PA-C

Ultimate Physician Assistant Gift Guide - 2018

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Wondering what to get for all of the PAs in your life? Whether Pre-PA, current students, or practicing PAs, we’ve got you covered with this 2018 Holiday Gift Guide. We’ve broken it down by category and you’ll find more practical options to go with some of the more fun choices. Feel free to pass this guide along to your family and friends to give them some hints about what’s on your shopping list. Some of the links in this post are affiliate links, which means we get a small percentage if you make a purchase as no extra cost to you. This list is just in time for Black Friday so make sure to keep your eyes peeled for deals!

To Wear

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Looking professional is a staple as a physician assistant! Medelita is my go-to brand for medical wear in clinic. A gift card will provide a choice between the various scrubs, white coats, or scrub jackets, but I’ll share some of my favorites.

Medelita offers free shipping, the option of embroidery, a 1-year warranty, and at-home try-on. What more could you ask for? I recommend any of the scrubs, and my favorite white coats are the Ellody or the Rebecca. If you’ve never bought anything from Medelita, you can set up a new account and get $20 off your first purchase over $70. Use the code PAPLATFORM1 for a 20% discount.

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If you’re looking for something more casual, check out Medthusiast for the cutest and comfiest T-shirts and sweatshirts. Both Medelita and Medthusiast are companies that were created by PAs, which makes them even cooler!

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To Read

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For the Pre-PA Student - To help future PA students reach their goals, there are some must have resources out there to make the process much easier. The Applicant’s Manual of Physician Assistant Programs provides information about all of the current PA programs. This is a huge time saver because it can be difficult to track down that info. After applying, the interview is the next step, so the Physician Assistant School Interview Guide is a great present for anyone in the application process.

For the current or soon-to-be PA Student - There were 2 books that were extremely helpful to me while I was in PA school - the “green” book and Lange Q&A. I used these the entire time and particularly when studying for boards. I’ve also heard great things about PANCE Prep Pearls.

For anyone and everyone - Dr. Atul Gawande is my favorite non-fiction/medical author. His books should be mandatory reading for anyone in medicine. Better and Complications would be welcome stocking stuffers for any PA!

For School

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While PA school is thankfully a somewhat distant memory for me, there are a few things I couldn’t have survived without.

A great computer. If you really love your PA student (or soon-to-be student), make sure they have a functioning laptop. I’ve heard great things about the iPad Pro and Notability for taking notes, so that’s a good option too. I started school with a MacBook Pro and ended with a Microsoft Surface. I wish I had my Surface at the beginning of my program so I could have taken notes directly on our never ending PowerPoints. I’m back to a MacBook now, but the Surface was great for studying for boards.

A functioning printer. Even though everything is online these days, I’m still a pen and paper type of person at times. I like to write things out and take notes by hand, particularly for last minute studying before a test. I have the HP Envy, and it’s wireless, and does the job.

A water bottle. I’m the first to admit I’m the worst at staying hydrated. At work I use one of the large Tervis tumblers to keep my drinks cold or a good Yeti cup. I love this water bottle that helps to remind you to drink frequently by glowing to help increase water intake.

Amazon Prime. Having 2-day shipping was a lifesaver during PA school and clinical year. When my feet and back were so sore during my surgery rotation, I was able to get some compression socks and better shoes on the way ASAP because by the time I got off work nothing was open and I just wanted to sleep.

For Clinic

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If you’re in the market for a new stethoscope, and want one that functions excellently and looks sharp, check out the ERKA stethoscopes from Medelita. I don’t use a stethoscope frequently in dermatology, but my husband has claimed by ERKA as his own and uses it daily at the hospital. There are plenty of color options, and the tubing holds up nicely even with frequent use.

For a coffee drinker, Medthusiast has amazing ceramic coffee mugs with gorgeous artwork on them. These mugs will be the envy of everyone else in the office!

For CME

While I wouldn’t recommend booking a full CME trip for someone else, travel essentials are always a great gift. After going to a few conferences this year, I’ve realized I don’t have great luggage or carry-ons, so those are at the top of my list this Christmas.

Lecture halls at conferences are always freezing for some reason. While I dress business casual and professional when I go to CME events, I’ve been carrying my Medelita Ionic scrub jacket with me to keep me warm. It’s a great weight and still looks professional, so I’ll just leave it at my seat in between sessions. Mine is embroidered so I don’t worry about it going missing. These are available for men and women, and they fit true to size. This is also my husband’s favorite jacket to wear at the hospital, even more than his white coat. (And don’t tell, but even all of the non-medical people in my family are getting these jackets this year!)

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At conference, I always take a good size purse or bookbag to lectures, and I have my trusty Lilly Pulitzer notebook and a ton of pens. You could create a little conference survival kit and that would be an awesome present. Don’t forget the candy and snacks!

For Fun

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Makeup and skincare are always a nice present because who doesn’t love a little pampering. Put together a basket with some bath bombs, sunscreen, and skincare kit for someone who needs to relax a little bit. I’m the first to admit that I’m a product junkie, but most recently, I’ve been using the FRÉ Skincare line. Being a dermatology PA, I’m very picky about products, but these are easy to use, gentle, and leave my skin feeling fresh. The choices aren’t overwhelming and I love that I only have to leave the Detox mask on for a few minutes. You can use the code SAVANNA1 for 15% off, and make sure you’re following me on social media for extra deals (and there’s a really good one coming for Black Friday!)

For more of my recommendations and favorites, check out my Amazon list.

Guest Post from PA Cents: Should You Do a PA Residency?

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You’re in the final stretch of Physician Assistant school: graduation, PANCE, new job, it’s in your sights. You’ve been looking online at job openings and are not sure if you’re ready to join the workforce and be a full-fledged certified PA, practicing real medicine on real patients; so you think maybe a residency might be a good choice.

Possibly you’ve been looking for a job in a competitive area and can’t find a job in the specialty that you want so you want to gain more experience. There is a lot to consider if you’re thinking about applying to a residency.

I went to PA school in Southern California where there are a number of PA schools and a large pool of PA graduates to choose from to fill positions. The hospital where my orthopedics rotation was at had a lot of medical students, residents, PA students and PA residents. I asked one of them why they chose to do the residency and she said she was not able to find a job in that location in orthopedics.

If you’re tied to a certain area and really want to be in a specific specialty then more training in that area could be helpful and might help you find a job in that specialty. You will get a lot more training and might feel more competent after a residency.

A residency is by no means a necessity to get a job in any specialty. After I graduated from PA school I had multiple job offers that were all in different specialties. I interviewed for jobs in orthopedics, neurosurgery, and endocrinology. I ended up accepting a job in general surgery.

