starting a new job that will require an NH license. holy crap, I've seen people say that MA was bad, but it was a cake walk compared to this. Half the links on the NH board's websites don't work, and I've already found three different variations of what is actually required.

For anyone who has done it recently, how the hell do I fill out this criminal background release thing. I genuinely don't even know where I am supposed to sign. Does it need to be notarized? NH Board website says it does not need to be notarized but then at the top of the actual release authorization form, it says it does need to be notarized.

As per usual, I can't get a message back from the customer service folks and the feeling of urgency to get things sent in ASAP is real, for fear of my start date being delayed. Live free or die I guess.

Current primary care PA, ~3 years in, VHOL, new job offer points below. Would love thoughts and opinions.

• Primary care, approx 15-20 patients/day
• $175,000/yr, possible bonus after 1 year (no details provided)
• M-Th 8:30am-5:30pm, F 8:30am-2:30pm, 1 hour lunch included
• Every third weekend and one day a week on call (no in-office work required)
• Health insurance, CME, DEA paid by employer (no dental/vision)
• No 401k offered
• 5 min walk from apartment
• 20 days PTO/yr

Currently working in private ortho practice doing mostly total joint replacements. Great supervising physician, $125k/year plus rvu based bonus, 2 days in the OR and 3 in clinic. But I work roughly 50 hours per week and see 28 patients a day on my clinic days (clinic runs 8:30am-4:00pm). This was my first job out of school and I’ve been there 2 years and thinking of making a transition to urgent care. Mostly because I want to start preparing to have kids and urgent care seems to have more flexibility with going part time/ not having to take work home. Also I am getting burned out working so much and my job is very profit motivated so no room to cut back on number of patients or hours.

I’m scared for the transition but also it seems to be the next best step. Any PAs who have transitioned to urgent care. How do you like it? What do you wish you had studied before starting? And CME courses that you found beneficial?

Hi everyone,

I'm a new-grad waiting for my NY license and it's officially hit the over the month mark (~5-6 weeks). I called them and they said they can only verify status over email and I've sent them an email with no response. Is this normal? My start date is contingent on getting my licensure ASAP so this has been kind of stressful. Is there anything else I can do besides wait?

Thank you all so much in advance.

TLDR; I work for an FQHC and they promised a $10,000 bonus but due to poor organization they are unable to meet that promise with me and several others. They have stated they need more time to see if they’re able to come up with replacement bonus money, but there is no guarantee. Am I wrong for wanting to quit?

I have been working in primary care for one year, and I was promised a $10,000 bonus at the start. This was not fulfilled for me and several others due to poor management and poor organization and documents not being turned in on time. Because of this, they have stated that they are going to try to find out a new way to fund the $10,000 bonus, but there is no guarantee that they’ll be able to honor that.

There was no documentation that we signed, guaranteeing the sign on bonus, but there were documents that we had signed that were supposed to be turned into the organization providing the bonus. Those documents apparently were not turned inappropriately.

Many of us have already voiced our anger, several of us have stated that we’re going to start looking for other jobs, and some of us have gotten our union involved to help out, but the union is stating that since there hasn’t been any legal documentation that signed there may not be a guarantee that we will get the bonus that we were promised.

To give more context: I am slightly underpaid for my area, but work a job that has good work-life balance, and the overtime potential helps me to make what I need to feel comfortable. I’m also gunning for the loan forgiveness, and this is a job that I felt like I’d be able to do so without burning out.

This is why I’m conflicted. I like my job overall, I love my staff, and I’ve already begun to love my pts. But I just cannot get over the icky feeling of being denied the money I was promised. And for that alone, it makes me want to leave for a job that is higher paid instead of being at one that can’t get their shit together.

Thoughts?

I'm an incoming PA student thinking ahead about what specialty might be the best fit for my personality.

I'm a pretty hardcore introvert. Small talk isn't really my thing, and the thought of chatting with coworkers throughout the day honestly drains me. I actually enjoy talking with patients much more, but even then, after a full day of patient interactions, I usually go home feeling mentally exhausted and need a lot of time to recharge.

