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How to Weigh Non-Obvious Necessities in a First PA Job


Searching for your first PA role as a near- or new-PA grad is an exciting window into a new kind of life.

 

Instead of forking over borrowed money for tuition, books, and medical equipment, you'll finally be earning an income. You'll get scheduled time off AND be paid for it. Rather than being filled with studying or guilt over not studying, weekends will be yours again.

If you have a vision for what kind of PA role you'd like from the outset, you can center your job search on a particular specialty or specialties and within a practice area, like outpatient versus inpatient. You can regulate these variables in a potential role by controlling your search.

Vetting a position, on the other hand, is often focused on the elements offered to you: pay, benefits, paid time off, schedule, and CME allowance.

In the interview process, you're likely to meet the physician(s) you'll be closely working with or, in a large group practice, the other physician assistants who are operating in a role similar to the one you're considering.

 

And while a desired practice environment, competitive compensation, and the opportunity to be mentored are all extraordinarily important when considering your first PA job, they're also obvious aspects not likely to be overlooked.

However, there are some factors of any PA position that aren’t as apparent when you’re a near- or new-PA grad.

Until you've experienced practicing as a PA, the importance of these below-the-surface aspects (and the consequences of their absence) are less recognizable.

So if you're heading into your first PA job search (or dreaming about a future when you will), here's what not to miss when weighing an offer.

Training plan, both thoughtfulness & length

The lead-up to starting a role as a medical provider can be a long one. Licensing and credentialing can take a few months for any PA, even when you’re experienced.

Add graduation and taking the PANCE to the front end of that timeline, and you'll likely be asking a future employer to be rather patient if they want to hire you.

You'll be anxious to start, and they'll be eager to have you up and running in the clinic, on the unit, or in the OR. However, if an employer is willing to consider taking on a new grad, they should also be prepared to train you for long-term success.

When you're considering a role, ask about the training plan. Find out how long your orientation will be and when you'll be expected to be operating reasonably independently. Get the details on how you'll be trained and if you'll have a mentor through the process.

If any of these questions are met with a blank stare, your potential employer may not have thought through what it means to take on a brand-new PA. Not having a plan mapped out from the get-go is not a deal breaker, but not developing one once it's clear there's a need for it is.

If there is a training plan in place, ask about contingencies in the event that you feel you'd benefit from additional training time or instruction in a particular area.

If no variation is possible because they started booking patients on to your schedule before you finished your first interview, it's a red flag that they're looking for a warm body with a medical license. Run.

The challenge of the role

As anyone who's been through it can tell you, the best and worst thing about PA school is absorbing a ton of material in a very short amount of time. Getting through it is exhausting, but the intensity of it is what builds your confidence in your ability to function as a provider.

While the fervor of training can be dialed back a bit as you start practicing PA, your first role should still be an intellectual challenge if you hope to grow as a provider.

How to Look Behind the Scenes in a First PA JoblBe a Physician Assistant

Intellectually challenging is different than physically challenging. Working yourself to the bone is not what I mean. Nor is feeling abandoned as a new PA, left to make all of the decisions with no one to bounce ideas off of or receive feedback from.

You can feel out these potential pitfalls in advance by asking about scheduling and the day-to-day opportunities for collaboration with your colleagues when considering a role.

For most newbie PAs, finding a role that is appropriately challenging rarely means declining positions that seem overly difficult. If there is a struggle, it more often lies in finding a role that is stimulating enough.

If choosing a particular role means all of your work will be checked by someone else, your confidence will stay at the level of a PA student. If there's no opportunity to practice at the top of your licensing and training, your potential as a PA will wither.

Mentorship is essential to a new PA position and having a good mentor should allow you to gain confidence in your abilities as your baby-PA reigns are loosened over time.

But when this doesn't happen, a first job might not be sufficiently challenging or push you to make independent decisions.

When you're underutilized in a role, it becomes difficult to break out of this pattern. You may hesitate to work in specialties that seem "too difficult" even if you're interested in them.

You may be five years into your PA career and feel less sure of your abilities than when you were a student. You might feel compelled to stay at a job you don't love because the potential independence of another role intimidates you.

A job that isn't sufficiently challenging will cut you off from the lateral mobility that may have been a driving factor in your decision to become a PA. And it will diminish your job satisfaction and lessen your impact on patients.

For a first PA role, strive to choose a position that’s both supportive and challenging. Finding opportunities with this balance may take some time, but the presence or absence of it will have a domino effect, for better or worse, in the future of your career.

Your potential crew

Most new PAs know to consider compatibility with a potential collaborating physician in their choice of position. And this is built into the interview process as PA candidates are interviewed by physicians and PAs in the practice.

But, what's often overlooked when searching for a first PA job is the importance of the larger team and its impact on your job satisfaction.

A collaborating physician may be a great mentor and resource, but it's rarely that provider who's making things happen in a practice.

The nurses, medical assistants, schedulers, case managers, and social workers are the people ensuring patients get their medications covered, fielding questions from patients and family members, and helping to arrange needed services for patients. 

 

The foundation of a practice often operates under the radar of what physicians see. They know things happen, but not always how they happen.

But as someone more likely to be integrated into the inner workings of these operations, knowing how things function and who’s pulling the strings will be vital to you as a PA.

So, ask to interview with the nurses. Not a nurse manager who represents all nurses. It's okay if they want you to meet with a manager too, but ask to talk to the people on the front lines of the practice.

If your request seems to confuse your potential employer, they may be undervaluing the work their nurses are doing.

Nurses are the ones fielding calls from patients and keeping things from falling through the cracks. They have the best insights into what works in a practice and what doesn't; getting their perspective is invaluable when considering a role.

These are the people you'll rely on most heavily in helping you care for patients. You're likely to interact with them far more than any collaborating physician.

High-quality nurses are one of the greatest assets you can have in any PA job, but they are particularly helpful as a newbie PA.

Nurses that are happy to work with brand new providers will save your behind more times than you can imagine.

 

So, if while considering a new PA role you want to get a sense how a practice functions and get to know the people you’ll be working most closely with, ask to talk to the nurses.


 When searching for your first PA job, you should seek out roles that excite you and that fulfill your criteria for compensation.

 

But, don't forget to include the non-obvious necessities of a new grad role that have a significant impact on sustaining your professional growth, build your confidence through experience, and allow you to feel supported in your first PA job.