Surgeons all use different techniques and they all think the way they do it is the best way. My first job was with a surgeon who was getting older, there were four surgeons in the practice and only one used a PA at the time.

The surgeon I worked with saw the value of having a PA in the OR, as well as in the office, and with hospital rounds and wanted to hire one too. By the time I left the practice the PA that was working there before me had already left and one of the other surgeons also hired a PA. All of the PAs they hired, including the one that replaced me, were new graduates.

An advantage of hiring a new PA rather than one that has been doing it for a while is that they could train them to do things how they wanted it done. They did not have to teach old dogs new tricks. If someone else has trained you then you might have “bad habits” or just do things differently than they are used to.

More education is never a bad thing and doing a residency does let you learn more. If you know you never want to do another specialty than taking a year to learn more in that specific specialty can help you learn a lot and possibly be a better clinician.

The first year out of PA school is like PA school part II - PA school prepares you to take the board exam and the first year of being a PA teaches you how to be a PA. When you’re looking at a first job you should look for something that is still going to help you along in your education and where there is a good learning environment.

This does not need to be a residency. There are plenty of jobs that provide a good learning environment without having to do a residency. The job that I currently work at allows new Primary Care PAs to rotate through different clinics and with different specialties before they start seeing their own patients.

Learning is also somewhat dependent on your supervising physician. The surgeon I worked with for my first job didn’t mind teaching/explaining things, but I had to ask questions a lot of the time to get him going.

There was another surgeon in our practice who was recently out of fellowship and did a better job of naturally explaining things. I think a part of this was he was just in the habit of doing it as he was used to working with residents and students at a teaching hospital, whereas the further out from training you get the less you’re in that thought process.

As a PA we have been trained as generalist and one of the beauties of being a PA is that you can change specialties without having to do more training. My first job was in general surgery and when I was ready to move on I had offers from other places in all different specialties. I was not stuck working in general surgery forever. If some people are doing residencies that may soon become the norm and with residency training for PAs if that becomes the standard we will no longer be generalist and the benefit of being able to switch specialties without more training will go away.

If you feel like residency is your only option as you’re not able to find a regular position as a PA, it’s good to know that you’ll probably have to take less money as residencies usually pay less than a regular position.

At the 2017 AAPA conference I did talk to a residency for general surgery and they were offering $75,000 which is better than the $40,000 I’ve seen in the past but it is much less than what you could get in a regular position.

Whenever you’re looking at a job you always have to weigh the pros and cons. There are some benefits, such as more training and ability to network while you’re in the residency. If you can afford to take less and invest the time to do the extra training it may help you with your skills before taking a regular position. If you’re looking at a first job and have decided to take a regular position be sure that it is a place that supports learning and is going to help you as grow as a new PA.


This article was written by the author of PA-Cents a personal finance blog for PAs; to contact the author or for information on PA personal finance visit www.pacents.com.

How I Paid Off my PA School Debt

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So have you heard that PA school is expensive?  Well, that might be an understatement.  Any graduate program is going to be a little pricey, but medical programs tend to be on the higher end of things.  If you look at estimated costs for PA school, you'll see a broad range from 5-digits all the way to hundreds of thousands of dollars.  That's a lot of zeros.  And you have to look at tuition + fees + books and other resources + tools + traveling for clinicals + housing + food + everything else!

Thankfully, I went to a public program so that initially cut my costs.  My second choice school would have cost 4x as much as my program cost.  Unfortunately, that's the norm.  I had a few other advantages that helped me to cut back on the amount of loans I had.  Which brings me to Tip #1 - Take the minimum amount of loans possible!  I was able to live with my parents for the first year, and although they couldn't cover all of my expenses, they covered my fees.  I only had to take out loans to cover my tuition.  I also went to a public program, and that decreased costs significantly.  Tip #2 - Don't take out extra money to put into savings.   The amount of return you get in savings is so much less than the amount you're being charged in interest, so it's just not a smart financial move.  

I took out federal loans though Sallie Mae, which is now Navient.  I made an interesting, somewhat subconscious, decision to not ever look at how much I owed until the end of PA school when they make you do financial literacy training.  I guess I figured that it wouldn't make any difference since I wasn't able to start paying them off yet anyways.  And although I was not able to do this, here's Tip #3 - If there's any way that you can make payments during PA school, do it.  (Even if it's a small amount.)  If you get any extra income, have a spouse who works, or have savings you're sitting on, think about putting some of it towards your loans.  Those small payments make a big difference in the long run, especially with high interest rates.  

So anyways, when I pulled up my loan summary, I owed around $75,000, and that was shocking to me.  Now I know that PA school costs a lot more for a lot of people, but you can't deny that 75K is a big chunk of money.  I mean, that's the average starting salary for a new grad PA.  About 55K was principal (meaning that I had actually borrowed that much), and the other 20K was interest (the fee for the money I borrowed).  My interest rates were varied, but averaged at about 6%.  

After you graduate, there's a grace period where you are not required to make payments on your loans.  Tip #4 - If possible, start making payments during your grace period.  While you don't have to make payments, your interest is compounding and growing.  From day 1 of getting a paycheck, it helps if you start making payments right away.  You won't miss the money if you already have it dedicated to your loans.  I committed to this at first, but then I got a little lazy.  My original goal was to put at least 1/2 of my salary each month towards my loans.  But then I got the great idea that I would just put whatever was left over at the end of the month towards them.  Just kidding.  Not a great idea.  That only lasted about 2 months before I got myself back in check.  After working so hard for 2 years in school with no compensation, it can be easy to go a little crazy.  I would love to tell you to make a budget and stick with it, but I'm personally terrible at budgets, so I can't give you much advice in that area.  

So I went back to committing at least half of my salary to go straight towards my debt.  Tip #5 - Decide how much you want to put towards loans each month, and do it.  As you see the amount you owe decrease, it's so reassuring.  There are differing views on what loans to pay off first.  Dave Ramsey has the "Snowball" plan, meaning you pay the one you owe the least on, without regard to the interest percentage, and go from there to gain momentum.  I paid off the one with the highest interest rate first, and then worked my way down.  If you do automatic payments, you may get a decrease in the interest amount.  

After you've put your committed amount towards loans, if you have any extra money coming in, consider putting it towards your loans.  Tip #6 - Try to put extra funds towards your loans.   Every little bit makes a big difference.  It may not seem like it at the time, but I don't think I would have paid off my loans as quickly as I did if I hadn't done that.  And I can think of specific purchases that I made that delayed my final payment, and they probably could have waited.  

