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  1. Monday to Friday 9-5. No weekends. But I’ve shadowed on Monday and they usually stay late. When the doctor is there the work seems very secretarial. Calling about results a lot of the time from what I’ve seen. There’s a PA there that’s been there for 3 years and even she seems to spend most of the time at the computer. But I will get to do joint injections and the standard pain management stuff. Benefits: 80k + 10k signing bonus (repaid in full if I leave within two years) Insurances Full Licensing, DEA, and credentialing; Full $750 CME 2 weeks paid for vacation and sick leave 1 week paid for CME Malpractice Covered with No tail (but tail seems to be required) 2 Year, 15 mile non-compete (they have 3 offices) Oh and they want me to start as an MA at $16/hr while my licensing is going through. Pretty bad huh?
  2. Hi guys, I hope to see if I can get any guidance about my current situation. I am a new-to-practice PA and started my job in CT surgery in February of this year. I graduated in August of last year. I am working in inpatient cardiac surgery and am currently still on orientation, but I am feeling quite overwhelmed and starting to wonder if this is not the right opportunity for me to have taken on as my first job out of school. To provide some background, the team I work on is 95% NPs, 5% PAs. The team is predominantly comprised of NPs that have had years of experience working on either the cardiac surgery floor or in the surgical ICU prior to becoming NPs. There is another new-to-practice PA that came about a year and a half before me, but I am the second new-to-practice PA that they have taken a chance with hiring. There is one other seasoned PA who has prior experience. I say "taken a chance with hiring" because the new-to-practice PA that had come before me was the trailblazer in that my manager was testing the waters to see whether new grads would be able to make it on this floor. PAs are typically in the OR for CT surgery where I work. The new-to-practice PA was on the verge of leaving but was encouraged to stay with the promise of an extension to her length of orientation (from 3 months to 6 months) and with her demanding that changes be made to how orientation for any future new-grad PAs be handled. I am currently being mentored by the seasoned PA, as well as another seasoned NP. I take three of their patients (typical patient load for a provider is about and they try to follow behind me so that we can address aspects that I am missing. While there are some opportunities during the day to talk through some topics, oftentimes the rigors and rounding schedules of the floor only allow for us to touch base briefly and intermittently. There are no residents or fellows on the floor, so it is only the team of NPs and PAs that are running the show while the surgeons are in the OR. Because of this set-up, there is very minimal addition of new knowledge within this team. There are no lectures to attend to ensure that we are practicing evidence-based medicine, each surgeon notoriously prefers different styles of practice based on their training and experiences that is un-Google-able, and I feel that my main sources of learning rely on what I can try to teach myself at home and what my mentor can offer in the limited time that we have during the work day for teaching. I feel that being so many months out from graduation, I am trying to find my way to regain and effectively apply all the knowledge I once had from school into my new role as an inpatient provider, while also trying to learn cardiac surgery, a specialty I had been minimally exposed to during school/rotations. I find myself leaving work feeling completely defeated by how inefficient I am with having managed only three patients (though complex patients) that day, with my head feeling full of everything from navigating the EMR system, to putting in orders for medications that I now need to know the dosages and frequencies for, to remembering the information that my mentors had offered me that day, to remembering how to clinically manage patient conditions instead of managing pretend patients that had once been in non-real-life-threatening multiple choice formats, to realizing that not only the surgeons differ in their practices but the NPs and PAs differ as well. My mentors are frustrated because it seems that I do not remember some topics we discuss, and while I can understand where their frustration is coming from I feel like I am drowning to try to keep up with absorbing all these things that are all new to me. I try to jot down notes whenever they say things, but there is not very much opportunity to ask why certain things are the way they are, nor are there always reasons why they are. Because of this, my memory feels like a "snapshot" memory and I am finding it difficult to then apply what I am being told to another situation that may be similar in the future. While I try to return home with what brain power I have remaining to review what we have gone over, there are ultimately gaps in my knowledge because there may have been aspects that I was not able to jot down quickly enough, or that I maybe didn't understand fully when the factoid was told to me in an isolated incident. I also find myself planning to research a whole laundry list of topics of confusion to find myself going down a deep rabbit hole just to feel like I have grasped the topic, only to find myself not making my way efficiently through my topic list and then returning to work and finding more topics of confusion. In the midst of my mentors' frustrations, it has now reached the point where I am afraid to ask questions because I am afraid that my mentors will say "we've already gone over this" when I truly do not recall it or when I only vaguely remember them saying something about that question but not in an in-depth way. I feel like they think they're being crystal clear and that the things they are telling me should be easy to remember the next time, and I wish I could ask them to be patient with me because it is a lot to digest. My manager's only consolation was "well in your interview you knew that this was not going to be a teaching floor," and I just wish I could find the voice to reply that even though I expected this to be hard, it doesn't make this any easier. I dread going to work and it's very difficult for me to gauge whether this is simply a new grad experience, or if this is an opportunity that was not meant for me right now when factoring in my new grad status and the resources and environment that I currently have to get my footing as a new grad. My confidence and self esteem are in the dumps because I feel like an idiot that can't remember anything from school, let alone remember anything about CT surgery to make my mentors feel that I am making adequate progress as I approach the end of my third month on orientation. If anyone has any advice, I would greatly appreciate it.
