How I Chose my Specialty

One of the biggest areas of concern for me while I was in PA school was what specialty I was going to enter after graduation. I remember sometime within the first week of PA school one of my professors asked for a survey by show of hands what specialty we wanted to practice medicine. I rasied my hand when she said Orthopedics. I had shadowed in ortho before school and was literally HELL BENT on definitely surgery and most likely ortho becuase of my athletic background.

Disclaimer: I don’t work in surgery or orthopedics. I honestly don’t think I ever will.

Here are the top 7 factors to consider when choosing your first specialty and job!

1. Medicine VS. Surgery

I think this is the first major decision. Do you like the OR or do you primarily like a medical based specialty? I did not have a great surgical roation and I think that definitely skewed my perception of PAs in surgery. Through rotations I learned that I liked the puzzle solving porition of medicine. I also did not want to deal with surgeon egos. The director of my program looked at me one day and told me I was not meant for surgery. I took this offensively at first, I now see the full picture (touche Dr. Opacic). Needless to say I am so happy I am in general medicine.

2. General vs. Specialty practice

Maybe you did a rotation in cardiology and loved it. Or you thought you would love your Nephrology elective and it made you miserable. Maybe you know that the OR is the place you want to be. Or emergency medicine is great for you because you love the idea of seeing a patient once, fixing the problem and saying peace out.

3. Work/Life Balance

Think about what hours you would like to work. Not that they always happen; but, in general what appeals to you? Days, nights, four 10 hour shifts, 7 on 7 off 12 hour shifts, 8-5 M-F, call/no call. Those are the basics. I think if I could have it my ideal way I would work two 16’s and 1 8 hour shift. That would be great (I’m not een sure that exists anywhere but I would jump on that opportunity!)

4. Who is hiring and Received Offers

Sometimes as a new grad you can’t seem to find EXACTLY what you want, and you need to take a job to get experience on your resume and that is ok. Don’t take just anything. However, taking a position slightly sub-optimal for a year or so is not a terrible idea. Obviously I would not express that thought process in an interview.

5. Collaborating Physicians and Co-workers.

If a company or group wants to offer you a job, ask to shadow for a few days and see what the work flow is like to make sure you like what you see on the inside. Everything can seem great superfically; but, when you shadow there are somethings that are less than appealing for whatever reason.

6. Salary

It is always going to be a factor. Areas of salary to consider/negotiate include: Overall salary, CME money, CME days off, vacation time, sick days, possibly maternity leave, sign on bonus, RVU/bonus incentives, non-compete clause (not exactly salary but something to be aware), raise policy/incentive. If you are between two job offers with all of the above you are pleased with and one job is offering you 5-8k more–it’s a no brainer. If you really want the other job–tell them. Maybe they will counter offer for more money.

7. Location

Do you want to stay in your home town or move to the beach, mountains, etc. What will your commute to work be? My first job ended up having a terrible commute. 45 minutes for 7 miles to and from work. Which to some may not seem bad but that was an hour and a half out of my day, everyday that I was basically contributing to work.

Disclaimer: The beautiful things about the PA profession… You can always pick something new 🙂

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