First Graduates from NMCSDs Emergency Department Physician Assistant Fellowship Program

By Mass Communication Specialist 3rd Class Pyoung K. Yi, Naval Medical Center San Diego Public Affairs

For the first time in Naval Medical Center San Diego’s (NMCSD) history, two Emergency Department physician assistants graduated from the Emergency Medicine Physician Assistant (EMPA) Fellowship program, Lt. Joseph Baugh (left) and Lt. Gareth Evans (right). Baugh and Evans have both previously completed tours as physician assistants (PA), returned for postgraduate training in Emergency Medicine at NMCSD. (Photo by Mass Communication Specialist 2nd Class Zachary Bell)
For the first time in Naval Medical Center San
Diego’s (NMCSD) history, two Emergency Department physician assistants
graduated from the Emergency Medicine Physician Assistant (EMPA) Fellowship program, Lt. Joseph Baugh (left) and Lt. Gareth Evans (right). Baugh and
Evans have both previously completed tours as physician assistants (PA), returned for postgraduate training in Emergency Medicine at NMCSD. (Photo by Mass Communication Specialist 2nd Class Zachary Bell)

For the first time in its history, Naval Medical Center San Diego (NMCSD) graduated two Emergency Department physician assistants from the Emergency Medicine Physician Assistant (EMPA) Fellowship program during a ceremony Jan. 23.

The two naval officers, Lt. Joseph Baugh and Lt. Gareth Evans, had already completed tours as physician assistants (PA) and returned for postgraduate training in Emergency Medicine at NMCSD.

During the EMPA Fellowship program, they trained alongside Emergency Medicine residents and gained experience through the Graduate Medical Education curriculum.

“They do some of the same clinical rotations as the Emergency Medicine residents do, attend weekly education conferences, and monthly journal club,” said Lt. Kishla Askins NMCSD’s EMPA Fellowship director. “An Emergency Medicine physician assistant provides Navy Medicine and operational forces with an additional skill-set that is in keeping with Navy Medicine Strategic Map.”

Currently, there are more than 20 EMPA programs (including military) across the country, but only one is accredited. NMCSD’s EMPA program is the only one in the Navy and is currently going through the accreditation process.

The program is 18 months and includes rotations on the USNS Mercy (T-AH 19) and at Naval Hospital Camp Pendleton.

NMCSD’s EMPA program is extremely demanding and requires physician assistants to come in with a humble attitude and an eagerness to learn.

“I tell the candidates: This will be the most academically, physically, and emotionally demanding program you have gone through,” said Askins.
During their time in the program, the physician assistants have one day off per week on most weeks but are expected to be tired and recuperating on that non-work day.

One of the two graduates of the program, Evans, sees himself as a pioneer of sorts, and believes he and Baugh must pave the way for future Navy physician assistants.

“We have to set the standard high,” said Evans. “This program is in its infantile state and has room to grow. We need to keep pushing to make this an even better program for the PA’s that come behind us.”

Evans, a native of Abington, Pa., originally enlisted in the Navy in 1991. He earned a master’s degree in physician assistant studies from Butler University in 2008.

After serving as a search and rescue (SAR) hospital corpsman for more than 10 years at duty stations such as Marine Heavy Helicopter Squadron 363 (HMH-363) in Tustin, Calif. and Helicopter Combat Support Special Squadron (HCS-4) in Norfolk, Va., he decided to pursue a different career.

“I wanted to do something more mentally challenging,” said Evans. “Being a physician assistant allowed me to have the career I wanted with the flexibility that the military demands.”

Evans initially became interested in joining the Navy after a high school friend enlisted. It got him thinking about a military career.

“It was a great first step since as a 19-year-old ‘boy’ I was not ready for college,” said Evans.

As a physician assistant at NMCSD’s emergency department, Evans has noticed the doctors and nurses and other experienced staff go out of their way to pass on knowledge to him.

“The amount of mentorship available in the learning environment is incredible,” said Evans. “All the attending are so willing to take time from their patient load and help teach. It seems more so at NMCSD than anywhere else I rotated.”

Aside from the ideal teaching environment, Evans enjoys particular aspects of being a physician assistant.

“It’s flexible, mentally challenging, and I get to help others,” he said.

The other graduate of the program, Baugh, believes it is an honor to represent physician assistants, and says he and Evans must show the fleet what physician assistants can bring to Navy Medicine.

“The physician assistant community is notoriously hard charging,” said Baugh. “It’s important Lt. Evans and I hit the deck plates running. We need to go out there and show Navy Medicine the value of emergency room physician assistants and pave the way for the next generation”

In 1992, Baugh, originally from Hempstead, N.Y., enlisted in the Navy at 22 to travel and pay for his education. He earned a master’s degree as a physician assistant through the Interservice Physician Assistant Program in 2006 at Fort Sam Houston, Texas.

As a prior Independent Duty Corpsman from 2000 to 2004, Baugh served aboard the USS Dwight D. Eisenhower (CVN 69) and at Branch Health Clinic Sasebo (Japan).

Baugh found he liked working with patients and wanted to continue his academic learning.

“I realized how much I enjoyed patient care and had a desire to further my education and saw becoming a physician assistant as the next logical step,” he said.

Like Evans experience at NMCSD’s emergency department, Baugh has particularly enjoyed working alongside and learning from the staff.

“I can’t say enough about the level of expertise and professionalism possessed by everyone,” said Baugh.

Baugh appreciates several characteristics of being a physician assistant, especially because of the fact he has the opportunity to serve fellow Sailors and pass along what he has learned to NMCSD’s hospital corpsmen.

“It’s challenging, requires constant learning and, moreover, we have the chance to have a positive impact on those who need it the most: our shipmates and their families,” he said. “Equally important, it gives me a chance to teach and mentor our corpsmen.”

As the first physician assistants to complete NMCSD’s EMPA program, Baugh and Evans were very proactive in the education process and lessons they learned.

“They both took ownership of the future of Emergency Medicine and physician assistants working in Emergency Departments,” said Askins. “They are both strong advocates for their patients, the operational forces, and future PAs.”

Although NMCSD’s inaugural EMPA program had only two training slots available, its future goals include obtaining additional training quotas in order to provide Navy Medicine with more Emergency Medicine physician assistants, according to Askins.

“It won’t be long before more operational forces and Emergency Departments are requesting more EMPAs after they see what Emergency Medicine Physician Assistants bring to Navy Medicine,” said Askins.

To pursue acceptance into the program, Navy physician assistants can apply through the annual Medical Service Corps Duty Under Instruction (DUINS) request. Each year, training quota numbers are determined by the needs of the Navy. Once the training quotas have been determined, applicants may apply for consideration. The Medical Service Corps DUINS board meets annually to select trainees for the following fiscal year.

For more information about Naval Medical Center San Diego, visit www.med.navy.mil/sites/nmcsd, www.facebook.com/nmcsd, www.twitter.com/NMC_SD and www.navy.mil/local/sd/.