  3. I'm about 3.5 months away from graduation. Recently, an advisor from our school came to talk to our class about finding our first jobs. He recommended going on LinkedIn, looking up former grads from our program who are employed where we'd like to work, and calling them or sending them emails asking for advice on getting hired, even if we don't know them from Adam. I feel a little weird about doing this, and I want to know what the general consensus is on this one.
  4. New grad here currently considering taking my first job at an urgent care clinic. The goal is for me to act as a solo provider at a new rural location to be opened in the coming months (with an off-site supervising physician.. the specifics of who I should contact depending on when a question/concern comes up are to be discussed and I plan to have them included in my contract in writing.) It has already been discussed that I would have at least 4 weeks of one-on-one training with a supervising physician at the existing clinic, where there are always at least two providers working, before beginning independent work at the new location. I know all new grads experience some hesitation and nervousness about their first job, even WITH colleagues on-site for questions and I can appreciate that these feelings are in fact healthy and will keep me working hard to continue expanding my knowledge and improving my skills. I also know how important receiving sufficient training at your first PA position is, essentially building the foundation for the rest of your career. My question to you: when you started your first position (whether it was urgent care or something else - it would be helpful if you specify), what kind of training did you receive and for how long, and did you feel like it adequately prepared you for independent practice?
  5. I am starting to put together my resume so I can be prepared to start the job search well before graduation day. However, if I start applying to jobs prior to graduation, what do I list as my 'title' after my name? Do I list 'physician assistant' or 'physician assistant student'? The first seems disingenuous (given that I haven't yet graduated), but then listing my title as 'student' in big bold letters seems like a recipe for getting ignored... given that I am not listing PA-C (certified) is it appropriate to use the title 'PA' without the 'certified' qualifier? Thanks for the insight.
  6. I just received my first offer at an Orthopedic practice just 30 minutes south of Boston, MA as an Orthopedic Spine PA 2 days in OR/3 days in clinic. 40 hours. Salary: 80k "On call potential": "10-20k+" ($350/night on weekdays and $750/night on weekends) 3 weeks vacation 40 hours sicktime; 1 personal day Full benefits Practice pays for disability, malpractice, and licensing fees 5 days CME + $1500 401k + 3% match Is this even worth considering?
  7. Hello all, I’m a new grad as of August. I turned down a fellowship due to a last minute contract change of an added time comittment in an area I did not want to stay in. With that, I started looking in the area I want to live, but now I feel behind in the job search and beginning to feel very pressured. I’m in an area with high COL and low job availability for new grads. I was recently offered a full-time ER position as a 1099. Malpractice with tail coverage only. There is also a productivity incentive (current PA said they average an extra $1500-2k per month). I have been offered $65/hour. Average 2 patients/hour, 12 hour shifts (no overnights). I have read so many negative things about ICs especially as a new grad, but the other 3PAs have been there for >5years and began as new grads too. I know this will be good ER experience, but I’m concerned about the lack of benefits. Please, any advice is welcomed! Counter suggestions?? Run for the hills?? thank you!
