May 19, 2020

My Journey Getting a Job as a PA

My Journey Getting a Job as a PA

“Did you get a job yet?” “Are you planning on working as a PA?” “Where are you working?”

Ah, yes. The most frequently seen sentence that has slithered its way into my direct message inbox over the past 6 months.

  1. I feel so entirely grateful that people are so invested in my journey.
  2. It was a little stressful.

BUT it has all worked out and I’m thrilled to announce I’ll be starting my career as a primary care physician assistant in a community health setting.

The spark notes version:

I needed a little time after graduation to figure out what I really wanted / where I wanted to be in medicine / to fully decompress after a grueling two years. I also needed time to get a lot of blog + business things settled and figured out: taking on a management company, hiring an accountant, working with a financial advisor, finding a graphic designer / videographer / photographer to have on hand for when I have new projects, updating my blog and coming out with a big city guide (the last two of which are still in the works). This took me 3-4 months. Once these moving parts felt settled, I found a place in medicine I really loved and could see myself integrating my many different passions (local primary care office).

I tried getting an interview but they weren’t taking new grads. So after getting my yoga teacher certification and with the help of a new friend who works in one of the clinics of the larger organization, I taught a yoga class to a group of patients. I then re-emailed HR and the chief primary care PA / co-chair of primary care (one person, two roles), discussing the ways I was dedicated to the community and again asked for an interview. At this point, both she and HR had seen my name 2-3 times, so it was clear I was being selective and intentional about wanting to specifically work there. I then got a phone interview, followed by in in-person interview, and a few more phone calls. After these, I was invited back for one final interview but then COVID-19 hit, creating a hiring freeze in primary care. I waited a month, honed in on the skills I highlighted in my interview, then reached back out. After a few more emails, they notified me they would take me on. !!!!! A bit different than some of my classmates (their post-grad hiring stories here), but couldn’t be happier with where I ended up.

The odyssey:

Shortly after graduation, knee deep in the comparison game with my brilliant classmates, the whispers of imposter syndrome started to get a little louder. Why don’t I have a job yet? Shouldn’t I be working? All my friends are working!! I wish I was working!! Followed by: WOW. I am so exhausted. How could I possibly go into healthcare when I myself feel so unhealthy?

Similar to my classmates, I began browsing the job boards early. Just to sort of see what was out there. I fell in line with them in terms of applications as well. Especially because by the time graduation rolled around, the first question out of anyone’s mouth was, “so do you have a job yet?!” 

**insert external flat smile and internal screaming here**

When I graduated in August and took my boards, I was riding a HUGE high. Just a giant exhale after feeling like I had been holding my breath for two whole years.

I used that adrenaline to carry me into job applications. I applied to just about everything I was interested in and enjoyed rotations in: primary care, emergency medicine, and gastroenterology. And I applied exclusively in the western medicine world. I knew I didn’t want to do integrative or functional medicine for a few different reasons.

  1. I absolutely 100% want to be covered by insurance.
  2. My passion is in community health and this is where all my volunteer experience has been. Because I firmly believe you can’t attribute a behavior or diagnosis exclusively to an individual. They are set up for success or failure based off of community and environment. So I want to take that birds eye approach and see what can be done from there.
  3. Less importantly, but still a factor: I shadowed a functional medicine physician in school and he advised against it. Because you don’t really know enough western medicine yet. And much of functional medicine is patients who are motivated to come off their medication, which is really, really scary if you don’t know why they’re on it, how to put them on it, and the tapering off process.

But I was applying somewhat haphazardly and lethargically. I’d send out an application, but then wouldn’t actively search for a contact through LinkedIn or online. My fingers were typing out cover letters, but my mind was big time drifting.

I felt faced with this huge decision of integration vs compartmentalization, similar to how I felt in PA school.

Do I want to try to combine all of my passions into one – medicine, nutrition, yoga – or would I rather continue feeling like I was living two separate lives and apply to something with shift work. This way, I could work 12 hour shifts, 3-4 times a week as a PA and then have the extra days to fulfill my hobbies and passions.

