So, You Want to Change PA Specialties… Here’s What to Do Next

August 1, 2022
Maybe you settled for a specialty you’re less excited about or entered a nonspecialized field with a plan to specialize in the future. Or, you thought your specialty would be the perfect fit at first, only to learn it wasn’t at all what you expected. No matter how you got here, one thing is for certain: you want to change PA specialties.
Leaving and changing jobs is an inevitable part of life, and PAs are no exception. According to AAPA, the average PA usually changes specialties two or three times during their career! So, how do you know when it’s time to change PA specialties, and what should you do next?

1. Evaluate your current situation

Sometimes the signs are blatantly obvious, while often you only have a gut feeling that you aren’t where you’re meant to be. Maybe you feel ready for a change and frequently check local job postings looking for “something more” but need that extra push to make the leap.

For some additional guidance, ask yourself the following questions:

  • Are you satisfied with the amount of administrative work in your specialty?
  • Is your work-life balance sufficient?
  • Is your lifestyle compatible with your schedule?
  • Do your clinical cases still interest or excite you?
  • Do you feel satisfied with your salary and benefits?
  • Are you comfortable with the number of procedures in your specialty?
  • Do you have the amount of autonomy you desire in your specialty?
  • Does your job offer the professional growth you’re looking for?
  • Is there a sense of stability in your position?
  • Are you satisfied with the amount of variety in your patient cases?
  • Are you comfortable with the productivity bonuses available in your field?
  • Do you feel emotionally healthy in your position (as opposed to feeling burned out, overwhelmed, stressed, or compassion fatigued)?
  • Do you connect with your current patient population?
  • Does your job give you the amount of specialization you’d like?
  • Does your specialty challenge you in the way you’d like?

Lastly, if you answered “no” to most of the questions above, would your answers realistically change if you were to switch specialties? It’s important to pinpoint whether your gut feeling is pointing you toward a new specialty altogether or a different position within your current specialty.

2. Consider alternative options

Sometimes it’s not the specialty that’s the problem, but rather the circumstances surrounding your current employment situation. Changing your work environment may revitalize your love for the specialty you originally chose and for medicine as a whole.

If you’re still not sure whether you should change PA specialties but know that you need something new, see if any of these remedies could help:

Questions to ConsiderPossible Remedy
Is there a specific site, colleague, or administration issue that makes your specialty feel like a mistake, but you otherwise enjoy the cases and patient population?Consider moving to a new employer within the same specialty.
Does your current schedule impact your life negatively, but you otherwise enjoy what you do?Consider speaking to your employer to see whether your schedule can be adjusted to better align with your life goals (e.g., four 10s, three 12s).
Do you dislike the physical setting that you’re in but otherwise enjoy the cases that you see?Consider remaining in the same specialty but switching the setting type (e.g., inpatient to outpatient, outpatient to inpatient, adding OR time, adding clinic).
Are you struggling with the overall number of hours that you’re working?Consider dropping down to a part-time or per diem status.
Do you love primary care but no longer want to deal with a specific age group?Consider remaining in primary care but changing to pediatrics, geriatrics, etc.
Do you not like clinical work and you’re now second-guessing becoming a PA altogether?Consider a PA career in research, academia, leadership, management, administration, or medical education.

3. Create an action plan

If you do decide to change PA specialties, first remind yourself that this is one of the greatest benefits of being a PA. Many of us probably cited “specialty mobility” in our personal statements as one reason we wanted to become PAs. Specialty mobility allows us to try our hand at different interests and, just as importantly, move on from a clinical setting that may not be a good fit. 

So, what should you do after you decide to change PA specialties?

  1. First, self-reflect on what’s not working or what may be missing in your current situation.
  2. Create an inventory of what’s important to you and any red flags you want to avoid. Think about specific job duties, patient populations, salaries, schedules, clinical settings, and degree of autonomy.
  3. Then, use your inventory to make a list of desired specialties that best fit your criteria.
  4. Review your current contract for any restrictive covenants that may limit your job prospects.
  5. Research your specialties of interest. This step could include networking with other PAs, reviewing the AAPA Salary Report and Areas of Practice Guide, or joining PA specialty organizations.
  6. Review job postings and set alerts for opportunities that interest you.
  7. Craft your CV and cover letter to better align with your desired specialties.
  8. Determine whether you need any additional training (specialized courses, postgraduate education) before applying for a job in your new specialty.
  9. Submit your resignation letter and tie up any loose ends within your current position. This could include informing your patients and transferring their care to another clinician.
  10. Verify whether you need tail or nose malpractice coverage.
  11. Compile your certifications, licenses, and documentation to prepare for credentialing.
  12. Update your address and collaborating/supervising physician information with necessary organizations.
  13. Lastly, refresh your medical knowledge and skills to increase your confidence and help you prepare for your desired field (e.g., AAPA boot camps, Rosh Review Qbanks, JAAPA, conferences).

4. Trust your gut

No matter the outcome, it’s important to trust your instincts when something feels off in your current situation. When you take the time to identify why you have this uneasy feeling, you can take actionable steps to find a better fit as soon as possible. See which opportunities are out there and speak with other PAs who can empathize and provide insight into other areas of medicine.

Finding the right specialty and work environment for you can lead to improved career satisfaction, reduced stress, greater work-life balance, and better pay. Though pivoting jobs may seem intimidating at first, the changes you make now will lay the foundation for a more fulfilling career for years to come.

Rosh Review is the leader in online test preparation with board exam review for PA students, programs, and PA-Cs across the U.S. Learn more about Rosh Review’s PA-C Qbanks for the PANRE, PANRE-LA, CAQs, and more.

For more info about PA specialties, check out the Is This The Right PA Specialty For You? series that provides practical advice for PAs looking for their right fit.

By Jennifer Comini, PA-C


Get a little more clarification

How do I choose a PA specialty?
If you haven’t started PA school yet, try getting hands-on medical experience (like as a scribe or medical assistant) in a field that interests you to make sure it's the right fit. While going through your clinical year of PA school, reflect on your experiences during rotations:
  • What subject gets you excited just thinking about it?
  • Do you feel a sense of purpose at the end of the day during a particular rotation?

Keep in mind that a negative experience during a rotation, such as poor organization or preceptorship, doesn’t mean you shouldn’t pursue that specialty. Ultimately, being in a fulfilling role is what's important.

Learn more about different PA specialties with the Is this the right PA specialty for you? series.
How do I get my first PA job?
During a rotation, if you’ve decided you'd like to work in that particular field, there are a few ways you can get your foot in the door:
  • Make your interest in the specialty clear to your preceptor and any attending staff you work with.
  • Show your commitment to the specialty and your desire to actively participate. This will open up the conversation for recommendations on additional resources (like helpful textbooks), and it can give your preceptor time to contact colleagues who may be hiring.
  • Do your elective or preceptorship with the clinician or facility you would like to work at.
  • Consider joining professional associations for your specialty to network with other PAs and learn more about the field.
For other tips, such as how to tailor your CV and cover letter to a specific position and what questions to ask in an interview, read How to Get Your First Job After Passing the PANCE.
How can I become a cardiology PA?
During the clinical year, get an elective in cardiology and consider shadowing a cardiologist on your days off. Spend some time with the telemetry technicians to pick up on common ECG variations.

Read Is Cardiology the Right Specialty for You? for more info.

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