Worth it to take unwanted job to get foot in the door at hospital?

[sscheinfe]

So, I'm trying (for years) to get into Emergency medicine.   Despite submitting my resume specifically for ER jobs only, I got an offer from a local major hosptial system here in NYC for...exactly the same job I'm doing now.

 

 As I said, my goal is ER, and I don not want to continue doing what I am doing now...but a friend suggested I "get my foot in the door" at the hospital.  Now, technically, the job is not at the actual hospital site but at a nearby office, but I get an ID card I assume, and I'm part of the system.  Does this "getting your foot in the door" thing ever work?  I feel like, after 6 months, if I tell my sup. "hey, it's been great, but I'd like to transfer to the ER", they will make sure not to let me do that...they hired me for another job that I do well, so why let me go and change departments?  Or is there any benefit to having a foot in the door in that kind of way?

 

Anyone ever try this sort of thing...

 

Thanks!

[gbrothers98]

I think you would be wasting your time.

Instead, I would try to find out why you are getting turned down for consideration of the ED jobs.

GB PA-C

[db_pavnp]

I have done this.  It was necessary.  The cards can be really stacked against a lot of people who want to work in healthcare.

[EMEDPA]

there are plenty of EM jobs out there. you likely just need to relocate.

[BruceBanner]

Could be that you have no experience or you are just in a saturated market. Most metro areas take 2-5 years direct experience only  for EM. I doubt getting into that hospital, even peripherally, would increase your chances.

[SocialMedicine]

NYC is a very challenging market to enter ER. you will need few years experience or a residency. I do not see any area  hospital outside of maybe some of the nyc ones in BK/queens having any different policy for the foreseeable future. You may want to look at some LI or Jersey City hospitals ... not terribly far from the city  If you thought my constant complaining about new PA schools was obnoxious wait till I get off on all the new urgent care centers hah. In NYC you can find an urgent care on every street corner now days. City MD Is a decent company to work for I have heard. That could be an introduction to a FAST track position ? If you are a hospitalist or specialist in the hospital where you want to work in ED I could see that being an introduction. But if you are at some satellite clinic in another town it is def not the same thing. Also if you are taking this job you do not want and might leave in a short period think about how your CV will look. I just reviewed CV's for an open position and a few people were in a different place every 1-2 years. Even if it is someone trying out new things it still raises eyebrows

[ventana]

NO Don't do it!!!!!!!!!!!

 

 

The  ONLY time you truly have any leverage in a large hospital system is BEFORE you are hired.  Once you are hired, you are just an employee.  

 

I would start taking the ACLS, PALS, ATLS, airway course on your own, get as proficient as possible with out working EM, then maybe look into coming about 3 hours north to my local hospital system to work in the ER - they need PAs - might be able to take a Amtrack to Albany NY, then drive over (about 50min) to hospital, and work a couple stacked shifts, then head home......

 

Get your experience, then apply back in the city.....

 

 

 

 

OR 

 

 

Do an EM residency - ie Albany Med or Baystate

[EMEDPA]

there are several em pa residencies in nyc as well. presby, staten island, etc.

[RichardLPeeA]

It all depends on how bad you want it and how much you're willing to work for it.

 

Residency is one option it is a lot of work, reduced pay, but it will get you to where you want to be in a year, and be an amazing educational experience.  Another option is doing urgent care, for a few years and hopefully eventually break into the ER.  I have heard of people working in internal medicine, and then getting picked up by cardiothoracic at the same hospital because she was able to approach CT directly and express interest in the position.

[sscheinfe]

The strange part is that I know of several new grads in classes from my school that got ER jobs immediately...though they are, almost exclusively, female (I am not). I have applied to nearly every hospital in NYC and have, in turn, gotten turned down at nearly every hospital in NYC. EM residencies are great but I don't think I could survive and pay rent...they pay about half of what I make now, and as well I was rejected for one of the two here in NYC...they seems to favor out-of-state trainees.

 

I don't know what the deal is...I have 11 years experience as an EMT/Paramedic ( I would think that would count for SOMETHING) and have been a PA for four, but still, doors are opening for new grads that remain closed to me....it is very, deeply frustrating. I guess it's ultimately all about who you know, Or so it seems with the jobs I hear about...but I am really curious as to why all the turndowns. 

 

I have taken numerous weekend EM CMEs but, that doesn't seem to count for much....as for Urgent Care, those that consider PAs exlusively hire only PAs  with several years of ER exprience, as the docs there don't seem to want to train anyone.

[sscheinfe]

Oh and Ventana, which system do you work at?  Thanks....