I loved my emergency medicine rotation, and could really see myself there. BUT, that would mean I’d kind of release my giant plan and goal and overarching purpose that I generated 5 years ago: incorporating nutrition and yoga and this giant umbrella term of “wellness” into medicine. At least temporarily for my first gig. But this really sounded appealing because the shift work mindset would likely provide a bit more flexibility for an outside life. And I wanted that extra time because I still don’t want to give up my blog. It provides such a necessary creative outlet, and I genuinely learn so much from it.

PA school quite honestly stripped me of every creative bone in my body. I have never felt less like myself than in school. Okay, maybe slight hyperbole. But some days, that statement felt very real. Whereas I once woke up every day brimming with creativity and purpose, I just felt sad and a little bit broken. And this was likely because I continued working throughout school. It felt…congested.

While it is something I do not regret at all, and I am so entirely grateful to have been able to pay my rent and entry level life necessities throughout school on my own, I began to see blogging as a chore. It wasn’t fun, and I felt like my message just wasn’t landing or resonating with readers. Which makes sense because I lost my sense of messaging as a person. I had a really tough time relating to my online community and cohort. What I was learning in school and seeing on rotations felt entirely opposite to what I was seeing on the internet.

By the end of school, I really wasn’t excited about much. After pushing, pushing, pushing, straddling two spheres for two years, trying to maintain my sanity and figure out where I fit, I was downright exhausted. I was uninspired in both worlds. And was just really, really tired. I had thought that once school ended I would magically be reinvigorated and happy, but the cloak of fatigue didn’t slip off that easily.

Around October, I applied to one last job that felt really hopeful to me. Somewhere where I could potentially see a world of integration. It was a community health practice with multiple locations throughout the greater Boston area, as well as a teaching hospital. I was actually walking in my neighborhood one day and saw they had an entire mindfulness and compassion center within their practice. On their website, I saw they also had community health improvement teams and programs for community health. I saw an opening online and somehow managed to get a call with HR (from the help of a classmate who was hired in surgery and put in a good word for me – thank you, M!!!), and felt really good about it. A week later, I received an email that the practice wasn’t hiring new grads. WHOMP.

After that, I decided to stop applying.

And then I fell into a really tough time. It kind of reminds me of when you study for finals and are fine, and then the very next day when you finally have a break, you get rocked with a head cold. And that was my emotional headspace. November was not fun, and was possibly the darkest form of depression I’ve ever experienced. I wasn’t sleeping well. I struggled to get out of bed. I was constantly weepy. I found no joy in food or friends. And was really no fun to be around. I didn’t have a rotation to be at or something to study for, so I really just sat in it. The voices of defeat and feeling like an imposter were LOUD. I felt like I let myself down and I let down the quite literal thousands of people who believed in me and threw their support behind me. Of course now I can look back and realize these thoughts were just thoughts and not truths, but in the moment it was like trudging through the color grey. Just heavy and colorless.

In this mindset, I couldn’t begin to imagine how I could provide for someone else’s health when mine felt so far from my baseline. So I started taking care of myself again.

I saw a doctor for the first time in over two years – embarrassing, but wow it’s tough to get a primary care appointment when you’re in school + working. I had lab work drawn (and realized I was iron, B12, vitamin D, and omega-3 deficient). I tried to reconnect with a therapist (which was tough because after school and not having a job meant I was paying for insurance out of pocket and many weren’t covered by my insurance). I started going to acupuncture (there’s a community acupuncture site in my neighborhood that operates on a “pay what you can model,” which makes it so much more accessible). I did a LOT of yoga. And very gentle yoga I may add. I stopped doing the sweat-until-you-drop type flows and instead really leaned on the slower and more restorative practices. I did yoga teacher training.

