What position sounds the best?

[anonymous PA]

I've posted previously under a different name, but just wanted to post this anonymously just in case one of the involved parties was to stumble across it…

 

I am a new grad and on the job hunt; I've recently interviewed at a number of places. I think that, for a first job, I'm not as concerned about salary (although it would be nice to be done with loan repayment asap!). What I really want at this point is an opportunity to learn and really get my feet wet in order to become a more competent and confident provider. I am sort of debating whether an academic medical center is the best place to do that for a new grad or not. Obviously, you have the advantage of the educational opportunities: grand rounds, journal club, attendings that don'tmind teaching, cases that you might never see in private practice, etc. but the pay probably isn't as good and you may or may not have to "compete"with residents. I currently have 3 major prospects on the table, 2 of which arein academic centers, and are all pretty different:

 

Job #1: EM at a community hospital affiliated with an academic medical center. They do have a plan in place to transition in new grads, as well as a postgrad training program (not really a true residency) to learn procedures, etc. PAs get to work in all parts of the ED, not just fast track. Some residents but not many, and they're not stepping on the PAs' toes. I did my EM rotation here, so I am familiar with the environment. Would have a long-ish commute, ~40 mins but not much rush hour to contend with. Pay is low 80s to start. In a way, I think it would be sort of good to do something broad based like EM right out of school to "cut my teeth" and improve my skills/knowledge from school, but don't know if it's something I see myself doing for my whole career at this point.

 

Job #2: Surgical subspecialty at academic medical center (sorry for being a little vague...) I actually just sent them my CV on a lark - they didn't have any advertised positions, but I did a rotation in the specialty with a private practice and really liked it. The department chair was really enthusiastic and said that they had actually been meaning to hire another PA for some time but just hadn't gotten to it. He said the job could really be what I wanted to make it, and I might be a little bit of a "pioneer" as they refine my role a bit over time,but he thought it would probably be a little bit of everything - seeing referrals from primary care, scrubbing on surgery, doing procedures. He said the dept is very friendly, the attendings are all approachable and like to teach, and that they anticipate a wide scope of practice for the PA. He anticipated doing some sort of residency-like training for about a year(teaching me how to do their procedures, etc) to get me up to speed. I think it certainly sounds interesting and love the specialty, but am not sure if it would pigeonhole me too early in my career. Also, since there is not"officially" an open position right now, there's the question of whether creating a new position would actually get approved (I think there is probably a pretty good chance but would hate to put all my eggs in that basket and have it fall through). No idea about what the pay would be like. I do currently live in the same city so it would be nice not to have to move.

 

Job #3: Private practice ortho. Working closely with 2 ortho trauma surgeons. They do their surgeries at a academic medical center as well, but this one doesn't have an ortho residency. Lots of OR time; probably only 1-2 days a week in clinic. Good provisions in place to transition the new person in - the current PA isn'tleaving for another year and would be training the new person; would be taking 1/6 call but not until I'm comfortable. I was told that the surgeons like to teach and do know that the current PA is allowed to do a lot. The city maybe isn't as desirable to live in, but I would probably be ok with living there forseveral years, anyway...and the cost of living would be super cheap. We haven't talked salary yet, but the PA advised that the base pay might not be great but call pay + profit sharing +bonus would "make up for it." The sample contract I was shown indicated that there was no tail coverage...so that would definitely be a point of negotiation.

 

Any thoughts on which sounds best? Only Job #1 has actually offered at this point, but I'm pretty sure the others might try to offer in the next week or so, and I'm going to have to make a decision. I think part of my debate too is that I genuinely enjoy a lot of areas in medicine, and I think I'll probably end up switching specialties several times throughout my career. My last preceptor did make a good point that you shouldn't go into your first job expecting to stay there forever…but I would like to be happy while I am there.

 

Thanks for any advice you can offer!

[anonymous PA]

I've posted previously under a different name, but just wanted to post this anonymously just in case one of the involved parties was to stumble across it…

 

I am a new grad and on the job hunt; I've recently interviewed at a number of places. I think that, for a first job, I'm not as concerned about salary (although it would be nice to be done with loan repayment asap!). What I really want at this point is an opportunity to learn and really get my feet wet in order to become a more competent and confident provider. I am sort of debating whether an academic medical center is the best place to do that for a new grad or not. Obviously, you have the advantage of the educational opportunities: grand rounds, journal club, attendings that don'tmind teaching, cases that you might never see in private practice, etc. but the pay probably isn't as good and you may or may not have to "compete"with residents. I currently have 3 major prospects on the table, 2 of which arein academic centers, and are all pretty different:

 

Job #1: EM at a community hospital affiliated with an academic medical center. They do have a plan in place to transition in new grads, as well as a postgrad training program (not really a true residency) to learn procedures, etc. PAs get to work in all parts of the ED, not just fast track. Some residents but not many, and they're not stepping on the PAs' toes. I did my EM rotation here, so I am familiar with the environment. Would have a long-ish commute, ~40 mins but not much rush hour to contend with. Pay is low 80s to start. In a way, I think it would be sort of good to do something broad based like EM right out of school to "cut my teeth" and improve my skills/knowledge from school, but don't know if it's something I see myself doing for my whole career at this point.