  8. Hello! I am a new grad PA and I start a job in a month for a GI consulting service. I will spend 3 weeks of the month in the hospital doing consults, rounding, dictating notes and 1 week in clinic. I did a rotation in GI during school, but it was all outpatient Hepatology with a day a week in a general GI clinic. So I don't feel super prepared to go to the consulting service right now. Can any GI PAs recommend any books/resources that you found helpful for hospital work? It would be greatly appreciated!! I found a book online called: Textbook of Clinical Gastroenterology and Hepatology 2nd Edition--- It is quite pricy-- 250$.... But it if it useful I will buy it. Please any advice is appreciated!! Thanks!
  9. This is an 100% outpatient practice. They have multiple locations but I'll be working between two clinics in a major city with high COL. I interviewed with the director of Human Resources and I'm scheduled tomorrow for a tour of one of the clinics that I'll be assigned to. 40 hours per week, Mon-Friday (No weekends, no on-call) $100,000 salary Medical, Dental & Vision 401K* 6 Holidays 5 sick days with accrual to up to 2 weeks the first 2 years Reimbursement for DEA & State License renewal fees, not initial Malpractice* 3 CME days annually $500 CME annually 6 month training period; there will always be 2-3 doctors/NPs/PAs on-site. 18-20 patients per day (They assign 15 minute blocks for Follow Ups and 45 minutes blocks for New Consults) *I'm not sure whether malpractice includes tail coverage and whether 401k includes matching, but I'll be getting the official contract by the end of this week A couple concerns: Lower than average salary for my location. I'm thinking of countering with 105k. Average starting salary in my area is 110k but to be honest this is the best offer I've received. I know a few classmates who accepted an equivalent ~110k salary with small physician-owned practices but were lacking on benefits (e.g. no Medical/Dental/Vision, no 401k) As detailed in another post, I'm not sure if oncology is the specialty I want to stay in (although I want to stay in the general internal medicine field). However this is the best best offer I've received after looking for the past 2-3 months. I know that's not a relatively long time for a job hunt and I am okay with searching a bit longer for a better offer in a more generalized field; I'm just not sure if it will come at this point. Any thoughts appreciated.
  10. I am currently still in my clinical year--I have 2 rotations still left to complete. This is the second job offer I've received. My first offer was from a local ED, which I declined because 1. It was my first offer, and from this forum I've learned that you probably shouldn't just jump on the first offer that you see 2. Before PA school, I worked as an ED tech working the 1400-0230 shift--and back then it was just my wife and I, and since then we've added 2 little girls to our family--and I just don't think I want to take on the ED hours, stress, etc 3. I ran my offer by a few different PAs that I know (PA school faculty and practicing PAs), and they were less than impressed with the offer ($115k starting, but didn't increase yearly as much as it probably should have; PTO was minimal; etc.) 4. In hindsight, I think I made the right decision. 12 hour shifts, 14 total shifts per month. This position is an urgent care where I'll be "training" with an MD or experienced APP for 60 days at a monthly pay of $6834 (would be salary of $82k--$40.67/hr). After this time, I'll move to my regular pay of $59.52/hr, $119,992/year. 3 tier PA job ladder--starting at PA1 (years 0-3), then move to PA2 (years 4-7), then senior PA (years 8+). They haven't said what the pay scales will be yet for PA2, senior PA. I told them I will not be signing until I know what that scale looks like with exact figures. They agreed that they would have that information before I sign. License reimbursement of $1170 $1500/year CME UpToDate annual subscription--approx. $500 Benefits eligible 1st of the month following 60 days of employment--Is this normal?? Non-compete clause--they haven't stated the exact details. I will get this information before I sign. 401K plan--have to wait 1 year to receive a match, but after that year I am 100% vested. After 1 year of employment they will match 100% up to 4%, then 50% of the next 3%. PTO accrual: 2 weeks in the first year, then increases incrementally yearly after that. They haven't stated exactly what it will incrementally increase to yet though. Again, will not sign until these numbers are firm and included in the offer. Thoughts?? Initially, I asked for $64/hr, which breaks down to $129, 024/year. I am thinking I want to counter with $61/hr--only a difference of $2984 over the course of a year (extra $248/month--that's a good chunk of our childcare). In any case, let me know honest thoughts. Anything that stands out as concerning? Thanks Forum! I've been reading other's post their contract offers, and have been waiting for my opportunity to post!