I just started actively participating in feeling well again. Which is an absolute luxury and privilege that I know and acknowledge many do not have the time or financial capacity to do. I didn’t post much of this journey on social because I knew that it just wasn’t accessible to many, and didn’t want to spark a jealousy or comparison trap in anyone. Aka it wasn’t cheap. It likely would have been a lot cheaper with a bit better insurance, but at this point I was paying out of pocket for my own because my school kicked me off their insurance once I graduated. But that’s a tale for another day.

Another thing that helped: I ASKED FOR HELP.

I am by nature a very stubborn person, and it’s hard for me to admit when what I’m doing is just not working. While in school, I had received a few emails from management companies asking to take on the back-end side of things. I was hesitant to do this because they typically take 20% of your earnings, and I didn’t feel like I was earning enough to sacrifice that potential income.

What I didn’t realize was that the things they help with were the things that took so much away from my creative energy. You know what’s really not fun at all? Coming home from a 10-12 hour rotation day or study day and then spending 3-4 hours invoicing companies who haven’t paid you for a job you finished months ago. Again, an absolute privilege to be in that position. But on top of studying, rotations, boards, exams, etc., I didn’t realize how draining it was until I accepted that I needed someone to help me with it.

I reached out to a management company whom I had worked with on a smaller level over the years (hi Smith and Saint), and was provided with an angel of an angels: my manager Kaila. Wow. The way that woman can craft an email astounds me each and every day. She is hysterical and whip smart and creative and did I mention hysterical? She makes my day pretty much every day. My level of happiness skyrocketed when I relinquished just a little bit of control. It allowed me to spend all that time I spent invoicing companies and negotiating for a fair price to instead be thinking about what free, useful, and educational content I can be producing.

So from November to January, I was just trying to get in my own rhythm again. I didn’t apply to a single job. I was doing yoga teacher training. I was volunteering with Cooking Matters. I started reading again. I focused on improving my sleep. I slowed way, way, way down. The color that drained from my face and soul started to make a return.

Around mid-December, a kind, kind amazing, intelligent, smart, funny (okay, fine, I’m done) soul named J- slipped into my DM and said she thought I would be interested in a local community health practice where she worked. I expressed my interest in primary care / my dream job on Instagram stories, and she thought it may be a good fit. We decided to meet up and take a workout class together and she is truly just the best. She spoke about loving her job and how the practice as a whole thinks about medicine beyond just medicine. There are group sessions available for patients that include an exercise class and a nutrition lesson. Ironically, the community health practice she was talking about was the same one I applied to in October. After our meet-up, she passed my resume on to the chief-PA and co-chair of primary care, as well as HR.

I hadn’t heard anything through January, but J reached out to me and said there was an opportunity to teach the exercise portion of the nutrition/movement class mentioned above. I had just (JUST) finished my yoga teacher training so thought WHY NOT! I emphatically said yes, and told myself I’d figure the rest out later.

Prior to the class, I went to the site and met with the physician who not only leads the group but participates in the class! She, her resident, a medical student, me, and the group ALL participate. And then also participate in the yoga lesson afterwards.

I know this may not sound like a lot. But this participation of medical team with patients gave me so much hope and moved me to tears.

Why, you ask?

During the end of PA school, we had the opportunity to provide feedback. I suggested that one Friday a month, we have a half day to schedule whatever we may need for our own health and wellness: a doctor’s / dentist appointment, therapy, or maybe even nothing. Just something that we do for ourselves in order to attempt to re-establish health baseline. The response was along the lines of (and I’m paraphrasing, and completely admit that perhaps my memory made it sound like this while in reality it may have landed differently – 100% memory bias here) – “I see your point. Though get used to it because as healthcare providers we’ll never have time for ourselves.”

In their defense, there is A LOT of material to get through in PA school. And even having a half day on a Friday means you have to cut curriculum elsewhere. I had recommended they restructure / reframe the nutrition class (ironic, I know), because a lot of what we learned was specific to dietitians (think: calculating TPN for inpatient medicine) rather than how PAs can use nutrition in their practice. It was a semester long class, and I just think it could’ve been shorter and more relevant to our specific role. (Maybe I’ll do that in a few years. Tossing that one in the 5 year plan.)

