ShannonN Posted July 12, 2012 Share Posted July 12, 2012 I'm not really sure what to do. I am graduating in August 2012, taking the PANCE August 27, and hoping to work ASAP. About 2 weeks ago, I started looking for jobs. As a background, I just had a baby boy in April (he is 3 months old) and I have a 3 year old daughter. I want something to fit my life, where I will still have time to see my kids and husband. And my husband has a contract job through the end of this month, but is waiting to get a new job until after I figure out what I'm doing. These are the jobs that are currently on the table: 1) Family practice 32-35 hours/week + full benefits. I had this interview yesterday and they basically said they really wanted to hire me. They are putting together a contract and are going to email it to me. The hours are 9-4 Tues-Fri and 9-1 Sat. I know the pay will be hourly. They also said "if you don't like something in the contract, please let us know and we can definitely work something out." So, I have high hopes for decent wages as they have several PAs who have been there a long time and their attrition is very low overall. The drawback? They want me to see 3-4 pts/hour once I get going. I was hoping for no more than 3, but they are very busy. Plus they see quite a bit of suboxone and chronic pain patients...I'm not sure how I feel about that. I have a little experience with it, but not a lot. 2) Obstetrics position at a major hospital. Night shift 3 12-hour shifts per week 7 pm to 7 am (weekdays only), no call. I shadowed there yesterday and was basically told the job is mine unless I totally blow the interview. I know the pay is around $92K with great benefits. My concern there is the opposite of the one above. There's not a whole lot to do! Plus you actually have to present every single patient to either the attending or resident. I don't understand the point of a PA in that case; a nurse could do the job. Apparently doing this in the middle of the night sucks because the docs don't want to hear about it because they're sleeping. The other drawback is the night hours and not seeing my kids much. However, the night shift likely won't last that long because they're looking at adding a lot more PAs and those with more seniority will go to days. 3) Telemetry Floor position at a major hospital. This is an "inside scoop" job (not a posted position). A person who works there emailed me and asked me about it. It is 4 10-hour shifts/week, all day shifts, some weekends, no call. I LOVE the idea of 10-hour shifts. I have not interviewed for it yet (my contact there just sent my resume to the hiring manager). But I have high hopes that I will be called to interview there, and with her recommendation, I have a sense that I should get it unless I botch something. The pay is likely mid-90s, not sure exactly. GREAT benefits including 5 weeks off and immediate health insurance. I also used to be employed by this hospital, so again, that bodes well for me. 4) Cardiovascular surgery floor position at another major hospital. I am interviewing there next week. But I don't know too much about it at this point, other than it's 5 8-hour days. I have some other applications out also. We'll see what comes of those. My biggest concern about the family practice is the heavy patient volume and suboxone/chronic pain population. The hours are awesome and I think they will likely make me a good offer. (I am making them throw out the first offer.) It is a great place to learn primary care, but I worry about being stressed. I think my next favorite would be the telemetry position because of the hours, pay, and benefits. But it is specialized. I guess I'm not sure if I should specialize just yet or get primary care experience. If I take a cardiovascular or OB job out of school, will I get stuck in it? Any advice? Thanks, Shannon Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 12, 2012 Moderator Share Posted July 12, 2012 unless you are passionate about a specialty it is almost always better to start in primary care as that is a good foundation for any later job.could you talk the fp position into four 8 hr shifts/week with alternating weekend coverage? best of both worlds... Link to comment Share on other sites More sharing options...
ShannonN Posted July 12, 2012 Author Share Posted July 12, 2012 unless you are passionate about a specialty it is almost always better to start in primary care as that is a good foundation for any later job.could you talk the fp position into four 8 hr shifts/week with alternating weekend coverage? best of both worlds... That is a great idea, but I don't know if they would do that at this point. They are busier during the early part of the day (big geriatric population), so they want me there earlier (9-4 instead of 9-5 or 9-6). But I could broach the subject with them once my contract is sent over. The other benefit I just thought of is that I'd be home in time to make dinner every night for my family. I don't mind working weekends at all. I actually offered since it's only half-day. I have a lot to think about, that's for sure. Link to comment Share on other sites More sharing options...
