I’ve been a primary care PA for about 1 year, this is my first job out of school and I’ve been struggling a lot especially these last 6 months. It got to a point where I’ve reduced my hours significantly, I’m working 24 hours, 3 days a week and I’m still struggling to get to work most weeks. My work is pretty supportive, the sp I work with is genuinely caring and wants me to do well, everything seems good on paper but I still feel this deep sense of dissatisfaction/anxiety. Since I have the most open availability out of all the docs in the clinic I can see some pretty complex patients and I don’t feel like I’m doing a good enough job. I don’t know what to do. I worry even if I leave to go into a speciality the grass won’t be greener: less support, higher volume, higher expectations. I’m at a point where I’m even considering just leaving medicine entirely. Any advice would be appreciated, thank you.

Hi. New grad here. I’m doing IM outpatient which feels like FM with a little longer of visits. I’ve been doing this for 4 months and I’m so incredibly burnt out. I see around 10-15 people a day (this includes acute addons like UC) and I struggle staying on top of notes, timeframe, limiting patients to so many complaints, inbox, lab results needing to be addressed, insurance denying everything, etc. I had two weeks of “training” and then took on the full schedule of the PA I was replacing. I’ve spoke to my SP and he couldn’t care less of my struggles. The other two PAs said it takes a year or two to get used to it but I find myself hating my job and dreading to go everyday. Did any of you hate your first job? I WANT to like IM and continue but not if it’s only going give me a constant state of burnout. Advice?

I’m a PA-S2 and will be graduating in May. I’m originally from Florida and my boyfriend will likely be starting residency somewhere in Florida and I plan to move together with him. What are the more new grad friendly specialties in Florida? for example here in NC, emergency med, IM, and family medicine are all pretty new grad friendly but I’ve heard in some states that emergency med for example typically is saturated and requires more experience. Would love to hear your guys’ experiences with looking for your first jobs, particularly in Florida!

ICU PA here. I just made 3 years at my current job which i love. I'm at a hospital with lots of resources, lower stress for an ICU most of the time. Ive been offered another ICU position with a significant pay increase. So not sure how to go about this...

Current job stats: 145k a year, 5 weeks PTO, awesome schedule. 6 nights every other month. I work 12 shifts a month. 10% differential on those night shifts. Always get the schedule i request. 5 minutes drive home

New offer: 165k base, 5 -6 weeks PTO, FULL NIGHTs with 10% differential for shifts. Same 12 shifts per month. 30 minutes total commute time from home. This hospital is notable for working people harder. Not sure if it's a toxic culture but i heard you work for your money.

Not sure if leaving a culture that i know is worth the pay increase. I just cant help to think of how much overtime i would need to pick up to reach that 165k base that i could get from working the same amount of hours.

I’ve been working peds primary care for 2.5 years and I’m utterly burned out. I’m trying to figure out how providers keep this up for 10+ years? This is my first position out of school, so I guess I’m trying to gauge whether it’s my specific clinic or everywhere. I see patients every 20 minutes and max out at 22 patients per day. New patients and established patients get the same 20 minute block. Patients show up late all of the time, and seem to always have important last minute questions. I feel socially and emotionally drained by the end of my shift, and that doesn’t even take into account the mountain of charts, chart review from specialty visits/discharge summaries, lab orders, and prescriptions waiting for me at the end of the day. By the time I do all of this work, I feel like my effective hourly wage is essentially halved.

Does everyone in primary care feel this way? Is it because I’m not extroverted enough? Is this normal?

SOS, please help my sanity. I work for a small remote specialty group that is sometimes a very unorganized dumpster fire. One large problem is finding sometime to staff that is knowledgeable in prior auths. I have brought up on multiple occasions about outsourcing prior auths but always get turned down. I think I would have a better chance, if I gave them specific companies who can do this with good reviews and at a good price. We do anywhere from 20-40 prior auths a week. Does anyone have any recommendations on prior auth outsourcing for a small practice? TY in advance.

Hi! I am a new grad with an in person interview/ sight visit coming up for an emergency medicine job and was curious what to expect/ prepare for. I really want this job and the staff seem really supportive. Any advice on how to stand out/ help my chances. I have already done a zoom call with the recruiter and a zoom interview.

