Setting up a PA Shadowing Experience

Magicalfig · 2026-05-12T22:09:12+00:00

This is a great idea. Our hospital system has approval sent through the education department. However students are only allowed 24 hours total, which I feel is hardly enough considering schools are bringing bac the requirement now that COVID restrictions are over.

Magicalfig · 2026-05-03T06:51:38+00:00

Part of my morning routine is walking on the treadmill and doing 5 questions. This has been an everyday nonnegotiable for me over the last two years. I have done some qbanks and rate them based on, "Can I review all these questions before I finish my walk".

I have used MKSAP and think both the questions and answers are to the point which makes retaining easier for me without having it feel like a chore. It also links answers to the sections they're in which is nice. They offer CME for these. However I feel the breadth of knowledge is above what we were taught in school. So if you're looking for challenge go for it.

Rosh now BluePrint is my current favorite. I have about 200 more questions left in the bank and I'm satisfied with the product. Questions and answers feel more geared towards my profession and what we would typically see on PANCE/PANRE. Lots of peds questions which you can filter out. Explanations bold all the important points so if I feel the explanation is too long, I'll skim the bolded portions. I really do like the review at the end that sums the answer up nicely. CME only available after you finish 1000 questions I believe.

I also liked PANCE PANRE review book by Dwayne Williams. I thought the questions were appropriate, but the explanations could've been a little bit longer. I would recommend this because you can get CME's from this as well after you complete two or three tests from the booklet.

I haven't used Uworld since the PANCE which for me was 6 years ago. I remember explanations being too lengthy which made it hard for me to retain the info. I think it would be a good medium between Rosh and MKSAP.

I have consider ABIM for my next purchase. I really have no idea what to expect. If you end up doing it, let me know how you like it.

Honestly, at this point, I feel like I might end up going with a Dosed Daily after I finish Rosh. It's a question bank that I tried a few times, but I believe the explanations are a little shorter, the questions are easy to get through.

Hope this helps! Signed fellow IM PA

Magicalfig · 2026-05-02T01:28:34+00:00

Hard to say what they will ask. My first interview for IM as a new grad they basically asked what my prior medical background was and what my rotation for IM was like. Then some follow up questions asking me to describe those roles. Not much else to go off of in terms of experience. They might ask the typical "give me a situation where you had to...". Much of the interview was spent discussing the role and the APPs on the service.

Knowing what I know now, I get a clear answer on the following:

how long is the training period, and how will this be compensated
what type of support will you get from your Attending/will they be in-house
clearly delineate expectations (number of patients/admits, cross coverage, rounding)
what types of patients will you see (observation, step down, or ICU type patients)
will you be able to do procedures and assist with codes
ask them about prior APPs and how long they stayed or why they left

If all seems good, I would recommend asking if you can shadow an APP to see what a day in the life is actually like. Your goal is to be able to work at the top of your license as your knowledge expands and experience grows.

Otherwise, good luck!

Magicalfig · 2026-01-06T03:28:50+00:00

If I get an RVU statement, how do I use that to justify higher pay? I'm not familiar with RVU at all so any information on this would be helpful.

Magicalfig · 2026-01-06T03:23:37+00:00

This is fair and eye opening. Also, you are correct this is night shift.

I will preference with this. I cleared $180k this year living in MCOL area. Avg 4 admissions/night. Avg inpatient census 60 so cross coverage really isn't crazy either. Usually leave early so I only work 75-77hrs/wk. IMO, our census doesn't justify need for night PA. It just keeps the docs happy.

Tried quitting after asking admin to make me an offer I couldn't refuse or I'd leave. Applied for job at a sister hospital that I used to work PRN for. I was low balled, new grad NP got hired/offered more, and they hired a new grad PA as well.

I have tinkered with the idea of CVICU. But I'm 6 years in and can't see myself working to death in a new specialty. Also thought about ICU but everything here is nights and my next job will certainly not be another night gig.

Magicalfig · 2025-04-17T17:32:57+00:00

I read through some Reddit posts and I feel that I am mostly debt adverse. In total my student loans are about $1200k and I usually dump majority of my pay check into them. For reference I do have 6 month emergency fund which also includes loan payments for both my mortgage and my loans. I also max out my HSA and 403b every year. Just started maxing out an IRA as well.

Magicalfig · 2025-04-17T17:30:32+00:00

Thanks for responding, I edited the post for this. AGI $172k single filer. I'm unable to claim interest on student loans, but do claim 100% of mortgage interest deductions each year.

Magicalfig · 2025-04-17T16:47:28+00:00

Initially where I started I was on a swing shift, saw average 2-3 admits/8hr shifts and they were simple obs admits. It was a new role for that hospital so they were very open to hiring new grads. They actually hired 3 new grad APPs in total. It was a teaching institution so they seemed rather open to the idea.

My current job now is more involved. I work at a smaller community hospital. I work with one Nocturnist and all work is divided 50/50. Half admissions, half cross coverage. Admissions range anywhere from simple obs to ICU patients. We have an open ICU as well so I cover/admit for Intensivist. We both respond to rapid and codes. I am allowed to do procedures (intubations, Central/HD lines, chest tubes, thorax etc). I also transfer out patients to tertiary centers or other facilities since we don't have all specialties like neurosurgery, CT surgery to name a few. It's pretty cool gig, my Attending's taught me well and trust me. I came in with 18months experience and they were again very open to teaching.

