Have you ever told a drug rep to basically get lost? We have one that keeps showing up unannounced. There is absolutely nothing to talk about. They offer us very few perks. Today I immediately told them to stop doing this because we hate it and I don't think they want to leave a bad taste in our mouth. There was no fake friendly conversation this time. How do they not realize how annoying they are??? What a terrible job.

I have applied to SO MANY jobs. I passed the PANCE in April. I am Tennessee licensed. Looking in the East TN area. Applying within cities, suburban and rural areas. Honestly have only heard back from one posting and offered an interview, however they hired someone else with experience prior to the interview date.

I am genuinely wondering if I am doing something wrong. I have sent emails to recruiters at my local hospital system and been ghosted. Applied for hospital med, acute care, orthopedic surgery, neurosurgery, etc on practice link, LinkedIn, Marit and others, and haven't heard back from a single application on any of those. I am wondering if something is wrong with my CV, or if this is an average experience haha any thoughts? Should I call recruiters I have already emailed but had no response from? Walk in local practices and drop off my CV? I am genuinely willing to do anything and very open to any suggestions!

Hello! New grad here. What is the new grad rate for EM in wisconsin? Mostly Appleton and Green Bay area? Would $75-$80 per hour be reasonable? If you're willing to share, what is your rate, hours, bonus, benefits, etc?

I have a question for anyone that has/does work with residents in a procedural specialty. I was wondering what the legality/ethics of “timing out” and/or supervising a resident for a low risk procedure would be (para for example).

I’m at an academic center where I am now the sole PA in the group and we have some residents/fellows within our service more or less full time and then some off service residents that join as well. Most of these residents know how to do these procedures already, and in the past I have been asked to time them out on something like this (a previous PA would sometimes do this and I have done it as well). Of course if it’s something I am not comfortable with then I’d say no, but if it’s something I know I am competent in, is this still inappropriate and should I kindly redirect them to an attending or is it ok? Just trying to understand how this works in this type of setting, especially since I am still a pretty new PA. Thanks!

Could some current PAs share how their experience as a new grad was and whether they felt prepared? If anyone has experience switching specialties, how has that experience been? Is it really possible? Finally, are there any PAs who have gone beyond clinical work? How can you build on the career?

I’m a PA with about 15 months experience as an ED PA now. Almost exclusively working the “urgent care” area of the ED. I’m planning to finish my 2 year commitment and then move on to another specialty with a better schedule. I don’t have one specific “passion” that I feel drawn towards. I do have some interest in women’s health. I’m nervous about starting over when I don’t feel well trained in one particular field.

I’m looking for advice from those of you who moved on and specialized early in your career. Was it harder or easier than you anticipated? Extra interested in folks in similar situations or those coming from urgent care. Ideally I’d like to stay PRN in the ED but I don’t think my group will allow it as so many people are trying to do the same.

I’ve struggled with a few mental health conditions all my life. Sometimes I feel almost out of place or have imposter syndrome thinking I shouldn’t be a provider bc I’m struggling with these issues if that makes sense. I’m not too dysfunctional to not do my job or provide best patient care and I don’t know if it’s the lack of transparency of mental health conditions beyond depression and anxiety between providers or “influencer” PAs/healthcare professionals that makes me feel out of place. It almost makes me feel alone to not know if there’s someone that struggles with my specific condition and the symptoms of it.

I know a lot of people struggle with depression and anxiety and I know this career has a high burnout rate, but I’m referencing other mental health conditions like OCD, BPD, bipolar schizophrenia etc. I’m being vague because I struggle to announce my condition bc of fear of being judged which might be the issue.

hello all. i’ll try to keep this brief..
i’m wondering what you all would do in this case or any helpful insight anyone may be able to offer

im currently working in UC and have been for 3 years, since becoming certified
pros: 3 to 4 shifts weekly, base pay 111k/yr paid biweekly at hourly rate, FT 36hrs/wk and additional 25/hr after going over the FT 72hrs in a pay period (which i always seem to do so pay is easily 120-125/yr with the OT)
cons: TWELVE hr shifts, having to see any and everything that decided to walk in that day, unpredictable patients/volume therefore unpredictable day burning me out for sure

got an ID offer.. outpatient position with a week a month of inpatient rounding, autonomy once trained with one SP “always reachable and willing to teach”
pros: 8am to 5pm shifts, 11% bonus yearly broken down as 6% productivity and 5% RVU somehow?; i love ID as a specialty. more predictable days, likely better learning/growth opportunity. seeing 2 patients an hour in clinic once used to the flow (they will start me with one patient an hour, the “easy” follow ups and the HIV patients)
cons: 115k/yr and no OT may be less than what im used to making.. but as already mentioned the potential 11% bonus yearly and they will adjust to market value yearly as well; five day workweek .. not sure how im feeling about that really though its shorter hours. also this MD has not had a PA before so while im sure he’ll be great (i like his personality!) im hesitant about it

benefits packages comparable to one another so a nonissue . both are with large health systems in my area.

hopefully someone can say something to make my decision easier .. i know ultimately i have to choose whats best/right for me and my family but would like an idea of what others would do. TIA <3

Has anyone gone from certified in Canada to practicing in the US? If so, how and what did you do?