  11. Hello! I'm a new grad and recently received a job offer and contract. I wanted to see what other PAs thought and things I should negotiate since this is my first experience with this. Position is with a spine surgery practice in Texas: - Salary $90K with yearly bonus "at discretion of CEO." This seems a little low, but hard to negotiate as I have no experience. - 2 weeks paid vacation - In my interview they also stated that major holidays were off as well. Need to clarify if these would be paid or not. Is this reasonable time off or too little? - 5 days sick leave with doctor's note - CME allowance of $2500. They stated in interview that I also would have 5 days for CME, so I need to clarify this with my contract and whether they are paid or not and have this included in writing. - Malpractice insurance is provided "consistent with reasonable surgical physician assistant coverage." Obviously need to clarify whether occurrence or claims maid. And tail or not. - Individual health insurance covered by employer. Family health insurance covered by employee. I only need coverage for myself, so this sounded like a good deal to me. Other than above, I also wanted feedback on my hours. My schedule is described as up to 5 days a week but then later says that 5 days is routine and more days as agreed by PA and physician as needed. Hours may or may not extend past 10 hours per day with workload not to exceed 80 hours a week. There is no mention of call but when discussed they said I should "rarely" be on call. Obviously I'm not trying to get tricked into working 80 hours a week when the job was described as a M-F position. What is the best way to ask that this is clarified and protect myself from being exploited? Appreciate all of your feedback! Thank you!
  12. So I am a new grad.. I was offered a job in a specialty. Pay is 80k. Schedule: 2 weeks hospital, + on call 1 of those weeks (call from nurse and pts not from Physicians which goes to on call physician). 2 weeks outpatient. PTO: 15 days/ year. + holidays. 200/month for insurance. CME 2 days. 1500$ Do you think the pay is too low ? Also let me add that I graduated in December-2017- I was trying SO hard to find a job in my city but could not-- eventually gave up and applied outside of my state. I am scared this may be the best offer I can get because of my time off.
  13. Hi all, I'm graduating PA school tomorrow and taking my PANCE in a week (wooooo!). I'm highly motivated to pursue a career in emergency medicine, particularly rural EM, and interviewed at multiple programs this summer. Unfortunately, I did not get into a program that felt like the right fit for my goals, so I've decided to reapply to more of the quality programs with open applications this fall. Most of these residencies don't start until late next spring or summer. Here's the issue: that would leave me with a minimum 7 month gap in employment, and up to 10 or 11 months, before starting a residency. That's terrifying! As far as I can tell, here are my only options, none feeling all that great: 1. Find a non-clinical job to fill the time/money gap. I have a job offer with an EMR implementation & consulting company that is OK with my timeline, but I fear I would lose so much knowledge if I'm not actually practicing what I've learned these last two years. Also, this might reflect poorly on my applications this fall. 2. Locum tenens work, ideally in urgent care or EM, but may have to do family med for a bit. I'm not really comfortable with this, as I've read on here that locums might be a pretty terrible idea for a new grad. The last thing I want to do is be in an unsafe environment, but somehow this feels like the better option. 3. Take an urgent care or EM job, not disclosing my plans to leave (who would hire me otherwise?). This feels dishonest and I'm least comfortable with this idea. I think it'd be terribly rude to leave any clinic/ED in such a short period when they've put in the effort to train a new grad. Am I off base with that? I could also work somewhere for a few years then reapply, but we all know how life goes; I'd rather do the hard work now before family/house payment/etc are deterrents. I'm really stuck on this and hoping that the experienced crowd here could impart some wisdom in my process. I'd really appreciate any advice!