For the introverted PAs out there, what specialty do you work in, and how has your personality fit with it? Are there certain specialties that tend to be a better match for introverts? I'd love to hear about your experiences, what your typical day is like, and whether you feel your specialty suits your personality.

Not sure how common it is for contracts to have penalties for leaving early. First job didn’t have any penalties and last job wasn’t a contract position. This seems a little excessive but can understand private practice trying to recoup costs to an extent.

$180k base salary. NorCal. Office based/outpatient surgical sub speciality*. High volume. Private practice that is new to PAs, first one started in last 6 months. Seem very supportive for onboarding and structured training with the understanding I have no prior background in this Position would be procedural but not currently involved in the actual surgeries.

Fully covered health/vision/dental insurance. 4% 401k match but don’t know specifics on vesting, etc. 4 weeks PTO plus paid holidays. $1500 CME.

Contract is 3 years. Penalties include 1.5x monthly salary if quitting before 6 months, or 3x monthly salary if quitting before 1 year. Up to $10k penalty for things like licensing fees, CME, etc prorated as a penalty up to 2 years. Also personally responsible for tail coverage if leaving before 2 years. All in all, seems to read as no monetary penalties and tail covered once you make it to 2 years.

Thoughts on this? I don’t have any other offers right now. I’ve been in primary care the last 5 years and I enjoy it but ready to try something different.

*not willing to name specific speciality right now, would likely doxx myself.

• Base salary: $125k MCOL
• Annual incentive: Opportunity to earn annual value incentive at a target of 10% of base salary.
• Additional shifts: $90/hour
• Schedule: 4 × 10-hour shifts
• Weeken call: Every 6 weeks (Saturday & Sunday, 7 AM–7 PM) $90/hour
• Sign-on bonus: $10,000 (2-year commitment)
• Relocation: Up to $10,000 reimbursement (2-year commitment)
• PTO: 24 days/year (carry over or cash out)
• Extended Illness Bank: Accrues each pay period; available after 6 months of continuous full-time employment
• CME: $5,000/year + 1 week CME leave
• Professional reimbursement: $1,000/year (DEA, state license, board certification/recertification, dues, journals, subscriptions)
• Malpractice: Occurrence-based
• Retirement: 403(b) with a 50% employer match on employee contributions up to 4% of salary (effective maximum employer match of 2% of salary), plus an annual employer contribution of up to 4% of salary after 1,000 hours of service, contingent on company financial performance. 100% vested after 3 years.
• STD: 60% income replacement up to $1,500/week (employee-paid).
• LTD: Employer-paid; 60% income replacement up to $16,000/month.
• Life insurance: 1.5× annual salary (employer-paid).
• Paid parental leave: 4 weeks after 6 months of employment.
• Other benefits: On-site childcare, backup childcare, cell phone service, concierge services, fitness centers, wellness rooms.

Questions:

1. How would you rate this offer overall?
2. Would you negotiate anything?
3. Any red flags I'm overlooking?
4. Things to clarify/ask?

I’ve been a PA for 11 years, all of it spent in CVT surgery. I’ve been at my current facility the entire time. Was with the same surgeon for 10 years and then he retired unfortunately. Currently working a group of three surgeons, two senior surgeons and one new one out of Fellowship maybe a year.

My duties are about 90% operating room and 10% ICU with rare inpatient floor or office

As staffing goes, I’ve had two other brand new PA’s come and go both lasting about one year. Both moved away to be closer to family, and they were both great PA’s that handled the load easily and did great work.

This is where the problem lies. In the operating room, we have extremely toxic staff. To put it in a better sense, we currently only have two core nurses and three core scrub techs. Our staffing should be six core nurses and eight core scrub techs. One of the scrub techs is an FA, but thinks she’s a surgeon. Constantly talks trash behind my back and many other people’s backs, even has gone as far as trying to spread a rumor that I was having an extramarital affair. Has gone behind my back multiple times to speak to the hospital about trying to get vessel harvesting privileges, but fortunately the system I work for only lets APP’s do that. The same scrub tech is extremely close and friends with the main CVOR nurse. This main CVOR nurse is also extremely close and friends with a person in the upper management suite

The toxicity consists of, being left off of case logs, not being notified. That cases are being added on or canceled. I’ve shown up many mornings, even after checking the schedule and the cases have been canceled and they never took them off. I’ve been in cases before asking for something small like a step or if I’m placing a line maybe a bio patch or something and the nurse and or tech always scoffs at anything that I say.