 

Job #2: Surgical subspecialty at academic medical center (sorry for being a little vague...) I actually just sent them my CV on a lark - they didn't have any advertised positions, but I did a rotation in the specialty with a private practice and really liked it. The department chair was really enthusiastic and said that they had actually been meaning to hire another PA for some time but just hadn't gotten to it. He said the job could really be what I wanted to make it, and I might be a little bit of a "pioneer" as they refine my role a bit over time,but he thought it would probably be a little bit of everything - seeing referrals from primary care, scrubbing on surgery, doing procedures. He said the dept is very friendly, the attendings are all approachable and like to teach, and that they anticipate a wide scope of practice for the PA. He anticipated doing some sort of residency-like training for about a year(teaching me how to do their procedures, etc) to get me up to speed. I think it certainly sounds interesting and love the specialty, but am not sure if it would pigeonhole me too early in my career. Also, since there is not"officially" an open position right now, there's the question of whether creating a new position would actually get approved (I think there is probably a pretty good chance but would hate to put all my eggs in that basket and have it fall through). No idea about what the pay would be like. I do currently live in the same city so it would be nice not to have to move.

 

Job #3: Private practice ortho. Working closely with 2 ortho trauma surgeons. They do their surgeries at a academic medical center as well, but this one doesn't have an ortho residency. Lots of OR time; probably only 1-2 days a week in clinic. Good provisions in place to transition the new person in - the current PA isn'tleaving for another year and would be training the new person; would be taking 1/6 call but not until I'm comfortable. I was told that the surgeons like to teach and do know that the current PA is allowed to do a lot. The city maybe isn't as desirable to live in, but I would probably be ok with living there forseveral years, anyway...and the cost of living would be super cheap. We haven't talked salary yet, but the PA advised that the base pay might not be great but call pay + profit sharing +bonus would "make up for it." The sample contract I was shown indicated that there was no tail coverage...so that would definitely be a point of negotiation.

 

Any thoughts on which sounds best? Only Job #1 has actually offered at this point, but I'm pretty sure the others might try to offer in the next week or so, and I'm going to have to make a decision. I think part of my debate too is that I genuinely enjoy a lot of areas in medicine, and I think I'll probably end up switching specialties several times throughout my career. My last preceptor did make a good point that you shouldn't go into your first job expecting to stay there forever…but I would like to be happy while I am there.

 

Thanks for any advice you can offer!

[anonymous PA]

I've posted previously under a different name, but just wanted to post this anonymously just in case one of the involved parties was to stumble across it…

 

I am a new grad and on the job hunt; I've recently interviewed at a number of places. I think that, for a first job, I'm not as concerned about salary (although it would be nice to be done with loan repayment asap!). What I really want at this point is an opportunity to learn and really get my feet wet in order to become a more competent and confident provider. I am sort of debating whether an academic medical center is the best place to do that for a new grad or not. Obviously, you have the advantage of the educational opportunities: grand rounds, journal club, attendings that don'tmind teaching, cases that you might never see in private practice, etc. but the pay probably isn't as good and you may or may not have to "compete"with residents. I currently have 3 major prospects on the table, 2 of which arein academic centers, and are all pretty different:

 

Job #1: EM at a community hospital affiliated with an academic medical center. They do have a plan in place to transition in new grads, as well as a postgrad training program (not really a true residency) to learn procedures, etc. PAs get to work in all parts of the ED, not just fast track. Some residents but not many, and they're not stepping on the PAs' toes. I did my EM rotation here, so I am familiar with the environment. Would have a long-ish commute, ~40 mins but not much rush hour to contend with. Pay is low 80s to start. In a way, I think it would be sort of good to do something broad based like EM right out of school to "cut my teeth" and improve my skills/knowledge from school, but don't know if it's something I see myself doing for my whole career at this point.

 

Job #2: Surgical subspecialty at academic medical center (sorry for being a little vague...) I actually just sent them my CV on a lark - they didn't have any advertised positions, but I did a rotation in the specialty with a private practice and really liked it. The department chair was really enthusiastic and said that they had actually been meaning to hire another PA for some time but just hadn't gotten to it. He said the job could really be what I wanted to make it, and I might be a little bit of a "pioneer" as they refine my role a bit over time,but he thought it would probably be a little bit of everything - seeing referrals from primary care, scrubbing on surgery, doing procedures. He said the dept is very friendly, the attendings are all approachable and like to teach, and that they anticipate a wide scope of practice for the PA. He anticipated doing some sort of residency-like training for about a year(teaching me how to do their procedures, etc) to get me up to speed. I think it certainly sounds interesting and love the specialty, but am not sure if it would pigeonhole me too early in my career. Also, since there is not"officially" an open position right now, there's the question of whether creating a new position would actually get approved (I think there is probably a pretty good chance but would hate to put all my eggs in that basket and have it fall through). No idea about what the pay would be like. I do currently live in the same city so it would be nice not to have to move.

 

Job #3: Private practice ortho. Working closely with 2 ortho trauma surgeons. They do their surgeries at a academic medical center as well, but this one doesn't have an ortho residency. Lots of OR time; probably only 1-2 days a week in clinic. Good provisions in place to transition the new person in - the current PA isn'tleaving for another year and would be training the new person; would be taking 1/6 call but not until I'm comfortable. I was told that the surgeons like to teach and do know that the current PA is allowed to do a lot. The city maybe isn't as desirable to live in, but I would probably be ok with living there forseveral years, anyway...and the cost of living would be super cheap. We haven't talked salary yet, but the PA advised that the base pay might not be great but call pay + profit sharing +bonus would "make up for it." The sample contract I was shown indicated that there was no tail coverage...so that would definitely be a point of negotiation.

 

Any thoughts on which sounds best? Only Job #1 has actually offered at this point, but I'm pretty sure the others might try to offer in the next week or so, and I'm going to have to make a decision. I think part of my debate too is that I genuinely enjoy a lot of areas in medicine, and I think I'll probably end up switching specialties several times throughout my career. My last preceptor did make a good point that you shouldn't go into your first job expecting to stay there forever…but I would like to be happy while I am there.

 

Thanks for any advice you can offer!