I am a graduating PA and am currently looking for outpatient jobs, particularly in primary care. From what I have heard and seen, many primary care clinics are going through hiring freezes, and the few positions I have seen have required 2-5 years of experience. I have applied to them anyway in case they take a look at my CV and consider me, but they have either not contacted me or told me that I do not have enough experience.
I had a good first and second interview for an endocrine PA position. I do like endocrine, however I believe at least 90% of my time will involve working only on diabetes management. If I am offered this position--or if I am offered a position in another specialty that I do not see myself in long-term--should I take it to get experience (and a paycheck)? Should I wait it out hoping for a primary care position? If I take a specialty position will I be less desirable as a future applicant for primary care positions? The job market is difficult, generally, for any new grads, but the pandemic seems to have made things a bit harder as well.
I have been a practicing PA for 4 years working in adult acute care medicine (ER, ICU, transplant cardiology). I was recently approached by a recruiter for PA position in pediatric cardiac surgery, which would involve OR and ICU clinical work. Even prior to PA school, I had an affinity for pediatrics and loved my pedi rotation. I had always imagined going into pedi cardiac crit care. My professional life took me towards adult care, and unfortunately has not permitted much in the way of pedi exposure. Has anyone made the jump from adult acute care to pediatric acute care? From chiefly medicine position to surgery? Can you tell me about your experience and any additional insights? It's a helluva jump, I am not naive, but just wanted to see if anyone else has any experience with this. Thanks!
Just wondering if anyone has connections to PA, MD, or DO's in the state of Hawaii that might be interested/willing to take on PA students for clinicals, especially in primary care. My wife and I are both in PA school and applied and interviewed with the MEDEX program set to start in Kona. We didn't get into that program, but did get into another and we would still love the opportunity to help with the healthcare shortage in the state. Any tips or suggestions are greatly appreciated.
Because many of the PA certification study resource tips I see on this site are related to PANCE, I wanted to share a few takeaways from my PANRE study resource experience from when I tested in December of 2019.
As a PA practicing in dermatology (nearly exclusively since becoming a PA), I had previously sought study resource suggestions on this forum in advance of preparing for my third PANRE. I landed on the ones listed below. There are other resources I wanted to try such as Kaplan and CME4LIFE which were also recommended. This is by no means a comprehensive list of the best resources. It is simply a list based on my own limited experience.
List of resources used for 2019 PANRE Prep:
Rosh Review question test bank (took about 2,200 questions). Rosh provides a very convenient app which allows one to drop in any time and utilize the study mode for immediate feedback with a good review of rationale provided for answers. Tests can be set up in a variety of ways and can be timed or untimed. Final “projected PANCE score” turned out to be about 15 % lower than my PANRE score but I know others have reported experiencing the opposite scenario. Note: I am unaware how or if this is supposed to correlate to PANRE (vs. PANCE) projected score. I found the best price for Rosh Review test question banks on this forum and purchased access through two members whose dates of access overlapped which worked out great. I highly recommend Rosh Review questions.
Joe Gilboy, PA-C test booklet and SoundCloud audio files (https://paboardreview.org). Joe is a rather entertaining speaker who moves through various system lectures in a way that keeps you engaged, although he can go off topic a bit. In his lectures, he covers system topics without exhaustively discussing a given system all the way through and then comes back to it later. His theory is that he loses people's interest if he covers a subject cover to cover. He sells access to members only SoundCloud lectures that follow a book outline which he will send to you within days of your order. Total cost is $125. Joe called back from the phone number I called listed on his site and was very willing to answer any questions. He seems to have a genuine passion for helping PAs pass the boards and I greatly respect this. Cardiac Pharmacology is his number one ranked SoundCloud lecture. I highly recommend his Hepatitis lecture as well. Test questions are in his book and some of them are discussed in his lectures. The questions are rather limited in number overall. The lecture and book served as a great resource which should probably be supplemented with a more comprehensive review book when preparing for the boards. He provides a list of suggested additional study resources in his book.
