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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!

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Many new grads have some gaps between school and first job particularly in saturated markets. However your knowledge and skills will begin to wither with any length of time you spend not practicing. It is also a big difference to a prospective employer or residency between "i have been looking for a job" and "I took a non-clinical job waiting for a residency." 

Do something medical even if you feel it is a sub-optimal position. Don't let your skills and knowledge stagnate.

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Like sas5814 said, many new grads have a few gap months after passing PANCE and starting first job. When I graduated years ago, I took the PANCE in June and didn't start working until October/November. Many of my classmates started around September/October since they had jobs lined up before graduation. So, for the most part, there is usually a 2-4 months gap for credentialing and what not. 

Now i don't know what your case is? Have you been accepted to a residency already and are just waiting to start? Or are you going to wait to apply to a residency in 7-10 months, not knowing if you will actually get accepted yet?

Because if you have been accepted to a residency/job and are just waiting for the start date, they will usually give you some material to review on your own time, so it is possible to get a non-clinical job to have some source of income while you wait, and then brush up on some material to keep the knowledge fresh in your mind. However if you are waiting to apply to a residency until next year, it may be wise to first find a position working as a PA somewhere and then apply to the residency when the time comes. 

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I should clarify that I don't currently have a residency position. I applied to 6 programs this spring, was offered 5 interviews, actually interviewed at 4, and offered 2 positions. I declined both, as they did not seem like the right fit. Based on this, I'm *assuming* I'll have similar opportunities with the upcoming programs. There are at least 8 that I would happily attend tomorrow, based on secondhand information and reputation of these places. I may be naive, but I think I'll find the right place that will start by next summer. That's the main reason I've been hesitant to accept a traditional (non-locums) job--assuming I'll leave them in <1 year--but maybe I should rethink my logic?

Edited by climbthatmountain
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Yes definitely rethink your logic. Take a UC or EM job. If you get a residency position that you want then leave. If not, or if you like the job you end up at and are learning alot then you have a good fall back option. Waiting 7-10 months to practice and without any guaranteed residency position is not a good option. Locums is almost never good for a new grad. You are typically expected to hit the ground running with little support or training beyond learning the EMR. 

Edited by marktheshark89
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23 minutes ago, marktheshark89 said:

Yes definitely rethink your logic. Take a UC or EM job. If you get a residency position that you want then leave. If not, or if you like the job you end up at and are learning alot then you have a good fall back option. Waiting 7-10 months to practice and without any guaranteed residency position is not a good option. Locums is almost never good for a new grad. You are typically expected to hit the ground running with little support or training beyond learning the EMR. 

Seems so obvious now that you say it like that. Ha! Thanks for giving some perspective. I've definitely been stuck in my own head about this. 

I figured if this residency application season went anything like the last then I would definitely get a position, hence my hesitations. 

Edited by climbthatmountain
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Just be aware that a lot of ERs, at least where I am make you sign 2 year contracts. I don’t know about UCs. Also you can check out openings for operservation units. I started my career in an observation unit. It’s gave me a good mix of inpatient combined with a little ER medicine as well. Also  you learn what should be admitted versus what can go home.

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