First job as a new grad

[zacleejohnson]

Hello,

I am hoping to get some advice/opinion on potential first jobs as a new grad.  I recently graduated and have interviewed for a number of drastically different positions.  I have been told that I was a top candidate for a couple of them and felt good about all of them, but have not gotten an official offer for any yet.  However, I want to be prepared if/when I do.  The three jobs I have interviewed for are:

 

Orthopedic/spine surgery:  a large, multi-specialty practice with about 12 physicians and 15 PAs.  This would be a good learning environment with a well-established and growing practice.  They offer a competitive salary (100K+, profit sharing, % of billed) and good benefits.  I have a background in sports medicine and orthopedics and know that I would enjoy both the work (clinic and OR time) and the physicians I would be working with.  Sounds like normal hours with occasional long days depending on OR cases, no first call.   My biggest concern is becoming so specialized right out of school, as one of the biggest draws of becoming a PA was the lateral mobility

 

Cardiothoracic surgery: this is in a smaller practice, but is looking to expand.  I’m not sure about the compensation but imagine it would be competitive.  The physician understands I’m a new grad and sounds very willing to teach and seems understanding about the learning curve.  Also, most of the time would be hospital based rounding and eventually OR first assisting, which I enjoy more than clinic.  The downside again being specialization early, though I feel the critical care experience would be beneficial/transferable.  The schedule is also a little odd working 10 on, 4 off (unsure of the daily hours), plus call.

 

Correctional medicine: this would be more a primary care/outpatient (as outpatient as prisoners can get) with a broad range of acute to chronic illnesses.  I also have a background as an ER tech and enjoy the ED, so I feel this would be the closest I could get in the city I’m living.  This is a state job, so good salary ~95k with good benefits, 7 on 7 off schedule and no call.  I think this would give a good work/life balance and give the broadest experience right out of school.  The downside is that it is essentially a solo provider job with 24-hour support by phone and typically some face to face contact with the SP for a couple hours Monday-Friday, which is a little concerning right out of school.  I know I would be forced out of my comfort zone and again would face a steep learning curve, which isn’t necessarily a bad thing.

 

 

I think I would learn a lot in any of these positions and would enjoy different aspects.  My biggest concern is a good learning environment and a good launching point for a long career.  Again I have no official offers but want to have an idea of what I would do if I were fortunate enough to get offers at all three.  I know this is a long post, so thank you for any advice and opinions.

[cinntsp]

10 on 4 off sounds like a miserable schedule, especially if you will be spending long days in the OR at some point.  Burn out city.  There are several threads on correctional medicine that you can find on here but it was not recommended for a new grad from what I remember.

[electric130]

Of those three the ortho position sounds the best.  I agree the 10 on 4 off schedule sounds terrible with the cardiothoracic group.  You may not mind it at first, but being at the top of your game like you need to be in medicine is very difficult to do for that many days in a row.  I have done it and it is exhausting.  Correctional medicine would give you broad experience but I would never take a position right out of school where you did not have a SP on site most of the time at least for your first year out.  A few years out of school that would be a great opportunity but I wouldn't take it now.  The ortho PAs I work with at the hospital seem to be very happy, they are at the top of compensation and given a lot of autonomy. 

[BruceBanner]

OP your concerns are valid and I would caution you against getting too specialized right out of school. My first job was in ortho spine, and to be frank with you it set me back a couple of years as a PA.

 

What I mean by that is that a PA without general medicine experience is a really tough sell to employers. Unless of course you want to specialize, in which case this isn't an issue....but it sounds like you are weighing your options wisely and have some concerns about getting cornered professionally.

 

If you had to chose between the three, I would take correctional medicine, but honestly I would try to wait for something with direct physician contact on a daily basis to start. You will have so many questions and not enough time to look everything up.

 

Ortho pays well but can have some long hours with lots of responsibilities like call, rounding, and other ancillary hospital stuff.

[cbrsmurf]

Serious question: Can inmates sue for malpractice? 

 

 

I wouldn't take the correctional job without another provider to show you the ropes for a few months at least.

[winterallsummer]

Out of those I'd say ortho wins unless the CV position can get you a better schedule. The prison job is not good for a new grad. Yes anyone can sue for malpractice. If you miss a stroke in an inmate you can of course get sued for that. That being said I have to imagine (but am just guessing) fee inmates sue even for poor care because they have such limited resources.

[zacleejohnson]

Thank you all for your responses so far.  Just to make matters a little more complicated, I also just recently interviewed with a pediatric surgery group at a local hospital and it sounds like it could be a pretty good job if I get an offer.  

 

Pros: The position is employed by the hospital I worked at for about 5 years prior to PA school, and I know its a good place to work.  A new surgeon is starting in the next month or two and was in charge of training PAs in their previous position, so I think there would be a strong educational component.  I spoke with the PA I would be replacing and they spoke very highly of the job but were interested in moving to another specialty.  I would be the only PA so I would first assist on all OR cases (no residents) and would manage the patients on the floor.  The schedule seems the nicest out of the options I've seen so far with 4- 10 hour shifts with 1 weekend of call per month with opportunities to pick up more if I wanted to earn a little extra.

Cons: The department is in a bit of a transition period with the new surgeon starting after the previous surgeon chose to go into private practice.  The hospital is non-profit, so the salary sounds like it would  be mid to high 90K, I and would probably top out rather quickly (roughly 2 years from what the previous PA told me).  I would be the only PA in the department as the other is leaving in a month (though they plan on eventually hiring 4 total along with a second surgeon).

 

I know pediatric surgery is quite specialized, but I feel that the experience may be transferrable later in my career.  Any thoughts?

[rev ronin]

This sounds the best of them so far--good TRAINING, even if it is specialized.  4 10's is a good, workable, sustainable schedule in medicine.  My gut says the pay is average for a new PA in that specialty, but you may want the salary report.  And working environment can be everything...

[winterallsummer]

90k non-profit with good benefits is a good deal, with a good schedule of course.  Sounds like a good fit I say go for it if you aren't set on ortho or CV.  Also with non-profit you are eligible for loan repayment plans.  Main thing is somewhere you are respected and can be taught, with a schedule that gives you a good QOL.