By Jennifer Anne Hohman
Launching your PA career is such an exciting time—all of your hard work and dreams of joining the world of medicine are about to come to fruition. It can also be a challenging time. Setting yourself up for success in your first PA position involves a number of factors, and in this article, I’d like to provide orientation and guidance, as well as advocate for new PAs working with their employers to obtain the support and resources they need to ensure their success.
Interviewing for a Supportive First PA Employer
When I work with new graduates and help them assess potential employers during the interview process, we look for signs of a good environment to start practice in. Asking about their onboarding process for new graduates is always a good idea and an indicator of how much thought they have given to the needs of a new graduate transitioning to full-time clinical practice.
Questions for a prospective employer might include:
- What kind of structured feedback can you anticipate in the first six months through year one of practice?
- How much contact and communication from more experienced clinicians will you have?
- What is your anticipated patient load and how will it change over time?
- When is your first review?
I also suggest observing the demeanor and communicativeness of the clinicians you’ll be working with. Have they mentored new PAs in the past and if so, are those PAs still with the company? Do they seem approachable, flexible, even excited about working with a new PA?
From my discussions with new grads, the top reasons new PAs leave their first jobs are lack of clinical mentoring/“being thrown in the deep end,” and being overscheduled into premature burnout. These are issues to be aware of in vetting your first employer and their conception of your roles and responsibilities. It is a green flag when a robust onboarding and training program is already in place. For new PAs considering an offer from an employer who has not worked with a PA before, proceed with caution. Make sure they have done their research about team practice and have a competent management capable of organizing your onboarding.
Negotiate for Salary & Schedule – Your Wellbeing is at Stake!
After receiving an offer, pay particular attention to negotiating a schedule that is sustainable and mirrors prior discussions with the employer—I’ve found that discrepancies are not uncommon! Try to negotiate a schedule that you can live with in the intense transition period from program to practice. Does the contract define a minimum number of patient encounters per day or shift and are those minimums reasonable?
Confirming that a collaborating physician will be available for your consultation is also key. Many first PA jobs become untenable due to the absence of such mentorship and support.
Review the entire contract carefully, and highlight areas that are unclear, don’t make sense, contradict prior discussions, or seem like red flags. Have these assessed by a trusted advisor, and draft negotiation talking points to address these concerns before signing. This process is so valuable in assuring that there are clear expectations that will guide your employment relationship from day one, and will protect you from accepting an offer with serious red flags.
Acclimating and Thriving in the Workplace
Shadowing before your official start date can be a great way to get acclimated early: ask the employer if this is an option as it creates opportunities to connect with the key people and places. Familiarizing yourself with the physical layout of your new workplace, and your own space within it along with technology you may be using should boost confidence, as is trying out your commute in advance to see what traffic entails.
Try to meet with your colleagues and team members early to boost your sense of inclusion and camaraderie. Everyone you interact with, from front office staff to fellow PAs, nurses, and physicians, will be part of your transition to full practice, and its growth as well as challenges. Take a look at my article on Building Collegial Connections for ideas and suggestions on creating good working relationships with your new team members.
It’s empowering to come into a new work environment with a grasp of its people, culture, history, current projects, and concerns. Seek out mentors who can help you acclimate during your orientation period. This experience will help you be a good mentor to future new colleagues.
Having a defined onboarding process is critical to success in many new PA roles. Ask the employer about theirs in the interview and revisit/clarify as you negotiate an offer. How do you know if they offer a solid one? A good onboarding process should bring you into the practice culture in an intentional, structured way and offer ongoing training, support, and feedback and communication over your first months. Documented benchmarks can also help clarify your employer’s goals and see if they are attainable in practice, or not.
New Job Stress and Solutions
Many of my clients admit that they can be very hard on themselves and that learning to be more self-compassionate and less perfectionistic is an important part of their growth. I think this applies very much to new graduates facing the challenges of acclimating to their first PA job. Navigating not only the clinical aspects but the work culture and its intricacies, and fully transitioning to your new role as a PA is huge!
Being compassionate with yourself, expecting to make some mistakes, and setting realistic short- and long-term goals, especially in conjunction with your collaborating physicians/mentors, will help. Actively seek feedback while at the same time trusting yourself through experience. Many new (and also more experienced) PAs find that planners are an aid to well-organized practice (an example is this one). Becoming an adept user of medical records technology can also bring order, calm, and confidence to one’s practice, especially in its early stages.
The uniquely patient-centered approach of the PA profession can provide sources of hope and positive morale if you focus on meeting patients with an open mind, and being revitalized by empowering and educational interactions with them. Practicing active listening with both patients and colleagues will help build the relationships that make work rewarding. Celebrate every positive, empowering encounter that reminds you why you became a PA.
This is also a time to practice self-care: eating healthy and nutritious meals, exercising, getting enough sleep and taking time for fun and unwinding are all ways of coping with the stress of a first year in practice. Journaling is another self-care practice that can really help with integrating and reflecting on your experiences as a new PA. I suggest that with each entry, writing a response to the following questions:
- What is a new insight/lesson I can take from today’s experiences?
- How did I express my values (such as compassion, advocacy, professionalism, openness to learning and growth) today?
Your support network is also a key to resilience: don’t be afraid to reach out to not only friends and family for support, but also your new grad PA peers who are on the same journey and know exactly what it’s like. AAPA’s Huddle offers a uniquely valuable way to network with other PAs and benefit from the collective experience of the PA community. Joining professional organizations in your state and specialty are also effective ways of building a network of fellow PAs. Being part of these groups can boost your sense of professional identity and morale. Many employers will pay for professional memberships—keep this in mind during contract negotiation!
Jennifer Anne Hohman is founder of PA Career Coach, a service offering individualized career support for PAs. I’m here to help with career and contract concerns and help you craft healthy new practice pathways—contact me at [email protected].