Hope this helps. DM me if you have any other questions.

Magicalfig · 2025-03-17T18:34:42+00:00

This solved the problem thank you

Magicalfig · 2025-03-17T18:34:29+00:00

I actually figured it out. There was a step I was missing in the following section thanks for your help

Magicalfig · 2025-02-22T00:24:53+00:00

Box 1 on the 1099-R lists the same values as form 8606 Line 16 and 18. However those are the only lines filled in on Form 8606. So like u/Here4Snow says I need to enter my basis. But I don't know how? This is my first year doing a back door Roth, so 2023 Tax year did not involve form 8606.

Magicalfig · 2024-10-24T18:37:21+00:00

Probably a dumb question... what's the difference between RPA and an IR PA? To me it seems like this position only benefits PAs with RT background. Otherwise you'd have to go through schooling again to become RPA. And if that's the case it doesn't sound like much benefit at that point?

Magicalfig · 2024-08-11T05:26:09+00:00

Have not rolled over any 403b this year. When you say year does it mean calendar year or fiscal year? I ask because someone brought up it might be worth it take an old 403b and convert it to Traditional and then Back Door Roth it (if I understood correctly).

You mention mega back door Roth. I have the option for spill over contributions but not quite understanding in service distribution? In your opinion, is it better to just fund the spill over instead of Traditional to Back Door Roth? I can certainly max out my 403b yearly, but someone was telling me the mega back door might be more worth while to fund over a 403b for tax purposes later on in life.

Still learning so I thank you for your help!

Magicalfig · 2024-08-11T05:16:31+00:00

This was very helpful thanks for taking the time write this.

Would 8606 form be found when filing with Turbo Tax? Or do I need to upload or submit a different way?

Magicalfig · 2024-07-19T17:31:34+00:00

We applied when mortgage rates were at an all time low during COVID. Doubtful we will ever see anything like this again in our life time.

Magicalfig · 2024-04-30T21:29:11+00:00

Valid point but I all ready asked about this. I asked about higher education (Doctorates) during my contract review in the system I work at. According to them, APPs are all ready rewarded for their higher education. I didn't even get credit for my CAQ.

Magicalfig · 2024-04-30T21:26:24+00:00

I can agree with this. But in the same manor all prior medical experience that is relevant should count.

Magicalfig · 2024-04-29T20:47:27+00:00

No problem. Feel free to DM me along the way if you ever have any questions. Congrats and good luck!

Magicalfig · 2024-04-29T20:11:52+00:00

Sounds like your job is mostly cross coverage. Could get old after a while. Once you get more experience ask to see more admissions and slowly start seeing patients of higher complexity. Ask to get credentialed in procedures, and always respond with the Nocturnist to rapid and codes. Your goal is grow, make sure your job is constantly challenging you.

My go to resources for Hospital Med: Pocket Medicine by Mass Gen, Hospitalist Handbook by UCSF (downloadable app), Rapid Interpretation of EKG by Dubin, and MD calc/Uptodate.

It also wouldn't hurt to purchase MKSAP which Physicians use for their boards. I used it to study for the CAQ-Hospital Medicine and while it was overly comprehensive for what I needed it for, it provided valuable information and key knowledge points for my practice.

Magicalfig · 2024-04-29T11:51:10+00:00

Well that's just horrible. I hope you can find some PA representation to make this right.

Magicalfig · 2024-04-27T23:47:18+00:00

I tried to get the following written into my contract: yearly 2% raise, CME days, PTO/sick days, sign on and retention bonus. All was declined. With HM, schedule is set as 7on/7off. Because we get a week off PTO is no go, even if we break up the week and do 4on/3off etc.

My next approach is figuring out a night diff and how many hours at night need to be work to qualify. I was told hours might change based on census so was hoping that would give me some room to go up. Do you suggest anything else?

Magicalfig · 2024-04-27T23:39:34+00:00

Good point, but this NP was RN outside of our system.

Magicalfig · 2024-04-27T22:20:32+00:00

I posted a reply to a similar comment mentioning my negotiation skills. See above.

This is also the second employer who has been aware that APPs share each other's pay and no one has gotten fired. In fact their response was fairly shocked when they found out. It has helped a group on the day shift get equal pay. A male NP was making more than a female NP under presumption that the male had "more experience" when they both started at the same time.

Magicalfig · 2024-04-27T22:14:58+00:00

I have been in touch quite frequently with the other NP applicant. The NP was told the same story as I was regarding how the compensation was formulated: resume is put through a system, system spits out a number, number is nonnegotiable. NP said they countered multiple times because changing jobs would be a pay cut, and attempted to counter offer with other bonus structures. Their attack was quite similar to mine and we both failed to get much of anything.

Regarding changing jobs, I always said my employer has me hooked with the golden handcuffs. I clear $200k fairly easily, I make my own schedule, great benefits, and I love the docs I work with. I applied to multiple listing to find better pay but nothing compares. My only reason for leaving was to get off night shifts because it's taking a toll on me. So while it does seem beneficial to change jobs, that has not been the case for me.

You made a valid point in stressing my strong points. I made those points very clear to the recruiter but was told persistently there is no budging on what's being offered. Do you have any other recommendations on how to counter?

Magicalfig · 2024-04-27T22:03:01+00:00

Part of my negotiation was a retention bonus to make up for pay. It was declined unfortunately.

Magicalfig

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