So back to my loans.  After I found out how much I owed, I committed to paying half of my salary each month to my loans, and any bonuses I got.  There were a few hiccups along the way, but I got better at it with time.  I tried to put any extra funds to my loans.  I started working in August 2014, and this past January 2016 I made my last loan payment!  It felt awesome.  Took my entire bonus/commission, and drained our bank account, but it was worth it.  I feel like a weight has been lifted off my shoulders, and I have a lot more freedom at this point.  Instead of going to the beach a few hours away, I can afford the trip to the DR without feeling guilty for not paying towards my loans.  Tip #7 - Make frugal choices while paying your loans, not extravagant ones.  

Everyone is different, and I'm sure not everyone will agree with how I did things.  But that's ok, and I'm extremely happy with where I'm at.  Debt-free, and able to start saving more and making good financial decisions.  Tip #8 - Do what works for you.  I'm a generally frugal person anyways, but I can splurge on something like a vacation or good meal.  Making big purchases, like furniture, are a lot more fun now too.  

At the end of the day, whether you're still in undergrad or worried about affording PA school, your loans will be paid off at some point.  It may not be as soon as you would like, and you'll probably make some mistakes, but it will happen!  If you have any other tips for others about paying off loans, please comment!  Or if you've paid off you're loans, I would love to share your story and help others to have confidence that it is possible!  

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PANCE/PANRE Review Course - The Resource You Need to Pass Boards!

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From the first day of PA school, you are fully aware that boards will be necessary at the end to practice as a Physician Assistant.  Although some people wait until after school to buckle down and study exclusively for the PANCE, I think it's best to start studying from day 1.  All of the tests during didactic year and clinical year are important, but that last test is the MOST important.  

I'm really excited to be able to share an awesome resource when it comes to studying for the PANCE - the PANCE/PANRE Study Guide and Review Course. There are so many aspects to this that will be helpful to every kind of learner.

The Study Guide - When studying for this all important test, you want to make the most of your time and focus on high yield material. The Study Guide is a 109 page PDF that focuses on everything you need to know. It's short and sweet, and to the point. It's essential that you are able to recognize buzzwords and match them with diagnosis, imaging, or treatment. For example sausage mass on palpation in a pediatric patient should automatically make you think of intussusception. This is the resource you need to focus your brain on what you NEED to know. If you just want the guide, you can download the study guide for 9.99.

Online Content - For the review program , you log in, and are able to access a ton of content. The course is organized based on the NCCPA Blueprint, so again, the focus is everything you actually need to know. In each section, you'll find an introductory video, the NCCPA Blueprint information for that section, the percentage it is on the PANCE, an audio review section, the PANCE Study Guide for that section, quizzes, flash cards, and more review material. Basically, there's a little bit of everything and the material is reviewed in multiple ways.

Quizzes - There are different options available when it comes to the quizzes.  There are basic ones that just ask pretty straightforward questions and some situational ones, and then there are buzzword matching ones.  Practicing actual questions is the best thing you can do because you are testing your understanding and knowledge.  Knowing buzzwords for the PANCE is also necessary.  Like other standardized tests, there is strategy involved, not just knowledge.   I was reminded just how much I don't remember from school after taking just 2 quizzes.  

So why should you invest in this review course?  Well, if you don't pass your boards, you get a full refund.  That's a pretty bold promise.  There's a free trial available that still has a ton of valuable knowledge, so you can try it and see if it would work for you.  For lifetime access, it's $199 (and there's a discount below!), and you get access to so much knowledge.  And that means you can start it the day you start school and use it throughout your program.  This is a resource that I will use to stay up to date on the material I need to know and I plan on using it when I have to recert.  The creators have worked really hard to make this an all-inclusive study guide, and I think they have succeeded.  

I think if I was using this today to study, I would do a practice quiz, then read through the study material, listen to the audio review, and then take more quizzes.  It's basically everything I did to prepare for PANCE 2 years ago, just in one source instead of multiple books.  

If you are interested in checking out the study guide or review course here is a coupon code that will get you 15% off of your purchase!! - thepaplatform15

I was provided access to the course and a copy of the study guide for free, but my thoughts are completely my own!  


My Favorite Books to get through PA School

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If your program is anything like mine, they will give you recommended books or resources for each section.  While a few of these were helpful, there were other books that I used during the entire didactic and clinical years, and I don't think I would have made it without knowing where to find the information I needed.  The internet is a great resource, but I love being able to flip through a book and highlight and make notes too.  Here are some of my favorite books, and make sure to comment below with anything you think I left off! This post contains some Amazon affiliate links. 

A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants - This was my main PANCE study book, but I used it all year long.  It is based off of the NCCPA Blueprints for the PANCE exam and goes through every single section with the main ideas that are important for PA school.  I would always read through the related section the morning before a test just for a refresher.  My only complaint about this book is that the medications are not always specific in the treatment section, and I could use a little more info there.  

Step Up to Medicine - While this book is technically for medical school, it's great for studying all of the basics of PA school, especially all of the Internal Medicine topics.  It's split up really well and easy to read.  This book fills in what the PANCE review book leaves out, and I wish I had known about it for more of didactic year, but it's great for clinical year too.  

Pocket Medicine - This is a pocket reference for your white coat that I actually didn't have, but I wish I knew about it.  My husband currently uses this book on his medical school rotations, and it's really cool.  It has all of the current recommendations for Internal Medicine subjects, and also all of the articles that the recommendations are based on, so it's truly evidence-based.  If you're in an academic center, the attendings love it when you can reference an important study.  There's a Pediatric version as well.  

Maxwell Pocket Reference - This is another book you should have in your white coat.  It's really small, and for $5 it comes in handy.  This little book has outlines for different types of notes in the hospital, ACLS codes, physical exam and history, and all kinds of other important topics.  Unless they've stopped, if you join the AAPA as a student, they will send you a copy of this.  

Lange Smart Charts for Pharmacology - This was my go-to for pharmacology, aka the worst class of PA school.  It's just so hard until you're actually seeing these drugs on rotations or practicing .  This book is a flip chart of all the drugs separated by class with everything you want to know, including brand name, mechanism of action, side effects, and contraindications.  I love a good chart, and these made studying so much easier.  

Bate's Physical Examination - This is basically the go-to book for learning how to do a proper physical exam.  It was required by my program, and my husband used it as a reference in medical school too even though it was never recommended.  There's pictures and great explanations for any part of the physical exam that you can imagine.  And there's even a pocket version as well.  

Lange Q&A Book - This was my main book for practice questions.  Doing questions and attempting to apply the knowledge I'm trying to learn has always been the best way for me to evaluate where I'm at.  I used this book during the clinical year and studying for the PANCE, but I wish I had it for didactic year as well.  The questions cover all subjects, and have awesome in-depth explanations.  

