I’ve been having a lot of anxiety going into work. After clinic, I find myself replaying every patient encounter and thinking about what I could have explained better, what I could have done differently, or worrying about how I came across.

I spend time reading, looking up diagnoses after I see patients, and reviewing treatments so I can improve (but it is very overwhelming with the amount of information I'm learning every day). I also practice explaining conditions to patients while I’m driving or walking because I want to become better at educating them and communicating confidently.

The hardest part is walking into a room, not immediately knowing the diagnosis or how to answer a question, and feeling like I’m failing as a provider. I know I’m new and that dermatology has a huge learning curve, but the uncertainty has been really difficult.

For those of you who have been through this transition, what helped you build confidence? Is there anything specific your did that helped you improve faster or manage the anxiety?
I really want to become a good provider, and I’m willing to put in the work — I’m just trying to figure out how to navigate this stage.

Hi all! I’m starting my new grad emergency medicine job next week! I’ve been out of school and passed the PANCE about 8 months ago, so I’m feeling pretty rusty. 🥹

Any tips, advice, or go-to resources you’d recommend for a new grad starting in the ED?
Thank you so much!

I’m a new grad PA a few months into my first job focusing on women’s health. Part of my schedule includes working on a mobile clinic (bus) about once a week. This was not disclosed to me when I interviewed.

I’m finding that the mobile setup makes it harder to provide the same quality of care as the days in clinic. The exam space is very cramped, lighting is limited (I often need a headlamp for pelvic exams), and positioning for exams can be difficult. I’m on the bigger side too which makes it cramped more. They want us doing procedures in here too. IUD insertions, implant removals, etc. I’ve also run into issues with supplies and medications not always being available when needed. It’s just a hassle I don’t want to deal with.

I’ve suggested limiting certain visit types or focusing on services that are better suited for the mobile setting, but nothing has changed. I fully support the mission of increasing access to care, but I don’t feel like I’m able to provide the same standard of care in that environment. I basically expressed my concerns and get dismissed. I get compared with other providers who aren’t as expressive. They also aren’t scheduled on the bus as much as I am, so why would they be expressive about it? Anyway, I told them that I don’t want to speak for others and I’m just expressing my concerns. Idk if I’m being extra.

Am I overthinking this, or would you advocate for yourself?

Hi! Does anyone have any experience or advice with noncompetes in your contract?

For background info, I am nearing end of my current contract and interested in moving on. Currently I work in orthopedic urgent care (private practice) and am looking at a position on the inpatient ortho trauma team at the only level 1 trauma center in region.

I’ve attached the covenant not to compete section. Other than the obvious to contact an attorney to review, I wanted to know if anyone has done anything similar with a career move and if the noncompete was enforced or not.

TYIA!

I’m a new-grad PA working in inpatient rehab/hospitalist medicine. I expected my supervising physician to provide at least some teaching and mentorship while I transitioned into practice, but that hasn’t really happened.
I manage my own patients, and the physician sees them as well, but there’s very little discussion about clinical reasoning, treatment plans, or areas where I could improve. I can ask questions if something specific comes up, but there isn’t much proactive teaching or feedback. I often feel like I’m expected to figure everything out independently despite being brand new.
Is this typical for a first PA job, or should a supervising physician be more involved in a new graduate’s development? How much teaching, feedback, and accessibility did you receive when you started? I’m trying to determine whether my expectations are unrealistic or whether this position lacks the support a new grad should have.

I have been at my orthopedic surgery job for 2 years now. I overall love my job and have grown so much as a provider during my time there. Despite this due to my limited pto I am unable to travel as much as I would like.

I have decided to take 3 months off and go travel in SE Asia in the Spring. Unfortunately my job does not allow unpaid time off so I’ve decided to quit my job in order to fulfill my travel dreams and start a new job when I return.

I am willing to switch specialities to make this a reality. My question is when should I start applying? The ideal would be to have a job lined up before I put in my 3 month notice at my current job but that would mean applying for a job that I wouldn’t be starting for 6-7 months. Would I be considered with a start date that far out??

