Jump to content
PAFL12

New Grad. Got burned with first job. Cold feet now.

Recommended Posts

Title basically says it all. I’m a new grad in South Florida (yikes, I know). I’m currently on the job hunt after leaving my first job after a month due to pretty horrific administrative/institutional issues. Left on good terms, still friends with my SP, but the experience scarred me, truthfully. Luckily, I’m decent at hustling and have had several interviews and do possess a job offer in a surgical sub specialty that I’m experienced in (Urology). Problem is, I have major cold feet about practicing. I will be honest and own the fact that I do struggle with anxiety and am receiving treatment for it. 

My true issue is that I simply don’t feel ready to practice medicine yet. I was a stellar student in school, had excellent reviews on my clinical rotations, achieved a phenomenal score on my PANCE...and yet I feel that all I’ve learned is how to test well. My imposter syndrome is pretty bad. I won’t lie: I believe I’m the type of person who has “book smarts” but for some reason just can’t effectively apply what I’ve learned in a clinical setting. I don’t feel comfortable being throw in to sink or swim. If I’m being brutally honest, I feel  that I need some babysitting/hand holding (training, what ever you want to call it) from a SP who is willing to teach to be comfortable practicing right out of school. Problem is, this seems to be nearly impossible to find. 

 The pickings are very slim where I’m located and moving out of state isn’t an option for me at the moment. I’m so anxious about being throw in  and having another bad experience with an employer. The standing offer I do have isn’t even a good one, but I feel pressure to accept it out of desperation for lack of any better option. I’m truthfully not sure what to do in this situation. Accept the offer with a practice that isn’t a good fit, or hold out for something better. I’m now 5 months post-graduation and don’t have much to show for it. 

Share this post


Link to post
Share on other sites

Look into residency programs. Truth is nothing replaces experience. That is the purpose of a residency. A year of hand holding so you can develop knowledge and confidence

  • Like 1
  • Upvote 3

Share this post


Link to post
Share on other sites

1.  Your not alone.  This is almost exactly how most new grads feel, even if they won't admit it.

2.  The reason why it's so hard to find a doc "willing to teach", is that most doc's don't own their own practices anymore.  They simply work for corporate overlords like .  They have zero incentive to "teach".

3.  Your PANCE score is great, but don't take this the wrong way, in the real world it doesn't mean jack. 

Advice,

-Move.  That area is horrible for new grads.  Do a residency.  The only way to feel more comfortable practicing is to practice in a controlled setting.  A residency is literally designed around this, and I sincerely believe that a residency will be required in the next 8 years....see move advice above.  It does get better.  Most of the time.  Just learn and know now that medicine has for the most part become a corporate endeavor.  If you have ever worked in the business world then you know what I mean.  Almost all practices today have real corporate struggles.  Just plan for it and set your expectations accordingly.

  • Like 2

Share this post


Link to post
Share on other sites
42 minutes ago, Cideous said:

1.  Your not alone.  This is almost exactly how most new grads feel, even if they won't admit it.

2.  The reason why it's so hard to find a doc "willing to teach", is that most doc's don't own their own practices anymore.  They simply work for corporate overlords like .  They have zero incentive to "teach".

3.  Your PANCE score is great, but don't take this the wrong way, in the real world it doesn't mean jack. 

Advice,

-Move.  That area is horrible for new grads.  Do a residency.  The only way to feel more comfortable practicing is to practice in a controlled setting.  A residency is literally designed around this, and I sincerely believe that a residency will be required in the next 8 years....see move advice above.  It does get better.  Most of the time.  Just learn and know now that medicine has for the most part become a corporate endeavor.  If you have ever worked in the business world then you know what I mean.  Almost all practices today have real corporate struggles.  Just plan for it and set your expectations accordingly.

Solid advice! I’m looking into moving right now, but I’m scared about how the employment gap will look for future employers. 

Totally agree about my PANCE scores haha! I just wanted to demonstrate that from an academic standpoint at least, I’m hard-working and capable. 

It also seems like you’re not in favor of me accepting the less-than-ideal offer I have. I’m soo nervous about passing up this opportunity because, again, I feel the pressure and am getting desperate but don’t want to get involved in (another) bad situation. 

Edited by PAFL12

Share this post


Link to post
Share on other sites

Congratulations on all you have accomplished. You have everything to be successful as a PA!!

About your current situation... Second everything already said above. 

Also... if you don't have one yet, see a therapist, a good one. It helps. 

Good luck on your career!

  • Upvote 1

Share this post


Link to post
Share on other sites
18 minutes ago, BayPAC said:

Congratulations on all you have accomplished. You have everything to be successful as a PA!!

About your current situation... Second everything already said above. 

Also... if you don't have one yet, see a therapist, a good one. It helps. 

Good luck on your career!

Thank you for your kind words! I don’t feel that I’ve accomplished much though. I bailed on my first job (granted I basically had to and was advised to by faculty members from my program I consulted about the problems I was encountering) and honestly feel like a failure. I mean, how many new PAs break the “you must stay in your first job for a year” rule? Seems like not many...