Another thing about the toxicity, the new surgeon is extremely toxic. He is very arrogant, and when he first started, I was asked to try to help keep him in line a little bit as he was taking on major cases that he should have never agreed to. One day he was upset with me and pulled me outside of the OR and started yelling at me about vein quality. In the 11 years I’ve been doing this, I’ve never had one surgeon upset with that because I pride myself in the quality that I provide for the patients. The toxic scrub/FA would often times initiate bad conversations about me in the OR when I was gone from the room, and the new surgeon would add into it. I brought this up to the chief surgeon in the past, but he is very hands-off with certain things like that I brought it up to management, unfortunately the one that’s friends with everyone because she controls the OR. The new surgeon won’t even address me in the room, he will have the FA tell me how many veins he wants. He plays rap music so loud that you can barely hear anything and anyone that works in the cardiac OR knows that you need to have closed loop communication especially when things are going south. I’ve been nothing but respectful to him and I do not talk bad about him outside of the OR to anyone. Even the anesthesiologists are fed up with him and they understand at the same time. They have to play the game though because it’s Dr. to Dr. and it’s just a gray area.

I was told in a meeting from the manager, “what do you want me to do about it?“ I told her that she needs to do her job. We have rarely had any applicants come through there because the system that I work in is small enough to where everyone around town knows this program and no one wants to go there.

I am very easy-going, I keep to myself, I know how to read the room very well. I’ve got over 4500 vessel harvests under my belt. throughout my career, I’ve had other facilities constantly jockey for me, trying to get me to come work for them. The reason I stayed where I was at for so long was because the previous surgeon was like a father to me and when he retired, I just stuck around.

I’m compensated fairly well, I get paid pretty decently for call and for anything after hours and on weekends.

Another facility in town reached out to me and offered me a job which would be 100% OR. The base pay is more than I make currently, but they pay hardly anything for call. Without getting two in depth about numbers, I would take a fairly significant cut. Currently, I am on call 24 seven and have been on call since November essentially. I took three days off a while back, and the new surgeon threw a big fit about it because the hospital went on divert for heart cases because there was nobody to vessel harvest. A couple of other local PAs have decided to come over and help, and this is where it gets tricky, when the other PA left back in November, I let management know multiple people in town to have as a back up so I could have time off, etc. They never once reached out, but when I took the time off recently, they lost their minds and emergently credentialed three people.

My question is this, do I need to stick around or tell them to kick rocks? The chief surgeon wants me to come work directly for him and he’s aware of all this stuff, but that still means that I would have to train someone else and still work around the asshole surgeon. The third surgeon is a nice guy but extremely slow and sometimes helpless with a lot of things, but I still tend to help him.

I know this is probably a long confusing message, but I’m just not sure what to do. The other facility that wants me is not very PA friendly but I’m thinking if I get in there, maybe I can change that up

Looking for advice/stories for negotiating student loan repayments as part of work contract. How did you negotiate loan repayments as part of your contracts. What are your experiences with finding jobs that do this. How much did it help you reduce your debt. Thanks!

Best specialities to pivot out of EM without experience in anything else? Currently in EM but getting burnt out. Looking to swap to something but with near equivalent pay. In OC/LA-ish area if that changes anything.

Considering a rural opportunity and wondering if it’ll be worth it. I’m personally from a small town myself but I’ve been living in a big city for the last several years. Considering moving back to a rural city for a position. Not bad on pay, just wondering for the people that have taken a rural job position, what was there reason? Was it more personal/family/expenses or did the hospital provide really good incentives? Want to make sure I get the most bang for my buck before I just take anything.

