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The current STATE of PA jobs availability 2017...


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I had a recruiter call me yesterday to ask if I would be interested in taking a locum job....in Neurosurgery.  I was excited to say yes, except for one small issue.  I have never done Neurosurgery before.  I understand that recruiters cold calling is part of their job, and a crappy part at that, but I always try and hear them out and not be rude.  They tell me all the time how horrible providers can be to them on the phone and generally thank me for just listening.  After informing the nice lady that I had no experience in Neurosurgery, I did ask what other jobs she might have available in my field of Urgent Care/Occmed here in Texas....

Thus started an almost hour long conversation about the current state of job availability for PA's.  She immediately started to describe in great detail the massive contraction of jobs over the last two years in almost every state they place in.  Both temp and perm positions.  She said it has become so bad in states like Florida that for every APP position that pops up, there is an absolute feeding frenzy for it.  Her words.  I asked why she thought that was the case and her answer was crystal clear.  Nurse Practitioners.  More specifically, the massive graduation rate and dumping into the job market of NP's.  She went on to say that 90% of the calls she gets are NP's new or recent grads looking for jobs....any jobs.  She said they will take very low pay, few to no benefits and do virtually anything in medicine.

As I directed the conversation back to Texas, she said she sees the same thing occurring in my state of Texas.  MASSIVE flooding of the market with NP's.  I recently was told by a hospital admin I know that for every mid-level job she posts, she gets 12-25 applications and most are from NP's.  So here is the thing, I have nothing against NP's.  I have concerns about completing a provider centric medical degree in mostly an online format, but other then that I have met some really good providers who are NP's.  What I am most concerned about is job candidate saturation.  So I have compiled a list of concerns I see coming down the road at us all, especially new grad PA's.

 

1.  MUCH less lateral specialty movement.  Better be sure about what field you go into because the days of moving into another specialty are quickly coming to an end.

2.  Residency, a must.  If I was getting out of PA school today or had within the last 5 years, I would be applying for a residency....like now.  It is the only thing that is going to separate you from the hoard of applications being sifted through for the ever rare new job listing.

3.  LIVE WELL BELOW YOUR MEANS.  EMDPA has a great section discussing this, and I can not agree more.  When I graduated there was approximately 12-14 jobs for every PA.  Those days are gone gone gone.

4.  Be prepared to be "let go".  So far in the last two years I have watched almost half a dozen providers be "let go" (fired), by corporate management.  Not for performance issues, but because of "Strategic partnership" choices.  At least that is what they told them.  Two of the providers I knew had been recruited from other states and moved their entire lives to DFW.  6 weeks after they started working, the corporate over-lords showed up in clinic one day and said, "sorry, we are restructuring this clinic and you are both let go, effective immediately".  No severance, no warning, nothing...They hired two, less expensive and FAR less experienced providers and booted the two that had just moved from out of state, right out the door. (See living below your means...)

5. Get multiple licenses in multiple states.  Most states license process sucks.  It takes a long time even with everything in order.  Get started early.  As PA's you need as many options as you can get.

6.  If you get named in a lawsuit, pretty much forget about locum work.  I have been told by three separate agencies that they won't even credential you if you have been named in a lawsuit.  They put it off on the clients and state that no client wants anyone who has had to defend themselves for any reason, EVEN IF THE LAWSUIT WENT NO WHERE.  If you do get tagged, consider very strongly staying in the job you are in, because getting another just became a lot harder.  I will say I have to laugh every time I credential for another locum agency and they start the verbal screening.  They always save the, "Have you ever been *named* in a lawsuit" question for 3rd or 4th so as not to offend, but almost to the man (or women), the response is always the same..."whew!, if you had said yes I would of ended the screening because we can't take anyone even named in a lawsuit"...I tell them that is not fair and they agree, then blame the client.

7.  Doing something else with a PA degree.  Let's just answer this for new PA's now...without further training, degrees or education, the options for a PA degree are virtually nill.  Perhaps PA centric academia, but don't get a PA degree expecting to use it for anything else.  You will be disappointed.

 

Take pride in the accomplishments you have a long the way.   I have shocked people quite literally back to life, diagnosed meningitis a dozen times and caught potentially life threatening conditions in time to save the patient.  I have also missed things that, while not necessarily obvious at the time, I have a hard time forgiving myself for. Enjoy your successes, get over your failures and save enough money to retire early if it just becomes too much.

