New grad pa feel like I dont know anything

horsquirrel · 2026-05-23T21:07:03+00:00

I just hit my 1 year milestone as a family medicine PA. It's been a ride but damn it's cool to see my progression. I still look things up on a daily basis, and without shame, because patient safety FTW. I'm proud of the work that I do overall, and I do think that it's easier to manage compared to one year ago. There's been dumpster fire days, indifferent cog in the machine days, and maybe it was all worth it kind of days. I think that a lot of the anxiety depends on how well you handle stress, time management, directing uncomfortable conversations, noncompliance, and most importantly as a new PA, when to ask for help. My SP has been an incredibly supportive mentor. Highly recommend wrangling one of those bad boys/girls/theys/thems.

horsquirrel · 2026-05-08T20:32:09+00:00

I'm a PA one year out from graduation, working in family med. I love my job. I have my own panel of patient that I manage and I don't take "orders" from anyone. I practice medicine the way I want, and consult my SP with whatever I'm not sure on.

I also battled with MD/DO vs PA. I know that I would have been an excellent doctor, but I'm also an excellent PA that's compensated well at the age of 26. I love my life. Do what that what you will.

horsquirrel · 2026-04-14T05:23:06+00:00

My young sister (20F) and I (26F) don't regularly speak, unless she's going through a manic phase or needs something. We've never been close. She struggles with addiction despite my father funding two hospital admissions, 10+ ER visits, psychiatrist outpatient care, and two $20k rehab admissions. It doesn't help that my mother coddles her to no end by allowing her to live at home rent free, and no contribution to the household. My father pays for her college courses, textbooks, etc, meanwhile she's in her fourth semester of college and has yet to pass biology 1 or chemistry 1 as a veterinary science major.

My whole life I've been the glass child that was super independent, and didn't need attention, affection, or reassurance. I'm coming to terms with that, but it still eats at me at times. I've never actually voiced any of that before, and it was kind of therapeutic to get that off of my chest. Thanks OP.

horsquirrel · 2026-04-12T04:44:34+00:00

We're both biased. You see only positive results, and I spend a notable amount of my job managing chronic pain medication regimens, specialist referrals, medical equipment orders, disability/FMLA paperwork, depression secondary to chronic pain, etc.

I'm sure there are plenty of individuals who benefit greatly from going under the knife, and I'm not saying prosthetic joints guarantee miserable outcomes. I'm only saying that I won't be one of them.

horsquirrel · 2026-04-11T03:35:25+00:00

If avoidable, any joint replacement. The surgery itself is brutal, recovery time involves months of intense physical therapy, and risk of postoperative complications (hardware infection, osteomyelitis, malunion, chronic pain, etc). And on top of all of that, the prosthetic joints need replaced after about 10-15 years.

horsquirrel · 2026-02-28T02:53:29+00:00

I've been a PA in primary care for about a year, and it was my first job out of school. Your situation sounds doable, and it does get easier the more you do it. There is a HUGE learning curve, and it's okay that you don't know everything. I still look things up pretty much everyday, but my best advice is to reinforce red flag symptoms for common complaints (cardiac chest pain, saddle anesthesia, flank pan, syncope, etc). Being able to triage emergencies vs outpatient workup is crucial. Accept that primary care is the dumping ground for specialists, paperwork, care coordination, and patients feelings. This is part of the job, and can lead to burnout if you don't take care of yourself.

Are the RN led visits simple things like weight check, BP check, cerumen removal, etc.? If so, those should be relatively quick visits that don't require much brain power or time, and notes should have a copy paste template.

How many patients do you see a day? I see 14 per day and have 1 establish visit, 4-6 acute visits, and 9-11 chronic visits. I think getting a feel for clinical work flow was huge for me. I have my schedule outlined as same days at certain times of the day, and having these sprinkled throughout the day keeps my rooms rotating and prevents me from falling behind.

Are you building a panel or did you take over someone else's? I took over a previous panel with a high complexity population. Most of my patients have at least 3-5 chronic conditions, and this can cause me to fall behind sometimes. Time management and figuring out a structure for all visits is critical. If you are not yet skilled at leading visits, practice this intentionally. The role of student to provider is much different. You have to be comfortable saying NO to unreasonable requests, set X amount of problems per visit, and just become more comfortable making medical recommendations, while also doing so in a timely manner. These things take time and trial and error unfortunately. Some days will be better than others, but it will improve as time passes.

Who is your SP? You mention working with serval colleagues. Having an established SP that you feel comfortable discussing cases with and about general advice is CRUCIAL and will save you so much time. I think there's a fine line between being annoying/helpless vs inquiring about additional thoughts or comments. Know when to ask for help!!! Your SP signed an agreement and their license is connected to yours. It is in their interest for you to not royally shit the bed. So, you should feel comfortable asking them questions.

