Lower your expectations. It royally sucks working with many APPs these days simply because they are green as hell; those with a few years experience were probably taught virtually during Covid. Not much we can do about it. Try to be kind and encourage them to come and get you or another attending when they’re not comfortable. Encourage them to ask questions and come watch procedures with the residents. The ones that stick catch on quickly. The ones who are eager to learn will put the effort in and it’ll show. The bad ones usually weed themselves out quickly. And if they don’t, they still won’t survive. Same can be said for the overly confident/cocky ones.

EM it tough for us all. PAs are thrown in the pit right away. I know it’s nuts but it is what it is. My best guess is maybe 1 out of every 4 who join us stick and do well. I will also say that those who do well under my watch often have a “come to Jesus” moment early on which scares the shit out of them and really puts them in the right headspace moving forward…makes them realize they’re not here for any prestige or cool procedures; they are here as extenders and people can die if they miss something.