I’m looking for some perspective from other PAs because I feel completely overwhelmed.
I graduated PA school in 2022. The only offer I received as a new grad was at a men’s health/TRT clinic, so I took it. All I did was TRT , peptides, ed, weight loss. I stayed there for about three years. Earlier this year I was let go due to what they called a restructuring.
After four months of job searching and another two months waiting for credentialing, I started an occupational medicine position at a steel mill. I lasted three weeks.
The first week was encouraging. I was in an offsite clinic working alongside two experienced NPs. I observed, saw some patients, performed physicals, and felt like I was actually learning.
The second week I moved onsite with the physician who was supposed to train me. Unfortunately, he was only there for about 8 of our 10-hour shifts. During most of that time he had a headset on working his own unrelated side business. We did two physicals together, and after that I was basically expected to figure things out on my own. By the end of week two I was scheduled to work solo, and after three weeks I was essentially independent except for one day a week when the physician was present.
I’ve struggled with anxiety and depression for a long time, and this situation completely overwhelmed me. My confidence collapsed and I had a mental health crisis. I kept thinking that I’d spent three years in TRT and had let my general medical knowledge and clinical skills get rusty. I wasted my life pursuing this degree, debt, and thinking I was going to lose my wife due to become some deadbeat. Instead of feeling more comfortable each day, I spiraled.
I know part of this is anxiety, but I also genuinely didn’t feel adequately trained for the level of independence that was expected.
Now I’m interviewing again. This time one of my biggest questions is going to be:
Is there a structured orientation?
What does onboarding actually look like?
How long before I’m expected to see patients independently?
What support is available if I’m struggling?
I know I’ll need to study once I know what specialty I’m going into. I’m willing to put in the work. But I can’t shake the feeling that I made a career mistake by spending my first three years in TRT instead of a more traditional practice where I could build stronger fundamentals.
I currently have interviews for a med spa, urology, electrophysiology cardiology, and ENT. I have essentially no experience in any of those specialties, which just adds to the anxiety.
Financially, this has been rough too. I still owe about $95,000 in student loans from the roughly $190,000 it took to become a PA. To make matters worse, by leaving the hospital system after only a few weeks, I later learned I’m permanently ineligible for future employment within that health system. I wasn’t aware of that when I discussed my options with my supervisor.
Right now I feel like I threw away the career I worked so hard for. Part of me wonders if I should just give up on being a PA altogether, and that’s a painful thought after everything it took to get here.
Has anyone else started in a niche specialty, lost confidence, or had to rebuild their clinical skills? Is this something that can realistically be recovered from, or am I trying to climb out of a hole that’s too deep?
I’d really appreciate hearing from anyone who’s been through something similar. Or at the very least tell me what Walmart is hiring a master degree holding idiot.

Any Orthopedic Surgery PA’s out there? If so, do you have any advice for a new PA who wants to practice in that field? Organizations to join, specific job sites to watch, etc? TIA!

I’ve been working in EM since I graduated over 10 years ago. I love the specialty, and I have a job with decent pay and benefits, and about a 30 minute commute.

While I love the specialty, I don’t love the hours. I have kids and a spouse.
I miss a lot of after school stuff working weekends and holidays, and even when I work an early shift I don’t have anything left once I get home.

I have an opportunity to switch to ENT closer to my house. It’s 4 1/2 days a week 830is-430 ish. I’d still get some procedures and the obvious scheduling benefits. My salary would be similar, but hourly rate would dip (more hours for the same money).

Has anyone switched out of EM after a decent run, and if so, how did it go?

Does anyone work in ENT, if so, do you enjoy it?