Tarascon Pocket Pharmacopoeia 2015 - Shirt version and White coat version - This is another reference book you can use on rotations.  I know you have Epocrates on your smart phone, but I liked having this book as well.  It's really easy to find what you're looking for and they update it every year.  

Basic Concepts in Pharmacology - This is a small book, and it has really short and straightforward chapters about different drug classes.  I liked to read the relevant sections before Pharm tests as just a quick overview.  I probably just need to read this book every month to retain some of the knowledge from PA school.  Sometimes it feels like all I prescribe are topical steroids and acne medicine! 

First Aid for the USMLE Step 2 CS - If you have physical exam or practical examinations with standardized patients, then you need this book.  This is another one that I unfortunately did not have while in school, but it would have made my life so much easier.  I spent hours trying to come up with practice cases, and come to find out, here's a book with everything I was looking for.  There are checklists for each case, and you'll need a partner to get the most out of this book.

Pance Prep Pearls - This book had just come out when I was in study mode for PANCE, but a few of my classmates did use it, and they passed!  I've heard a lot of buzz about this book recently, and I definitely plan on using it when it comes time for me to recertify...in 8 years! 

Here is a blog post from a fellow blogger with her recommended resources, some of which are the same as the ones you will see here.  


Conference Review: GDPA Dermatology PEARLS

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The Georgia Dermatology Physician Assistants (GDPA) puts on an annual conference called Dermatology PEARLS (Physician Extenders Advanced Regional Learning Symposium).  It is held in Atlanta, GA or somewhere nearby.   It was in October this year, and the next one is scheduled for March in the Buckhead area of Atlanta.  There was a maximum amount of CME of 26.5 hours offered, with a possible maximum of 22.5 hours for each attendee.  8 of those hours could be self-assessment if you are in the new CME cycle.  3 workshops were offered - Intermediate Surgery, Hyperhidrosis, Neurotoxin & Fillers - but I didn't participate in any of these.  The price for this conference was really reasonable.  For early registration a non-GDPA member, it's $300, and if you were a member, it was $275.  These prices increased by $75 each for later registration, so plan early!

The location was at the Cobb Galleria Centre, and the hotel was adjacent to the convention center.  I didn't need to stay at the hotel since my sister lives in Atlanta, but it would have been nice to have just a 5 minute walk to the conference.  The conference was 3 days long, which I felt like was appropriate.  There was a ton of information presented, and I was exhausted at the end of each day.   Everything was extremely organized, and the schedule ran on time.  There were a few lectures I would have liked a little more time for questions, but it was nice to know what to expect throughout the day.  

There was a notebook given that had all of the information for the conference, wi-fi information, and a page for notes on each of the lectures (and I took tons of notes).  The speakers were all awesome.  There were some physicians and some PAs, and I would just love to spend a day with any of them.  I don't think there was a single lecture that I felt like I didn't learn something.  There were a few instances where I felt like the information went over my head (immunology!), but I still feel like I learned a lot.  I got so many pearls, and I'm really excited to try them out in practice.  It was also reassuring to hear from people who have been practicing dermatology for 10, 20, or 30 years that they struggle with treating some of the same skin diseases that I feel frustrated by.  

I had a great time at the conference, and I learned so much.  This is definitely a conference that I plan on attending again in the future!


Tips for a Medical Conference

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This past week I attended my first ever Continuing Education conference.  The one I went to was put on by the Georgia Dermatology Physician Assistants (GDPA), and it was their bi-annual Dermatology PEARLS conference.  The next one will be in March in Atlanta, GA if you have any interest in dermatology or are looking for a conference.  I went there not really knowing what to expect, but it was an awesome conference!  (I guess I don't have anything to compare to, but I did enjoy it.  I'm going to do a separate post reviewing this particular conference, but here are some tips I would like to share if you are getting ready to go to a conference!

  • No matter what you wear, you probably won't be the most underdressed or overdressed.  There were people in anything from jeans to suits.  
  • Bring a sweater!  It might be cold, and you'll be sedentary for most of the day.  
  • Welcome back to PA school!  Be ready to sit and listen to lectures for about 8 hours, unless you go to a conference that only has lectures in the morning.  
  • There's lots of food and coffee.  We had a breakfast and lunch buffet, and lots of coffee breaks with little snacks and drinks.  
  • Goodies!  They gave me a bag, pens, a notebook, and a jump drive with lectures when I arrived.  And then in the Exhibit Hall, there are a bunch of booths with pharmaceutical reps, hospitals, and other medical products that have handouts and information.  
  • You can come and go as you need to.  You can only claim the CME for the parts that you are actually present for, but it's not a big deal if you need to leave early.  
  • The sessions can be very interactive.  We had clickers to answer questions, and the speakers were very engaging, and encouraged questions.  
  • You need to know generic names.  All of the speakers try to be non-biased so they will use the generic names instead of the brand names as much as possible.  
  • Learning is exhausting, especially when it's been a while since you've had such intense classroom time.  
  • Students welcome!  There were a good bit of students at the conference I went to, and I think I would have been overwhelmed as a student, but also I would have learned a lot.  It's a great place to make connections and meet people for finding rotations or a job after graduation.  
  • And lastly, if you go to a dermatology conference, then everyone will have perfect skin!  But seriously, they did.  

Comment with any of your tips for conferences, or any CME events that you've been to and would recommend!


The Hard Parts of Practicing

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As much as I love what I do, I have days that are just really tough, or entire weeks, like this one.  When I first started working, there were more days and weeks like this just because I felt like I didn't have a great grasp on dermatology and felt like I should already know everything.  It's definitely gotten easier, but there are still some days that are just so hard.  

I feel like we mostly talk about the good stuff of practicing medicine while we're in school, but there's a lot more to it than that.  Occasionally, we'll learn about difficult or non-compliant patients, but that just barely scrapes the surface of what it's like in the real world.  You can role-play situations as much as you want, but you won't know how to react or what to say until you're actually encountering patients.  I work in dermatology, so I know there are others in specialties that deal with even more difficult situations than me.  