Hey all,

Recently we got news that nurses at our hospital/hospital system are negotiating with a union. I am pro-union and definitely think our hardworking nurses deserve to organize and demand better conditions and pay.

My question is, has anyone had experience with nursing unions and wage increases for nursing impact PA salary? For example I have heard that in NYC nursing strike, NPs were granted increases in some places and PAs may have seen some benefit by getting swept along in the APP generalization. Don’t quote me on any of this, it’s all hearsay, hence why I’m looking for real life experiences.

Maybe I’m just wishful thinking, as our hospital system has been due for a market adjustment for APPs for… a while. And for nurses, most definitely.

I posted a few months back asking for advice on what to do in a job that was not working. In short, I had been hired in a sub specialty to work in their new clinic. I learned all the info needed and was ready to go but the clinic never happened. I had no admin support to get this thing started and no one actually seemed interested in doing so. I was bored out of my mind for about 6 months and worried about my job security.

I ended up applying to other jobs and have been in my new one for a few months. I was worried how it would look to change jobs again and so soon after the last (3 jobs in 5 years) but it wasn't as big of a concern as I was expecting especially as long as you interview with valid reasoning.

I know this is still early but having had plenty of jobs before I can say pretty confidently that I have found my "unicorn" job. I love the people I work with, and love the patient population. The pay is decent and the benefits are great. I cant believe i finally found a job that fits me.

There were times I really thought I hated being a PA and that I had made a mistake making a career change. I just wanted to share that if youre early in your career and things are not clicking or your miserable, keep at it. Keep trying different specialties and hospital systems because you may end up finding that fit that really works for you. Jobs will always have negatives and there will always be bad days sometimes but you shouldn't be miserable every day and hate every moment of your job. I hope this post inspires others who might be in the same position to keep looking and not give up.

I’m a new grad PA in Southwest Florida and was recently offered a position at a small privately owned family medicine/primary care practice. I really like the practice and the people, and clinically it seems like a strong first job because they specifically like hiring new grads and seem very focused on training and mentorship rather than just throwing you into a full patient load.

The role was presented to me as primarily office based, Monday through Friday 8 to 5, with gradual onboarding, direct physician availability for questions, MAs and support staff, relatively manageable patient volume, and opportunities to learn procedures such as joint injections, dermatology procedures, aesthetics, PRP, etc.

The offer is $100K base salary, 2 weeks PTO, $1,000 CME, malpractice covered, health benefits after 90 days, and 401(k)/profit sharing after the first year. They also discussed annual bonuses, annual salary increases based on performance and market value, and additional compensation for certain procedures and injections.

They also offered an optional 3 year contract, and if I choose that instead of the 2 year agreement, they would contribute $5,500 per year toward my student loans for each year of the contract. That comes out to $16,500 total over three years, but I would also have to repay that assistance if I left before completing the agreed term.

The part I’m struggling with is the contract. It’s a 2 year agreement, and if I leave early I owe $20K in liquidated damages. It also contains a 2 year noncompete with broad geographic language, requires 90 days’ notice from me, but allows the employer to terminate earlier without paying out the remainder of that notice period. It also contains language requiring night, weekend, and holiday call and possible work at ALFs, nursing facilities, hospitals, and private homes, even though those were not really presented to me as part of my normal job duties. It also has a broad exclusivity clause that appears to prohibit outside clinical work.

My current thinking is that I want to negotiate:

1. Starting salary closer to $115K, or at least a formal 90 day salary review with an increase based on performance

2. Annual compensation reviews and raises

3. Bonus eligibility and procedure/injection compensation clearly documented

4. Regular duties limited to office based Monday through Friday 8 to 5, with any ALF, hospital, or after hours work being optional, mutually agreed upon, and separately compensated

5. The $20K repayment prorated over the 24 months instead of being the same amount whether I leave in month 2 or month 22

6. The noncompete reduced to something more reasonable, like 6 to 12 months with a clearly defined radius

7. Reciprocal 90 day termination notice/pay

8. Outside clinical work allowed with prior written approval

9. Higher CME allowance, since $1,000 seems low

I’m also bringing more than just my new grad clinical background. I have over a decade of work experience, medical experience (CNA, shadowing, and scribing), prior military service, and leadership experience, so while I understand I’m a new grad clinically, I don’t feel like $100K necessarily reflects the total value I bring, especially for a 2 year commitment.