I do not know why, but this statement broke me. Maybe because it was the end of school. Maybe because I was already so exhausted. Maybe because I viewed the response as basically telling me my thoughts and contributions were a waste of time (in hindsight, projection and my noise). But I began to settle into the fact that maybe he was right. A fleeting idea that was only a sometimes thought began to settle and cement as an always truth. Maybe I’d never make a difference. Maybe my idea of integrating wellness into a model of illness was naïve and would never work and why did I even bother? Maybe it wasn’t sustainable. Maybe it was pointless. But the reality set in that if we can’t expect this of our healthcare providers, how could we ever expect it of our patients.

So to witness firsthand a practice where physicians are modeling to residents and students that they stay late or do a little bit extra to participate in the education and wellness of their patients was the spark of hope I needed to keep going. To put frankly, it lit me and woke me the f*** up.

After teaching the class, J provided me with the email of the chief-PA / co-chair of primary care (one woman with both roles – YEAH, amazing I know). I wrote her a note that I had taught the yoga class, was interested in a primary care position and was committed to the community (and basically begged for an interview). At this point, she had seen my name a few times, as I had applied in October, J sent along my info in December, and then I popped back in her inbox again. So it was clear I was committed to this job, and this job specifically. A few hours later, I received an email from HR saying that I had somehow landed a phone interview. (OMG OMG OMG OMG OMG OMG OMG OMG)

I had the phone interview and really honed in on how I was different and what I wanted to add to the practice (note: this is the opposite of what I did in PA school and on rotations when I just wanted to blend in). I was motivated to do this because she discussed how at the sites, they love when providers bring something a little bit different to the table. So that everyone is learning from each other in a unique way. I spoke about nutrition, about yoga, and how I had heard of a PA that was able to bank a few minutes from each patient encounter and pool it to do a group session. And how I really wanted to integrate leading group sessions into my practice. In my mind, it was a risk to speak so openly about how I wanted to be as a provider, especially as a new grad with zero clinical experience. I wanted to be a PA, AND I wanted to implement the various tenets of my background into the practice. And somehow, some way, I landed an in-person interview. Repeat OMG^n here.

On interview day, I arrived and was brought to a room with multiple copies of my resume on the table.

Me: hmm must be a printer error

Then the entire office slowly trickled in. It was a group interview of around 15-20 people (I truthfully cannot remember because I was so nervous. When I retell the story, I tell everyone there were 100 people in the room because that’s what it felt like). While this was nerve-wracking and my armpits were swamps (sorry), it again confirmed why I wanted to work there. Every single member of the staff was involved in the hiring process to ensure the candidate would be a good fit. Did it go 100% how I wanted it to? Absolutely not; I was terrified the entire time. But I put everything out there. I talked about nutrition, yoga, social media, and medicine. I breathed through it. I answered questions the best I could, and I hoped for the best. Do your best, forget the rest kinda energy ~*~*~*

After the in-person interview in February, I had two more scheduled calls: one with the director of operations and the other with the second co-chair of primary care. I also reached back out to the chief PA after the interview, and she suggested a feedback call to discuss how it went. She noted that some in the interview were weary because I was a little bit different, and because I focused so much on nutrition, it was a little unclear if I was committed to the medicine part. Which really made sense, and was something I was thinking back on about the interview, too. I was so nervous through the interview, that truthfully I’d be weary about me too. 

She also mentioned that she brought my blog and social media up to the marketing team of the hospital, and that they were impressed. I know this seems small but social media in medicine is very new and very scary. And isn’t just about tiktoks of people wearing scrubs. It’s something I felt like I had to hide throughout school. So I was so thrilled that even the marketing team was aware of my entire background, and everything was out on the table. All in all, I was invited back for one last in-person interview to clear up some additional questions with only the providers this time. I felt hopeful and just so grateful to be granted another opportunity to talk about why I wanted to work there.