These are the things that I've found difficult during my first year of working, and during this incredibly long week:  

  • When patients are frustrated that the treatment regimen you gave them for their eczema or acne didn't work
    • I promise I gave you what I thought would work the best and be most cost effective.  But sometimes, I'm wrong.  I didn't do it on purpose, and I will keep working to find what works for you.  
  • When a patient wants you to inject an area that you know may cause blindness 
    • There isn't always a quick fix for everything, and I would never purposefully do something that would harm my patient.  Like injecting steroid into a stubborn acne bump in an area (the glabella, aka in between the eyebrows) that could potentially cause blindness.  Sometimes we have to wait it out and let our body heal itself, even if it takes longer than we would like.  
  • Having to make a phone call to a patient to tell them they have melanoma
    • I hate melanoma phone calls.  That's about the worst thing to do in dermatology, and it can be a really tough conversation.  Most of the public is not very knowledgeable about skin cancers, or don't consider them "real cancers."  I think once you have a 50-year old patient with a melanoma that gives him a 15% 5-year survival rate, that counts as real cancer.  
  • Having 3 patients in a row no-show, but also patients showing up 30 minutes late or with no appointment at all, which just throws the whole day off
    • This is something I still have trouble not getting frustrated about, but things happen and I try to give patients the benefit of the doubt.  
  • Having to tell a patient she might have MRSA and probably shouldn't hold her new grandbaby until the culture results come back, and then her calling saying I "didn't help at all"
    • It's not a good feeling to have a patient call with a complaint like that.  Especially when I treated her appropriately.  That's where emotions of the patient get involved, and things get complicated.  A phone call usually helps.  I was dreading calling this patient back, but when I did it actually made the situation better.  I was able to tell her she has normal Staph and not resistant Staph, and although I still want her to avoid the baby, it made it not quite as bad.  Patients will most always appreciate your time, and I think as providers we should take the time to make situations like this better if we can.  
  • Seeing a 7-year old with a skin disease that could potentially cause him to lose mobility of his leg
    • Kid stuff is hard.  This kid had something called lichen sclerosus et atrophicus, and areas had progressed to morphea.  This was something I had read about, but never actually seen.  Hopefully, we should be able to help him before things progress too far.  

Honestly, those are just the few highlights, and there were plenty of other situations I could talk about.  Part of what makes my job so tough is that at times I get the feeling that patients are thinking I just gave them a medicine for the heck of it, or that I didn't make them better on purpose, or that I don't care that I'm 30 minutes behind and they had to wait a little longer.  Truthfully, these things actually bother me.  A lot.  And I know they bother most other providers as well.  I wish patients were able to see the behind the scenes sometimes, instead of thinking we just mosey around at our leisure.  

I've been on the patient side too.  At my annual GYN appointment last year, I waited for 3 hours to see my physician.  And she spent about 5 minutes with me.  But she had an emergency patient that had to be seen to, and when it comes down to it, I know that if I was the one having an emergency she would have made someone else wait.  People are very quick to make judgments these days and very impatient.  I see Facebook posts almost weekly about "Why would my appointment be at 3:00, but the doctor didn't see me until 3:30?" or continual updates about how long the person has been sitting in the doctor's office.

 As someone who has seen both sides, and is sometimes responsible for people sitting in the waiting room, I think we need a little more grace.  Both patients and providers.  It is not uncommon for my patients to be late.  And not just a few minutes.  I've had patients show up an hour late and most of the time they don't even mention it.  If I make a patient wait more than 5 minutes, I apologize because I hold myself to higher standards than that.  So I do get frustrated with those patients who are late.  At the end of the day, we're all just people.  Both patients and providers, and we all make mistakes, so I hope we can give each other a break.  


1 Year Out

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I just recently realized that I've officially been a graduate for 1 full year, and it was about this time last year where I was nervously awaiting PANCE results.  It's been somewhat of a whirlwind year, and I wanted to reflect and share some advice to you guys as I look back.  It's amazing how time flies in PA school, and then it still goes as fast when you're busy working.  I went to a pharmaceutical dinner last night for PAs, and some of my past professors, and now colleagues, were there.  It was so funny because one of the teachers couldn't even remember when I graduated!  And she wanted me to call her by her first name, which just still seems weird to me.  It's amazing what a difference a year can make.  

This time last year, I had officially graduated, taken PANCE, and was training at my dermatology job.  I was almost as nervous to check my board results as I was to actually take the test.  I was at work that day and as soon as I got the e-mail that scores were posted, I went outside of the building to check them.  I had pretty much decided that if I failed, I would just leave and not go back.  Luckily, I didn't have to do that, but passing boards is what made it feel real, like I had finally made it.  I'm dreading retaking them in 10 years, but I just won't think about that for now.  

Some advice to Pre-PA students - Being a PA is a great job, and I definitely recommend it, but look at all of your options closely and decide why being a PA will be a good job for you personally.  Although in many fields, you do most of what the physician does, PAs are not physicians, and some people will never be happy in that role.  It takes hard work to become a PA and you have to decide that it's worth it you.  While you're doing all of the prerequisites for PA school, have some fun.  Looking back, I had a great college experience, but I was almost too goal focused and I do wish I was a little more laid back at times.  The stress and tears weren't really worth it.  

Advice to current PA students - Eventually, you will be done with classes and rotations and boards and you will be a PA too!  It does end, so just remember that during the weeks that you think you might just not make it.   There are still about 2 weeks that I remember as just being terrible, but we all made it through.  I would encourage you to still take care of yourself and your passions.  It can be easy to lose those things when you're so microfocused on school all the time.  I don't think I read a single book for fun while I was in PA school, instead I would read study material until I fell asleep.  Was that necessary?  Probably not.  Also take time to invest in your friendships and family.  The first 2 semesters of PA school, I wouldn't even go out to eat with my family because I "had to study."  Looking back, it would have taken probably 30 min- 1 hour, given my brain a rest, and given me nourishment and fellowship.  Maybe I got 1 point higher on the test by skipping dinner?  But I think I would have rather gone to dinner.  So don't be so uptight that you let things slip away.  Become friends with your classmates too, and hang out with them outside of school!  Some of my best friends are girls I met in PA school, and most of the things we did were unplanned and random, but just what we needed to survive.  Like buying last minute floor seats to see Taylor Swift 2 days before the show, with multiple tests the next week...maybe not the best plan, but exactly what we needed at the time.  (And it was so worth it.)  One last thing, you will find a job.  So no need to cry over that like I did either.  Your first job probably will not be your last job, but there are plenty to go around.  While job searching, I would recommend not discussing specifics of jobs with your friends or close classmates because it can get a little uncomfortable if you and your best friend are interviewing for the same job.  So just make a plan to hold off until you've signed the contract.  

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Advice to new grads - Congrats, you made it!  Welcome to the real world!  Vacation is something different now, and if you're working in a clinic with a set schedule, be prepared to ask off months in advance because they really don't like having to move 20-30 patients when you decide you're ready to go to the beach. Be wise with your money.  I had a great plan right out of school that I would just buy whatever I want and then whatever was left would go to my student loans.  Yeah, that's  a terrible plan.  Look into paying off your loans early and investing as soon as possible.  (A great resource - White Coat Investor).  While being wise with your money, don't be afraid to have some fun too.  You've deserved it!  Like if you want to plan a random trip to Las Vegas with your spouse or buddies, do it!  And keep up with your classmates.  It takes a family to get through PA school, and now that you have a bunch of new colleagues, use those resources to make each other better PAs.  If you hate your current job, look for a new one.  I once heard that you should never stop looking for a job, and there are tons out there so don't stay somewhere that you are unhappy.  Don't forget to give back to your program either, and not necessarily financially.  If you are able to lecture or be a preceptor for students, that's a huge help to the program and even more to the students.  