 

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Well this was depressing, but unfortunately probably accurate with regard to the current job situation and future prospects. The explosion of crap NP and PA programs in the past 5-10 years is finally starting to have an effect. Everyone (ahem, US News) still thinks PA/NP is the greatest gig in medicine, but just like with lawyers about a decade ago having to take jobs as copy editors, market economics is always supply and demand.

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Sometimes I feel a little stuck because while I sit on acceptances, I keep hearing negativity surrounding the profession on these forums. Thinking this is what I want to do, having built towards it for so long, I'm not sure what to do. What do you guys have to say for aspiring PAs and those who are graduating soon? Hope?

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7 minutes ago, ajames said:

Sometimes I feel a little stuck because while I sit on acceptances, I keep hearing negativity surrounding the profession on these forums. Thinking this is what I want to do, having built towards it for so long, I'm not sure what to do. What do you guys have to say for aspiring PAs and those who are graduating soon? Hope?

Rural America.

Everyone want to live in the city.

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I can verify this.  I don't want to tell my story just yet, but I'm a perfectly good PA job searching with under a year experience and I'm really, really feeling this.  

The number of PA programs has almost doubled in the last 4 years.  Today, as I type this, there are 229 PA programs active and many more on the way.  

Who knows?  It will likely shine a light on NP "education" and make it much more difficult for the PA to find work in FP or at Walgreens if those are what you want.  Watch for salaries to start falling, NP's first.  I'd offer an NP at CVS $65k and I bet you would have no shortage of takers. This will drive more PA's into surgical and more advanced medical fields and make those more competitive.

Residencies are the answer, but there aren't enough of them.  Trust me on this, even the crappy ones are getting 60+ applications for 2-3 spots. 

I plan on steering my kids away from medicine, if they ever ask.  If they were to insist, I'd say BSN---> work as RN---> to PA and forget every other path.  

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Cideous,  Excellent post and right on the mark.  Your recommendations and those of EMED were spot on and I hope PA's reading this will take head.  AAPA and NCCPA need to belly up to the table and get their collective acts together and quit posturing.  This is starting to look like the Titanic except for one thing...  There will be no survivors.  IMHO

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On 11/30/2017 at 0:57 PM, Cideous said:

7.  Doing something else with a PA degree.  Let's just answer this for new PA's now...without further training, degrees or education, the options for a PA degree are virtually nill.  Perhaps PA centric academia, but don't get a PA degree expecting to use it for anything else.  You will be disappointed.

Great post and I agree. This should be required reading for aspiring PAs.

A few of us here have been heralding the 'great saturation' of PA jobs for years now...not because we are know-it-alls, but we saw it coming down the pipeline with the incredible proliferation of schools. It sounds like NPs are an even bigger factor than I realized.

Most of your points I've found true through personal experience. As to #7, especially important to let that sink in. One of the benefits of an MD is that there is much more laterality outside of clinical medicine. Business opportunity, authorship, consulting; many other avenues available simply due to the credibility built in to that title. Not saying they are easy seamless transitions, but MUCH more accessible.

For PAs....I've searched high and low, and there is virtually nothing outside of clinical work. There are a few niche jobs out there, but these are truly random discoveries and not a plug-n-play option for those looking to exit medicine.

 

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11 hours ago, ajames said:

Sometimes I feel a little stuck because while I sit on acceptances, I keep hearing negativity surrounding the profession on these forums. Thinking this is what I want to do, having built towards it for so long, I'm not sure what to do. What do you guys have to say for aspiring PAs and those who are graduating soon? Hope?

Read the OPs list again.

Good rural jobs still exist, but you have to be willing to make the family and/or social sacrifice. Most arent.

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I think the downside of medicine is that residency spots are very tightly controlled so that there is a shortage - there is lots of oversight to make sure that the training is good and people have to justify every spot.  The upside is that with a few notable excepions (pathology, for example), there's always jobs almost everywhere in every specialty.