Share this post


Link to post
Share on other sites

Imposter syndrome is real.

Try looking into any employer that also has residents/fellows if you can't actually do your own residency.  There is often more of an ingrained teaching mindset.  I jumped into a specialty right out of school (with some background in it) and I still ask my SP questions about A LOT 6 months in, which he actually appreciates.  

Don't be afraid to know your limits.  Can you look something up on uptodate and feel comfortable prescribing?  Great.  Do you want to run it by someone just to make sure?  Do it.  It really is about finding the right environment.  If the offer you have won't afford you that, don't take it.  The more jobs you attempt that put you in bad situations will only kill your confidence further.  

A lot of my classmates didn't even start their first jobs until 4-5 months (or even longer) after graduation.  Better to find a good position than have a string of 1 month employments that worsen your anxiety.

Remember that we aren't really trained to graduate and be practicing solo out of the gate.  We should have on the job training.  We should still be studying and learning.  If an employer doesn't understand that, you'll find yourself in bad situations.

  • Upvote 1

Share this post


Link to post
Share on other sites

As to the employment gap, the only thing worse then a gap is multiple short stents...unless they are locum assignments.  I would pass on the second sucky job and move on...literally.  

Share this post


Link to post
Share on other sites
9 minutes ago, Cideous said:

As to the employment gap, the only thing worse then a gap is multiple short stents...unless they are locum assignments.  I would pass on the second sucky job and move on...literally.  

My inclination as well. Solid points. Thank you!

Share this post


Link to post
Share on other sites

Your situation is not unlike hundreds of other PAs who have gone out to the workforce. Regardless of what PA program you attended and what scores and award you received, you still need to have the experience. I used to tell my students that you are not a PA when you get your "C" but two years later as it takes that much time to pull it all together. Look at your first job or jobs, as a residency. It's a time to learn and remember you have those hundreds who have gone on before you and are now professors.

Share this post


Link to post
Share on other sites
6 hours ago, surgblumm said:

Your situation is not unlike hundreds of other PAs who have gone out to the workforce. Regardless of what PA program you attended and what scores and award you received, you still need to have the experience. I used to tell my students that you are not a PA when you get your "C" but two years later as it takes that much time to pull it all together. Look at your first job or jobs, as a residency. It's a time to learn and remember you have those hundreds who have gone on before you and are now professors.

I agree. My issue is that I just seemingly can’t find a position that provided a good environment in order to acquire that experience. As the time post-graduation and working increases, it looks worse and worse and I’m really beginning to get stressed. I feel like I can’t do anything to help myself despite pulling on every resource I can and networking like crazy. 

Share this post


Link to post
Share on other sites

You are not alone for sure. I’m a few years out now and still ask questions once in awhile. Much less than previously. I work in a rural urgent care clinic where people come in daily that are higher acuity than we can even handle simply because there is a lack of access out here. This definitely adds to increased stress. I had a boat load of HCE in EMS (13 years) and still struggled with imposter syndrome after graduation. The smartest thing looking back I did is get into a fellowship in urgent care. Sure, it was for a lower wage at first but it allowed me to practice in a controlled environment and was able to ask as many questions as I needed. Had a mentor who actually wanted to teach and would bend over backwards to offer advice on patient care or just offer reassurance. I am thankful for that time and now work solo often with minimal sleepless nights worrying about my patients. I echo all the advice above. Hold out until you get the job with a supportive environment that will allow you to grow as a clinician.  It’s not always all about the Benjamin's. 

  • Upvote 1

Share this post


Link to post
Share on other sites

Like the others, you’ve given great advice. I have the inclination to hold out as well. However, how do I explain the growing gap in employment post-graduation to prospective employers? Obviously I plan on telling the truth, which is: the market is saturated and I’m having a hard time finding a good fit that I plan on being in long-term. I’m considering just volunteering in a free clinic in my town just to keep my skills sharp and show I’ve been doing something. 

Edited by PAFL12

Share this post


Link to post
Share on other sites
7 hours ago, PAFL12 said:

Like the others, you’ve given great advice. I have the inclination to hold out as well. However, how do I explain the growing gap in employment post-graduation to prospective employers? Obviously I plan on telling the truth, which is: the market is saturated and I’m having a hard time finding a good fit that I plan on being in long-term. I’m considering just volunteering in a free clinic in my town just to keep my skills sharp and show I’ve been doing something. 

You've answered your own question.  Tell the truth.  Also consider that the alternative is much worse.  You're only a few months out from graduation, I think you're overestimating how 'bad' it looks.  If you were 2 years removed with no work history then I'd worry.