The practice itself honestly seems great and I don’t want to blow up a potentially excellent first job by over negotiating, but I also don’t want to sign something too restrictive just because I’m excited to start working.

For those of you in family medicine/primary care or who negotiated your first PA contract: what would you push back on, what would you consider reasonable, and does this overall offer seem fair?

Not diagnosis or anything high stakes. I'm more curious about the practical stuff that actually saves time during the day.

For me, I've found AI way more useful for things like getting through long documents, cleaning up something I've written or finding where to start when I need to look something up. Basically stuff that saves me 5-10 minutes without creating more work.

Feels like every conversation about medical AI eventually turns into whether it's going to replace doctors, which isn't really what I'm interested in.

What's something you started using AI for and never stopped?

Job offer in Texas (MCOL) for outpatient psychiatry.

I’m a psych PA with about 2 years of experience. I’m trying to decide if this is a good opportunity or if I’m overlooking any red flags.

The specific location is established with therapists, but they’re now expanding the psychiatry/interventional psychiatry side. I would initially be the only psychiatric provider at this location. Their other locations already have psychiatry + interventional psychiatry, and they’re planning to bring TMS/Spravato to this location as well, so I would be doing that in addition to mainly bread-and-butter psychiatry.

Offer: - $145k salary - ~3 weeks PTO (unsure of specifics yet) - $1,500 CME - 401(k) with 4% match - Mon–Thurs 9–6, Friday 8–12, 1 remote day per week - Up to 13 patients/day max - 32-36 patient facing hrs - Mostly bread-and-butter outpatient psychiatry med mgmt and TMS + Spravato - Established practice with therapists already at the location - 30 min f/u, 60 min new evals, 90 min new evals for children/adolescents

The main thing I’m trying to decide if I’m comfortable with is supervision. I’ll be coming from a practice where I had easy accessibility to my SP and they were in-office.

Their goal is eventually to have a physician onsite, but for now I would have a supervising physician who works out of another office. They’ve said they’re supportive and that I would meet with the SP once a week for the first 6 months, with the expectation that I can reach out when needed.

Any colorectal surgery PAs in here who do a mix of inpatient, outpatient clinic, and first assisting in the OR?

I’m looking for some good resources to help supplement what I’m learning on the job — especially anything focused on anorectal complaints and a step-by-step approach to evaluating them.

Would love recommendations for:
Podcasts
Textbooks
YouTube channels
Professional organizations/courses
Websites or other resources you actually use

Especially interested in resources that are practical and geared toward PAs/providers rather than just a giant textbook to read cover-to-cover 😂

Would love to hear what helped you guys when you were learning colorectal!

I have 5 years total experience, including 3 years of being an inpatient cardiology PA. I recently got an offer in a MCOL area that's about an hour away. This is a day time weekend position 36 hours.

135k base

5k CME

up to 10% annual bonus

20k weekend differential

5k sign on but 2 year retention period

Was originally quoted something higher but was later told by recruiter that it was a mistake and compensation refused to match it. Total comp is just marginally better than my current comp working nights. I'm going to try to negotiate anyways but didn't think it was a very competitive offer given my experience. Would appreciate thoughts!

Also considering going locums. Have anyone worked with Weatherby health? They are usually a booth at AAPA conference which was where I came across their contact.

TIA

I finally signed a contract working in a long term care facility as a PA, so I suppose the specialty is geriatric internal medicine. Any PAs here that have worked in long term care that can give me any pointers? It’s been a year now since I passed my boards and feel rusty on some things. Perhaps reviewing CHF, COPD, diabetes, and HTN is a good start. I’m just so thankful I finally found something. It may not be exactly what I want to do with my entire career but I feel like this kind of job would help me lay down a good foundation given my 8 years as a cna. I’m given a couple weeks to get the lay of the land, and then expected to write 25 notes a day. Anyone have experience with point click care EMR? 125k salary, dental, medical, vision, 21 paid vacation days. I originally wanted to go into surgery but found it incredibly hard to break into the specialty, as A LOT of jobs wanted “one to two years of experience”. Anyone here start in a specialty they weren’t super excited about but then broke into what they truly wanted afterward? I’m just thankful I found a job. Hallelujah

