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Hi everyone,

Someone, somewhere on this forum said this... You can have 2 out of the 3. Dream job(speciality), dream salary and dream location. 

I am a new grad with an offer in derm, good salary, but the location is rural... I love derm and it’s what I’ve always wanted to go into, but I don’t think I will be happy in a rural area.

I also have an offer in family med in a bigger city which I can see myself living in. I love family med as well and I believe it will make me a well-rounded provider.

As a new grad, I know it is recommended to start in FM. I don’t know if I am making the right decision walking away from the derm opportunity in the small town. I guess my question is, do you think there will be other derm opportunities in the future? How did you pick your first job? What is your advice and what would you have done differently? 

Thank you so much.

 

 

 

 

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Rural environments tend to be better for PA respect and compensation.  I would recommend learning to like working there, and then go into the big city for shows or weekends or whatever.  Rural's not bad if you can get out once in a while. Derm is a very sought after, well regarded, well compensated specialty--after a few years, you will have a lot more options.

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I worked in a rural area for many years. Quiet, treated well by clinic and community, lots of autonomy. We were an hour out of a major city so it was an easy trip or weekend to get our "big city" fix. You might like it. If not... get your skills and move. Derm is big money and most derm practices won't take someone without experience.

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https://www.aapa.org/news-central/2015/09/the-blessing-and-burden-of-flexibility-a-guide-in-choosing-your-specialty-as-a-new-graduate/

 

This is a short article that a friend and colleague wrote for AAPA regarding your question. I agree with the advice you've been given above. If you truly feel like derm is where your passion is, pursue it. It's extremely competitive to break into (I'm in derm as well), and a good opportunity might be tough to come by in the future. I grew up in a big city and have lived all over the country since then and can now say that I prefer a more rural setting. You might find that you get the best of both worlds if you live within a reasonable distance to a more metropolitan area. 

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I thought about going with the rural derm opportunity, but I would feel guilty leaving after getting the experience when the doc has invested his time in me... I want to do the right thing 😕

He said that the last few people stayed for a year and then left for a bigger city... they are kind people(doc and his wife) and I don't think I have it in me to get trained and then leave

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One of the greatest incentives for being a PA is that you have the opportunity to make many of these choices and without experience. If the employer desires to teach as you go the opportunities will be immense because of your formal PA training. Derm is a great specialty for three reasons; 1-Little call 2- You have the option to choose a medical derm practice and learn a tremendous amount of new medicine  3- You can choose cosmetic Derm and gibe Botox and fillers but you need to ask yourself this important question; "why did I both to learn all of these specialties only to use my knowledge for cosmetics?" A combination of both is ideal and in a rural practice you will get far less cosmetic work but will learn every rash in the book. Like ron, I feel there is plenty of time to move to the city and if you start rural you will have the necessary experience to work in a metropolitan area with some of its increased demand.

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  • 1 month later...

I want to thank you all again for your great advice. I just wanted to update everyone and anyone that reads this post in the future.

I ended up getting a derm job in a big city! Out of all my job offers, it was the first and only one where I felt excited about it! My advice to anyone in the future is to just be patient. If it's meant to be, it will be. And new opportunities show up almost every day!

If you don't feel good about a position, don't take it. I reminded myself that I worked hard all these years and that I should be happy about my job. I knew myself and I knew I wouldn't be happy in a rural area(even if it was temporarily) and I would feel bad taking a job with a plan to leave in a year. 

Be patient and don't settle!

Thanks again to everyone for your help! 

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