Sage Advice for New Graduates
Robert M. Blumm, PA-C Emeritus, DFAAPA
Congratulations! Many of you will be graduating from your PA & NP programs in the coming months. You are about to set out on a clinical career journey that could be as long as forty years. A few years ago, my wife and I planned a trip to Italy where we would visit all of the sights of Rome and Florence. Twelve days in Europe was a gift to ourselves - for me after many years of practice and for her, a lifetime of teaching Humanities to high school students. Our journey started six months before when she, as my task master, gave me several books earmarked with all of the relevant sights we were to experience. This homework was an invaluable crash-course on the art, architecture, poetry and history of all of the places we were to visit. Had she not crafted our course of study, I would have been like a child awakening on Christmas morning to twenty gifts which I could not open, let alone understand.
You have just completed an arduous course of study which has demanded a lot of sacrifice: study, financial cost, neglected friendships and delayed marriage plans. The initial goal was just to graduate; now you are required to take a certification examination to determine if all of your hard work was fruitful. When the large envelope arrives with your certification you are then ready to start. Correct? No! Now you will now need to make more decisions that determine your future. And these decisions are just as complex as your clinical training. Just like our trip to Italy, you will need to weigh many options and choices whose decisions will impact your success as a new PA or NP. My graduation present to you is this article which has the potential to better prepare you for your new journey as a professional clinician. It’s advice from me and my colleagues in business, administration and professional practice and will likely make your career journey safer and more satisfying. Like any advice, you can heed or disregard it – but hopefully, it will be a helpful component of your career blueprint for success.
These suggestions come from a variety of sources such as well-known PAs, like EMEDPA, a senior moderator on PhysicianAssistantForum.com, many of your PA Colleagues, myself included, Personal Liability Experts such as those from the AAPA endorsed provider and years of observing the pains and rewards of those who have provided healthcare to our nation in their professional capacity.
Ø Your first job is about learning your clinical skills, not about money.
Ø If you can afford to do a residency in your field of choice, do it! see #1 above.
Ø As a new grad you can have two of the following, three if you are lucky: location, specialty, salary. Choose wisely.
Ø Read your contracts thoroughly before signing them. Look for hidden details, such as mention of a non-compete clause. [A non-compete clause is a legally binding contract whereby the employee agrees not to work with a rival company or start a similar trade or profession for a specified period of time after leaving his current employer.]
Ø Choose a favorite maxim and then try to live by it. Mine remains: “Tis far better to show what you know than to say what you know”. Equally important: “Say, rather than show, what you don’t know.”
Ø Join your professional organizations and support them so that you will be empowered to make changes that the first fifty years of PAs were unable to accomplish.
Ø Don't take the first job you are offered unless it's ideal. Don't settle for mediocrity, ever.
Ø Don't accept a position in a specialty that you detest just because “it’s a job”. You will be miserable in a job that you dislike and you will never achieve excellence.
Ø Don’t accept a position that does not offer CME and vacation time that is adequate for you and your family. Do not accept call without pay, weekends without pay and no more than two weekends monthly.
Ø Do not work in a critical care setting immediately out of school. Hospitalist, ICU, CCU, pediatrics are all specialties for experienced providers. Spend at least two years of non-critical care clinical work so that transitions to other specialties can be accomplished more effortlessly.
Ø Don't work in a very narrow field right out of school unless it is your dream job and you never intend to leave the specialty. I know lots of folks stuck in jobs they hate who can't leave them.
Ø If you are getting burned out, consider the following: work fewer hrs./mo., see fewer pts/shift, switch specialty, switch location. Find something new where you are appreciated.
Ø An essential lesson that I learned which I discovered after working too hard for others. Your husband/wife/significant other and children should be your first priority, yourself your second, your practice third, and professional politics last. No one will ever care for you like your family. Jobs expire, positions fail to exist beyond their time limits and then you will be forgotten. You can never recoup the time you have lost working for others. I have served this profession as a leader for about thirty years. But I paid a price: my kids placed a photo of me at the dinner table at a certain time in our life. Sad commentary.
Ø Don't take a job where your clinical supervisor is an RN or office manager. We are not medical assistants.
Ø Don't refer to yourself as Dr Smith's PA. They don't own you. Say instead, “I'm John Doe, one of the PAs here." Or "I'm John Doe, I work with Dr Smith on the surgical service.” Words matter. Don't let yourself be treated like an assistant. Don't regularly take out trash, take your own vitals, room patients, etc. unless the docs in the group do so, too. I can see this in a small office, but there is no excuse for it elsewhere.
