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New grad here currently considering taking my first job at an urgent care clinic. The goal is for me to act as a solo provider at a new rural location to be opened in the coming months (with an off-site supervising physician.. the specifics of who I should contact depending on when a question/concern comes up are to be discussed and I plan to have them included in my contract in writing.) It has already been discussed that I would have at least 4 weeks of one-on-one training with a supervising physician at the existing clinic, where there are always at least two providers working, before beginning independent work at the new location. 

I know all new grads experience some hesitation and nervousness about their first job, even WITH colleagues on-site for questions and I can appreciate that these feelings are in fact healthy and will keep me working hard to continue expanding my knowledge and improving my skills. I also know how important receiving sufficient training at your first PA position is, essentially building the foundation for the rest of your career. My question to you: when you started your first position (whether it was urgent care or something else - it would be helpful if you specify), what kind of training did you receive and for how long, and did you feel like it adequately prepared you for independent practice? 

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I don't think a month of training is enough to go solo in a new clinic. You should get 4 weeks training, then AT LEAST a few months working with another provider on site before going solo. Even then, hopefully your SP is very responsive to calls/texts. It's really best that an experienced provider take solo coverage.

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Maybe I'm old school, but you just had two years of training.  Ideally, you should start off with a limited patient load and slowly ramp up.

I was in fp, had a week of emr training, then a week or so of shadowing a couple of the providers, then I think I saw two patients in the morning, the two in the afternoon, with the SP checking the notes.

There was always something thereto ask questions, and thenurse would check the schedule to make sure nothing too exciting found its way onto my schedule.

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Malcolm Gladwell wrote that on average, mastery requires 10,000 hours of practice. 

4 weeks of shadowing will never be enough to prepare you to work solo. 

There are too many ways this job can end up being a nightmare for you. You won’t have enough experience that quickly determine the EM/UC goal of sick versus not sick. This will likely result is stress and burnout, fear of malpractice, excessive referral to the emergency room, prevent you from having time to learn the nuisances of diagnosis and treatment of UC chief complaints, or all of the above.

You sound very motivated from your post, but if this truly is the expectation from this position, I would give a strong recommendation to look elsewhere. 

I will be shocked if the more experienced providers on this forum don’t agree with or add to my concerns about the position.

Edited by LA_EM_PA

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53 minutes ago, thinkertdm said:

Maybe I'm old school, but you just had two years of training.  Ideally, you should start off with a limited patient load and slowly ramp up.

I was in fp, had a week of emr training, then a week or so of shadowing a couple of the providers, then I think I saw two patients in the morning, the two in the afternoon, with the SP checking the notes.

There was always something thereto ask questions, and thenurse would check the schedule to make sure nothing too exciting found its way onto my schedule.

In my mind that IS training.  You had back up.  While your SP wasn't seeing your patients, checking the notes may have prompted them to give you advice/guidance or catch something that could have been missed.  You started with straight forward patients and only a few.  You ramped up at (I assume) whatever pace you were comfortable with.  That's perfect!

OP - new grad in a specialty.  6 months in and I still consider myself in training.  A lot of shared visits.  Solo visits are on the same days as my SP so they are in the office so I can ask questions/bouce ideas off/punt to their schedule if something is out of my comfort zone at this point.  I always know who is covering my SP if I'm seeing patients when they are off, and the group as a whole is VERY receptive to questions so I can ask anyone, even if they are specifically covering.  Obviously a specialty is different than UC.  Knowing what I still look up and double check, I wouldn't want to be a solo provider at an UC after only 4 weeks of supportive learning.

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1 hour ago, MT2PA said:

In my mind that IS training.  You had back up.  While your SP wasn't seeing your patients, checking the notes may have prompted them to give you advice/guidance or catch something that could have been missed.  You started with straight forward patients and only a few.  You ramped up at (I assume) whatever pace you were comfortable with.  That's perfect!

OP - new grad in a specialty.  6 months in and I still consider myself in training.  A lot of shared visits.  Solo visits are on the same days as my SP so they are in the office so I can ask questions/bouce ideas off/punt to their schedule if something is out of my comfort zone at this point.  I always know who is covering my SP if I'm seeing patients when they are off, and the group as a whole is VERY receptive to questions so I can ask anyone, even if they are specifically covering.  Obviously a specialty is different than UC.  Knowing what I still look up and double check, I wouldn't want to be a solo provider at an UC after only 4 weeks of supportive learning.

From my point of view, training is where you go and do h&p, formulate an assessment and plan, present it to your preceptor.  The person overseeing you is fully aware of what you are doing.  

Call it what you want; you hold the license now.  You do what you need to do to get the job done. 

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4 weeks is not enough to prepare you work solo unsupported (not having another provider on site is essentially unsupported). This practice either has no experience with new grads or they dont have the resources to train you properly. 

Shadowing is a complete waste of time. You need to see patients. The best way to learn is to start with 1-2 straightforward pts per hour, with another provider on site and willing to help you, and gradually work up at your comfort level. Even for your first year of practice you should have someone else on site. 

Unless you can get this in writing, it sounds like this job would be a mistake. 

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I find a brief period of shadowing handy so I can see where supplies are kept, where the radiology suite is, who the nurse is, etc.  Get an idea of the flow of the office.

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