Launching your PA Career: Guide to your 1st Year of Practice
Congratulations on graduating from PA school and embarking on your journey as a physician assistant (PA)! As you step into your first year of PA practice, you are about to experience a transformative period of growth and learning.
This is a pivotal moment where you transition from being a student to becoming a healthcare professional, entrusted with the responsibility of delivering high-quality patient care.
The first year of practice is an immersive learning experience for new PA graduates. Through a combination of practical experience, mentorship, self-reflection, and ongoing professional development, you will gradually develop into competent and confident PAs who provide high-quality care to their patients.
The learning process extends well beyond your first year of practice, as you continue to refine your skills, expand your knowledge, and adapt to the evolving landscape of healthcare throughout your career.
I. The Transition from PA School to PA Practice
a) Reflect on your time in PA school
After years of rigorous coursework, countless exams, and extensive clinical rotations, you have successfully graduated from PA school.
Take a moment to reflect on the incredible journey you have undertaken to reach this point! Recognize the dedication, perseverance, and hard work that have equipped you with the knowledge and skills necessary to excel in your profession.
Your education has laid the foundation for your future success as a PA. The comprehensive curriculum and hands-on training have prepared you to provide competent and compassionate care to patients across a wide range of healthcare settings. As you embark on your first year of practice, have confidence in the education you have received and the abilities you have developed.
b) Transition from PA student to Practicing PA
Now that you have transitioned from a student to a healthcare professional, it is time to fully embrace your role as a clinician.
Transition to Practical Application: As a new PA grad you will experience a significant transition from the academic setting to the practical application of your knowledge and skills in a clinical environment. You must adapt to the fast-paced and high-stakes nature of patient care, while also navigating the complexities of the healthcare system.
Learning curve and skill development: There is a learning curve as you gain experience and proficiency in clinical decision-making, patient management, and the execution of procedural skills. Initially, there may be a sense of being overwhelmed or lacking confidence, but with time and experience, you become more comfortable and capable in your clinical responsibilities.
Supervision and Mentorship: As a new PA hire, you will receive supervision and mentorship from more experienced healthcare professionals. This guidance helps in the development of your clinical skills, critical thinking, and understanding of your professional responsibilities.
Patient Care Responsibilities: As a PA, you will have the privilege of working closely with patients, diagnosing illnesses, developing treatment plans, and coordinating their care. This responsibility requires not only clinical expertise but also excellent communication skills and a compassionate approach. This will be under direct or indirect supervision of a physician.
Remember that the journey to becoming an exceptional clinician is ongoing.
You will experience a period of adjustment, skill development, and professional growth as you transition into your role, while working towards delivering high-quality patient care and advancing in your healthcare career.
Embrace each patient encounter as an opportunity to refine your clinical skills, expand your knowledge, and develop your unique approach to delivering patient-centered care.
II. Starting your 1st PA Job: Orientation and training
a) Collaborate with your Supervising Physician(s)
As a physician assistant, you will work closely with a supervising physician who plays a vital role in your professional development and patient care. Building a strong and collaborative relationship with your supervising physician is essential during your first year of practice. Open and effective communication will foster a supportive environment and enhance your learning experience.
Take the initiative to introduce yourself and establish clear expectations with your supervising physician.
If the physician has not worked with a PA before, or is not as familiar with the profession you may have to advocate for yourself to practice at the top of your scope of practice.
Understand their preferred communication methods and the best ways to reach them for guidance or consultation.
Regularly engage in open dialogue to discuss patient cases, seek feedback on your performance, and address any concerns or questions that may arise.
Remember that collaboration with your supervising physician is not a sign of weakness but rather a testament to the team-based approach to healthcare.
Recognize the unique expertise and experience your supervising physician brings to the table, and view them as a valuable resource for guidance and mentorship throughout your career.
b) Orientation Process
Many healthcare organizations provide a structured orientation program for newly graduated PAs. This period serves as a crucial transition from the academic setting to the clinical practice environment. Make the most of your orientation by adopting a proactive and engaged approach.
During orientation, you will receive important information about the organization's policies, procedures, and protocols. Take the time to familiarize yourself with these guidelines, as they ensure patient safety and effective workflow. Ask questions, seek clarification, and actively participate in orientation activities to gain a comprehensive understanding of your new work environment.
Here’s an example of what to expect for orientation in your first PA job:
Example of an orientation checklist for a new PA hire:
i) Pre-Orientation
Provide the new PA with a welcome packet including essential information about the practice, its mission, values, and organizational structure.