Hey all. Wondering if anyone has any recommendations for CME courses that focus on reviewing physiology and pathophysiology? I feel like a lot of AAPA stuff only very briefly reviews physiology and focuses more on dx and management of conditions. Thanks!

I'm pursuing a Physician Assistant position performing Medical Disability Exams on Veterans through Valor Healthcare in New York State. I had an initial convo with the recruiter and I'm told I do not need a Supervising/Collaborating Physician as the position is only administrative with examinations and thus not requiring diagnoses, treatments, prescriptions, etc. I've searched thoroughly and I cannot verify if this is correct or not permitted within New York State. I've also contacted NYS licensing board but I'm waiting for a reply. Is this an exception to the typical Supervisory rules? My instinct tells me the recruiter is full of shit.

For more context, and to head off some possible critiques, this is a per diem 1099 gig, which is exactly what I want for taxes, etc. I'm a very experienced Critical Care and Cardiology PA and working locum 1099s typically do not work for me as these require way more shifts than I'm willing to work (currently job is M-F, lots of PTO, 6 major holidays, bottom line not leaving).

Appreciate everyones insight!

Currently 1 year of ER experience as a PA. Looking for options and got this offer:

Orthopedic Sports Medicine (I have no orthopedic experience other than the stuff I see in the ER)

Location: FL

2 OR days, rest of 3 days in clinic. 8a-4pm or 7a-3pm clinic schedule

120k base with 8 paid holidays. 3 weeks PTO front-loaded. No weekends. No call.

Quarterly bonus: once I bring in revenue equal to 2x my salary ($60k/quarter), I get 10% of everything above that

401k: 100% match on the first 4%, 50% on the next 2% (5% max)

Malpractice is claims-made, and I’d have to buy my own tail. No noncompete (i plan to keep my ER job as PRN)

Rant/advice, I guess. I graduated from PA school and then did a surgical fellowship. It went well, and I felt the training I got was valuable for the field I wanted to be in. Got a job in said field and thought I was the luckiest person! Well, that job turned out to be HORRIBLE, and I left three months in with four weeks' notice, with no other job lined up (it was that bad, y'all). I eventually got another job offer in a surgical subspecialty where I have NO experience, and I'll start in December. So I will have been out of medicine for about 6 months when I start... only 2 years after I graduated from school.

It sucks because all my PA school friends are already 2 years into their specialties, so smart and well-trained, and here I am... starting all over again in a new specialty and feeling nothing past a new grad. For those who had a really rough start to their careers, how did things end up for you?

Good afternoon! I’m currently a PA student in Georgia that’s about to graduate in 6 months. For as long as I can remember I’ve always wanted to live in Oregon so I need advice/leads on jobs for new grads in the state.
I have a vascular surgery rotation in Portland from February to March so hopefully I can also network during that time period.
Any advice is appreciated!

Just got a job offer from a dermatology practice in Southern California. $70,000 for first 3 months of training, $140,000 first year and $150,000 second year. Pretty standard benefits (but I can detail more if anybody thinks it would be helpful info!)

The only thing that is scaring me is if I quit from anywhere between day 1 and 2 years + 3 mo of the contract, I would owe them $250/day for everyday not worked and $50,000 as this was the cost of the 3 month training program they have. The training program includes a didactic and clinical rotation type situation.

Anybody have any thoughts on this? Is this common practice or am I signing my life away potentially? Just thinking worst case scenario.

I know there are plenty of posts like this one over the years, but I needed a place to vent lol

Started in a busy level 1 trauma center immediately after graduating and passing boards. I’ve had 5 training shifts where I was scheduled with PAs and in a couple days I’ll be on my own for the first time

I still don’t feel confident putting in most orders, especially when it comes to dosages and frequency of certain meds. I’m averaging 7 or 8 patients in a 10 hour shift which sounds light but as someone still learning the ropes there are times during the shift where things get overwhelming and I worry about making mistakes that can harm my patients. attendings are always running around so it’s hard to grab a hold of them to run my orders past them after I staff with them briefly. For example, I’ll staff with one of them and they’ll say order “x, y, z” then walk away and then I scramble to figure out what dosage, route, etc.

