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    • By KPMGZ8
      Hello All,
      I'm curious if anyone has recommendations for a question bank to help learn critical care medicine? I'm a relatively new PA (graduated in May 2018) and have been practicing in critical care for about a year now. I work in a 26 bed mixed ICU at a community hospital. I've been reading the Washington Manual of Critical Care, Marino's ICU Book, and Up-to-Date. I've also done the Critical Care board review course offered by the SCCM. I'd like to find a question bank that I can use to test my critical care knowledge as well as general adult medical knowledge.
      I used ROSH review to study for the PANCE and really liked it. I used the app on my phone and was able to answer questions throughout the day and found it easy to answer a few questions here and there without having to dedicate exclusive study time. I'd like to find something with an equivalent ease of use but ROSH doesn't have any questions geared specifically towards CCM. ROSH does have IM and EM question banks consisting of ~ 1000 questions geared towards residents which I've considered as an option. ROSH also has the NCCPA Hospital Medicine CAQ question bank for Hospitalist PAs that I've considered. Additionally, it seems that CHEST SEEK Critical Care Medicine and the SCCM Self-Assessment Multiprofessional Critical Care are used frequently by CCM fellows who are studying for the CCM Boards. I fear that these latter resources may be too dense for my understanding at this point.
      So... My hope is that someone out there has some insight into these (and other) question bank resources and can help guide my decision before dropping hundreds of dollars. I appreciate any help or suggestions.
    • By Spacey22
      Hey guys!
      My husband is in the Navy and he JUST got orders to Mississippi for March 2020. I also JUST got a new job where we are located at right now. I’m also a new grad PA, so I plan on doing the long distance thing for several months (ugh) so that I can say that I’ve got a year of experience on my resume. 
      Can anyone tell me what the job market is like in Mississippi (specifically Gulfport/Biloxi)? 
      Is the job market better in Alabama? Should I focus on getting my license there instead, or Mississippi? It’s an hour drive to Mobile.
      What’s the licensing process like for Mississippi? I heard the medical board has to interview you. What is that like?
       
      thank you!
    • By pennyp
      Hi everyone! I’m a new grad PA who just graduated a couple months ago and I’m primarily interested in GI, Family, or Hospital Medicine. A PA who I used to shadow in Thoracic Surgery reached out to me and asked for my resume and I thought, what the hell, I’ll give it a shot and see what this job is about. I just had an interview for this Thoracic surgery job and the team is willing to give me great training as a new grad. It seems great, but I’m not crazy about surgery and don’t have much procedure experience. They haven’t given me an offer yet, but I’m concerned that I won’t know what to do if they do. Should I hold out and see if I get an opportunity in specialty that I really want?  Part of me worries that if I turn this down another opportunity won’t come along...as I’ve already applied to about 15 different places the past month but haven’t heard anything back. Also how long is appropriate time to ask for before accepting an offer? 
    • By kuzya4236
      Monday to Friday 9-5. No weekends.
      But I’ve shadowed on Monday and they usually stay late. When the doctor is there the work seems very secretarial. Calling about results a lot of the time from what I’ve seen. There’s a PA there that’s been there for 3 years and even she seems to spend most of the time at the computer. But I will get to do joint injections and the standard pain management stuff.
      Benefits: 80k + 10k signing bonus (repaid in full if I leave within two years)
      Insurances Full
      Licensing, DEA, and credentialing; Full
      $750 CME
      2 weeks paid for vacation and sick leave
      1 week paid for CME
      Malpractice Covered with No tail (but tail seems to be required) 2 Year, 15 mile non-compete (they have 3 offices)
      Oh and they want me to start as an MA at $16/hr while my licensing is going through.
      Pretty bad huh?
    • By isoconfidence
      Hi guys, I hope to see if I can get any guidance about my current situation.