  14. Hello! I am a recent PA graduate, just got my certification and state licensure in the last month. I am currently 17 weeks pregnant with my first child, and am looking for my first job out of PA school. My baby will be due in early February, and I'm barely showing now, to the point where it's not noticeable in most clothing. When in the interviewing/ hiring process should I mention my pregnancy? I know that it is not legal for them to ask me, nor am I obligated to disclose this. I have recently done an interview at a large county hospital, and am waiting to hear back on their decision. My plan currently is to disclose my pregnancy after they give me a letter of intention, but before I sign the contract. Some people have told me to wait until I already have signed the contract, but it seems like getting off on the wrong foot to me, as it could be construed as purposefully misleading. My hope is that I can show good faith by disclosing this before both parties sign the contract, but by not telling them during the interview I minimize the risk of me being totally ruled out due to my pregnancy (which I know is not supposed to happen but obviously does). As far as maternity leave, I know that I won't be eligible under FMLA, so I am thinking I may have to use some combination of PTO, short term disability, or just have my husband use his unpaid FMLA time to help while I have to go to work (if I only get a few weeks off). In a month or two, once I start really showing (and if I haven't found a job yet), I think I will realistically have to mention it in an interview, just because it'll be noticeable and kind of an 'elephant in the room.' The only other idea I had was to work locums for 2-3 months before my baby comes, so I could save up some money, and get a permanent job after my baby is a few months old, but I've seen most people have discouraged new grads from locums work. Ultimately, I don't want to make any decisions that could impact my new career long term or jeopardize my license, so I'm now leaning against locums work. Any thoughts from other moms who have been through similar issues would be much appreciated. Thanks!
  15. Okay. So I have been having trouble finding a job out of PA school. I graduated in December. I applied to a few residencies and fellowships and made it to the final round of one of the residencies but ultimately was not chosen. (This process took 2.5 months of my life= 1.5 months waiting for the interview and 1 month waiting for the results). So now I am 7 months out of school and without a job. The biggest problem is that I struggle with confidence. I did very well on all my tests in school but I feel like 2 years in school wasn't enough for me to be ready to practice medicine. Unfortunately, all of the fellowships and residences have deadlines that have passed so I am trying to find a job that will be welcoming of a new grad and be training heavy. I have a few interviews/job offers but need some advice of which would be best for me. One job primary care. They will give me 1-2 weeks of shadowing the doctor then 2 months of working in the same clinic with the doctor who I can utilize for questions. After that time I would be solo at one of the clinics. Pay is okay 90k but job is in California which is kind of expensive. One job is Urgent care. Shadowing for maybe 1 month then would be solo "sometimes" at 2 of their locations. But able to call doc at other locations if I have a question. Better pay and benefits than the primary care job. But I have read on the forum that Urgent care may not be the best for a new grad to start in. One jobs is endocrinology (I am scared this may be too specific for my first job and I may not be able to get out of this specialty if I end up not liking it). Any advice of which I should take if offered the position (knowing that I am a new grad who struggles with confidence)? I wish there were more residencies and fellowships for pAs! Thanks!
  16. Hi all, I am a new grad PA-C in MI and just received an Urgent Care offer at the first clinic I interviewed with. Seems to not be great, but not bad and I’d appreciate any feedback you have for me moving forward! First off, I interviewed yesterday and received the offer today. $45 per hour was offered and I countered with $50. We settled on $47. Pay: $47 per hour, shifts are usually 3 12’s, holiday and OT pay is time and a half. Possibility of bonuses dependent on revenue were mentioned. Ability to pick up shifts at sister locations. (OT wouldn’t kick in if time was split between locations though) Malpractice: covered (possible tail, office manager said yes when asked, but didn’t sound confident) Health Insurance: 50/50 but find your own coverage CME: 2k per year PTO: 2 weeks accrued per year Training: 2 weeks, $30 per hour Pro’s: No non-compete clause, 1 year contract ( no penalty to leave early) office manager stated “no one has ever done that besides one girl that went to work at a hospital and still picks up PRN shifts” Brand new office and they anticipate 4-8 patients per day until they build a pateint base. I would have an MA to complete front and back office duties. Con’s: I would be the only provider on site, collaborating physician would be available by phone/text and could run over to the office “if needed” (I wouldn’t count on this). They also said they “aren’t allowed” to send the contract via email. I can come into the office to review it or she can read me the highlights over the phone while I write them down?...I’d like to have it looked at by an attorney, is this reasonable? They’d also like me to make my decision ASAP. My background was in a busy surgical office and where we saw 60-80 patients a day. A lot of them I saw independently for post-op dressing changes and suture removal. Spoke with two of my preceptors that think the offer is reasonable and I could handle the amount patients on my own, without a physician on site. Thanks in advance for any insights/help you can provide!