Over my 5 shifts I’ve had a couple admissions but the process is still very confusing and I’m trying to brace myself for annoying attendings and ask for help for navigating epic with some of these processes. Still don’t even know where most things are in the ED.

I was expecting a steep learning curve when starting in the ED but this is turning out to be much more stressful than I anticipated and the feeling of “I have no idea what’s happening” is still very much alive going into my first solo shift which is making me worried

I’m a PA student looking into the job market right now and I’ve come across multiple jobs ranging from deep in the city and out to the rural areas and I’m wondering how our roles as PAs change depending on where you practice. Specifically, I want to practice in Emergency Medicine but I also understand it’s more of an “urgent care” role at well staffed locations vs in critical access facilities, you’re the only provider on site. Is there a healthy in-between where I can practice with a little more autonomy in the city? Or do I have to go out of the area to do more in my field?

I am a new grad. The market sucks right now. I took a primary care position in HCOL city out of desperation. Making 50$/ hour for 3 months then salary of 110K. I've tried negotiating but they're pretty set. There are bonuses on productivity.

Job description below:
40 hours a week. Alternating saturdays. And on call once a month.

Below are the benefits:
• Three weeks PTO annually (four weeks beginning year three)
• Health, dental, and vision insurance after 30 days
• $1,500 annual CME reimbursement (no carryover)
• SIMPLE IRA eligibility after 90 days

NOW

1 am a month in the job and was offered another job for
120K starting 33 hours a week (4 days). Raise will be based upon survey results from coworkers, profitability of office and KPI's hit to be determined mutually.

Everything was matched:
- Three weeks PTO annually (four weeks beginning year three
- health insurance paid 50% only
- CME IS $1,000
- 401K

The primary care job is so stressful but everyone there is so nice. It's as if it is my own practice. It's stressful however because there are no MA's and support is lacking. I also don't want to leave after only being there for a month. I love primary care but I feel like I'm becoming burnt out idk.

The second job is super easy (I worked there temporarily).
It's just injections all day but I would not be able to prescribe any medications at that practice. It would be a less well rounded experience.

Idk what to do. Both far and commute sucks also. Options are limited 😔

I just signed an offer letter with tentative start date 3 months from now. I want to give my current workplace adequate notice (at least 2 months) and leave in good terms. Should I be waiting until the health screening, background check and credentialing is done? I’m afraid if I wait for that, it will be too late of a notice. When is the appropriate time to resign?

Edit: As far as I know, there does not seem to be a policy for how far in advance we have to give our notice.

Hi all, I’m an orthopedic surgery PA in San Diego, California, about five years in, and I’m trying to get a sense of how other practices handle cost-of-living adjustments. Our group doesn’t have a clear policy that I know of, and costs in my area have gone up a lot faster than pay.

I’d love to hear from people in different settings (private practice, academic, large health systems, VA):

1. Does your employer give an automatic COLA, and if so, how often?
2. How is it set? A fixed percentage, tied to CPI, or decided each year?
3. What size increases have you seen recently?
4. If there’s no COLA, how do raises work for you? Annual review, tiered pay scale by experience, or negotiated individually?
5. Has anyone been able to get retirement contributions or profit sharing to scale with inflation?
6. If you’ve negotiated for one, what worked? Did you use salary survey data (AAPA, PAOS) or local comparisons?

I’m an ER PA with five years of experience. At 150 hours/month, my current South Florida job would pay about $166,000 gross annually, including my PTO payout (120 hours at 82/hr) and Christmas bonus (5k), before additional holiday pay. I’m considering a Washington job where $250,000–$300,000 could be achievable at roughly 160–170 hours/month, depending on productivity and qualifying overtime. The lead PA told me he made around $320,000 last year working seventeen 10-hour shifts monthly. These are potential earnings, not a guaranteed salary. It is because of RVU bonus.

The new job is in the Pacific Northwest, and we would probably live in Tacoma or DuPont. It pays $90/hour plus a quarterly RVU bonus, time and a half after 40 hours in a workweek, and time and a half for working holidays. There are 10-hour shifts from 9 a.m. to 7 p.m. and some eight-hour shifts from 4 p.m. to midnight. There are more shift time but I didnt get that info yet.

The quarterly bonus pays $10 for each RVU/hour above a threshold of 5 RVUs/hour, then subtracts a $10/hour prepayment from the calculated bonus. For example, averaging 9 RVUs/hour would add $30/hour to my $90 base, for an effective cash rate of $120/hour before profit-sharing eligibility.