[Febrifuge]

This sounds like a tremendously frustrating experience. I think it's great that you're actively trying to look into why it hasn't been working out. That can be a tough process, because as the saying goes, after a certain number of things don't pan out, the one constant common denominator is... you. And that's no fun.

 

So I don't mean to be insensitive, but it's potentially just barely possible that some of what I notice in this post might be relevant, and I offer it in the spirit of constructive criticism.

 

The strange part is that I know of several new grads in classes from my school that got ER jobs immediately...though they are, almost exclusively, female (I am not).

 

Well, okay, maybe you're suffering from some bizarre form of sexism in the employment market that for once actually benefits women, but I tend to doubt it. In my area as well, it seems like 2/3 of the students and 2/3 or more of the working PAs are women, but if anything I think that's been good for me, as a dude. If you have ever in your life complained about the appearance of preference in favor of any minority, congratulations! Now you are one!

 

I have applied to nearly every hospital in NYC and have, in turn, gotten turned down at nearly every hospital in NYC.

 

As others have said, that's a lot of hospitals, but it's nowhere near enough. NYC is the biggest small-town in the world, after all, and I wouldn't be surprised if it's as over-saturated and cliquish as it sounds.

 

EM residencies are great but I don't think I could survive and pay rent...they pay about half of what I make now, and as well I was rejected for one of the two here in NYC...they seems to favor out-of-state trainees.

 

Again, it's possible you've uncovered some deep truth, and you're being unfairly frozen out. It's also possible there's a more benign explanation -- like the idea that people in town already have jobs they at least kind of like, and anyone seeking a residency is coming from elsewhere, hoping to break into the NYC 'scene' as it were. Or, it could just be there's something about you, your application file, the way you interview, or whatever that didn't work for that residency, on that day.

 

I don't know what the deal is...I have 11 years experience as an EMT/Paramedic ( I would think that would count for SOMETHING)...

 

Come on; of course it does. I'm sure it's a big part of how you got into PA school, for example. But at this point, honestly, yeah, it probably means a smidge less. The playing field tends to level after we all get that "PA-C."

 

...and have been a PA for four, but still, doors are opening for new grads that remain closed to me....it is very, deeply frustrating. I guess it's ultimately all about who you know, Or so it seems with the jobs I hear about...but I am really curious as to why all the turndowns.

 

It's totally frustrating, and a little venting is healthy. Not to mention, this is a good place for it. So vent on. I'm just saying, be careful if you are someone who naturally and automatically seems to make excuses or place blame externally, because that becomes a bad habit and after enough time, people can sense it on you.

 

I have taken numerous weekend EM CMEs but, that doesn't seem to count for much....

 

In terms of getting hired? No offense, but I don't think that's surprising. CME is just kind of what you do, as maintenance. I doubt it will sway anyone. Having said that, being able to point to 3 or 4 consecutive SEMPA conferences might be a nice way to show off your commitment to the field of EM. The other side of that double-edged sword is that an employer might question why someone who works in [your specialty area here] keeps going to EM conferences, instead of focusing on being the best possible PA in [your specialty area here].

 

...as for Urgent Care, those that consider PAs exlusively hire only PAs with several years of ER exprience, as the docs there don't seem to want to train anyone.

 

That is nuts, and if anything else, you are definitely not imagining that NYC is crazy. Urgent Care is a lot more like EM than it is like primary care, and no doubt years and years of EM experience are helpful -- but required? Yeesh.

 

Best of luck to you. I can't help but agree with all those saying to get out of the city, at least for a little while.

[db_pavnp]

Maybe you can find some way to get an impartial review of the resume you are putting out along with any other possible factors.  Sometimes there is no answer.  Sometimes resumes simply get deleted because they are missing certain keywords.  Maybe you have a bad reference who is backstabbing you, even inadvertently.

 

Personally, I feel companies play hardball to get laws in place to empower them over you, so anywhere you can get a leg up on them I advise taking it if it is important to you.  It doesn't really make sense to ask a website if anyone has ever managed to transfer departments.  I would discretely determine if you can transfer or crosstrain at the job YOU have been offered.

[ventana]

Oh and Ventana, which system do you work at?  Thanks....

 

 

www.berkshirehealthsystems.com 

 

PM me for more details

 

We are hiring!

[Acromion]

Dude you are in NYC! Don't take it personally. It's an oversaturated market in a desirable location. Everyone wants to work in NYC. There's plenty of ED jobs out there in flyover territory. The hospital I work at now was practically begging me to work for them, straight out of school. I signed on almost out of pity (but not before negotiating a sizable signing bonus) You get to pick 2: location, pay, practice environment. I love NYC. I would move there in a heartbeat if I could afford it and I could get a decent job.