  17. Hello all! I am a recent new grad who was offered a position in Trauma in SoCal. Though, I had never expected going into trauma, I am very excited for this opportunity and challenge!! Unfortunately I do not have much experience in ER, but the trauma surgeon really liked my personality so is willing to invest serious training. I am the first Truama PA at this hospital, so I do not really have a mentor to ask for tips from. Does anyone have any recommendations for resources, books, apps they used to best prepare for this role? Any other advice from fellow Trauma PAs out there?? Thanks in advance!! :)
  18. Hello everyone! I had recently posted about a derm offer, but I got another offer at a different practice/state and would love some thoughts on this one. Salary: 36 hour work week, Training salary for 4 months at a rate of 75K, and then 80K with bonus of 10% for collections exceeding 60K for a 3 month period that will be paid quarterly. Time off: 2 weeks PTO, 1 week of sick time, 2 days for CME and 2 personal days along with 7 paid holidays. Malpractice covered. 50% of tail coverage if I stay with practice for 2 years. CME: 1K Health insurance plan: 280/mo towards it 401K: allowed to enroll after 1 year Restrictive covenant for 7.5 miles State: Pennsylvania, outside philly Counters that I’m thinking: - I’m okay with the training period salary but will counter with 90K w/ 10% collections - 5 days for CME - Tail coverage required now - CME 2K - I need to get more info on the health insurance aspect. I really really like the Physician and she has a great plan for how to train/incorporate me into the practice. I feel like it would be a great opportunity but I also want to ensure I’m making the right decision realistically. I would love any input from you guys! Thank you!
  19. Hey there, I have been working in an Urgent Care clinic for 2 months now as a PA-C. Just wanted to share my experiences getting started in the field for those interested. Check out my post below: What It's Like to Work as a New Grad PA
  20. Hello folks, I'm currently a PA-S graduating in a few months. I'm posting in the general discussion since I wanted to get opinions from PA-C's, particularly w/ urgent care experience. I've applied for a number of EM jobs, and am in the process of applying to urgent care positions as well. I've decided work life balance is very important to me, and Urgent Care seems to fit the bill from what I've seen. My question is, do you guys think Urgent Care is an appropriate field for a new graduate? I will have had 2 rotations in EM by that point, and will not be solo at any of the UC locations. However, I've heard some members stating it is a poor choice, since you have more "autonomy" and need to have a good sense of what is high acuity and what isn't (which comes from experience). Given that it fits the lifestyle I want, should I still consider it? Thanks!
  21. I graduated PA school last May and 6 months ago I started "my dream job" - Ortho surgery. I was told it was going to be working 40hrs/week, half clinic half surgery, no call.. it all sounded perfect. Now this is my current reality - I am pushing 6 months at this place, love the field and a couple of coworkers. However the doc that was supposed to be a "super nice teacher" is done with me it seems like. At the current time I am working about 10-12 hours every day and scheduled to start taking calls soon. This amount of time plus the calls arrangement is not what I was told this position would be like during interviewing. That being said, I realize that I am getting so much experience, and being a new grad I can use as much of it as I can get. The major problem is the doc I work closely with. He gets upset with me when I ask him questions or am unsure about something, he was really good about walking me through a lot of stuff for the first few weeks but very early on I was expected to be a fully functional partner. I entered this job with them knowing that I am a new grad. I lack so much experience and despite my success in school this isn't something I learned before or even something I can pick up from a book. There are so many cases and they all can be so vastly different, even if its all shoulders. In my mind I think that patient safety and well being comes first but the doc I work with has been upset for some time as he thinks I am slowing them down. Basically for the last month or so he has been avoiding me as much as she can. I try not to ask him questions and instead go to my other colleagues, but i feel like his attitude isn't fostering a professional relationship between us. I can see that he is not fully wrong in expecting more of me but I don't know why they hired a new grad knowing that it would be very difficult for me to work on par with him within just a few short months. Just a couple of days ago he sat me down to tell me he isn't sure if we are a good fit for each other and that we should both think about that as my 6 month performance evaluation is around the corner. I knew that he has been annoyed with me and mostly sees me as a "kid" but this really took me by surprise. Especially since I asked him no more than a month ago how I could improve or what I am not doing well... to which he responded - "you are doing great". So now I don't know if I will even have a job by the end of April. Has anyone had similar situations? Am I supposed to start applying for other jobs? Do you think that a 6 month employment period will look super bad to new potential employers? I've been thinking about what he said and have come up with a few things I want to talk to him about further. I plan to speak to him again this week and tell him what I plan on doing to better my work flow and increase my knowledge as well as ways in which our relationship could be smoother (aka better communication on his part) but even if he doesn't fire me I don't know how we can come back from this. Sorry for the long post but i just needed to vent a little bit. Thanks for your replies in advance!