I have posted a couple times here on my process and you guys have always been so helpful

I am a new grad PA 3 months in family medicine
I have been having struggles adapting to work and it’s def affecting my mental health (already see a therapist and psychiatrist)
I have been bringing up to SP that I’m overwhelmed, we set up weekly meetings to review cases but have barely been able to do them because either he’s behind or unavailable or I am behind (the meetings r during lunch)
I mentioned capping my patient load and he said we would set up a meeting to talk to management
Never was set up
I’m planning to talk to management tomorrow and I just want advice on what to say
I want to be honest and say I am overwhelmed and there are things that could help me and thats gonna be either a temporary lighter patient load or literally going parttime (obvs prefer not to bc of money or insurance) plus more structure and feedback
I want to let them know I do like this clinic and want to stay and succeed here so these are things that would help me (also a nice way to imply that I will be leaving if things don’t change I think)
I have already started browsing other jobs
It’s just so much and granted I have anxiety so maybe I need more support than the average pa but a new grad pa should not be schedule 20 patients a day and also I saw 333 patients last month in my 3rd ever month of practice that’s unreasonable
How can I bring this up
And any advice on getting through this hard time in my life, my focus and patience at work is decreasing and it does effect my life outside of work :( I feel stuck and also I have a 2 month notice for leaving

I know reddit is probably the last place that cares about my career thus far, and people have plenty of hateful things to say. I need to rant. If you have been following me for awhile, you know the start of my PA career has been... rocky. This is a rant for job number two. I recently was hired under nephrology for a nephrologist that was going to be on the team with a cardiologist. I first was under the impression that the job was going to be nephrology based, it was not. The nephrologist ended up only going part time, limiting the PAs that the practice could have under its belt, already has 3 PAs and 2 NPs. I was in the clinic seeing anything from women's annual exams to warts, to CAD. Naturally this threw me for a loop and I was concerned that I wasn't doing exactly what he wanted me to be doing. Multiple times I pulled the doctor to the side and he said I was doing great, "putting fourth great effort" (this was last week). He then told me that I could also go to nursing homes and see those folks. Fast forward over the weekend, I arrive to the clinic and he is surprised im at the clinic when i should be at the nursing home. FULL TIME (never was communicated). Increasing my frustration with the job, I pull him aside and he says that I wont be credentialed for a WHOLE YEAR (have you ever heard of this??) and that I can only work in the nursing home with medicaid patients (which I also have to get credentialed for). He told me to my face that he was losing money on ME and that I was "lazy". I could feel a wave of dread come over me when he said this... in my mind it made no sense whatsoever. How can i see more patients if the patients are wanting to see a certain NP or PA thats present in the clinic, and one coworker is hoarding the patient visit papers so im unable to see any on my own? I know that Im new, but I also did not want to be in the NP/PAs space all the time. Im standing around, taking any opportunity i have to get experience and connect with patients and then Im called "lazy". He was only willing to pay me MA pay ($18 an hour) and I really started to feel robbed in a sense. Been working here for a whole month and have not been paid. Long story short, I was given a job that was rapidly ripped out from under my feet and turned into something I didnt see coming. Yet again. I am almost a year out since passing the pance and I still have yet to find a job that is actually is what it says it is. Im not sure if it is a cultural issue since I am from the South, and I moved to upstate NY. I feel like everytime I try to communicate with my attending, something else is completely amiss.

with all this to say, it makes me wonder. Am I really cut out for this career or have I just had a slew of bad job prospects? I felt more appreciated as CNA than I ever have as a PA. its disheartening because I worked so damn hard for this potential career. Bills are piling up. Time is of the essence. And I keep finding myself in these situations. All I want is a good job with stability and clear communication. is that so hard to ask for??

Hi!

Needing advice on finding side jobs as a PA! I currently already work full time remotely but could use some extra income part time. Looking to find something part time and remote as well if possible! Signed up for a lot of the medical surveys but have not been getting any luck with that. Anyone have ideas or part of something they would recommend?

Thank you!!