Share required paperwork, such as employment contracts, confidentiality agreements, and any other legal or administrative forms.
Provide information on obtaining necessary licenses, certifications, and malpractice insurance.
Coordinate the setup of necessary equipment, access to electronic medical record (EMR) systems, and other relevant technology.
Schedule a meeting with the supervising physician(s) to introduce the new PA and discuss expectations and responsibilities.
ii) Orientation
Introduce the new PA to the staff members and colleagues in the practice.
Provide an overview of the practice's policies and procedures, including hours of operation, emergency protocols, and communication channels.
Orient the new PA to the physical layout of the practice, including clinical areas, supply rooms, and administrative spaces.
Familiarize the PA with the organization's documentation and charting systems, including the EMR and other software used for scheduling, billing, and communication.
Review the practice's infection control protocols, safety guidelines, and emergency procedures.
Discuss the practice's quality improvement initiatives, patient satisfaction goals, and any relevant performance metrics.
Review the practice's medication management policies, including prescribing practices, controlled substances protocols, and medication reconciliation procedures.
Explain the referral process, including how to consult with specialists and communicate with other healthcare providers involved in patient care.
Discuss the practice's policies and procedures for handling patient complaints, privacy, and confidentiality of medical records (in alignment with HIPAA regulations).
iii) Clinical Orientation
A Period of Shadowing: Schedule time for the new PA to shadow experienced PAs or physicians within the practice to observe patient interactions, procedures, and clinical decision-making.
Otherwise taking the time to:
Provide an overview of common patient conditions and diagnoses encountered in the practice.
Review the practice's protocols for patient assessment, physical examinations, and diagnostic tests.
Explain the practice's procedures for ordering and interpreting laboratory tests, imaging studies, and other diagnostic procedures.
Discuss the practice's approach to preventive care, health maintenance, and chronic disease management.
Orient the PA to the practice's common treatment modalities, including pharmacological and non-pharmacological interventions.
Provide guidance on appropriate referrals, consultations, and collaboration with other healthcare providers.
iv) Professional Development
Discuss the practice's expectations for continuing medical education (CME) and opportunities for professional growth, such as attending conferences, participating in workshops, or engaging in research.
Share resources for accessing relevant medical literature, guidelines, and online CME courses.
Encourage the new PA to establish a personalized learning plan and discuss strategies for ongoing professional development.
Establish a schedule for regular performance evaluations, feedback sessions, and goal setting to support the PA's professional growth and progress.
Facilitate connections with mentors or experienced PAs within the practice who can provide guidance and support throughout the orientation period and beyond.
While orientation may provide an overview of various aspects of your new role, it is essential to remember that learning is a continuous process.
Take advantage of every opportunity to expand your knowledge and refine your skills. Seek out experienced colleagues, both PAs and other healthcare professionals, who can offer insights and guidance as you navigate the complexities of your first year of practice.
III. Self-Learning in your 1st PA Job
a) Learning how to be a PA
In addition to acquiring clinical knowledge, new physician assistant (PA) graduates learn to be effective PAs in their first year of practice.
This means taking a step up from your role as a clinical clerk. You’ll be responsible for patient assessments, diagnosis, ordering investigations, and clinical decision-making. However, you will be doing so with the supervision and guidance of a physician.
To make the most of the learning period as you start a new PA job, we suggest:
Treating each patient encounter as a learning experience: Each interaction with patients contributes to your understanding of the complexities of medical decision-making, effective communication, and providing patient-centered care. Read around cases. Discuss difficult and complex cases with your supervising physician.
Seek Feedback from your supervising physician: This supervision allows for ongoing learning, guidance, and mentorship. Collaborating with experienced physicians provides insights into clinical reasoning, treatment strategies, and the nuances of patient management - all to the benefit of the practice. This feedback may be formalized in “check-in” meetings, or you may have to ask for feedback directly.
Mentorship and Guidance from Experienced PAs: Seeking guidance from experienced PAs or healthcare professionals. Mentors can provide you with valuable insights, experiences, and offer support as you navigate the challenges of their first year. Mentorship fosters professional growth, enhances clinical skills, and provides a safe space for you to ask questions, seek advice, and learn from the experiences of others.