ENTER COVID-19 STAGE LEFT.

In the beginning of March, my last interview was rescheduled indefinitely as there was a hiring freeze on primary care. I was in contact with HR about possibly starting in internal medicine at the local hospital to help out, and then could hopefully transition into primary care as things settled. After this call, I heard back a week later that they weren’t taking on new grads. Hello, déjà vu.

So then I was faced with the new decision: do I wait it out and see what happens with my dream job or do I begin applying to new jobs?

On top of this, I cannot even tell you how guilty I felt that I wasn’t yet working. To see my classmates and peers and family members working tirelessly on the frontlines, and I was just sitting on my license. So. Many. Tears. Of gratitude for them and also for just desperately wanting to help. I mean, how much help I would have been as a new grad is greatly questionable, but still.

So I gave myself a month. And in that month I mobilized on social media, raised money for causes I’m passionate about, began teaching yoga, reviewed my nutrition information, applied to a nutrition fellowship specifically for PA’s that someone recommended to me via DM (THANK YOU!), and began taking a medical Spanish class online. All things that I thought would make me a stronger candidate within the context of what I discussed in my interviews.

After a month, I reached back out to my original contact (chief-PA and co-chair of primary care), discussing what I had been doing over the past month and that I was still extremely interested in the position. I had been avoiding contacting her because I respect her time immensely and know she had taken on a HUGE project during the restructuring process. To say I am inspired by her is an understatement.

Turns out, she got back to me right away and wrote that she would check in with someone about it tomorrow. AMAZING!

Later that night, I received another email from her that they would take me on.

I still get chills thinking about it. I cried immediately, (I’m sorry the word cry appears a literal 50 times in this post), wrote back a thank you email with way too many all caps and exclamation points, and was in complete disbelief.

I’m still not entirely sure what the position will look like, especially because there is so much restructuring going on in healthcare and just about everything feels to be in flux. But I know I can be flexible and I am just so excited to be working for not only a company but for PEOPLE who inspire me and for some crazy, unknown reason, believe in me during such a momentous time in healthcare. For opportunities for evolution and growth within the company. For the ability to be myself within medicine.

As you can literally see (this blog post is nearly 5000 words at this point…), it was a journey. And probably isn’t the typical job search saga. But I am just so proud of it. That I was able to pitch myself and my story in a way that made sense to others. Even though it isn’t exactly conventional.

So I hope all of these words reaffirm to you to celebrate what makes you different. And to show up for yourself.

School is really tough, academically: yes, but especially if you don’t fit the conventional mold. And it even feels silly to type this because I’m not that different at all. I just want a little bit of nutrition and wellness into medicine. And I like social media (hehe). THAT’S IT. And yet at times throughout school, I felt like a misfit.

Before rotations, I asked for a meeting to put everything in the open and gain clarity on social media policies. My program obviously knew I had my account, as it was something I highlighted in my interview process. So I scheduled the meeting as a check-in to review policies and make sure we were all on the same page. During the meeting, I was encouraged to pause my Instagram account during my didactic year.

No shade whatsoever and I firmly feel the recommendation was coming with my best interest in mind. Social media is really scary especially for medicine and especially in terms of patient confidentiality and especially as a student. I acknowledge that and quite honestly I think about it likely more than anyone. Which is why I am so incredibly mindful and overthink my messaging to the extreme. I’m constantly asking friends and family (especially those in healthcare) about how my message and posting will be received and if they think it’s appropriate, relevant, professional, safe, etc. I don’t collaborate with supplement companies or alcohol companies because I know this messaging can be confusing as a healthcare provider. Analysis paralysis? Yes. BUT worth it and necessary if I’m going to continue with my life on social media.

