Transition from PA-S to PA to PA-C with ease: First JOB (Part Two)

As one of the top 5 medical careers, a Physician Assistant job is not hard to find. Picking the best one for yourself as a new graduate can be a process. Check out the previous post on proper steps to get your license and average time for credentialing. Plenty of people begin their career with either a job they truly love and stay there for a long time, while some just take the first job they can due to several reasons not limited to paying back loans. My advice is also to be realistic with what you consider a dream job out of PA school. A job where you’ll learn, have support as well be able to grow are necessary requirement. Remember, you’ll have to show up to work, don’t take a job for frivolous reasons have to spend the next year miserable.

When I began to look for a job, I asked myself these questions:

  1. What specialty did I want? Emergency medicine (#1 choice) Surgery, Family Medicine, Dermatology?
  2. What hours was I willing to do? 9-5? 12 hour shifts (#1 choice)?
  3. Days or Nights shifts?
  4. Where did I want to work? Hospital (#1 choice), clinic, private practice?
  5. How far was I willing to travel for a job?
  6. How much was the salary?

Throughout the process, I found myself compromising on either the travel time or salary, but not on the hours. I knew I did not want a 9-5, five days a week job, which eliminated a lot of specialties that required that (i.e family medicine, certain surgical position, dermatology) but allowed me to explore potential internal medicine positions. I even thought ofย  orthopedic, ENT or neurology as those specialties looked to train new graduates more often than other specialties in my area.

There are different paths to finding a job. Positions recommended by people you know are always great because knowing someone within the organization has proven to help get you closer to an interview than simply sending a resume to the recruiting team. Tell you professors what specialty you’re interested in, or your clinical site supervisor to let you know if there are open positions. These are ways to get information early and apply. I also used Indeed, LinkedIn, recruiters, hospital careers websites and google search engine. There so many jobs opening and many of it will require experience. This could be disappointing, but a few of the time, I still sent in my resume and cover letter. I figured, I had nothing to lose.

Once I started getting positive response from the hiring team, I made sure to prepare my telephone pitch. It included who I was as person, what I was looking for and why I wanted that position. Phone interviews are very common with the recruiters of the hospitals you wish to work for, and it also helps you ask and learn more about a job before going in for a physical interview.

Physical interviews can be nerve wrecking. I remember my first one and my interviewer later told me how she thought I was a shy person (Ha! Anyone who knows me, can attest Iโ€™m the furthest from shy!). Since then, I have tried to allow my true self shine through and while Iโ€™m still learning, I got better. Practice makes perfect!

Some of the questions I asked during interviews included:

  1. What was their training timeline for new graduates?
  2. What is the turnover rate for employees working in the department?
  3. Is there opportunity for overtime hours?
  4. Are they aware of what a PA does and how do they utilize PAs?
  5. Are you mandated to take calls?
  6. Is there OR time allowed for surgical positions?

Most companies will reach out within 10-14 days if they do not offer the position right there to you. This has happened to me! Some may take a while if they’re still interviewing other applicants. Accepting a position is a commitment and most will ask you to sign an offer letter so they can begin credentialing. There are times where you may juggle a few offers and deciding which to accept will depend on what you really want out of the job. Remember, you ultimately decide if a job fits you, so ask questions and be active in the process.

Be aware of what youโ€™re willing to accept and step forward into the next phase of your career. This can be another long and frustrating process, but staying on track will make a difference in how you handle it.

Share and comment below if you found this helpful!

Transition from PA-S to PA to PA-C with ease: Part One

The Long Space between leaving PA school and practicing as a PA-C

If I could get a dollar for every time Iโ€™ve been asked โ€œdo you have a job?โ€ or โ€œhave you started working yet?โ€, Iโ€™m positive itโ€™d help pay off some of the interest accruing on my loans. While these questions are asked out of interest, it is frustrating to explain the long process it takes. This post is the first of two part that will include how to prepare if youโ€™re finishing up PA School and what to expect after you become a PA-C.

Within 60 days of your last day of PA School:

  1. Register for your PANCE as soon as you can. You can take your PANCE 7 days after your official last day of school, but you can register for it from when your program gives you the okay (my school was at least 60days before we finished). https://www.nccpa.net/pance-registration
  2. Create a resume and cover letter.
  3. Start applying for jobs.
  4. Make a schedule for how you want to tackle your PANCE.
  5. Take your BLS/ACLS/PALS course training if you donโ€™t have them or will be needing them in the specialty of your choice.

Officially a PA.

  1. Study hard and PASS your PANCE as soon as you possibly can. Check outย How to PASS the PANCE
  2. Continue to apply for jobs.

