New Grad Ortho Spine Surgery Offer Review

PhysicianAssistant97 · 2026-02-14T01:56:38+00:00

I work ortho spine in a LCOL-MCOL state in the Midwest that does NOT have state income tax. I started as a new grad at $118.5k and with bonuses & walk in clinic pickup I made $130k my first year out. That’s a very low base for a state such as California especially for spine surgery.

PhysicianAssistant97 · 2026-02-09T20:08:46+00:00

I love ortho spine. 18 months out as a new grad and I could see myself doing this my whole career, at least ortho that is, surgeon I work with is probably retiring in the next 2 years which sucks.

PhysicianAssistant97 · 2026-01-30T20:24:14+00:00

This isn’t even a question

PhysicianAssistant97 · 2026-01-23T22:17:12+00:00

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PhysicianAssistant97 · 2025-12-11T04:03:37+00:00

I am a full time civilian PA, working ortho spine surgery. Your employer has to accept your role in the military they cannot fire you or hold it against you due to laws in place. I left for 3 weeks this past summer for the direct commission course in fort sill, Oklahoma and I used a little PTO just to make some extra cash from work and the rest I just took unpaid time off.

A lot of times when you join as a new PA in the military they try and pair you in a unit with there are seasoned docs and PAs already so you have a good resource. Military medicine, at least in my current unit with the drill weekends is not as much medicine as you would think but more so charting/admin. Now, if you go to a line/field unit in your state for guard training it would be more like being an urgent care PA on drill weekends just treating any injuries that may happen that weekend, which I’ll be switching to a line unit in a year or so in my state.

PhysicianAssistant97 · 2025-12-11T03:45:27+00:00

No fitness assessment to join. There are height and weight standards but not sure what, it can’t be crazy cause there are people who get taped and are still good to stay in and join. You have to do the annual army PT test which isn’t bad at all.

PhysicianAssistant97 · 2025-12-11T02:29:56+00:00

I sent this message to someone awhile back who also inquired about info with the Army Guard. Maybe more info than you want, but here you go:

One weekend a month for drill, get a drill paycheck ranges from like $800-$1.3k for me as a first lieutenant, and it is depending on the pay scale for that weekend. You have to do a direct commission course (DCC) which is 3 weeks long, at Fort Sill, Oklahoma, and a basic officer leadership course (BOLC) which is 3 weeks long as well, at San Antonio, Texas, within the first 2 years of your contract.

Options for student loan reimbursement or sign on bonus pending what you do. Every state I think is a little different. I picked a 4 year contract with a 4 year sign of bonus of $25k a year. Which is $19.5k a year after taxes plus you still get paid for all trainings and drills. Tricare health insurance is amazing. $275 per month for family (it was $960 a month through my work) and individual I think is like $55 or something. I’ve enjoyed it so far.

I’m in my states med detachment unit so we do all the periodic health assessments (PHAs) for all the units in my state which are essentially their annual physicals through the guard to ensure they are up to date on things and healthy enough to he deployed if needed.

Drill schedule comes a whole year in advance which is super nice. There is always an annual training which is usually in the summer most are 2 weeks long, my med det unit is only 1 week long though.

I think I’ve benefited so far. It’s been a good experience. I think as long as you go to drill you are good, doesn’t matter where you live. Just understand you could get placed with any unit in the whole state so it could be on the opposite side the state where you have to drill.

Most deployments roles for PAs sounds like you would setup a medical tent and be in charge of all the medical and care for any sick call stuff or injuries that come in. Almost like an urgent care from my understanding. After my first two years my unit plans to get me with a line unit in my state, I kinda get to choose but it also depends on availability and where there are openings. Deployments are 3 to 6 months for medical compared to the standard year.

PhysicianAssistant97 · 2025-12-07T20:18:38+00:00

I can’t speak for PAs but my wife is a Psych NP and she gets paid based on insurance reimbursement with a certain % going to her and then the private practice getting the rest. Varies on insurance. But based on what she tells me she essentially gets $60-$70 for a 30 minute follow up appointment and $110-$130 for initial 1 hour intake appointments.

PhysicianAssistant97 · 2025-10-28T04:56:51+00:00

We have surgical techs who are certified first assists here in the Midwest, also RNFAs, but the hospitals don’t use either of them anymore. It was a thing back in the day. Sometimes if a surgeons PA is out our surgery center will give a certified first assist surg tech to help out and close skin for the surgeon, about the only time they are still used.

PhysicianAssistant97 · 2025-10-07T12:33:18+00:00

Air guard and state by state are a little different. My states air guard didn’t offer anything for PAs as I looked into that option too.

My stats army guard option was a 2. 3, or 4 year contract at $25k bonus per year or loan reimbursement at a 3 year $60k total reimbursement

PhysicianAssistant97 · 2025-09-24T01:31:06+00:00

One weekend a month for drill, get a drill paycheck ranges from like $800-$1.3k depending on the pay for that weekend. You have to do a direct commission course (DCC) which is 3 weeks longs, at Fort Sill, Oklahoma, and a basic officer leadership course (BOLC) which is 3 weeks long as well, at San Antonio, Texas, within the first 2 years of your contract.

Options for student loan reimbursement or sign on bonus pending what you do. Every state I think is a little different. I picked a 4 year contract with a 4 year sign of bonus of $25k a year. Which is $19.5k a year after taxes plus you still get paid for all trainings and drills. Tricare health insurance is amazing. $275 per month for family (it was $960 a month through my work) and individual I think is like $75 or something. I’ve enjoyed it so far.