I am also forever grateful for my program for introducing me to preceptors and adjunct professors that inspired me in ways that I didn’t know I needed. These preceptors encouraged me, told me what I was doing was cool, and enabled me to feel proud of myself again, when I sometimes (read: often) felt embarrassed and ashamed. They said yes when I wanted to teach nutrition lessons to groups and when I brought in nutrition hand-outs from my master’s program. They were thoughtful, encouraging, and kind, and made me think about the kind of provider I wanted to be. And I am just so excited to begin my career as a provider taking everything I learned from them and my program.

Okay. So a few lessons were learned in this experience. Let’s recap.

Overarching themes and lessons:

  1. Be pleasantly tenacious (my dad’s words, not mine) when checking in with HR and a job contact. my process overall took from February – May (October if you count when I first applied). You will likely feel extremely annoying and like you’re bothering people. I mean, don’t email every hour. But give enough time between your communication, then gently lob your name back to the top of their email box.
  2. If you KNOW you want to work somewhere, try to get your foot in the door in a different way / in a different department. I did this through yoga as a way to express I was really committed to that specific job. I knew I wanted to be there and I talked about that a lot in the interview. I was very exclusive in my job application because I really saw myself there long term. And I mentioned that many times.
  3. Don’t knock unconventional ways to get an in somewhere. I GOT MINE FROM INSTAGRAM DIRECT MESSAGE LIKE WHAT?!? I know of a classmate who went door to door to offices and handed out her resume. I know of another new grad who called the office of where she wanted to work and spoke with the office manager until she could get connected with the hiring physician. Sounds extreme, but if you want to stand out, get creative. More on how classmates got their jobs here.
  4. Don’t be afraid to share your interests for fear that different is bad. In fact, it makes you unique and likely adds value to wherever you’re interviewing.
  5. Put those interests bright and shiny and centered on your resume. Especially if they’re something you want to include in your practice in some way, shape, or form.
  6. School will be hard. Even when it feels personal, it’s not really about you and teaches you to sift through your own projection and noise. My program always had my best interest at heart. It sometimes just took me a bit of time to realize it.
  7. You will question yourself, doubt yourself, be ashamed or embarrassed and that’s okay. That’s the character juice.
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14 comments:

  • Allison

    Katie- my heart is bursting with joy for you!! You deserve all the good things in the world and I am so happy to see that this worked out for you. Thank you for being transparent in this post, it made me feel much better about my graduate school experience. I will graduate in August from my MA program for Speech Path and this post was very reflective of my job search (the good, bad, ugly, and detours). Good luck in all you do! 🙂

    • Katie

      Aw thank you so much, Allison! So. Many. Detours. But I’m just so thrilled to begin. Thank you again and a happy early graduation! Congrats!!

  • Julia

    Beautifully written, as always.

  • Cassandra

    Thank you so much for sharing this! I related on so many levels and it is really encouraging to see someone else’s process and to witness it working out! I am so happy for you!

  • Katherine

    I have so many things to say about this as a fellow primary care PA – first of all, I find it so inspirational that you took your time to really find your fit. Most people would not be bold enough to do that, and it is so important.
    I love what you said about the response you got from your school when you provided feedback about possible self-care time – my program would have had the exact same response. I repeatedly felt so frustrated through school because professors in my program loved to say “everyone wants to be a PA because they think PA’s have more time than doctors, but that isn’t true and we likely work even harder!” I always have found that mentality of healthcare providers working to exhaustion to be so frustrating.
    I am not in my ideal job situation right now, but I will be moving and looking to transition jobs soon so this really inspires me to take my time and find the right fit. I would love to work in an environment where I don’t feel guilty for taking care of myself in addition to my patients, and where I have the space to incorporate other aspects of wellness besides just the medicine.
    I am beyond happy for you and can’t wait to follow you through this next phase!

    • Katie

      Hi Katherine! Thank you SO much for your response. Can’t even begin to describe how much it resonates with me. Definitely seems to be the atmosphere in most medical programs. That you dedicate your whole self to medicine without much time for you. Which means you lose a lot of you in the process. Or at least I did, anyways. And completely echo what you said about frustrating. I hope you find your perfect fit soon and good luck with the move! Thank you again!!!

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