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Reconstructive Surgery


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Hi!  I am a relatively new grad and have only been at my current Internal Med job for about 2 months and I am BORED senseless. I took the job as almost a stepping stone as I was a little unsure about what specialty I wanted to go into and figured IM was broad enough to let me choose after a year or so of experience. Its a rather prestigious hospital in NYC which may look good on a resume but on the inside the job is kind of a disaster. I am not provided with much training at all, my boss has terrible communication skills, and overall I am really really bored with internal medicine. I don't feel like I'm making all that much of a difference to these chronically ill people who just straight up don't take care of themselves and are very noncompliant.  That aside, I think I have decided that my calling is really reconstructive surgery. I have an impeccable eye for detail and always try to make things look and feel ideal for people. However, I am finding it difficult to find such positions on job boards, forums, and groups. Many of the plastics jobs I have found are all for PAs to use lasers and botox. Any ideas where there are listings for positions for legitimate recon surgery?  Also, when is "too soon" to leave this position? I feel like by not having my hands in the OR right now I would continue to be a less desirable candidate for future positions if I stay longer than a year here. In terms of professionalism I of course would give 2 wks notice, but I'm not sure if being this unhappy for an entire year is worth the wait to make myself happy in my career. 

 

Any advice would be helpful at this point!

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  • 3 weeks later...

not a lot of plastics/cosmetic derm jobs out there for PAs. maybe look into ortho, gen surg., or em if you enjoy procedures.

probably ought to stay at the first job for at least 6 months, a yr would be better...oh, and join paft if you want to see more advancements for PAs...

http://www.pasfortomorrow.org/

 

When you say that there aren't a lot of plastic surgery jobs out there for PAs, is this because most plastic surgeons don't use a midlevel at all, or because most of them use NPs instead? If someone is still in PA school and wants to make it their goal to become a plastic surgery PA, are there any steps they can take to help make it happen? Or is it a mostly unrealistic goal?

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When you say that there aren't a lot of plastic surgery jobs out there for PAs, is this because most plastic surgeons don't use a midlevel at all, or because most of them use NPs instead? If someone is still in PA school and wants to make it their goal to become a plastic surgery PA, are there any steps they can take to help make it happen? Or is it a mostly unrealistic goal?

Most don't use PAs. For cosmetics its pretty much cash on the barrel head. If you employ a PA then you have to pay them PA wages. Most employ a CST to help them. Then they can tech at their surgery center and  assist if they are in the hospital. 

 

Programs that do big flap cases are typically at academic medical centers. PA there are going to be doing floor work for the most part. You only scrub if the residents are busy. There are a few private practice or academic without a residency but its relatively rare. 

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  • 7 months later...

When you say that there aren't a lot of plastic surgery jobs out there for PAs, is this because most plastic surgeons don't use a midlevel at all, or because most of them use NPs instead? If someone is still in PA school and wants to make it their goal to become a plastic surgery PA, are there any steps they can take to help make it happen? Or is it a mostly unrealistic goal?

Most plastic surgeons charge their patients at great costs than normal, due to which most of them are not looking forward to recruit anybody that is qualified. Their demands are high because their patients demands are high from them, so they cannot compromise on the quality of results that they produce. That's why either we do not keep PAs or instead we recruit high level doctors. 

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In most surgical specialty, you don't make the call. Expect to follow the surgeon's sort of algorithm. You will have no input in the day to day patient care. If you're the type that enjoy working independently (if such exist) nonsurgical practice is the way to go.

 

With less years as a surgical PA, expect to work as a secretary and nanny for the surgeon, literally.

 

Landing a dream surgical PA position where you are adequately utilize for what you went to PA school for requires careful job scrutiny which most often times comes after years being in the trench and being burn multiple times.

 

IMHO specializing too soon is a waste.

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  • 3 months later...
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If you are bored as a new grad in IM you are missing the boat

 

there is NO WAY you should be bored in ANY field as a new grad - you should be scared stiff, reading and learning all the time - BTW you are no longer going to be spoon feed anything, YOU need to take the initiative to learn about your patients and their disease processes.  Honestly I am scared for you that you think somehow you are bored with IM - you might not like it but to be bored with it shows what I would consider a lack of caring and understand or your current knowledge base.  

 

As for leaving your first job? after 3 months (2 weeks notice is really SHORT) - yeah that would not look good.

 

 

I think some reflection on yourself, your expectations, you true skill set and knowledge base is needed prior to thinking  about changing jobs.....

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  • 1 year later...

How to land a plastics job in NYC:

 

1. Have tons of experience in surgery. I'm talking about impeccable suturing skills, micro-surgery skills (using a surgical microscope while you operate), vascular surgery, etc.

    Plastics is not just boob and nose jobs. The few Plastic surgeons that are lucky enough to do only cosmetics usually use a nurse or MA to do injections in the office and they won't pay more just     to have a PA.    

 

2. Work in a facility for years and have great networking skills, so when an opening does occur, you can have referrals. These openings just don't get to be posted; someone gets the word way               before.

 

3. Move from NYC to a rural area where there is less competition.

 

4. Get lucky.

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Most Plastics make their money based on reputation aka results. I'm 100% for PA's but if it came time to get my breasts reconstructed after cancer or something like a tummy tuck, I'd want someone with light years of experiences, verifiable results and board certifications. Something more derm based like injectables , or non invasive procedures, I wouldn't mind but they have nurse injectors they can pay significantly less than a PA/NP.

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  • 4 weeks later...

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