PAs in OB/GYN

[LC8150]

Hi all,

I will be starting PA school in January and was looking for guidance about what path I should take to achieve my goals. If I could start over I might have chosen a different route to get to this point but I graduated with a Bachelors of Biology from Ohio State, went on to gain my patient care experience as a CNA, and applied for PA school. I really want to do something with babies so I am looking at Women's Health/OBGYN.

What is the best path to take to get a job working closely with delivery and babies? I know PA's are up and coming and at least in NC are not often hired in most fields working with infants. Finding a Neonatal PA job is like finding a needle in a haystack. Heck even a neonatal PA residency is few and far between. And I am considering labor and delivery but after working nights in the hospital, I like more of the clinic setting. Plus I have never shadowed in L&D so I am not sure what the job specifically entails from the provider standpoint. So that left me considering a Women's Health Clinic. I shadowed a PA in one of these clinics and I loved it but after some research it does not seem there is much opportunity in clinics for OBGYN PA's and most clinics prefer NP's.

So I wanted to ask some PAs who are currently out in the workforce and have wanted to work with newborns what their experience was like, how they found the position, and what they did to get there. What would be the best way to make myself competitive for an OBGYN PA provider position and what is the best way to find job openings in that field? Should I seek out an OBGYN residency after school or should I focus on real world job experience doing something that maybe doesn't interest me as much to gain work experience? Are there other possible careers I am forgetting about that will allow me to practice as a PA and work with infants/delivery?

I am also strongly considering pediatrics as another option which seems to be much more readily available to PAs but I have always been fascinated with the reproductive system so I appreciate the gynecological portion of women's health as much as I love obstetrics. Any advice would be greatly appreciated! I do not want to end up in the same position I did immediately after college where think about what I should have done differently if I could start over. I want to do it right the first time so I do not struggle to get into a field I love because I don't have a crucial experience in my toolbox. 

Any help is greatly appreciated!

Thank you!

[MT2PA]

My understanding is that it varies by state whether or not PAs can deliver.  My state doesn't allow it so the OB/gyn PAs from my rotation were 100% clinic duty.  Not sure how it would work inpatient.  So step 1 is figuring out what states will even allow you to do it.

Literally the way to get any job as a PA is to apply to it.  There's no magical secret way to get into a specialty.  Sure a residency can help and train you more specifically.

OB/GYN is heavy on the NPs and it's not likely to change (I think they have a women's health track?).

Other options for you:  RN to NP.  Midwifery.  I have no idea how much they get to do though.  Go MD/DO if you want it all.

To me babies means peds, not OB/GYN (that's moms).

[EMEDPA]

Unless you want to do one of the few OB residencies out there you are unlikely to get full privileges as a PA in OBGYN. One of my former students did the OB residency at Arrowhead and is credentialed for everything in OB aside from being primary surgeon in the OR. 

I hate to say it, but for OB/NICU/Peds job options MD/DO>NP/CNM>PA in the vast majority of situations. 

 

[LC8150]

Yeah unfortunately I'm learning that a little too late. Call me not motivated enough if you must but to go back and get my BSN and then experience for NP school will take me at least an extra 4 years and I currently don't even meet the requirements for an accelerated BSN. All the nit picky little stipulations for every type of provider ends up being really frustrating if you didn't have your life planned before you graduated high school. 

I am looking into the residencies but there are only two. I know there is no magical way to a job but thought someone might know a location where OBGYN PAs are more common. If a women's health rotation is required in schhol you would think women's health would have more PA positions available. 

I realize peds might see babies somewhat more often but I do know the one PA in women's health I could find to shadow used to do part time clinic work and part time inpatient with deliveries. But she was also from NY so it's very possible she did the obgyn residency there and didn't mention it.  

I guess I'll see what my rotations end up being like and go from there. I had an unrealistic picture in my mind because the one PA in the field that I shadowed did get to do it all but she never mentioned that it was such a small percentage of people that had that opportunity. And I was also kind of thinking since ob deals a lot with post partum as well that you may get to do the initial checkups or check in on mom and baby in the hospital afterwards. But I guess that many parents will get their child a pediatrician or PCP after birth for the checkups. 