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I think like most cases this is very likely due to location.  I'm sure that as more schools pop up it will spread but I live in a pretty major city in the Southeast and had five offers prior to graduation and since I've started my current job I've had four different groups call me out of the blue trying to get me to work for them.  Not recruiters.  Actual physicians and practice managers.  I just accepted a new position with one of them.  I'm less than a year out and the offer already puts me in the $120s with a written raise every year.  The good jobs are out there if you look for them.  I agree that saturation is occurring but it's not all doom and gloom and this is still a very rewarding and well paying profession. 

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Physicians appear to have the supply controlled, preventing this exact situation of the market being flooded. PA (and NP) supply exceed demand, the value goes down.  Maybe we should slow down the number of PA schools opening each year, and make the training more rigorous- make a PA more valuable than a mass produced NP.

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Honestly there is so much unnecessary negativity in one post. This profession is no different than any other profession in terms of finding and keeping jobs. There are going to be multiple people competing for one job, no matter what profession you are in. You are going to have to search, apply, make yourself stand out during the interview, and make sacrifices, just like lawyers, accountants, teachers, etc. If you do not perform up to the standards, or if another company buys out the hospital, being laid off is a possibility, just like other major corporations. That's how the world works.

Let's not isolate the PA profession in saying that it is the only profession that you should "be prepared to be let go" or many people are competing for one job. As with any other career, just because you have a degree does not make you qualified for the job. You need to prove yourself. The absolute negativity in these posts I am reading is truly unbelievable. 

Healthcare is a booming field, especially these days, so no one will be unemployed for long stretches of time, I don't care what you say. You people focus on "how many PAs and NPs are being produced each year," but do not look at "how many people are retiring per year." Our society is getting older and older, which is going to mean healthcare is soon going to accelerate at a pace faster than what it currently is. 

There is a reason why 19 of the top 25 jobs in America are in healthcare. There is a reason why NP and PA are 2nd and 3rd, respectively. There is a reason why PA was in the top 5 professions for the past 4 years. These are from multiple articles, not just one source. 

For those of you having difficulty jobs, location is the key factor. There are places where there are 10 PA and NP programs within a 50 mile radius, pumping out hundreds of PAs and NPs per year. Simple solution, look elsewhere.

I can tell you that I am out here in the northeast and there is no shortage of jobs. Lateral movement is common here, people are switching for derm to EM to psych to surgery with no problem. Residency is a plus, but is not absolutely necessary. I work in CT surg and we constantly look for new grads to train. 

Sorry for the ramble, but I needed to speak up and quiet this negativity. There may be certain locations or instances where what some of you say is true, but you can't blame this on the profession as a whole. Certain locations or specialities may be hard to find jobs, but this isn't true of the PA profession as a whole. 

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Guest HanSolo

My program also has had 100% employment within 6 months of graduation. I recently had two friends (new grads) move from east coast to west, one to Denver and one to San Diego, and both found good jobs within 3 months of moving without having done any leg work beforehand. Just upped and moved after graduation. 

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9 hours ago, NJPL1213 said:

Honestly there is so much unnecessary negativity in one post. This profession is no different than any other profession in terms of finding and keeping jobs. There are going to be multiple people competing for one job, no matter what profession you are in. You are going to have to search, apply, make yourself stand out during the interview, and make sacrifices, just like lawyers, accountants, teachers, etc. If you do not perform up to the standards, or if another company buys out the hospital, being laid off is a possibility, just like other major corporations. That's how the world works.

Let's not isolate the PA profession in saying that it is the only profession that you should "be prepared to be let go" or many people are competing for one job. As with any other career, just because you have a degree does not make you qualified for the job. You need to prove yourself. The absolute negativity in these posts I am reading is truly unbelievable. 

Healthcare is a booming field, especially these days, so no one will be unemployed for long stretches of time, I don't care what you say. You people focus on "how many PAs and NPs are being produced each year," but do not look at "how many people are retiring per year." Our society is getting older and older, which is going to mean healthcare is soon going to accelerate at a pace faster than what it currently is. 

There is a reason why 19 of the top 25 jobs in America are in healthcare. There is a reason why NP and PA are 2nd and 3rd, respectively. There is a reason why PA was in the top 5 professions for the past 4 years. These are from multiple articles, not just one source. 

For those of you having difficulty jobs, location is the key factor. There are places where there are 10 PA and NP programs within a 50 mile radius, pumping out hundreds of PAs and NPs per year. Simple solution, look elsewhere.