HIPPO PA video series and test bank (https://www.hippoed.com/pa/). There is access to experienced video lecturers through HIPPO PA but honestly, I did not enjoy this one as much. IMO, some of the lecturer’s back and forth was a bit annoying. Also, not all of the speakers held my attention equally, nor did they always stay on topic. However, I have read alot of positive feedback about this resource, so to each their own. HIPPO PA seems like it is more than adequate as a stand alone resource to pass PANRE because they definitely cover the NCCPA Blueprint and there is alot of content overall. The test bank was good and I liked the breakdown of feedback as to weaknesses and strengths in various categories. I felt that Rosh questions more closely resembled the questions I experienced on the PANRE.
Smarty PANCE Membership (https://smartypance.com). This seems to be one of the most economical choices and actually includes access to Joe Gilboy’s lectures with a visual aid of the pages of Joe’s book as it follows his audio lectures. Separately, there is a link through this site for Joe’s members only SoundCloud audio lectures. In comparing this to Joe’s site, I think the only advantage to using paboardreview.org to purchase lectures is if one wanted to purchase his book in addition to the SoundCloud lectures. I don't feel this is necessary but I liked the idea of supporting Joe directly by purchasing through him, so that’s why I chose to do both. I think Smarty Pance is an adequate stand alone resource for passing the PANRE. There are lots of questions (although currently weaker than Rosh) and many system oriented and comprehensive mock tests here as well.
PANCE Prep Pearls: A practical Comprehensive Study and Review Guide for the PANCE and PANRE by Dwayne Williams, 2nd Edition. (https://pancepreppearls.com) List price is currently $47. Lots of algorithms and thorough content overall. Of note, a currently priced $50, 2 volume third edition was recently released on the site above. It is promoted as “more user friendly” and “in line with the 2019 blueprint.” In my research, this book is often recommended for PANCE and PANRE test prep. I would recommend using this resource to supplement another source for test prep. There is also a related app that can be purchased but I have not tried it.
Now that I have taken and passed my PANRE, I would recommend the following if I was preparing for the PANRE in 2020: Rosh Review question bank access (per negotiated or Rosh direct purchase rate), Smarty Pance ($65 one year all access pass is the current rate), Joe Gilboy SoundCloud lectures accessed through Smarty Pance for on the go, and I would purchase the two volume 3rd Edition of PANCE Prep Pearls ($50). Part of my rationale for this is that one could probably get access to all of the above in 2020 for around $200 total (give or take a bit) which I think is reasonable. The price paid for CME resources varies widely and can be much more expensive, so please do your research on that.
The 2019 PANRE was different from past PANRE tests and perhaps a bit more difficult for me in that buzz words are gone compared to the previous tests. Also, I found myself reading through a question while thinking, “Oh cool, I know this diagnosis," only to be asked about a subtle lab or exam finding nuance. My overall score was the highest I have had for PANRE thus far but I also prepared more this time than in the past. I definitely recommend being thorough in test prep because relying on question banks but not knowing the material on a deeper level will only lead to unnecessary stress. Begin test prep months out, if possible. Remember that NEARLY everyone but not every single one person passes PANRE. This should be reassuring for those who are worried about passing the PANRE. This is a link for PANRE pass rates that goes through 2018 as of the date of this posting: http://prodcmsstoragesa.blob.core.windows.net/uploads/files/PANREPassRates.pdf.
I cannot speak to PANCE Prep since I know PANCE and PANRE present different challenges and degrees of difficulty.
I hope this is helpful. If you would, please comment with your preferred board prep resource and reasons as to why. I am happy to respond by DM with specific questions regarding this post. Thank you for reading it.