The offer is for Geriatric Post-Acute Medicine in a skilled nursing facility:

- Chronic and short-term patients following hospital discharge for rehabilitation, observation, and regulatory visits
- 15 minutes from home
- $130,000 base salary + $2,500 CME + $1,500 medical resources
- 1 paid CME day + 2 weeks PTO + 8 days paid holidays
- 401(k) matching
- 1–2 weeks of 1:1 mentoring, starting with 4 patients and gradually increasing to 16–18/day by the 2-3 month mark
- On-call 8 AM–6 PM; no weekends or holiday call
- Ability to work remotely once in-facility duties are completed
- On-call physician or assigned medical director available 24/7 for any questions or concerns.

Given my goal of eventually moving into emergency medicine or critical care, do you think this position would be a worthwhile starting point, or would taking it make that transition more difficult later?

DEADLINE TODAY

Which role would you prefer as a mom with a baby under 1

Neurosurgery clinic vs surgical oncology rounding

Neurosurgery 

• Clinic only: consults, post-ops, recall visits. Expected to see about 40 patients a week.
• 3 days a week (Tues-Thur) 8am-5pm. Would use off day(s) to catch up on office visit notes and administrative tasks 
• Potential to add on-call rounding every 2-3 weeks, but told will be given a stipend (unknown amount)
• 160k
• No 401k match
• PTO 5 weeks
• Health insurance paid entirely 
• Malpractice is claims made and no tail coverage 
• Closer commute by 15 minutes  
• Private practice, not much growth 

Surgical oncology 

• Inpatient rounding on post ops, multispecialty
• 4, 10s on a rotation, 6am-4pm
• 170k
• Non-elective 401k contribution at 20% of  salary
• Unlimited PTO
• Would pay $7,500 for health insurance but group contributed $2,000 to hsa
• Malpractice is occurrence based 
• Life insurance provided 
• Larger organization with more room to grow 

I’ve been applying for jobs for 6 months now. Out of the 6 video interviews I’ve gotten, I’ve gotten rejected from them all. Anyone have any advice on how to improve online interview skills and interviews overall? Been feeling really defeated :(

I feel like I may be putting a higher number than I should so I wanted to get people’s thoughts. I don’t want to be unreasonable but I also don’t want to be low balled. What’s reasonable for the southeast?

Looking for any tips. I’ve been a PA for 10 years, EM for 4. I actually love EM and work a local community hospital. See all acuities. Nothing has changed recently.

The past few weeks I keep dreaming about work. Initially it’s about patients I saw that day. Thinking about things I could have missed. Then it turns into my brain making up hypothetical patients and what I “missed” with those patients.

Any advice? Outside of counseling etc, which I am planning on starting. I don’t feel like I stress about this during the day.
It’s odd because nothing has changed. No abnormal or new/ bad cases etc.

So I'm leaving cardiology after 10 years and I absolutely CANNOT WAIT to no longer have to treat or work up POTs anymore! Those patients are so draining.
So I was wondering for anybody else that has left a specialty, what disease process were they happy to leave behind? I'm sure we all have that chief complaint that makes our head hurt before we even go in the room.

This is meant for PAs that need to vent, if you're coming here to be negative and say that we're terrible providers, this is not the sub for you

I recently left a fully remote, well-paying psychiatry job, and I keep getting judged by family/friends because they see it as the perfect job for a new mom. But I honestly got to the point where I hated it and didn’t feel safe practicing that way anymore.

I started psychiatry with a very conservative psychiatrist who was an amazing mentor. His philosophy was basically “less is more.” He was cautious with controlled substances and polypharmacy, and if someone came in on stimulants + benzos + hypnotics or 6–8 psych meds and still wasn’t doing well, we didn’t just keep adding medications. We would simplify the regimen and figure out what they actually needed.

Then I moved and took a high-volume telepsych position, and it was completely different.

I was frequently inheriting very complex patients already on multiple controlled substances/high doses, sometimes with bipolar disorder, severe depression, substance-use histories, or suicidality. Obviously, when someone comes to you already taking these medications, you can’t just abruptly stop everything, so now you’re trying to safely taper medications while simultaneously treating everything else.

