Mission

The mission of the U.S. Army – Baylor Doctor of Science in Physician Assistant Studies Residency Program, specializing in Emergency Medicine is to produce postgraduate-level emergency medicine-trained physician assistants and clinical scientists to better serve Military Health System beneficiaries and the Physician Assistant profession by providing advanced care in emergency situations. This goal is met through force-generating graduates with expertise in evidenced-based emergency care plus expertise in the research process. The residency provides active-duty U.S. military PAs an opportunity to develop advanced competencies in triage and the management of complex acute injuries and illnesses. Graduates will utilize these same competencies to stabilize and resuscitate critically ill or injured warfighters in preparation for transport to higher echelons of care from the battlefield.

Vision

The vision is to establish the benchmark for post-graduate emergency medicine physician assistant education through the pursuit of scholastic and clinical excellence. This vision is realized by developing clinical scientists who are prepared to conduct advanced scientific research, as well as provide quality emergency care for patients with a wide variety of illnesses and injuries in the emergency department and on the battlefield. These graduate clinical scientists will develop as future leaders and mentors through scholarly excellence.

Aims

The purpose of the U.S. Army – Baylor University Doctor of Science in Physician Assistant Studies Residency Program, specializing in Emergency Medicine, is to force-generate active-duty U.S. military DSc trained emergency medicine physician assistants. The program provides the unique opportunity to develop advanced didactic and applied research knowledge plus procedural and clinical competencies via a standardized curriculum in emergency medicine. The curriculum teaches evidence-based management of a wide variety of critical illnesses and injuries at military hospitals and clinics and local civilian hospitals. Learning to resuscitate critically ill or injured patients in the emergency room utilizes the same critical skills, knowledge, and goals as stabilizing ill and injured warfighters on tomorrow’s battlefield. This knowledge and experience make the residency invaluable to any military physician assistant. More importantly, this same knowledge and experience distinguish DSc trained EMPAs as critical members of optimized military medical and operational teams.

Thursday: *Main Academic day*

• EM Ninja / Foundations of Emergency Medicine focused didactic topics
• Mock oral boards and simulation scenarios in emergency medicine and critical care/resuscitation

Off-service rotations

• During most off-service rotations, learners will continue to attend didactics at SAUSHEC/BAMC EM
• Wednesdays while rotating at Christus Children's: pediatric didactics and advanced airway/anesthesia rounds
• Learners will join the off-service rotations didactic learning including EKG rounds and simulation scenarios while on ICU rotations

Emergency Skills Labs

• First Monday of every 28-day block: 3-4 hour labs focusing on high-fidelity critical care/emergency procedures including thoracostomy, thoracotomy, vascular access, airway management, cardiac pacing, resuscitation, etc.
• Twice per academic year: high fidelity rare procedure labs including cranial bur hole, regional nerve blocks, etc.

The clinical rotation practicum is designed to bridge the gap between theory and practice through one-on-one supervised hands-on training. To be effective, the clinical practicum must be conducted in a true patient care environment. The EMPA resident applies the principles and procedures they learned during the didactic phase. It is imperative the hands-on experience be an integral part of the entire program rather than a separate, unrelated experience. Because the projected assignments for EMPA residents will be in the outpatient setting, emergency and ambulatory care is emphasized. The clinical curriculum consists of 8 ED rotations, 2 pediatric ED rotations, 1 trauma and acute care surgery rotation, 3 intensive care rotations, a 28-day dedicated ultrasound rotation, 1 airway/anesthesia rotation, 2 elective rotations, and dedicated research blocks.

• Four (4) 28-day BAMC ED rotations
• Three (3) 28-day ED rotations at University Hospital Level 1 Trauma Center
• One (1) 28-day Trauma ED rotation at University Hospital Level 1 Trauma Center
• One (1) 28-day ED rotation at Methodist Stone Oak
• Two (2) 28-day ED rotations at Christus Children's
• Three (3) 28-day ICU rotations including trauma/surgery critical care, pulmonology/critical care, and cardiac critical care
• Dedicated rotations for Point of Care Ultrasound (28-days), Airway/ (2-weeks)

• Burn Intensive Care Unit / U.S. Army Institute for Surgical Research (2-weeks)
• Toxicology (1 to 2-weeks) at the South Texas Tox Center
• U.S. Southern Command Joint Task Force-Bravo Military Unique Curriculum-Honduras

We offer an elective rotating to U.S. Southern Command Joint Task Force - Bravo Military Unique Curriculum-Honduras.