I did not however know that pediatrics wasn't really open to PAs either. Now I'm kind of worried I might be choosing the wrong track. There are definitely other specialties I'm interested in but not as much as working with a baby

 

[EMEDPA]

Planned parenthood hires a lot of female PAs for women's health positions. Lots of counseling, routine paps, STI screening, etc

also consider the NICU PA residency. last I checked they had 100% job placement after graduation. 

[MT2PA]

7 hours ago, jinglebells0518 said:

Yeah unfortunately I'm learning that a little too late. Call me not motivated enough if you must but to go back and get my BSN and then experience for NP school will take me at least an extra 4 years and I currently don't even meet the requirements for an accelerated BSN. All the nit picky little stipulations for every type of provider ends up being really frustrating if you didn't have your life planned before you graduated high school. 

I am looking into the residencies but there are only two. I know there is no magical way to a job but thought someone might know a location where OBGYN PAs are more common. If a women's health rotation is required in schhol you would think women's health would have more PA positions available. 

I realize peds might see babies somewhat more often but I do know the one PA in women's health I could find to shadow used to do part time clinic work and part time inpatient with deliveries. But she was also from NY so it's very possible she did the obgyn residency there and didn't mention it.  

I guess I'll see what my rotations end up being like and go from there. I had an unrealistic picture in my mind because the one PA in the field that I shadowed did get to do it all but she never mentioned that it was such a small percentage of people that had that opportunity. And I was also kind of thinking since ob deals a lot with post partum as well that you may get to do the initial checkups or check in on mom and baby in the hospital afterwards. But I guess that many parents will get their child a pediatrician or PCP after birth for the checkups. 

I did not however know that pediatrics wasn't really open to PAs either. Now I'm kind of worried I might be choosing the wrong track. There are definitely other specialties I'm interested in but not as much as working with a baby

 

While moms may BRING their babies to their PP checks, an OB/GYN provider has no business evaluating a baby - there's a reason physicians have separate residencies for ob/gyn and peds - and a PA likely couldn't either due to SP/scope of practice laws.  Most practices require you have a pediatrician lined up before you even deliver.

Bottom line, if it's really what you want to do - might be worth it to take the time to get there.  Depending on your goals you may even find nursing to be the answer - plenty of doors open to find what you're looking for there.  Or maybe just primary care - you may see children and you may do well women exams...little bit of everything but no obstetrics and no babies.

Women's health comes up in a LOT of settings, not just OB/GYN, which is why it's part of our education.  But just because we are required to have rotations doesn't mean hospitals/clinics/etc have positions for us.

[lkth487]

15 hours ago, EMEDPA said:

Unless you want to do one of the few OB residencies out there you are unlikely to get full privileges as a PA in OBGYN. One of my former students did the OB residency at Arrowhead and is credentialed for everything in OB aside from being primary surgeon in the OR. 

I hate to say it, but for OB/NICU/Peds job options MD/DO>NP/CNM>PA in the vast majority of situations. 

 

I really don't think this is true in NICU or Peds (esp. inpatient peds) anymore.  Maybe outpatient peds (due to the specialized PNP track that NPs have).  There's certainly more NPs, but I don't think PAs face barriers at most places.  If anything, NICU PA residencies are exploding.  I hear about new ones ALL the time.

[lkth487]

11 hours ago, jinglebells0518 said:

And I was also kind of thinking since ob deals a lot with post partum as well that you may get to do the initial checkups or check in on mom and baby in the hospital afterwards. But I guess that many parents will get their child a pediatrician or PCP after birth for the checkups. 

 

Mom yes, baby, no.  They hand the baby over after delivery and they do not do any checkups on any baby afterward.  I have never seen it.  Maybe it happens in some random places but it really shouldn't.  I wouldn't ever examine the mother post-partum (with the exception of helping mothers with breastfeeding related issues), and they would never examine the baby.  There is a pediatrician/NICU trained person usually who is present for high risk deliveries, and for low risk ones where there doesn't need to be a provider present for the baby, they would be examined by the pediatrician in the nursery the next day.  When the baby is born, he or she immediately goes under the service of the pediatrics team at the hospital (could be family practice, pediatrics, or NICU), but I've never heard of the baby going on OB service.  If there are concerns with the baby, the nurse pages the on call pediatrics provider, not the OB.  And after discharge, they would always go to a pediatrics or a family practice for well child care, and not OB.  Now, family practice might be the exception where they may deliver the baby and take care of both mom and baby afterwards.