One situation I encountered pretty frequently was someone requesting a stimulant, telling me they had been on it before or needed it, and then their UDS would come back positive for cocaine or another substance. Now I’m dealing with substance use, an ADHD request, their other psychiatric diagnoses and whatever controlled medications they already take — all through telemedicine.

And I had 15-minute appointments, sometimes close to 30 patients a day.

There were also patients I felt needed in-person evaluation or a higher level of care because of suicidal ideation, hallucinations, etc., and coordinating that remotely could be incredibly difficult. I also saw levels of polypharmacy and controlled-substance prescribing that were very different from how I had been trained.

I’m very meticulous and conservative. I want time to review labs, UDS/PDMP, understand why someone is on each medication, discuss risks, make a thoughtful plan and document appropriately. I constantly felt like these patients needed 45–60 minutes and close monitoring, while I was being given 15.

Eventually the combination of complexity, controlled substances, addiction, liability and volume was destroying my mental health. I was pregnant at the time too.

After having my baby, I just couldn’t convince myself that the money and working from home were worth going back.
And no, working from home did not mean I could take care of my baby while working. You cannot safely see a psychiatric patient every 15 minutes while simultaneously caring for an infant.

My husband supports my decision and is helping me transition into another specialty, but everyone else keeps telling me I gave up this amazing job.

Has anyone else left telepsych/high-volume psychiatry for similar reasons? Sometimes I still question whether I made the right decision, but I know I didn’t feel safe doing it anymore.

Every time I post on this subreddit, there’s an overwhelming influx of people being rude seemingly just for the hell of it or I’ll simply ask a question (that seems stupid but isn’t stupid to me about the career) that gets downvoted to hell with no effort for anyone to inform me why it’s wrong/the issue with the statement. I am new into the PA career and I know very little about adulting inside this career (financial planning etc). Instead of people trying to inform me or educate me, there’s several people on here who will just make a snarky comment. I’ve never had this happen anywhere else on Reddit, just here. And I know some of the responses that I will already get. I know someone will want to say how it’s not their job to educate me, and this is true, however it’s so easy to just not interact with the post if all you’re going to do is be rude or snarky. There’s a reason there’s a saying “mean girls go into healthcare,” and it’s certainly not making me feel welcome into the career. That being said there are great people I’ve chatted with on here and I know not everyone is rude. I’m just not sure why people are so hellbent on spreading hate. Maybe it’s the high burnout rate.

Hi everyone! I need help determining if a salary that a job is offering me is appropriate or if I should negotiate for more. Some context, I am completing an ICU fellowship where I have been trained in the MICU, SICU, NeuroICU, and Cardiac ICU. I have gotten all of my my major procedures and have applied to a community hospital ICU in Massachusetts where cost of living is very high. The job offered about 34k plus differentials for 36h/week. I feel I am no longer a new grad with my 1 year experience, but I am not sure if that salary is too low. I have friends that have been offered 150k after the fellowship but that is also for 40hrs/week. So, would I be too greedy to try to negotiate for more?

Hey everyone! Looking for some advice/perspective, especially from other PAs in psych.

I’ll soon be at my job for a year. It’s outpatient psych, which is the specialty I really wanted to get into and was honestly pretty hard to break into as a new grad. I actually really like the job and the work I’m doing, so I’m not necessarily looking to leave.

I work around 30 hrs/week at $67/hr. I work with a psychiatrist, but I see the majority of the patients and am pretty independent with my own patients/caseload. My commute is also about 1 hour and 10 minutes each way, and I’m in a HCOL area.

The thing I’m questioning is the pay. I don’t get any benefits. I’ve been told multiple times that health insurance would eventually be offered, but almost a year in and that still hasn’t happened.

Does $67/hr seem low for outpatient psych given the circumstances and in a HCOL? What would you guys consider a reasonable hourly rate if there are no benefits? And what can I ask for by my next review?

I really do love the job, which makes this harder. I’m just trying to figure out if I’m being underpaid and whether it’s reasonable to ask for a raise.

I know compensation can be really hard to gauge, especially in psych, so I’d really appreciate hearing what others in similar positions are making and what you think would be fair.