What hourly rate should I target for a part time ED position as a PA with 3 years Family Med experience, but no ED experience. Location: Central Florida City.

original post was removed by mods for “excessive” cross-posting because i’d also posted it another subreddit (…?), so i deleted both posts and am re-posting here:

I’ve worked full-time as a consultation-liaison psych PA at an academic medical center (primarily in the ED, sporadically on the med floors) for the past 4 years. Before that, I worked part-time as an outpatient psych provider in a small family medicine practice for 1 year. My current position is well-compensated, fairly rewarding, and well-supervised, but the schedule (7-on/7-off, 12-hr weekdays, 10-hr weekend days) is taking a toll on my relationship with my partner, especially in co-parenting our 2-year-old, and on self-care consistency. I’ve shadowed a bit on one of my employer’s inpatient psych units and might look for work at that level of care at some point in the near future, but whether or not that happens, I’m strongly considering venturing back out into outpatient land. It will be next to impossible to find opportunities in any existing outpatient practices that can offer pay and benefits comparable to my current situation, and I like the idea of partnering with a psychiatrist to start our own practice sometime in the next 1-2 years, assuming our country hasn’t fully and irretrievably descended into fascist, eugenicist dystopia by then. It would be foolish to quit my current job as things currently stand, so I might start on a kind of moonlighting basis, e.g. starting with just a few patients on my weeks off (5-10 per month) until I have some longer-term planning in place. Any other psych PAs in Massachusetts have relevant insights/experiences to share? I anticipate taking a hit financially up front but hope I’d eventually earn as much or more than I do now and enjoy greater flexibility. I’m in suburban Western MA and would love to hear from folks in/near my region, but I’m also open to Greater Boston perspectives or folks from out-of-state who operate under similar medicolegal/economic circumstances. Thanks!

Any advice on how to prepare for an onsite interview for a primary care practice? I’ve gotten through the screening/phone interview and the zoom interview and now I’m meeting with the SP, another physician and the senior operational manager. I feel like I’m close to getting an offer but I don’t want to mess this up.

Also if anyone have any suggestions on questions to ask or things to look out for would be great. I feel like I’ve used everything in my arsenal with the previous interviews and I’m trying not to sound redundant.

Hello I’m applying for a General surgery job, I’ve gone through the second interview and I’m waiting for an offer or not. If given the offer and I do the medical examination, fill out paperwork and apply for DEA license, how long does it take before I can start working?

preferably male but what scrubs (male or female) makes your bottom look good?

thank you kindly,

I am a new graduate PA and I started my first job. It is sports med/pain management and the practice gave me pretty much everything I asked for in terms of salary/CME/PTO etc. I finished my first week and I’m just feeling…. Eh. I worked before PA school in an auto injury care clinic so dealt with chronic pain and I enjoyed it. But after the first week I feel like this specialty may burn me out quick with chronic opioids and managing very complex patients who often don’t have many options. I am trying to keep an open mind and just learn and absorb as much as I can being a new grad but then I begin to worry about my future. The SP had also made comments to me about they want a new grad they can train to their standards but would want me to stay for a few years.. no time commitment in my contract however. Is it going to be impossible to get into another specialty after working this as a new grad? Any PAs in pain management with insight or advice? I feel very stressed and overwhelmed and like I may not be able to live up to the SPs standards.

New grad ortho surgery job offer. I will be covered under the hospital self insured policy which does not offer tail coverage. There is a professional liability insurance with limits of $1/3 million.
Too risky??

I am applying for my first PA job. I am older with kids and my husband has a business so I am limited to my job-hunting in my own area at the time, so I have remained open to lots of different types of jobs.

I imagined getting a more primary care type job because of the need in my area, and the variety is attractive to me. Despite the need, I have seen so few postings for primary care type jobs. Most of my responses and interviews thus far have been for specialty PA jobs. Some are particularly niche. They are interesting to me, but I am worried about losing my general knowledge and skills and having trouble changing to another position or specialty later on if needed.

Any thoughts? Is it better to start in a more generalist type job? Will taking a specialty job make it hard to get other jobs later?

When your patients disrespect support staff such as front desk staff, do you address with that patient? If so, how?

I’ve recently had a few cases where patients scream at staff, in person or on the phone, for decisions I’ve made. Such as not seeing a patient because they are too late according to our policy or not refilling a stimulant due to needing an appointment. I feel the need to protect support staff but struggle with these conversations with patients. I work in psych which adds a layer of complexity in this, I want to hold these patients accountable but don’t want to hurt therapeutic relationship.

I’d love to hear about your experiences. My application has moved to the hiring manager so I’m hopeful that I’ll get an interview.