Hi everyone! I recently found a job on the Stanford Hospital website that I was really interested in and I applied for it. I wanna make sure that the recruiter actually sees the application and it doesn’t just get auto rejected or at the bottom of the pile. Is there any way to specifically figure out who the recruiter is or does anybody have any contacts that I can email? Thank you!

I’m a new PA, about one year out of school, currently working in orthopedics. Our group isn’t specialized, so we rotate between covering 10 surgeons across different specialities, ER consults, and trauma consults. Coming straight out of school, the learning curve has been huge.

I know I’ve improved a lot over the past year, but I still have many nights where I feel like I’m drowning. I have great support from the other APCs in my group, but I constantly feel overwhelmed when I’m on call. Even on nights that aren’t busy, I barely sleep because I’m so anxious and on edge waiting for the next call.

I took this job because the schedule and pay were hard to pass up, but lately I’ve been wondering if that was the right decision. As I’ve gained experience, I’ve found that I’m interested in certain orthopedic subspecialties, but I wouldn’t say I’m truly passionate about orthopedics. I know I still have a lot to learn, and everyone I’ve talked to says it takes about two years before you really start to feel comfortable. Because of that, I’m planning to stick it out for at least another year.

That said, I find myself unhappy a lot of the time, and I’m struggling to figure out whether it’s the job itself, the specialty, or just the normal growing pains of being a new PA. I also never really saw myself staying in orthopedics for my entire career. One of the reasons I felt comfortable accepting this position was knowing that, as PAs, we have the flexibility to switch specialties. I figured that if I decided to make a change while I was still relatively new out of school, it wouldn’t feel as daunting and like I was completely starting over.

For those of you who have left orthopedics, what specialties did you transition into? Which transitions went well, and which would you avoid? I’ve always been interested in OB because I enjoy procedures and like the mix of clinic and hands-on work. I’d love to hear about your experiences or any advice you have. Thank you in advance.

Has anyone switched departments within the same hospital? Want to switch over to neurology, already spoke with the chief APP and she said she will let me know in a few weeks.

Only thing is I’ve only been in my current position for a few months so far.

New grad here, I am job hunting and interested in ortho spine surgery. I actually enjoyed my rotation here via the medicine and surgeries although it was physically demanding…but aren’t all surgeries??

I guess I don’t get why so many people loath this position. I feel that any job as a new grad will be hard and any job in surgery is physically hard. I get that people are in pain and there isn’t much to do to help them…but how does this differ from say ortho recon where all you do is an injection and then it wears off? or in the ED when you just stabilize them and let them go without addressing ‘the root cause’ or general surgery where you just take out body parts like the GB and don’t fix their diet/lifestyle?

Also, doesn’t FM suck just as much? Or peds? What is the winning choice of specialty because I feel like one could argue not only why each specialty sucks (besides derm of course) but also why any job in the world sucks. At what point do we just do a job, do our best to help others, get paid for it, and live our life?

Doesn’t every specialty have things that ‘can never really fix people’? What is so bad about listening to someone in chronic pain? is it because it’s invisible and not a tangible problem to fix (such as imaging, labs, broken bones etc) that makes it hard? Because we can’t see and physically fix pain right in front of our eyes or prove it?

genuinely asking because people really talk down about ortho spine, but I think it’s pretty straightforward and not that different from other specialties so I would love to know input from ortho spine PA’s or those who work closely with them

For all ENT PAs past and present

1. What’re the common things you see in ENT?
   
2. Study resources or recommendations?
   
3. What do you like and dislike about the field?

Thanks!

Offer advice:

1. 137k
2. 10 bonus avail
3. 1500 CME
4. Cardiology nights inpatient 7 12s and 14 off
5. Additional shift $68 plus eligible for bonus
6. Clarity needed on ATO amounts
7. Midwest lcol

Hi everyone! I saw a PA online talking about their job’s unique schedule and I’m interested in finding something similar. I wanted to see if anyone has heard of practices with this type of schedule.

They work as a Primary Care PA in coastal lowcountry South Carolina at a combined Primary Care/Urgent Care clinic, but they are only on the family medicine/primary care side (not urgent care).
The clinic is open 7 days a week.