After one year, I would become eligible for profit sharing, which redirects 13.33% of the RVU bonus rate into my 401(k). For my tier, the cash payment would drop from $10 to $8.67 per RVU above the threshold, with the difference going toward retirement. +120 hours PTO yearly that can be rolled over. Can get 40 hours paid out yearly.

HERE IS WHAT GETS ME: The lead PA told me he made approximately $320,000 last year working seventeen 10-hour shifts per month and seeing around 25–30 patients per shift. He estimates his effective compensation at roughly $150/hour, although his experience and productivity may differ from what I could achieve.

The lead PA said other PAs generally average 7–8 total RVUs/hour while seeing about 20 patients per shift. He sees 25–30. I currently see around 25–30 patients over a 12-hour shift after a recent increase in volume. An older report showed about 7 RVUs/hour during a slower period (16 patients in a shift), so I’m trying to assess what I could realistically produce there.

My current job pays $84/hour, with 138 hours/month considered full time. I get 120 hours of PTO that can be paid out on start date anniversary, paid holidays even if I don’t work them, a $5,000 Christmas bonus, and a small retirement match.

Here’s what makes the decision difficult: my fiancée and I have an almost one-year-old daughter, and we live near a lot of family. We pay $1,600/month to live with relatives. Our daughter has grandparents, aunts, uncles, and three cousins nearby. My fiancée is doing prerequisites for ultrasound school, and her mom has offered to reduce her work hours to help with childcare once the program starts if I contribute another $600–$800 toward rent.

In Washington, we would need a second car, pay market rent, and arrange childcare around her school schedule. We would prefer a trusted in-home sitter for the hours we need. Her mom potentially moving with us has also come up, but that is not settled.

I’m willing to work hard for a few years to build savings and improve our family’s financial position. My fiancée is open to moving, and we’re both feeling more comfortable with the idea of in-home childcare.

But I genuinely love living in South Florida. I enjoy the sunshine, beaches, and having our people nearby. I previously lived in Pennsylvania and really disliked the dark, cold months. My fiancée has never lived outside Florida, and we don’t currently have family or friends in Washington.

For people who moved away from family with a young child for higher income, was it worth it? What expenses or family challenges did you underestimate? For anyone familiar with the area, how is your daily life?

For fellow EM PAs, I’d also appreciate thoughts on the sustainability of that schedule and productivity. I’m trying to assess the financial upside realistically while giving proper weight to the life we already have.

TL;DR: ER PA considering leaving South Florida, where I could earn ~$166k at 150 hours/month, for a Pacific Northwest job with potential earnings of $250k–$300k at 160–170 hours through RVU bonuses and overtime. The lead PA reported making ~$320k last year. We have a young daughter, $1,600 rent, nearby family support, and a lifestyle we love in Florida. Moving would mean higher expenses, an in-home sitter, and adjusting to dark winters while my fiancée attends ultrasound school. Is the financial upside worth leaving that support system?

Edit: grammar and wordiness

Hi all!

I have an offer for a niche specialty (good pay, good hours, benefits, location decent) ~3 months before graduation but it’s not really the specialty I want to do as a new grad. I really really want to do EM or IM (for multiple reasons, I like the inpatient hospital setting and I really want to grow my general clinical skills and be able to do procedures).

I have a couple weeks to decide - and I know I would rather do IM/EM but I’m scared I will be throwing away this opportunity waiting for those positions to interview. For context I just started applying to these specialties, still have 3 months before graduation. NYC area. Thanks in advance, any advice appreciated!

Hi everyone! I graduated in May, passed the PANCE, and am starting my first job as a neurosurgery PA in about a month. I honestly haven’t done much studying since graduating and am wondering how best to prepare.

Should I be panic studying before I start, or is it better to focus on the basics now and dive deeper once I’m on the job? For those in neurosurgery, what topics or resources would you recommend prioritizing beforehand?

Would love to hear from other new grads who have been in a similar position!

I work FT family med at an FQHC. I'm looking to supplement my income with a telehealth gig. I have an interview with One Medical today but i was hoping to get other people's recommendations.

Ideally, i'd like a very flexible position where I create my schedule. i.e i choose which weekends to work.

Licensed in California

Located in southern california

Thank you in advance!

Leaving my job next March, with that being said I want to use my PTO before my departure. I have a lot so I won’t be able to use all of it, but I want to make my last clinical day say the 5th of the month and then I want to use 2 weeks PTO for an international trip and officially depart with the hospital on like the 20th prior to starting new job on the 22nd.

Is this bad form? Should I feel like an asshole requesting this? I feel like this is my PTO I was given as part of my contract so I should be able to use it as I please but how does this look from an employer standpoint?

Thanks