Should You Do a PA Residency After Graduation?

No. A residency is by no means a necessity to land a job in any specialty. The author of this post graduated and had multiple offers across orthopedics, neurosurgery, and endocrinology before accepting a role in general surgery.

In fact, a lot of practices prefer to hire new grads precisely because they can train you to do things their way. As the author puts it, they do not have to teach old dogs new tricks. If someone else trained you first, you might carry habits that clash with how a particular surgeon or physician likes things done.

So if you are worried that skipping a residency closes doors, it does not. Plenty of specialties hire new graduates directly, and the first year on the job is where a huge amount of your real learning happens.

There are real situations where extra training helps. If you are tied to a competitive area and cannot find a job in the specialty you want, a residency can build experience and open a door locally. The author met an orthopedics PA resident who chose that path for exactly that reason: she could not find an ortho job in her location otherwise.

A residency also makes sense if you know with certainty that you want to stay in one specialty for the long haul. Taking a year to go deep can make you a stronger, more confident clinician.

That said, more training is never a bad thing on its own, but it is not the only way to get it. The first year out is often described as PA school part two: school prepares you for the boards, and that first job teaches you how to actually be a PA.

Money matters here. Residencies usually pay less than a regular position. At the 2017 AAPA conference, the author spoke with a general surgery residency offering $75,000, which was better than the $40,000 figure seen in the past but still well below a standard PA salary. [VERIFY]

There are upsides beyond the paycheck: more structured training and the chance to network throughout the program. If you can afford to take less for a year and invest in the extra training, it may sharpen your skills before a regular role.

If you are skipping the residency, the author's advice is to choose a first job that genuinely supports learning. A good supervising physician who explains things, or a practice that rotates new grads through specialties before they see their own patients, can give you that growth without the pay cut. Always weigh the pros and cons for your own situation.

Whether or not a residency is right for you comes down to your goals, your finances, and how location-flexible you are. Either path can lead to a strong career, so weigh the tradeoffs honestly. If you want help thinking through your post-graduation options, we are happy to talk it through.