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Stuck between two offers


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Hey all, thank you for taking the time to read this. Quickly, new grad here. I have two of the best job offers I could ask for. Which is why this is so tough. One is in General Surgery, the other is in Urgent Care. I have a background in EMS for 5 years, 3 masters blah blah, 29 years old. I love emergency medicine, hard to get a job as new grad and COVID times. I love both the urgent care and general surgery field. Literally stuck.

1) General Surgery- from all the surgery jobs I’ve heard, this just seems the best out there. 3 12’s minimum, up to whatever. Flexible schedule, with days nights evenings (mostly days) great differential, no call, robotics trained bonus. Many hours as I want (I have 200k in debt). I found in life that about 48-52 hrs/wk is perfect for me. Overall salary calculates out to be about 170k for 51 hrs total. Plenty of training with other PA’s, cME money, 6% 401k etc. Paid HOURLY so no taken advantage of long surgery cases or hot cases. Trying to find negative to it but just can’t. I would say surgery is a close second to EM/Urgent care prob because I just don’t quite have the same experience in it other than the months of clinical year.

2) Urgent Care outpatient offer- First year is a fellowship. Approx 80k first year for 36 hrs/wk. Again, extremely flexible schedule, every other weekend (same as Gen surgery). Focus is to transition you to principle provider. 401k match, health, dental whole 9 yards. After first year, calculations turn out to be approx 220- 260k/year for approx same hours (52/wk, how much I volunteer to work). Idea is to work your way up through the Patient Load over the year to approx 40 patients/a day. 
 

Both are incredibly flexible, both obviously offer great pay (which I’m not too concerned with the first year as I just want to keep my head above the water per say). Both have great resources there to utilize. I can definitely see more autonomy with Urgent care offer. I can def see more patient relationship with In patient. I honestly don’t prioritize on the money but sadly the huge debt of education drives an anxiety bullet deeper than most things. I am split on in patient vs out patient. I do love the idea of locus tenems some day when I have experience so I assume the urgent care would offer better potential for that? I would definitely be surrounded by more MD’s in the hospital who I assume would offer increased chance for learning opportunities. Both are approx 10 minute commute. I am literally 60:40 leaning one way, I won’t say which. But man what a terrible problem to have in life huh. Anyway, I am not asking for someone to make a decision for me. Just wondering what all the experienced PA’s out there would think in my situation or what door would they choose in this situation based on the details. I know I will work my butt off for either one and it will require great effort. Oh and I live in the northeast. Thank you again everyone

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surgery for several reasons. A lot of the skills you need in an eventual EM job will come from seeing really sick people and having procedures like suturing , chest tubes, etc under your belt. Rounding in the ICU is also a bonus. UC is great for learning basic skills, but 80k is ridiculously low. There is no such thing as an urgent care fellowship. That is half pay for a year. don't do it. Also 40 pts/12 hrs is a recipe for burnout. 

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2 hours ago, EMEDPA said:

surgery for several reasons. A lot of the skills you need in an eventual EM job will come from seeing really sick people and having procedures like suturing , chest tubes, etc under your belt. Rounding in the ICU is also a bonus. UC is great for learning basic skills, but 80k is ridiculously low. There is no such thing as an urgent care fellowship. That is half pay for a year. don't do it. Also 40 pts/12 hrs is a recipe for burnout. 

All this. I hate surgery (really just the OR) and I would definitely take it in this scenario.

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1 hour ago, LT_Oneal_PAC said:

All this. I hate surgery (really just the OR) and I would definitely take it in this scenario.

Agreed. UC doesn't sound sustainable, and while this may sound paternalistic 52 hours of EMS is a lot different than 52 hours of PAing.

I hate the OR with all my heart, everyone is so damn type A and aggro, I mean, if I get the damn gloves on that's all that matters right? Who cares how it happens.

Skills will be easily transferrable, will make recognizing those presenting conditions easier and I'm guessing you'll have a less likely chance of burning out.

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On 12/5/2020 at 7:13 PM, Newgrad20 said:

After first year, calculations turn out to be approx 220- 260k/year for approx same hours (52/wk, how much I volunteer to work). Idea is to work your way up through the Patient Load over the year to approx 40 patients/a day. 

How sure are you regarding this pay after the first year? Never heard of urgent care paying this much.

I'd personally recommend general surgery because of the procedural skills, and having that background knowledge is helpful. Plus you'll be working closely with the ER folks and I'm sure you can use that to eventually get an ER job. I'm biased though because I love having the variety of clinic/OR.

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59 minutes ago, AbeTheBabe said:

How sure are you regarding this pay after the first year? Never heard of urgent care paying this much.

A lot of UCs quote ridiculous salaries based on production, but the fine print says if you see 6 pts/hr and do a complicated procedure on each of them you could make infinity dollars/year!

https://www.bing.com/videos/search?q=bill+and+ted+infinity+push+ups&docid=608011376413838907&mid=14805FCE832A325ED04214805FCE832A325ED042&view=detail&FORM=VIRE

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26 minutes ago, EMEDPA said:

A lot of UCs quote ridiculous salaries based on production, but the fine print says if you see 6 pts/hr and do a complicated procedure on each of them you could make infinity dollars/year!

https://www.bing.com/videos/search?q=bill+and+ted+infinity+push+ups&docid=608011376413838907&mid=14805FCE832A325ED04214805FCE832A325ED042&view=detail&FORM=VIRE

Bing? You use BING?

You're not the man I thought you were.

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