  22. Hey all, would appreciate your inputs- thoughts, questions, concerns welcomed. Thanks! Rural midwest FQHC, 4 or 5 day work week. Low COL area. 85k base (nonnegotiable, increase to 90k after 2 yrs, no productivity) 10k student loan reimbursement Retirement 1% match, w/ potential 1% extra dependent on overall practice productivity Health benefits req. ~$30-100 monthly contribution a little over 7 weeks accrued PTO yearly (includes everything- vaca, holidays if scheduled, sick, cme) 3k CME Natl and state professional assoc fees, license, PANCE paid for, won't say no to others within reason. (Uptodate incl) malpractice with tail incl. but I need to spend more time understanding the actual coverage
  23. I recently interviewed and was offered a position in Family Medicine. I spoke with the recruiter today who said that a 'letter of intent' would be sent to me as well as a sample contract, but the organization does not allow for an actual contract to be signed until after I graduate and am certified. Is this normal? It seems like a huge red flag since the 'letter of intent' is generally not a legally binding agreement.
  24. I graduated in May 2017 and started working in psychiatry in August 2017. I work for a small physician group, and my primary responsibility is rounding on an inpatient psych unit. I've been feeling unsupported and uncomfortable with my supervising physician, and can't tell if I'm being unreasonable or overreacting. I will often round alone in the mornings, and he will round in the evenings if he has other obligations in the morning. I am comfortable with this, and feel capable. However, there is a clinical psychologist on staff who has developed a pattern of undermining me. If I make a decision she disagrees with, she will call my supervising physician and regardless of the situation he will give an order to undo what I have done and do whatever she suggests. Typical example of this happening: I saw a patient in the morning who the previous evening had presented in the ED saying she was suicidal. The ED called my supervising physician, and he gave the order to admit. When I saw her in the morning she was tearful, labile, screaming at staff and demanding discharge. She insisted she wasn't suicidal. She was generally very unpleasant. The therapists and nurse wanted to get her out so she'd stop being awful to them, but I felt uncomfortable immediately discharging her. She had said less than 12 hours prior that she was suicidal, and clearly was not emotionally stable at present. I explained my reasoning to the staff, including the psychologist, and ordered some Ativan to try to calm her behavior. I called my supervising physician, explained the situation, and what I had done. I said I'd rather he also see the patient when he rounds in the evening, and did not feel she was safe for discharge. He agreed. Half an hour later, the clinical psychologist contacted him and said she thought the patient should be discharged immediately. He called me, and told me to immediately discharge and write the discharge summary. He is my supervising physician, so I felt I had to do this even though I felt very uncomfortable as I was the only one who saw the patient and did not feel confident of her safety. I spoke to him and tried to explain why I was uncomfortable, but all I got was a lecture about cooperating with the treatment team. I'm not sure he understood that I feel as though he is neutering me by constantly overturning my decisions (even when he initially agrees with them), or that I wish he would see difficult patients himself before blindly trusting anyone's judgement. This is my first job, and I'm not sure if dynamics like this are unusual.
  25. Hello All, I am a new grad PA-C in Pennsylvania. Currently waiting to start my job in critical care medicine at a large academic medical center. I have worked in EMS for the last 9 years as an EMT-B with an ALS service. I have submitted an application through my regional EMS council to have my pre-hospital certification changed from EMT-B to PHPE (Pre-Hospital Physician Extender for those not familiar). The final step is to challenge the NREMT-P written exam. Has anyone else challenged this exam? How would you rate the difficulty given your education as a physician assistant? I'm not worried about taking this exam.... should I be?
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