I don't really comfortable speaking this frankly to my colleagues. None of my close friends or family are in the medical field so they don't truly understand. I am still a somewhat new PA and I am already considering a new career path. I went to PA school 2 years after graduating college, so I don't have any experience in any other fields besides healthcare. But I've been having serious thoughts about quitting my job and quitting the medical field altogether. A little background about me, I am in my late 20s and I have been a practicing PA for about 4 years. During this time I have been at the same practice, a specialty and internal medicine office. There are several physicians, but I am employed by one. I see patients in the clinic, in several acute care hospitals, and at nursing homes. Although I like the variety and the types of patients I see are very interesting to me, there are downsides to the job that just become more apparent every day. I work M-F 9-5 and 2 weekends per month. I have to take round at the hospitals and take calls on those 2 weekends, plus take calls 3 weekdays out of the week. I often work 3 weekends a month, and occasionally even 4 when my contract technically says 2.
My supervising physician is retirement age and he refuses to retire and instead delegates more and more tasks to me. For example, sometimes if he is too tired / lazy he will tell the staff to just transfer patient appointments to my schedule. Patients are understandably upset when they made an appointment with the doctor they've known for years and get switched to the schedule of a PA they don't know. I feel like "as the PA", and an employee of the doctor, I pretty much get saddled with all the grunt work and undesirable tasks that he doesn't want to do. I know in other settings PAs are treated with a little more respect and not just given the busy work to do. There are some upsides, I do like my SP, we work well together, and I feel like I can honestly and freely discuss patients with him without judgment. I also know that he may retire in a few years so this job won't be permanent either. I don't know if getting a new job will help.
I applied for two separate jobs that I did not get. One was a family practice M-F with no call/weekends and the other was an allergy practice M-F with no call/weekends. Getting rejected for both of those jobs really discouraged me and made me feel trapped at this job. It won't be easy to find a new position.
I get frustrated with patients too. It just feels like there are so many patients who are med seeking. Some providers in my area were recently sentenced to prison time for overprescribing narcotics. They were reckless with their prescribing and I am quite careful, but the fact that jail time is in the realm of possibility for our profession constantly looms over my head.
Patients also often want to be on disability when they clearly do not need to. There are so many patients wanting DMV disability placards and getting irate when I tell them they don't qualify. In addition, patients whose licenses get revoked want me to sign off on them being safe to drive when there was a clear reason the licenses were revoked. Again, I am on the receiving end of the brunt of their frustration and anger when I say they need a specialist clearance. There is just so much liability in our career field and so much stress involved. Liability is always there medically too. YOUR decision can affect whether a patient LIVES or DIES and it's so much stress that I have actually developed my own health issues secondary to the stress.
I have had a patient stalk me and become obsessed with me. He wrote me unhinged letters and made many calls to the office describing my car, etc. We had to get the police involved and I considered filing a legal restraining order. I know this is possible in any profession, but it feels like healthcare can be personal and intimate and patients can get the wrong idea. I again contemplated quitting the profession at this time.
I have looked into other careers such as being a pharmaceutical representative, working in research, being an accountant, ANYTHING other than this. I have contemplated quitting and just living off my savings until I figure it out. I have talked to some colleagues to an extent, many are much older and have been PAs longer than me. I sometimes question if I'm just being an entitled millennial who wants life-work balance early on in their career until I realize that it's not normal or common to work 24-25 days in a row. It's not normal to only get 4 days off a month (if that. Some days I would get 2 days off a month.) I actually finally told my SP I was considering leaving because I was too burnt out. He trivialized my concerns and said "Why are you burnt out? You're young. I have been doing this for 40 years." Which is true, but this wasn't the life I envisioned for myself. After talking, he did acknowledge my concerns, and he hired an NP who can help me with the workload and guaranteed that I will only have to work the 2 weekends a month as outlined in my contract and I did get a raise. (I still feel like I'm underpaid which is a whole separate story.)
Sorry for the essay, I just really needed somewhere to air out my frustrations with other people in my career field. Thanks in advance for reading.