New PA Grad: Harrison, Emergency Medicine PA

Harrison is a recent graduate from University of Toronto’s PA program Class of 2020 and is now working in Emergency Medicine as a PA. He shares his experience of the PA job hunt, how he selected his current position and advice for PA students on finding employment after PA school in Canada.

I took a position as an Emergency Medicine physician assistant at a hospital network in Windsor, ON. This involves working in the emergency department at 2 different hospitals servicing different populations. One hospital is a busy downtown emergency room, a level 2 trauma centre, and a psychiatric facility – meaning you see traumas, acute cardiac, critical care, resuscitations, and psychiatric emergencies in addition to typical ED complaints like chest pain, abdominal pain, syncope, shortness of breath.

This is a teaching hospital so I frequently get to work with PA students, residents, and medical students and help them get their bearings and orient them to the department. Both hospitals have an acute care section (CTAS 1-3), a Fast Track (CTAS 2-3, no resuscitation/critical), and a RAZ (rapid assessment zone) or MTA (minor trauma assessment) (CTAS 3-5).

As Physician Assistants we work in all sections as needed, often seeing patients in multiple sections at once. We see all levels of acuity (CTAS 1-5), primarily acute care and fast track (CTAS 2-3), as there are NPs in the RAZ/MTA (CTAS 3-5).

“It is a great time to become a Physician Assistant in Canada. I went into the program a bit concerned about job prospects, I had read some things online that concerned me. None of that turned out to be true. Most PA graduates I knew had more than one offer, there were far more job postings than new graduates, and the perception of the PA profession from every physician I worked with was excellent. I think there is a ton of room for us to grow as a profession moving forward.”

My PA Job Hunt

Harrison in first year of PA school in clinical skills.

My job hunt was actually very brief, my ED rotation was my last rotation of PA school and it was at the hospital network in Windsor that I work at now. On my last day, I had a chance of working with the department head and they asked if I wanted to interview for the position. To my knowledge, there was no formal job posting internally or externally.

I heard during my rotation that they were looking to hire another PA and was able to send my resume to the department head before getting to work with them during my rotation. I also got to learn the department well during this rotation and meet some of the PAs that already worked there. I interviewed the week after finishing PA school and was hired on.

I took a look at the career start grants jobs when they came out but was satisfied with my choice, and have been learning a lot.

Why I picked Emergency Medicine

I picked a job in emergency medicine because of the variety of cases and levels of acuity. I think it makes a great choice early in your career to be exposed to undifferentiated patients requiring you to hone your diagnostic skills.

You also get instant answers to your clinical questions since your labs and imaging are done the same day in the department so you can quickly see if you are on the right track and satisfy your clinical curiosity.

You also get to do procedures like casting, suturing, incision and drainage, and down the line – intubation, central lines, thoracentesis etc.

Our department has a few PAs already with well-established medical directives and staff that are comfortable working with PAs already so it made the transition from being a student to being a practicing PA much easier.

Right now I see everything from multivehicle traumas, code blues, and respiratory distress and psychiatric emergencies to lacerations, broken bones, and cough/URTI symptoms. I get a lot of practice presenting cases, consulting other specialties, working with many different physicians (we have 54 between 2 hospitals) and ED staff such as nurses, nurse practitioners, RTs, clerks, porters etc.

You also get practice dealing with different populations including geriatrics, pediatrics, agitated/intoxicated, nonresponsive and cognitively impaired which makes you a better clinician more equipped to deal with any patient that comes in.

I utilize all the physical exam skills, history taking skills and procedural skills I learned in PA school on a daily basis. It is also just really exciting not knowing what case will come in. It can be stressful, exciting, nerve-wracking but I think early in your career emergency medicine forms you into a very well-rounded, versatile, and mature PA with a lot of exposure to multiple areas of medicine at a level you don’t get from other specialties.

“I utilize all the physical exam skills, history taking skills and procedural skills I learned in PA school on a daily basis.. It can be stressful, exciting, nerve-wracking but I think early in your career emergency medicine forms you into a very well-rounded, versatile, and mature PA with a lot of exposure to multiple areas of medicine at a level you don’t get from other specialties.”
– Harrison, New PA Grad

Tips for PA Students on Finding Employment after PA School

Excel at your Rotations

Myself and a lot of Pas in my graduating class got their jobs from rotations they had. Even if a rotation doesn’t have a job to offer, your preceptors from your rotations are your best references for when you start looking for positions.

• Be timely, eager, prepared, always reading, always volunteering to see patients, be competent, follow-up and reassess your patients, know them well, talk to your preceptors about their expectations early and prove that you are meeting them, leave thank you notes or send a thank you email at the end of your rotations.

• Stay in touch with preceptors – send them an email every couple of months and let them know how your training is progressing, thank them for having you, remind them of interesting cases you saw together, let them know what specialty you are thinking of, then when getting close to graduating: ask them if they wouldn’t mind being a reference for you – it is a lot easier when you’ve been keeping in touch with them and they remember who you are.

Know where the PA jobs are!

Subscribe to “Physician Assistant” job alerts to your email on LinkedIn, indeed, monitor the health force Ontario and CAPA job bank (become a CAPA member to do this – as a student it is well worth it). Many jobs on those will show up as a career start grant job as well.

Send Letters of Interest

You can send out letters of intent or interest by email to job postings even while you’re in school saying how you found out they were hiring a PA and that although you are still in school you are intending to apply to their institution when you graduate. If they’re still hiring, have a new posting, or get approved for grant funding, this will give you an edge when you interview and help you stand out against other candidates.

Talk to your peers during the Job Hunting Process

Your peers are an excellent resource for sharing job postings and letting you know of opportunities, keep your communication with your colleagues very transparent and share information about where the jobs are, who’s applying, what offers people are getting, what interview questions you’re getting, what the process was like. If you and your friends/colleagues apply for the same job: prepare for the interview together, compare offers, more information is always better to make an informed decision.

Prep for interviews

You can’t just think about your responses to questions and what you’ll touch on, you need to say it out loud with no preparation and see how you sound. Ask someone to go through common interview questions with you and work on talking your way through them out loud with no preparation – with practice you’ll get more comfortable.

• Common interview questions: tell me about a difficult patient you had? Tell me about a difficult encounter or disagreement with a co-workers you had and how you handled it? What do you think your biggest challenge will be as a new graduate? What is your greatest strength/weakness, why did you decide to interview for a job in X specialty (know the specialty you are interviewing for very well.), tell me about an ethical dilemma you had and how you handled it?

• Always have a few questions for the end of the interview, I like: “Where do you see the role of Pas in your department going in the next few years” “How can I be the best PA for your department” “What are the unique challenges your department/office faces that Pas can help with?”, “Do you see any barriers to expanding the PA role at your department/clinic?”.

Above all else – keep studying and learning.

Make yourself into the PA you would want to be treating you. Read often, work on your communication skills, get comfortable being uncomfortable, practice your procedural skills, take every opportunity you can to get exposure to cases, stay sharp.

I would also just want to say that it is a great time to become a Physician Assistant in Canada. I went into the program a bit concerned about job prospects, I had read some things online that concerned me. None of that turned out to be true. Most PA graduates I knew had more than one offer, there were far more job postings than new graduates, the perception of the PA profession from every physician I worked with was excellent. I think there is a ton of room for us to grow as a profession moving forward.