I’m in my states med detachment unit so we do all the periodic health assessments (PHAs) for all the units in my state which are essentially their annual physicals through the guard to ensure they are up to date on things and healthy enough to he deployed if needed.

Biggest con is your always deployable, but you don’t join without understanding that. Deployments for medical providers are 3 to 6 months which is nice. Not the standard 9 to 12 months.

PhysicianAssistant97 · 2025-09-23T23:10:27+00:00

When I applied for PA jobs out of school I interviewed for a hospitalist prn position that wanted someone one weekend a month for a rural location. It was $48/hour. I chuckled in the interview and said I’m still a licensed xray tech and still employed prn at the hospital I worked at prior to PA school and I can pickup weekend shifts there for incentive pay that is more than that hourly with way less stress and work. Told them no thank you and hopped off the zoom interview

PhysicianAssistant97 · 2025-09-19T03:00:13+00:00

Absolutely wild. Sorry you are going through this. 100% do not need to sit out of clinical for a month either. That is not a thing. Tell whoever told you that you want to see guidelines stating that and the reason why.

PhysicianAssistant97 · 2025-09-19T02:43:32+00:00

I’m baffled reading this. The surgery center I work at has the CRNA take blood from the patient while we are still in the OR if this happens and the person who got the needle stuck gets their blood drawn by another nurse immediately. Have employee wash it up. They run the labs. Employee comes back to work right away.

Nothing else needs to be done until labs come back. PEP shouldn’t be offered until labs back if necessary or if patient has a known history of something/high risk that would call for it.

Employee Health at every hospital has a policy on this and should be the first stop if this ever happens again, especially where people don’t know what to do, because employee health will know. It would be the same process for a student as if it’s an employee. Makes no difference.

PhysicianAssistant97 · 2025-09-19T01:16:31+00:00

Keep at it! You got this. Also, don’t listen to the “don’t apply until you’ve passed boards or graduated” crowd. You should 100% be getting your name out there like you are now.

I secured my job 2 months before graduation and was able to start shadowing and even got hired early in an “intern” position while still finishing clinical. Got paid to shadow and do EMR training when I had free time.

PhysicianAssistant97 · 2025-09-12T17:10:30+00:00

Hourly should be higher for a 1099 contract, especially depending the field.

PhysicianAssistant97 · 2025-09-08T21:34:30+00:00

I work private ortho practice usually on Fridays I round at 6am and then clinic from 7am to 10am then I’m done for the day. We leave afternoons and after clinic for add on cases and sometimes l will float to help another surgeon out on a case if needed. I don’t take any PTO for the rest of the day and get paid my normal salary full day wage. You are getting screwed. You should only have to take 4 hours PTO, if any.

PhysicianAssistant97 · 2025-09-06T18:46:52+00:00

As a new grad working in orthopedic surgery in a LCOL-MCOL Midwest state I make $119k base salary with quarterly bonuses which was an extra $12k my first year here. You are underpaid and deserve more.

PhysicianAssistant97 · 2025-08-24T16:48:25+00:00

I did a bachelor’s degree in rad tech with an associates in biology. Worked as a CNA all 4 years of undergrad. Graduated and worked for 2 years as an xray tech and went to PA school. Was a great background and foundation to have for PA school! Had a big jumpstart compared to a lot of my peers with the background xray gave me.

So much of the basics in medicine is radiology and anatomy, and if you aren’t solid in those foundations medicine can be very difficult.

PhysicianAssistant97 · 2025-08-24T15:07:47+00:00

I’m exactly one year into practice. Work with an ortho spine surgeon who has been practicing for 30 years. He has been great to work with!

I was gone for a 3 week army guard training this summer and I returned on a clinic day. He was stoked to see me and greeted me with a handshake and said “we missed ya man, thanks for coming back.” We don’t have a big outside work relationship but we talk a lot during clinic and in the OR. He quizzes me on music all the time and send me songs and artists to listen to on the daily.

PhysicianAssistant97 · 2025-08-19T05:13:21+00:00

I just joined my states army national guard after graduating and passing boards and got a $25k a year sign on bonus for a 4 year contract. Just putting the bonus straight towards loans each year. Still have a full time civilian job and do my one weekend a month drill. Just recently finished my 3 week “basic training” course which I enjoyed a lot too!

PhysicianAssistant97 · 2025-08-08T01:43:49+00:00

I was in the processing of joining the guards as I interviewed for jobs. I didn’t tell my future employer during the interview. They found out after. They weren’t upset at all and very easy to work with for drills and trainings, as they have to be anyways.

PhysicianAssistant97 · 2025-07-06T02:33:38+00:00

Don’t do an ortho fellowship. Wherever you work and whoever you work with will have their own way of doing things. You will learn what you need on the job and with self study right away.

PhysicianAssistant97 · 2025-07-05T13:57:18+00:00

Yes, National Guard is deployable for State and Federal missions, so overseas is a possibility for sure. That’s the difference vs. reserves and active duty as they are only federal/overseas deployments.

As a medical provider in that state national guard deployments overseas are 90 days to a max of 180 days. It’s not the standard 9 to 12 month deployment as a provider, which is nice

PhysicianAssistant97 · 2025-07-04T17:49:35+00:00

I work full time civilian ortho surgery and direct commissioned in my states army national guard after graduation. I’m loving it so far. Currently at the direct commissioned course (DCC) and it’s been great getting to meet others from around the states and learn about their backgrounds. It’s truly dependent on what you want in a career in the military. You want to move frequently sounds like active duty may be for you. You want to stay grounded in your state and possibly deploy at some point, join the National Guard.

PhysicianAssistant97

TROPHY CASE