Almost 3 weeks In

I have been employed as a PA for nearly 3 weeks now. I still don't have my license though thanks to the bumbling bureaucrats in charge of licenses here. My company has had me shadowing my supervising physician since I started but they are getting antsy and I am getting bored.

The Occ Med practice I work at sees a lot a trauma because one of our big clients is a meat packing plant. They take cattle from the feed lot to packaging. As a result we see a fair amount of lacerations, hand, wrist and shoulder injuries, and more than a few crush injuries including forklift injuries. We see other patients in other occupations like office workers, health care providers and numerous blue collar occupations. We saw a concrete finisher who got too close to a power line with his float pole and was electrocuted. He lost a portion of one foot and needed a skin graft on the other. Another day we saw four forklift crush injuries that were all pretty nasty.

The breakdown of the types of patients I have seen are:
50% orthopedics
20% neurological
15% trauma/urgent care
15% DOT and employer physicals

There are more than a few patients who are faking or playing up their injuries in hopes of getting some big payout from the insurance companies but most just want to go back to their $12/hr job hacking apart a cow or driving their truck.

I am employed

Well I don't start until 10/18 but I have a job. I will be working in occupational medicine in a small clinic that handles people working in meat packing plants and agriculture, among other things. The physician I'll be working with is really quite nice and likes to teach, and has experience in ortho and neuro surgery. I'll be getting paid a lot more than I ever hoped to coming out of school too. I never would have told anyone I wanted to go into occ med a month ago but I am happy to have the opportunity to make a good living and learn medicine. There will be lots of procedures to perform which is cool. It feels more like occ med/urgent care so I think it will be able to carry my interest. The drive will be long (50 min, all rural highway, interstate), but no longer than when i worked in heath insurance (one hour for 19 miles of interstate highway!). I'll keep posting even though the blog is no longer about becoming a PA. Now it'll be about becoming a confident and effective PA.

Ohhh say can you "C" ?....PA-C that is!

This is the biggest feeling of accomplishment I've felt in a long time. I passed the PANCE and am now a certified PA. I did OK on it...sorta average but the main thing is that I passed. I am now having my license application processed so I should be really official in a couple weeks.

The job hunt on the other hand has been rough. I haven't heard back from the last interview I had a couple weeks ago and I am assuming I did not get the job. It was part-time which was the major draw back but the cool thing was that it was part of a family practice residency so I would have had the opportunity to learn a lot more on the job and have a preceptor to go to with questions rather than having to pull my supervising physician out of an exam room or away from charting to ask them a question. Not too many places around here want to hire a new grad, and here I thought getting a job would be one of my lesser worries!

Here's a run down of post-graduation expenses incurred over the last month through this month:

Review course: $700
Airfare: $200
Hotel: $730
Food: $100

PANCE test: $475

State licensing fee: $300

DEA license: $551

My credit card balances are climbing and my credit score is sinking. My school loans must have just hit my credit report cause my score took a 30 point hit.

I keep telling myself I am not in this for the money, but the debt really stinks.

Anyway, here's to me being a PA-C! Cheers!

PANCE

I am biding my time waiting for my PANCE results. I didn't feel horrible about the test when I was taking it but now that I have time to stew I am starting to worry a bit. Geez would it ever suck to fail the PANCE and have to wait another 90 days to re-take it!

Jobs for new grads are few and far between here and I am resorting to applying for any opening just to get my foot in the door. I am sure the fact that I haven't got my license yet isn't helping. I am a bit pissed that all these loan re-payment jobs here want you to be fluent in spanish. Fu**! I am missing out on employment opportunities and loan re-payment opportunities because there are so many spanish speakers here that they indirectly determine what kind of jobs I can get.

Anyway, I'll be a lot happier when I pass the PANCE and get licensed and start making some money. I know my wife will happier when I can pay for things again.

NEXT!

I have officially graduated! I actually graduated 2 weeks ago but I have been busy with family and and studying. Interestingly, graduating felt very anti-climactic. Maybe it's because I have so many other things to accomplish in order to practice? It was a bit sad for me to realize that I will never see some of my classmates again. We spent so much time together and shared so many unique and trying times that I feel there will always be a bond between us.

Last week I went to a review course for my certification exam. We were in "class' 13 hours a day and had a 2 hour test each evening. It was exhausting but I think it will be worth it in the long run. Tomorrow I have a 2nd interview with a family practice group - more about that later. I take the PANCE next week. I think I should pass based on my tests at the review session but I am studying a bit more between now and then just to shore up weak spots. Wish me luck and put some good vibes out there for me the morning of the 9th.

Balance?

Many readers have asked how I balanced my school work with my family life. The cut and dry answer is poorly. I went into this afraid I might fail. As a result I put 80% of free time the first year into studying, maybe more. As a result I didn't fail. I did piss off my wife considerably and my son vented the way a toddler knows how. My clinical year was really just like having a job, but without the pay or respect. I worked 6 to 15 hrs a day depending on the rotation and particulars of the day. I still had to work on my masters program but that took maybe 6 hrs a week. Things went a lot better but not having an income and thus no money to be able to buy groceries when needed or pay for car registration and having to ask my wife to do all that really continued to wear on her. I think there was slight resentment that I was able to go to school and not have to work. I feel that my wife thought PA school was fun, maybe like undergrad was for her. Other than the occasional moment here and there it was not fun. It was hard-ass work that I will be paying for for many years to come.

Balance? I did my best. Many times it wasn't good enough for the other parties involved but I HAD TO make sure that I did as well as I possibly could while I had the chance. I will graduate with a 3.8 in my PA studies and a 3.9 in my masters, which is from another school. I am still married - today is my 8th anniversary and I hope for many more. My son still loves me and likes to be with me. I'll see if any of that changes if can't get a job real soon!

Hospitalist Rotation

I am seeing a bunch of stuff I have never come across on this rotation. A sickle cell crisis, various county jail prisoners, various substance addictions, lots of chronic kidney disease, lots of uncontrolled diabetes,a gut who swallowed a bunch of pencils, lots of dialysis patients and all their complications, HIV, people from far away lands, TB and then your garden variety CHF and COPD.

I graduate in less than a month and am looking to avail to find a job. It is hard because a lot of employers want experience. Add to that the fact that I am not yet certified means no one is returning my calls/emails. Maybe once I get certified things will turn around. I am so tired of the hassle not having money has created between me and my wife. Rather, me not having any money. She makes well into 6 figures however. And never the two shall meet!