Well, we have covered many of the rules and suggestions but now let me conclude and write about the most important task on your new medical journey. Remember my trip to Italy which I spoke about earlier? Your excitement as you begin your career is comparable to the thrill and anticipation one feels as they set off to explore the Renaissance. But unforeseen events can destroy that cherished vacation: robbery, an injury to you, a crisis at home. So, as your journey begins, a critically important item to secure is a professional liability insurance policy, better known as a malpractice policy, and it is never more affordable than when you first graduate. The AAPA, your professional organization, has endorsed an excellent provider and secured special rates for you, the new PA.
Every PA should carry personal liability insurance for all time periods during which they have practiced. A malpractice suit can be brought against you at any time after seeing a patient (days, weeks, months or even years). And a malpractice suit can jeopardize your professional reputation and impact your credentials with the potential of losing your license by suspension or revocation. Your malpractice history is a matter of public record and your NPI number creates a profile of your lifetime practice. Your ability to secure employment will be decided partly upon this information. New graduates have a one-time opportunity for securing discounted insurance premiums for five years which offers comprehensive protection. Congratulations on your graduation and best of luck!
Hello PA forum.
After doing some soul searching, I decided on maybe going for PA school. I am only a 2nd semester freshman. However, due to many circumstances, such as adjusting to online school, and a 1 star professor, my first semester of college was a 2.5. I also was not planning on anything after undergrad so I wasn't totally motivated on acing everything. I am doing my best this semester to make up for that, and getting a 3.75 or 4 this semester is realistic at the moment since Ive bee working extra hard. I am very worried however that all of the hard work that will come in the next years will be for naught if my 2.5 first semester will weigh me down. I know I am capable of getting mostly As and Bs from here on out, but will my first semester be the bane of my PA school application? Will schools take into account covid college and and very bad professors who hardly knew how to operate education software? Will schools see the upward trend as a good thing? I also understand that my application will be looked at as a package rather than just GPA, so I have some hope, but this worry still lingers.
I'm currently in my undergrad program taking my prerequisites for PA school. I plan on graduating in the Spring of 2023 and applying for PA school that same year.
As I begin my PA school research, I keep having self-doubts on my ability to learn the content in PA school, which questions my ability to "make it" as a PA.
While I am doing well in my undergrad/prerequisite courses, I fear I am not genuinely learning the information - just merely memorizing and doing well on exams. My question is: Will I/How badly will I struggle in PA school if I don't remember/didn't efficiently learn the coursework from prerequisites like Biology/A&P/Chemistry?
I do not fear applying for PA school/getting accepted (aware that it may not happen the first time I apply), but my current GPA is 3.8 and I've been working full-time as a medical assistant for 3 years (plenty of PCE, HCE & shadowing). However, I fear getting into PA school and having the feeling of "what did I get myself into". I've had PAs that I work for all tell me that I can do it, but I keep having this lingering self-doubt that my ADHD brain and I will not be able to grasps concepts like others will due to my lack of deep understanding during prerequisites (and just having recently been diagnosed with ADHD & still learning what medication works best for me).
Is this feeling normal?
Thank you to whoever can give me some honest insight!
Sorry if I'm posting this in the wrong place I'm new here.
Hi, I need some advice! I already know I am not a traditional pre-pa student. Here are my stats:
Biology of Cells - C
A&P 1 - C
A&P 2 - C
Micro - C
Genetics - C
2020 (Spring, Summer, Fall):
Gen Chem 1 - B
Gen Chem 2 - A
Organic Chem - B
Organic Chem Lab - A
Spring 2020 GPA: 3.75
Summer 2020 GPA: 3.67
Fall 2020 GPA: 3.75
Compared to previous semesters an upward trend is definitely happening. It’s just I feel like it’s to late for that to count for much.
BioChem - TBD
Physics 2 - TBD
sGPA = 2.53
cGPA = 3.26
I already know that I have to do a post-bac, most likely a diy depending on how high I can get my gpa before graduation.
The question is should I retake 1-2 classes I originally got a C in before I graduate? Or should I take classes like Organic Chem 2, Essential Physiology (Bio class), etc? I know that when doing my post-bac I will retake classes that I got a C in. So would it be a better decision to take upper-level classes before I graduate & retake lower-lever at my local community college? I could also retake classes from the college I’m graduating from its just more expensive.
SpnGPA: 3.8 - Major
PsyGPA: 3.8 - Minor
Thanks for any help!
To my veteran PAs:
I recently received an email about the Student to Service HRSA scholarship that states NPs and Certified Midwives are now eligible disciplines for the upcoming scholarship cycle. The reason for the addition is the bolster primary care and obgyn providers in underserved and rural areas. Makes sense to me... however to my surprise PAs are not included in this scholarship opportunity.
Is this an issue that the AAPA would take up? If not, who can I write about this issue other than the HRSA?