      I am a new-to-practice PA and started my job in CT surgery in February of this year. I graduated in August of last year. I am working in inpatient cardiac surgery and am currently still on orientation, but I am feeling quite overwhelmed and starting to wonder if this is not the right opportunity for me to have taken on as my first job out of school. To provide some background, the team I work on is 95% NPs, 5% PAs. The team is predominantly comprised of NPs that have had years of experience working on either the cardiac surgery floor or in the surgical ICU prior to becoming NPs. There is another new-to-practice PA that came about a year and a half before me, but I am the second new-to-practice PA that they have taken a chance with hiring. There is one other seasoned PA who has prior experience. I say "taken a chance with hiring" because the new-to-practice PA that had come before me was the trailblazer in that my manager was testing the waters to see whether new grads would be able to make it on this floor. PAs are typically in the OR for CT surgery where I work. The new-to-practice PA was on the verge of leaving but was encouraged to stay with the promise of an extension to her length of orientation (from 3 months to 6 months) and with her demanding that changes be made to how orientation for any future new-grad PAs be handled.
      I am currently being mentored by the seasoned PA, as well as another seasoned NP. I take three of their patients (typical patient load for a provider is about 😎 and they try to follow behind me so that we can address aspects that I am missing. While there are some opportunities during the day to talk through some topics, oftentimes the rigors and rounding schedules of the floor only allow for us to touch base briefly and intermittently. There are no residents or fellows on the floor, so it is only the team of NPs and PAs that are running the show while the surgeons are in the OR. Because of this set-up, there is very minimal addition of new knowledge within this team. There are no lectures to attend to ensure that we are practicing evidence-based medicine, each surgeon notoriously prefers different styles of practice based on their training and experiences that is un-Google-able, and I feel that my main sources of learning rely on what I can try to teach myself at home and what my mentor can offer in the limited time that we have during the work day for teaching. I feel that being so many months out from graduation, I am trying to find my way to regain and effectively apply all the knowledge I once had from school into my new role as an inpatient provider, while also trying to learn cardiac surgery, a specialty I had been minimally exposed to during school/rotations. I find myself leaving work feeling completely defeated by how inefficient I am with having managed only three patients (though complex patients) that day, with my head feeling full of everything from navigating the EMR system, to putting in orders for medications that I now need to know the dosages and frequencies for, to remembering the information that my mentors had offered me that day, to remembering how to clinically manage patient conditions instead of managing pretend patients that had once been in non-real-life-threatening multiple choice formats, to realizing that not only the surgeons differ in their practices but the NPs and PAs differ as well.
      My mentors are frustrated because it seems that I do not remember some topics we discuss, and while I can understand where their frustration is coming from I feel like I am drowning to try to keep up with absorbing all these things that are all new to me. I try to jot down notes whenever they say things, but there is not very much opportunity to ask why certain things are the way they are, nor are there always reasons why they are. Because of this, my memory feels like a "snapshot" memory and I am finding it difficult to then apply what I am being told to another situation that may be similar in the future. While I try to return home with what brain power I have remaining to review what we have gone over, there are ultimately gaps in my knowledge because there may have been aspects that I was not able to jot down quickly enough, or that I maybe didn't understand fully when the factoid was told to me in an isolated incident. I also find myself planning to research a whole laundry list of topics of confusion to find myself going down a deep rabbit hole just to feel like I have grasped the topic, only to find myself not making my way efficiently through my topic list and then returning to work and finding more topics of confusion. In the midst of my mentors' frustrations, it has now reached the point where I am afraid to ask questions because I am afraid that my mentors will say "we've already gone over this" when I truly do not recall it or when I only vaguely remember them saying something about that question but not in an in-depth way. I feel like they think they're being crystal clear and that the things they are telling me should be easy to remember the next time, and I wish I could ask them to be patient with me because it is a lot to digest. My manager's only consolation was "well in your interview you knew that this was not going to be a teaching floor," and I just wish I could find the voice to reply that even though I expected this to be hard, it doesn't make this any easier.
      I dread going to work and it's very difficult for me to gauge whether this is simply a new grad experience, or if this is an opportunity that was not meant for me right now when factoring in my new grad status and the resources and environment that I currently have to get my footing as a new grad. My confidence and self esteem are in the dumps because I feel like an idiot that can't remember anything from school, let alone remember anything about CT surgery to make my mentors feel that I am making adequate progress as I approach the end of my third month on orientation. If anyone has any advice, I would greatly appreciate it.
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