I can tell you that I am out here in the northeast and there is no shortage of jobs. Lateral movement is common here, people are switching for derm to EM to psych to surgery with no problem. Residency is a plus, but is not absolutely necessary. I work in CT surg and we constantly look for new grads to train. 

Sorry for the ramble, but I needed to speak up and quiet this negativity. There may be certain locations or instances where what some of you say is true, but you can't blame this on the profession as a whole. Certain locations or specialities may be hard to find jobs, but this isn't true of the PA profession as a whole. 

True that saturated job markets and competition are not unique to our field. We also routinely acknowledge the location factor. But I dont think the posts above constitute "negativity". Much of this is factually-based and there are more people here corroborating that experience than those who think the future's so bright they have to wear shades. How many people seek out this forum because they cant find a job? Or are getting used? Or are finding it wasnt what they thought it would be? Sure there might be a selection bias, but these are real PAs.

I also dont buy the "top profession" BS. Fake news. What exactly does that mean anyway? Projected jobs, median salary, and unemployment rate. They dont look at jobs relative to the number of new grads. Median salary, ok it's decent, but not relative the amount of educational debt most incur. Unemployment rate is tallied by those who actually FILE for unemployment. Fake click-bait news. You know what else is on that list? Dentist, OB/GYN (lol), pediatrician...

This forum is a place where you can get the straight dope on what real PAs are experiencing. Which includes all opinions, even perceived 'negativity'.

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Also, a little off topic but I think recruiters often exaggerate.  I had a recruiter call me several times like in the OP and tell me how it's going to be so hard to find a job and the one he's telling me about will probably be the only one I find.  He said I'd most likely have to move and he gets calls daily from PAs and NPs begging for positions, etc.  very similar.  He told me there was a family practice job so I interviewed and they made an offer of $72K.  The recruiter got straight up hostile when I told him I was going to turn it down.  He said I need to set realistic goals because $72K was the highest I'd ever see as a new grad.  Two days later I had an offer for $115k in the "super saturated field". 

Again, I'm not disagreeing that saturation isn't happening. I do think we need to stop making a school on every other block because it lowers the quality of rotations.  Just saying that sometimes recruiters stretch the truth I feel.

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I agree with many points being made.  When I started PA school there was only 120's something programs.  Fast forward 12 years and the addition of over 100 programs.  Here in Ohio we have two reputable programs though being shut down.  We have a good supply of PA jobs still.  I've read far more posts about NPs having a harder time finding jobs as a new grad then PAs.  There volume of new grads entering the work force though is greater. 

The comment about not being able to do anything else with the PA degree is very true.  There are so many more options for someone with an RN behind their name.  I went back to school because I want to leave clinical practice soon (like yesterday) and I enjoy admin work and education.  As I search for positions that align with my passions and goals I come across far more positions wanting an NP/RN for admin/leadership roles that I want.  I still apply for them, but never get a response.   Would love to teach at a PA program, but don't want to relocate and my local PA programs aren't interested/aren't hiring. 

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4 hours ago, cg02186 said:

Also, a little off topic but I think recruiters often exaggerate.  I had a recruiter call me several times like in the OP and tell me how it's going to be so hard to find a job and the one he's telling me about will probably be the only one I find.  He said I'd most likely have to move and he gets calls daily from PAs and NPs begging for positions, etc.  very similar.  He told me there was a family practice job so I interviewed and they made an offer of $72K.  The recruiter got straight up hostile when I told him I was going to turn it down.  He said I need to set realistic goals because $72K was the highest I'd ever see as a new grad.  Two days later I had an offer for $115k in the "super saturated field". 

Again, I'm not disagreeing that saturation isn't happening. I do think we need to stop making a school on every other block because it lowers the quality of rotations.  Just saying that sometimes recruiters stretch the truth I feel.

tell the recruiter about the 115k job so he has an idea of what the market is actually like and stops repping clients who offer 72k.

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Just a thought...

There are 234k NP per AANP.  Roughly twice the number of NPs than PAs  

https://www.aanp.org/all-about-nps/np-fact-sheet

NPs graduate about twice as many PAs per year. 

There has been a “boom” of new NP and PA programs leading to saturation in certain markets.

Several people have posted that decreasing the number of PA programs will help decrease the “flooding” of new PA graduates driving down salaries. 