Officially a PA-C.

  1. Apply for jobs if you are still searching.
  2. Send in your state registration application. There are usually multiple steps for state registration, read the instructions carefully and pay the required fees. You can start this process while studying for your PANCE. In New York, it cost $115 and you can begin the application prior taking your exam and release your scores after youโ€™ve passed. http://www.op.nysed.gov/prof/med/rpaforms.htm
  3. Sign up for your NPI. The easiest of all things youโ€™d have to do. https://nppes.cms.hhs.gov/#/
  4. Apply for your DEA โ€“ (optional). If your job requires (as most do), your practice may pay for this or waived if working for a state institution. It cost $731 and most people reluctantly pay for this out of pocket. It can take up to 6weeks (Although it has taken less from what I hear) https://apps.deadiversion.usdoj.gov/webforms/
  5. If youโ€™ve secured a job prior to finishing school or while studying for your PANCE, then you continue to start the credential process with your job. Private practices take less time to complete as opposed to hospital settings where average time is 3-4 months.

The delay is mainly due to credentialing. Iโ€™m speaking specifically for NYC here, make sure to keep in contact with the credentialing specialist assigned to you. There is a medical board that must review your credentials and to my knowledge, they meet once or twice a month and if your documents are not in order, you will not be presented and must wait for the next round. After accepting a job offer, youโ€™ll have to complete a series of request. You must be proactive to email, ask for updates and complete all required tasks on time, otherwise, it will delay how soon you can start working.

Each company requirement for credential varies but you can expect the following plus more:

  1. Complete job application
  2. Medical clearance
  3. Recommendation from program director and clinical supervisors
  4. Background check
  5. HIPPA training and other training related to your job
  6. BLS/ACLS/ATLS/PALS etc as needed.

If you have not secured a job, continue to search, apply and interview.

Completing these steps are dependent on the individual, position and company. This is my experience and will be sharing the part two, which will include details on finding a job, deciding and more.

 

 

How to PASS the PANCE

I started this blog post several weeks ago, where I added things, removed some and debated if it was worth sharing with the world. This topic is universal and very subjective because Iโ€™m only a recent graduate who is sharing her one-time experience with the PANCE. The rest of the post will be very informal, so judge very lightly.

These are my views on the topic and everything I wrote about is not going to apply to every student.

Was the test hard? Yes, it was. ย Probably one of the most challenging exams I’ll ever take.

What study tools did I use? I used Pance Prep Pearls and Rosh Rapid Review e-text as my text resource. Hippo education, PPP question book, Smarty Pance and Rosh Review were my resources for questions. In hindsight, I probably couldโ€™ve benefited from an additional study guide, but I am a person who doesnโ€™t like too many sources. Once something works, rarely do I ever want to change it.

  • Rosh: I did all the body system questions, the family, internal, surgery and emergency medicine EORs. I also completed the Mock PANCE to replicate the PANCE in a 5 hour sit down. This was done 7 days before my exam.
  • Hippo: I completed at least 4x 200+ random question per practice exam. I reviewed mostly the questions I got wrong and allowed HIPPO to pick my questions based on my weak areas.
  • Smarty Pance: I did 3 of the comprehensive 225 questions exam during the first 2 weeks of my studying. I didnโ€™t return to use Smarty Pance because it wasnโ€™t as tough as the remaining resources.
  • PPP question book: I only did 160 question out of the whole 600 question book. I was short on time and simply preferred computerized practice question. Although if I had more time, Iโ€™d have done more of these questions because they helped.

Tutor or Exam mode while doing questions? I believe that tutor mode makes me lazy as it helps answer future questions. Simply put, I didn’t do any tutor mode. I timed myself for every exam to build up my stamina. Youโ€™re going to be taking an exam, so start stimulating that and youโ€™ll be ready. Sidebar, I had about 8-10 min in each section of my PANCE to review my exam and news from fellow classmates was how they were running out of time.

Did I take the NCCPA Pretest? ย Yes, I did and totally worth the $50 investment. Honestly, this is the only test that is very similar to the actual test and helps to show where you stand among your peers whoโ€™ve taken it. Do not take the pretest until you’ve reviewed all the topics and at least 10-14 before your exam date. It has a way of unnerving even the calmest students, so prepare for it because you donโ€™t want to waste your money or time taking it when youโ€™re not ready.

What were my weak areas? Pulm, Msk, OBGYN & GU were my weak points. I did terrible on reproductive system because I did not review those topics before taking the pretest. Therefore, it is important to finish reviewing all materials before taking it. TRUST ME.

