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printer2100

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  1. I think the problem is that you have no leverage at all when there are 5 NPs waiting to step up next in line for any job. They aren't coming out of school riddled with debt and going from making $25 an hour to $40 an hour is a big gain for evening courses, hanging out with friends for clinical rotations, and an ability to continue working over a 2 year period. I have some leverage with my work history, but a new grad PA can't prove themselves any better than a new grad NP. The reality is that this is happening right now also. The PA program that I attended has had several new graduates really struggling to land jobs months after graduation. These are excellent students, several who have been clear that they are willing to go anywhere for a position. I am not sure how we compete when it is so easy for NPs to just flood the market and drown us out of existence. We need to prove that we are more valuable to a system. I suspect that some sort of residency will soon be the expectation for the primary medicine fields.
  2. I suspect the advantage from Duke would be rotational placement. They have an extremely large alumni network and that may get you good rotations, place you in situations where you are offered a job, and place you in an area you would like to live/practice. That is not negligible, especially considering that 2nd year placement is becoming more and more challenging for all programs. Most of your didactic learning will be done on your own time. Bells and whistles are nice and may help out here or there, but I would encourage you to focus on tuition cost, prior PANCE pass rates, and rotational placement/job placement after graduation.
  3. It is easy for me to think about the past and how I should have left my job years before I did, but it is simply the case that hindsight is 20/20. This is totally a you call. I think that I probably could have done well unemployed, but I suspect that everyone would just need to weigh the current stress they are under versus the stress they would expect to have without an (2nd) income. I think what you are seeing with these responses on the forum is a population that knows how awful that day-to-day grind can be in a subpar or seemingly abusive situation. I do think that there are far less good jobs floating around, but maybe that is my slightly pessimistic view of medicine spilling over. I don't think/doubt it is much better as a physician.
  4. I enjoy it quite a lot (and work at a large, state institution). I worked for several years in a community health setting with low rates of health literacy and high rates of morbidity and, compared to that, student health has been really refreshing. I almost never get bothered about not giving antibiotics. I almost never get whiny students. I have never had a parent call and complain. If you treat them like the adults they are and don't assume a snowflake complex, they are really some of the best patients I've ever treated. While the stressful stuff is sometimes complex, it occurs with enough frequently that there are systems in place to limit the confusion (though they are still exceptionally rare). You will still see medically complex things also (e.g. acute abdomen, neurological disorders, unique infectious disease from international populations, travel medicine, psychiatric illnesses, etc...). I imagine your mileage may vary, but don't go in with a bad attitude.
  5. I was unemployed for nearly 6 months 6 years ago after graduation. There are markets that are saturated and markets that are just dominated by 1 or 2 major hospital systems that put limits on hiring at times. While a residency is a good option, there aren't exactly a lot of of them and they tend to not have a lot of slots for students. I suspect the problem is also that there simply aren't a ton of family medicine, cards, psych, or women's health jobs generally. In the new graduate PA job world, I see a fair number of postings for jobs that aren't in generalist fields (e.g. surgical sub specialties, pain mgmt). I would recommend that you reach out to your school and see if they can connect you with the alumni base that are currently working in your fields of choice. They tend to have insider info about jobs that are available or soon to be available. On that note, if possible, be ready to move!
  6. I used the EMRAP Crunch Time series. They are 1-5 minute audio segments on several diseases organized by systems. They have a complete ER focused set and a lot in their primary care focused set. It isn’t free, but you get a year subscription to a great podcast also.
  7. Does anyone know if the PANRE got updated like the PANCE did this year? To answer the OP's question, I found the PANRE to be pretty straightforward. I did well on the test and certainly found that after reading a vignette, if I was thinking about an answer before I had a chance to look down at the answer choices and that thought was one of the choices, it was correct (I didn’t change a single answer and you get feedback about the wrong ones). There were no tricks and there weren't even very many totally off the wall diagnoses. Go with your gut and I think you will do fine.
  8. Interesting, but there are some potential issues here. 1) There are obvious conflicts of interests as the first author receives grants from PAEA and is a PA. 2) Confidence intervals are either really broad or they sit on the border of non-significance. This was a lot of subjects and I wonder if it was over powered. 3) Even if we cost patients less, I want to see equivalent morbidity and mortality and that wasn’t assessed. It matters if you got admitted to the hospital but didn’t die or maybe salvaged some QALYs.
  9. Teaching... School health was also pretty darn easy. Some stressful behavioral health stuff at times, but 90% of the patients were snot and vomit.
  10. Ohio. 1d/wk role. Low acuity, but busy UC. I think underpaid at $42/hr.
  11. The complexity of this case changes a ton based on that fact alone. She is either uncontrolled with what sounds like resistant hypertension or she just ran out of meds. The latter situation with some simple refills may leave her perfectly stable and not needing urgent follow-up. The real question is why can’t she find a PCP? This is where you can shine and have an office manager or knowledgable MA get an appointment scheduled for you. Make some calls and help this lady get follow-up. People don’t get sued for helping, they get sued for blatantly poor decisions and for having awful bedside manners. It doesn’t sound like this is either situation and a jury is likely to feel similarly. From the PCP perspective, change that beta blocker to spironolactone and if that doesn’t fix the problem, she needs a secondary HTN work-up. Of course, the diabetes needs managed better too and is likely a large component.
  12. Maybe we are seeing two sides of the same coin. I am happy to pay what I am reading (above) as the same amount, to do the same course work, and be awarded a doctorate degree. I couldn't care less if the term assistant happens to be associated with a doctorate degree. I would still be a PA, but I am now on course to be paid fairly by the government, can be treated equally in academia, can likely provide more political persuasion to advance our profession, and the list goes on. It isn't a clinical advancement, but when I have to effectively do little to nothing more to have the other benefits, I am on board. I am happy to change our title, but to use that as an argument to not award the appropriate degree is just not convincing me otherwise.
  13. The same thing is being bandied about on Reddit/r/medicine (there is a huge post there for anyone that wants to drive a screwdriver in to their own skull reading it). Makes me crazy, along with all of the other silly assumptions about the program. I am blown away by how many PAs "don't want it" for what sounds like nothing beyond not wanting to confuse patients, as if we aren't the LAST group of non-physician professionals joining the club. I don't think any of us are out to confusion anyone and if we are going to be expected to have a doctorate in 10 years and we've all done/are doing the expected work for a doctorate anyhow, I think it is an obvious step in the right direction for all of those entering the field today.
  14. Yes. I worked in that world for 5 years. It is a difficult mixture of family medicine, psychiatry, urgent care, and emergency medicine. It probably won't land you the job because those jobs aren't particularly hard to find if you want one, but it will make it a MUCH easier transition for you.
  15. Yeah, that is a super valid point. I think there are opportunities like that for PAs also, but they are certainly more open to physicians. I more so mean that I could more quickly pay off debt as a PA (I was debt free before I would have ever been an attending) and also limit the sheer time spent on obtaining the degree if I found that I didn't enjoy practicing clinically. I would, realistically, have to spend another 3-5 years working and living frugally as an attending to pay off my debt. I would then be almost 40 by the time I could change away from something I figured out I wasn't a huge fan of as a PA at more like 30. I am sure I am losing out on money, but I think I probably made the right decision and I am absolutely winning on the happiness front.
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