Continuous Self-Reflection: Engage in self-reflection to assess their strengths, weaknesses, and areas for improvement. Reflect on your clinical encounters, evaluate your decision-making, and identify opportunities to enhance their skills. This process allows you to identify your learning needs, knowledge gaps set goals, and develop strategies for continuous improvement
b) Expanding Knowledge in the Specialty you work within
In your first year of practice, you will learn to prioritize ongoing education, engage in continuing medical education (CME) activities, attend conferences, and participate in workshops. By staying updated with the latest research, guidelines, and advancements in medical knowledge, you will ensure that you deliver the most current, evidence-based care to your patients.
Here are some effective ways to enhance specialty-specific knowledge:
Revisiting notes from PA school and the PA certification exam can be a valuable way for to reinforce your knowledge and refresh your understanding of key concepts
Attend Teaching Rounds: If available at your practice, see if you can attend teaching rounds that are often made available to medical learners.
Read Specialized Literature: Stay updated with the latest research, journals, and publications relevant to your specialty. Subscribe to specialty-specific journals or newsletters and allocate regular time to read articles, case studies, and research papers
Attend Specialty-Specific Conferences and Workshops: Look for conferences, seminars, and workshops focused on your specialty.
Case Discussions and Collaborative Learning: In your first year of practice, you will often participate in case discussions and interdisciplinary team meetings where you can collaborate with colleagues, share your experiences, and learn from the expertise of others.
Engage with Professional Organizations: Join professional organizations or associations related to your specialty. These organizations often offer resources, webinars, and networking opportunities specific to the field. Participate in their events, webinars, and online forums to connect with experienced professionals, access educational materials, and stay updated with industry news.
Utilize Online Resources: Leverage online resources specific to your specialty. Online platforms, medical websites, and forums often provide specialty-specific content, case discussions, and educational materials. Engage in online communities and discussion boards to connect with peers, ask questions, and exchange knowledge.
IV. Challenges and How to Overcome them in your 1st year of PA practice
While challenges may arise in your first year of practice, they are opportunities for your growth and development as a new PA.
With time, experience, support, and a commitment to ongoing learning, you can overcome these challenges and thrive in your first PA job.
Here are some common challenges that you may face:
Adaptation to the Clinical Environment: Transitioning from the classroom to the clinical setting can be overwhelming. You must quickly adapt to the fast-paced, high-pressure nature of patient care, learn to navigate electronic medical record (EMR) systems, understand practice workflows, and become familiar with the physical layout of the clinical setting.
Building Clinical Confidence: Initially, you may experience a lack of confidence in your clinical skills. You may question your abilities, feel uncertain about your decision-making, or worry about making mistakes. Developing confidence takes time and experience, and it's important for you to embrace a growth mindset and seek support from colleagues and mentors.
Expanding Clinical Knowledge: Your first PA job will likely introduce you to a wide range of clinical scenarios and patient populations. You may encounter cases that were not extensively covered during your education, requiring you to quickly learn and adapt. Expanding your clinical knowledge and staying updated with the latest research and guidelines are ongoing challenges for you as a new PA.
Balancing Autonomy and Supervision: You must navigate the balance between exercising your skills and working under the supervision of a collaborating or supervising physician. Learning how to effectively collaborate and seek guidance from physicians while also demonstrating autonomy and initiative in patient care can be challenging.
Time Management and Workload: Managing a busy schedule, prioritizing tasks, and efficiently completing patient documentation can be demanding for you as a new PA. Learning time management skills, setting realistic expectations, and seeking support from colleagues can help you navigate the workload effectively.
Building Professional Relationships: Establishing relationships with colleagues, other healthcare professionals, and support staff is crucial for your success as a new PA. Building rapport, effective communication, and teamwork are skills that take time to develop but are essential for delivering coordinated patient care.
Developing Efficient Documentation Skills: Learning the specific documentation requirements of the practice, understanding coding and billing processes, and accurately and efficiently documenting patient encounters can pose a challenge for you as a new PA. Emphasizing proper documentation practices early on and seeking guidance from colleagues can help you develop efficient documentation skills.
Emotional Impact of Patient Care: Providing patient care can be emotionally challenging, particularly when dealing with difficult or complex cases. You may face emotional stress, compassion fatigue, or feelings of being overwhelmed. Developing self-care strategies and seeking support from peers and mentors are important for maintaining your emotional well-being.
Final notes
As you embark on your first year of PA practice, it is crucial to navigate the challenges and seize the opportunities that lie ahead. By reflecting on your education, embracing your role as a clinician, prioritizing orientation and training, engaging in continuing medical education, understanding your scope of practice, and seeking guidance from experienced colleagues, you will set a strong foundation for a successful and fulfilling career as a physician assistant.