In my opinion if that happens it is doubtful the NP profession will also concurrently decrease their new graduate numbers but instead place their new graduates in positions that might instead go to a new PA (due to decreasing new PA graduates).  This will lead to a decrease in the number PA positions over time in respect to the number of NP positions.  

Don’t know what the correct course would be ... but unless NPs decrease their number of graduates limiting PA graduates does not seem to be an ideal situation for the future of our profession.

 

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7 hours ago, BruceBanner said:

True that saturated job markets and competition are not unique to our field. We also routinely acknowledge the location factor. But I dont think the posts above constitute "negativity". Much of this is factually-based and there are more people here corroborating that experience than those who think the future's so bright they have to wear shades. How many people seek out this forum because they cant find a job? Or are getting used? Or are finding it wasnt what they thought it would be? Sure there might be a selection bias, but these are real PAs.

I also dont buy the "top profession" BS. Fake news. What exactly does that mean anyway? Projected jobs, median salary, and unemployment rate. They dont look at jobs relative to the number of new grads. Median salary, ok it's decent, but not relative the amount of educational debt most incur. Unemployment rate is tallied by those who actually FILE for unemployment. Fake click-bait news. You know what else is on that list? Dentist, OB/GYN (lol), pediatrician...

This forum is a place where you can get the straight dope on what real PAs are experiencing. Which includes all opinions, even perceived 'negativity'.

First off, this a majority selection bias. Yes these are real PAs but there are also hundreds of thousands of PAs that do not go on this site, or do not post about their experiences because they are content with their job. Then you have the few that feel the need to vent about a bad day or bad experience, so they make a post on this site. I am not saying that they shouldn't, but these few posts are not indicative of the profession as a whole. So yes, the points being made should be considered negativity, as I could name hundreds of good things about the profession as well.

All I am saying is that this profession is no different then any other profession in the points that are being made. Yes, some of the things you are saying were not a problem 10-20 years ago when some of you started practicing and when there were not as many PA or NP programs up and running yet. But times are changing, and in my opinion, healthcare is changing in a way that is more beneficial for us to be practicing. Like I said in my first post, doctors, lawyers, accountants, teachers, nurses, police officers, etc. all have things that make their profession good and bad. If you scrutinize something enough, you can find something wrong with it. All these points being made are thoughts of negativity. 

Additionally, I don't see how you can consider these articles "fake news." These are off multiple platforms (non-health related) and were for several years. Yes, dentist, OB/GYN, and pediatrician are on this list. They are good jobs, with good pay, good outlook, good quality of life, etc. I found articles back 10 years ago, where business-oriented jobs dominated the list. However, with the way our government chooses to run, coupled with the fact that people are getting older, healthcare related jobs are taking over. I don't see how it is that hard to believe. 

I'm not trying to be bias and talk our profession up so much. I'm also not trying to defend the profession and say there is nothing wrong with it. I do believe that times are changing and some things need to be done for the future for us to be able to succeed. However, the negativity that some of you are spitting out, merely thinking that this is the only profession that this is occurring to, just sounds plain foolish. A lot of what is being said is deterring young individuals away from the profession, instead of finding a way to correct the problems that lay ahead. 

Also, the title of this post "The current state of PA job availability" is totally misleading. This may be the state of the job market in your speciality and in your area, but this is NOT the current state of the PA job market as a whole.

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^^^

When I read post after post here and on other sites starting with..."Why didn't anyone tell me it was going to be like this....?", over and over again, I just don't feel like sitting on my hands.  I've been a practicing PA for a long time, agree with me or not I have seen a few things in this field.  I simply mention my specific experience in the DFW area and also relayed what I had been told by a recruiter who called me concerning the Florida market.  That's why we have these boards, open discussion.  If the jobs in Florida are falling out of the palm trees and she was 100% wrong, then great.  I can only relate my experiences from the region I am in.  Your milage might vary.

Having said that, blowing sunshine and roses up the rear ends of potential PA's is not something I feel comfortable doing.  You might, but that's up to you and again why we have open discussions here.

As a profession in general we are not at critical mass yet, but regionally there are places that absolutely are.  Denying or sugar coating this does a disservice to other providers considering a move to those areas and coming here seeking advice. 

As for the thread title, I'm sorry you disapprove.  I will PM you next time for a title pre-auth ;)

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