Even when we are running a code and we need extra hands, I've never heard of the OBs being involved at all (except once when I had the OB resident call an RT to bring a ventilator into the resuscitation area since it was just me and a RN resuscitating the baby).

[LC8150]

12 hours ago, EMEDPA said:

Planned parenthood hires a lot of female PAs for women's health positions. Lots of counseling, routine paps, STI screening, etc

also consider the NICU PA residency. last I checked they had 100% job placement after graduation. 

Oh I will have to reach out to the PP locations near me. Thank you!

And yes Neonatology is one specialty I am definitely considering. I think I may use my extra clinical rotation to be in the NICU. I shadowed an NP at my local hospital in a level III NICU but it was nothing like I imagined. This specific hospital is not allowed to hire PAs in the NICU regardless of if you have completed the Neonatal residency and the NPs work 24 hours shifts, most of which was sitting at a computer punching numbers for med calculations. It is also a pretty small unit.

I only shadowed one time though so I would love to get a more representative experience and I know the school I am attending typically offers a NICU rotation at Johns Hopkins. I looked at every major hospital in the state of NC and none of them have PAs in the NICU. I am pretty flexible about where I will live when I finish school but my boyfriend really wants to stay in NC so that is also a bit of a restraint. I am keeping my options open because a lot can happen between now and finishing school. You never know what connections you might make or how your clinical experiences can affect your decision even though you were so sure of your desired specialty before starting school.

[LC8150]

Thank you for all the information. I will definitely do some more research. I see many PAs in my state but I am surprised how limited they are in NC in fields relating to infants and women's health considering the PA program was founded at Duke. I really have not shadowed any pediatrics but there seems to be a lot of opportunity in that field for PAs

[EMEDPA]

4 hours ago, lkth487 said:

I really don't think this is true in NICU or Peds (esp. inpatient peds) anymore.  Maybe outpatient peds (due to the specialized PNP track that NPs have).  There's certainly more NPs, but I don't think PAs face barriers at most places.  If anything, NICU PA residencies are exploding.  I hear about new ones ALL the time.

please share a list. I know of one in KY

[lkth487]

1 hour ago, EMEDPA said:

please share a list. I know of one in KY

Off the top of my head:

• UPMC (Pittsburgh)
• Nationwide (Columbus)
• University of Kentuky
• CHOP (Philadelphia)
• Seattle

And I know two other places that are beginning discussions to start some.  These are some excellent children's hospitals, and will give you great training.

 

 

[LC8150]

14 minutes ago, lkth487 said:

Off the top of my head:

• UPMC (Pittsburgh)
• Nationwide (Columbus)
• University of Kentuky
• CHOP (Philadelphia)
• Seattle

And I know two other places that are beginning discussions to start some.  These are some excellent children's hospitals, and will give you great training.

 

 

I had heard of all of these except the one in Seattle. Are there only two residencies available for OBGYN (CA and NY)?

[EmPA26]

9 minutes ago, lkth487 said:

Off the top of my head:

• UPMC (Pittsburgh)
• Nationwide (Columbus)
• University of Kentuky
• CHOP (Philadelphia)
• Seattle

And I know two other places that are beginning discussions to start some.  These are some excellent children's hospitals, and will give you great training.

 

 

I'm a 2nd yr PA student, planning to apply to a NICU residency. Those are all the current ones I know of, but I also know a few new ones starting. Neonatology itself is exploding due to more high risk pregnancies, greater technology, and sadly, the opioid epidemic. There is also a huge shortage of neonatal providers- NNP's and neonatologists. True, this specialty used to be more NP dominated, but more and more hospitals are hiring PA's in the NICU and PA's have long been preferred for peds surgery and peds critical care positions in all the children's hospitals I worked at. The NICU director at the I most recently worked at said "I've never hired a PA, but I'll hire you". It's not that PA's can't get hired for these jobs, they just aren't advertised as "Neonatal PA". 

OP- I think you are putting the cart before the horse a smidge- just get through PA school first. If you decide you want to work in the NICU, you will likely have to do a residency or have an amazing NICU elective at a site that is hiring.