Overall, I'm extremely happy with my decision to become a PA and I love my job.  There are still some days when I feel overly stressed and exhausted, but there are far less than when I first started working.  I'm excited to see where our profession is heading, and how it will change and evolve.  I'm still figuring everything out, but it's getting much easier.  And I'm just happy to not be studying for the PANCE right now.  


Providers as Patients

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Obviously we are all patients at some point in time, and that is where we develop empathy for our patients and can really step into their shoes.  I wanted to share my most recent experience as a patient and how it's affected how I practice, and possibly can provide some clinical insight for your patients!  

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I'm not a super "moley" (not a medical term, but commonly heard at my job) person, but I've always had 1 mole on each of my feet.  I've never worried about them, but over this past year I started to think they were maybe getting a little larger, and then one of them in particular began to darken.  Those are pretty typical signs of possible dysplasia (atypical changes) in pigmented lesions like moles.  I had shown them to my supervising physician when I first started about a year ago, and she thought they were fine at the time.  When I showed her this past week, her opinion had changed, which was what I was expecting.  If I saw these moles on a patient, I would want to take them off.  

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You have to be really careful with moles on the feet because they can be forgotten and due to the volar skin that is a little different, the characteristics you look for are slightly different.  In dermatology, we use a tool called a dermatoscope, which is basically a magnifying glass with a light.  Dermoscopy is very helpful, but if you are suspicious of a mole with the naked eye, the dermatoscope should really only confirm your suspicions and decision to biopsy.  There pictures are of my moles (because I had to send them to all my friends from PA school of course).  

So here's the deal with moles and biopsies or removal.  There are 2 types of biopsies.  Both consist of numbing the area locally with a shot of lidocaine, usually with epinephrine.  A shave biopsy is basically a razor blade that you bend to shave underneath the lesion.  This is typically done for raised moles being removed or to biopsy possible skin cancers, among other various things.  A punch biopsy is like using a cookie cutter to remove a portion of skin all the way down to the subcutaneous fat, which requires stitches.  This gets the epidermis and the dermis, which provides a deeper sample.  There are different sizes of punches, ranging from 2mm-8mm.  These are done on any lesion suspected for melanoma or moles that are suspected to be atypical/skin cancers if you can remove the entire lesion.  Everyone has different standards and there are some practices that do more punches or more shaves and may not agree with those standards, but those are my (very rough) guidelines.  

So for the size of my moles and the dark pigment, punch biopsies were the best option.  I had about a week to think about how bad the shot was going to hurt, and honestly it was just as bad as I expected.  There are so many nerves in your hands and feet, that a shot there is killer.  And lidocaine burns like crazy.  Then it feels very strange when your feet are numb.  So we did the biopsies at lunch last Thursday, and luckily I didn't have to work on Friday.  Here is a picture of my feet post-biopsy (sorry for the ugly foot pic).  The white area around the stitches is the blanching from the numbing shot.   

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I took a picture of the samples in the specimen bottles as well.  

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Friday morning it felt like I had a chunk taken out of both of my feet, and they were extremely sore.  I basically hobbled around all weekend and sat as much as possible.  This process has made me very thankful for my feet, and I can't wait for them to feel like normal again.  

So here we are a week later, and only one of my biopsy sites is infected, even though I've been keeping them covered constantly, and both of my feet are still pretty sore.  But of course, I've been working all week and that probably doesn't help.  I feel like I have so much empathy for my patients now, and I know exactly what they are going through and how tender it is when I have to give them a numbing shot.  I understand that it's difficult to relax while someone is cutting on you.  I think it's helpful for patients to know that I've been through this as well and that I can relate.  I'm a huge proponent of being honest with patients and letting them know that we go through the same things they do.  I think there is sometimes a stigma with providers, but we're all just people too.   

My advice to patients who need a biopsy done is:

  • It's not as scary as it seems 
  • The shot does hurt pretty badly (especially on the foot), but it only lasts about 5 seconds.  
  • The feeling pressure and no pain is very strange, especially when the suture are being put in 
  • Even if you do everything you're supposed to do for aftercare, you can still get infected
  • Stitches are really itchy!  
  • The biopsy site may be sore afterwards, but it's nothing ibuprofen or acetaminophen can't take care of. 

My advice to providers doing a biopsy: 

  • Don't try to pretend the shot doesn't hurt because it does.  Just try to get it done as quickly as possible, and remind your patients to take deep breaths while you are injecting.  And if you are injecting in such a sensitive area, you may want to recruit some help for keeping the patient still and ask the patient to try to not jerk with the needle stick.  
  • If you think a spot needs biopsied, be confident in that decision and either take it off yourself, or if you are not working in dermatology refer the patient to a dermatologist.  If you really think it may be atypical or malignant, it's probably best for it to be biopsied in a dermatology office because it's really helpful to see a lesion before it's messed with.  

Respecting Patients

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There has been a lot of press about a news story that came out recently.  Basically, during a routine colonoscopy, the patient accidentally had his phone recording, and happened to hear some very insulting remarks being made by the anesthesiologist during his procedure.  The things that were said were pretty outrageous, but unfortunately it is not too uncommon in many medical settings to hear negative comments about patients at times.  There were many things wrong with this case, including that the physician was making inappropriate comments, no one tried to protect the patient, and the physician made comments about billing for diagnoses that weren't present.

This case is a good reminder that it is our job as healthcare providers to protect our patients, and not just because you could lose money over it.  Working in the medical field day after day can be exhausting and sometimes it is easier to complain and rant then to just keep the frustrations in.  Whether it's the late patient, the difficult patient, or a drug seeker, it is not our job to judge the person who comes to us for help.  Even if you're not the initiator, you can help to be a positive influence in your workplace.

A story like this gives medical providers a bad wrap, and makes patients even more skeptical about whether we are really there to help them.  Especially if a patient is going under for a procedure, there's a good chance they are nervous about it, and the focus needs to be on "doing no harm" at all times, even when it's hard.  I hope you keep this in mind when you are out in clinic or hospitals and let's be more aware of how we are treating our patients.


Free Apps for Clinic Use

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We're lucky to be practicing medicine in a time where technology is readily available.  As frustrating as working on an EMR can be at times, I'm thankful that my computer is there if I need to look anything up or get more information about anything.  Phones and tablets have also found a place in medicine, and can be great tools to look something up quickly.  Today I'll share some apps with you that I use frequently in practice and that would also be useful for rotations.  Make sure to comment with any other apps that you find helpful!

