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Want to fall in love with the profession again…


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I graduated 2 years ago. I have been working for close to 2 years in an STD clinic. Originally my goal was to get my loans paid and get a part time to keep refreshing my knowledge.

 

However the part time did not happen. Someone close in my family had medical issues and that got me busy with family affairs for close to a year. Now that my contract with NHSC is about to expire I don’t know how to take the next step.

 

I am very intimidated by what would be expected from me at the next job. Many people in this forum talk about how they know as much as doctors do, and I wonder where did they get all the knowledge? I certainly did not get it at school, and unfortunately I don’t feel ready close to 2 years into the profession.  I mean, I have taken CME courses and read books, but still I don’t know how someone with this master’s would be comfortable seeing more complex patients.

 

How and when did you find yourself comfortable in this profession?

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It takes time and it takes seeing patients. And it takes asking questions and looking stuff up when something new comes along. From my experience, I'd say it's asymptotically approaching something resembling competence by 6 months or so and then slowly get better after that. At 8 years in the same specialty, I'm still learning, but can handle the vast majority of what I need to deal with.

 

Don't lose confidence in yourself; everything starts with that.

 

Good luck.

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I think what you are feeling is similar to anyone that worked in a very specialized area of medicine for a period of time and then is considering branching out to more general medicine.

Have you started to look at other jobs and if so, in what areas?

I think first with any employer you have to be up front that your 2 years of experience was in a limited focus. On the other hand, you interacted with patients and were practicing medicine so dont cut yourself short. You got something out of that, you just are unable to see as of yet how this past experience will translate into your future endeavor.

But it will.

Here is my suggestion to you. If you are going into primary care, then you will be faced with one of 3 types of visits.

1. Well visits and physicals. So take a look at guidelines for health care maintenance.

2. Manage chronic conditions. So refresh on diabetes, hypertension, hyperlipidemia.

3. Acute visits. So here you will get to see quite a bit of snot and maybe some musculoskeletal problems. So think about how you are going to differentiate between the flu, a uri, a sinusitis, a strep throat an otitis. Know your treatments for ankle and wrist sprains.

Always put the patient in the perspective of what did they come to see me for today, what is their symptoms?

All of that is a start at least.

I worked in the ED first thing out of school. I had some good mentors at the first job and then enough self direction at the second to be a success.

So look for a place that will give you some support but realize that much of what happens next is truly due to your efforts.

Good luck.

G Brothers PA-C

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Thank you for the replies!

I was thinking about applying to a job in Internal medicine (PCP), occupational medicine. I was actually considering the geriatrics fellowship in FL.  I feel so experience depleted.

 

At my current clinic there are two supervising physicians but they dont like to be bothered with questions.

I try to refresh internal medicine topics on my own, but it really gets old when you read and don't reinforce the knowledge by seeing patients with those problems, things just get forgotten.

 

It seems to me like "finding good mentors" appears to be more a matter of luck. I wish there was a universal site for evaluating preceptors. I am currently hired by a famous teaching hospital, but that doesn't help me when the clinic where I actually work has only 2 docs that don't care about mentoring.

 

Gbrothers98 I will keep in mind those 3 types of visits as I am reviewing material. Thank you!

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Yes, unfortunate though it may be, Occ Med equals Workers' Comp (adversarial) and various types of disability evaluations (also adversarial, employer on one side, employee on another).   Add in the struggles with chronic pain management and you have a situation that does not generally foster patient/clinician trust and respect.  There are exceptions, though.  

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I recommend a residency or fellowship to all my students today. credentialing requirements get worse every year. you really need a strong skills set and a solid procedures list to lands the better jobs. residency is the place to get that. you could work fast track for 20 years and not see and do the stuff an em pa residency student sees in a year.

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Be careful about occupational medicine.  I don't meet too many people who are enthusiastic about that specialty.

 

 

Yes, unfortunate though it may be, Occ Med equals Workers' Comp (adversarial) and various types of disability evaluations (also adversarial, employer on one side, employee on another).   Add in the struggles with chronic pain management and you have a situation that does not generally foster patient/clinician trust and respect.  There are exceptions, though.  

 

 

^Truer words...

 

Let me just put out a PSA here tell you NOT to get involved in Occ Med for any reason other than maybe you are about to go bankrupt.

 

I spent almost 2 years in Occ Med (I have threads on it here) and it while it was a good experience for me at first, just to get my feet wet with acute injury and not have a restrictive schedule, I grew to truly hate it. I mean HATE it.

 

High prevalence of malingering, adversarial relationships (patients want one thing, employer wants another, insurers playing doctor), restrictive practice (not unique to Occ Med), and spending probably 80% of your time treating absolutely nothing ("my back kinda hurts, I need light duty") or doing mindless repetitive physicals.

 

In a nutshell, stay away. It wont get you anywhere in the long run as a PA.

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