[sscheinfe]

Thanks all for your advice, especially febrifuge's analysis.  I'll admit it may be me! I just think it's not...haha.

 

Part of the frustration is that I am a lifelong NYC resident.  I'm not some out-of-state kid trying to move to the big apple and start a life (no offense if you are, that's fine), I've been here my whole life, my whole family is here, I can't so easily just pick up and move to gosh-knows-where.  I feel like as a native and long-time and future resident, I should get a little more credit in local hospitals before they hire (more experienced) out-of-state blood, as that is what I know has happened in several cases (including the residency).  Especially as I am not going to work for a year, pick up and leave; I don't WANT to be a PA in NYC, I just am, I was born and educated here. I wish that counted for something...you know, like how those hipsters will only buy locally grown stuff, support your local businesses, etc...haha.  I wish I can somehow sell my locality, and hence my dedication and intent to stay long-term, but it seems like experience is the bottom line...(besides who you know of course)...

[FfIghter23]

Just a thought-- and this may not be applicable in your case, but I've seen many admin in ER look for PA's that are "moldable." They look for PA's that aren't yet set in their ways and have the complex of "I want to jump right in and take care of anything and everything."

 

They go for the PA's that they can start out just giving low acuity cases and the PA will be okay with that. You have to understand, just because you may know your capabilities... the hospital and attendings don't and you have work up to that trust. Try conveying that you are 1) teachable 2) humble 3) know your role and able to work up the ladder from there. It will go a long way in building that initial trust and landing you a job!

[ventana]

Just a thought-- and this may not be applicable in your case, but I've seen many admin in ER look for PA's that are "moldable." They look for PA's that aren't yet set in their ways and have the complex of "I want to jump right in and take care of anything and everything."

 

They go for the PA's that they can start out just giving low acuity cases and the PA will be okay with that. You have to understand, just because you may know your capabilities... the hospital and attendings don't and you have work up to that trust. Try conveying that you are 1) teachable 2) humble 3) know your role and able to work up the ladder from there. It will go a long way in building that initial trust and landing you a job!

 

I have also seen this is the common justification for hiring new grads on eh cheap!

[True Anomaly]

there are several em pa residencies in nyc as well. presby, staten island, etc.

 

Will vouch for Staten Island; I don't know about Presby.  Albany would be great too if you wouldn't mind moving upstate

[sscheinfe]

Just a thought-- and this may not be applicable in your case, but I've seen many admin in ER look for PA's that are "moldable." They look for PA's that aren't yet set in their ways and have the complex of "I want to jump right in and take care of anything and everything."

 

They go for the PA's that they can start out just giving low acuity cases and the PA will be okay with that. You have to understand, just because you may know your capabilities... the hospital and attendings don't and you have work up to that trust. Try conveying that you are 1) teachable 2) humble 3) know your role and able to work up the ladder from there. It will go a long way in building that initial trust and landing you a job!

 

That's a good point. I'll keep that in mind and adjust my resume/cover to try to convey more of that...

[sscheinfe]

One more Q....any point in going in to the HR departments and handing in my resume?  A lot of times a clerk took it and tossed it in a pile...same as emailing it in.  Only once or twice did I find an actual department head or an HR person....

[gbrothers98]

Thanks all for your advice, especially febrifuge's analysis.  I'll admit it may be me! I just think it's not...haha.

 

Part of the frustration is that I am a lifelong NYC resident.  I'm not some out-of-state kid trying to move to the big apple and start a life (no offense if you are, that's fine), I've been here my whole life, my whole family is here, I can't so easily just pick up and move to gosh-knows-where.  I feel like as a native and long-time and future resident, I should get a little more credit in local hospitals before they hire (more experienced) out-of-state blood, as that is what I know has happened in several cases (including the residency).  Especially as I am not going to work for a year, pick up and leave; I don't WANT to be a PA in NYC, I just am, I was born and educated here. I wish that counted for something...you know, like how those hipsters will only buy locally grown stuff, support your local businesses, etc...haha.  I wish I can somehow sell my locality, and hence my dedication and intent to stay long-term, but it seems like experience is the bottom line...(besides who you know of course)...

Do you have the ability to network with ED providers, ie PAs, NPs, MDs, in NYC hospitals? Or even techs and nurses that can introduce you to those people?

I think you would stand a better shot if you knew someone whom could advocate for you that is in the trenches and wants you to join them to work with.

I agree with your rationale about being a lifelong resident and the higher likelihood of longevity vs someone without the ties you have. I would always relate this at some point in conversation with decision makers.

Last, you have a job, it pays the bills. You are in place. Things may not move according to the pace you would like them but another tact as described above and some more time may get you to a place you want to be.

Good luck.

G Brothers PA-C