How long did I study? PANCE is an individual race. You must know where you’re as a student and know what works best for you. I took my exam exactly 6 weeks after my first board review. I put in about 10 hours x 4 days a week consistently in the library and a about 6 hours here and there on days I wasnโ€™t in the library. ย I needed the structure of the library and no distraction to complete what I needed to do. While this worked for me, it can be different for you. I know a lot of people say you’re studying for PANCE while in clinical rotation, but that time is not the same because you’re still focused on passing an EOR & graduating. There must be time set apart to focus on solely studying for the PANCE and that time varies. Average recommended time is 4-8 weeks depending on who youโ€™re. Some students will take it within 2 weeks, while some will take 10 weeks or more. Its all up to where you stand.

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How much time is too much time? Just as you don’t want to take the exam unprepared, don’t take forever either. You can be ready objectively but subjectively you may feel not ready and willing to keep pushing off the test. If your practice scores show that you’re doing well, your pretest places you in the green and you know your stuff, don’t take forever waiting. Because life will be happening around you, which can affect how well you study if you are weeks to far into it.

What topics needs extra attention? The main heavy hitters to know are cardio, pulm and GI. BUT, reproductive health, GU, and professional practice are content areas not usually given much thoughts to and I’d recommend paying closer attention to them. Personally, I treated reproductive health as a topic that โ€œI should know alreadyโ€ but it turns out that I needed to read and put in more effort. ย Do not sleep on professional practice content areas.

Was I anxious? I had a lot of anxiety leading up to my exam and even until the morning I got my result. I was blessed to receive so many great news that morning- my niece was born that morning as well. I believe that being mentally prepared for the exam was just as important as studying for the actual blueprint. We know the material but learning to be a test taker and not doubting yourself is vital. After my exam, I felt like such a weight was lifted and that I could have passed. While thinking about that, I tried to quell my eagerness because you just never know. That was the hardest part and the waiting was bad. Thank God for great friends who will adjust their plans to keep you company after taking that exam!

Does your score matter? I simply have no idea. To me it doesnโ€™t matter if you pass at 350 or 750, because youโ€™re both a PA-C. Your test score doesnโ€™t determine what type of practitioner youโ€™ll be. While studying, ask your faculty what numbers are ideal to be scoring. If you reach out to me personally, I will share what numbers I think can tell you where you stand. I have only my knowledge and other classmates to use as my source for it, which is why I do not feel comfortable sharing it here.

Test taking tips… Do not change the question asked. Answer what you’re given, as it is given. Do not think like a clinician, think exactly like the textbook. Read the last line first and then start from the beginning to help focus. Review questions you answered wrong then find out why you answered it the way you did and learn from it.

Group study or no? I did one group study session with my friends and it was only on cardiology. While it was helpful, we found that we were all at different points and wasnโ€™t going to be productive to keep meeting up. We stayed in touch via video chat, group text and phone call whenever someone had a question, which was very often!

My support system wasโ€ฆ My three closest friends in the program were the people I spoke with the most. I shared everything from my anxiety, study techniques, stress and tips with them and vice versa. I limited the amount of people who had access to me during my study time because I didnโ€™t want to interrupt the energy I had cultivated. My state of mind during those 6 weeks were fragile and life was happening all around me and I had to block a lot of it out. You must do what you have to do sis!

If youโ€™ve made it this far, I hope you learned something and will share my experience with the 2019 PANCE with others. It was an exam that put my 27 months in the program to test, to see if I had what it takes to practice. I am blessed to have family and friends who supported me because it was a tough 6 weeks. No one else will be able to understand what youโ€™re feeling, except for your classmates, so it is okay to take however long you need to be ready. If I remember more helpful information, Iโ€™ll update this post as needed.

B.

p.s: be mentally prepared by learning how to control your anxiety.

p.s.s: If you are a borderline student or struggled while taking your EORs, PACKRAT etc, then I’d recommend taking your time to evaluate your weak areas and strengthen them. Those areas do not disappear just because you’re done with school. The PANCE is too important and expensive to just “go take it”. There are students who don’t pass or do well, thatโ€™s the sad reality of it. It doesnโ€™t mean theyโ€™re not smart, they just must adjust to taking a test. Do yourself a great service and do whatโ€™s best for you. Check how youโ€™re scoring on your practice test; find patterns in questions you get wrong and alter your studying appropriately.

p.s.s.s: the passing score of 350 from last year exam will not yield a 350 this year according to the information regarding the 2019 PANCE. That means the PANCE was harder this year, which has put alot of people on edge. It is neccessary to stress, because you want that “C” bad, but don’t let the stress stop you from effectively studying and learning to be a better tester.

The 2019 PANCE was a real one, from my experience and the passing rate nationwide.