ShannonN Posted July 12, 2012 Author Share Posted July 12, 2012 Well, I guess the primary care job fell through. They have decided to hire someone else "with more experience." So crazy. I love the fact that they said they wanted to hire me and were going to put together a package this week. That is really disappointing, but as my husband says, I might be better off in the long run. Oh well. But there is still the OB and two cardiac positions. Plus I'll apply to more primary care, since I do think that would be best. Link to comment Share on other sites More sharing options...
jmj11 Posted July 12, 2012 Share Posted July 12, 2012 Just a word of encouragement. While it is certainly best to do primary care out of school it is not a career ruining move if you don't. I worked primary care for only 6 months and moved into a sub specialty. Years later I moved by into primary care again . . . for a while. You do have to pay the piper at one point, meaning, there will be a learning curve, but a couple of points, 1) after 5 years primary care changes anyway, guidelines for treating certain chronic illnesses, the basics, 2) doing a pelvic, suturing, listening to breath sounds or the heart, is a little like riding a bike . . . as long as you had it in the first place. Link to comment Share on other sites More sharing options...
mjohnson3604 Posted July 12, 2012 Share Posted July 12, 2012 Hi, As a student, it's really inspiring to see the range of potential opportunities you have (already). Just wanted to weigh in some considerations for the night shift position. Not sure of the flexibility your husband has with working, but for us (my husband, 5yr old son) one person working that 7pm-7am shift has been a bit challenging...for instance, you're working nights and he's working days (so you'll be asleep during the day...will the kids be at daycare?), after completing your rigorous program and having an infant I'm sure you'd like to get some time with the family--when you're up they're sleep & vice versa...for us, we try to pack so much into off days that it can feel laborious. Of course there are ways to work it all out, just some considerations. Best wishes with your decision Link to comment Share on other sites More sharing options...
queenofhearts Posted July 12, 2012 Share Posted July 12, 2012 Can you tell me what your OB position entails? I am interested in working in OB in the future, but not really sure as a PA what exactly i'll be able to do and how satifying it would be? Would you mind explaining here, or feel free to send me a PM :) Link to comment Share on other sites More sharing options...
ShannonN Posted July 12, 2012 Author Share Posted July 12, 2012 Can you tell me what your OB position entails? I am interested in working in OB in the future, but not really sure as a PA what exactly i'll be able to do and how satifying it would be? Would you mind explaining here, or feel free to send me a PM :) The OB position is an interesting one. It is triage 2 of 3 days and the other 1 of 3 days it is the board, which would involve monitoring/delivering babies. This hospital is in an urban area, and I don't think that most PA OB positions involve delivering babies. This one does, but it might be a rarity. Not sure. A lot of OBs are latching on the PAs at this point, though. It used to just be midwives, but things are changing slowly it seems. Good luck in that endeavor! Link to comment Share on other sites More sharing options...
queenofhearts Posted July 13, 2012 Share Posted July 13, 2012 That sounds pretty sweet! And delivering, even better! Glad you mentioned that you live in an urban area, because i have no intention of live rurally! I hope this offer comes available to me in the future--You are so lucky :) So you only work 3 days a week in this position? Is that common? Will the ob allow you to help with c-sections, and gyn surgeries? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 13, 2012 Moderator Share Posted July 13, 2012 for those really interested in OB you might want to consider the ob residency at arrowhead in CA. one of my former students did it and remains on faculty there. he does solo deliveries, first assists all ob procedures in the o.r., takes first call to the er for all ob emergencies, does colposcopy, IUD placement and removal, endometrial biopsies, etc...pretty much the full ob md scope of practice outside the o.r. where he first assists(which often involves him doing much/most of a procedure). Link to comment Share on other sites More sharing options...
queenofhearts Posted July 13, 2012 Share Posted July 13, 2012 yea, i would consider it :) But i just don't want to live in the area afterwards...not a great area to reside in Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 13, 2012 Moderator Share Posted July 13, 2012 yea, i would consider it :) But i just don't want to live in the area afterwards...not a great area to reside in no argument there. commute, everyone else in L.A. does. at my first job out of school I commuted 63 miles one way every day to work...it involved 5 freeways..but at least I was going against traffic(east) in the morning. I bought a new car that year and put 30k miles on it. when I moved to the pacific nw I averaged 7k/yr. Link to comment Share on other sites More sharing options...
ShannonN Posted July 13, 2012 Author Share Posted July 13, 2012 for those really interested in OB you might want to consider the ob residency at arrowhead in CA.one of my former students did it and remains on faculty there. he does solo deliveries, first assists all ob procedures in the o.r., takes first call to the er for all ob emergencies, does colposcopy, IUD placement and removal, endometrial biopsies, etc...pretty much the full ob md scope of practice outside the o.r. where he first assists(which often involves him doing much/most of a procedure). So, so funny you mention this residency. My friend was accepted to this residency but declined it due to getting a job at the aforementioned urban hospital. Her preceptorship was MFM because she LOVES obstetrics and knew that's what she wanted to do. She did amniocentesis, deliveries, first assist in OR, cerclages, and quite a few more procedures. Her preceptor loved her. He encouraged her to apply to that residency. She was going to take it because she didn't expect to get a true OB job. She did get this job, but just started. So she's not sure if she made the right decision by foregoing the residency. BTW, when I say "urban," I don't mean suburban. I mean URBAN. When I was shadowing the other day, a 19-year-old girl came in 28 weeks pregnant and had positive urine for barbiturates, THC, and chlamydia. That was just one example. I did my OB rotation in the nice suburbs and there was no way those ladies were going to let me deliver their babies. But at this hospital, they don't care. So it makes a difference where you are. Link to comment Share on other sites More sharing options...
queenofhearts Posted July 13, 2012 Share Posted July 13, 2012 Thank you for the clarification! Does your friend who got her dream job also work in an urban setting as well? Yea, private practice/suburban would be my ideal working situation. But I see your point that those women would not let you near them. However, some reason I thought c-sections was naturally in the scope of a PA? Link to comment Share on other sites More sharing options...
