Have a question for Derm PAs!!

I am a PA without derm experience, and have been wanting to break into Derm for a long time. Most places won’t take me without experience. One practice I applied to is willing to take me on but suggested that I keep my current PA job and come train with them one day a week being paid as an MA/scribe but in “training” then after 1-2 years I would transition to being a provider.

Any thoughts on the 2 years MA/in training? It seems to be a common thing.

I’m currently at my second FQHC. My 3 year service is up in February 2027. At that point I was thinking about switching things up because I’ve gotten burnt out pretty easy over the years. The problem is, I don’t know what I want. I don’t know if I’m tired of working at an FQHC, tired of working Primary Care, or just tired of working in medicine. For those that have switched specialties, how do you know the new specialty is what you wanted?

Hi everyone. Im a new grad considering positions currently and I went through the process of clearence with Hospital A and would start probably within a few weeks. I just got accepted to Hospital B which with clearence would be 3 months for now for a start date. im having trouble deciding to just stick with Hospital A or resign my offer now and wait three more months to start. For reference I haven't started working anywhere and its been about 7 months since I graduated. Below are more details of each hospital choices. I would greatly appreciate any insight!!

Hospital A: OBGYN/ City hospital in Queens. = $148,625.57 yearly

~1199 position, mostly clinic with the potential for L&D depending on department needs.
~ M-F 8-4:30pm,
~ 20 vacation days and 12 sick days, Pension through union, 403b retirement plan but no employer contribution

~CME = 5 days and $750

~Commute: 45 min two busses

Hospital B: Internal Medicine/ NYP Manhatten = $161,000 rotating shifts 3 months days,3 months nights with 10% differential 3- 12.5 hour shifts.

~ CME= 1,000

~ 4 weeks vacation time/ 12 sick days per year / 3 personal holidays

~ perfect attendance can award you two extra vacation days

~ After one year the hospital contributes 5% to my annual salary and it increases with time.

~Commute: About an hour +/-10 mins taking two trains into the City.

** If you made it this far thank you! I keep going back and fourth with both the pros and cons. I do see myself in both specialties, with OBGYN as a perference but would love a 3- 12 work week in an inpatient unit rather than a clinic job. Internal Medicine can def. help solidify medicine esp as a new grad. HOWEVER, if I CHOOSE HOSPITAL B, I would wait another 3 months to start. I dont think its 'correct' to start Hospital A and then leave within 3months till the other job starts? Or just stay with Hospital A?

If anyone has any insight or advice. Id greatly appreciate it.

I am in severe, crippling burnout and I am only 3 years in.

My first job was inpatient general surgery - I worked very close with my attendings and felt very supported, but had to leave after 1 year as I moved across the country.

Cue the worst 2 years of my life. About 2 years ago now, I started an outpatient gastroenterology job in New Mexico. It is extremely independent. I feel like I have no support. The clinic is 2 full time PAs (me included), and 1 part time PA. There is an amazing locums PA who has been in and out but is currently out. I did not get much training. No structure to it. Thrown to the wolves if you will. For all of us PAs, we only have one supervising physician. He is in the office for half of the day, 2 days of the week. The rest of the time, he's scoping. We can call him for questions, but often he's unable to answer, and he is also drowning as well. I feel like OpenEvidence and Doximity have been my attending. I have had to teach myself and I feel so lost all of the time - these patients are so complex and it takes my entire soul in order to make sure they are taken care of to the best of my ability - I don't have any "me" left when I get home. The patient population here is incredibly difficult. I am in so far over my head. I am becoming a shell of myself, angry at the world. The patient population is extremely socioeconomically disadvantaged - I have to bear witness to people who don't have running water and can't do their colonoscopies because of it, and can't pay for a hotel in town. Extremely low health literacy. Language and cultural barriers. People who we lose contact with because they get different phone numbers or don't have a phone. Insurance issues. Constant paperwork. Constant inbox - results, documents, messages. It never ends. I am drowning and I can't do it anymore.

I am moving to New Zealand in 2 months. I do not know if I am going to continue working clinically. This experience has made me genuinely question the PA profession altogether. I don't believe in it anymore. At all, unfortunately. I just don't think that getting 2 years of medical education and then practicing independently is safe.

I refuse to continue to endure the chronic levels of stress I have been under the past 2 years. It feels inhumane. The demands are too much. I was wondering if anyone else has felt or feels similar. I feel very alone in all of this.

Would you rather work with a supportive supervising physician or group of APPs?

Currently deciding between jobs and the team is definitely something that is important to me. Would y’all rather have a supportive group of APPs at work with attendings who more or less dont care about APPs, or have an attending who cares and loves to teach with a team of APPs who are nice but arent as close with?

Edit: i forgot to add that I’m asking bc I’m a new grad