When I first started practicing as a PA, I jumped straight into an urgent care setting. I thought I was ready for anything after the grind of PA school—little did I know, nothing could quite prepare me for what I was about to face. I found myself seeing 50+ patients a day, and I was seeing them in a variety of settings: some were indoors in the clinic, while “infectious patients” were required to be seen outside in their cars. I saw all age groups and sometimes parents would bring in multiple children at a time.
As a sole provider with only a few days of training, I quickly realized just how fast things could escalate. I was simply overwhelmed! There were moments when I barely had time to think between patients. I’d be finishing up with one, and five more would walk through the door. The rapid-fire nature of it all opened my eyes to just how different real-world practice is from what is experienced in school. It’s a whole other ballgame when you’re suddenly the one making the calls.
While it was a shock to the system, it taught me invaluable lessons in time management, prioritization, and how to manage stress while still providing quality care. I had to adjust quickly and learn to trust my training—and, just as importantly, my instincts. Looking back, it was a tough but transformative experience that gave me a deep appreciation for the fast-paced nature of medicine and the resilience required to succeed in demanding environments.
So, if you’re about to dive in as a new grad, just remember: it’s normal to feel overwhelmed at first. Give yourself time to adjust and trust what you have been taught.
I’m going to break down some of the most common misconceptions about what it’s really like to go from PA school to working in a clinical setting. Let’s dive in!
In PA school, you probably spent a lot of time learning how to take a patient’s history, do physical exams, and provide thorough counseling. However, in reality, patient care is often a whirlwind. You might find yourself jumping between several patients at once, seeing an average of 20 or 30 people in a day (or more, depending on your practice setting). This rapid pace means that you don’t always get to spend the amount of time you want with each patient, and you’re constantly shifting gears.
You’ll have to be nimble, efficient, and able to quickly switch between tasks. For example, you might be in the middle of an asthma flare-up consult, and then be pulled away to evaluate an abdominal pain case. It’s a balancing act that requires sharp focus and flexibility.
In addition, this also means that sitting down with your patients and giving them a 10-minute run-down of healthy eating habits and lifestyle changes is virtually impossible. In PA school, you had the time to explore these conversations during clinical rotations, but the reality of a busy clinic or hospital schedule is a little different.
Time is precious, and a 15-minute appointment often doesn’t allow for in-depth discussions about diet or exercise. You’re frequently moving from patient to patient, and unfortunately, lifestyle education often takes a back seat to acute issues that require immediate attention. You may get a chance to bring it up briefly, but with everything else on your plate, it’s tough to spend the time you want on this important aspect of patient care.
Pro Tip: Use apps/websites like Amboss, MDCalc or EMRA Antibiotic Guide for quick, evidence-based decision-making on treatment options (there are TONS available but these are a few of my favorites). This can help streamline your consultations and free up a few moments for those lifestyle conversations when they arise.
Amboss: https://www.amboss.com/us and App
MD Calc: https://www.mdcalc.com/ and App
EMRA Antibiotic Guide: App
In the world of electronic health records (EHRs), the ability to write out the perfect, detailed note for every patient is more myth than reality. With so many patients to see and so many tasks to juggle, note-writing can quickly become a time-consuming task. You’ll often find yourself typing summaries in a rush during or after your patient encounters.
Here’s the reality: sometimes you’ll have to stay late to finish them, or worse—work on them over the weekend. It’s not glamorous, and it’s one of the least talked-about parts of the job. You may even feel like you’re losing out on your personal time just to get your documentation completed. But remember, these notes are not only crucial for continuity of care but also for billing and legal purposes.
Pro Tip: Check out the resources from Prosperous Life MD for efficient note-writing tips. Their approach to streamlining this process can help you find more balance between patient care and documentation. I have not used them personally, but I have heard great things about them!
Also, if you’re working with EHRs that are difficult to navigate, be sure to explore any training sessions your practice offers—they can make a world of difference.
Prosperous Life MD: https://prosperouslifemd.com/
When you’re practicing as a PA, you’ll be bombarded with text messages and emails from your supervising physician, colleagues, patients, pharmacies, insurance companies, and more. Whether it’s to clarify a medication dose, get updates on lab results, or respond to patient questions, your email inbox will never be empty.
You’ll quickly learn that managing these emails is part of your job. At times, you may feel like you’re constantly juggling emails along with patient care. It can be overwhelming, but staying organized and setting aside time during your day to address them will help keep things from spiraling.
Pro Tip: Consider advocating for some administrative time with your employer, even if it’s just an additional hour per week. Alternatively, you could request the help of support staff (if allowed by your employer) to help manage and filter messages.
You might think that after a couple of years of practicing in one field, transitioning to another would be a smooth process. However, in reality, it’s very challenging, especially if you are in a specialized field.
For more information about lateral mobility, check out my other blog: Lateral Mobility as a PA.
Most practices expect PAs to have specialized knowledge and experience in the area they’re hired for. That means if you’re transitioning from dermatology to cardiology, for example, you’ll need to start from square one in terms of learning the nuances of the new specialty. Some practices may offer training, but this is rare and should not to be expected.
Pro Tip: Before making a switch, make sure to do your homework and consider attending a program like the HIPPO Bootcamp series to get up to speed on the new specialty. You’ll need to be proactive about learning on the job and may even need to pursue additional certifications or training.
HIPPO Bootcamp Series: https://home.hippoed.com/
While PA school gives you a taste of what clinical practice will be like, practicing medicine is much more fast-paced and unpredictable than you might expect. It’s not all about giving perfect advice or having long chats with patients about their health—it’s about being able to adapt quickly, manage your time, and juggle the many tasks that come with the job.
But here’s the thing: it’s also incredibly rewarding. The impact you can have on your patients’ lives, the satisfaction of solving a challenging case, and the joy of being part of a healthcare team—those things make the hard days worthwhile.
So, as you embark on this exciting new chapter, keep these realities in mind, and don’t be afraid to lean on your resources—whether it’s clinical tools like MDCalc or Amboss, or the support of fellow PAs and mentors. The learning never stops, and with the right mindset and tools, you’ll thrive in your new role. And remember, it typically takes 1-2 years to truly feel comfortable practicing medicine, especially as a new grad. Be patient with yourself and allow time for adjustment. Embrace constructive feedback as an opportunity for growth, and avoid letting it become a source of stress. Focus on continuous improvement while giving yourself the grace to learn and develop in the process.
Good luck, and remember: it’s all part of the journey!
And as always, if you ever need help or additional support, we are always here for you! Do not hesitate to reach out to us!
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