- Medscape - This is one of my favorite resources for an all-inclusive source of information.  When you look something up on Medscape, it includes physiology, presentation, work-up, differential diagnosis, treatment options, prognosis, and basically anything you would want to know.  Even when I google stuff on the computer, Medscape is typically my go-to source if I'm not using UpToDate (which requires a paid subscription).

- Epocrates - This is a very important pharmacology app.  It can be especially tough to keep up with all of the changes in medications.  There are constantly new drugs coming out and changes being made in availability, and this app does a great job of staying up to date.  On the free version, you can look up specific medications and find out dosing, alternate names, how it is supplied, adverse affects, contraindications, and even pictures of what the medications look like.  There is also a feature that you can add all medications that a patient is on and see if there are any cross reactions.

- Figure 1 - This app is like Instagram for medicine, and it is amazing.  Since I work in dermatology, and a lot of my cases depend on what I see, it's especially interesting to me.  Basically, people can post pictures and descriptions of cases for discussion.  Sometimes people will be looking for input into a case, or they may post something that they have seen to let other people become familiar with it.  This may not be something that you look things up on in clinical, but it may be helpful if you have a question, and it can familiarize you with diagnoses you may not frequently see.

- GoodRx - This is another pharmacology app, but it is more to the benefit of your patients.  You are able to put in medications and your zip code and find out the cost of the medications based on dosage.  This helps to compare and see what the most cost effective option is for your patient if you are deciding between medications.  There is an app, but you can also just pull the site up on your phone.  You can also print out coupons for specific pharmacies that make the prescriptions cheaper.

These are the ones I use the most, but I would love to know what you use as well!  And definitely check with your school or hospital and see if there are any apps that they offer subscriptions to as well.

And here are some other sites with their lists of top apps!


The PA Job Search: Where to Find Jobs

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Earlier this week, I did a post on what to look for when first starting a job search, so here's a follow-up post about where to actually look for the jobs.  I promise they're out there!  Some areas are more saturated with PAs than other areas so it can be a little more challenging, but the more flexible you are, the better luck you'll have finding a job.

The Internet:  This is pretty obvious, but it's a good idea to start with Google to get an idea of what may be open in your area.  When I was first starting, I would just search "physician assistant job augusta ga," and it usually took me to indeed.com or some other job site.  Most of the results from these searches go through an agency or are hospital listings.  Looking at specific hospital websites that are in the area you are interested in can also be helpful.  The only issue with these is that they may not update the listings very frequently, but there are usually at least a few positions posted at each of the hospitals in my area.

Preceptors:  When you are on rotations make it well-known what areas you are interested in working in to your preceptors and staff at your rotation sites.  When I first started rotations, I thought I should act like I loved whatever area I was working in for the month, but once I started being honest and talking about my love for dermatology and surgery was when I started hearing about job opportunities.  I attribute to my job to my surgery preceptor for the most part.  He was a colleague of a doctor that I heard was hiring and gave her a call on my behalf.

It's sometimes said during rotation orientation that you should expect to get numerous job offers while on rotations, but that isn't always true.  If most of your sites are ones that have been used for a long time and always have students, it is not likely that they are looking to hire.  You're going to have a much better shot at a job offer if you are able to do rotations at sites that have not had students in the past.

Cold Calls:  One of my teachers recommended this and it was incredibly intimidating, but now I definitely recommend doing it.  The best way to do this is to call offices, ask to speak to the office manager, and then ask if they are looking to hire a PA.  The majority of offices I called said not currently, but asked me to send my resume anyway.  I felt like this was possibly a dead end, but I actually met 2 different PAs during the time I was looking that recognized my name from my resume, and then told me about jobs they had heard about.

Program Resources: Some programs are really great about helping their students to find jobs after graduation.  Ask your advisor and any faculty you feel comfortable with if they know of any open positions (if you want to stay where your program is).  Our program also has a job board and a Facebook page for alumni where jobs are posted frequently, so see if your program has this, and if not just start one yourself!

Staffing Agency: Some offices go through agencies to find PAs.  I've talked to a few of these, but I'm not sure how effective they are.  Two of my closer friends from my program applied to and interviewed for programs through an agent, but from what they said they had to follow up very frequently and ultimately didn't get anywhere.

I hope this gives you some direction if you're job searching, and please comment with your tips for finding a job!


The PA Job Search: What to Look For

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About this time last year, I was nervously getting ready to start my final 2 rotations at the dermatology office that so graciously decided to take me on as a new grad.  Looking back, that job search was a bit exhausting and honestly there were some tears involved.  I love my job, and I feel very fortunate as this is my first position, but I thought it may be helpful to share some of the things I learned along the way.  As a new grad, you're excited and ready to get out into the working work, but getting there takes some effort.

So congratulations if you just graduated/are graduating soon, or if you are finding yourself looking for a new position and leave a comment below if you have any other tips!

What to Look For:

So when looking for a job, I've read multiple theories and recommendations about what you should focus on.  You have to decide what's important for you personally.  It seems to me the more essential aspects of a Physician Assistant job are - location, specialty, supervising physician, salary/benefits.

You need to rank these factors in order of importance to you.  A year on rotations should have helped to make it a little more clear what your priorities are.  I decided that having a great supervising physician and doing something I loved were more important to me than salary.  In my opinion, I would much rather wake up and want to go to work than dread my job or who I'm going to work with.

Location is important if you have an area you really love or family you want to be near. I was raised in Augusta and went to PA school in Augusta. My husband is still in medical school here, so that was an obvious choice for me. If location isn't as important to you, it may be a great opportunity to try out a new place and get some experience so later you can find your dream job in your dream location.

Rotations give you a good idea of what areas you do and don't want to work in. The main questions that came up for me were sick vs not sick and appointment vs walk-in and procedures vs no procedures and continuity of care. I'll explain that a little more because I didn't really get it until I was in the field.  When it comes down to specialty as well, I will mention that it seems any experience you have makes you very valuable for other fields, so I think it is much better to have an open mind when starting your job search.

Sick vs not sick - Some specialties you see "sick" patients, which I consider the ones that have things you could catch. This includes pediatrics, family medicine, internal medicine, urgent care, and ER. Other specialties like dermatology, pulmonology, cardiology, hem/onc, GYN, and lots of others have patients that may have diseases that make them very sick, but they aren't going to cough on you so you could catch it.  Personally, I didn't love seeing the flu and strep throat all winter long.  And when other students say you should plan on getting sick on your pediatrics rotation, it's absolutely true.  (And sidenote - go to the doctor or health clinic when you start feeling sick, and not the last day of your rotation, so maybe you can avoid being diagnosed with pneumonia like me.)  A lot of the patients I see in dermatology have very real, serious disease that affects their lives, so I definitely still feel like I'm helping patients even though I'm not seeing the acutely "sick" ones.