 

  • Upvote 1

Share this post


Link to post
Share on other sites
10 hours ago, PAFL12 said:

Like the others, you’ve given great advice. I have the inclination to hold out as well. However, how do I explain the growing gap in employment post-graduation to prospective employers? Obviously I plan on telling the truth, which is: the market is saturated and I’m having a hard time finding a good fit that I plan on being in long-term. I’m considering just volunteering in a free clinic in my town just to keep my skills sharp and show I’ve been doing something. 

What exactly are you looking for? A position where you see four or six patients a day, the doc goes over the differential, testing for each one, then spends hours teaching you about each disease?

While I understand you got a raw deal on your first gig after graduation, the impetus is now on you to teach yourself.  You need to identify deficiencies and gaps in your knowledge base, and read up on those.  Your sp may teach, but you need to learn even if he doesn't; ask questions.  

Every day that you are not seeing patients, you are losing a bit of practical experience that you are hoping a prospective employer will make up for.  Frankly, that ain't going to happen.  I don't know why you are adverse to moving, but reconsider it; there are lots of fp jobs in the Midwest that would gladly hire you.

Share this post


Link to post
Share on other sites

I think you have been given excellent advice and your personal summation is accurate. Go for the gold, look ahead. Capture your destiny.

"To accomplish great things, we must not only act, but also dream; not only plan, but also bevel." Anatole France

Share this post


Link to post
Share on other sites

Welcome to life. Like many of my military colleagues I graduated and was sent overseas to a remote post where I had 500 active duty troops and their families to look after. My first patient ever...ever was a senior NCO who came in with blood in his urine. What he had was a little urine in the blood. Based on my training I called the urologist (80 miles away) because I thought he needed a cystoscopy and IVP. He laughed and said "give him some Bactrim for a week and if it doesn't go away call me back" and he hung up. I did and the patient got better. This was my first inkling that perhaps my skill set wasn't up to the task and my education inadequate. What I lacked was experience.

So you have a choice. You can recognize that you are at the very beginning of a life long learning adventure or you can fold. The jobs where you have a lot of hand holding for a long period of time may exist but they are rare. IMHO what you need is a position where you are working with and around experienced providers you can lean on a bit when you need it. Also anyone that hires a new grad or someone with minimal exposure should give you a light schedule for a while until you get into the rhythm of things. Your job is to do everything you can do, read, study, stretch yourself a bit every day. Your colleagues will help you if they see you doing these things. If they have to hold your hand they will resent you.

You have done a lot of hard work to get where you are today. Don't let fear take it away. good luck.

  • Upvote 1

Share this post


Link to post
Share on other sites
7 hours ago, thinkertdm said:

What exactly are you looking for? A position where you see four or six patients a day, the doc goes over the differential, testing for each one, then spends hours teaching you about each disease?

While I understand you got a raw deal on your first gig after graduation, the impetus is now on you to teach yourself.  You need to identify deficiencies and gaps in your knowledge base, and read up on those.  Your sp may teach, but you need to learn even if he doesn't; ask questions.  

Every day that you are not seeing patients, you are losing a bit of practical experience that you are hoping a prospective employer will make up for.  Frankly, that ain't going to happen.  I don't know why you are adverse to moving, but reconsider it; there are lots of fp jobs in the Midwest that would gladly hire you.

Definitely don’t want THAT intense degree of hand-holding. I just would prefer to have a one-on-one relationship with a physician who is accessible and won’t expect me to function like a doctor when I’m a new grad PA. 

Share this post


Link to post
Share on other sites
6 hours ago, surgblumm said:

I think you have been given excellent advice and your personal summation is accurate. Go for the gold, look ahead. Capture your destiny.

"To accomplish great things, we must not only act, but also dream; not only plan, but also bevel." Anatole France

I agree, and thank you! I’m actually actively looking into sort of charting my own course in forensics (medicolegal death investigation). Super hard to find info on, but PAs do it in NYC and Washington’s D.C, so why not FL?

Share this post


Link to post
Share on other sites

South Florida is going to be an issue to be honest. the pay and culture here is pretty poor

much better states to go to. not sure how much of it is an option for you 

Share this post


Link to post
Share on other sites
On 1/15/2019 at 10:07 AM, FSUnoles said:

South Florida is going to be an issue to be honest. the pay and culture here is pretty poor

much better states to go to. not sure how much of it is an option for you 

What is exactly wrong with South Florida? I start PA school in August i  South Florida and plan on staying here(life long Fl resident) after I graduate. 

Share this post


Link to post
Share on other sites
19 minutes ago, Batman said:

What is exactly wrong with South Florida? I start PA school in August i  South Florida and plan on staying here(life long Fl resident) after I graduate. 

Those there say the job market is super tight and worse for new grads.  Check on the state specific Florida section on the boards here.

Share this post


Link to post
Share on other sites
7 hours ago, surgblumm said:

I have three friends, all PAs , two who were the Chief Medical Examiner and one who was the assistant chief medical examiner in NYC.

Ah this is amazing! I honestly haven’t ever been able to talk to a PA who worked in this field. Do you have any recommendations for getting a hold of people like this short of just cold calling them lol?

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More