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Practicing PAs: thoughts on starting out in rural vs. urban location?


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I am a soon to be graduating PA student who is beginning to look at jobs. I wanted to get some perspectives on starting out in a rural vs. urban location. I am currently in a large city and I've noticed that many (not all, of course) of the PAs seem to be more like glorified secretaries and don't seem like they make even simple decisions without consulting multiple attendings. There is just so much micromanagement. I know PAs in rural areas tend to have more autonomy and often develop more skills as a result. However, being a new grad, I obviously have less knowledge and skill than a seasoned PA and will require more oversight. I am not currently looking for much autonomy with being a new grad but I am still thinking about a few years ahead. I understand that a good employer will give me less responsibility and hopefully good mentoring as I begin my career but the opportunity to develop more skills and responsibility with time is appealing and I feel a rural area may serve me better.  Please let me know your thoughts and personal experiences. Thanks!

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if you work for a rural hospital you will likely have a great scope of practice. if you work for a solo practice it will be hit or miss as Rev said, but I think the rural mindset is generally for PAs and NPs to do more, manage their own panels, etc.

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I am currently in NYC. I understand that rural areas tend to do more and a lot of it is SP dependent , but I am trying to get a perspective on which location would be better to start out my career in with regards to developing the most skills. I am interested in critical care eventually, if that helps. I do not want to do a residency since I have heard too many negative things but was hoping to work for around 5 years as a hospitalist before possibly switching to the ICU. I am just wondering if beginning in a rural area would be better for career development.

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  • 3 weeks later...

Anywhere but New York city!

Average rentals in New York city are now $3,000 a month.

For 99% of the nation...that is ABSURD!!

Throw in that NYC has so many PA/NP programs that are driving DOWN the pay for PA/NPs...you can have a worse standard of living as a PA than a RN.

Plan on MOVING after graduation.  Look at jobs ANYWHERE except the I-95 corridor between Philly and Boston (due to # of PA/NP programs and exorbitant cost of living), Florida (due to malpractice environment), and the I-5 corridor between San Diego and SF (again, # of PA/NP programs and outrageous cost of living).

If you move almost anywhere else your standard of living will double.

 

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Come to Maine and make $ and get a good scope. Or ruralish NC.

 

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Unrelated to this thread...but I got a cold call from a locums recruiter about an ED job "2 hours North of Ellsworth".  12 hour shifts, sounds like full scope of practice, and good pay (they offered $75/hr + my travel & hotels).  Not sure if you're interested, but that would be pretty close to you.

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Unrelated to this thread...but I got a cold call from a locums recruiter about an ED job "2 hours North of Ellsworth". 12 hour shifts, sounds like full scope of practice, and good pay (they offered $75/hr + my travel & hotels). Not sure if you're interested, but that would be pretty close to you.

Probably Lincoln or Greenville..Weird that they used Ellsworth as reference.. I'm set where I am for the moment, but thanks for thinking of me! I'm half way promoted to lead PA..

 

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i told her about my house in Ellsworth. Congrats on the half-way promotion?!?

ohhhh gotcha.

Yeah waiting for it to become official with administration (barf). But from our perspective it is all set. Would really enjoy a raise with that..to help pay for the Porsche

 

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I started working in a rural area when I was a new grad just to get experience, but I absolutely loved it and ending up staying.  It definitely is not for everyone, but if you love automony, constantly learning and keeping busy, it's for you.  My friends in a nearby urban area see about half to two-thirds of the patient load I see.  They do hip to hip rounding and run almost all decisions past the attending.  I run around like a busy bee, practice almost completely independently and feel confident doing so.  Also, the days also go by fast.  In my experience, people tend to rise to the occasion.  When you show up the first day and you are handed a list of people to manage as a new grad without an orientation, you find a way to figure it out.  There's a learning curve and nothing is handed on a silver platter, but those problem solving skills are so valuable.  At this point, when a patient shows up with a rare disease or circumstance that I've never heard of or considered, I find a way to manage them.  I love that.  It sounds scary, but when you start as a new grad, you have nothing to compare it to and the boundaries seem limitless.  I would recommend my position to anyone.

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  • 1 month later...

Thanks for all your perspectives!

 

As for NYC a lot of hospital systems, such as NYP offer employment housing so you can find affordable (for NYC) housing, but regardless the salary offers seem to be disappointing.

 

I have a ton of family in FL, but I know PA practice isn't the best there. NC sounds lovely as does Maine, but I don't know if I could handle the Maine winters!

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This threat also brings up a question I have recently thought about. What do most people think is better for a new graduate?....Private practice medicine w/ a couple physicians an a few PAs, or a large hospital owned organization. 

 

Any tricks on how to tease out how the SP is going to treat his PA when interviewing with private practice places??? 

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This threat also brings up a question I have recently thought about. What do most people think is better for a new graduate?....Private practice medicine w/ a couple physicians an a few PAs, or a large hospital owned organization.

 

Any tricks on how to tease out how the SP is going to treat his PA when interviewing with private practice places???

Why not a community hospital..tend to have better benefit and pay and somewhat like private.. I dunno..

 

Easiest way is to interview with the other PAs or try to find past PAs

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