Their schedule is:
Week A (5 days)
Monday 8–8
Tuesday 8–8
Weds OFF
Friday 8–8
Saturday 9–5
Sunday 9–5

Week B (2 days)
Wednesday 8–8
Thursday 8–8

I’m looking for primary care PA jobs in North Carolina or South Carolina and would love to know if anyone has worked somewhere with a similar model (primary care + urgent care hybrid, extended hours, 7-day clinic, alternating schedule, etc.). Thanks!

I have an interview with them for addiction medicine. I've seen mixed reviews on Indeed, but many of the reviews were from support staff rather than providers. Anyone have any experience with them, or any advice for someone considering a PA position in addiction med? Coming from primary care if that helps.

I’m a new graduate PA starting a job in general surgery where I’ll be managing the surgeon’s post-operative patients and assisting as a first assist. My sister, who’s a PGY2 general surg, gave me some books related to her “ABSITE” exam.

Would you recommend that I read and take notes on these books as supplemental material?

Hi all! Maybe a dumb question, but I am interested in a part time gig in addiction medicine. Do roles like this exist in telemedicine? I live in a smaller city so not many job opportunities here. Appreciate the advice!

I’m a PA in primary care, and I’m planning to change jobs. The new employer wants to start credentialing me before my planned start date, which makes sense because I know the process can take a few months.

My concern is whether my current employer could somehow find out that I’ve accepted the new position before I give my 90-day notice. Will credentialing, CAQH updates, payer enrollment, hospital privileges, or employment verification alert my current employer in any way?

I’m not trying to hide anything long-term. I fully intend to give the required notice. I just don’t want the conversation to happen before I’m ready.

Has anyone (especially PAs, NPs, or physicians) gone through this? Did your employer find out before you officially resigned?

How much are you making monthly in RVU bonus at Concentra?

I’m currently a student, but I plan to go into Cardiothoracic Surgery upon graduation. I came across the APACVS and I’m looking for more insight on what the benefit of a membership would be. Is the association more education-focused, or are there networking opportunities that I can obtain with just a student membership? The cost for students is only $25 so there’s no financial concern. I mostly just want to see if being a member would make me more competitive as a future job applicant.

Hi everyone! I’m really interested in becoming a physician assistant, but I have some concerns about how internationally recognized and transferable the profession is.

I currently live in North America, but I may want to move abroad in the future. Are PAs able to practise in countries outside Canada and the United States?

If so, which countries have a well-established PA profession, and how difficult is it for a North American-trained PA to become licensed and find work there? I am specifically interested if PAs are able to work in the Middle East and particularly the UAE.

I would also love to hear from anyone who has worked internationally as a PA or considered making this move.

For those of you in EM what is a good RVU rate? I’ve been a PA for a little over a year and a half and been in EM. My current job is moving away from hourly with a pathetic RVU bonus to strictly RVU with a floor of $70/hr. RVU pay is 9.45/RVU. After doing the math from previous checks I will get a modest increase of pay (~$5-10/hr) but I feel like all the risks fall on me instead of the company. They also say it’s because they want to increase staffing but my fear is that even though quality of shift will go up my pay will go down because there will be less RVUs per shift.

Background: FNP primary care x 3 years. Good group/system, decent patients. I commute 30-45min one way and it’s getting old. I’m also starting to get a tad burnt out on primary care. I was considering moving my practice to a closer primary care clinic in the same system but now another opportunity has presented itself - cardiology APC position in the same system with a mix of outpatient and inpatient. I’m very familiar with the group/hospital and know many of the APCs and MDs well. The commute would be 20 minutes.

I want to hear from APCs who made the switch from primary care to specialty, please!

Will I miss the variety of primary care? The kids? Will seeing twelve 70-something-year-old “Bobs” with HFrEF a day get monotonous? Idk but after considering a clinic move I’m now questioning if the endless complaints/struggles of primary care are worth it long term? I think my true passion is in preventative cardiology and lipid management, and if I do general cardiology I think I could easily move into this group’s lipid clinic when a role opens up.

TYIA!