ShannonN Posted July 15, 2012 Author Share Posted July 15, 2012 Thank you for the clarification! Does your friend who got her dream job also work in an urban setting as well? Yea, private practice/suburban would be my ideal working situation. But I see your point that those women would not let you near them. However, some reason I thought c-sections was naturally in the scope of a PA? I would not call this her dream job. It is in the same urban hospital I shadowed at. I get the feeling they have a hard time getting people to work there. She loved her preceptorship in MFM because she got to do everything she does here, plus more procedures. Where she is now, she will not be in the OR assisting in c-sections. She is either going to be in triage or on the board, monitoring and delivering babies (vaginally). I mean, yes, it is doing obstetrics and it is delivering babies. But it is for women who don't really appear to care about themselves or take care of themselves. That is quite a bit different from her other experience during her rotations. Still, she loves delivering babies and working with pregnant women, so she will stay here and get experience, hoping that it will eventually land her the dream job she longs for. She wanted to do the residency, but the pay is low and they would have been working her to death. I think in the residency, she would have been working 6 days a week. In any event, good luck. :smile: Link to comment Share on other sites More sharing options...
Just Steve Posted July 15, 2012 Share Posted July 15, 2012 I would not call this her dream job...I mean, yes, it is doing obstetrics and it is delivering babies. But it is for women who don't really appear to care about themselves or take care of themselves... I've been following along your dilemma concerning your first job and while intrigued at your decision making process, I am caught off guard at a few of your comments regarding inner city population. I noted a couple of quotes from your last post and include your comment about the 28 week gestation patient with a positive UDS and a STD... I am sure we can all agree that this demographic of patient may be very challenging to work with. However, the tone of your posts regarding these patients reads as if you don't think they are worthy of quality medical care, or are "below" you and your cohorts. The same tone gets carried by providers when they reach a level of burn out. As a new grad, looking for their first job, it is a bit surprising to think that you may be burned out already. While I am sure this is not your true intention, I would ask that you may reconsider how you are trying to communicate your points. have a good day Link to comment Share on other sites More sharing options...
ShannonN Posted July 17, 2012 Author Share Posted July 17, 2012 I've been following along your dilemma concerning your first job and while intrigued at your decision making process, I am caught off guard at a few of your comments regarding inner city population. I noted a couple of quotes from your last post and include your comment about the 28 week gestation patient with a positive UDS and a STD... I am sure we can all agree that this demographic of patient may be very challenging to work with. However, the tone of your posts regarding these patients reads as if you don't think they are worthy of quality medical care, or are "below" you and your cohorts. The same tone gets carried by providers when they reach a level of burn out. As a new grad, looking for their first job, it is a bit surprising to think that you may be burned out already. While I am sure this is not your true intention, I would ask that you may reconsider how you are trying to communicate your points. have a good day Thank you for your comment. I re-read my post and I can see your point. Thank you so much for pointing it out. It is not my intention to convey that these populations do not need quality medical care. I am actually looking for jobs in the urban area where I live. Working with this population does not bother me and some of my rotations have been at this hospital (or those in the area). What does bother me is that they do not take care of themselves and their babies. My friend would prefer to work in other areas where you do not see as many mothers with drugs and STDs. I do not believe these women are below anyone; it's just frustrating, especially as a 2-time mom who tried to stay away from everything I was supposed to and tried not to anything to hurt the babies. That doesn't mean I'm better (or most the other pregnant women I know who do the same thing for their babies). You can say they're ignorant about what does and doesn't harm them and the baby due to socioeconomic disadvantages, but they are smart enough to know that drugs are a no-no in pregnancy. That is about putting a life before your own. That is where I have a problem. It's not like I would talk down to them or yell at them; I would try to figure out why they're doing it. And, if for some reason they're uneducated about it, we would discuss it. I agree that they deserve medical care just like anyone else, but at what point are we, as providers, allowed to be frustrated when someone is potentially hurting someone else? Also, I should have mentioned the wonderful young lady who was having her third child and finishing college at the same time. I didn't mention her, and should have, because she is the antithesis to the first case. In any event, thank you so much for your comment. It gave me a lot to think about. And growing and learning is really important in everything we do. :) Link to comment Share on other sites More sharing options...
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