• Orientation / Intro to Research – occurs during orientation
• Advanced Trauma Life Support – prefer prior or during orientation
• Advanced Burn Life Support – prefer prior or during orientation
• Neonatal Resuscitation Program – prefer prior or during orientation
• Fundamentals of Critical Care – occurs during orientation

• Emergency Medicine Simulation Curriculum interspersed throughout didactics
• Monthly Emergency Skills Labs

Our program values leadership and offers multiple opportunities throughout residency including:

• EM PA Chief Resident position
• Operational Medicine topics throughout the academic year

U.S. Army-Baylor Doctor of Science in Physician Assistant Studies-Emergency Medicine Program learners are required to develop an Institutional Review Board-approved, research proposal and answer a specific research question. This can be accomplished as new, individual project or as part of an existing, IRB-approved protocol with multiple sub-projects.

Emergency Medicine PA Residents are encouraged to bring their experience and knowledge to bear by engaging in Quality Improvement initiatives and projects through the Brooke Army Medical Center Emergency Department and SAUSHEC Emergency Medicine Residency Program. Participation meets certain graduation requirements for the EMPA program and is often conducted in concert with Emergency Medicine physician colleagues.

Emergency Medicine PA Residents are required to present a ground rounds lecture at least twice during their residency and are encouraged to present specialty lectures/teaching at professional conferences.

Multiple civilian training sites across the San Antonio metropolitan area.

There is a 40-hour Introduction to Emergency Medicine Course (formerly the EM Basic Skills Course) that is offered twice a year. Attending the course is encouraged to learn about slight programmatic differences and with an understanding that training site preference may not be able to be honored. An annual All Army Activities Message is released with course-specific dates and instructions for requesting attendance. Unit funding is required as the course is not centrally funded. Courses are typically held: 

• January: Commonly hosted at Beaumont AMC (Fort Bliss) and Brooke AMC (JBSA-Ft Sam Houston)
• September: Commonly hosted at Darnall AMC (Fort Cavazos) and Madigan AMC (JBLM-Ft Lewis)

Joint services, active-duty physician assistants interested in applying for the U.S. Army – Baylor University Emergency Medicine Physician Assistant Residency Program are encouraged to contact the current DScPAS-EM program chair (U.S. Army) as well as their service-specific senior EM PA. Applicants must be designated by their respective services to attend this program via:

• Army: Long Term Health Education Training - LTHET
• Air Force:  Air Force Institute of Technology - AFIT
• Navy: Duty Under Instruction - DUINS

Regardless of service component, applicants must meet or address all U.S. Army pre-requisite requirements and be accepted into the Baylor Graduate School prior to matriculation.

Applicants should have a track-record of high academic performance and leadership. The service-specific selection boards (i.e. Army- LTHET, AF- AFIT, Navy- DUINS) place high value skills that are essential for success in this advanced program including independent learning, strong work ethic, and emotional intelligence.

EM PA Residents will graduate with training and experience well beyond the requirements needed to sit the National Commission on Certification of Physician Assistants Emergency Medicine Certificate of Added Qualification.

EM PA Residents are involved in teaching Post Graduate Year-PGY1 physician residents, medical students, and PA students. Residents also are encouraged to participate as guest instructors in emergency medicine, trauma resuscitation, point-of-care ultrasound, and other topics for the Interservice PA Program and at local conferences such as Society of Army Physician Assistants and Air Force Physician Assistants Readiness Course.

• Toxicology
• Trauma Critical Care
• Emergency Medical Services
• Emergency Ultrasound

The program has formal research mentorship assignments with current faculty and encourages informal mentorship with program alumni.

EM PA Residents engage in regular scheduled wellness activities coordinated by the SAUSHEC Emergency Medicine Residency Program. Additionally, they have full access to the Well-Being programs within San Antonio Uniformed Services Education Consortium.