, WV. In fact, one of your third year residents moonlighted at that hospital. I think his name is Ferraro or something like that. Anyways, I am just super interested. Thanks for reading.

 

[GCS:3]

I am very interested in EMS and just moved from outside of Pittsburgh. I have applied to AGH. When should I expect to hear something from them. I know it is still early. I loved it there and would love to go back. Any tips?? Two of my LOR's are from local ER docs in Wheeling, WV. In fact, one of your third year residents moonlighted at that hospital. I think his name is Ferraro or something like that. Anyways, I am just super interested. Thanks for reading.

They're starting to review apps and I think have offered a couple interviews, but things aren't quite in full swing yet. I can tell things are picking up when the attendings have app files mixed in to their piles of charts to be dictated. The wait can be painful. Good luck!

btw, "ferraro" is in NC now.

 

[mikecwru]

MetroHealth does not cover their service with their residents exclusively. Other residency's residents moonlight there as do attendings from MetroHealth (as well as other organizations, please correct me if I am wrong Mike!).
- H

True, the overwhelming majority are EM physicians. There are a couple of surgery residents/surgeons that also fly. You do a dedicated (non-paid) month as part of your residency in third year. The rest of the time, you are paid as a moonlighter. You can have your fill of shifts, though within RRC/residency regulations.

 

[Aeromedicalese]

Hello everyone.

I just joined the forum and I find these questions very interesting. Primarily because we conduct an aeromedical traiing program in Spanish and English, since 1088 in California.

Due to the growth in the Latin American and European medical aviation services, we will be moving our training to Fort Lauderdale, FL where we will offer an aeromedical Director Internship for docs or residents (also open to nurses and paramedics) who want to obtain an ICAO..International Civil Aviation Organization and FAA, Federal Aviation Administration based program leading to the designation ofTrained Aeromedical Crewmember. TAC .

The advanced Aeromedical Director Internship will be offered as early as January 2009.

For more information you may find our web page helpful

http://aeromedicina.org
Aeromedicalese.

 

[pseudoknot]

I just joined the forum and I find these questions very interesting. Primarily because we conduct an aeromedical traiing program in Spanish and English, since 1088 in California.

Wow, that was extremely forward-thinking of you, to say the least.

 

[KYTNOH]

St. Vincent in Toledo has PGY2 and PGY3 residents on Lifeflight helicopters. LifeFlight has 5 helicopters I believe with two based at St Vincent (one active and one backup). The active helicopter based there is always staffed by one of the residents. The others are based around NW Ohio and are not staffed by a flight physician. I don't know if they are paid as moonlighters or have it integrated as part of their ER shifts. They do have dedicated shifts spent with LifeFlight, and these are interspersed with normal ED shifts throughout the ED months. From what the residents were saying they fly all the time, and the program really pushes for aeromedical transport. From what I understand LifeFlight in Toledo was one of the pioneers in aeromedicals transport back in the 70s.

 

[crewmaster1]

Cinci has 2 helos. One at the hospital that is staffed by the R2 and a flight nurse. The R2 does have 8 beds in the ED and signs these out to the attending when they get a flight (it isn't as bad as it sounds, I love getting a flight it is like being rescued from the pod!) Our second helo is 20 minute drive north. During the day a resident is scheduled to work purely on the helo as part of your monthly shifts. At night on helo #2 residents are paid to moonlight 35/hr. We fly about 40-45% scene and the rest interfacility. Good mix of experience. I really enjoy the opportunity and learning experience.

 

[gutonc]

At night on helo #2 residents are paid to moonlight 35/hr.

Dude! Unless that 3 is supposed to be an 8, you guys are getting hosed. I get paid a little more than double that to watch TV and nap (and answer silly pages and occasionally take active care of sick people) while doing night coverage on a BMT/Onc service. And I just got paid triple that to supply tech support to other docs on a newly rolled-out inpt EMR. And unless I trip and kill myself falling down the stairs, it's pretty safe work.

 

[SolidGold]

Dude! Unless that 3 is supposed to be an 8, you guys are getting hosed. I get paid a little more than double that to watch TV and nap (and answer silly pages and occasionally take active care of sick people) while doing night coverage on a BMT/Onc service. And I just got paid triple that to supply tech support to other docs on a newly rolled-out inpt EMR. And unless I trip and kill myself falling down the stairs, it's pretty safe work.

It's not really considered moonlighting, but "paid elective" shifts because being on Air Care is an educational experience. It's a good way for the younger residents who can't officially moonlight at hospitals yet to make a little extra money. In fact, I've used/will use some of that money to pay for Step3, FCVS, state medical license, DEA# so I can moonlight for bigger money. Once I'm eligible to officially moonlight, I don't see myself signing up to do many of these paid elective shifts.

Plus, you're a fellow and in a little different position than 2nd year residents.

 

[crewmaster1]

Dude! Unless that 3 is supposed to be an 8, you guys are getting hosed. I get paid a little more than double that to watch TV and nap (and answer silly pages and occasionally take active care of sick people) while doing night coverage on a BMT/Onc service. And I just got paid triple that to supply tech support to other docs on a newly rolled-out inpt EMR. And unless I trip and kill myself falling down the stairs, it's pretty safe work.

I agree with you th at the dollar amount is low. It is by far the lowest moonlightling like opportunity we have. However, it was just a recent expansion in the program to have 24 hr coverage on the second helicopter and part of making it work is keeping the finances straight. The amount will likely go up (it's only been going now for a few months). It is also a great experience so people are willing to do the shifts for less money. As Solidbronze said above it also allows residents who can't yet moonlight to make a few extra bucks. Believe it or not many senior residents would could be making 4 times as much still sign up to work the paid flight shifts for 35/hr! Sometimes it's not all about money.

 

[howelljolly]

Can Critical Care Medicine fellows get any aeromedical experience? I know that Pediatric Critical Care fellows do in some places.

 

[southerndoc]

Can Critical Care Medicine fellows get any aeromedical experience? I know that Pediatric Critical Care fellows do in some places.

If you're EM residency trained, then you can probably moonlight on the helicopter. I think some services will let anesthetists fly as well. Doubt you could get a flight job as an internist who is doing a critical care fellowship, but it's worth a try.

The main problem will be finding a flight program that staffs the helicopter with physicians. <5% of flight programs fly physicians.

 

[howelljolly]

If you're EM residency trained, then you can probably moonlight on the helicopter. I think some services will let anesthetists fly as well. Doubt you could get a flight job as an internist who is doing a critical care fellowship, but it's worth a try.

The main problem will be finding a flight program that staffs the helicopter with physicians. <5% of flight programs fly physicians.

I was wondering about this... this thread makes it seem like docs on flights is pretty standard... I would have thunk that flight medics and flight nurses are more the norm. I cant imagine that a second year EM resident has more experience and skill than, say, a flight medic with 15 years on the job, and military experience to boot.