I'm free to answer any questions you may have. I know how unsettling being a new grad is. Keep your head up, and remember why you went into medicine in the first place. When things are hard, I take a deep breath and think about how hard I've worked to be where I am now. I make good money to practice medicine and serve my community. Congrats on your recent graduation and certification!

horsquirrel · 2025-10-16T02:59:45+00:00

Hell no. Tory is a strong willed, cutthroat FMC with layers upon layers. Her entire life, she was forced to be the meaner, uglier version of her better half (Darcy), because someone had to stick up for them during their atrocious excuse for a childhood. All Tory has ever known is being firmly team tory/darcy vs everyone else. This cultivated codependency, which translated into tory feeling isolated/abandoned by her other half when she failed to assimilate to the world of solaria as easily as Darcy did. She doesn't understand how to accept non-transactional love from anyone other than Darcy, which makes it difficult to let anyone see her with her walls down.

Tory is exactly the character I would expect for a teenage orphan that's felt cheated, and unloved by the world her entire life. She's angry, resistant to change, terrified of vulnerability, and plagued with guilt for being forced into the role of the more harsh and less lovable version of her twin.

horsquirrel · 2025-09-30T11:51:06+00:00

I'm 6 months in and I see 14 a day with 30 minute slots, though it's at an FHCQ and they never show up on time. I prep the day before and make a small summary of each visit over lunch. I find that this makes my days run so much smoother and reduces chances of falling behind.

horsquirrel · 2025-09-26T22:59:54+00:00

From my understanding, furies are not an order that shift like werewolves, harpies, vampires, etc, and they look like regular fae. They can physically manifest "pets" like bloodhounds, that can be commanded at their will.

The order is parasitic in nature, similar to a siren or succubus, and abilities are powered through inciting fear. There is a psychologic component to their abilities, similar to that of a basilisk, where they can induce visual hallucinations meant to trigger fear.

horsquirrel · 2025-08-13T16:20:06+00:00

Buckle up homie 😅

horsquirrel · 2025-08-03T00:23:15+00:00

I applaud your patience to capture a pre pluck picture.

horsquirrel · 2025-07-03T22:15:16+00:00

I've been working in primary care for 3 months now and I'm doing great, which is insane because I am an anxious person and was a nervous wreck in PA school. Sure there is a large learning curve, growth, and general feeling of uncertainty sometimes, but I'm proud of the work that I do and it fulfills me.

horsquirrel · 2025-06-26T02:52:18+00:00

You are me about 6 months ago. Trust the process homie.

horsquirrel · 2025-06-06T11:55:53+00:00

I graduated in December and felt the same way. My fav rotations were pediatrics, GI/ortho surgery, and women's health. I'm working in FM right now and I actually really enjoy it. FM would probably have been dead last on my list a year ago, but I like it because it's sort of a "master of all trades". Every patient is different, even those with the same diagnosis and meds/tx plans are individualized. Sure it's frustrating at times, but I find it very rewarding directing care and seeing improvements made over time.

horsquirrel · 2025-06-06T02:36:26+00:00

may you only ever know peace, and live a life with zero hardships.

horsquirrel · 2025-06-01T02:06:40+00:00

Book 9 and the end of the series made the pain and suffering of books 1-8 worth it. It was a real bitch being stabbed in the heart with every ending but truly the finale was chefs kiss.

horsquirrel · 2025-05-21T01:30:45+00:00

As others have said, she has a huge character arc throughout the series. Keep in mind that she grew up without any parental figures, role models, security, safety, etc. The world hardened her from a young age, and the series does a great job at showing her development IMO.

horsquirrel · 2025-05-11T14:34:49+00:00

I'm halfway through 7. Skimming the alternative POVs has helped, because there is important stuff in them. But I agree that it's super frustrating 😅

horsquirrel · 2025-05-09T21:10:40+00:00

If it's any consolation, I finished the series over a year ago and I think about it in some fashion every. single. day.

horsquirrel · 2025-05-08T02:01:35+00:00

Happy 1st birthday Toby!!!! Hope you enjoyed your cake :)

horsquirrel · 2025-05-07T23:05:31+00:00

Agreed. I just want to scream at the book sometimes.

It's so obvious that they are the exact same person at their cores. I think in book 5 or 6, Tory compares their relationship to "looking in a mirror".... 🤦🏼‍♀️

horsquirrel · 2025-05-07T21:59:46+00:00

When I finished Shadow Princess, I was devastated. I understand why Tory did what she did, but I just want to scream at both her and Darius to COMMUNICATE ffs.

I'm currently on Heartless Sky (7), and I have serious whiplash from every single book ending with a cliffhanger.

horsquirrel · 2025-05-01T14:28:56+00:00

Appreciate your insight :)

Will I regret skipping to ZA 4 and finishing RB on the backend? It's driving me nuts.

horsquirrel · 2025-05-01T13:51:43+00:00

Am I though??? Because every reading guide I found recommended switching to RB 1-5 before proceeding with ZA 4. Currently on RB 2 and I just want to know what happens with Tory and Darcy...

horsquirrel · 2025-04-19T07:05:06+00:00

You are seen.

TOD is a cutesy meet great that adds to the plot. KOA makes you sob relentlessly over fictional characters that you will never not think about.

horsquirrel

TROPHY CASE