Appointment vs walk-in - If you're working in private practice, you will likely have a schedule of patient appointments that you are expected to stay pretty much on time with.  If you are good at time management and a fairly quick decision maker, this should be fine for you.  The frustrating thing about having a set schedule is that it can easily get thrown off by late or complicated patients.  It's personally very important to me to stay on time out of respect for my patient's time, but there are definitely days where it seems like everyone is complicated, so they need more time (and I'm becoming a little more okay with that.)  Areas like urgent care, emergency med, or being in the hospital will mean that your patients just show up or are already there.  This has it's advantages because you don't have to worry as much about the late patients or your own punctuality, and it's ok if you need to take longer with some patients.  The disadvantages to not knowing your schedule for the day mean it's a bit of a surprise, and you can't predict as well if your day will be slow or hectic.

Procedures vs no procedures - This is pretty straightforward, but if you loved surgery and getting to do things with your hands, then you probably want to do something where you can do procedures.  I would say in most specialties there's at least a possibility of being able to do some hands-on stuff.  Specialties that are more lab-based (ex - endocrinology) may not have as much going on there.  General or family practice is a bit of a toss-up because there are some that do their own injections and even biopsies, and then other practices that don't do any of this.  So that's just something to consider when looking for what field you want to be in.

Continuity of Care - It was really important to me that I know how my patients are doing after I treat them, and I wanted to be able to build relationships with my patients.  You may get a little bit of this in urgent care or emergency med, but usually when you recognize a name there it's not a good thing.

Now on to supervising physician(s).  It's much easier to work under one SP, but sometimes if you're looking at working for a large practice or hospital, that's not going to be the case. I cannot stress how much having a supportive SP who is willing to adequately train and teach you is important.  My SP will stop what she's doing, even if she's running behind, to come see a patient if I ask her to.  You also want a SP that will support your decisions, and although they may not agree and will tell you that in private, they should never throw you under the bus in front of a patient.  There's a saying that if a patient sees a bad doctor, they'll find another doctor, but if they see a bad PA, they'll never see another PA.  I think that's true because most patients still have a little bit of a difficult time understanding what a PA is and what we can do, so they are quick to lose faith if something happens.

Now for salary and benefits.  I have a much different opinion on this than other PAs from things I've read and discussions I've had.  I definitely believe in not being lowballed, but I also believe in being willing to accept a fair offer, especially as a new grad.  It is going to take both money and time, and probably mistakes, to train you to be a good PA.  And you have to weigh the worth of location, supervising physician, and experience you will gain.  So really look at everything involved, and not just the number.  Is there a bonus structure in place?  That can potentially make a huge difference.  There's a lot out there that says you should never take a job if it's less than the national average and that new grads should be making 90K+.  I think this is possible, but is not necessarily the norm, so you have to be realistic.  Also, consider vacation/sick time, CME days and money, insurance, retirement, and just quality of life.

What are some of the things you are looking for in a job?  What helped you make the decision to take a certain job?


Dermatology Resources

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After I graduated, I went straight into working in dermatology.  During didactic year in school, we got about 2 weeks of derm, and it makes up a whopping 5% of the PANCE.  Those 2 weeks and some dermatology shadowing I did before were enough to spark my interest in the field, but not quite enough to make me feel confident enough to know what I really needed to.  I am extremely lucky to have a great supervising physician and I was able to do my 2 elective rotations in dermatology, so that was helpful, but even after being at my job for almost 3 years, I still find myself looking up information multiple times daily!  Today, I'm going to share with you some resources I found helpful while in school and what I currently use in practice!

In school:

  • AAD Basic Dermatology Curriculum - The American Academy of Dermatology has a specific curriculum for medical education, and it's awesome.  The lessons are thorough and a great overview of some basic dermatology topics that are likely to come up both on boards and rotations.  They don't take a ton of time, and I think are definitely worth taking a look at.
  • Dermatology Secrets Plus - This is a small, simple book that is filled with pictures, which are so helpful in dermatology.  I used this book during didactic year, and I still refer to it occasionally in practice as a quick reference.  Not the best book if you are looking for every detail on a subject, but more of a quick overview w/ pics.

In practice:

  • UpToDate -  I recommend UpToDate for any specialty really!  Like the title says, it has the most current information and is updated regularly.  One of my favorite features is print outs for patients!  These are so helpful, and the majority of the time there is one for what I'm looking for.  The drug information is also very specific and always provides exactly what I'm looking for, including dosage and how the medication is supplied.
  • VisualDx - This is a resource that I use on a daily basis.  I pull it up on the computer as soon as I get to work to have it ready to go!  You can look up multiple dermatologic subjects and there is a huge photo library with great examples, and it provides all the info you need to know, including pearls, diagnosis methods, differentials, and treatment.  There's a really nice accompanying app as well!
  • Habif's Clinical Dermatology - This is the first actual textbook I got for derm when I started working, and I have used it a bunch!  For a textbook, this one is very easy to read. My one complaint is that sometimes it does lack some of the details I'm looking for so I'll visit my supervising physician's library to borrow one of her books. 
  • Practical Dermatology- Practical Dermatology is my favorite journal for getting all of the up and coming derm news.  It's very easy to read and the topics tend to be more common things that I actually want to read and learn about.
  • Litt's Drug Eruption and Reaction Manual - Possibly my most helpful book.  This is my go to for any rashes that could be caused by drugs. It lists every medication and the possible side effects.  Great for my itching, photosensitive, and hairloss patients when medications are involved. 
  • Wolverton Comprehensive Dermatologic Drug Therapy - This is the most in depth book about dermatology medications. If I have any question about side effects, contraindications, dosing, etc, this is my go to.  UpToDate is great, but this is strictly derm, and sometimes I just sit and read it. (Nerd alert)
  • Andrews' Diseases of the Skin and Bolognia's Dermatology - These are my supervising physician's favorite books. She can actually just pick one of these up and turn to the page she wants because she used them so much during residency.  It's amazing! But they have so much detail and every obscure derm disorder ever. 
  • SDPA Diplomate Fellowship Program - I've just started these modules, but so far, they are very well done. This is training specifically for derm PAs, and it follows Bolognia's Dermatology Essentials

Some of these links are affiliates, which means if you use them, I get a small cut from Amazon, but you pay the same low prices and get your Prime shipping! I hope that some of these are helpful to you, and please comment with any other resources you love to use!